The largest, and to date deadliest, outbreak of Ebola Virus Disease (EVD) has overrun the health care capabilities and facilities of several western African nations and is stoking fears of global spread now that it has crossed the seas to America and possibly Europe.
In the United States, an American missionary doctor, who was infected with the Ebola virus in Liberia while tending to patients, has been evacuated to the Emory University Hospital in Atlanta where he was reported to be improving after having received an experimental serum while still in Africa. A fellow missionary was also evacuated to Atlanta after being infected with the virus which, according to the World Health Organization (WHO), has a fatality rate of up to 90 per cent.
WHO notes that the Ebola virus was originally introduced into the human population through close contact with the blood, secretions, organs, or bodily fluids of infected animals (chimpanzees, gorillas, fruit bats, monkeys, forest antelopes) and has subsequently spread into the community through human-to-human transmission. The Telegraph in the UK has also reported that doctors in Wales have confirmed that several Britons have voluntarily quarantined themselves after coming into contact with infected people in western Africa.
The Ebola virus is closely related to the Marburg virus; both are marked by severe bleeding, organ failure, and high fatality rates. They are native to Africa, where sporadic outbreaks have occurred since Ebola was first identified in 1976 in Sudan and the Democratic Republic of Congo. The current outbreak is by far the most widespread, affecting large areas of Liberia, Sierra Leone, Guinea, and more recently Nigeria. According to WHO, as of April 1, over 1,600 people have been infected with the virus in recent months resulting in 887 deaths, including as many as 61 new deaths in two days just prior to August 1.
Related: Travel Alert: Ebola
According to our survey of advisories from the WHO, the US Centers for Disease Control and Prevention, the Mayo Clinic, and public health agencies in Canada and the UK:
Ebola and Marburg viruses live in animal hosts, and humans can contract them from infected animals. Butchering or eating infected animals can spread the virus; so can other physical contact. After the initial transmission from animal to human, the viruses can spread from person to person through contact with bodily fluids—sweat, saliva, urine, blood. They are not spread through the air or by touching doorknobs or toilet seats. In this respect, transmission of the Ebola virus is far different than was transmission of SARS in 2003, and is more akin to transmission of HIV, the AIDS virus. There is also no evidence that the Ebola virus can be spread by insect bites.
Early signs and symptoms of Ebola infection include fever, severe headache, joint and muscle aches, chills, and weakness. Over time, symptoms become more severe and may include nausea and vomiting, diarrhea (may be bloody), bruising, internal bleeding (usually from the eyes, or in the most severe cases from the ears, nose, and rectum), chest pain and cough, severe weight loss, and stomach pain.
To date, there are no vaccines that might protect people from infection, or medications to treat them once they are infected, although an infected American doctor treated with an experimental serum while still in Liberia is reporting to be making good progress in an Atlanta hospital.
Check your travel insurance
Clearly, travel to western Africa poses the greatest risk of infection. If you don’t have to go, don’t. The US and Canadian governments have raised “Avoid Non-Essential Travel” warnings for large sectors of western Africa, which means that your travel insurance could be severely limited if you venture into the “warning alert” areas. You need to check with your government websites before you leave on your trip and at least daily while travelling.
At this point, there is no valid reason for you to curb travel plans outside of the designated areas in western Africa, so long as you have travel insurance and/or trip cancellation or interruption coverage. But you need to be vigilant and up-to-date on this serious threat now that it has broken out of its local confines and impacted the chain of human-to-human transmission.
And you also need to follow the basic rules of good health:
- Avoid areas of known outbreaks
- Wash your hands frequently
- Avoid bush meat
- Avoid contact with infected people (their bodily fluids and tissues, blood, semen, vaginal secretions, saliva)
- Follow infection-control procedures (particularly if you’re a health care worker)
Stay with us when travelling or making travel plans. We’ll keep you updated.