Leading international organizations and associations from the transport, trade and tourism sector stand firmly with the World Health Organization (WHO) against general bans on travel and trade, as well as restrictions that include general quarantine of travellers from Ebola-affected countries.

WHO does not recommend general bans on travel or trade

The Travel and Transport Task Force, established in August 2014, calls for international cooperation of governments and the transport sector in following the recommendations of the International Health Regulations Emergency Committee on Ebola, convened by WHO. WHO does not recommend general bans on travel or trade, or general quarantine of travellers arriving from Ebola-affected countries, as measures to contain the outbreak. Such measures can create a false impression of control and may have a detrimental impact on the number of health care workers volunteering to assist Ebola control or prevention efforts in the affected countries. Such measures may also adversely reduce essential trade, including supplies of food, fuel and medical equipment to the affected countries, contributing to their humanitarian and economic hardship.

Exit screening for Ebola

Current exit screening of all persons departing affected countries through international airports, seaports and major land crossings is recommended by WHO and can reduce the numbers of people with symptoms from travelling from the countries with high levels of Ebola transmission. While screening upon entry into non-affected countries may provide an opportunity to further increase public awareness about Ebola, such screening also can require significant resources including staff, facilities and systems to care for ill travellers who might be suspected of having Ebola.

Preparedness for non-affected countries

The best protective measures for non-affected countries are adequate levels of preparedness, including heightened surveillance to detect and diagnose cases early and well prepared staff and operational planning to ensure that suspect cases of Ebola are managed safely and in ways to minimize further spread. Communication campaigns should be conducted to inform travellers, airlines, shipping crews, staff working at points of entry, and health workers everywhere about the symptoms of Ebola virus disease and what to do if a person has symptoms. Data on the efficiency of exit screening should be made available.

Advice to travellers

People who have travelled to 1 of the 3 West African countries currently affected by Ebola virus disease (Guinea, Liberia and Sierra Leone) should take the following precautions for 21 days after returning:

• stay within reach of a good quality health care facility
• be aware of the symptoms of infection (sudden fever, intense weakness, muscle pain, headache, vomiting, diarrhoea, rash, and sometimes bleeding)
• immediately report a fever of 38° C or higher to their local medical emergency service (ideally by phone) and mention their travel history.

Note

Early treatment improves the chance of recovery. To catch Ebola requires direct contact with the body fluid of an Ebola-infected person. Asymptomatic individuals are not infectious, even if they are incubating the disease.

Attending international meetings

The IHR Emergency Committee agreed that there should not be a general ban on participation of people from countries with transmission of Ebola from attending international meetings and events. The decision of participation must be made on a case by case basis by the host country. This country may request additional health monitoring of participants.

The Travel and Transport Task Force, which includes WHO, is working together to:

• develop guidance on exit screening recommendations for affected countries
• provide a set of considerations and steps for planning entry screening at point of entry for countries that wish to introduce this as part of their preparedness plan
• inform the aviation and maritime sectors on procedures for caring safely for travellers who are suspected to be infected with Ebola on board an aircraft or ship, or at arrival points
• provide information on Ebola to travellers arriving at or leaving airports, ports or other transit points
• develop protocols for the passenger shipping sector
• collect data and work with authorities to reduce restrictions to port arrivals and ship and aeroplane movements.

The Task Force is concerned about reports of denial of medical care for ill seafarers on board ships that had previously called at ports in the Ebola-affected region.

About the Travel and Transport Task Force

Members of the Travel and Transport Task Force include the World Health Organization (WHO), the International Civil Aviation Organization (ICAO), the World Tourism Organization (UNWTO), Airports Council International (ACI), International Air Transport Association (IATA), World Travel and Tourism Council (WTTC) International Maritime Organization (IMO), the International Chamber of Shipping (ICS) and the Cruise Lines International Association (CLIA). The Task Force was set up in August 2014 to support the global efforts to contain the spread of Ebola virus disease and provide a coordinated international response for the travel, trade and tourism sector.

About Ebola virus disease

The risk of transmission of Ebola virus disease during travel is low. Unlike infections such as influenza or tuberculosis, Ebola is not spread by breathing air (and the airborne particles it contains) from an infected person. Transmission requires direct contact with blood, secretions, organs or other body fluids of infected living or dead persons or animals, all unlikely exposures for the average traveller.

People are only infectious after they have started to have symptoms, which include fever, weakness, muscle pain, headache and sore throat. This is followed by vomiting, diarrhoea, rash and, in some cases, bleeding. If a person, including a traveller, may have been exposed to the Ebola virus, he/she should seek medical attention at the first sign of illness. Early treatment improves chance of survival.

Infectious Disease and Mental Health Specialists Bring Global Perspective.

GeoBlue, a leader and innovator in serving the health care needs of world travelers, is tapping the expertise of their experienced and reputable Regional Physician Advisors in more than 60 locations around the world to keep its members, and the public at large, educated on the Ebola Virus and its potential spread. GeoBlue consults regularly with specialists in fields from infectious disease to mental health to bring an alarmed populace the latest advice and guidance through its web sites and blog postings.

Dr. Vanya Gant, PhD, FRCP, FRCPath, a specialist in Infectious Diseases and Microbiology, is Divisional Clinical Director for Infection at the Hospital for Tropical Diseases in London, England. In addition to patient care, Dr. Gant develops new techniques and materials for combating infection. He has appeared in several public service television programs on matters of infection and microbiology, some of which he co-wrote.

He urges the public to remain calm and be vigilant: "It is very important to remember that you will not be at risk of Ebola infection unless you have been in close contact with people who are infected. You cannot catch Ebola from people who are well; however, patients who have recovered from the virus may still be infectious for a considerable period of time, so close contact, such as of a sexual nature, is risky." Dr. Gant has contributed "Ten Things You Need to Know About Ebola" for GeoBlue members.

Dr. Suzanne A. Black, Psy.D., is a clinical psychologist licensed in New York, California and in France and has served as professor of psychiatry at University of California, San Francisco Medical School. Currently, Dr. Black works with international patients in her private practice, specializing in medical psychology, cross cultural psychology and mood disorders.

Dr. Black recently posted an assessment of "Ebola panic" on http://www.healthytravelblog.com, finding that it arises from an emotional response to an existential threat: "When we selectively attend to a concept – such as Ebola in this case, a deadly virus which invokes fear – we direct our energies and focus on Ebola, and have a natural tendency to ignore and try to refute any information that serves as evidence against the threat of contracting it. We are then using our emotions to estimate the potential for risk of contracting the virus; this creates a misperception of risk. In order to calm the anxiety caused by these concerns, it is important to focus on the facts to dispel the myths that are being circulated and sensationalized by some media sources."

"GeoBlue is grateful for the leadership and courage that physicians and other healthcare professionals have demonstrated in the fight against Ebola," said GeoBlue's Chief Executive Officer, Angelo Masciantonio. "We hope that our reputation as experts in international healthcare helps convey important facts about Ebola to the public at large. With the timely distribution of expert knowledge we can manage the risks the Ebola poses."

GeoBlue members have access to GeoBlue's worldwide databases, downloadable app and mobile tools to stay abreast of unfolding health and security risks and to get the care they need from highly qualified doctors around the globe.

International SOS has launched a dedicated Ebola website in response to the developing outbreak in West Africa.

iPMI Magazine reported the ebola virus outbreak as it happened, click here to read more.

The site is being regularly updated with disease information, actualité en français (news in french), country-specific updates, travel advice and educational materials for members to download. The first outbreak of the deadly Ebola virus in West Africa seems to be spreading, with cases confirmed initially in Guinea and now Liberia. Governments and NGOs are working hard to control the outbreak and there have been some border closures.

Doug Quarry, Group Medical Director for Medical Information and Analysis at International SOS said, “The situation continues to deteriorate. This means that more international resources will be required to contain it. In addition, the outbreak may be coming closer to a number of mining operations in the affected areas. Operators at these sites must be ready to train staff on how to avoid the disease. They should also be prepared if some staff ask to be evacuated from the area.”

The dedicated website is available for International SOS members and can be accessed at the following address: www.internationalsos.com/ebola

Members are encouraged to contact one of the 27 International SOS Assistance Centres for advice before, during or after travel to any of the affected countries.