Ebola primer

Knowledge yields protection for travelers in disease hotspots.

A recent article in The New York Times summed up the first thing business travelers should do to prepare for the risk of contracting Ebola: Consult a map of world.

If your travels do not take you to West Africa—specifically to Liberia, Sierra Leone and Guinea—then your risk of getting the disease is very small, despite what you may be hearing in unnerving media reports. That was the message recently delivered to Global Business Travel Association members by Eugene Delaune, a doctor who’s the chief medical officer for crisis protection provider Europ Assistance USA.

Delaune, a presenter during GBTA’s Oct. 22 webinar on managing Ebola risk, advised business travelers to use reliable, official sources of information such as the U.S. Centers for Disease Control to assess vulnerability. A quick look at the CDC’s regularly updated Ebola Case Counts shows why: As of Nov. 5, the death count from Ebola was 4,950 in Liberia, Sierra Leone and Guinea. In Nigeria, which now has been declared free of Ebola, the death count stands at 8. In Mali, 1 death was recorded—a child who traveled there from Guinea. In the United States, it’s also 1—a man who traveled from West Africa to Dallas, where he was hospitalized and later died.

If your travels do take you to West Africa, take steps to protect yourself from the disease, Delaune advised. A business traveler who is not a medical provider, journalist or support staff should be able to keep Ebola at bay with a basic understanding of the disease and a few precautions. Here’s a summary of what Delaune and other medical experts say travelers should know.

Ebola: A primer for travelers

Transmission

Fruit bats host Ebola, and the disease can be transmitted from bats to other animals. People contract the disease when they slaughter these animals for food and come into contact with their infected blood or other body fluids. So, an Ebola outbreak in Africa often begins when people hunt and butcher wild game or “bush meat.”

Body fluids—such as blood, vomit, urine and saliva—are also the primary way Ebola passes between humans. That’s what makes health care workers particularly vulnerable and why African burial practices that involve touching the corpse have accelerated the spread of the disease.

Symptoms and sickness

People are not contagious until they develop symptoms, which occur two to 21 days after a person contracts Ebola. Symptoms usually show up in eight to 10 days. According to the World Health Organization, the first symptoms are fever, fatigue, muscle pain, headache and sore throat—all of which begin suddenly. This phase is followed by vomiting and diarrhea and may also include rash, symptoms of impaired kidney and liver function, and, in some cases, internal and external bleeding. Laboratory tests will show low white-blood cell and platelet counts and elevated liver enzymes.

People with Ebola grow more contagious as they get sicker. The viral load multiplies, as do effects of the disease such as vomiting, which can increase the likelihood of transmission. The virus can remain in body fluids for up to 30 days after the onset of symptoms and even longer in some secretions, such as semen, meaning a person may still be contagious even if they are showing signs of recovery.

Diagnosis and treatment

Early diagnosis can be difficult because the symptoms are vague and commonly associated with other illnesses, such as the flu. Laboratory tests can confirm the presence of the disease after a few days, but collecting and analyzing samples of blood or other body fluids can create risks for health care workers in an uncontrolled environment.

The most important aspect of treatment is isolation to keep others from contracting the disease. Other treatments are mostly supportive: providing the sick person with fluids, oxygen and medications needed to treat secondary infections or complications. Access to supportive care can greatly enhance a person’s chance of recovery.

Getting treatment in Ebola hotspots

Ebola clinics in Liberia, Sierra Leone and Guinea provide the most experienced care for the disease, but they also present problems. First, if a person has potentially been exposed to the disease but is not showing symptoms, they should avoid going to an Ebola clinic where exposure is certain and medical providers are prioritizing the sickest patients. Second, these clinics are like medical camps. They move around, sometimes daily. So, it’s important to know where to go.

Also, don’t assume you’ll be able to leave if you do get sick with Ebola while in West Africa. Country-to-country travel restrictions on the continent complicate evacuations, and few carriers are willing or able to transport Ebola patients. In addition, traveling may not be helpful and could even be harmful to someone in the throes of the disease.

Organizations such as the WHO and CDC are working with regulatory authorities and scientific and clinical companies to study potential therapies and vaccines for use in treating and preventing Ebola. Some of these are being tested in the field. But right now, there are no specific Ebola vaccines or treatments approved for use in humans.

Staying in touch and informed

If you’re traveling in West Africa, maintain daily, scheduled contact with your company back home. If possible, have more than one way to get in touch (i.e., mobile phone and satellite phone). Keep up with news from the WHO, CDC, European Centre for Disease Prevention and Control, and national agencies such as the U.S. State Department. In addition, BCD Travel’s Global Crisis Management team is posting regular updates about crises and disruptions affecting travelers to Africa on its EMEA Twitter feed: @BCDemea.

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