Is it time for medical screening for travel in and out of the country?

I realize that most of you don’t need yet another thing to worry about, what with everything else going on these days, but there’s an article at the Washington Post this weekend that you might want to take a peek at. It deals with a highly disturbing report of a “new” virus in Africa (it’s not actually new) which has health professionals highly concerned. They’re talking about a disease which is casually being referred to as “monkeypox” and it’s made the jump to human beings. If you’re at all familiar with our species’ communal history with other poxes, you can probably guess that this is potentially some seriously bad news.

A cousin to the deadly smallpox virus, the monkeypox virus initially infects people through contact with wild animals and can then spread from person to person. The disease produces fever and a rash that often turns into painful lesions that can feel like cigarette burns. It kills up to 1 in 10 of its victims, similar to pneumonic plague, and is particularly dangerous in children. Monkeypox is on the U.S. government list of pathogens such as anthrax and Ebola with the greatest potential to threaten human health. There is no cure.

Over the past year, reports of monkeypox have flared alarmingly across Africa, one of several animal-borne diseases that have raised anxiety around the globe. The Congolese government invited CDC researchers here to track the disease and train local scientists. Understanding the virus and how it spreads during an outbreak is key to stopping it and protecting people from the deadly disease.

At this point you may be wondering what this has to do with immigration and travel policy, as implied in the title. It’s an uncomfortable subject, but the two are actually closely related. This monkeypox virus is on the move, though thus far it seems to have remained in sub-Saharan Africa. As the CDC points out, at this point there is no cure and the disease kills 10% of the people it infects, including otherwise healthy, young adults. Now compare that to the highly justifiable panic over the Zika virus a couple of years ago. We dodged a bullet there, metaphorically speaking, but we don’t seem to have learned our lessons quite yet. To do so we might want to look a bit further back into history.

The Black Plague is now believed to have originally come from China, where it did not wipe out the entire population. The people there had evolved with it and developed at least some limited immunity. But when travel and trade by ships became common, the virus spread via fleas on black rats to the west. It took out more than half of the population of Europe by some estimates.

Smallpox is also believed to have started in China and Korea, spreading via trade to Japan and then North Africa. The crusades brought it to Europe. Colonization and the slave trade brought it to South and later North America. The total death tolls are still being debated to this day.

The 1918 outbreak of the Spanish Flu (as it was incorrectly called) also came from China, moving into Canada with thousands of imported workers. It wound up killing 50 million people globally and was the chief reason that the next United States census recorded one of the smaller increases in the American population for that era. People were literally dying in the streets. And yet again, as National Geographic reported, the country of origin fared much better than the rest of the world.

Historian Christopher Langford has shown that China suffered a lower mortality rate from the Spanish flu than other nations did, suggesting some immunity was at large in the population because of earlier exposure to the virus.

With all of that in mind, is it time to expand our idea of “extreme” vetting for immigration to include medical screening? For that matter, should we have a fresh look at medical screening of even American tourists who leave the country and come back? Surely the medical technology has advanced far enough to be able to do this without oppressively excessive delays.

Yes, we’ll get into a huge food fight with privacy advocates over such an idea, particularly when it comes to citizens. (Non-citizens seeking entry should have far fewer options to complain.) But I’m not talking about full medical histories here. Just tests for a list of the known, virulent diseases we’re watching out for, such as Monkeypox, Zika and the latest edition of the flu. Given how fast a virulent disease can spread once modern transportation gives it a head start, this surely has to be something to consider. It took the Black Plague centuries to finish making its rounds, but ships were slow and few in number by comparison, and the rest of the scant number of travelers were walking or using draft animals. Today, planes, trains, automobiles, buses and subways can accelerate such transmissions from years to a matter of days or even hours.

It seems to me that part of any screening process for new migrants should include such testing. And both business and leisure travel to other countries by citizens should include some sort of screening either before they leave to come home or as soon as they arrive. Expensive? Yes. Time consuming? At least to a degree, certainly. Invasive? You could probably say that. But do you really want to rerun 1918 all over again?