What is this article about?

The article examines what previous Ebola outbreaks in West Africa and the Democratic Republic of the Congo tell us about airport and point-of-entry screening. It finds that screening rarely identified confirmed cases directly, but it could still support risk communication, referral, traveller monitoring, and wider surveillance. For South Africa, it recommends a risk-based, layered approach rather than relying on temperature checks or border screening alone.

Why does this matter?

Screening cannot reliably identify every infected traveller because people may be incubating the virus and have no symptoms when they travel, while early symptoms are often non-specific. Large screening programmes also require substantial resources and can generate false alarms and delays. South Africa needs to balance proportionate measures at points of entry with strong healthcare and event-based surveillance, laboratory readiness, safe referral, and rapid response.

How did this article come about?

The article grew out of the need to assess the lessons from previous Ebola responses in the context of the 2026 Bundibugyo virus disease outbreak affecting the Democratic Republic of the Congo and Uganda. Rather than assuming that more screening necessarily means greater protection, it brings together published evidence on screening outcomes, operational costs, and international spread to consider what is most useful for South Africa.

What was your role in the development of this article?

As lead author, I brought together and critically reviewed the published evidence on Ebola point-of-entry screening, traveller surveillance, and international transmission. I used that evidence to assess the practical implications for South Africa and develop recommendations for a proportionate, integrated approach to preparedness. The focus was on distinguishing direct case detection from the wider surveillance and response benefits that screening may provide.

Why should people read this article?

The article challenges the assumption that airport screening alone can prevent an imported Ebola case. It explains both the limitations and potential value of screening, using evidence from previous outbreaks rather than treating visible border measures as proof of preparedness. It also sets out practical priorities for South Africa, including airline notification, healthcare surveillance, laboratory capacity, rapid referral, and contact tracing.

What impact do you hope this article will have on public health policy and healthcare access?

I hope it encourages decision-makers to base border measures on current epidemiological risk and to invest in the connected systems that make early detection and response possible. Screening should lead to appropriate assessment and referral, not create a false sense of security or unnecessary barriers. A proportionate, evidence-based approach can strengthen preparedness while limiting avoidable disruption, stigma, and the diversion of resources from essential surveillance and healthcare functions.

Mr Nevashan Govender is the Operations Manager at the Emergency Operations Centre at the National Institute for Communicable Diseases.

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