Precautions for travellers going to Ebola areas

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"At present, there are no Ebola cases reported in South Africa and there is no need for South Africans travelling to or working in countries that have experienced Ebola outbreaks to be unnecessarily alarmed. Those working in and travelling to impacted areas should however take the necessary precautions to prevent contracting this disease," says Dr Pete Vincent of Netcare Travel Clinics and Medicross Tokai Family Medical and Dental Centre.

"The Ebola haemorrhagic fever is a severe, acute viral illness usually characterised by fever, muscle pain, headache, a sore throat and intense weakness. The disease then progresses to diarrhoea, vomiting, a rash, impaired kidney and liver function, and internal and external bleeding, and is often fatal."

The Ebola virus has been found in both humans and in animals such as bats and primates. One can only contract the virus through exposure to the blood, organs or bodily secretions of infected individuals or animals; the virus cannot be passed on merely by being in the same vicinity as someone with the disease.

Ebola outbreaks are believed to originate from contact with the blood or bodily fluids of infected animals, for example when hunters come into contact with infected dead animals, or when handling the raw meat of infected animals. Once a person in a community contracts the disease, the Ebola virus can spread to other individuals if they have exposure to the blood or bodily fluids of the infected person.

According to Dr Vincent an experimental drug, known as ZMapp, is currently under development and has been dispensed to some severely ill patients in Africa, it is however not generally available. Treatment at this stage is therefore largely limited to supportive therapy. Medical professionals can only manage a patients' symptoms, through balancing fluids and electrolytes, maintaining oxygen status and blood pressure and treating patients for any other infections.

"The risk of infection with the Ebola virus is extremely low, even for travellers visiting areas where cases of Ebola have been reported. This is because contraction of the virus occurs through direct contact with the blood, secretions, bodily fluids or organs of infected individuals or animals (living or dead), which is highly unlikely for the average traveller.

"However, although the risks of getting infected with Ebola are very low for travellers, it is still important to take precautions as there is no vaccine or cure for the disease and 50% to 90% of diagnosed Ebola cases are fatal."

Travellers' tips

• Practise careful hygiene.
  
• Avoid contact with blood and bodily fluids of other persons.
  
• Do not touch items that may have encountered blood or bodily fluids.
  
• Avoid burial rituals, which involve handling the body.
  
• Avoid contact with animals or raw meat.
  
• Get medical care immediately if you develop fever, a sore throat, headache, a rash, diarrhoea, vomiting, aches, stomach pain or red eyes.
  
• Monitor your health after you return from an area with an Ebola outbreak. If you do develop the above symptoms, be sure to inform your doctor about your recent trip and symptoms before you go to the doctor's rooms or hospital. The doctor will need to take certain precautions to ensure the protection of others.
  
• Do not panic if you present with any of these symptoms; remember that the likelihood of you contracting Ebola is very low. Also be aware that the symptoms of Ebola are the same as many other infections, including flu viruses, malaria, dengue fever, typhoid fever and Lassa fever.

"It is also important to note that, after contracting Ebola, it can take up to 21 days to show symptoms of the disease, although 8-10 days is more common. Until a person exhibits symptoms, they are not contagious, so you do not need to be concerned about getting the virus from apparently healthy individuals. There is also low risk of spreading the infection in the early stages of the illness.

"Although it cannot be said for certain whether the disease will spread beyond West Africa, measures are in place at many international airports which have direct flights into the region or are major air travel hubs to prevent the spread of the disease. These measures include health screening for symptoms of the disease," he concludes.

Precautionary safety measures at Netcare

Dr Anchen Laubscher, medical director at Netcare says, "Even though there is no current Ebola outbreak in South Africa, the company has developed a set of comprehensive clinical pathways which are used routinely and as a precautionary measure by its emergency medical personnel, doctors and hospital staff to assess any patient who has been exposed to risk factors associated with viral haemorrhagic fevers (VHFs). These include having travelled to affected or endemic VHF areas within the past 21 days or showing clinical signs which may be related to a VHF.

The clinical pathways, which were developed in consultation with the NICD and were made available to the Department of Health, comprehensively cover the assessment of these patients and their subsequent management. Patients from within Africa who are referred to Netcare hospitals for specialised treatment, for example cardiac treatment, are assessed and managed according to the same clinical pathways.

For more information, go to www.travelclinic.co.za.