A British man died in Macedonia on Thursday, and the death might have been caused by the Ebola virus.
Macedonia is a country in the central Balkan peninsula in southeast Europe, having declared independence from Yugoslavia in 1991. It’s bordered by Greece, Albania, Serbia, and Bulgaria.
There was confusion after the unnamed Briton died, with a Macedonian health ministry spokesman saying that initially they received information that the man had been to Nigeria, but then a man told authorities that he and the victim hadn’t been anywhere.
“Medical authorities have informed us that up till now they cannot confirm whether the patient who died had Ebola. But as a precaution, based on the protocol of the World Health Organisation, medical authorities are taking all measures as if the patient had been suffering from a highly infectious disease,” a government spokesman told the Telegraph.
Sources in the government later said that the British man who died in Skopje had hemorrhagic fever but likely not to be Ebola.
Public Health England later added: "Public Health England is aware there are unconfirmed reports of a British national dying in Macedonia, who may have exhibited some symptoms compatible with Ebola.
“We understand Ebola to be unlikely as the cause of death but are will continue to work with partners to investigate.”
Meanwhile, European and other countries are weighing the risks of flights to and from West Africa.
“Of course we are all scared,”said cellphone worker Vijay Kumar, who was getting his temperature scanned Thursday at the airport in Casablanca, Morocco by medical crews in blue gowns and masks — one of dozens who relied on Royal Air Maroc’s continuing flights to West Africa.
But “we really appreciate their procedures, it’s a good system.”
He was finally heading home to Chennai, India, relieved that there were still flights operating, afterBritish Airways and Emirates suspended travel to the outbreak countries. Airlines from Morocco, France and Belgium are still flying in and out of West Africa, encouraged by the World Health Organization, because stopping would keep out needed aid workers and supplies — and wouldn’t necessarily halt the spread of the disease.
It can take up to 21 days before a person infected with Ebola starts to show symptoms that can be found in airport screening tests. During that period, an individual carrying Ebola can get a flight to anywhere in the world and fall ill later — as happened with a Liberian man who developed Ebola and died in the U.S. this week.
Departing passengers in Africa are being screened. U.S. officials said they will soon start screening arrivals from the affected countries. European governments so far have held off, even though it’s conceded infected passengers could arrive undetected. If someone gets sick in Europe, they are hoping to focus on quick response in advanced isolation wards like the one at Frankfurt, Germany’s University Clinic — not far from its international airport.
As a major hub for travel to West Africa, Casablanca airport functions as a gateway to the rest of the world. Thursday morning’s arrivals board included flights from the Ebola-hit cities of Monrovia, Liberia and Freetown, Sierra Leone, among others. Besides Royal Air Maroc, Air France and Brussels Air also still fly to and from West Africa.
Travel bans aren’t the way to go, says a top WHO official.
“You can stop a direct flight, but you can never stop people from moving,” either by connecting through other cities or crossing land borders, said Dr. Isabelle Nuttal from the World Health Organization.
The U.N. health agency is not asking countries to have people screened when they arrive on a flight. Nuttal warned that on-arrival screening could lead to a false sense of security, when the key step is that doctors “need to ask people where they have been.”
She cited the case of Thomas Eric Duncan, who died Wednesday in Dallas. He passed an airport screening at Monrovia before he flew to Brussels and on to the U.S. because he was not yet showing symptoms. When he did fall ill, he was sent home by a Dallas hospital at first.
Ilham Kazzini, senior vice president with government-owned Royal Air Maroc, said the company is still flying to West Africa because Morocco has an official policy of solidarity with the region.
“It also is in response to the calls by international organizations fighting against Ebola, like the U.N. and WHO, who called on the company to maintain its flights as the best way to fight the disease,” she said. “We transport members of international organizations, food and medical aid.”
As the passengers lined up in Casablanca to be scanned by thermal cameras and checked by remote thermometers, they expressed relief that there were still flights. Passengers from West Africa who stay in the country have to give the police contact details, travel plans and are handed a free mobile phone to stay in touch with medical officials.
Passenger John Hyland, who had visited Sierra Leone on a mission for Virginia-based Project Hope, emphasized the importance of not cutting West Africa off from the rest of the world.
“These countries need foodstuffs and all the things they usually import,” he said. “If Air Maroc can fly there, why not British Air?”
The airport’s chief medical officer, Mohammed Moussif, said they had yet to discover a case of Ebola in months of screenings, but travelers staying in the country must remain in contact.
“By default, we consider all of them to be in the phase of incubation and they are followed up with by a medical team no matter where they are in Morocco, in the north or south, until the end of the incubation period,” Moussif said.
U.S. officials say exit screening of about 36,000 people attempting to board airplanes in West Africa showed 74 had a fever and three others had some other symptom that led to them being pulled out of line. That’s roughly 1 in 500 people. None are believed to have had Ebola.
The Associated Press contributed to this report.
