Ebola Travel Crisis: How Does it Stack up to SARS and Swine Flu?

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An-Attention-Ebola-Sign
An-Attention-Ebola-Sign

(Photo: Thinkstock)

News of a third Ebola case in Dallas is adding fire to a growing Ebola panic. A Washington Post-ABC News poll finds that almost two-thirds of Americans are concerned about a widespread Ebola epidemic in the United States.

Federal officials are worried too. According to Fox News and CNN, the CDC is now considering adding the names of health care workers being monitored for Ebola to the government’s no-fly list. That comes after two Dallas nurses were diagnosed with the virus after treating Ebola victim Thomas Edward Duncan at Texas Health Presbyterian Hospital.

Related: CDC Could Quarantine U.S. Citizens for Weeks If They Refuse Ebola Screenings

Meanwhile, the United States is tightening airport screenings on passengers arriving from West Africa, where the number of Ebola cases is expected to top 9,000 by the end of the week. New York’s John F. Kennedy, Chicago O’Hare, Atlanta, Newark, and Washington Dulles airports have instituted special screening procedures for passengers flying in from the hardest-hit countries, Guinea, Liberia, and Sierra Leone.

passenger-screening
passenger-screening

Passenger being screened for Ebola in a Moroccan airport. Similar measures are being taken all over the world, including the U.S. (Photo: AP)

The worldwide travel scramble being caused by the Ebola outbreak has some big similarities, and some big differences, with other recent outbreaks.

SARS

SARS
SARS

The 2003 SARS outbreak also led to mass passenger screenings. Here are passengers being checked for fever on a thermal screen at Singapore’s Changi International Airport. (Photo: Getty Images)

A dress rehearsal of sorts for the international Ebola response occurred during the 2003 outbreak of SARS (severe acute respiratory syndrome), which appeared to originate in China. In response to the outbreak, the CDC and the World Health Organization each issued their first-ever travel advisories — high-level alerts in which they advised against all but essential travel to the affected areas in Southeast Asia. WHO later extended its travel advisory to the hard-hit city of Toronto as well, angering Canadian officials.

sars-outbreak
sars-outbreak

The SARS outbreak led health officials worldwide to issue unprecedented travel advisories. Similar advisories are in effect today in the Ebola crisis (Photo: AP)

Airports in Canada and other foreign countries began passenger-screening procedures — including taking passengers’ temperatures. The U.S. health officials didn’t do this, but they did hand out cards to air passengers warning them of SARS symptoms.

The WHO says the SARS outbreak ended up sickening 8,098 people worldwide. Of these, 774 died (in the U.S. there were eight confirmed cases and zero fatalities).

Swine flu

Swine-Flu-H1N1
Swine-Flu-H1N1

Black and white ink stamp for swine flu virus. (Photo: Thinkstock)

Six years later, in 2009, the world was fearing another epidemic: a new strain of flu called H1N1, popularly known as “swine flu.” First discovered in Mexico, swine flu ended up being diagnosed in more than 70 countries.

The U.S. didn’t institute any travel bans, but the United States and European Union did advise against nonessential travel to Mexico. Argentina and Cuba banned flights from Mexico, and airlines and cruise lines cut back on, or avoided, trips to Mexico.

swine-flu-travel
swine-flu-travel

The 2009 swine flu scare affected the holiday travel season in the U.S.

In some countries, Americans were seen as the at-risk carriers. American tourists visiting Asia reported having their temperatures taken by health workers (some clad in hazmat suits) before being allowed out of the airport.

The CDC later estimated that 274,000 Americans were hospitalized during the H1N1 epidemic and more than 12,000 died.

Similarities with the Ebola outbreak

temperature-screening-doesn't-work
temperature-screening-doesn't-work

One way the Ebola outbreak is like the others: temperature screening isn’t all that effective in the identifying carriers of the disease (Photo: AP)

So now, people are lining up in airports getting their temperatures taken to combat this new health scare, just like we saw during the H1N1 and SARS scares. And now, as then, experts are debating whether that’s really helping.

“I’ll be personally honest: SARS temperature screening didn’t work,” says Dr. Arthur Reingold, professor and head of epidemiology at the University of California, Berkeley School of Public Health. He notes studies that found that out of the millions of people Canada tested during its SARS outbreak, none of them had SARS. “Most people with fever don’t have SARS or Ebola,” he says, pointing out that a wide range of diseases, from malaria to the common cold, can cause someone to be flagged in an airport temperature screening. Plus, some Ebola carriers do not have a fever.

WATCH: Airlines, Railways Taking Precautions When it Comes to Possible Ebola Cases

And while he’s not suggesting ending airport temperature screenings, Reingold cautions, “At the end of the day, it doesn’t turn out to be terribly helpful.”

Something else to consider when comparing the Ebola scare with previous outbreaks: Ebola is much harder to get and transmit via travel than either H1N1 or SARS. "H1N1 was an airborne contagion; it was something much more easily spread,” says Katherine Harmon, director of health intelligence at iJET, an international risk management company.

The Ebola risk for travelers is much lower. “If someone is not vomiting or having diarrhea, I think the risk of transmission on an airplane for this particular disease is not great — basically nonexistent,” says Reingold.

ebola-travel-ban
ebola-travel-ban

Many health experts oppose travel bans to Ebola-affected countries. They say it would keep much-needed aid workers out of Africa. (Photo: AP)

Reingold and Harmon nevertheless are telling people to follow the advisories in place for the Ebola-affected countries in West Africa (“Most people’s business and pleasure trips can be postponed,” says Reingold). But they, along with a chorus of international health experts, agree that an outright travel ban to the stricken countries could worsen the outbreak. “Assistance and aid has to go to these regions, and it’s gotta come from somewhere,” says Harmon. “When you make it difficult to pump in aid, care, and humanitarian efforts, then you’re making it very difficult to stop this outbreak.”

With no end to the Ebola outbreak in sight, it’s clear that the current scare could rival or even surpass those of previous outbreaks, despite how deadly those epidemics were. “Influenza is a global killer in that it actually causes more deaths numerically per year than any other communicable disease,” says Harmon, “but when you say ‘Ebola,’ everybody perks up because these are the things Hollywood movies are made of. It’s a terrifying disease.”

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