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1
Intro
Epidemic evolution
Available healthcare and cases
per country
Restrictions on crossing borders
and at airports
Travel recommendations
What is Ebola?
Definitions
Precautions
Q&A
Contact & sources
While the outbreak is still not contained and expected to last for the next six
months, an increasing number of neighbouring countries have closed their
borders with the affected countries during the week.
This week-end, Democratic Republic of Congo has reported several
confirmed cases of Ebola in the remote Northern Equateur province. This
outbreak is not considered in any way related with the ongoing outbreak in
West Africa . Quarantine measures in a radius of 100 km around the location
have been announced by the Ministry of Health and no travel advisories for
Congo Have been issued.
Health workers are paying a heavy toll to the disease with 240 of them
infected and 120 fatalities. This is creating a lack of medical staff in health
facilities which are already overwhelmed. WHO is calling for international
support from the healthcare professionals.
An experimental treatment (ZMAPP) which had thus far never been tested in
humans has raised hopes after the recovery of two US aid workers who were
discharged from hospital after being given the treatment. It has not been
confirmed that the treatment was the reason for the cure. A Japanese
company has announced introduction of an antiviral medication that may
help counteract the Ebola virus, but it is in very early stages and untested on
animals or humans. Therefore it is important to keep in mind that Ebola
remains a disease without available specific treatment.
Locally the risk remains low for (non- healthcare workers) expatriates or
travellers who follow strict hygiene rules by avoiding close contact with the
patients or contaminated materials in high risk environments. However,
expect a heightened state of alert related to the outbreak, resulting in more
restrictions on travel. Additionally, expect that transportation entities and
government authorities will act very cautiously to enable evacuation of any
ill or injured foreigners in Ebola affected areas.
For all above reasons, AXA Assistance’s recommendation remains to avoid
or interrupt any travel to the countries of Guinea, Sierra Leone, Liberia for
non- essential personnel.
Dr Cai Glushak
International Chief Medical Officer
Legend
Update of information
August 27,2014
2
Intro
Epidemic evolution
Available healthcare and cases
per country
Restrictions on crossing borders
and at airports
Travel recommendations
What is Ebola?
Definitions
Precautions
Q&A
Contact & sources
This outbreak started in March 2014 in Guinéa and rapidly spread
to Sierra Leone and Liberia, and then to Nigeria.
Disease activity has been most concentrated in the primary
epicenter, Gueckedou, located in the Forestiere region along the
Guinea-Sierra Leone border. However, significant foci have also
appeared in coastal Guinea near Conakry, coastal Sierra Leone
near Freetown, and coastal Liberia near Monrovia.
On August 24, the Democratic Republic of Congo's health minister
said two Ebola deaths have been confirmed in the Equateur
province in the north-west of the country. These cases of Ebola
have not been confirmed by the WHO. According to the Minister,
the outbreak in this country has "nothing to do with the one in
West Africa".
At the present stage, the Ebola outbreak is considered as an
epidemic by the WHO. Friday 8th August, The World Health
Organization says the Ebola epidemic constitutes a "Public Health
Emergency of International Concern (PHEIC)".
This outbreak started in March 2014 in Guinéa and rapidly spread
Disease activity has been most concentrated in the primary
epicenter, Gueckedou, located in the Forestiere region along the
ne border. However, significant foci have also
appeared in coastal Guinea near Conakry, coastal Sierra Leone
near Freetown, and coastal Liberia near Monrovia.
On August 24, the Democratic Republic of Congo's health minister
confirmed in the Equateur
west of the country. These cases of Ebola
have not been confirmed by the WHO. According to the Minister,
the outbreak in this country has "nothing to do with the one in
e Ebola outbreak is considered as an
epidemic by the WHO. Friday 8th August, The World Health
Organization says the Ebola epidemic constitutes a "Public Health
3
Guinea : suspected and confirmed case count : 607
Suspected case deaths: 406
Laboratory confirmed cases: 443
Sierra Leone : suspected and confirmed case count : 910
Suspected case deaths: 392
Laboratory confirmed cases: 804
Liberia : suspected and confirmed case count : 1082
Suspected case deaths: 624
Laboratory confirmed cases: 269
Nigeria : suspected and confirmed case count : 16
Suspected case deaths: 5
Laboratory confirmed cases: 12
In Guinea, Sierra Leone and Liberia: the healthcare system is very limited with
lack of medical facilities and hospital equipment.
Reliable medical facilities, able to provide minimum level of care, are to be found
in the capital cities only. Some private medical facilities offer a better range of
treatment options than public facilities but are still well below global standards.
There are no ambulance or emergency rescue services and trauma care is
extremely limited.
Hospitals and medical facilities are very poorly equipped and are barely able to
provide basic care. Emergency services similar to those existing in western
countries are non-existent, and the blood supply is unreliable and unsafe for
transfusion. Medicines are scarce, often beyond expiration dates, and generally
unavailable in most areas. Sterilization of equipment should not be assumed.
Treatment is frequently unreliable.
The level of sanitation throughout urban areas is very poor, which increases the
potential for disease transmission. Upper respiratory infections and diarrhea are
common, as well as more serious diseases like, cholera typhoid and malaria.
In Nigeria: the level of health care is poor in the whole country; the only few
good quality medical facilities are located in Lagos and Abuja
Intro
Epidemic evolution
Available healthcare and cases
per country
Restrictions on crossing borders
and at airports
Travel recommendations
What is Ebola?
Definitions
Precautions
Q&A
Contact & sources
4
Intro
Epidemic evolution
Available healthcare and cases
per country
Restrictions on crossing borders
and at airports
Travel recommendations
What is Ebola?
Definitions
Precautions
Q&A
Contact & sources
Curfew
Liberia
The government of Liberia has imposed a nationwide 2100-0600 curfew.
Movement into or out of West Point (due north of Roberts International
Airport (ROB)) in Monrovia and Dolo's Town in Margibi County is prohibited
due to government quarantines.
5
International airports
Guinea
Liberia
Payne Airport (MLW)
Intro
Epidemic evolution
Available healthcare and cases
per country
Restrictions on crossing borders
and at airports
Travel recommendations
What is Ebola?
Definitions
Precautions
Q&A
Contact & sources
Sierra Leone
Freetown
Nigeria
Abuja
Lagos
Port
All passengers departing from all major international
airports must fill out a health form and have their
temperature taken.
At this level of the
been enforced by the authorities. Travelers should check restrictions before
travelling.
International airports
Guinea: Conakry - Gbessia International Airport (CKY)
• Remains open.
• The only entry point by air in Guinea / chartered aircraft are able to
leave Guinea from any open airport.
• Medical teams from the Pasteur Institute of Paris and various French
NGOs are positioned on site for specific assistance to Guinean sanitary
authorities.
• All passengers departing from the capital city’s airport must fill out a
health form and have their temperature taken.
Liberia: Monrovia - Roberts International Airport (ROB) & Monrovia
Payne Airport (MLW)
• Remain open.
• The only entry points by air in Liberia.
• All passengers departing from the capital city’s airport must fill out a
health form and have their temperature taken.
Sierra Leone:
Freetown - Lungi International Airport (FNA)
• Remains open.
• The only entry point by air in Sierra Leone.
• From Freetown city, only reachable by boat, ferry,
overcraft or helicopter (30 mn)
All passengers departing from the capital city’s airport
must fill out a health form and have their temperature
taken.
Nigeria:
Abuja - Nnamdi Azikiwe Intl. Airport (ABV),
Lagos - Murtala Muhammed Intl. Airport (LOS),
Port-Harcourt - Omagwa Intl. Airport (PHC)
All passengers departing from all major international
airports must fill out a health form and have their
temperature taken.
At this level of the outbreak, a number of travel restrictions have already
been enforced by the authorities. Travelers should check restrictions before
travelling.
Gbessia International Airport (CKY)
by air in Guinea / chartered aircraft are able to
edical teams from the Pasteur Institute of Paris and various French
NGOs are positioned on site for specific assistance to Guinean sanitary
departing from the capital city’s airport must fill out a
health form and have their temperature taken.
Roberts International Airport (ROB) & Monrovia - Spriggs
All passengers departing from the capital city’s airport must fill out a
health form and have their temperature taken.
rom Freetown city, only reachable by boat, ferry,
All passengers departing from the capital city’s airport
must fill out a health form and have their temperature
All passengers departing from all major international
outbreak, a number of travel restrictions have already
been enforced by the authorities. Travelers should check restrictions before
6
Intro
Epidemic evolution
Available healthcare and cases
per country
Restrictions on crossing borders
and at airports
Travel recommendations
What is Ebola?
Definitions
Precautions
Q&A
Contact & sources
Flight suspension
Sched
to the Ebola outbreak (alphabetical order: name [IATA code + hub]):
AFRICAN AIRCARRIERS
- Air Côte d'Ivoire [HF / Abidjan]
- Arik Air [W3 / Lagos + Abuja]
- Asky [KP / Lomé]
- Ca
- Douniah Airlines [DH / Bamako]
- Eagle Atlantic Airlines [E2 / Accra]
- Gambia Bird Airlines [3G / Banjul]
- Kenya Airways [KQ / Nairobi]
- Mauritania Airlines International [L6 / Nouakchott]
- Senegal Airlines [DN / Dakar]
OTHER
- British Airways [BA / Londres]
- Emirates [EK / Dubaï]
Flight operations to any areas affected by or suspected of being affected by
Ebola could be suspended anytime with little notice by governments or air
Borders (air+land)
Guinea
Senegal closed its
Ivory Coast closed its borders with Guinea on Aug 23.
Sierra Leone
However, the border is porous.
regions since 06/08/2014.
Liberia
Ivory Coast closed its borders with Liberia on Aug 23.
State of emerg
However, the border is porous.
Nigeria
Highway 7 (TAH7) bet
State of emergency declared since 09/08/2014.
On August 18th, Cameroon has c
and suspended all flights to and from Nigeria.
Flight suspension
Scheduled Airlines having suspended their flights to the concerned countries due
to the Ebola outbreak (alphabetical order: name [IATA code + hub]):
AFRICAN AIRCARRIERS
Air Côte d'Ivoire [HF / Abidjan]
Arik Air [W3 / Lagos + Abuja]
Asky [KP / Lomé]
Camair-Co [QC / Douala]
Douniah Airlines [DH / Bamako]
Eagle Atlantic Airlines [E2 / Accra]
Gambia Bird Airlines [3G / Banjul]
Kenya Airways [KQ / Nairobi]
Mauritania Airlines International [L6 / Nouakchott]
Senegal Airlines [DN / Dakar]
OTHER AIRCARRIERS
British Airways [BA / Londres]
Emirates [EK / Dubaï]
Flight operations to any areas affected by or suspected of being affected by
Ebola could be suspended anytime with little notice by governments or air
Borders (air+land)
Guinea closed its borders with Sierra Leone and Liberia on 09/08/2014.
Senegal closed its borders with Guinea on Aug 21.
Ivory Coast closed its borders with Guinea on Aug 23.
Sierra Leone: land borders closed since 31/07/2014 + state of emergency declared
However, the border is porous. Total sanitory blocade on Kénéma and Kailahun
regions since 06/08/2014.
Liberia: land borders officially closed since 27/07/2014.
Ivory Coast closed its borders with Liberia on Aug 23.
State of emergency declared since 06/08/2014.
However, the border is porous.
Nigeria: land border remain open, especially at the border post on the Trans African
Highway 7 (TAH7) between Lagos and Cotonou (Benin).
State of emergency declared since 09/08/2014.
On August 18th, Cameroon has closed its borders (land, sea and air) with Nigeria
and suspended all flights to and from Nigeria.
uled Airlines having suspended their flights to the concerned countries due
to the Ebola outbreak (alphabetical order: name [IATA code + hub]):
Mauritania Airlines International [L6 / Nouakchott]
Flight operations to any areas affected by or suspected of being affected by
Ebola could be suspended anytime with little notice by governments or air
eone and Liberia on 09/08/2014.
Ivory Coast closed its borders with Guinea on Aug 23.
: land borders closed since 31/07/2014 + state of emergency declared.
Total sanitory blocade on Kénéma and Kailahun
cially closed since 27/07/2014.
Ivory Coast closed its borders with Liberia on Aug 23.
land border remain open, especially at the border post on the Trans African
ween Lagos and Cotonou (Benin).
losed its borders (land, sea and air) with Nigeria
7
A number of authorities have started to issue travel advisories. In the wake of the United States Centers for
Disease Control and Prevention (CDC) statement of July 31st
, US nationals should defer non essential travel to
the Ebola Virus Disease (EVD)-affected countries of Sierra Leone, Guinea, and Liberia. Several other countries
have issued similar travel recommendations. These include:
Australia: www.smartraveller.gov.au/zw-cgi/view/TravelBulletins/Ebola
Canada: http://travel.gc.ca/travelling/health-safety/travel-health-notices/ebola
France (French): www.diplomatie.gouv.fr/fr/conseils-aux-voyageurs/infos-pratiques-20973/article/virus-ebola-
guinee-forestiere
Germany (German)
Guinea: www.auswaertiges-amt.de/DE/Laenderinformationen/00-SiHi/GuineaSicherheit.html
Liberia: http://www.auswaertiges-amt.de/DE/Laenderinformationen/00-SiHi/LiberiaSicherheit.html
Sierra Leone: www.auswaertiges-amt.de/DE/Laenderinformationen/00-SiHi/SierraLeoneSicherheit.html
The WHO has not yet recommended travel or trade restrictions for Ebola-
affected countries. However, the organization is reviewing terms with air
authorities and other global travel officials to devise communication. The
WHO likely remains reluctant to issue restrictions because of the many
economic and political ramifications that may befall a nation when facing a
global suspension of travel. Since it is up to national health officials to
determine the risk threshold for the nation it represents, many countries have
issued their own travel recommendations urging travelers to defer
nonessential travel to Sierra Leone, Guinea, and/or Liberia. Furthermore,
many countries - especially in or near West Africa - have increased health
screenings at border checkpoints and at international airports. Several airlines
have suspended service to Sierra Leone and Liberia due to Ebola concerns, and
authorities in Sierra Leone and Liberia have implemented a number of
response actions in an attempt to contain the spread of disease.
Intro
Epidemic evolution
Available healthcare and cases
per country
Restrictions on crossing borders
and at airports
Travel recommendations
What is Ebola?
Definitions
Precautions
Q&A
Contact & sources
AXA Assistance strongly recommends to avoid all travel to the affected
countries and that non essential personnel leave the area.
Additionally, refer to the recommendations and advice by Governmental
authorities in your country.
8
What is Ebola Hemorrhagic Fever (EHF)?
Ebola hemorrhagic fever is a severe, often-fatal viral disease in humans and
nonhuman primates (monkeys, gorillas and chimpanzees), caused by infection
with the Ebola virus. Health officials believe the virus originates in the animal
population in parts of Africa and then spreads to humans. Subsequently the
virus is spread from person to person through human contact. The current
strain affecting West Africa has a mortality (death) rate of greater than 80%
and as high as 90%. EHF causes a syndrome that starts like a general non-
specific viral syndrome (like the flu), but which then causes failure of multiple
organ systems and is noted for the development of bleeding from various body
sites.
There is no known cure for the illness nor any known preventative vaccine or
medication.
How is Ebola spread?
Ebola is primarily spread by human-to-human contact or contact with body
fluids. This can occur by direct contact with infected individuals, contact with
items and surfaces contaminated with body fluid, and contact with the bodies
of patient who have died of EVH. One of the major sources of spread is
thought to be through the traditional handling of the remains of deceased EVH
patients by family members and other contacts.
It is also thought that transmission from animal sources occurs through
handling and consumption of bush meat (usually monkeys).
Intro
Epidemic evolution
Available healthcare and cases
per country
Restrictions on crossing borders
and at airports
Travel recommendations
What is Ebola? (1/3)
Definitions
Precautions
Q&A
Contact & sources
9
What are the signs and symptoms of EHF?
EHF starts as a non-specific febrile (fever) illness with symptoms typical of a viral
illness like flu. Because EVH symptoms are non-specific at the onset, it is impossible
in the early stage to distinguish it from many other less serious conditions. The
following are the symptoms patients will experience and a patient may have all or
only some of the symptoms:
- Fever
- Headache
- Joint and muscle aches
- Sore throat
- Diarrhea and vomiting
- Rash
- External/internal bleeding
External bleeding is a later manifestation and indicates breakdown of the
coagulation system. Liver abnormalities, shown on certain blood tests, are a
hallmark of the disease. The patient will likely show signs of confusion as the
neurological system is affected and he/she succumbs to malfunction of other
organs.
How long does it take for a patient to develop symptoms of EHF?
The incubation period of EHF is 2 to 21 days, meaning this is the period of time that
it may take between exposure to Ebola virus and development of symptoms.
Persons who are being traced and observed for the development of Ebola are not
considered to have EVH and pose no risk for illness or spread of the virus if they
have not developed symptoms after 21 days.
Intro
Epidemic evolution
Available healthcare and cases
per country
Restrictions on crossing borders
and at airports
Travel recommendations
What is Ebola? (2/3)
Definitions
Precautions
Q&A
Contact & sources
10
What tests are done to determine if a patient has Ebola?
The specific test for EHF does not turn positive immediately, so the patient is likely
to be seriously ill before a positive test result will be available. However, there are
several abnormalities that are consistent with EHF infection. If negative, the
patient is considered not to have EHF. As well, since patient in this area are
vulnerable to a multitude of other illness (like malaria or gastroenteritis), a positive
test for another illness helps rule out EHF. The key tests that will be done are:
- Complete blood count with platelet
- General chemistry
- Liver function tests
- Blood, urine and stool cultures
- Serological tests for the Ebola virus
- Other tests as indicated by specific complications.
What is the prevention and treatment for Ebola?
There is no vaccine or medication that will prevent EHF or decrease the severity of
the illness. The only prevention is avoidance through proper hygiene practices and
avoidance of certain practices (see below).
There is no cure or effective treatment for EHF. Patients are typically placed in
strict isolation to prevent spread to others and given fluids, antipyretics (anti-
fever)) and pain medications until they expire or recover on their own (which a
small percentage do).
Intro
Epidemic evolution
Available healthcare and cases
per country
Restrictions on crossing borders
and at airports
Travel recommendations
What is Ebola? (3/3)
Definitions
Precautions
Q&A
Contact & sources
11
* Source : World Health Organization
Please find here below the definitions of the different stages of a contagious
disease as described by the WHO.
The outbreak so far is defined by the WHO as an epidemic has been declared
“an International Public Health Emergency”.
SPORADIC
Disease occurring occasionally, singly, or in scattered instances
ENDEMIC
Disease restricted to a locality or region
EPIDEMIC
Disease affecting or tending to affect an atypically large number of individuals
within a population, community, or region at the same time
PANDEMIC
Epidemic occurring on a scale which crosses international boundaries, usually
affecting a large number of people
*Source: http://www.who.int/en/
Intro
Epidemic evolution
Available healthcare and cases
per country
Restrictions on crossing borders
and at airports
Travel recommendations
What is Ebola?
Definitions *
Precautions
Q&A
Contact & sources
12
The World Health Organization (WHO) reiterated its position that the risk of
transmission of Ebola virus disease during air travel remains low.
“Unlike infections such as influenza or tuberculosis, Ebola is not airborne,” says Dr
Isabelle Nuttall, Director of WHO Global Capacity Alert and Response.
“It can only be transmitted by direct contact with the body fluids of a person who
is sick with the disease.”
On the small chance that someone on the plane is sick with Ebola, the likelihood of
other passengers and crew having contact with their body fluids is even smaller.
Usually when someone is sick with Ebola, they are so unwell that they cannot
travel. WHO is therefore advising against travel bans to and from affected
countries.
“Because the risk of Ebola transmission on airplanes is so low, WHO does not
consider air transport hubs at high risk for further spread of Ebola,” says Dr Nuttall.
The guidance recommended no ban on international travel or trade.
However, WHO recommends extreme caution in these countries: measures already
described in the previous weeks and they do not change.
What preventive measures should be taken?
Observe strict health precautions, including frequent hand washing with soap and
water or with hand sanitizer.
Where possible, limit exposure to crowds, including markets and other areas where
large numbers of people congregate.
Stay away from any locations where bush meat is collected, butchered, or sold.
Avoid places and areas of dense population.
Avoid contact with animals and items that may have come in contact with an
infected person's blood or bodily fluids.
Avoid funeral and burial ceremonies – especially in traditional local settings.
What should I do if I become ill or have a fever?
If you feel ill or develop a fever, immediately report to a healthcare practitioner.
Avoid close contact with colleagues and family if you have fever or other viral
symptoms as described.
Contact AXA Assistance and your embassy or consulate to get up-to-date referral
advice on providers who will see you.
Expect to be carefully screened for infectious illness by your healthcare provider.
Expect healthcare workers to where protective garments and masks and possibly to
apply masks and other protective cover to you.
Describe the onset and nature of your symptoms accurately. If you have not had
fever, make sure to mention this clearly. Also, if you have not had any exposure
that you feel would put you at risk for contracting EVH, make sure this is well
understood by the provider. Your provider will put great emphasis on your history
and any behavior that will diminish or heighten the possibility you could have
contracted Ebola.
Intro
Epidemic evolution
Available healthcare and cases
per country
Restrictions on crossing borders
and at airports
Travel recommendations
What is Ebola?
Definitions
Precautions
Q&A
Contact & sources
13
1. What is Ebola virus disease?
Ebola virus disease (formerly known as Ebola haemorrhagic fever) is a severe, often
fatal illness, with a death rate of up to 90%. The illness affects humans and
nonhuman primates (monkeys, gorillas, and chimpanzees).
Ebola first appeared in 1976 in two simultaneous outbreaks, one in a village near
the Ebola River in the Democratic Republic of Congo, and the other in a remote
area of Sudan.
The origin of the virus is unknown but fruit bats (Pteropodidae) are considered the
likely host of the Ebola virus, based on available evidence.
2. How do people become infected with the virus?
Ebola is introduced into the human population through close contact with the
blood, secretions, organs or other bodily fluids of infected animals. In Africa,
infection has occurred through the handling of infected chimpanzees, gorillas, fruit
bats, monkeys, forest antelope and porcupines found ill or dead or in the
rainforest. It is important to reduce contact with high-risk animals (i.e. fruit bats,
monkeys or apes) including not picking up dead animals found lying in the forest or
handling their raw meat.
Once a person comes into contact with an animal that has Ebola, it can spread
within the community from human to human. Infection occurs from direct contact
(through broken skin or mucous membranes) with the blood, or other bodily fluids
or secretions (stool, urine, saliva, semen) of infected people. Infection can also
occur if broken skin or mucous membranes of a healthy person come into contact
with environments that have become contaminated with an Ebola patient’s
infectious fluids such as soiled clothing, bed linen, or used needles.
Health workers have frequently been exposed to the virus when caring for Ebola
patients. This happens because they are not wearing personal protection
equipment, such as gloves, when caring for the patients. Health care providers at all
levels of the health system – hospitals, clinics and health posts – should be briefed
on the nature of the disease and how it is transmitted, and strictly follow
recommended infection control precautions.
Burial ceremonies in which mourners have direct contact with the body of the
deceased person can also play a role in the transmission of Ebola. Persons who
have died of Ebola must be handled using strong protective clothing and gloves,
and be buried immediately.
*Source: http://www.who.int/en/
Intro
Epidemic evolution
Available healthcare and cases
per country
Restrictions on crossing borders
and at airports
Travel recommendations
What is Ebola?
Definitions
Precautions
Q&A* (1/6)
Contact & sources
14
People are infectious as long as their blood and secretions contain the virus. For
this reason, infected patients receive close monitoring from medical professionals
and receive laboratory tests to ensure the virus is no longer circulating in their
systems before they return home. When the medical professionals determine it is
okay for the patient to return home, they are no longer infectious and cannot infect
anyone else in their communities. Men who have recovered from the illness can
still spread the virus to their partner through their semen for up to 7 weeks after
recovery. For this reason, it is important for men to avoid sexual intercourse for at
least 7 weeks after recovery or to wear condoms if having sexual intercourse during
7 weeks after recovery.
3. Who is most at risk?
During an outbreak, those at higher risk of infection are:
health workers, family members or others in close contact with infected people;
mourners who have direct contact with the bodies of the deceased as part of burial
ceremonies; and hunters in the rain forest who come into contact with dead
animals found lying in the forest.
More research is needed to understand if some groups, such as immuno-
compromised people or those with other underlying health conditions, are more
susceptible than others to contracting the virus.
Exposure to the virus can be controlled through the use of protective measures in
clinics and hospitals, at community gatherings, or at home.
*Source: http://www.who.int/en/
Intro
Epidemic evolution
Available healthcare and cases
per country
Restrictions on crossing borders
and at airports
Travel recommendations
What is Ebola?
Definitions
Precautions
Q&A* (2/6)
Contact & sources
15
4. What are typical signs and symptoms of infection?
Sudden onset of fever, intense weakness, muscle pain, headache and sore throat
are typical signs and symptoms. This is followed by vomiting, diarrhoea, rash,
impaired kidney and liver function, and in some cases, both internal and external
bleeding.
Laboratory findings include low white blood cell and platelet counts, and elevated
liver enzymes.
The incubation period, or the time interval from infection to onset of symptoms, is
from 2 to 21 days. The patients become contagious once they begin to show
symptoms. They are not contagious during the incubation period.
Ebola virus disease infections can only be confirmed through laboratory testing.
5. When should someone seek medical care?
If a person has been in an area known to have Ebola virus disease or in contact with
a person known or suspected to have Ebola and they begin to have symptoms, they
should seek medical care immediately.
Any cases of persons who are suspected to have the disease should be reported to
the nearest health unit without delay. Prompt medical care is essential to
improving the rate of survival from the disease. It is also important to control
spread of the disease and infection control procedures need to be started
immediately.
6. What is the treatment?
Severely ill patients require intensive supportive care. They are frequently
dehydrated and need intravenous fluids or oral rehydration with solutions that
contain electrolytes. There is currently no specific treatment to cure the disease.
Some patients will recover with the appropriate medical care.
To help control further spread of the virus, people that are suspected or confirmed
to have the disease should be isolated from other patients and treated by health
workers using strict infection control precautions.
*Source: http://www.who.int/en/
Intro
Epidemic evolution
Available healthcare and cases
per country
Restrictions on crossing borders
and at airports
Travel recommendations
What is Ebola?
Definitions
Precautions
Q&A* (3/6)
Contact & sources
16
7. What can I do? Can Ebola be prevented?
Currently there is no licensed vaccine for Ebola virus disease. Several vaccines are
being tested, but none are available for clinical use right now.
Raising awareness of the risk factors and measures people can take to protect
themselves are the only ways to reduce illness and deaths.
Ways to prevent infection and transmission
While initial cases of Ebola virus disease are contracted by handling infected
animals or carcasses, secondary cases occur by direct contact with the bodily fluids
of an ill person, either through unsafe case management or unsafe burial practices.
During this outbreak, most of the disease has spread through human-to-human
transmission. Several steps can be taken to help in preventing infection and limiting
or stopping transmission.
Understand the nature of the disease, how it is transmitted, and how to prevent it
from spreading further. (For additional information, please see the previous
questions about Ebola virus disease in this FAQ.)
Listen and follow directives issued by your country’s respective Ministry of Health.
If you suspect someone close to you or in your community of having Ebola virus
disease, encourage and support them in seeking appropriate medical treatment in
a care facility.
If you choose to care for an ill person in your home, notify public health officials of
your intentions so they can train you and provide appropriate gloves and personal
protective equipment (PPE), as well as instructions as a reminder on how to
properly care for the patient, protect yourself and your family, and properly dispose
of the PPE after use.
When visiting patients in the hospital or caring for someone at home, hand washing
with soap and water is recommended after touching a patient, being in contact
with their bodily fluids, or touching his/her surroundings.
People who have died from Ebola should only be handled using appropriate
protective equipment and should be buried immediately.
Additionally, individuals should reduce contact with high-risk infected animals (i.e.
fruit bats, monkeys or apes) in the affected rainforest areas. If you suspect an
animal is infected, do not handle it. Animal products (blood and meat) should be
thoroughly cooked before eating.
*Source: http://www.who.int/en/
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Available healthcare and cases
per country
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and at airports
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What is Ebola?
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17
8. What about health workers? How do they protect themselves from the high
risk of caring for sick patients?
Health workers treating patients with suspected or confirmed illness are at higher
risk of infection than other groups.
In addition to standard health care precautions, health workers should strictly
apply recommended infection control measures to avoid exposure to infected
blood, fluids, or contaminated environments or objects – such as a patient’s soiled
linen or used needles.
They should use personal protection equipment such as individual gowns, gloves,
masks and goggles or face shields.
They should not reuse protective equipment or clothing unless they have been
properly disinfected.
They should change gloves between caring for each patient suspected of having
Ebola.
Invasive procedures that can expose medical doctors, nurses and others to
infection should be carried out under strict, safe conditions.
Infected patients should be kept separate from other patients and healthy people,
as much as possible.
9. How does WHO protect health during outbreaks?
WHO provides technical advice to countries and communities to prepare for and
respond to Ebola outbreaks. WHO actions include:
• disease surveillance and information-sharing across regions to watch for
outbreaks;
• technical assistance to investigate and contain health threats when they
occur – such as on-site help to identify sick people and track disease
patterns;
• advice on prevention and treatment options;
deployments of experts and the distribution of health supplies (such as
personal protection gear for health workers) when they are requested by
the country;
• communications to raise awareness of the nature of the disease and
protective health measures to control transmission of the virus;
• activation of regional and global networks of experts to provide assistance,
if requested, and mitigate potential international health effects and
disruptions of travel and trade. *Source: http://www.who.int/en/
Intro
Epidemic evolution
Available healthcare and cases
per country
Restrictions on crossing borders
and at airports
Travel recommendations
What is Ebola?
Definitions
Precautions
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Contact & sources
18
For any question:
Our sources:
• WHO - World Health Organization
• CDC - Centre for Disease Control and Prevention
• AXA Assistance Response Team
o Local and international coordinating doctors
o International medical network
o International Operations Direction
o Health Business Unit
• Ministries of Foreign Affairs
• iJET
10. What about rumours that some foods can prevent or treat the infection?
WHO strongly recommends that people seek credible health advice about Ebola
virus disease from their public health authority.
While there is no specific drug against Ebola, the best treatment is intensive
supportive treatment provided in the hospital by health workers using strict
infection control procedures. The infection can be controlled through
recommended protective measures.
11. During an outbreak, numbers of cases reported by health officials can go up
and down? Why?
During an Ebola outbreak, the affected country’s public health authority reports its
disease case numbers and deaths. Figures can change daily. Case numbers reflect
both suspected cases and laboratory-confirmed cases of Ebola. Sometimes
numbers of suspected and confirmed cases are reported together. Sometimes they
are reported separately. Thus, numbers can shift between suspected and confirmed
cases.
Analyzing case data trends, over time, and with additional information, is generally
more helpful to assess the public health situation and determine the appropriate
response.
12. Is it safe to travel during an outbreak? What is WHO’s travel advice?
During an outbreak, WHO reviews the public health situation regularly, and
recommends any travel or trade restrictions if necessary.
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.
WHO’s general travel advice
Travelers should avoid all contact with infected patients.
Health workers traveling to affected areas should strictly follow WHO-
recommended infection control guidance.
Anyone who has stayed in areas where cases were recently reported should be
aware of the symptoms of infection and seek medical attention at the first sign of
illness.
Clinicians caring for travelers returning from affected areas with compatible
symptoms are advised to consider the possibility of Ebola virus disease.
*Source: http://www.who.int/en/
Intro
Epidemic evolution
Available healthcare and cases
per country
Restrictions on crossing borders
and at airports
Travel recommendations
What is Ebola?
Definitions
Precautions
Q&A* (6/6)
Contact & sources
19
Intro
Epidemic evolution
Available healthcare and cases
per country
Restrictions on crossing borders
and at airports
Travel recommendations
What is Ebola?
Definitions
Precautions
Q&A* (6/6)
Contact & sources
For any question:
Our sources:
• WHO - World Health Organization
• CDC - Centre for Disease Control and Prevention
• MSF - Médecins sans frontières
• Ministries of Foreign Affairs
• iJET
• AXA Assistance Response Team
o Local and international coordinating doctors
o International medical network
o International Operations Direction
o Health Business Unit