An eye on bordering nations

Dr. Isabelle Nuttall, the World Health Organization's director of global capacity, alert and response, said that while the Ebola cases in the United States and Spain are a concern, they are less of a concern because they have high-quality health care systems and "good infection control."

Of more concern, she said, are Mali, Ivory Coast, Senegal and Guinea-Bissau, countries that border the three African nations with widespread transmission -- Guinea, Liberia and Sierra Leone -- because of the trade and travel among those countries.

"They really need to be better prepared," she said, adding that WHO has been working with African nations for years to control outbreaks -- any outbreaks -- and handling Ebola involves the same steps: "Be ready, detect, inform, assess, respond."

Border protection statement

U.S. Customs and Border Protection has released a statement about its work with the CDC and how its agents are at all U.S. points of entry to "observe all travelers entering the United States for general overt signs of illnesses":

CBP and the CDC have closely coordinated to develop policies, procedures, and protocols to identify travelers at all ports of entry who are potentially infected with a communicable disease and to minimize the risk to the traveling public. These procedures have been utilized collaboratively by both agencies on a number of occasions with positive results. CBP personnel review all travelers entering the United States for general overt signs of illnesses (visual observation, questioning, and notification of CDC as appropriate) at all U.S. ports of entry, including all federal inspection services areas at U.S. airports that service international flights, land-border crossings and seaports.

In addition to the measures already in place at all ports of entry, CBP and CDC have developed enhanced passenger screening for travelers entering the United States from or through an Ebola-affected country. These measures will be in place at the five U.S. airports where about 94 percent of travelers from Guinea, Liberia, and Sierra Leone arrive. JFK implemented enhanced screening Saturday, Oct. 11. On Thursday, Oct. 16, enhanced screening begins at Chicago's O'Hare International Airport, Dulles International Airport in Virginia, Hartsfield Jackson International Airport in Atlanta and Newark International Airport in New Jersey. The enhanced screening includes isolating the traveler from the traveling public while the individual completes a questionnaire and contact information form and medically trained personnel take the traveler's temperature. If the traveler has a fever or other symptoms or may have been exposed to Ebola, CBP will refer the traveler to CDC for a public health assessment. CDC will then determine whether the traveler can continue to travel, is taken to a hospital for further evaluation, or referred to a local health department for further monitoring.

CBP personnel at all U.S. ports of entry, including all U.S. airports that service international flights, continue to observe all travelers entering the United States for general overt signs of illnesses (visual observation, questioning, and notification of CDC as appropriate) and continues to distribute a CDC health notice to travelers entering the U.S. that have traveled from or transited through the affected countries informing travelers to watch their health and what they need to do if they become ill in the future. When a traveler is identified with a possible communicable disease or identified from information that is received from the CDC, CBP personnel will take the appropriate safety measures by donning personal protective equipment (PPE), to include gloves and surgical masks, which are readily available for use in the course of their duties.

CBP personnel receive training in illness recognition, but if they identify an individual believed to be infected, CBP will contact CDC along with local public health authorities to help with further medical evaluation. The traveler would be isolated from the traveling public while the CDC and local public health authorities conduct an evaluation.

Lack of surgeon general political?

Randi Weingarten, president of American Federation of Teachers, the second-largest nurses union, had some sharp words about the United States having no surgeon general in her remarks earlier today.

"This should be a wake-up call to make public health care investment a priority in the USA," she said. "We have had years of cuts and cuts and cuts and cuts, leaving many states without the public health infrastructure necessary to provide the education and services on a wide range of health care issues, including this one, and frankly, partisan politics have left us without a Surgeon General and that has to change too.

Ebola case mishandled

Dr. Daniel Varga, chief clinical officer for Texas Health Resources, apologized during his testimony to a House subcommittee, saying his staff mishandled the case of Thomas Eric Duncan: "We made mistakes. We did not correctly diagnose his symptoms as those of Ebola, and we are deeply sorry."

When Duncan succumbed to the disease, he said, "It was devastating to the nurses, doctors and team who tried so hard to save his life, and we keep his family in our thoughts and prayers."

Student in Connecticut undergoing tests

A Yale doctoral student who recently returned to Connecticut from Liberia and has a fever is in isolation at Yale-New Haven Hospital and is being tested for Ebola, officials at the hospital said Thursday. Results should be available within 24 hours, they said.

Travel restrictions

Asked if the CDC might change its stance and put in place travel restrictions on countries facing the Ebola outbreak, CDC Director Tom Frieden told a House subcommittee, "We will consider any options to better protect Americans."