Ihsan Al-Bayati, Sarmad Said
Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Science Center, El Paso, TX, USA
Med Sci Rev 2014; 1:24-27
The number of infected subjects with Ebola virus disease (EVD) continues to increase in affected countries in West Africa. Hence, the likelihood that infected patients will travel is growing. To minimize this risk, the primary strategy, as recommended by the World Health Organization (WHO), is to conduct exit screening of all passengers in the affected countries. This preventive screening can be done at the departure (exit screening) or arrival point (entry screening). This method was already practiced during recent epidemics (SARS) and pandemics (H1N1 influenza) to halt the spread of disease.
Affected countries launched the exit screening, helped by the US Centers for Disease Control (CDC). The present estimated prevalence of EVD in these countries is 2 per 10 000 populations; the positive predictive value of the detection through the screening is very low, as no cases of EVD were confirmed in 77 subjects who tested positive among 36 000 screened individuals. The entry screening, in addition to the exit screening, has been adopted by only a small number of countries. Based on current data, the prevalence of detectable cases with screening is very small if an exit screening has been conducted effectively.
In general, EVD screening can identify few contagious cases, if used over time. When exit screening is in place, entry screening has an exceedingly low yield.
This review is a guide of traveller restriction and EVD transmission by international connections based on the current recommendation of the CDC, WHO, and European Union.
Keywords: Airports, Ebolavirus, epidemics, Travel Medicine