http://www.nytimes.com/2014/10/24/travel/new-ebola-screening-measures.html 2014-10-23 22:30:19 New Ebola Screening Measures A guide to the steps being taken to prevent travelers from spreading Ebola. === The international response to the West African Ebola outbreak has affected travel by air, rail and cruise ship. Here is a guide to what governments and the travel industry are doing. How are air travelers being screened in the United States? Enhanced screening measures The screenings are taking place at Kennedy Airport in New York, Passengers at other points of entry will continue to be screened by customs agents, who examine travelers for visible signs of illness and distribute fact sheets to those who have traveled in West African nations affected by the outbreak. In addition, the T.S.A. is providing guidance to airlines on how to identify passengers who are ill. On Oct. 27, the Centers for Disease Control and Prevention will begin implementing a post-arrival monitoring plan for nonsymptomatic travelers arriving in the United States from Guinea, Liberia or Sierra Leone. The plan calls for state and local health departments to begin checking in with those travelers every day for the 21 days following their departure from West Africa, the length of time in which Ebola can remain dormant. Upon arrival in the United States, each passenger will receive a Check and Report Ebola kit, which includes an information graphic on monitoring their health for three weeks, a thermometer and instructions for tracking and logging body temperature, pictorial descriptions of Ebola symptoms and a card with instruction on whom to contact should symptoms arise. Passengers will be asked to check in daily with state or local health departments in order to report their temperature, any other symptoms and any travel plans, including both in or out of state. If a traveler does not report in, public health officials are to take steps to locate the person and ensure that active monitoring continues. Six states, including Georgia, Maryland, New Jersey, New York, Pennsylvania and Virginia, which together receive more than 70 percent of those passengers traveling from West Africa, have already been prepared to begin post-arrival monitoring. Anyone showing symptoms will be isolated and by local health officials trained in protocols to limit exposure, and will be directed to a medical facility trained to receive potential Ebola patients. The C.D.C. will assist the effort by informing state officials of passengers who will require monitoring and by providing extra technical support, guidance or funding, as necessary. “Post arrival monitoring is an added safeguard that complements the existing exit screening protocols, which require all outbound passengers from the affected West African countries to be screened for fever, Ebola symptoms, and contact with Ebola and enhanced screening protocols at the five U.S. airports that will now receive all travelers from the affected countries. All three of these nations have asked for, and continue to receive, C.D.C. assistance implementing exit screening,” the C.D.C. said in a statement Wednesday. Are passengers being screened elsewhere? The European Union Britain Screenings are also taking place People departing the West African countries hit hardest by the outbreak Hong Kong International Airport has begun encouraging travelers who have been to Guinea, Liberia, Nigeria, Sierra Leone and the Democratic Republic of the Congo within the past three weeks, or who hold a passport or other travel document from those countries, to fill out a voluntary screening questionnaire upon their arrival at the airport, Travelers exhibiting symptoms of Ebola or who may have been exposed to the virus will be referred to the Infectious Disease Center of Hong Kong at Princess Margaret Hospital for further testing and evaluation. ​ “These are supplementary measures to existing border control measures,” Dr. Edwin Tsui, Hong Kong’s chief port health officer for the Department of Health, said at a press conference on Monday. “Now we have temperature screening measures at borders and also ongoing health screening activities at borders to advise those incoming travelers who present illness to seek help from our port health officers,” he said. “We hope these new, voluntary health surveillance questionnaire measures can supplement and also enhance our capacity to detect Ebola virus.” Are there plans for a travel ban from West Africa? While the idea a travel ban on flights to and from those West African countries affected by Ebola is being debated, the Obama administration and the Department of Homeland Security announced that beginning Wednesday, anyone traveling to the United States from Liberia, Sierra Leone or Guinea will have to fly into one of the five United States ​airports where enhanced screening procedures were taking place, “We are working closely with the airlines to implement these restrictions with minimal travel disruption,” Jeh Johnson, the Secretary of Homeland Security said in a statement. “If not already handled by the airlines, the few impacted travelers should contact the airlines for rebooking, as needed.” About nine people per day will have their flights rerouted due to the new restriction, according to a statement from Airlines for America, a trade group made up of several major U.S. carriers. North Korea, citing fears of Ebola, Several cruise lines Are carriers still operating flights to affected nations? Some international airlines, including British Airways and Kenya Airways, have suspended flights since August. But others, including Royal Air Maroc, have regularly scheduled departures to destinations in West Africa. Keep in mind that What are air carriers doing? Airlines follow general guidelines issued by the C.D.C. and the World Health Organization. They have also informed their flight attendants about the hazards of Ebola, its symptoms and how the disease is spread. The C.D.C. has asked United States airlines and international airlines with direct flights to or from the United States to begin asking any sick passengers if they had traveled to Guinea, Liberia or Sierra Leone in the past 21 days. If the answer is yes and the passenger is exhibiting symptoms of Ebola specifically, the airline must report the incident immediately to the C.D.C. and follow the agency’s infection control guidelines, according to the agency’s In general, the guidelines call for flight crews to take steps to protect themselves as well as other passengers, including washing their hands often and thoroughly, wearing waterproof gloves and face masks when dealing with a sick passenger and treating any and all bodily fluids as if they were contagious. Sick passengers are also advised to wear a face mask, unless they are nauseated or vomiting. To minimize exposure, the C.D.C. also advises isolating sick passengers as much as possible and minimizing crew and passenger interactions with them. Strict cleaning procedures are also outlined for in-flight and ground crews, both of which are instructed to wear personal protective equipment like aprons, goggles and other gear typically included in a Universal Precaution Kit, which Plastic bags are to be used to dispose of tissues and any other waste that might have been used to clean the area in which the passenger is seated, and then must be sealed tightly, much as a hospital does with biohazards. Once on the ground, any soiled area of the plane that cannot be thoroughly disinfected is to be removed, according to the C.D.C. If flight attendants become sick midflight, they are required to stop work immediately and isolate themselves. Airlines are working closely with the C.D.C. and the Department of Homeland Security to mitigate risk to the traveling public and airline employees, as they have done in the past during SARS and H1N1 Virus outbreaks, Jean Medina, a spokeswoman for Airlines For America, the trade group for major airlines, said in an email. Crew members have been trained in the C.D.C.'s infection control procedures and all members of the group carry Universal Precaution Kits aboard their planes, she confirmed. Flight attendants have been trained to passively screen passengers for several types of illnesses, she continued. “Once someone does appear to have symptoms, airlines have had the ability to directly connect with medical experts midflight to consult on whether there is an actual concern about Ebola. This includes connecting with the C.D.C. emergency operations center.” Should that rare situation occur, she said, airlines are instructed to do everything they can to isolate the passenger to the best extent possible, while also complying with all F.A.A. safety rules, including having all passengers remain in their seats. Are people potentially exposed to the virus allowed to travel? There is no travel ban in effect. However, The C.D.C. notified Carnival of the passenger on Wednesday, according to a statement from the cruise line. The employee and her traveling partner remained in voluntary isolation in a cabin aboard the ship throughout the voyage, which returned to Galveston, Tex., Sunday morning. She was monitored by a physician throughout the trip and remained asymptomatic. A blood test on Sunday confirmed that she did not have Ebola, Roger Frizzell, a spokesman from Carnival said. “The Galveston County Health District, as part of the Unified Command, has reviewed all available information regarding a potential Ebola contact voluntarily isolated on a cruise ship returning to the Port of Galveston Sunday, Oct. 19,” a statement from Carnival said. “This morning, the Galveston County Health Authority has made the assessment that there is no evidence of a public health threat to cruise passengers or to Galveston County. The passenger and her travel partner have been allowed to disembark without restrictions.” Any passenger sailing with the line must answer a series of health screening questions during embarkation, according to an earlier statement from Carnival, and any guest or crew member who has visited or traveled through Liberia, Sierra Leone or Guinea within 21 days of a cruise departure date will be denied boarding. Can you get Ebola by sharing a flight with someone who is infected? It’s not likely. Reporting by Rachel Lee Harris, Emily Brennan and Nicola Clark.