A MAN collapses at an international airport: It’s a hackneyed scene from almost every plague film ever made. But now it has happened — airports around the world are on high alert as fears mount that the deadly Ebola virus is on the move.

Nigerian health authorities are racing to stop the spread of the flesh-eating Ebola virus after a man sick with one of the world’s deadliest diseases carried it by plane to Lagos, Africa’s largest city with 21 million people.

Nigeria is so concerned it has ordered the establishment of “disease isolation centres” at international airports across the country to prevent any further entry of the untreatable disease.

But the horse may have already bolted.

WHO Regional Director for African Region said #Ebola outbreak can be contained w/ known prevention, control measures http://t.co/Z6lnSji0ke — WHO (@WHO) July 27, 2014

Not only did the passenger come into contact with people at the megacity’s main airport and in the aircraft itself, he’d spent time in an airport at the uninfected African country of Togo where his flight had a scheduled stopover.

ISOLATING DESPAIR: Doctor tells of Ebola outbreak horror

Any number of the passengers, staff — and even visitors — to these places may have already been exposed. Togo is now on high alert as it government fears it will become the fifth African nation to be afflicted by the poorly understood virus.

Airports in Guinea, Liberia and Sierra Leone, the three other West African countries affected by the current Ebola outbreak, have implemented preventive measures, according to officials in those countries. But none of the safeguards are foolproof, say health experts.

IS EBOLA HEADED OUR WAY? A look at the spread of the virus

The head of efforts in Liberia to contain the Ebola outbreak, Dr Lance Plyler, says that such screening may help slow the spread of the disease — but it was no guarantee it wouldn’t be spread by aircraft travellers.

Seek medical care immediately if in contact w/ a person known, suspected to have #Ebola & beginning to show symptoms http://t.co/Jfs4gVGXxY — WHO (@WHO) July 26, 2014

“Unfortunately the initial signs of Ebola imitate other diseases, like malaria or typhoid,” he said.

Federal Aviation Authority of Nigeria spokesman Yakubu Dati confirmed health officials were now working at airports, sea ports and land border crossings.

“They are giving out information ... on what to do, what to look out for,” he said.

Preparations include the setting up of secure holding rooms where any potential cases would be isolated.

This is by far the deadliest ever Ebola outbreak.

Some 670 deaths have been reported since it was declared an outbreak earlier this year.

Most have been in remote and regional areas. The largest population centre so far affected is Conakry, capital of Guinea.

EBOLA: • Avoid handling live or dead wild animals. Some species of animals besides primates may carry the Ebola virus. — NEMA Nigeria (@nemanigeria) July 26, 2014

Last week, the West African nation of Sierra Leone had a “Typhoid Mary” scare where an Ebola-infected woman escaped into their capital city of Freetown. She has since turned herself in — and died in an ambulance on the way back to hospital.

Any outbreak in the Nigerian city of Lagos, where a large portion of its population live in squalid, close conditions, could prove catastrophic.

“Lagos is completely different from other cities because we’re talking about millions of people,” said Plan International’s Disaster Response and Preparedness Head, Dr. Unni Krishnan.

‘CONSULTANT’ CARRIED THE DISEASE

Patrick Sawyer, a consultant for the Liberian Ministry of Finance arrived in Nigeria on Tuesday last week and was immediately detained by health authorities suspecting he might have Ebola, according to Dr Lance Plyler, who heads Ebola medical efforts in Liberia for aid organization Samaritan’s Purse.

Any people who are suspected to have #Ebola virus disease should be reported to the nearest health unit without delay http://t.co/Jfs4gVGXxY — WHO (@WHO) July 26, 2014

On his way to Lagos, Sawyer’s plane also stopped in Lome, Togo, according to the World Health Organisation.

Authorities announced on Friday that blood tests from the Lagos University Teaching Hospital confirmed Sawyer died of Ebola earlier that day.

Sawyer reportedly did not show Ebola symptoms when he boarded the plane, Plyler said, but by the time he arrived in Nigeria he was vomiting and had diarrhoea. There has not been another recently recorded case of Ebola spreading through air travel, he added.

Nearly 50 other passengers on the flight are being monitored for signs of Ebola but are not being kept in isolation, said an employee at Nigeria’s Ministry of Health, who insisted on anonymity because he was not authorised to speak to the press.

Ebola virus disease Key facts: Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, is a... http://t.co/IVjw4TFAR3 — NOA Nigeria (@NOA_Nigeria) July 25, 2014

Sawyer’s sister also died of Ebola in Liberia, according to Liberian officials, but he claimed to have had no contact with her. Ebola is highly contagious in unsanitary conditions and kills more than 70 per cent of people infected.

The virus is believed to have originated among fruit bats.

HOW FAR CAN EBOLA SPREAD?

The spread of Ebola requires contact with bodily fluids - making the untreatable virus possible to contain.

Toronto-based international infectious disease specialist Kamran Khan told NPR: “The chance of Ebola spreading out of West Africa is very, very low. But if it did spread, Paris is probably the first city on the list.”

The specialist studies how viruses move around the globe in an effort to predict the spread of major contagens.

The key factors here, he said, were how many people had the infection and how many of them travel: “The big question is whether sick people are going to get on a plane and spread the disease.”

#HNNHealth #Ebola virus epidemic causes #Nigeria's ARIK airline to suspend flights to Liberia, Sierra Leone — KemiOmololuOlunloyo (@HNNAfrica) July 27, 2014

The city currently experiencing the worst Ebola outbreak is Conakry, in Guinea. About 10 per cent of the flights out of this city’s airport, he explains, end up in Paris.

If Ebola were to establish itself in a nation such as Nigeria, with international airports sending flights to all the world’s major hubs, the equation gets more confused.

Cities such as Hong Kong, Singapore and London could also be among the first to record cases.

A Qantas spokesperson said the World Health Organisation had implemented strict constraints to ensure the disease was contained in West Africa and at the moment the airline was operating as normal. Qantas only flies into Johannesburg in South Africa.

What is Ebola? Ebola virus disease is a severe and often fatal illness. There is no specific treatment and outbreaks have a mortality rate of up to 90%.

Earlier this month, the Centers for Disease Control and Prevention (CDC) in the US updated its guidelines for managing passengers on board an aircraft if Ebola virus is suspected.

The guidelines state that crew members on a flight with a passenger or other crew member who is ill with a fever, jaundice, or bleeding and who is travelling from an Ebola risk area should keep the sick person separated from other passengers as much as possible, provide them with a surgical mask; and to wear disposable gloves for direct contact with blood or other body fluids.

The guidelines also state the captain of any airliner bound for the United States with a passenger with Ebola-like symptoms on board is required by law to report to the Centers for Disease Control and Prevention.

Nigerian health official Mr Yakubu Dati said screening would examine passenger manifests to determine who had been to areas afflicted by the virus and could therefore be potential carriers.

The screening centres were being set up to prevent further arrivals of the disease in Nigeria, he told Punchng.com

“It is for international airports and international points of entry. Ebola is not in Nigeria. So, our strategies are for the points of entry,” he said.

There is no specific treatment to cure #Ebola, but some patients will recover w/ appropriate medical care http://t.co/yYD8uPBO9r — WHO (@WHO) July 26, 2014

EARLY SYMPTOMS ‘COMMON’

Some of Ebola’s symptoms are similar to other diseases — and it has an unpredictable incubation period. A person can carry the disease for anywhere between two and 22 days before diagnosis is possible.

There is no known cure for Ebola, which begins with fever and sore throat and escalates to vomiting, diarrhoea and internal and external bleeding.

#Ebola symptoms: Sudden onset of fever, intense weakness, muscle pain, headache and sore throat http://t.co/pxSHAodnE5 — WHO (@WHO) July 25, 2014

The World Health Organisation says the disease is not contagious until a person begins to show symptoms.

Ebola is passed by touching bodily fluids of patients even after they die. Traditional tribal burials that include rubbing the bodies of the dead contribute to the spread of the disease.

There is no “magic bullet” treatment for Ebola, but early detection and treatment including fluids and nutrition can be effective. Quickly isolating patients who show symptoms is also crucial in slowing the spread of the disease.

West African hospital systems have weak and “often paralysed” health care systems and are not usually equipped to handle Ebola outbreaks. International aid organisations have stepped in, but they also lack enough funding and manpower. “We need more humanitarian workers,” one aid worker said. “We need resources.”

AID WORKERS AFFLICTED

A US doctor working with Ebola patients in Liberia had tested positive for the deadly virus late last week, and now a second US health worker has been diagnosed with the disease.

A news release from US-based Christian relief group Samaritan’s Purse said Dr. Kent Brantly was being treated at a hospital in Monrovia.

Now aid worker Nancy Writebol — who worked at the same medical compound — has tested positive.

The news follows the death last week of prominent Liberian doctor, Samuel Brisbane, after a three-week battle with the virus.

URGENT PRAYER! Medical Director for our Ebola Center in Monrovia, Liberia, has tested positive for the Ebola virus. http://t.co/LfWstRosxI — Samaritan's Purse (@SamaritansPurse) July 26, 2014

“It’s been a shock to everyone on our team to have two of our players get pounded with the disease,’’ Isaacs said. Writebol had been working as a hygienist who decontaminated those entering and leaving the hospital’s Ebola care area, he said.

Both Writebol and Dr. Kent Brantly, the 33-year-old medical director at the centre on the outskirts of the Liberian capital, Monrovia, have been isolated and are under intensive treatment, Isaacs said. Brantly was in stable and in very serious condition, and Writebol was in stable and serious condition, he said.

Writebol’s husband, David, told an elder in the church via Skype on Saturday that she was very sick and he couldn’t even enter the same room with her, according to the Rev. John Munro, pastor of Calvary Church in North Carolina. The church has sponsored her work with SIM, or Serving in Mission, which runs the hospital where Samaritan’s Purse has the Ebola care centre.

People who have died of #Ebola must be handled using strong protective clothing and gloves, buried immediately http://t.co/3dZ5fD2Zn3 — WHO (@WHO) July 25, 2014

“We are hopeful and prayerful,” Isaacs told The Associated Press by telephone.

Health workers are at serious risk of contracting the disease, due to its spread through contact with bodily fluids.

Early treatment improves a patient’s chances of survival, and Brantly recognised his own symptoms and began receiving care immediately, said Melissa Strickland, a spokeswoman for Samaritan’s Purse.