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Ebola and the traveller to West Africa

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.


Nomad Travel Health Services

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Using the Nomad clinic services gives you a one-to-one experience with a qualified, highly trained, travel health nurse.

The consultation includes:

  • A detailed medical history
  • Risk assessment based on style and length of your trip
  • Advice on preventative measures you can take

Your pharmacy based travel clinic is all very well but for specialist advice at the same or lower cost come to Nomad. This is strongly advised if you are on a more adventurous or complex itinerary, or have special medical needs. Nomad Travel Clinics are specialists in:

  • Last minute travel
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  • Open 6 days per week

allowing 6-8 weeks for your vaccination programme, you have time to fit in full courses of vaccines where required which provides you with the best possible protection against certain vaccine preventable diseases. If you don’t have time to complete courses before you go, you risk travelling with little or even no protection against sometimes high risk diseases.

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The hot topic in Travel this summer is without doubt the Ebola Virus outbreak in West Africa. How scared should travellers really be and what can be done to reduce the risks? Is it going to hit the UK? What happens if you are on an aircraft with an Ebola victim?

There is little doubt that this is the worst outbreak of Ebola that we have ever seen, but as I will discuss the implications for the traveller, provided correctly informed and prepared, are not currently of great concern.

In reality as a traveller the odds against catching Ebola are remote in the extreme. The World Health Organisation has not recommended any travel restriction to even the worst affected countries, even though on the 8th August they declared it a Public Health Event of International Concern. This means that travellers will see heightened border controls and checks in flights to and from affected countries as well as WHO themselves putting extra resources into managing the problem. One of the reasons that the outbreak is so bad in countries like Sierra Leone is that they have poor healthcare infrastructures unable to contain spread of the disease.

Even sitting near a victim on an aeroplane for a long haul flight is thought to present a very low risk of infection.


Why is the risk to travellers so low?

It's all related to how the disease is spread. The virus can only be transmitted from person to person via body fluids e.g. blood or other secretions. It is not spread by droplet infections which means for instance there is no risk if an Ebola victim sneezes near you. The body fluid with virus, which could be either directly from the patient or be on an object that has been contaminated, needs to enter via a cut/graze or mucous membrane (e.g the mouth) in order to cause the infection. The victim does not transmit the disease in the incubation period before symptoms develops and they are not really very infectious in the early stages of the disease. Adding all this up a traveller would almost have to go out of their way to come into contact with victims to stand a significant risk of catching the disease. The highest risk would be if you were caring for Ebola patients in some way. Even sitting near a victim on an aeroplane for a long haul flight is thought to present a very low risk of infection.


Minimising the risk

Minimising the risk of infection is therefore a matter of common sense i.e. avoid any direct contact with Ebola victims. In areas where there is the most intense outbreak then for most travellers the greatest risk situation is likely to be a visit to a hospital that is treating Ebola patients and not imposing good quarantine procedures. For now therefore it might be wise to consider postponing travelling to countries like Sierra Leone unless the trip is essential. The other group of travellers who should recognise a greater risk are those visiting friends and relatives who might enter into caring for victims and even have contact with contaminated corpses. It is also a matter of reducing any chance of casual contact with the virus by good hand hygiene. Wash hands regularly and apply a hand sanitiser with 70% or greater alcohol content, which should be done by all travellers to prevent gut problems. It is a good idea not to eat any ‘bush meets’ as wild animals are thought to be the reservoir for the virus.


Checks

Finally check before you go – ask about the hospital facilities in the country and look on reliable WEB resources for up to do date information. Of the greatest importance is checking that health insurance is adequate and covers repatriation. As ever good preparation for a visit to countries in Africa is of the highest importance so a visit to a Nomad clinic will ensure you get the best possible advice.