Fears that international air travel could spread the deadly Ebola virus beyond West Africa are being met with an appeal for calm from IATA, which points out that because the disease is not airborne the risk of catching it from a fellow passenger is very low.
The World Health Organization (WHO) – from which IATA takes its advice – has not recommended any Ebola-related travel restrictions or closure of borders, although possible passenger screening revisions are currently under review.
While no official travel bans have been initiated, some airlines have begun instigating measures of their own. And the Centers for Disease Control and Prevention (CDC) has issued a warning suggesting that people exposed to the virus shouldn’t board a flight until they’ve undergone 21 days of monitoring. “Sick travelers should delay travel until cleared to travel by a doctor or public health authority,” it says.
Nigerian carrier Arik Air announced on 28 July that it was suspending flights to Monrovia in Liberia and Freetown in Sierra Leone. This followed Nigeria’s first case of Ebola, in which a male passenger died from the virus after landing in Lagos after a flight from Liberia, via Lomé in Togo.
The Togolese airline which carried this passenger – ASKY – also suspended flights to Nigeria, but says it has since resumed services to Abuja and Lagos following discussions with the Nigerian civil aviation authority, Nigeria’s health minister and the WHO.
Ethiopian Airlines has issued a statement outlining a number of voluntary precautions it is taking, which include “stringent and specific surveillance being carried out regarding all flights from West Africa at Addis Ababa airport”.
No such measures appear to have been put in place at Lagos Airport, however, with one UK-based passenger who recently returned from the Nigerian capital telling Runway Girl Network that he saw “no extra security or health checks anywhere” and “no warnings or special measures anywhere I’ve been”.
In addition, the hysteria whipped up by some tabloid newspaper headlines in the UK and North America regarding Ebola appears to contrast sharply with public opinion in Nigeria. “People are coming to work as normal and I haven’t heard anyone even talking about Ebola, never mind panicking,” says the recently-returned passenger.
An IATA spokesman points out that because Ebola is not airborne and can only be spread through direct contact with an infected person’s bodily fluids, it presents a “different type of challenge” to the global SARS outbreak earlier this decade. “There has never been a case of contracting Ebola from being on a plane – it’s extremely unlikely,” he says.
The official information from the WHO when it comes to the risk of catching Ebola on a flight is as follows: “There is a possibility that a person who had been exposed to Ebola virus and developed symptoms may board a commercial flight, or other mode of transport, without informing the transport company of his status. It is highly likely that such patients would seek immediate medical attention upon arrival, especially if well-informed, and then should be isolated to prevent further transmission.
“Although the risk to fellow travelers in such a situation is very low, contact tracing is recommended in such circumstances.”
Even though passenger screening revisions have been placed under review – with input being sought from Airports Council International and the World Tourism Organization – the WHO says: “Screening of passengers at points of entry (arrival or departure) is costly and expected to have very limited impact because it is very unlikely to detect any arriving person infected with EVD [Ebola virus disease].
“This is particularly true for EVD with its incubation period of two to 21 days and symptoms that are not specific. As part of this, the use of thermal scanners that rely on the presence of ‘fever’ in arriving passengers is costly, unlikely to detect any arriving person infected with EVD and is not encouraged.”
The advice from the WHO on the measures that should be taken onboard an aircraft in the event of a passenger displaying symptoms of Ebola – which include fever, weakness, muscle pain, headache, sore throat, vomiting, diarrhoea and bleeding – is to re-seat surrounding passengers away from the symptomatic passenger and to give that passenger exclusive use of a bathroom.
It also recommends covering the patient’s nose and mouth with a surgical mask and assigning only one or two cabin crew members to taking care of them. Hand washing with soap must be carried out after any direct or indirect contact with the passenger, authorities at the destination airport should be notified in advance, and the passenger should be immediately isolated upon arrival.
Airlines are monitoring the issue of Ebola closely but, as it stands, it is a case of business-as-usual for the majority of carriers. Lufthansa chief financial officer Simone Menne, responding to a question about Ebola during the German airline’s recent first-half earnings conference call, said: “We are constantly monitoring the development of Ebola and we’re co-operating with authorities to make sure there is no risk within the Lufthansa group. We don’t see that there is a huge impact, but we are watching.”
Illustrating how seriously the issue is being taken, London’s Gatwick airport was yesterday forced to issue a statement to reassure people that a passenger who had landed at the airport from West Africa, fallen ill and died on arrival, did not have Ebola. “We can confirm that a passenger on board a Gambia Bird flight on Saturday 2 August became unwell after disembarking the aircraft, was treated by experienced medical airport staff at the scene but sadly later died at East Surrey Hospital.
“Given the origin of the flight, the hospital carried out tests for Ebola and other infectious diseases as a precaution. The tests came back negative,” says the airport, adding that as a further precaution the aircraft and relevant airline and airport staff were isolated.
It is easy to see why people are so concerned about Ebola. It is a severe illness with a fatality rate of up to 90%, according to the WHO, and there is currently no vaccination or cure. Over 700 people in Guinea, Liberia and Sierra Leone have died from the virus this year in the worst outbreak of the disease so far.
This is a developing story and we expect there’ll be more changes to come as Ebola spreads.