Three Ebola Cases A Month Are Expected To Slip Out Of West Africa

A burial team prepares to deal with an Ebola victim in Liberia. Photo: Getty

Three Ebola-infected travellers are predicted to depart on an international flight every month from West Africa if exit screening isn’t put in place, according to modelling research published in medical journal The Lancet.

Dr Kamran Khan at St Michael’s Hospital in Toronto, Canada, and colleagues analysed worldwide flight schedules and historic itineraries of passengers from 2013 to predict expected population movements out of Guinea, Liberia and Sierra Leone.

They also used WHO Ebola virus surveillance data to model the expected number of exported Ebola virus infections and to determine how useful air travel restrictions and airport departure and arrival screening might be in controlling the spread of the deadly virus.

The analysis, assuming no exit screening, showed that based on current epidemic conditions and
international flight restrictions to and from Guinea, Liberia, and Sierra Leone, just under three (2·8) travellers infected with Ebola virus are projected to travel on an international flight every month.

Although airport screening is currently in place , the research draws attention to the importance of ensuring that exit screening is implemented and maintained effectively.

“The risk of international spread could increase significantly if the outbreak in West Africa persists and grows,” says Dr Khan.

“Risks to the global community would further increase if Ebola virus were to spread to and within other countries with weak public health systems.”

Of the almost 500,000 travellers who flew on commercial flights out of Guinea, Liberia or Sierra Leone in 2013 more than half had destinations in five countries: Ghana (17.5%), Senegal (14.4%), UK (8.7%), France (7.1%) and Gambia (6.8%).

More than 60% of travellers in 2014 are expected to have final destinations in low or lower-middle income countries.

“Given that these countries have limited medical and public health resources, they may have difficulty quickly identifying and effectively responding to imported Ebola cases,” says Dr Khan.

The findings also indicate that it is far more efficient and less disruptive to screen travellers for Ebola as they leave affected countries rather than screen the same travellers as they arrive at other airports around the world.

“The best approach to minimise risks to the global community is to control the epidemic at
its source,” he says.

The latest situation from WHO puts the death toll at 4,546.

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