As the Ebola outbreak continues, here is an update on this rapidly changing situation as well as advice for Global Rescue members regarding travel:

Outbreak Background

The current outbreak of Ebola virus disease (EVD) in West Africa began in Guinea in December of 2013; however it was not identified as Ebola until March 2014.  This delay likely allowed the virus to gain significant traction within the locales where EVD is now present.  By May, EVD spread to Liberia and Sierra Leone, likely aided by very porous regional borders.  EVD was imported to Nigeria by a single sick traveler in July from Guinea, which is not geographically contiguous with any of the original affected countries.  Senegal also reported an imported case in late August. A Senegalese student who had been studying in Guinea was infected, developed symptoms and returned home to Senegal.  There have been no confirmed cases of EVD importation elsewhere in the continent, or world, since the Senegal case.

Current Situation

As of the most recent World Health Organization (WHO) Situation Report dated 18 September, the current total number of cases associated with the West Africa outbreak is 5,335.  This figure includes 2,622 fatalities as of 14 September.  Currently, the only countries affected by the West Africa outbreak are Guinea, Liberia, Sierra Leone, Nigeria, and Senegal.  Widespread transmission exists in Guinea (942 total cases), Liberia (2,710 total cases), and Sierra Leone (1,673 total cases). In Sierra Leone, dozens of new Ebola cases and deaths were recorded as the country concluded its three-day nationwide lockdown on 21 September.  Nigeria, and Senegal have fewer than 25 total combined cases, and thus far have not seen the intense transmission noted in other affected countries.  This is likely due to aggressive isolation efforts within both countries once import-vectors were identified, as well as public-health campaigns and response posturing by international healthcare organizations. 

Unrelated Outbreak – Democratic Republic of Congo

There is an additional outbreak of EVD in Equateur province in the Democratic Republic of Congo.  While the strain identified in the DRC is the same as the strain affecting West Africa, it has been confirmed to be epidemiologically unrelated.  The DRC outbreak is believed to have started in the village of Ikanmongo, where a pregnant woman died on 11 August.  She was reported to have recently butchered a bush animal, and then fell ill with flu-like symptoms.  As of 17 September, there have been 71 cases reported, and 40 fatalities. 

The outbreak zone within the DRC is remote – approximately 1,200 kilometers from Kinshasa.  There are no major transportation routes that connect the zone with other regions of the DRC, and risk of transmission/importation to other major population centers is considered unlikely.  U.N. analysis suggests that the outbreak there is under control at this time

Prevention is primarily guided by awareness of how the disease is transmitted, and practicing safe hygiene.  These preventative measures may include:

• Avoid nonessential travel to Liberia, Guinea, and Sierra Leone.
• If you must travel, please make sure to do the following:
• Practice safe hygiene. Avoid contact with blood and body fluids of people who are sick with Ebola.  Regular hand-washing is essential and highly recommended.
• Do not handle items that may have come in contact with an infected person’s blood or body fluids.
• Avoid funeral or burial rituals that require handling the body of someone who has died from Ebola.
• Avoid contact with wild animals and with raw or undercooked meat (bushmeat).
• Avoid hospitals where Ebola patients are being treated. Global Rescue can provide advice on facilities that are suitable for your needs.

Is it safe to travel during an outbreak?

While travelers should always be vigilant with regard to their health and those around them, the risk of infection for travelers is very low since person-to-person transmission results from direct contact with the body fluids or secretions of an infected patient.

Is it safe to travel to West Africa?

The risk of travelers becoming infected with Ebola virus during a visit to the affected areas and developing disease after returning is extremely low, even if the visit included travel to the local areas from which primary cases have been reported. Transmission requires direct contact with blood, secretions, organs or other body fluids of infected living or dead persons or animals, all of which are unlikely exposures for the average traveler. That being said, the Centers for Disease Control and Prevention (CDC) has issued Level 3 (Avoid Nonessential Travel) notices for Liberia, Guinea, and Sierra Leone.  Should travel to one of these locations be necessary, be mindful of the prevention guidance noted above.