Scientists have used Ebola disease spread patterns and airline traffic data to predict a 75 percent chance that the virus could be imported to France by Oct. 24 and a 50 percent chance that it could hit Britain by the same date.
Those numbers are based on air traffic remaining at full capacity. Assuming an 80 percent reduction in travel to reflect that many airlines are halting flights to affected regions, France’s risk is still 25 percent and Britain’s 15 percent.
“It’s really a lottery,” said Derek Gatherer of Britain’s Lancaster University, an expert in viruses who has been tracking the epidemic — the worst Ebola outbreak in history.
The epidemic has killed more than 3,400 people since it began in West Africa in March and has now started to spread faster, infecting almost 7,200 people so far. Nigeria, Senegal and the US have all seen people carrying the Ebola hemorrhagic fever virus — apparently unwittingly — arrive on their shores.
France is among the countries most likely to be hit next because Guinea is one of the worst-affected nations, alongside Sierra Leone and Liberia. Guinea is a French-speaking country and has busy travel links to France, while Britain’s risk is amplified by Heathrow Airport — one of the world’s biggest travel hubs.
France and Britain have each treated one national who was brought home with the disease and then cured. The scientists’ study suggests that more may bring it to Europe not knowing they are infected.
“If this thing continues to rage on in West Africa and indeed gets worse, as some people have predicted, then it’s only a matter of time before one of these cases ends up on a plane to Europe,” Gatherer said.
Belgium has a 40 percent chance of seeing the disease arrive on its territory, while Spain and Switzerland have a 14 percent risk each, according to the study, first published in the journal PLoS Current Outbreaks and being regularly updated at www.mobs-lab.org/ebola.html.
The WHO has not placed any travel restrictions and has encouraged airlines to keep flying to the worst-hit countries, though British Airways and Emirates airlines have suspended some flights
Complicating matters is that the risks change every day the epidemic continues, said Alex Vespignani, a professor at the Laboratory for the Modeling of Biological and Socio-Technical Systems at Northeastern University, who led the research.
“This is not a deterministic list, it’s about probabilities — but those probabilities are growing for everyone,” Vespignani said in a telephone interview. “It’s just a matter of who gets lucky and who gets unlucky.”
The latest calculations used data from Oct. 1.
“Air traffic is the driver,” Vespignani said. “But there are also differences in connections with the affected countries [Guinea, Liberia and Sierra Leone], as well as different numbers of cases in these three countries, so depending on that, the probability numbers change.”
Patients are at their most contagious when Ebola is in its terminal stages, inducing internal and external bleeding, profuse vomiting and diarrhea — all of which contain high concentrations of infectious virus.
However, the virus can also have an incubation period of up to 21 days, meaning people can be unaware for weeks that they are infected and not display any symptoms.
This, it seems, is what allowed Liberia visitor Thomas Eric Duncanto to fly to the US and spend several days there unaware that he was carrying the deadly virus, before being diagnosed and isolated.
In the EU, free movement of people means someone unknowingly infected with Ebola could easily drive through several countries before feeling ill and seeking help, and spend weeks in contact with others before becoming ill enough to show up on airport scanners.
Jonathan Ball, a professor of molecular virology at Britain’s Nottingham University said that even with exit screening at airports of affected countries, the long, silent incubation period meant “cases can slip through the net.”
“Whilst the risk of imported Ebola virus remains small, it’s still a very real risk and one that won’t go away until this outbreak is stopped,” he said. “Ebola virus isn’t just an African problem.”
However, the chance of the disease spreading widely or developing into an epidemic in a wealthy, developed country is extremely low, healthcare specialists say.
According to an Ebola risk assessment by the European Centers of Disease Prevention and Control, “the capacity to detect and confirm cases … is considered to be sufficient to interrupt any possible local transmission of the disease early.”
Gatherer cited Nigeria as an example of how Ebola can be halted with swift and detailed action.
Despite being in West Africa and being home to one of the world’s most crowded, chaotic cities, Nigeria has contained Ebola’s spread to a total of 20 cases and eight deaths, and is likely to be declared virus-free in coming weeks.
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