Around the World: Air Travel and Ebola Virus Disease Transmission

It has often been said that vaccine-preventable diseases are just a plane ride away, and recent Ebola cases have brought the spread of disease via air travel to the forefront. In the current situation, air travel-related stories have come in two contexts. Certain flights were identified because the passenger manifest included individuals known to have been exposed to others that were sick with Ebola; and passengers flying into the United States from Ebola-affected countries in West Africa were restricted to one of five arrival airports in the U.S. so they could be screened for symptoms of the disease.

Despite the media attention that Ebola is receiving and the precautions issued in regard to air travel, Ebola is in general quite difficult to spread, and an outbreak in the United States remains highly unlikely:

• Currently, only a small part of the world (three West African countries) is affected by Ebola outbreaks.
• Ebola is spread by contact with an infected person’s bodily fluids when they are experiencing symptoms. Persons without symptoms are not contagious, making the tracking and control of disease spread much easier than for some other infectious diseases.
• Most importantly, Ebola virus is not spread by the respiratory route (meaning from coughing, sneezing or talking) so it’s hard to catch. Early in infection, when the patient has few if any symptoms, it’s extremely difficult to catch.

Vaccine-preventable diseases that are not common in the U.S., like polio and rubella, still occur in many other parts of the world. And diseases like influenza, pertussis and meningococcus can be spread by people without symptoms. Additionally, other diseases, like measles, can be transmitted simply by sharing the same air. For these reasons, diseases other than Ebola are much more difficult to contain. Therefore, the current experiences with Ebola can serve as a reminder of just how small the world really is when it comes to the potential for sharing infections.