DALLAS/OTTAWA (REUTERS, AFP) - The US government has ordered five airports to start screening passengers from West Africa for fever, after the first person diagnosed with Ebola in the United States died on Wednesday.
Canada also announced tightened controls at its airports but did not specify when or where the controls would go into effect or which countries would be targeted.
The death of Liberian national Thomas Eric Duncan, 28, in Dallas has sparked concern that someone with Ebola had been able to fly into the United States from Liberia, raising the spectre that more passengers could arrive and spread the disease outside of West Africa, where nearly 4,000 people have died.
The White House said screening for fever will be carried out for arriving passengers from Guinea, Liberia and Sierra Leone at New York's John F. Kennedy airport from the weekend. From next week, similar screening will start at Newark Liberty, Washington Dulles, Chicago O'Hare and Hartsfield-Jackson Atlanta.
Together, the five airports account for nearly 95 per cent of travellers from Guinea, Liberia and Sierra Leone - the three countries hit hardest by the crisis, reported Washington Post.
Travellers from Guinea, Sierra Leone and Liberia will be taken to airport areas set aside for screening. Customs and Border Protection staff will take their temperatures, look for signs of illness and ask questions about travel histories and possible exposure to the virus.
The screening areas are not meant as "long-term holding facilities or isolation facilities", said Chris Paolino, a spokesman for Dulles airport.
Travellers who have a fever, other symptoms or worrisome answers on a health questionnaire will be checked more closely at a separate quarantine station manned by the Centre for Disease Control and Prevention (CDC). CDC staff will take their temperature again and evaluate them.
Travellers who need additional assessment will be referred to public health authorities; those who do not require additional checking will be asked to leave their contact information and will receive tips for self-monitoring.
Washington Post said it is the first time in recent history that the US has conducted this type of screening. During the Sars epidemic in 2003, health workers conducted visual screenings and observed passengers coming from affected countries for signs of illness.
US Secretary of State John Kerry on Wednesday appealed to other governments to do more to help contain the spread of Ebola. "The fact is more countries can and must step up.
"I'm here... to make an urgent plea to countries in the world to step up even further," he said.
His comment came as World Bank president Jim Kim admitted that the international community had "failed miserably" in its response to the Ebola virus, warning that the situation in the US was going to get much worse.
Kim said he wanted Western governments to back a new US$20 billion (S$25.5 billion) global health fund that would be able to react instantly to emergencies.
"It's late. It's really late," he said in an interview with the Guardian newspaper before the annual meeting of the Washington-based organisation this weekend.
"We should have done so many things. Health-care systems should have been built. There should have been monitoring when the first cases were reported. There should have been an organised response."
Britain meantime unveiled plans to send 750 military personnel as well as a medical ship and three helicopters to Sierra Leone.
Questions over US patient's death
The death of Duncan on Wednesday - 11 days after he was hospitalised on Sept 28 - has underscored questions about the timeliness and quality of care he received. He initially sought treatment two days before being admitted, but was sent home with antibiotics.
"I trust a thorough examination will take place regarding all aspects of his care," Duncan's fiancee Louise Troh wrote in a statement. Troh, who was in quarantine, said: "I am now dealing with the sorrow and anger that his son was not able to see him before he died."
Dr Craig Smith, medical director for infectious disease at University Hospital in Augusta, Georgia, said Ebola, like any disease, was easier to beat the sooner it was treated. "I'm not surprised he unfortunately passed away," Smith said. "I think two days would have made a big difference."
Duncan had been in critical condition and on a ventilator and kidney dialysis at Texas Health Presbyterian Hospital. He was given an experimental medication to try to keep him alive starting last Saturday, six days after being admitted.
But Ebola experts asked why Duncan received the experimental drug brincidofovir made by Chimerix Inc, which has not been tested on humans or animals, rather than Tekmira Pharmaceuticals drug TKM-Ebola, which has been given to another US patient, Dr Rick Sancra, who contracted Ebola while working in Liberia and was cured.
"We know Dr Sacra was pretty damn sick when he began treatment," said virologist Thomas Geisbert of the University of Texas Medical Branch, who has done pioneering work on Ebola treatments. It "potentially saved him."
Duncan was able to fly to the US from Liberia because he did not have a fever when screened at the airport in the capital Monrovia, and filled out a questionnaire saying he had not been in contact with anyone infected with Ebola.
Liberian officials have said Duncan lied in the questionnaire and he had been in contact with a pregnant woman who later died. He was not screened on arrival in the US.
About 48 people who had been in direct or indirect contact with Duncan since he arrived in Dallas are being monitored, according to health officials.
Texas Health Presbyterian said a man had been admitted on Wednesday after reporting that he had had contact with Duncan and was exhibiting symptoms. Other officials said he was a law enforcement officer who had visited the apartment where Duncan had been staying, days after the Liberian went to the hospital.
CDC director Thomas Frieden described the person as someone who "does not have definite contact with Ebola or definite symptoms of Ebola".
The CDC and other US health officials have also said the chances of Ebola spreading in the US are very slim.
The hospital has not released details on how it will handle Duncan's body but said it will follow protocols from the CDC. The guidelines recommend careful preparation of the body before movement, including enclosing it in two bags and disinfecting the bags. The body can then be transported without the need for protective gear for a driver or others who are near the body but they are not to handle the remains before cremation.
Situation in Spain
In Spain, three more health workers have been admitted to hospital for monitoring on Wednesday, including two doctors who had contact with a nurse who has been infected with the disease.
The Spanish nurse, who is the first person to contract Ebola outside of Africa, may have touched her face with the gloves of her protective suit while caring for a priest who died of the disease, a doctor treating her said on Wednesday.
The nurse, Teresa Romero, was being treated for the deadly infection at a Madrid hospital while Spanish officials launched an investigation into how she was able to contract Ebola despite strict protocols for handling contagious patients.