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# Exposure
Without exit screenings, 3 people with Ebola would fly out of West Africa every month
New research has also found that screening people leaving West Africa is far more efficient than screening those arriving at other countries.
IT IS FAR more efficient and less disruptive to screen travellers for Ebola as they leave affected countries in West Africa rather than screen them as they arrive at other airports.
That’s according to new research published in The Lancet.
It found that just under three (2·8) travellers infected with Ebola would travel on an international flight every month – if there was no exit screening.
However, airport screenings are currently in place in airports in Guinea, Liberia and Sierra Leone - the three countries currently experiencing widespread Ebola virus outbreaks.
Doctor Kamran Khan at St Michael’s Hospital in Toronto, Canada, and his colleagues found that:
“Exit screening at the three international airports (Conakry, Monrovia, and Freetown) in Guinea, Liberia, and Sierra Leone should allow all travellers at highest risk of exposure to Ebola to be assessed with greater efficiency compared with entry screening the same passengers as they arrive in cities around the world.
He added that, “The best approach to minimise risks to the global community is to control the epidemic at its source.
While screening travellers arriving at airports outside of West Africa may offer a sense of security, this would have at best marginal benefits, and could draw valuable resources away from more effective public health interventions.
Risk of international spread could increase significantly
The researchers analysed 2014 worldwide flight schedules and historic flight itineraries of passengers from last year to predict the expected population movements out of Guinea, Liberia, and Sierra Leone. They also used the World Health Organisation Ebola virus surveillance data.
Of the almost 500,000 travellers who flew on commercial flights out of Guinea, Liberia, or Sierra Leone in 2013 – over half had destinations in five countries:
- Ghana (17.5%)
- Senegal (14.4%)
- UK (8.7%)
- France (7.1%)
- Gambia (6.8%)
More than 60% of travellers in 2014 are expected to have final destinations in low or lower-middle income countries.
Dr Khan said, “The risk of international spread could increase significantly if the outbreak in West Africa persists and grows.
Risks to the global community would further increase if Ebola virus were to spread to and within other countries with weak public health systems.
“Given that these countries have limited medical and public health resources, they may have difficulty quickly identifying and effectively responding to imported Ebola cases.”
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