Assessing the International Spreading Risk Associated with the 2014 West African Ebola Outbreak

[Dani]

Re: Assessing the International Spreading Risk Associated with the 2014 West African Ebola Outbreak

We know passenger screening is ineffective, but I never realized just how ineffective: US Will Screen Air Passengers for Signs of Ebola. Will It Work?

Australia checked 1.8 million incoming passengers during the SARS epidemic of 2003, identified almost 800 who had a fever, but did not find a single SARS case.

The country which did the most to attempt to control SARS was probably Singapore, which because of its political culture was able to impose mandatory fever screening not only at airports and land crossings, but in schools as well. But in a series of analyses afterward (including this and this), Singaporean researchers concluded that temperature screening had not been useful. The authors of those papers are surprisingly candid about what temperature screening was good for: as a reassuring sign that the government was taking action, whether or not that action worked.​

Of course, there might not have been many cases in Australia and Singapore to being with, in which case you'd expect not to find many SARS patients coming into those countries.

 

[Gert van der Hoek]

Re: Assessing the International Spreading Risk Associated with the 2014 West African Ebola Outbreak

According to ECDC exit screening could be effective:

 

[bwilde]

Re: Assessing the International Spreading Risk Associated with the 2014 West African Ebola Outbreak

I dont see why travelers leaving the affected countries cannot be screened as for why they are leaving. If they are truly aide workers, then that would not be a problem. But leaving to marry your girlfriend after not seeing her for a decade and more, that is NON ESSENTIAL. Not in middle of an epidemic.

It just seems like the rest of the world has to stay wide open to spread this disease. If its not fair to Africans, well it is hardly fair to the rest of the world the way this is set up. I know, diseases are not fair, but really, the complete lack of willingness to even LOOK at any sort of travel ban is very frustrating.

 

[JJackson]

Re: Assessing the International Spreading Risk Associated with the 2014 West African Ebola Outbreak

... the complete lack of willingness to even LOOK at any sort of travel ban is very frustrating.

They have looked, and studied the data they gained. They concluded that it caused more problems than it solved.
Who are you planning to ban? Just the 3 worst infected countries? Why draw the line there, the US and EU have cases and each has free pratique within their borders? Just Dallas and Madrid, then why not exclude most of northern and western Guinea none of which have had cases in the last 21 days.
Drawing lines is tricky and apt to draw retaliatory measure. The economic consequences of drawing a line only to then have either the US or EU get more cases and then become ostrosised are scary.

 

[bwilde]

Re: Assessing the International Spreading Risk Associated with the 2014 West African Ebola Outbreak

Comparing Spain and Dallas with the 3 West African countries at this stage is not even close. But if you just continue to keep the air open like this then I guess they might be. I just fail to see how Duncan's trip was important enough to imperil a whole other continent. Nor how his trip helped aid to Africa at all.

Even Liberians in the US want a travel ban, perhaps even more so than your average American. But it seems like the powers that be want to wait until its too late and then once again, the blame will be on the west for not acting soon enough. Ok we didn't...but are the Africans going to bear any responsibility for their cultural practices that led to the spread? Geez, I know, duck, the r word..

 

[JJackson]

Re: Assessing the International Spreading Risk Associated with the 2014 West African Ebola Outbreak

That is not how quarantines work. You keep everyone out who is coming from and infectious area, if you don't the quarantine fails.
Look at BSE, countries were banning all beef as soon as one country had a single case. The only workable line is 'no passengers from any country which is not disease free' try fudging it to exclude countries with small outbreaks only delays import. Even banning everyone seldom works for large areas because someone will always slip through the net. Try and find wording that would be universally acceptable and not spark retaliatory measures. Countries that are disease free are not going to accept you, or anyone else, telling them 'we should be exempt because we don't think we have many cases' it is an invitation for nations to cover up cases. Most countries which are rabies free will not let you bring in a dog from a country that is not (unless it spends the required stay in quarantine kennels), regardless of the fact you came from an area which has not seen a case in decades.

Ok we didn't...but are the Africans going to bear any responsibility for their cultural practices that led to the spread?

I am going to guess you are American and that you are referring to burial rights. If so there are plenty of American funerals where you will see an open casket with a deadman in his best suit and tie looking serene, he may also be kissed by mourners in some societies. How did he get like that? He may have died in pain in a hospital gown. Someone in a mortuary made him look serene and dressed him in his suit. Is this the kind of dangerous burial practice you are referring to. What kind of backlash might you expect in the US if you declared all bodies are immediately put in a body bag and burnt without the family having any say in the matter - in the best interests of disease control. You need to view these issues from all sides and not just from one perspective.

 

[Gert van der Hoek]

Re: Assessing the International Spreading Risk Associated with the 2014 West African Ebola Outbreak

are the Africans going to bear any responsibility for their cultural practices that led to the spread?

In the 80's and 90's serosurveillance studies were done in several West African countries. High prevalence of antibodies against Ebola were found. In Liberia f.i. ca 13% . In Ivory Coast a human Ebola case from Liberia popped up.

Ten years ago a study was published stating West Africa was prone to an outbreak of Ebola. Biologists had mapped bats with Ebola antibodies.

No response by anyone.

Here we have a region with extreme poverty and hardly any healthcare infrastructure.

Ebola was a crisis waiting to happen. No one was prepared. The response was - and still is - to little and to late. And many mistakes were and are being made in the approach by the local government, MSF, WHO and others.

One of the mistakes was/is : not relating to the communtity. If you go to the community and listen to them and talk to them you can find a way to deal with what you call "cultural practises".

It could be the wrong approach - our own "cultural practises" - of WHO MSF etc. which increased the fear and the further spread of Ebola. Not because "we" wanted to, but because "we" did not know what "we" were doing.

The world was completely UNprepared. If you fail to prepare, you prepare to fail.


See also: Ebola “Fear Mongering” Critiqued by Medical Anthropologist (thanks to Laidback All).

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[bwilde]

Re: Assessing the International Spreading Risk Associated with the 2014 West African Ebola Outbreak

Delaying import would have given other countries better chances to prepare, better chances for treatment and vaccine to proceed further. But no, it appears our leaders want to make certain we suffer along with Africa.

One thing is for **** sure, no ban is DEFINITELY spreading it.

 

[annaraven]

Re: Assessing the International Spreading Risk Associated with the 2014 West African Ebola Outbreak

I have to wonder if there wasn't a bit of political agenda involved to increase foreign aid without protest. Maybe they just wanted us to pay attention - like kids acting out. Now everyone is intent on "helping West Africa", whereas before most of the developed world ignored it.