Available evidence suggests that the outbreak began in Guinea’s Guéckédou Prefecture during December 2013, with subsequent spread to other prefectures in Guinea (including the capital Conakry), as well as neighbouring Liberia and Sierra Leone.
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The outbreak has not been brought under control and new cases and deaths continue to be reported in all three affected countries.
In total, 1 201 cases including 672 deaths (case fatality rate 56%) have been reported during the 2014 outbreak. Since Ebola was discovered in 1976, some 1 200 people have been killed by the virus from 3 147 cases - illustrating the virulence of the virus this time round.
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Of concern is the surge in new cases in all three affected countries, which reflects ongoing transmission of infection in the community and in healthcare facilities.
This is likely due to inadequate treatment facilities, insufficient human resources and, in some areas, persistent community resistance to instituting preventive measures.
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The Ministry of Health of Nigeria has reported a probable case of EVD, but the results of confirmatory testing being conducted at a WHO Collaborating Centre in Senegal are pending.
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The case-patient was a Liberian national who is reported to have travelled by air to Lagos on 20 July 2014, and was admitted to hospital immediately on arrival; he died 5 days later.
Risk of imported Ebola virus disease cases to South Africa
The risk of infection for travellers is generally low since most human infections result from direct contact with the body fluids or secretions of infected patients, particularly in hospitals (nosocomial transmission) and as a result of unsafe procedures, use of contaminated medical devices (including needles and syringes) and unprotected exposure to contaminated body fluids.
EVD cases have been reported from the capital cities of Conakry and Monrovia during the current outbreak; given the frequency of travel between southern and western African countries, there is a risk of EVD cases being imported into South Africa, but overall this risk is currently thought to be low.
Healthcare or international agency workers involved in the outbreak response may also travel to and present themselves in South Africa for medical care, and a high index of suspicion is important for such cases.
A detailed history regarding travel and level of contact with suspected/confirmed EVD cases is extremely important.
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Recommendations for travel to/from Guinea, Liberia, Sierra Leone, Mali and West Africa
The World Health Organization (WHO) does not currently recommend that any travel or trade restrictions be applied to Guinea, Liberia, or Sierra Leone.
There are no special precautions or directives for commercial flights, passengers or crew departing on flights bound for or returning to Guinea, Liberia, or Sierra Leone.
Any ill persons reported on flights from Guinea, Liberia, Sierra Leone and neighbouring countries will need to be evaluated by the relevant Port Health officials.
All requests for medical evacuation of persons from Guinea, Liberia, Sierra Leone or Mali with febrile illness or suspected infectious disease will need careful evaluation by the Port Health officials.
Symptoms of Ebola typically include:
Fever, headache, joint and muscle aches, weakness, diarrhoea, vomiting, stomach pain and lack of appetite
While the risk of introduction of Ebola virus into South Africa is considered low, the NICD strongly recommends that surveillance for viral haemorrhagic fevers (and at present, particularly EVD), be strengthened. The symptoms are similar to those of influenza and malaria.
This should be done primarily through Port Health services, but it is also extremely important that public and private practitioners are on the alert for any ill persons that have travelled to viral haemorrhagic fever risk areas.
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