Ebola Outbreak
Travel impacts and specific restrictions
The CDC (USA) has issued a level 3 travel warning asking people to restrict non-essential travel to West Africa
Australia’s Department of Foreign Affairs and Trade strongly recommends:
The Australian Government advises reconsidering any need to travel to Sierra Leone, Guinea or Liberia because of the Ebola virus disease (EVD) outbreak and the possibility of criminal activity and civil unrest. Given the increasing restrictions on travel due to the EVD outbreak, and the extremely limited care options, we advise you to leave while limited commercial flights continue to operate.
Many countries in Africa, including the major travel hubs of South Africa and Kenya, have now banned entry to travellers who have been in EVD affected countries.
Travel restrictions are in place in many African countries as a result of the EVD outbreak. Authorities in a number of countries have implemented flight bans and an increasing number of carriers have indefinitely suspended flights into Guinea, Sierra Leone and Liberia. Many land borders have been closed.
Health screening is being undertaken at many international airports that have direct flights into the region or that are major air travel hubs.
Travellers with fever or EVD-like symptoms may be subject to quarantine or denied entry or exit from certain countries. If you are unwell, you should consider the possible implications of this health screening should you choose to travel to west Africa.
A summary of restrictions is detailed below, based on the latest confirmed advice from foreign governments. This list is not exhaustive. If you are planning travel, you should be aware that further restrictions may be put in place with little or no notice. Monitor the media closely and before you travel, confirm that borders remain open and/or check with your carrier for the most up to date information on flight schedules.
Specific warnings for the worst affected nations:
Guinea: Health screenings have been introduced at border crossings. Travellers with fever or EVD-like symptoms are subject to quarantine or denied entry or exit from the country. While Guinea has not closed its borders, a number of neighbouring countries have closed their borders to people leaving Guinea (see below). Only a small number of carriers are continuing to operate commercial flights.
Sierra Leone: A state of emergency has been imposed, which enables the military to enforce quarantine zones, restrict public movements and limit public gatherings. The government of Sierra Leone has imposed restrictions on internal movement and further travel restrictions are in place in areas bordering Guinea and Liberia. Health screenings have been introduced at border crossings. Travellers with fever or EVD-like symptoms are being subject to quarantine or denied entry or exit from the country. While Sierra Leone has not closed its borders, a number of neighbouring countries have closed their borders to people leaving Sierra Leone. Only a small number of carriers are continuing to operate commercial flights.
Liberia: Liberian authorities have implemented a state of public emergency in response to the EVD outbreak. They have put in place a range of measures to combat the spread of the disease including closing the majority of Liberia's borders and imposing restrictions on travel within the country. A nationwide curfew is in place between 11 pm and 6 am. Local emergency measures may change without warning. Travellers with fever or EVD-like symptoms are being subject to quarantine or being denied entry or exit from the country. Only a small number of carriers are continuing to operate commercial flights.
The Australian Government has limited capacity to provide consular assistance in these circumstances. A medical evacuation would be extremely difficult to conduct. Australian High Commission personnel have deferred non-essential travel to Guinea, Sierra Leone and Liberia as a result of the EVD outbreak.
For further specific warnings for African nations and more details on the situation in Guinea, Sierra Leone and Liberia see http://www.smartraveller.gov.au/zw-cgi/view/TravelBulletins/Ebola
NOTE: Australia has also suspended the issuance of visas to travellers from Guinea, Liberia and Sierra Leone. Travellers from these countries who hold permanent visas can enter Australia if they have been quarantined for 21 days prior to arrival, while those who have received non-permanent visas and who have not departed for Australia will have their visas cancelled.
Other Travel Restrictions
source https://www.internationalsos.com/ebola/index.cfm?content_id=435&language_id=ENG
The United Statesannounced that beginning 22 October, any passengers beginning their travels in Liberia, Sierra Leone or Guinea will only be able to enter the country through the following airports: JFK International Airport (JFK, New York state), Newark International Airport (EWR, New Jersey), Dulles International Airport (IAD, Washington, DC), Hartsfield-Jackson International Airport (ATL, Georgia) or Chicago O'Hare International Airport (ORD, Illinois).
North Koreahas banned foreign tourists since 24 October over fears of Ebola; the ban applies to all entry points and border crossings.
Southern African Development Community (SADC) member states – Angola, Botswana, Democratic Republic of Congo (DRC), Lesotho, Madagascar, Malawi, Mauritius, Mozambique, Seychelles, South Africa, Swaziland, Tanzania, Zambia and Zimbabwe – have stated that travellers coming from Ebola-affected countries (according to the World Health Organisation, WHO) would be monitored for 21 days and that travel to member countries for any gatherings would be discouraged. There are also reports that some countries require health documentation for entry.
Travellers are advised to contact the embassy or health ministry of their destination country to clarify their individual circumstances and prepare their trips accordingly.
Further list of travel restrictions here for African nations, and also South and Central America and the Caribbean:
https://www.internationalsos.com/ebola/index.cfm?content_id=435&language_id=ENG
Flights restrictions:
Frequently Asked Question: might Ebola mutate into an air-borne virus?
Short answer: No. This is very unlikely.
The World Health Organisation reports no cases where Ebola has been transmitted by sneezing or coughing that it is aware of. However, basic common sense suggests not getting to close to anyone who is sneezing or coughing is a wise idea in any case.
"Epidemiological data emerging from the outbreak are not consistent with the pattern of spread seen with airborne viruses, like those that cause measles and chickenpox, or the airborne bacterium that causes tuberculosis.
Theoretically, wet and bigger droplets from a heavily infected individual, who has respiratory symptoms caused by other conditions or who vomits violently, could transmit the virus – over a short distance – to another nearby person.
This could happen when virus-laden heavy droplets are directly propelled, by coughing or sneezing (which does not mean airborne transmission) onto the mucus membranes or skin with cuts or abrasions of another person.
WHO is not aware of any studies that actually document this mode of transmission. On the contrary, good quality studies from previous Ebola outbreaks show that all cases were infected by direct close contact with symptomatic patients." – source: http://www.who.int/mediacentre/news/ebola/06-october-2014/en/
Expert reaction to media coverage questioning whether Ebola could become airborne
"To suggest that Ebola could become airborne is completely irresponsible. The way the virus is spreading is consistent with what we've seen in all previous 25 outbreaks, only transmitting through blood and bodily secretions. There is no precedent for a virus changing its mode of transmission so drastically. Other viruses such as HIV - which transmit in the same way, have passed through millions of humans, and are known to mutate more than Ebola - have not become airborne. Making such claims is an unwelcome distraction from the urgent need to scale up the international response to the ongoing humanitarian crisis in West Africa," Professor Peter Piot, Director of the London School of Hygiene & Tropical Medicine, and co-discoverer of the Ebola virus
"Ebola is found in the bloodstream, which is part of what makes it so difficult to transmit compared to other viruses. To become airborne, Ebola would need to fundamentally change the way it grows. That is very unlikely in my opinion," Dr Ben Neuman, Lecturer in Virology, University of Reading.
"Evolution can be unpredictable, but there is no good reason to expect that Ebola will become more dangerous with time. Severe diseases like Ebola often happen when a virus clashes with a brand new host for which it is poorly adapted. Recent experience with H1N1 swine flu shows that viruses are likely to mellow as they adapt to their new hosts.
"There is no evidence that Ebola can spread via the air in the real world. Ebola can only be transmitted through the air under carefully controlled lab conditions. One clue that emphasises how different Ebola is from flu is how slow the virus is spreading. Compared to this Ebola outbreak, the H1N1 swine flu had already spread to an estimated 10,000 times as many people in its first ten months."
The CDC (USA) has issued a level 3 travel warning asking people to restrict non-essential travel to West Africa
Australia’s Department of Foreign Affairs and Trade strongly recommends:
The Australian Government advises reconsidering any need to travel to Sierra Leone, Guinea or Liberia because of the Ebola virus disease (EVD) outbreak and the possibility of criminal activity and civil unrest. Given the increasing restrictions on travel due to the EVD outbreak, and the extremely limited care options, we advise you to leave while limited commercial flights continue to operate.
Many countries in Africa, including the major travel hubs of South Africa and Kenya, have now banned entry to travellers who have been in EVD affected countries.
Travel restrictions are in place in many African countries as a result of the EVD outbreak. Authorities in a number of countries have implemented flight bans and an increasing number of carriers have indefinitely suspended flights into Guinea, Sierra Leone and Liberia. Many land borders have been closed.
Health screening is being undertaken at many international airports that have direct flights into the region or that are major air travel hubs.
Travellers with fever or EVD-like symptoms may be subject to quarantine or denied entry or exit from certain countries. If you are unwell, you should consider the possible implications of this health screening should you choose to travel to west Africa.
A summary of restrictions is detailed below, based on the latest confirmed advice from foreign governments. This list is not exhaustive. If you are planning travel, you should be aware that further restrictions may be put in place with little or no notice. Monitor the media closely and before you travel, confirm that borders remain open and/or check with your carrier for the most up to date information on flight schedules.
Specific warnings for the worst affected nations:
Guinea: Health screenings have been introduced at border crossings. Travellers with fever or EVD-like symptoms are subject to quarantine or denied entry or exit from the country. While Guinea has not closed its borders, a number of neighbouring countries have closed their borders to people leaving Guinea (see below). Only a small number of carriers are continuing to operate commercial flights.
Sierra Leone: A state of emergency has been imposed, which enables the military to enforce quarantine zones, restrict public movements and limit public gatherings. The government of Sierra Leone has imposed restrictions on internal movement and further travel restrictions are in place in areas bordering Guinea and Liberia. Health screenings have been introduced at border crossings. Travellers with fever or EVD-like symptoms are being subject to quarantine or denied entry or exit from the country. While Sierra Leone has not closed its borders, a number of neighbouring countries have closed their borders to people leaving Sierra Leone. Only a small number of carriers are continuing to operate commercial flights.
Liberia: Liberian authorities have implemented a state of public emergency in response to the EVD outbreak. They have put in place a range of measures to combat the spread of the disease including closing the majority of Liberia's borders and imposing restrictions on travel within the country. A nationwide curfew is in place between 11 pm and 6 am. Local emergency measures may change without warning. Travellers with fever or EVD-like symptoms are being subject to quarantine or being denied entry or exit from the country. Only a small number of carriers are continuing to operate commercial flights.
The Australian Government has limited capacity to provide consular assistance in these circumstances. A medical evacuation would be extremely difficult to conduct. Australian High Commission personnel have deferred non-essential travel to Guinea, Sierra Leone and Liberia as a result of the EVD outbreak.
For further specific warnings for African nations and more details on the situation in Guinea, Sierra Leone and Liberia see http://www.smartraveller.gov.au/zw-cgi/view/TravelBulletins/Ebola
NOTE: Australia has also suspended the issuance of visas to travellers from Guinea, Liberia and Sierra Leone. Travellers from these countries who hold permanent visas can enter Australia if they have been quarantined for 21 days prior to arrival, while those who have received non-permanent visas and who have not departed for Australia will have their visas cancelled.
Other Travel Restrictions
source https://www.internationalsos.com/ebola/index.cfm?content_id=435&language_id=ENG
The United Statesannounced that beginning 22 October, any passengers beginning their travels in Liberia, Sierra Leone or Guinea will only be able to enter the country through the following airports: JFK International Airport (JFK, New York state), Newark International Airport (EWR, New Jersey), Dulles International Airport (IAD, Washington, DC), Hartsfield-Jackson International Airport (ATL, Georgia) or Chicago O'Hare International Airport (ORD, Illinois).
North Koreahas banned foreign tourists since 24 October over fears of Ebola; the ban applies to all entry points and border crossings.
Southern African Development Community (SADC) member states – Angola, Botswana, Democratic Republic of Congo (DRC), Lesotho, Madagascar, Malawi, Mauritius, Mozambique, Seychelles, South Africa, Swaziland, Tanzania, Zambia and Zimbabwe – have stated that travellers coming from Ebola-affected countries (according to the World Health Organisation, WHO) would be monitored for 21 days and that travel to member countries for any gatherings would be discouraged. There are also reports that some countries require health documentation for entry.
Travellers are advised to contact the embassy or health ministry of their destination country to clarify their individual circumstances and prepare their trips accordingly.
Further list of travel restrictions here for African nations, and also South and Central America and the Caribbean:
https://www.internationalsos.com/ebola/index.cfm?content_id=435&language_id=ENG
Flights restrictions:
- Gambia has banned the entry of flights from Guinea, Liberia, Nigeria and Sierra Leone.
- Gabon has banned the entry of flights and ships from countries affected by Ebola.
- Senegal has banned flights from Guinea, Liberia and Sierra Leone
- Cameroon has banned flights to and from Nigeria.Chad has suspended all flights from Nigeria.
- Nigeria has suspended flights to the country operated by Gambian national carrier Gambia Bird.
- Côte d'Ivoire has now lifted the ban on passenger flights from Guinea, Liberia and Sierra Leone.
Details of airlines that have restricted flights to Ebola-affected countries:
- Air France suspended flights to Sierra Leone from 28 August.
- The Togo-based carrier Asky Airlines has suspended flights to and from Guinea, Liberia and Sierra Leone.
- Arik Air (Nigeria), Gambia Bird and Kenya Airways have suspended services to Liberia and Sierra Leone.
- British Airways has extended their suspension of flights to Liberia and Sierra Leone until 31 December.
- Emirates Airlines has suspended flights to Guinea.
- Korean Air suspended flights to and from Kenya from 20 August.
- Senegal Airlines has suspended flights to and from Conakry (Guinea) until further notice.
Frequently Asked Question: might Ebola mutate into an air-borne virus?
Short answer: No. This is very unlikely.
The World Health Organisation reports no cases where Ebola has been transmitted by sneezing or coughing that it is aware of. However, basic common sense suggests not getting to close to anyone who is sneezing or coughing is a wise idea in any case.
"Epidemiological data emerging from the outbreak are not consistent with the pattern of spread seen with airborne viruses, like those that cause measles and chickenpox, or the airborne bacterium that causes tuberculosis.
Theoretically, wet and bigger droplets from a heavily infected individual, who has respiratory symptoms caused by other conditions or who vomits violently, could transmit the virus – over a short distance – to another nearby person.
This could happen when virus-laden heavy droplets are directly propelled, by coughing or sneezing (which does not mean airborne transmission) onto the mucus membranes or skin with cuts or abrasions of another person.
WHO is not aware of any studies that actually document this mode of transmission. On the contrary, good quality studies from previous Ebola outbreaks show that all cases were infected by direct close contact with symptomatic patients." – source: http://www.who.int/mediacentre/news/ebola/06-october-2014/en/
Expert reaction to media coverage questioning whether Ebola could become airborne
"To suggest that Ebola could become airborne is completely irresponsible. The way the virus is spreading is consistent with what we've seen in all previous 25 outbreaks, only transmitting through blood and bodily secretions. There is no precedent for a virus changing its mode of transmission so drastically. Other viruses such as HIV - which transmit in the same way, have passed through millions of humans, and are known to mutate more than Ebola - have not become airborne. Making such claims is an unwelcome distraction from the urgent need to scale up the international response to the ongoing humanitarian crisis in West Africa," Professor Peter Piot, Director of the London School of Hygiene & Tropical Medicine, and co-discoverer of the Ebola virus
"Ebola is found in the bloodstream, which is part of what makes it so difficult to transmit compared to other viruses. To become airborne, Ebola would need to fundamentally change the way it grows. That is very unlikely in my opinion," Dr Ben Neuman, Lecturer in Virology, University of Reading.
"Evolution can be unpredictable, but there is no good reason to expect that Ebola will become more dangerous with time. Severe diseases like Ebola often happen when a virus clashes with a brand new host for which it is poorly adapted. Recent experience with H1N1 swine flu shows that viruses are likely to mellow as they adapt to their new hosts.
"There is no evidence that Ebola can spread via the air in the real world. Ebola can only be transmitted through the air under carefully controlled lab conditions. One clue that emphasises how different Ebola is from flu is how slow the virus is spreading. Compared to this Ebola outbreak, the H1N1 swine flu had already spread to an estimated 10,000 times as many people in its first ten months."
Key facts about Ebola
There are only two ways Ebola has been transmitted person-to-person:
- direct contact with the blood or body fluids (including but not limited to feces, saliva, urine, vomit and semen) of a person who is sick with Ebola;
- contact with objects (like needles and syringes) that have been contaminated with the blood or body fluids of an infected person or with infected animals.
A person who has contracted the Ebola virus is only contagious once symptoms are present. These include:
- Fever (greater than 38.6°C or 101.5°F)
- Severe headache
- Muscle pain
- Vomiting
- Diarrhea
- Stomach pain
- Unexplained bleeding or bruising
Symptoms may appear anywhere from 2 to 21 days after exposure to Ebola but the average is 8 to 10 days. Those most at risk of contracting Ebola are family members and healthcare workers who are potentially exposed to the infected person’s bodily fluids.
The fatality rate of the current Ebola outbreak is around 50 per cent. It has been as high as 90 per cent in previous outbreaks.
Useful Links
World Health Organisation http://www.who.int/csr/disease/ebola/situation-reports/en/
Dr Ian Mackay Australian Infectious Diseases Research Centre – regularly updated charts and data
http://virologydownunder.blogspot.com.au/2014/07/ebola-virus-disease-evd-2014-west.html
Further detail on travel restrictions: https://www.internationalsos.com/ebola/index.cfm?content_id=437&language_id=ENG
World Health Organisation http://www.who.int/csr/disease/ebola/situation-reports/en/
Dr Ian Mackay Australian Infectious Diseases Research Centre – regularly updated charts and data
http://virologydownunder.blogspot.com.au/2014/07/ebola-virus-disease-evd-2014-west.html
Further detail on travel restrictions: https://www.internationalsos.com/ebola/index.cfm?content_id=437&language_id=ENG