Ebola Outbreaks - Latest Updates

What is Ebola?

Ebola is a viral disease that causes serious hemorrhagic fever and nausea and can lead to multiple organ failure and death.  Ebola first appeared in Africa in 1976 and has reoccurred frequently since that time.  However, those outbreaks were limited to remote rural areas; therefore, it was easier for healthcare systems to better control their spreading as infected regions were confined in limited geographic spread.  Current Ebola outbreaks are affecting urban and largely populated regions and cities in Liberia, Guinea and Sierra Leone in West Africa.  According to the World Health Organization (WHO), the number of Ebola cases has reached over 6,000 with very high mortality rate, often estimated at 70%.  This is the reason why these outbreaks have raised concerns for possible transfer and spread to other countries, including some neighboring countries such as Mali, Côte d’ivoire, etc. as well as globally through humanitarian activities and global trades and travels.

How does Ebola get transmitted?

It is very important to know that Ebola is NOT transmitted through air like the common cold or flu or other common illnesses.  Ebola transmission happens ONLY through direct contact with infected persons’ bodily fluids (such as blood, saliva, etc.). We know now that many Ebola infections in West Africa happen because of local burial traditions where people are in direct contact with the dead bodies as well as the lack of good healthcare system and hygiene. 

Travel Precautions and Information:

Most of the Ebola affected countries have implemented screenings at airports and border crossings with monitoring of high fever or other illness symptoms.

Individuals who have been exposed to Ebola should NOT travel on commercial flights and should be monitored for 21 days (Ebola’s maximum incubation period). 

Business Travels:  The U.S. Center of Disease Control (CDC) advises postponing business related travel to regions where Ebola outbreaks are occurring.  If travel to affected regions is required, the WHO and CDC suggest the following precautions:

·    Avoid contact with animals (alive or dead) and assure that any milk consumed is pasteurized and meat is thoroughly cooked.

·         Avoid close or unprotected contact with sick people

·         Take good precaution for personal hygiene such as thorough hand and feet washing.

·         Discuss with their physician for appropriate vaccination and other vaccination.

If employees traveling to affected regions remark symptoms such as high fever,  running nose, nausea, headache, should stay and seek medical care LOCALLY before returning home.  This would help minimize the risk of the disease spread while traveling.  They should use healthcare facilities with good track record of infection control and reach out to organizations such as Médecins Sans Frontières (MSF), the WHO or local NGOs.

Latest Updates - November 1st:

Brazil - Screens air passengers from West Africa for Ebola: Air passengers from the three West African countries hardest hit by Ebola will be screened at Brazilian airports, the authorities announced. As from Friday, passengers from Guinea, Liberia and Sierra Leone must undergo a body temperature check and claim their health status at airports, Health Minister Arthur Chioro told a press conference. They will also be given a pamphlet with information on the symptoms of Ebola and where to seek medical attention in Brazil in case they come up with any signs of the disease. The measures are already in place at Brazil's busiest airport, Guarulhos Airport in Sao Paulo, Chioro said, adding that they will be extended to other airports in November. As there are no direct flights to Brazil from West Africa, the risk of an Ebola outbreak in the South American nation is "extremely low," Chioro said. He dismissed the possibility of implementing stricter controls, such as travel bans to the affected countries or bans on passengers from those countries. So far, there have been two suspected cases of Ebola in Brazil, but both tested negative.

Canada - Amid Ebola scare, Canada restricts visas: Canada's Conservative government said it is suspending visa applications for residents and nationals of countries with "widespread and persistent-intense transmission" of the Ebola virus. With Friday's decision, Canada joined Australia in suspending entry visas for people from Ebola-stricken countries in West Africa in an attempt to keep the deadly disease away. Canada has not yet had a case of Ebola. Canadians, including health-care workers, in West Africa will be permitted to travel back to Canada, the government said. The countries most severely hit by the worst Ebola outbreak ever are Liberia, Sierra Leone and Guinea. Canada receives very few travelers from those countries, which have no direct flights to Canada. A similar move by Australia was slammed Wednesday by Dr. Margaret Chan, the World Health Organization's director general, who said closing borders won't stop spread of the Ebola virus. Canadian Health Minister Rona Ambrose said in a statement the "number one priority is to protect Canadians." Canadian Immigration Minister Jason Alexander said the government would act in the "best interests of Canadians." Kevin Menard, a spokesman for Alexander, said the move is similar to but a bit less restrictive than the one the Australian government announced this week. He later called it "considerably different." "We have instituted a pause, but there is room for discretion and if we can be assured that someone is not infected with Ebola," Menard said in an email after declining to comment on the phone. He said the government was "doing anything we can to keep Ebola from coming to Canada." Nancy Caron, a spokesman for Citizenship and Immigration Canada, said that "a number of African countries have imposed stricter travel bans as have several other countries around the world. Other countries such as the United States have started to place restrictions on travelers from countries with Ebola outbreaks." The government said Canadian citizens or foreign nationals with a visa and foreign nationals who do not require visas will continue to be screened at ports of entry in Canada and will be subject to appropriate health screening. Declining to criticize the move, an Obama administration official said Friday that Canada remains an important partner in the effort to stop Ebola. The official was not authorized to discuss diplomatic relations by name and spoke on condition of anonymity. Stephane Dujarric, a spokesman for the United Nations secretary-general, said the world body welcomed Canada's support in fighting the Ebola outbreak but also advocated "against isolating the three most impacted countries and stigmatizing its citizens." David Fidler, an international law professor at Indiana University, said the moves by Canada and Australia place both countries in violation of the International Health Regulations, a 2005 World Health Organization treaty to which both are signatories. The treaty "just seems to be disintegrating in this Ebola panic," Fidler said. "And to have countries like Australia and Canada be in the forefront of this is even more disheartening," he said, because they had been supportive of the international treaty meant to prevent panic during such a health crisis. New Democrat Libby Davies of the Canadian opposition also criticized the visa ban, citing criticism by the World Health Organization and the World Bank and questioning the announcement's timing. "Sending this announcement on a Friday afternoon only worsens concerns that this policy is a public relations exercise, and irresponsibly ignorant of what health experts have advised," she said.? The International Health Regulations are designed to help the world fight infectious disease outbreaks that have the potential for international spread. They were revised and strengthened in the wake of the 2003 SARS outbreak. The 2003 outbreak in Asia and Canada of SARS, or severe acute respiratory syndrome, led the World Health Organization to issue travel advisories directing people around the world to avoid places battling severe outbreaks. Ontario's then health minister, Tony Clement — now a federal cabinet minister— was among those incensed by the WHO's move. Clement led a delegation to Geneva to successfully demand the WHO rescind the travel advisory against Toronto. Health officials say that more than 13,700 people have been sickened by Ebola, and nearly 5,000 have died. The hardest hit countries of Liberia, Sierra Leone and Guinea have resorted to extraordinary measures to combat it. Canada has donated 800 vials of an experimental Ebola vaccine to WHO. The vaccine, developed by the Public Health Agency of Canada and known as VSV-EBOV, has been sent to the U.S. Walter Reed Army Institute of Research in Maryland for testing on healthy volunteers, with preliminary results about its safety expected by December. The next stage would be to test it more broadly, including among those directly handling Ebola cases in West Africa.

United Kingdom: Staff at GP practices around the country have been provided with step-by-step guidance on handling patients suspected of having Ebola. The advice, from the Royal College of General Practitioners (RCGP), aims to minimise the risk to healthcare workers and other patients. Although the UK is considered at low risk from Ebola, Secretary of State for Health Jeremy Hunt has warned the country to expect "a handful" of cases by Christmas. Any patient arriving at a GP surgery with a possible case of Ebola will be asked to go to an isolation room and will be assessed by the duty doctor over an internal telephone system. If Ebola is still considered a possibility, GPs are asked to alert an infectious disease specialist at their local hospital and warn local public health protection teams. The guidance, issued in the form of index cards, has been tailored for each individual member of staff at GP practices including receptionists, duty doctors and practice managers. If follows Ebola guidance issued by Public Health England to GP surgeries last month, which warned that practices may have to be temporarily closed if patients with symptoms such as bleeding, vomiting or diarrhoea are suspected of having Ebola. Receptionists are advised to ask patients displaying symptoms of fever, headache, muscle pain, vomiting, diarrhoea or abnormal bleeding whether they have been abroad in the past 21 days, and whether they have been to West Africa. In the new guidance, GPs are told that isolation rooms and toilets potentially visited by an Ebola patient should not be used until assessed by a health-protection team.

United States - Ebola fears hit another New Orleans’ health convention: A major U.S. public health organization has become the second group impacted by Gov. Bobby Jindal’s Ebola response policy as it prepares to bring 14,000 people to New Orleans. State health officials advised the American Public Health Association that registrants recently returned from Ebola-stricken countries and those who have treated patients stateside should stay home. “We vigorously disagree. It’s not scientifically based, as it needs to be,” Dr. George Benjamin, executive director of the APHA, said Friday. “We respect their right to have that opinion. We will abide by it and share it with our members.” The conference is scheduled for Nov. 15-19. The same message earlier went to the American Society of Tropical Medicine and Hygiene, which opens its big annual meeting in New Orleans on Sunday. The group’s leadership also noted its strong disagreement with the policy. State Department of Health and Hospitals communications director Olivia Watkins said the state policy applies equally to Louisiana residents and visitors to the state. Louisiana residents returning from an Ebola-impacted West African nation must be monitored for 21 days, as well as refrain from public transportation. “As we are aware of conferences that may have participants that may meet the travel or exposure criteria, we will issue similar guidance as needed,” Watkins said. Benjamin said the number of Public Health conference registrants impacted by the state’s position would be minimal. On one conference day, a morning-long session is planned involving “important health features of the Ebola virus disease epidemic in West Africa and the roles of public health professionals in addressing this major epidemic.” Benjamin said none of the scheduled speakers would be impacted by the state policy. Benjamin said people infected with the Ebola virus first have to exhibit symptoms before they are contagious. “Even when you get symptoms, the risk of infecting someone is extremely low,” he said. The medical professionals who have been treating Ebola-infected patients at hospitals get to go home every day, Benjamin said. In addition, the family members of those who elect to self-quarantine also go out of their residences every day, he said. Benjamin said state officials said they want to treat everyone in the same way whether it be Louisiana residents or anyone coming to the state. “We just disagree that it’s necessary,” he said.