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CDC Director on Ebola: Banning travel to West Africa will cause more problems than it will solve

Posted at 10:21 AM, Oct 08, 2014
and last updated 2014-10-08 17:11:38-04

DALLAS – Centers for Disease Control and Prevention Director Dr. Tom Frieden said Wednesday that banning all travel to West Africa to prevent the spread of the Ebola virus would cause more problems than it would solve.

“It makes it hard to get health workers in, because they can’t get out,” he said. “If we make it harder to respond to the outbreak in West Africa, it will spread not only in those three countries (in West Africa hit hardest by Ebola) but to other parts of Africa and ultimately increase the risk here” in the United States.

Frieden made these remarks at a press conference announcing enhanced Ebola screening measures at select U.S. airports targeting travelers from West Africa.

These measures will “find people with fever” as well as those who have been in contact with people infected with the virus, he said. Most passengers tracked in West Africa with fevers actually had other illnesses, something that Frieden acknowledged could happen in the United States as well.

“So we expect to see some patients with fever,” the CDC director said. “And that will cause some understandable concern at the airports.”

Frieden said that these new measures are helpful, but they won’t entirely eliminate the risk of the virus spreading.

“Whatever we do can’t get the risk to zero here in the interconnected world that we live in today,” he said.

The CDC director also offered his condolences to family and friends of Thomas Eric Duncan, the first person diagnosed with Ebola in the United States who died from the virus earlier in the day.

“He is a face that we associate now with Ebola,” Frieden said of Duncan, before mentioning all those who have died from the virus in West Africa.

The body of Thomas Eric Duncan, who died in Texas from Ebola, will be cremated, state health officials said.

Duncan died Wednesday morning at Texas Health Presbyterian Hospital in Dallas, the hospital said.

He had been in critical condition after being diagnosed with the virus in mid-September. People who had contact with the 42-year-old Liberian national are being monitored for symptoms.

Louise Troh, Duncan’s longtime partner, said through a public relations firm that she believes “a thorough examination will take place regarding all aspects of his care.”

“I am now dealing with the sorrow and anger that his son was not able to see him before he died,” Troh said. “This will take some time, but in the end, I believe in a merciful God.”

Pastor George Mason of Wilshire Baptist Church in Dallas said that he told Troh about Duncan’s death.

“It was a painful and difficult time for her. She reacted as almost anyone would, with great shock and despair,” Mason said.

When she learned about his death, Troh responded with many “what ifs” about his care, Mason said.

“She is not seeking to create any kinds of divisions in our community over this. She certainly, like all of us, would want to see justice done. She wants to see that people are treated well and treated fairly, and that includes Mr. Duncan. But this is a human drama. It’s not a political drama. … It is a drama of human grief,” Mason said.

Duncan’s family members were devastated upon learning of his death, Mason said, and worried that “this will be the course that their life will take next.”

Some members of Duncan’s family are being monitored for the virus — their temperatures taken twice daily — to make sure they don’t have symptoms. Ebola can take 21 days to show itself. The U.S. Centers for Disease Control and Prevention said that as of Tuesday, they had not shown any symptoms.

Several who have had contact with him were moved to a secure location Friday.

A memorial for Duncan will be held Wednesday evening, Mason said. The event was originally planned as a prayer vigil, Mason said.

After word of the death, CNN correspondent Gary Tuchman went to a Dallas apartment where Duncan’s family members were previously and spoke with the adult daughter of Duncan’s partner.

The daughter, Youngor Jallah, is not considered to have come into contact with Duncan. She was crying and declined to speak, though she did say the family had received a call from the hospital and knew that Duncan had died.

Five Dallas schoolchildren who possibly had contact with Duncan remain on the school district’s homebound program during the 21-day wait, and none are showing symptoms, the district said Wednesday.

It has just been a little over a week since Duncan was hospitalized for treatment.

Those days have been an “enormous test of our health system,” said Dr. David Lakey, the commissioner of the Texas Department of State Health Services.

“For one family it has been far more personal,” he said in a statement. “Today they lost a dear member of their family. They have our sincere condolences, and we are keeping them in our thoughts.”

He vowed that health care workers will continue to try to stop the spread of the virus “and protect people from this threat.”

The Ebola virus can live in bodies, the CDC says, and it can be transmitted after death if the body is cut, body fluids are splashed, or if the body is handled. Only personnel trained in handling infected human remains, wearing protective gear, should touch or move Ebola-infected remains, the agency says. An autopsy should be avoided, it says, but if one is necessary, the CDC should be consulted.

State officials, in announcing the planned cremation, cited the strict federal policies. “The cremation process will kill any virus in the body so the remains can be returned to the family. No protective gear is needed to handle the remains after cremation,” said a statement from the Texas Department of State Health Services.

Airport screenings

New measures at U.S. airports to screen for people possibly carrying the Ebola virus will include taking passengers’ temperatures and handing them questionnaires, according to a federal official and a second person briefed on an announcement the federal government plans to make Wednesday.

The enhanced methods, focused on people coming from West African nations hit by the Ebola crisis, will begin soon at New York’s JFK airport and then expand to four other major international airports: Newark, Chicago, Washington Dulles and Atlanta.

A federal official says the enhanced screening will apply only to passengers arriving from Sierra Leone, Guinea and Liberia.

The new measures at U.S. airports come a day after Dr. Thomas Frieden, the director of the CDC, told reporters that devising travel guidelines was in the works but nothing had yet been finalized enough to announce.

The Ebola virus can spread through contact with bodily fluids — blood, sweat, feces, vomit, semen and saliva — and only by someone who is showing symptoms, according to the CDC.

People with Ebola may not be symptomatic for up to 21 days.

Symptoms generally occur abruptly eight to 10 days after infection, though that period can range from two to 21 days, health officials say.

Air travelers must keep in mind that Ebola is not transmitted through the air, said Dr. Marty Cetron, director of the CDC’s Division of Global Migration and Quarantine.

“There needs to be direct contact frequently with body fluids or blood,” he stressed.

Questions about Duncan’s case

Duncan came to the U.S. to visit family and friends, departing Liberia on September 19, according to the CDC. It was his first trip to America, his half-brother Wilfred Smallwood said. Liberian authorities said he was screened for Ebola before flying.

It’s unclear how he got Ebola, but witnesses have said that he had been helping victims of the virus in Liberia, and The New York Times said he’d had direct contact with an Ebola-stricken pregnant woman. Duncan answered “no” to questions about whether he’d cared for someone with the virus.

His symptoms first appeared “four to five days” after he landed in the U.S., Frieden said.

Duncan went to Texas Health Presbyterian Hospital after 10 p.m. on September 25 and was treated for a fever, vomiting and abdominal pain — all symptoms of Ebola — but he was sent home with antibiotics and a pain reliever and was not screened for Ebola.

He returned two days later and was then tested for Ebola, after which his treatment at the hospital began.

There are a lot of questions about the handling of Duncan’s case.

Dr. Alex Van Tulleken, an expert in tropical diseases at Fordham University in New York who is not involved in the case, said on CNN on Wednesday that the two-day lag time could have been “significant.”

Cases in Europe

Meanwhile, Frederic Vincent, a spokesman for the European Commission, told CNN on Wednesday that there have been eight confirmed cases of Ebola in European countries. There is one case in the United Kingdom that has been treated and the person has recovered; one case in France like that; two cases in Germany in which patients are receiving treatment; and three cases in Spain: two deceased Spanish missionaries and a nurse’s assistant who is being treated.

There is also a case in which a Norwegian staffer with Doctors Without Borders is being treated, he said.

Also in Spain, health officials said four more potential Ebola cases — in addition to the nurse’s assistant — are under observation.

The nurse’s assistant said that she had no idea how she had contracted the virus, but a doctor treating her said that she may have been exposed while she removed her protective suit.

Dr. German Ramirez said the assistant, who is in isolation at Madrid’s Carlos III Hospital, had told him it was possible that a part of the suit — possibly the gloves — touched her face.

On Wednesday, top British officials discussed ways to contain the virus. Prime Minister David Cameron, who led the meeting, received the latest updates about the United Kingdom’s efforts in Sierra Leone, where it has provided support. The UK will also deploy 750 defense personnel to help establish the Ebola treatment centers.

U.S. personnel are also being deployed.

Cases in West Africa

The globe’s largest outbreak of Ebola has killed more than 3,400 people in Guinea, Liberia and Sierra Leone. Since March, more than 7,400 people have contracted Ebola in those nations, according to the World Health Organization.

The CDC is tracking the latest cases in the region.

NBC News freelance cameraman Ashoka Mukpo was diagnosed with Ebola in Liberia on Thursday. He left Liberia on a specially equipped plane Sunday and was headed to Nebraska, the network reported.

Mukpo is in stable condition at The Nebraska Medical Center, hospital representative Taylor Wilson said Wednesday.

The CDC’s Frieden said Tuesday that battling the virus will be a “long, hard fight.”

“The virus is spreading so fast,” he said, “that it’s hard to keep up.”

CNN’s Gary Tuchman, Alexander Felt and Rene Marsh contributed to this report.

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