Geneva: Ebola remains a global emergency, the World Health Organisation (WHO) said on Thursday, flagging grave concerns over hard-hit Guinea, Liberia and Sierra Leone.
“The situation in these countries remains of great concern,” the UN agency said after a session of its emergency committee.
“It was the unanimous view of the committee that the event continues to constitute a public health emergency of international concern,” it added.
Liberian President Ellen Johnson Sirleaf on Thursday announced strict checks on Liberia’s borders with neighbouring Guinea and Sierra Leone.
Liberia has been worst hit by the outbreak, with 4,665 recorded cases and 2,705 deaths, according to WHO.
“We will make sure that the immigration officers protect the borders. We are going to ask them to monitor them carefully,” Sirleaf said.
Screening passengers for Ebola on their arrival may have “a limited effect” in stopping the virus spreading but whether it adds anything to exit screening from affected countries is a decision for governments, the WHO said on Thursday.
The advice from the WHO’s Emergency Committee on Ebola came a day after the United States said travellers from three West African countries at the heart of the epidemic must fly into one of five major airports for enhanced screening for the virus.
“Entry screening may have a limited effect in reducing international spread when added to exit screening, and its advantages and disadvantages should be carefully considered,” the committee said in a statement after its third meeting.
Passengers are already screened as they leave Liberia, Sierra Leone and Guinea, a measure that is critical for reducing the exportation of the virus, it said.
The committee of experts, which meets virtually to advise WHO Director-General Margaret Chan, said some countries had introduced entry screening and they should share their experiences and lessons learnt.
States should be aware that screening incoming passengers helped to sensitise individuals to the risk of the disease, but “resource demands may be significant”, even if only targeted screening is put in place.
The committee also said some states with no Ebola cases had cancelled international meetings and mass gatherings, which the committee did not recommend. It acknowledged, however, that such decisions were complex and should be decided on a case-by-case basis and on the basis of risk.
Competitors and delegations from countries with Ebola transmission should not be subject to a general ban on attending events abroad, although the host country should decide on a case-by-case basis, it said.
Several countries — including Haiti, Dominican Republic, Colombia, Jamaica and North Korea — have restricted incoming travellers to some degree, although the committee has said there should be no general ban on international travel or trade. It reiterated that advice on Thursday.
“A general travel ban is likely to cause economic hardship, and could consequently increase the uncontrolled migration of people from affected countries, raising the risk of international spread of Ebola,” it said.
“The Committee emphasised the importance of normalising air travel and the movement of ships, including the handling of cargo and goods, to and from the affected areas, to reduce the isolation and economic hardship of the affected countries.”
The measure, introduced by the US, applies not only to visitors from those countries but also returning American aid workers, federal health employees and journalists.
Starting Monday, each traveller will be handed an Ebola care kit at the airport after being screened by US Customs and Border Protection, which is responsible for the enhanced airport screening. The kit includes instructions, a digital thermometer, a 21-day log sheet for recording morning and evening temperatures, a display card that shows the nine symptoms of the illness, and a list of telephone numbers for the CDC and state health departments.
The travellers will be required to report their temperature daily and call a state hotline if they show any symptoms of the illness. The programme will begin Monday in New York, Pennsylvania, New Jersey, Georgia, Maryland and Virginia, and expand to other states later, CDC Director Thomas Frieden said.
“We’re tightening the process by establishing active monitoring of every traveller who returns to this country from one of the three infected countries,” Frieden said in a conference call with reporters.
The monitoring plan was the administration’s latest step to intercept travellers who may have been exposed to the lethal virus in Guinea, Liberia and Sierra Leone.
Airline passengers already are being screened for symptoms of the illness as they board planes in those countries headed to the United States, during their flight here and upon their arrival in the United States at five designated airports that are the required entry points for travellers from those countries.
Now, those who arrive without exhibiting any sign of the illness will be followed for 21 days — Ebola’s incubation period — in the event they develop the virus.
The burden of monitoring will fall to state and local health officials, who have legal authority to control infectious disease, Frieden said.
“What a logistical nightmare,” said John Connor, an associate professor of microbiology at Boston University and an investigator with the university’s National Emerging Infectious Diseases Laboratories. “It is an abundance of caution, and certainly, if carried out properly, it would do a good job of identifying anyone who is infected. This is going to be a very difficult task.”
The number of people arriving in the United States from the Ebola-stricken countries has dwindled from an average of 150 a day to roughly 80 a day in recent weeks, most likely because US residents have postponed trips to see relatives there for fear of the illness. Still, that translates into thousands of people for local authorities to screen and follow in coming months.
Those deemed high-risk, even though they have no symptoms, because of contact with an Ebola victim will not be allowed to travel on planes, trains or public buses. Those who ignore the no-travel edict could be prosecuted in some states under state laws intended to impede the spread of infectious diseases.
Frieden said the monitoring effort will allow authorities to react quickly if a person shows any signs of the illness.
“The strongest health measure we can take to protect each of us is to quickly isolate someone with symptoms of Ebola,” he said.
Meanwhile, scientists will start testing whether treatment with antibodies in the blood of Ebola survivors can help infected patients fight off the deadly disease in a clinical trial starting in Guinea next month.
North Korea will close its borders to foreign tourists on Friday due to Ebola fears, travel agencies said.
Three travel agencies specialising in North Korean tours, two of them based in China, issued statements Thursday informing clients that the country was closing itself to tourists until further notice because of the threat of the disease.
North Korean state news agency KCNA did not confirm the ban, but said “thorough preventive measures” were being taken in Pyongyang and elsewhere to combat Ebola.
“The virus has not entered the country as yet,” it added.
It was unclear whether the reported travel ban would also apply to business and official travellers.
