Ebola - general information
What is Ebola?
Ebola disease is a serious and often fatal viral disease. There are no licensed vaccines or treatments. There are no Ebola cases in the UK. There is very low risk of infection for people living in countries outside Africa.
Which countries are affected?
The outbreak of Ebola in West Africa has resulted in approximately 14,098 cases to date, including 5160 deaths (as of 9 November 2014). Ebola has affected the following countries and areas:
Sierra Leone: As of 9 November, 5368 cases including 1,169 deaths have been reported. Transmission remains intense, with 421 cases reported in the last week. The majority of cases are being reported from Freetown, Bombali, Port Loko, Western rural area and Tonkolili. Koinadugu and Kambia are emerging as areas of concern.
Liberia: As of 8 November, 6822 cases including 2836 deaths have been reported. In the last week 97 cases have been reported, with the majority of new cases being reported in Montserrado district. Weekly case numbers appear to be stabilising and will be closely monitored to see if this can be maintained.
Guinea: As of 9 November, 1878 cases including 1142 deaths have been reported. Transmission in Guinea is intense with 145 new cases reported in the last week. Transmission remains high in Macenta and Kerouane, both near to the Liberian border. Cases continue to be reported from the capital Conakry and the district of Siguiri which borders Mali.
Mali confirmed its first case on 23 October in a child who had travelled from Guinea. On 12 November WHO reported a new cluster of infected in Mail’s capital Bamako, unrelated to Mali’s first case. A total of four cases have been reported in Mali, all of which have died, and further cases are likely.
There have also been imported cases in Nigeria and Senegal. These have both been contained and as there have been no new cases for 42 days, the outbreak in Senegal was declared over by the World Health Organisation on the 17 October 2014 and in Nigeria on the 20 October 2014.
Spain has had one confirmed case and the US four, both following an initial imported case.
How does Ebola spread and who is at risk?
Ebola is spread by contact with blood/body fluids (such as urine, saliva, faeces) of an infected person. Those most at risk are people caring for an infected person e.g. hospital workers, laboratory workers, and family members. Mourners have also caught Ebola during the funeral of an infected person, through touching the body and other ritual practices.
Initially, it is thought that the infection starts by spread from animals to people through close contact with the blood or body fluids of an infected animal, commonly when slaughtering, handling or eating the meat of wild animals (bush meat). Key facts about Ebola include:
- Patients are not infectious until they are symptomatic.
- It is not a robust virus and is destroyed by alcohol gel or soap and water.
- It is transmitted via contact with body fluids and there is no evidence of airborne transmission, so it cannot be caught by talking to someone with the infection.
- The virus cannot pass through intact skin but can pass through mucous membranes (mouth/eyes). Most of the people who have been infected introduced the virus into their mouth after their hands had been contaminated.
- Patients become more infectious as their disease progresses. The risk of transmission through casual contact with a mildly ill patient is low.
Preparing for travel to Sierra Leone, Liberia or Guinea?
The Foreign Office advises against all but essential travel to Sierra Leone, Liberia and Guinea except for those directly involved in the Ebola response. If you do travel to these countries, your personal risk will depend on the areas you visit and what you will be doing whilst you are there.
- Consider taking disposable gloves, protective gowns and surgical masks. You can ask your local pharmacist to order these items for you if you might need them.
- See your GP for general advice on travel health (ideally six weeks before).
- Make sure that you have adequate travel insurance.
Being careful while you are in Sierra Leone, Liberia and Guinea
The risk to general tourists and visitors to Sierra Leone, Liberia and Guinea is considered low. Your personal risk will depend on the areas you visit and what you will be doing whilst you are there.
- Avoid touching the blood and body fluids (saliva, vomit, urine, faeces) of a sick person if you are caring for someone who is unwell. If you have access to protective gowns, gloves and face masks, wear them. Wash your hands with soap and water after every contact.
- Avoid touching the body, clothing and bedding of a deceased person during funeral rituals. A person may have died from Ebola even if the cause of death is unknown or is thought to be from something else.
- If you cannot avoid touching the body or items of a deceased person, consider wearing protective gowns, gloves and masks.
- Dispose of gloves, masks and gowns carefully as they may be contaminated – place in a bag, seal and burn if possible.
- Ebola can be spread through having unprotected sex for up to seven weeks after recovery. Practice Safe Sex and use barrier contraception such as condoms.
- Avoid close contact with live or dead wild animals (including monkeys, forest antelopes, rodents and bats).
- Avoid preparation and consumption of “bush meat”.
- Wash hands regularly with soap and water.
If you develop fever, chills, muscle aches, headache, nausea, vomiting, sore throat or rash while in Sierra Leone, Liberia or Guinea, you should visit a clinic or hospital. It is a legal duty in Sierra Leone to report to your nearest health clinic or hospital if you or someone in your family have recently travelled to an affected area and have symptoms suggestive of Ebola.
What should I do if I come back from Sierra Leone, Liberia or Guinea and feel unwell?
If you feel unwell with fever, chills, muscle aches, headache, nausea, vomiting, sore throat or rash within 21 days of coming back from Sierra Leone, Liberia or Guinea, you should stay at home and immediately telephone your GP surgery or out of hours SELDOC 020 8693 9066 and explain that you have recently visited West Africa. These services will tell you what to do next and will be able to ensure that the medical services are expecting your arrival.
The risk of Ebola is low for most travellers and there are other illnesses with similar symptoms, so proper medical assessment in important to ensure the right diagnosis and treatment. Malaria, for example, is a much more common infection in West Africa with similar early symptoms and is treatable if diagnosed quickly.
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