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Wednesday, November 4, 2015

CDC Travelers' Health: Ebola in Sierra Leone travel notice downgrade

What is the current situation?

For more than a year, Sierra Leone, Liberia, and Guinea have been experiencing the largest and most complex outbreak of Ebola in history. Cases continue to be reported in Guinea. Currently, there are no known cases of Ebola in Liberia or Sierra Leone. The health system in Sierra Leone continues to monitor for new cases and to take precautions to prevent transmission in the country. CDC is also closely monitoring the situation and will update information and advice for travelers as needed.
CDC is no longer recommending that US residents avoid nonessential travel to Sierra Leone. However, CDC recommends that US residents practice enhanced precautions when traveling to Sierra Leone.Although the risk is extremely low, there is the possibility of reintroduction of Ebola into the country. Travelers should follow CDC’s advice for avoiding contact with blood and body fluids. Travelers should also be aware that getting medical care in Sierra Leone may be difficult because the health infrastructure has been severely strained by the Ebola outbreak. Certain travelers, such as senior citizens, people with underlying illnesses, and people with weakened immune systems, should consider postponing travel.
For more information, visit 2014 Ebola Outbreak in West Africa on the CDC Ebola website.

What is Ebola?

Ebola is a rare and deadly disease. The disease is caused by infection with one of the Ebola virus species (Zaire ebolavirus, Sudan ebolavirus, Bundibugyo ebolavirus, or Tai Forest ebolavirus). Ebola is spread by direct contact (through broken skin or mucous membranes in, for example, the eyes)
  • with the blood or body fluids (such as urine, saliva, sweat, feces, vomit, breast milk, and semen) of a person who is sick with or has died from Ebola;
  • with objects (like needles and syringes) contaminated with body fluids of a person sick with Ebola or who has died of Ebola;
  • with infected fruit bats and primates (apes and monkeys); and
  • possibly with semen from a man who has recovered from Ebola (for example, contact during oral, vaginal, or anal sex).
Signs of Ebola include fever and symptoms such as severe headache, fatigue (feeling very tired), muscle pain, vomiting, diarrhea, stomach pain, or unexplained bleeding or bruising.

Who is at risk?

Travelers could be infected if they come into contact with blood or body fluids from someone who is sick with Ebola or has died from Ebola. Healthcare workers and the family and friends in close contact with patients with Ebola are most at risk of getting sick because they may come in contact with infected blood or body fluids.
People also can become sick with Ebola if they come into contact with infected wildlife or raw or undercooked bushmeat (wild animals hunted for food) from an infected animal.
Ebola virus has been found in the semen of some men who have recovered from Ebola. It is possible that Ebola could be spread through sex or other contact with semen. It is not known how long Ebola might be found in the semen of male Ebola survivors. Based on the results from limited studies conducted to date, it appears that the amount of virus decreases over time and eventually leaves the semen. CDC and other public health partners are continuing to study how Ebola is spread and will share what is known as it becomes available.

How can I be exposed to Ebola?

You can be exposed to Ebola if you have direct contact with blood or body fluids (such as urine, saliva, sweat, feces, vomit, breast milk, and semen) of a person sick with Ebola without wearing the right protective clothing and equipment. For healthcare workers, this includes wearing a face shield or goggles, a medical mask, double gloves, a waterproof gown or coveralls, an apron, and waterproof boots.

Exposure can happen if you —

  • Are stuck with a needle or splashed in the eye, nose, or mouth with blood or body fluids of someone sick with Ebola.
  • Handle blood or body fluids of a person who is sick with Ebola.
  • Touch a person who is sick with Ebola.
  • Touch the body of someone who died from Ebola.
  • Care for or live with a person who is sick with Ebola.
  • Spend a long amount of time within 3 feet (1 meter) of a person who is sick with Ebola.

What can travelers do to prevent Ebola?

There is no approved vaccine or specific treatment for Ebola, and many people who get the disease die. If you are traveling to Sierra Leone, please take the following steps to prevent Ebola.
  • Practice careful hygiene. For example, wash your hands frequently with soap and water or use an alcohol-based hand sanitizer.
  • Avoid contact with blood and body fluids (such as urine, saliva, sweat, feces, vomit, breast milk, and semen).
  • Avoid contact with dead bodies.
  • Until more information is known about sexual transmission, avoid contact with the semen of a man who has recovered from Ebola (for example, during oral, vaginal, or anal sex). If you do have sex, use a condom the right way every time. Consider bringing your own supply of condoms.
  • Avoid contact with animals (such as bats or monkeys) or with raw or undercooked meat.
  • Do not eat or handle bushmeat (wild animals hunted for food).
  • Seek medical care immediately if you develop fever (100.4°F / 38°C or above) or other symptoms such as severe headache, fatigue (feeling very tired), muscle pain, vomiting, diarrhea, stomach pain, or unexplained bleeding or bruising.
    • Limit your contact with other people when you travel to the doctor. Do not travel anywhere else.
    • The US Embassy or consulate is often able to provide advice on facilities that are suitable for your medical needs. The US Embassy in Sierra Leone can be reached at (232) (99) 105 500.

Preparing to Travel to Sierra Leone

CDC recommends you take steps to protect yourself from other health risks in Sierra Leone. See Health Information for Travelers to Sierra Leone to learn more about ways to stay healthy and safe on your trip.
  • Visit a travel medicine provider, ideally 4 to 6 weeks before you leave, to discuss health recommendations based on your medical history and travel plans.
    • Because it may be difficult to get medical care in Sierra Leone, certain travelers, such as senior citizens, people with underlying illnesses, and people with weak immune systems, should talk to their doctor about whether they should consider postponing travel.
  • Check your health insurance plan to learn what is covered in the event that you become sick. CDC recommends that anyone traveling to Sierra Leone have full coverage, including coverage for emergency medical evacuation.
    • Information about medical evacuation services can be found on the US Department of State’s website on the Air Ambulance/MedEvac/Medical Escort Providers page.
    • Be sure to check the coverage limits for evacuation insurance. Also check to see if the policy covers evacuation to the United States or to the nearest location where adequate medical care is offered.
    • Some insurance providers are excluding medical evacuation coverage for people who have Ebola. Check with providers to ensure you have the coverage you need.

Returning to the United States

See CDC’s Screening and Monitoring Travelers to Prevent the Spread of Ebola fact sheet for information about exit screening in West African countries with Ebola outbreaks and entry screening in other countries, including the United States.
You can also learn more about how you will be connected with a health department after you arrive in the United States to monitor your health for Ebola symptoms.

Traveling to Other Countries or on Cruises

Let your health department know about your travel plans, especially if you are going to another state, leaving the country, or taking a cruise. If you are allowed to travel, there may be special steps you need to follow.
  • If you plan to travel to another country, let your health department know and call the country’s embassy to find out if they have any travel bans or quarantines for people who have recently been in a country with an Ebola outbreak.
  • If you plan to take a cruise, call the cruise line to learn about restrictions that may apply to you. Some cruise lines may not allow passengers to board ships if they have recently been in or traveled through certain countries.

More Information

Traveler Information

Information for Humanitarian Aid Organizations

Clinician Information

Information for Airline Personnel

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