Stopping Ebola in America

The widening Ebola epidemic in West Africa — combined with the fears generated by an Ebola patient who carried the virus to Dallas — have led to calls for the United States to screen travelers when they reach American airports. That is a reasonable defensive tactic if done judiciously, although it is unclear if that would have stopped the Liberian man, who carried the virus to Dallas before developing symptoms.

The American health care system needs to react with greater vigilance when cases do reach this country. It is incredible that doctors in a Dallas hospital reportedly made no effort to ascertain the patient’s travel patterns, and there were delays in cleaning the Dallas apartment where he had been staying, disposing of the medical waste and moving other residents of the apartment to a safer location.

Top American health officials are strongly opposed, with good reason, to take the more extreme step of banning all travel to the United States from Guinea, Liberia and Sierra Leone, where the epidemic is concentrated, as several prominent Republicans, like Louisiana’s governor, Bobby Jindal, have recommended. That could actually hamper the battle to contain the epidemic abroad — the first line of defense against the disease — in part by leaving Americans who are risking their lives to contain the epidemic stranded in Africa with no way to return home. If volunteer workers can’t return home, they may elect not to go in the first place, thus weakening the fight against the epidemic.

Currently, air travelers are screened in West Africa before they are allowed to board planes leaving their countries. Their temperatures are checked, and they must fill out a detailed questionnaire asking if they have various symptoms, such as fever, headache or vomiting, and if they have had any contact with Ebola patients or other possible exposures. The questionnaire is comprehensive, well designed and useful — assuming travelers answer honestly.

Thomas Eric Duncan, who took the virus to Dallas, did not answer honestly. He had no temperature when he left Liberia or when he first arrived in Dallas. But he lied on a questionnaire. When asked if he had been exposed to anyone with Ebola, he answered no, even though he had carried an Ebola victim shortly before she died. He is now in critical condition in a Dallas hospital. So far, none of the people he had close contact with have developed symptoms.

There is room to improve the screening in West Africa, where government officials and workers are often incompetent and in some cases unable to use the temperature devices they have been given. Still the system seems to be working. Though the epidemic has been growing since it was first identified in March, only one case, Mr. Duncan’s, has reached the United States, while scores of people have been blocked from boarding planes.

Even so, it makes sense to add another layer of protection at airports in this country. Travelers from West Africa could be asked to fill out an additional questionnaire, on which they might be less tempted to lie since they will already have reached American soil. Verbal questioning could further probe whether a passenger is likely to be infected. Until the epidemic in West Africa is controlled, it remains possible, even likely, that another Ebola case would reach this country. The American health care system should be prepared to move quickly, treat the victim and trace and isolate all people the patient had contact with. Bungled responses like the one in Dallas are simply unacceptable.

A version of this article appears in print on , on Page A28 of the New York edition with the headline: Stopping Ebola in America. Order Reprints | Today’s Paper | Subscribe