The bulletin contains new information about a confirmed death from the Ebola virus in Sierra Leone, which had previously been declared by the WHO as Ebola free. This is a reminder to travellers about the potential for flare-ups of the virus in the region.
The outbreak of Ebola Virus Disease (EVD) centred in Guinea, Liberia and Sierra Leone has led to more than 11,000 deaths. This is the most serious outbreak of EVD in recorded history.
We strongly recommend that Australians residing or travelling in Africa, as well as Australian businesses with commercial interests in the region, subscribe to this bulletin and relevant travel advisory updates to receive an email notification each time these are updated.
We currently advise Australians to a exercise a high degree of caution to Liberia and Sierra Leone. We advise Australians to reconsider your need to travel to Guinea. If you choose to travel to, or remain in these countries, we strongly recommend that you register your travel and contact details with us, so that we can contact you or your family in an emergency.
The Zaire strain of the Ebola virus causes EVD in humans, with a case fatality rate of up to 90%. The fatality rate in the current outbreak, however, is approximately 60% according to the World Health Organization. The symptoms of EVD are severe and can include high fever, muscle pain and weakness, headache and sore throat, followed by vomiting, diarrhoea and in some cases, internal and external bleeding. There is currently no vaccine to prevent Ebola and no proven safe and effective specific treatment for EVD, however prompt and high-quality supportive care can be life-saving. A number of providers are currently working on vaccines for EVD, with some advancing to in-country clinical trials, however their effectiveness is yet to be determined.
The virus is introduced into the human population through direct contact with the blood or body fluids of infected animals (often through the hunting or preparation of “bushmeat”). Human to human transmission then occurs through direct contact to broken skin or mucous membranes with the body fluids of an infected person, including blood, faeces and sweat. Transmission can also occur through direct contact with the body or body fluids of a deceased EVD patient.
In 2014, the World Health Organization (WHO) announced that the outbreak of EVD in west Africa was a Public Health Emergency of International Concern. The WHO released an Ebola Response Roadmap intended to guide and coordinate the international response to the EVD outbreak in west Africa.
The WHO declared Guinea Ebola-free on 29 December 2015. Heightened screening measures remain in place until at least March 2016. A small number of new cases of Ebola have emerged in Liberia in recent months. Authorities are monitoring contacts of these cases.
On 15 January 2016 Sierra Leone health officials confirmed a new death from the Ebola virus. The WHO, which had previously declared Sierra Leone Ebola free, has stressed the potential for flare-ups of the virus in the Ebola-affected countries.
The Australian Government advises Australians to reconsider their need to travel to Guinea and exercise a high degree of caution to Sierra Leone and Liberia following the outbreak of EVD and the risk of new cases emerging. This reflects the seriousness of the outbreak, the challenges in containing it, the limited emergency care options, and travel restrictions which reduced freedom of movement in the region.
Sporadic demonstrations and local disturbances have been reported across Guinea, Liberia and Sierra Leone related to the EVD outbreak. There have been violent incidents specifically targeting healthcare workers.
Australians in EVD affected countries may find it difficult and costly to leave. Only a small number of commercial airlines continue to operate out of these countries and some land borders were temporarily closed during the outbreak. Additionally, many countries in Africa banned entry to travellers who had been in EVD affected countries. These bans may persist.
You should closely monitor the advice provided by local health authorities and the WHO. Maintain strict standards of hygiene and avoid all direct contact with patients with EVD or unknown illnesses. Avoid contact with any objects that could have been contaminated with the body fluids of someone with EVD. Avoid contact with wild animals and do not eat or handle raw or undercooked animal products, such as blood and meat. Know the symptoms of EVD and see a healthcare provider immediately if you feel unwell, or if any EVD symptoms develop.
The standards of local emergency health care in affected countries are well below Australian standards. The current outbreak of EVD has overwhelmed many local health facilities and options for obtaining routine or emergency medical care may be severely limited. You should also be aware that non-EVD related medical evacuations from EVD affected countries will be substantially more complicated than usual due to the restrictions on travel from EVD affected countries.
If you choose to remain in the region for work, you should ensure that your employer has contingency plans for treatment or evacuation should you show symptoms of the disease. If, despite our advice, you are considering undertaking independent travel, you should ensure that your travel insurance will cover healthcare and/or medical evacuation for EVD and any other illnesses.
For details on affected areas, including maps, check the latest situation reports on the WHO website.
Limits to consular assistance: The Australian Government has limited capacity to provide consular assistance in these circumstances. Medical evacuations for any potential EVD patient – and particularly symptomatic EVD patients - will be difficult to conduct. Australia does not have a diplomatic or consular mission in Guinea, Liberia or Sierra Leone and the Australian High Commission in Accra, Ghana has consular responsibility for these countries.
Travel restrictions were put in place in many countries as a result of the EVD outbreak. Authorities in a number of countries have implemented flight bans and a number of carriers suspended flights into Guinea, Sierra Leone and Liberia. Commercial flights are available to all three countries by a limited number of companies. Some land borders were closed during the outbreak. The region is volatile and governments may decide to close borders at short notice for a variety of reasons.
Health screening is being undertaken at a number of airports worldwide. Travellers from West Africa with fever or EVD-like symptoms may be subject to quarantine or denied entry or exit from certain countries. If you choose to travel to West Africa, you should consider the possible implications of this health screening should you become unwell.
Check the country specific travel advice for your destination, monitor the media closely and before you travel, confirm that borders remain open and check with your carrier for the most up to date information.
The Australian Government introduced new border screening processes for travellers returning to Australia from Ebola-affected countries. For more information, visit the Department of Health website, Department of Agriculture website and the Department of Immigration and Border Protection website.
World Health Organization:
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Smartraveller travel advice: