Ebola hemorrhagic fever outbreak travel considerations

  I. What are WHO’s travel recommendations?  During an epidemic, WHO regularly assesses the public health situation and makes recommendations for travel or trade restrictions as necessary, and may notify national governments for implementation.  Although travelers should be vigilant about their health status and that of those around them, the risk of infection for travelers is low because interpersonal transmission of Ebola is caused by direct contact with body fluids or secretions from patients.  Second, is it safe to travel with someone who is carrying Ebola?  Like people with other diseases, individuals who have been exposed to Ebola are likely to choose to travel. If the individual has not yet developed symptoms, they will not spread the virus to others around them. If the individual develops symptoms, they should seek immediate medical attention at the first sign of discomfort. If the onset is on transportation, the individual needs to report to the staff of the vehicle they are traveling on and seek medical attention as soon as they arrive at their destination. Travelers should be isolated at the onset of early symptoms of Ebola infection to prevent further transmission. Although the risk of infection to other travelers in this situation is very low, follow-up of contacts is still recommended.  Is it safe to travel to West Africa for business/office or to visit friends and family?  People traveling to Ebola hemorrhagic fever endemic areas or on business/office travel have a very low risk of contracting Ebola during the trip and developing the virus on the return trip, even if the trip includes travel to the areas where the most prevalent cases have been reported. Transmission of the virus requires direct contact with the blood, secretions, organs or other body fluids of sick or infected animals, or dead patients and animals, to which the average traveler is unlikely to be exposed. Travelers are advised to avoid these exposures under all circumstances.  If you are visiting friends or relatives in an infected area, the risk is similarly low unless there is direct contact with the sick or deceased. If so, it is important to report to public health authorities and receive follow-up. The purpose of follow-up is to confirm whether you have been exposed to Ebola and to prevent further spread of the disease through surveillance.  WHO’s general travel recommendations: 1) Travelers should avoid any contact with patients; 2) Medical personnel traveling to infected areas should strictly follow WHO’s recommended guidelines for infection prevention and control; 3) Anyone who has spent time in areas where recent cases have been reported should be aware of the symptoms of the disease and seek medical attention as soon as signs of the disease appear; 4) Clinicians should consider patients when providing medical care to travelers returning from infected areas with relevant symptoms. 4. Clinicians should consider the possibility of Ebola infection when providing medical services to travelers returning from infected areas with related symptoms.