Ebola: Ghana must track incoming travellers, not rely on temperature checks – Prof Amuasi
Ghana must prioritise effective surveillance and the tracking of incoming travellers in its preparations against Ebola, rather than rely heavily on temperature checks and hand sanitisers at airports, a public health expert has warned.
Professor John Amuasi, Head of Global Health at the School of Public Health, Kwame Nkrumah University of Science and Technology (KNUST), said visible screening measures offered limited assurance because people infected with the virus might not show symptoms when they arrived in the country.
He said the country's preparedness should focus on collecting accurate information on travellers, verifying their contact details and ensuring they could be reached quickly if they developed symptoms after arrival.
Speaking on Joy News' PM Express on Monday, October 26, Professor Amuasi said Ghana needed to strengthen its surveillance systems to identify and follow up on people who might have been exposed to the virus.
His comments come amid concerns about the risk of cross-border transmission as African countries respond to Ebola cases and strengthen measures to prevent further spread.
Professor Amuasi, who is also a research leader at the Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), said the experience of recent cases underscored the importance of surveillance at points of entry and the ability to follow up on travellers after they had entered a country.
Surveillance beyond the airport
The professor said airport screening could not, on its own, reliably identify all infected travellers, particularly those who were not yet showing symptoms.
He said measures such as temperature checks and hand sanitiser stations could reassure the public but should not be mistaken for a comprehensive system for detecting Ebola.
“What I was trying to explain was that it's easy to put a bunch of measures in place at the airport, you know, these temperature checks and doing the hand sanitiser thing, but there's a little bit to which this is helpful. And this is why I am not personally too alarmed about what has been put in place at the airport in terms of what you can see with your eyes,” he explained.
He stressed that the absence of visible symptoms did not necessarily mean a traveller posed no public health concern, making follow-up systems an important part of outbreak preparedness.
“Nobody is going to be coming off an aeroplane, in fact, or even jumping off an aeroplane when they are visibly sick with signs and symptoms of Ebola. And therefore, your ability to catch it when someone is coming off a plane is really limited,” he stated.
Professor Amuasi said the effectiveness of Ghana's response would depend on whether health authorities could identify people who might have been exposed and take appropriate action if symptoms emerged.
“Temperature checks, use of alcohol, hand rubs – all these things are nice. They give people some level of confidence. But the reality is that they are not going to catch Ebola cases for you,” he noted.
Reliable data, prompt follow-up
The KNUST academic said a more effective approach would involve gathering accurate information from incoming travellers and establishing reliable means of contacting them after arrival.
He said authorities should verify telephone numbers and have mechanisms to locate travellers when necessary, while providing clear instructions on where to report if they developed symptoms.
“What is needed is actually the ability to test. And this doesn't exist as it stands right now. We can't be doing PCR tests for everyone coming in.”
Professor Amuasi acknowledged that testing every person entering Ghana would not be practical. He argued, however, that accurate traveller information and an effective follow-up system would help public health officials respond more quickly when a potential exposure was identified.
“So for me, the single most important thing is being able to collect as accurate data as possible on every single person who comes off a plane in this country, making sure that the phone numbers they submit are accurate and finding a way of verifying it, making sure that we have a way of being able to geolocate them if necessary, and also making sure that they are able to report to designated facilities or via the phone lines or other contact means if they come down with any of the symptoms. So for me, the education is more towards those who are coming into the country and ensuring that we're able to collect as detailed data as possible of those coming in. But for the other visual things we see like the alcohol hand rub and the temperature checks, they are nice.”
He added that the visible measures had a role in reassuring travellers but should not distract from the need for effective surveillance and follow-up.
“They help people to be more confident and comfortable. But at this stage right now, they don't come to bear.”
Nigeria's experience
Professor Amuasi also urged caution in interpreting reports of Ebola cases in the region, saying the situation in Nigeria needed to be understood in the context of the known exposure and subsequent response.
He said the World Health Organisation (WHO) had indicated that there was no active Ebola case in Nigeria at the time of his comments, following the evacuation of the infected person.
“Currently, as we speak, the WHO is indicating that there is no active case of Ebola in Nigeria right now because the one person who had it has been evacuated. Of course, we will need to wait for a while to see whether there was any further transmission.”
The situation, he said, reinforced the importance of tracing contacts and monitoring people who might have been exposed, rather than depending exclusively on checks conducted when travellers first arrive.
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