The Tribune

EDITOR, The Tribune.

The possibility of a person who has been exposed to Ebola virus who then travels to the Bahamas is remote, but real. A number of countries have instituted precautionary approaches to mitigate this possibility. The Bahamas has been slow to execute an effective policy at our borders.

If there has been significant planning, the general public can neither see it nor feel that we are adequately prepared for such a possibility. It certainly appears that the degree of national preparedness is a well kept secret despite tremendous international and local concern.

The precedent of SARS – while clumsily executed worldwide – taught valuable lessons about screening and surveillance. Much can be learned from that experience.

According to Wikipedia: “Severe acute respiratory syndrome (SARS) is a viral respiratory disease of zoonotic origin caused by the SARS coronavirus (SARS-CoV). Between November 2002 and July 2003, an outbreak of SARS in southern China caused an eventual 8,273 cases and 775 deaths were reported in multiple countries with the majority of cases in Hong Kong (9.6 per cent fatality rate), according to the World Health Organization (WHO). Within weeks, SARS spread from Hong Kong to infect individuals in 37 countries in early 2003.”

EBV (Ebola Virus Disease) is endemic (widespread transmission) in the West African countries of Guinea, Liberia and Sierra Leone. There has been localised transmission in Nigeria. There have been documented travel associated cases in the United States and Senegal.

The Bahamas survives on its appeal as a tourist destination. We would benefit from an expertly considered, evidence-based approach to the global threat. Our approach can be based on the World Health Organization document published in September 2014 entitled “Travel and transport risk assessment: Interim guidance for public health authorities and the transport sector.” The link for the document can be found at: http://apps.who.int/iris/bitstream/10665/132168/1/WHO_EVD_Guidance_TravelTransportRisk_14.1_eng.pdf?ua=1

Another useful and important resource is entitled “WHO interim guidance for Ebola Event management at points of entry.” The link for this can be found at: http://apps.who.int/iris/bitstream/10665/131827/1/WHO_EVD_Guidance_PoE_14.1_eng.pdf?ua=1&ua=1

Options for intervention include the creation of a questionnaire for all international passengers who disembark in the Bahamas. Questions could include details of travel to countries currently experiencing active cases of EVD. Further, selected index passengers could be directed to undergo digital temperature screening and brief further questioning.

The Bahamas should lead the region in the planning and execution of an effective strategy to address this public health matter.

The programme should be implemented within the next few days. There is no better strategy than a proactive clearly planned and executed approach to this real public health threat.

We are a leader in regional tourism. We ought to lead in our approach to this threat while providing reassurance to our people and visitors.

DUANE SANDS, MD

Nassau,

October 8, 2014.

• ‘Govt slow on Ebola’ - page 7