Symptoms of Ebola When Flying

After I wrote the last blog about Ebola a couple days ago, a couple people emailed me to ask just what are the symptoms of this infectious disease. Yes, you could Google it or look them up on the CDC website but here are the symptoms in print.

To get the answer, I went straight to the definitive source, the Center for Disease Control in Atlanta. They provide a list of symptoms which looks suspiciously similar to a host of other maladies. For example, they say to look out for headache, muscle pain, weakness, diarrhea, vomiting, and abdominal pain. Not much help so far. After all, this pretty much describes the typical flu bug or common cold, something frequently seen this time of year. Indeed, quite a few passengers will say the same symptoms perfectly describe how they feel after eating airplane food.

But there are a couple differences that make Ebola stand out. An infected person may also have unexpected bleeding or bruising. This rules out most common illnesses on aircraft. Nevertheless, passengers are often bumping into one another or picking up a bruise while loading bags in overhead compartments. But here is a big difference. Bruises take time to develop. If you didn’t have it when you boarded but suddenly you do, this along with the other symptoms may make you an Ebola candidate.

The primary symptom that separates Ebola from other contagious illnesses is a relatively high fever (101.5F). Yes, someone could have a body temperature that high and it might be the flu. For that matter, a fever like that could indicate a host of possible illnesses. The big kicker that ties all these symptoms together is whether the person has recently been in Africa, particularly West Africa, or come in contact with someone who was.

The good news, Ebola is not transmittable through the air like the flu. The bad news, it is a very deadly virus that can inadvertently be transmitted by infected body fluids like blood or saliva. CDC created guidelines page for airlines and related workers as well as infection control guidelines for crew members. Note that a flight crew can deny boarding to anyone they may suspect of being an infected danger to other passengers, whether Ebola or anything else.

Now the CDC will begin checking temperatures of passengers arriving from West African nations.  It will apply to the following five airports – JFK, Newark, Dulles, O’Hare, and Atlanta.  Will this be a good first line of defense or more like TSA security theater?  It certainly has the potential to be the latter.  First, it does not apply to passengers who fly here from other cities.  That means anyone who flies from West Africa to, say, Europe, and then the U.S. will not be monitored.  Can passengers lie and say they haven’t been in Africa when in fact they have?  Oh yes, this is a concern to health officials but they are probably hoping that immigration agents will notice the African passport stamps when passengers arrive in another country.  Fact is, it may be unrealistic to believe an agent will look through every stamp in a passport to find one from Africa.  My passport has dozens of stamps so it would take quite a while to vet passengers like me.

Second, the CDC is asking passengers who do not have symptoms to monitor their conditions while they are in the U.S.  While I hope it works out well, the TSA has been asking passengers for years not to bring weapons on planes yet there is still someone every week that gets caught with a gun.  Without strict controls, there is little hope that people will actively monitor their conditions while in the U.S.

But there is a bigger problem with identifying the infectious disease among passengers.  Symptoms may not appear for 2-21 days after exposure, though the average is 8-10 days according to CDC.  Thus it is very possible that someone could fly from somewhere – even from Africa – with virtually no symptoms but those symptoms could become active weeks later after they arrive at their destination.  If that happens, the destination community would be at risk and the airline carrier would need to belatedly contact all the passengers.  Note to readers: Make sure your contact information with the airlines is up to date.

If Ebola begins to spread around the world and no vaccine is developed to stop it, this could be an international health epidemic of extreme size. I understand the problem but still intend to fly every week. Some flights are domestic, others international. Personally I have no plans to modify my travel because of the very slight possibility that someone on my flight may be carrying the Ebola virus. Could it happen? Of course, and then I would have to deal with the consequences but for now, I have no intention of letting it become the tail that wags the dog. On the other hand, I have no plans to fly to Africa. I may be a bit crazy but I am certainly not stupid.

For those who want more information about Ebola, check out the CDC page for travelers and their helpful FAQ.