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Ebola situation Update for October 2014

About the author

Larry

Prof. Larry Goodyer, MPharm Phd MRPharmS FFTM RCPS(Glasg) FRGS

Medical Director

As well as being the Nomad Medical Director he is currently Professor of Pharmacy Practice at Leicester School of Pharmacy at De Montfort University.
He is one of the leading international pharmacist experts in the field of travel medicine and a Fellow of the Faculty of Travel Medicine at the Royal College of Physicians and Surgeons, Glasgow. Prof Goodyer is currently the Vice Chair of the British Travel and Global Health Association and editor of their Journal. He is a council member and past Chair of the Pharmacist Professional Group of the International Society of Travel Medicines. He has researched and written widely on areas of Travel Medicine as well as appearing on radio and television on the subject.


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The important message for all travellers as I wrote last month is that the ‘the odds against catching Ebola are remote in the extreme’. However, because of the continuing presence of the disease in three countries in West Africa (Sierra, Leone, Guinea and Liberia), the World Health Organisation now recommends against all non essential travel to these destinations unless specifically intending to work in a health care capacity. There is also now screening at UK airports though many health experts have questioned the value of this. Exit screening from airports in the three affected countries is also in place.


What is now the risk for the traveller?

The most effective way to minimise risks still further is good hand hygiene, as we know that Ebola is not a very robust virus and even soap is effective as well as an alcohol based hand sanitiser.

As I explained in my last article that outside of these three countries any traveller is extremely unlikely to come into contact with an Ebola victim as it is only by contact with the body fluids of such people that Ebola can be caught. Even then Ebola is not an airborne infection and you would need to come into contact with say contaminated blood or saliva that has entered your body through a cut or mucous membranes (e,g. mouth). You can’t catch it from those who are carrying but not yet showing signs of the infection. I think these facts should reassure travellers in particular.  The most effective way to minimise risks still further is good hand hygiene, as we know that Ebola is not a very robust virus and even soap is effective as well as an alcohol based hand sanitiser. I recommend good attention to hand hygiene for all travellers as this helps to prevent the very common problem of diarrhoea. Carry a travel soap and hand sanitiser at all times.

The risk of Ebola to travellers should also be put into context. In the three affected countries from the beginning of year up till October there were 8011 cases with 3857 deaths ie around a 50% death rate. The worst affected country is Liberia with nearly 4.000 cases and the Sierra Leone at around 2,700 cases, though without further help this could escalate greatly by Christmas. However it is worth reflecting that malaria is still a greater killer. For instance there were over 13,000 deaths from malaria in Sierra Leone in 2011. Every year nearly 2,000 travellers from the UK catch malaria which despite treatment around 10 will die and many more end up on intensive care with permanent disabilities. Concern regarding Ebola should not detract from taking precautions against serious diseases like malaria.


Is it coming to the UK?

The real media hysteria concerns the threat of Ebola reaching the UK. I think anything like an outbreak seen in West Africa happening in Europe is also not something we should be concerned over. Certainly the need for identifying and putting into place quarantine measures of those reaching the UK with the disease are essential, but it is precisely why we are able to instigate these precautions that any significant spread is highly unlikely. The reason why the disease cant be contained in West Africa is simply because they don’t have the resources to implement the necessary measures and desperately need aid and help from other nations. It is encouraging that Nigeria, which does have somewhat better resources, was able to contain the spread of the infection when cases emerged in July and there have been no further reports of infection since September.

I think before the end of the crisis there will be a number of healthcare workers who contract and tragically die from the disease, mostly those who have been working in the affected countries .The nurses who caught Ebola in Spain and the US looking after victims despite protective clothing measures remains a mystery. It is likely that there was some failure in procedure or perhaps faulty equipment. It does emphasise though that nearly all those from outside West Africa who have contracted Ebola were in regular contact caring for the victims.

To date no unexpected cases of Ebola have arrived in Europe. Of course the situation can change so keep an eye on this Blog and if you have any concerns our Nomad clinics are able to offer the best support for all travel health related issues.