The Travel Health and Vaccine Specialists

Health Alert


LEVEL 2 - PRACTICE ENHANCED PRECAUTIONS

Ebola in Guinea

Updated December 7, 2015

What is the current situation?

For more than a year, Guinea, Sierra Leone, and Liberia have been experiencing the largest and most complex outbreak of Ebola in history. There have been no cases reported in Guinea in recent weeks. The public health system in Guinea has shown that it is able to detect and respond to cases quickly by having a robust surveillance system in place, including cross-border communication and reporting systems; therefore, the overall risk of Ebola in the West African region has been reduced.

CDC no longer recommends that U.S. residents avoid nonessential travel to Guinea. However, CDC recommends that U.S. residents practice enhanced precautions when traveling to Guinea. The risk is extremely low. Travelers should follow CDC’s advice for avoiding contact with blood and body fluids. Travelers should also be aware that getting medical care in Guinea 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 weak 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, nose, or mouth).

  • 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 (such as needles and syringes) contaminated with body fluids of a person who is sick with or has died from 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?

How can I be exposed to Ebola?

You can be exposed to the Ebola virus if you have 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.

This kind of 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 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.

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.

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 Guinea, 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).
  • Do not handle items that may have come in contact with an infected person’s blood or body fluids.
  • Avoid contact with dead bodies, including participating in funeral or burial rituals.
  • Until more information is known about sexual transmission, avoid contact with the semen men who have 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.
    • Avoid facilities in West Africa where Ebola patients are being treated. The US Embassy or consulate is often able to provide advice on facilities that are suitable for your medical needs.

Preparing to Travel to Guinea

CDC recommends you take steps to protect yourself from other health risks in Guinea. See Health Information for Travelers to Guinea(http://wwwnc.cdc.gov/travel/destinations/traveler/none/guinea) 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 Guinea, 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 Guinea 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.

Special Recommendations for Travelers Who Will Be Working in Healthcare Settings

If you will be working in a healthcare setting while in Guinea, you should be prepared to care for patients in a region where resources are limited and the healthcare system is strained.

Healthcare workers who may be exposed to people with Ebola should be sure to follow these steps:

  • Wear the recommended personal protective equipment (PPE).
  • Use proper infection control and decontamination measures.
  • Isolate patients with suspected, probable, or confirmed Ebola from other patients.
  • Avoid direct contact with dead bodies without wearing recommended PPE.
  • Immediately notify your organization, health officials, and the US embassy or consulate in Guinea if you think you have been exposed to someone with Ebola but were not wearing recommended PPE.

See CDC’s resources on the Ebola: Non-US Healthcare Settings page and the CDC Safety Training Course for Healthcare Workers Going to West Africa in Response to the 2014 Ebola Outbreak. The World Health Organization also has advice in their Infection prevention and control guidance for care of patients in health-care settings, with focus on Ebola document.

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