The WHO say travelers leaving countries affected by the Ebola virus should be screened for signs of infection.
Without specifying exactly which countries they are, the UN health agency "requests" in a statement issued on Monday that affected countries "conduct exit screening of all persons at international airports, seaports and major land crossings, for unexplained febrile illness consistent with potential Ebola infection."
Anyone whose symptoms are consistent with Ebola virus disease should not be allowed to leave an affected country, unless they are leaving as "part of an appropriate medical evacuation," says the World Health Organization (WHO) statement.
The UN agency is not currently recommending that non-affected countries that do not share borders with affected countries bring in travel restrictions and active screening of passengers arriving at sea ports, airports or ground crossings.
The current outbreak of Ebola virus disease, which to date has claimed over 1,000 lives, is thought to have started in Guinea last December. It has since spread and is still spreading in Guinea, and neighboring Liberia and Sierra Leone, and a traveler carrying the virus also infected a small number of people in Nigeria.
In a more recent situation statement issued on Tuesday, the WHO says while the outbreak continues to develop, at present no cases have been confirmed anywhere else in the world outside of these four countries.
On August 8th, the UN agency declared the Ebola outbreak in West Africa a Public Health Emergency of International Concern (PHEIC), as defined by International Health Regulations (2005).
Travel and Transport Task Force is established
To try and contain the disease and prevent it spreading to other countries, a Travel and Transport Task Force has been set up to monitor the situation and keep travelers, plus travel and tourism organizations, up to date.
Members of the task force include heads of WHO, the International Air Transport Association (IATA), the World Travel and Tourism Council (WTTC), the International Civil Aviation Organization (ICAO), the World Tourism Organization (UNWTO), and Airports Council International (ACI).
In the Monday statement, the UN agency reminds travelers and travel organizations that Ebola does not spread easily and risk of transmission in an airplane is low. Ebola cannot spread in the air, unlike flu and TB. You can only catch it by direct contact with blood and other bodily fluids from an infected living or dead person or animal.
Also, an infected person is only contagious when they start to experience symptoms. The incubation period can be from 2-21 days, after which initial symptoms like fever, muscle pain, headache, weakness and sore throat begin, and are then followed by more severe symptoms like vomiting, diarrhea, rash, and in some cases, bleeding.
Another reason that the risk of catching Ebola during air travel is so low is that infected people are usually so sick they are unlikely to be traveling and getting on an aircraft.
In any case, travelers are urged to wash their hands regularly and practice good hygiene.
Ebola is spreading in West Africa mainly because sick people are infecting family and friends who are nursing them. It also spreads when people do not follow strict prevention and control measures when preparing the bodies of those who have died of the disease for funerals and burials.
Another way the disease is spreading is in clinics and health care facilities where people come into unprotected contact with infected patients. In Nigeria, all cases of infection were of people who were in direct contact with a single traveler who was taken into the hospital when they arrived in Lagos.
Risk of outbreaks in affluent countries extremely small
In a recent article describing how the current Ebola outbreak highlights global health care disparities, a US expert on infectious diseases says the risk of an infected traveler triggering an outbreak in an affluent country like the US is extremely small.
In contrast to West Africa, affluent countries have the health care infrastructure to isolate suspected cases, provide advanced medical care, surveillance, and handle biohazards, says Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases.
The WHO say all countries should give citizens traveling to countries affected by Ebola up-to-date, relevant information about the outbreak and advise them on how to reduce exposure and risk of infection.
Situation in Guinea and Nigeria showing encouraging signs
Meanwhile, the agency reports that the situation in Nigeria and Guinea is showing "encouraging signs."
In Guinea, there is higher public awareness of the facts surrounding Ebola and how to reduce risk of infection. Villages that had previously been resisting outside help are now cooperating, resulting in a surge of reported cases.
However, this does not mean the outbreak is under control. Progress is fragile, and there is a real risk that the outbreak could resurge as indicated by the report of a new case in a previously unaffected area.
In Nigeria's capital Lagos, where the first imported case was detected in July, the situation "looks reassuring," say the WHO. So far, the evidence points to all 11 other infected people being part of a single chain of transmission. These include medical staff and another patient in the same hospital.
Nobody else on the same flight as the initial patient was infected, and "intensive contact tracing" by the Nigerian health authorities with help from the US Centers for Disease Control and Prevention, has so far not identified any further confirmed cases outside the initial transmission chain.
The fact that one of the infected people has recovered is also reassuring, say the WHO, and helps counter the widespread perception that infection with Ebola is a death sentence. There is evidence that if you detect it and treat it early there is a good chance of survival.
The authorities remain cautiously optimistic as they stay on high alert and continue with intensive efforts to search for new cases, so that any further spread in Nigeria can be stopped.
Written by Catharine Paddock PhD