Ebola outbreak could lead to an economic disaster in West Africa for years to come

The virus is predicted to cost the region affected up to £20bn by the end of next year

Promise Cooper, 16, fills a bottle with chlorine solution, helped by community worker Kanyean Molton Farley (Jerome Delay/AP)

The world is finally attempting to defend itself against a virus without borders. From Madrid to New York, from Conkary to Dallas to Freetown, a now familiar routine is being followed: quarantine, isolation, death.

The projections – the number of deaths from Ebola will double, and continue to rise, perhaps up to 1.4 million cases by January according to one estimate – inspire fear. Already 4,000 are dead, 3,700 children have become orphans. Many more have died but are not registered on World Health Organisation estimates.

Barely an hour passes without another body to bury in West Africa. Often, however, they go unburied: the dead are easy to find.

And yesterday, as the fear of Ebola continued to outpace its spread in the West, the first airport in the United States (John F Kennedy in New York) began to screen passengers arriving from West Africa.

"I would rather wait in a long line, and know that I'm not going to catch Ebola," said one passenger yesterday, interviewed by an excitable local television reporter on the concourse at JFK. Customs officials estimate that 150 people travel through JFK from Liberia, Sierra Leone or Guinea to the US per day.

This week, public health workers at JFK will use no-touch thermometers to take the temperatures of the travellers; those who have a fever will be interviewed and asked if they have had contact with a patient with Ebola. Each of the five airports in the US trying out the screening (JFK, Newark Liberty, Washington Dulles, Chicago O'Hare and Hartsfield-Jackson in Atlanta) have quarantine areas. However, the extra screening probably would not have identified Thomas Eric Duncan when he arrived from Liberia last month, because he had no symptoms while travelling. Duncan, the first person to be diagnosed with Ebola in the US, died on Wednesday in Dallas.

The epidemic is making plenty of headlines now. There have been the Texas patient, the Spanish nurse, the Briton in Macedonia (now proved not to have been an Ebola death), the protest over Excalibur, the "Ebola dog", in Spain.

Three more people were placed under observation at the Carlos III hospital in Madrid, bringing the total number to 16. A nursing assistant infected with the virus, Teresa Romero Ramos, remained in a serious but stable condition yesterday. Those recently quarantined were a nurse who had contact with Ms Romero, a hairdresser who attended to her and a hospital cleaner, a government statement said. None of the 16 in quarantine, who include Ms Romero's husband, as well as five doctors and five nurses, have shown any symptoms. Yesterday, some of them could be seen to be leaning out of windows on the fifth-floor of the hospital, giving victory signs to the assembled media below.

Ms Romero, 44, the first person known to have contracted the disease outside West Africa in the current outbreak, had cared for two Spanish priests who died of Ebola at the hospital, one in August and the other last month. State broadcaster TVE showed journalists asking Jesusa Ramos, Ms Romero's mother, if her daughter was making any improvements. "She seems to be," said Ms Ramos, from her hometown of Becerrea in north-western Spain.

The isolation Guinea, Liberia and Sierra Leone now experience risks plunging the countries – and their neighbours – into an unprecedented economic disaster. Ebola is predicted to cost West Africa up to £20bn by the end of next year, according to the World Bank. The consequences would be particularly pronounced if the epidemic spreads into neighbouring countries, some of which have much larger economies.

Prices will rise, food will become scarce, already desperately needed medicines will be less readily available. The World Bank last week warned of a catastrophe caused by "a slow-containment, High Ebola scenario". It was an opportune time, then, for Sierra Leone's Energy minister, Henry Macauley, to visit London last week, seeking private investment for a national initiative to cater for demand for energy in the country.

He did not, he told the Independent on Sunday, pass through any more stringent checks entering Britain, despite government plans to follow the US's lead and screen travellers. "We needed to come and let the world know that we do intend to look at the period beyond Ebola," he said. "The Ebola issue took the whole world by surprise.

"There is no doubt in my mind that if the world had known, had foreseen, that it would get to this level, from the first case the world would have rushed in to stop it."

He added: "Our government has very little means to fight against this disease … Had we known, we would have taken bigger steps to increase awareness … No one knew that this was looming."

West Africa still awaits medicine and a vaccine to halt Ebola's spread. Mr Macauley pondered the chances of such drugs being distributed. "There is no price on a human life, and I'm sure they will find a way to get it done."

As the western media became increasingly preoccupied with potential Ebola cases across Europe last week, aid workers called for some perspective. Vickie Hawkins, executive director of Médecins Sans Frontières in Britain, said: "Anyone reading the latest reports speculating on the chances that Ebola could reach our shores should spare a thought for the outbreak's real victims – the people of West Africa.

"Every day our teams see first-hand the dire consequences of the outbreak and the glacial pace of the international response … The best way to contain the outbreak is to lend resources, skills and support where they are needed most – in West Africa."

One fewer victim was the Briton reported to have died from the disease in Macedonia. After authorities sealed off a hotel he had stayed in, and put 35 people into isolation, it emerged the man who died last week had not, in fact, had Ebola, although he had symptoms including fever, vomiting and internal bleeding.

"We have just received the results from the lab in Hamburg and they are negative for Ebola, which means that the patient did not have the Ebola virus," said Dr Jovanka Kostovska of the Macedonia Health Ministry's commission for infectious diseases. In the as yet unidentified man's case, it is thought alcohol, not Ebola, was the cause of death.