Foot baths and fever scanners in The Philippines

Like Indonesia, the Philippines is an archipelago, comprising some 7000 islands of varying size. It is also close to Indonesia, which lies just to the south across the Sulu Sea. Indonesia has more bird flu deaths than any country in the world and the disease is endemic in poultry all over that huge country. But so far, The Philippines has reported no H5N1 in poultry or humans. The fact that The Philippines has reported no bird flu is remarkable. Maybe too remarkable.

Here's the map indicating the human cases in Indonesia, as kept up to date by a cadre of dedicated FluWikians, here. The Philippines is in the upper right, southeast asia (Cambodia, thailand, Vietnam, Laos) in the upper left:

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Clearly the Philippine authorities are aware they are a likely place to see the virus appear, and they are taking some steps. Whether they are likely to be effective is another matter.

The Manila International Airport Authority has intensified its campaign against bird flu, which has killed 150 in China and neighboring Asian countries.

MIAA general manager Alfonso Cusi issued a memorandum order following the recent outbreak in Indonesia where authorities bared the death of a 35-year-old female.

"The Ministry of Health of Indonesia has confirmed the country's 57th death from H6NI [sic] or avian influenza," said Cusi, urging strict monitoring of arriving passengers.

He said the Ninoy Aquino International Airport Terminals 1 and 2 would use thermal scanning and foot bath to prevent the entry of the virus.

Under the directive, Cusi said medical staff of the Bureau of Quarantine would be posted at the arrival area to ensure the government?s guidelines are strictly enforced. (Manila Standard)

Thermal scanning (to pick up passengers with fevers) at airports was used in the SARS outbreak in 2003 but there is no evidence it did any good. No cases were detected in this fashion. Influenza is even less likely to yield to this tactic than SARS, since we believe people are infectious for up to 24 hours before showing any symptoms or signs, unlike SARS which is infectious mainly after symptoms appear. If it didn't work for SARS, it isn't likely to work for influenza. As for foot baths are concerned, that's the bird flu equivalent of removing shoes at US airports.

The Philippines knows it's in the cross-hairs. They won't wiggle out of them by these airport measures. Then again, I'm still taking off my shoes when I fly in the US. What do the facts have to do with it?

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Why wouldn't dipping shoes in a foot bath of disinfectant might be useful? They could issue paper foot coverings to wear inside of a plane while putting the shoes in a plastic baggie.Or offer paper coverings for the shoes after the disinfecting process. Also give out face masks for breathing in all that recyled air. Might cut down on something like colds, if not on H5N1.How many people come down with some bug after a long flight. A lot of people I know do.

The main results I see from disinfectant footbaths are cranky passengers with wet feet, and damage to footwear. Unless everyone was forewarned to wear galoshes. I don't know how cold it gets in the Phillipines, but that doesn't strike me as the best way to cut down on passengers having the sniffles.