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Homeland Security

DHS’s Coordinated Response to Ebola

The 2014 Ebola Epidemic

The 2014 Ebola epidemic is the largest in history and has had a significant impact in multiple West African countries.   In response to this international situation, the U.S. Government, the World Health Organization (WHO) and other partners have been actively engaged in West Africa, specifically in Liberia, Sierra Leone, and Guinea, which have been the hardest hit areas. In the midst of this public health event, it is important to remember that the Centers for Disease Control (CDC) has stated that the risk of a widespread Ebola outbreak in the United States is very low.  Still, the Department of Homeland Security (DHS), in coordination with the CDC and the National Security Council have already taken significant and prudent steps to mitigate the spread of Ebola in the United States. 

The Department of Homeland Security's Response

DHS, through U.S. Customs and Border Protection (CBP), is engaged on a daily basis with its interagency partners to prepare for and respond to Ebola and other potential threats to public health.

CBP and the CDC have closely coordinated to develop policies, procedures, and protocols to identify travelers at all ports of entry who may potentially be infected with communicable diseases 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 to CDC as appropriate) at all U.S. ports of entry, including all federal inspection service areas at U.S. airports that service international flights, land-border crossings and seaports.

As part of the Department of Homeland Security’s ongoing response to prevent the spread of Ebola in the United States, DHS is instituting additional screening and protective measures for travelers from Ebola-affected countries at our ports of entry.

CBP has developed enhanced passenger screening for travelers entering the United States from or through an Ebola-affected country. These measures are in place at five U.S. airports where over 94% of travelers from the affected region enter the U.S., which started with John F. Kennedy International Airport on Saturday, Oct. 11.  Chicago’s O’Hare International Airport, Dulles International Airport in Virginia, Hartsfield Jackson International Airport in Atlanta and Newark International Airport in New Jersey implemented enhanced screening Thursday, Oct. 16. The enhanced screening includes:

  1. Identifying and interdicting travelers from the Ebola-affected countries 
  2. Isolating these travelers from the rest of traveling public while the individual completes a questionnaire and contact information form
  3. Medically-trained personnel will 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 is referred to a local health department for further monitoring
  4. Encouraging the traveler to seek health care at the first sign of any potential illness 

Next, the Department of Homeland Security will exercise its authority to direct those passengers flying from Liberia, Sierra Leone and Guinea to arrive in the United States at one of the five airports with enhanced screening and resources – JFK, Newark, Dulles, Atlanta and Chicago. This means that airlines will route passengers from these three affected countries to U.S. airports that have the enhanced screening procedures implemented and added personnel in place. DHS is working closely with the airlines to implement these restrictions with minimal travel disruption.

Below is a breakdown of the number of travelers who have already undergone enhanced screening procedures at each of the five international airports as of Feb 2.

Flights with passengers requiring Ebola screening through February 2, 2015

Airport Date CBP Primary CBP Secondary CDC Conducted Tertiary Passengers Transported to a Medical Facility
Questionaire Temperature Reading
Passengers Automatically Referred for Enhanced Screening Based on Travel Other Passengers Referred Positive Negative Elevated Normal
JFK New York Oct 11 to Feb 2 3418 124 103 3439 3 3539 114 0
Newark Liberty Oct 11 to Feb 2 853 15 75 793 3 865 77 3
Chicago O'Hare Oct 11 to Feb 2 405 16 26 395 1 420 30 5
Hartsfield-Jackson Atlanta Oct 11 to Feb 2 736 73 171 638 3 806 170 3
Washington Dulles Oct 11 to Feb 2 1949 118 161 1906 4 2063 170 4
Cumulative Total Oct 11 to Feb 2 7361 346 536 7171 14 7693 561 15

Passengers Automatically Referred for Enhanced Screening Based on Travel – Travelers that have been identified in advance of travel based on passengers’ travel information received by CBP from airlines operating flights, to, from, or through the United States.
Other passengers referred – Travelers identified by CBP officers during the inspection process as having recently traveled through one of the affected countries. CBP officers interview travelers about their recent travel and examine travelers’ documents, including their customs declaration form, and passport stamps which would indicate recent travel to the affected region.
Questionnaire (positive/negative) – If a traveler answers “yes” to at least one of the questions on the CDC questionnaire, the traveler is referred to the CDC for a public health assessment. These questions include if the person has come into contact with a person exhibiting symptoms of Ebola.
Temperature Reading (elevated/normal) – The traveler’s temperature is taken by medically trained personnel.

Normal – Travelers with a temperature within the normal range according to the CDC thresholds and who responded “no” to all of the questions on the questionnaire are admitted into the United States (provided there are no other inadmissibility issues) and provided a CDC Travel Health Alert Notice tear sheet.
Elevated – Travelers with a temperature above the normal range of the CDC threshold and/or travelers who responded “yes” to any of the questions on the questionnaire will be referred to the CDC for a public health assessment.

CDC Tertiary Screening – CDC Tertiary Screening is also referred to as the public health assessment. The traveler’s temperature is taken again by CDC. From there CDC will decide during the assessment if the traveler can continue to travel; if the traveler should be taken to a hospital for evaluation, testing, and treatment; or if the traveler should be referred to a local health department for further monitoring and support.
Passengers Transported to a Medical Facility – Passengers CDC determine need additional screening at a local hospital.

Additionally, DHS has measures in place to identify and screen anyone at all land, sea and air ports of entry into the United States who we have reason to believe has been present in Liberia, Sierra Leone or Guinea in the preceding 21 days. If CBP discovers that the traveler has been in one of the three countries in the prior 21 days, he or she will be referred for additional screening and, if necessary, CDC or other medical personnel in the area will be contacted pursuant to existing protocols. 

These precautions will add to the current layers of protection, and funnel travel by individuals who have been in the affected region to airports that have enhanced screening and additional medical resources. For all travelers from the affected countries and passport holders of these countries, CBP has been and continues to distribute health notices, observe for any overt signs of illness, ask specific CDC questions to assess any potential recent symptoms and/or Ebola exposure risk, and refer travelers to medical officials if necessary.

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). 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 potentially ill travelers, CBP will contact CDC along with local public health authorities to conduct further medical evaluation. The traveler would be isolated from the traveling public while the CDC and local public health authorities conduct an evaluation

The Transportation Security Administration is also actively engaged with the aviation industry, providing them with guidance on recognizing symptoms of Ebola and providing important guidance and contact information if they have a concern.

The DHS Office of Health Affairs (OHA) has issued Occupational Health Advisories to DHS components. Through the National Biosurveillance Integration Center, OHA is also monitoring the outbreak to coordinate information in response to the event.

More Information

Guidance

U.S. Government Websites

Last Published Date: February 3, 2015
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