Facts and Information About Current Ebola Outbreak
What is Ebola?
- Rare and deadly disease caused by an infection with one of the Ebola virus strains. Can affect humans and non human primates (monkey, gorillas, etc)
- Four of the five identified Ebola virus species are known to cause disease in humans:
- Ebola virus
- Sudan virus
- Taï Forest virus
- Bundibugyo virus
- Ebola viruses are found in several African countries and were first discovered in 1976 near the Ebola River in the Zaire (Democratic Republic of the Congo).
- The natural reservoir host of Ebola virus remains unknown. But researchers believe that the virus is animal-borne and that bats are the most likely reservoir
Outbreaks
- Areas with widespread transmission are in West Africa – Sierra Leone, Guinea, and Liberia, while Nigeria has seen localized transmission. Senegal and the US are countries with travel-associated cases.
- First known outbreak: 1976 in Zaire (Democratic Republic of the Congo)
- 318 reported cases in humans, 280 deaths among cases
- Disease was spread by close personal contact and by use of contaminated needles and syringes in hospitals/clinics.
- 1976 to present – multiple countries in West Africa, the Philippines, Uganda, Russia, Sudan, Gabon, South Africa, Ivory Coast, USA, Zaire/Congo, England
- 14,098 reported number of cases, 5,160 deaths among cases (includes 1976 outbreak in Zaire)
- United States
- CDC confirmed on Sept. 30, 2014, through lab tests, the first case of Ebola to be diagnosed in the US in a person, Thomas Duncan who had traveled to Dallas, TX from West Africa. He died on October 8th, 2014.
- Mr. Duncan did not exhibit symptoms on the flight back to the States, but developed symptoms 5 days after arriving in the US
- He had definite exposure with 10 people and possible exposure with 38 people.
- On October 8, 2014, Mr. Duncan died from Ebola. He has been the only person in the United States to die from the virus.
- In the past 10 years, the US had 5 imported cases of Viral Hemorrhagic Fever (VHF) diseases similar to Ebola. None resulted in any transmission in the US
Transmission
- Ebola can only be transmitted by direct contact with the body fluids of a person who is sick with the disease. Body fluids include saliva, mucus, vomit, feces, sweat, tears, breast milk, urine and semen.
- Coughing and sneezing are not common symptoms of Ebola since the disease is transmitted by direct contact with body fluids. Direct contact means that body fluids from an infected person, alive or dead, have touched someone’s eyes, nose, or mouth or an open cut, wound, or abrasion.
- All cases of human illness or death from Ebola have occurred in Africa – with the exception of laboratory contamination cases: one in England and two in Russia
- Healthcare providers caring for Ebola patients and the family and friends in close contact with Ebola patients are at the highest risk of getting sick. People can also become sick with Ebola after coming in contact with infected wildlife. Example: in Africa, Ebola may spread as a result of handling bushmeat and contact with infected bats
- Evidence shows that people who recover from Ebola develop antibodies that last for at least 10 years, possibly longer. Once someone has recovered from Ebola, they can no longer spread the virus. However, it’s not known if people who recover are immune for life or if they can become infected with a different species of Ebola.
- There’s no evidence that mosquitoes or other insects can transmit Ebola virus. Only mammals have shown the ability to spread and become infected.
Treatment
- No FDA-approved vaccine or medicine is available for Ebola
- Symptoms of Ebola are treated as they appear
- Providing IV’s and balancing electrolytes
- Maintain oxygen status and blood pressure
- Treating other infections if they occur
- Experimental vaccines and treatments for Ebola are under development, but they have not yet fully been tested for safety or effectiveness
- Experimental treatment for the two US patients that contracted Ebola in Liberia was arranged privately by Samaritan’s Purse. The NIH was not involved with procuring, transporting, approving, or administering the treatments
- The product is still in an experimental stage and there is a very limited supply, so it cannot be purchased and is not available for general use.
- ZMapp, being developed by Mapp Biopharmaceutical Inc., is an experimental treatment that hasn’t been tested in humans for safety or effectiveness. ZMapp isn’t being developed as a preventative medicine, but rather as a therapeutic product for treatment
- Two other companies – Tekmira and BioCryst Pharmaceuticals – receive funding from DoD’s Defense Threat Reduction Agency and have therapeutic candidates for Ebola in early development
- DoD is working with a company called Newlink to develop an Ebola vaccine candidate
- BioCryst, with NIH support, is working to develop an antiviral drug to treat Ebola that’s expected to begin Phase 1 testing later in 2014
Steps the US is taking to deal with the outbreak and the virus entering the US
- The White House announced on October 8, 2014, that additional Ebola screening will be put in place at 5 US airports – JFK in New York, Newark Liberty, Washington Dulles, Chicago O’Hare, and Hartsfield-Jackson Atlanta
- These 5 airports are the destination of 94% of individuals who travel to the US from the three countries that are currently affected by Ebola – Guinea, Liberia, and Sierra Leone
- The CDC has issued “Level 3, Avoid Nonessential Travel” alerts for these 3 countries as of October 7th, 2014
- CDC is working to prepare US healthcare facilities about how to safely manage a patient with suspected Ebola virus disease
*We will continue to monitor the situation and provide you with updates as we become aware.
*UPDATES*
From the White House
Press Release
Oct. 8, 2014
ENHANCED EBOLA SCREENING TO START AT FIVE U.S. AIRPORTS FOR ALL PEOPLE ENTERING U.S. FROM EBOLA-AFFECTED COUNTRIES
New layers of screening at airports that receive more than 94% of West African Travelers
The Centers for Disease Control and Prevention (CDC) and the Department of Homeland Security’s Customs & Border Protection (CBP) this week will begin new layers of entry screening at five U.S. airports that receive over 94 percent of travelers from the Ebola-affected nations of Guinea, Liberia, and Sierra Leone.
New York’s JFK International Airport will begin the new screening on Saturday. In the 12 months ending July 2014, JFK received nearly half of travelers from the three West African nations. The enhanced entry screening at Washington-Dulles, Newark, Chicago-O’Hare, and Atlanta international airports will be implemented next week.
“We work to continuously increase the safety of Americans,” said CDC Director Tom Frieden, M.D., M.P.H. “We believe these new measures will further protect the health of Americans, understanding that nothing we can do will get us to absolute zero risk until we end the Ebola epidemic in West Africa.”
“CBP personnel will continue to observe all travelers entering the United States for general overt signs of illnesses at all U.S. ports of entry and these expanded screening measures will provide an additional layer of protection to help ensure the risk of Ebola in the United States is minimized,” said Secretary of Homeland Security Jeh Johnson. “CBP, working closely with CDC, will continue to assess the risk of the spread of Ebola into the United States, and take additional measures, as necessary, to protect the American people.”
CDC is sending additional staff to each of the five airports. After passport review:
- Travelers from Guinea, Liberia, and Sierra Leone will be escorted by CBP to an area of the airport set aside for screening.
- Trained CBP staff will observe them for signs of illness, ask them a series of health and exposure questions and provide health information for Ebola and reminders to monitor themselves for symptoms. Trained medical staff will take their temperature with a non-contact thermometer.
- If the travelers have fever, symptoms or the health questionnaire reveals possible Ebola exposure, they will be evaluated by a CDC quarantine station public health officer. The public health officer will again take a temperature reading and make a public health assessment. Travelers, who after this assessment, are determined to require further evaluation or monitoring will be referred to the appropriate public health authority.
- Travelers from these countries who have neither symptoms/fever nor a known history of exposure will receive health information for self-monitoring.
Entry screening is part of a layered process that includes exit screening and standard public health practices such as patient isolation and contact tracing in countries with Ebola outbreaks. Successful containment of the recent Ebola outbreak in Nigeria demonstrates the effectiveness of this approach.
These measures complement the exit screening protocols that have already been implemented in the affected West African countries, and CDC experts have worked closely with local authorities to implement these measures. Since the beginning of August, CDC has been working with airlines, airports, ministries of health, and other partners to provide technical assistance for the development of exit screening and travel restrictions in countries affected by Ebola. This includes:
- Assessing the capacity to conduct exit screening at international airports;
- Assisting countries with procuring supplies needed to conduct exit screening;
- Supporting with development of exit screening protocols;
- Developing tools such as posters, screening forms, and job-aids; and
- Training staff on exit screening protocols and appropriate personal protective equipment (PPE)
Today, all outbound passengers are screened for Ebola symptoms in the affected countries. Such primary exit screening involves travelers responding to a travel health questionnaire, being visually assessed for potential illness, and having their body temperature measured. In the last two months since exit screening began in the three countries, of 36,000 people screened, 77 people were denied boarding a flight because of the health screening process. None of the 77 passengers were diagnosed with Ebola and many were diagnosed as ill with malaria, a disease common in West Africa, transmitted by mosquitoes and not contagious from one person to another.
Exit screening at airports in countries affected by Ebola remains the principal means of keeping travelers from spreading Ebola to other nations. All three of these nations have asked for, and continue to receive, CDC assistance in strengthening exit screening.
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From the White House
Fact Sheet
Oct. 8, 2014
SCREENING OF TRAVELERS AT AIRPORTS
This fact sheet helps explain the measures the Centers for Disease Control and Prevention (CDC), the Department of Homeland Security’s Customs and Border Protection, and their partners are taking at airports both in the United States and in affected countries in West Africa to prevent the spread of Ebola.
Exit screening in countries with Ebola outbreaks
Since the beginning of August, CDC has been working with airlines, airports, ministries of health, and other partners to provide technical assistance to countries with Ebola outbreaks. CDC has helped affected countries screen departing travelers from these countries (exit screening). Exit screenings are conducted at airports in these outbreak-affected countries to look for sick travelers or travelers exposed to Ebola and to delay them from boarding an airplane until it is safe for them to travel.
We continue to support and strengthen exit screening in these countries with CDC staff, protocols, and educational materials.
What exit screening looks like
Exit screening might look a little different in each country but contains the same basic elements.
1. All travelers
- Have their temperature taken
- Answer questions about their health and exposure history
- Are visually assessed for signs of potential illness
2. Travelers with symptoms or possible exposures to Ebola are separated and assessed further.
3. This assessment determines whether they are
- Allowed to travel
- Not allowed to travel on a commercial flight and referred to public health authorities for further evaluation
Entry screening in the United States
Looking for sick travelers at U.S. airports
Every day, CDC works closely with partners at U.S. international airports and other ports of entry to look for sick travelers with possible contagious diseases. These measures will be enhanced to detect possible cases of Ebola.
Because of the Ebola outbreak, CDC and Customs and Border Protection (CBP) are beginning enhanced entry screening of travelers who have traveled from or through Guinea, Liberia, and Sierra Leone. By doing enhanced entry screening at 5 U.S. airports, we will evaluate over 94% of travelers from the affected countries. Our staff at all airports remain trained and ready to respond to any reports of ill travelers, and our robust public health system is prepared to respond and assist.
What enhanced U.S. entry screening looks like
For each arriving traveler who has been in Guinea, Liberia, or Sierra Leone:
1. CBP will give each traveler health information that includes
- Information about Ebola
- Symptoms to look for and what to do if symptoms develop
- Information for doctors if travelers need to seek medical attention
2. Travelers will undergo screening measures to include:
- Answer questions to determine potential risk
- Have their temperature taken
- Be observed for other symptoms of Ebola
3. If a traveler has a fever or other symptoms or has been exposed to Ebola, CBP will refer to CDC to further evaluate the traveler.
CDC will determine whether the traveler
- Can continue to travel
- Is taken to a hospital for evaluation, testing, and treatment
- Is referred to a local health department for further monitoring and support
Entry screening is a part of a layered approach. When used with other public health measures, entry screening can strengthen our efforts to battle this virus. It is important that we act as global citizens, continuing to put our full weight behind response efforts in West Africa and providing support for those traveling here from that region.
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