Air travel from countries undergoing the 2014 ebola pandemic should be limited to and directed by the United Nations. Commercial airlines pose considerable risk of transmitting the Ebola virus to disparate population centers igniting local epidemics. The spread of Ebola to other major metropolitan areas in Africa and around the world poses a threat for all nations. A robust and vigorous humanitarian response in the form of direct medical, logistical, personnel, and food aid is required by the United Nations with the United States and former colonial powers in Africa (UK, France, and Belgium) at the tip of the spear. The current Ebola outbreak is estimated to have infected confirmed 7,470 and up to 20,000 cases when accounting for underreporting.
The CDC estimates that at current rates of infection and with continued lack of international intervention the number of infected individuals could be as high as 1.4 million in the region by January.
Below is an estimate by the CDC of the number of new infections/day in the next five months. The plot on the left is based on the current number of confirmed infections and the plot on the right is the prediction with underreporting factored in.
How do these numbers affect us? Aside from the precipitous humanitarian disaster that is ensuing there is an ever-increasing likelihood of the pathogen spreading beyond its current west African domain and infecting other parts of the world. As of October 6th a patient in Dallas, Texas who traveled from Liberia came down with ebola hemorrhagic fever in the United States.
Additionally, on October 6th it was confirmed that a nurse in Madrid, who treated an infected priest, is infected with Ebola.
A health worker employed to care for an Ebola patient under isolation coming down with the disease calls into question developed world’s ability to adequately respond to and extinguish outbreaks that may arrive on international airlines.
Monrovia, Liberia a city of nearly 1 million people is at the heart of the epidemic with 3834 confirmed cases in the country.
I was able to locate tickets with Google’s Flight Matrix (http://matrix.itasoftware.com/) leaving Monrovia, Liberia within the next 96 hours arriving in;
Lagos, Nigeria Africa’s largest city in, 1 stop in Casablanca Morocco (cmn)
Cairo, Egypt Africa’s second largest in, 1 stop (cmn)
Kinshasa, DRC Africa’s third largest in, 1 stop
New delhi can be reached in a single stop through Brussels
Mumbai can be reached by 1 stop through Brussels
Washington-Dulles can be reached by 1 stop through Brussels
Interestingly the Liberian man hospitalized with Ebola in Dallas, Texas flew from Monrovia to Brussels to Washington Dulles, to Dallas, Texas.
http://www.washingtonpost.com/blogs/dr-gridlock/wp/2014/10/01/texas-ebola-patient-traveled-through-dulles-international-airport/
Direct flights are available twice daily at 2:20 am and 2:45 am to Casablanca Morocco airport code (cmn).
In the next 96 hours there are flights from Casablanca Intl airport that fly direct to; Paris- 3 flights, Cuneo, Italy 1 flight, Milan, Italy 2 flights, Tunis, Tunisia 1 flight, Moscow 1 flight, Stockholm 1 flight , Tripoli, Libya 1 flight
There is a single direct flight that leaves Monrovia daily at 8:40pm bound for Brussles
Flights departing Brussles in the next 96 hours include;
Most European capitals; Montreal,Tel Aviv, Dubai, Doha, Beirut, Bangkok, Addis Ababa, Abu Dhabi, New Delhi, India, Mumbai, India, New York-JFK, Atlanta, Chicago-O'Hare, Newark, Washington-Dulles, Philadelphia
This means that a traveler can fly to any of the above airports, while at some proximal stage of their ebola infection, with a single stop.
Fever screening is taking place in Casablanca (cmn).
http://www.reuters.com/article/2014/10/03/us-health-ebola-screening-idUSKCN0HS09J20141003
I have been unable to locate any evidence that fever screening is taking place in Brussels.
Can our government and our European counterparts handle this epidemic? Only time will tell. Can The government of India handle a local outbreak in Delhi or Mumbai? Doubtful.
India’s cities have some of the worlds worst sanitation with open defecation rates as high as 60%.
Being that there are large populations of Indian immigrants in Africa is is not inconceivable that someone may travel back to India to visit family carrying the disease with them. If a epidemic flares up in either of the two cities that can be reached from Monrovia with single stop, Mumbai (18 million) and Delhi (16 million) the global rate of infection could sky rocket.
As the number of Ebola cases in west Africa continues to rise and people are able to leave the country with relative ease traveling to and through major commercial hubs isolated outbreaks will continue to appear.
Austin, I definitely agree with you that isolated outbreaks will continue to appear and leave other third world areas like India in much greater danger of more widespread transmission. I am surprised how relatively easy it seems that anyone can travel into or out of Liberia and proceed onto other major world travel hubs. It appears that there were several mistakes by the hospital staff in the handling Thomas Duncan’s illness, but it shows how easily someone can bring Ebola into the US. There needs to be a better screening/quarantining process for people who may have interacted with Ebola-infected people when exiting Liberia. I also agree with you that the US and other countries with advanced medical resources need to be more proactive about helping the Liberians and preventing this from becoming a greater problem than it already is.
ReplyDelete