The primary mitigation strategy to reduce this risk is for affected countries to conduct exit screening of all persons at international airports, seaports and major land crossings for unexplained febrile illness consistent with potential Ebola infection. WHO also recommended that there should be no international travel of known Ebola cases or contacts of cases, unless the travel is part of an appropriate medical evacuation. Entry screening is also being considered, or has been adopted, by a small number of countries, in addition to the ongoing exit screening.
Based on the current evidence of the validity of methods currently available for entry screening at major points of entry, the added value of entry screening – if exit screening is being conducted effectively – is likely to be very small, and the resource implications considerable. However, complementing exit screening with entry screening may be considered 1) when there are doubts about the efficiency of exit screening and 2) to detect the few who may develop fever between the time of departure and the time of arrival.
Low yield and high investment
The report concludes that, overall, screening for EVD among travellers may detect a few contagious EVD cases over time. Given that exit screening is in place in the affected countries and the poor intrinsic performance of the methods available, entry screening for EVD is likely to have an exceedingly low yield and represents a high investment, which may only contribute to a limited extent, to the prevention of importation of the disease.
As the epidemic of Ebola virus disease (EVD) continues to rise in West Africa, there is an increasing possibility that infected individuals will travel to the European Union.