Ebola in Sierra Leone
|Warning - Level 3, Avoid Nonessential Travel|
|Alert - Level 2, Practice Enhanced Precautions|
|Watch - Level 1, Practice Usual Precautions|
Updated: September 11, 2014
CDC urges all US residents to avoid nonessential travel to Sierra Leone, Guinea, and Liberia because of unprecedented outbreaks of Ebola in those countries. CDC recommends that travelers to these countries protect themselves by avoiding contact with the blood and body fluids of people who are sick with Ebola.
What is the current situation?
An outbreak of Ebola has been ongoing in Sierra Leone since May 2014. Outbreaks are also occurring in Guinea and Liberia; these outbreaks of Ebola are the largest and most complex in history. A small number of cases have also been reported in Lagos and Port Harcourt, Nigeria. Affected districts in Sierra Leone include Bo, Bombali, Bonthe, Kailahun, Kambia, Kenema, Kono, Moyamba, Port Loko, Pujehun, Tonkolili, Western Area Rural, and Western Area Urban (including the capital of Freetown). Civil unrest and violence against aid workers have been reported in West Africa as a result of the outbreak. The public health infrastructure in Sierra Leone is being severely strained as the outbreak grows.
Sierra Leone’s government has recently instituted enhanced measures to combat the spread of Ebola, many of which will likely make travel to, from, and within the country difficult. The government has taken the following steps:
- Instituted new protocols for arriving and departing passengers at Lungi International Airport.
- Instituted restrictions on public and other mass gatherings.
- Instituted quarantine measures for communities affected by Ebola; travel in and out of those communities will be restricted until a medical team clears them.
- Authorized house-to-house searches to locate and quarantine Ebola patients and requires all deaths be reported before burial.
- Authorized police and military personnel to help enforce these and other prevention and control measures.
- Required local government officials to establish laws to support Ebola prevention efforts.
CDC recommends that US residents avoid nonessential travel to Sierra Leone. If you must travel, such as for humanitarian aid work in response to the outbreak, protect yourself by following CDC’s advice for avoiding contact with the blood and body fluids of people who are ill with Ebola.
The recommendation to avoid nonessential travel is intended to help control the outbreak and prevent continued spread in two ways: to protect US residents who may be planning travel to the affected areas, and to enable the government of Sierra Leone to respond most effectively to contain this outbreak. CDC is committed to the multinational effort to help Sierra Leone in controlling the outbreak and is scaling up its response activities by, among other things, deploying additional staff to the affected countries. Substantial international humanitarian assistance is required, and CDC encourages airlines to continue flights to and from the region to facilitate transport of teams and supplies essential to control the outbreak.
What is Ebola?
Ebola is a rare and deadly disease. The disease is caused by infection with one of the ebolaviruses (Ebola, Sudan, Bundibugyo, or Taï Forest virus). It is spread by direct contact (through broken skin or mucous membranes) with a sick person’s blood or body fluids (urine, saliva, feces, vomit, and semen). It is also spread by direct contact with objects (such as needles) that have been contaminated with infected body fluids or infected animals.
Symptoms of Ebola include fever, severe headache, muscle pain, vomiting, diarrhea, stomach pain, and unexplained bleeding or bruising.
Who is at risk?
Travelers could be infected if they come into contact with blood or body fluids from someone who is sick or has died from Ebola. People also can become sick with Ebola if they come into contact with infected wildlife or raw or undercooked meat (bushmeat) from an infected animal. Health care workers and the family and friends in close contact with Ebola patients are at risk of getting sick because they may come in contact with infected blood or body fluids.
What can travelers do to prevent Ebola?
There is no vaccine or specific treatment for Ebola, and many people who get the disease die. Therefore, it is important to take steps to prevent Ebola.
- Avoid nonessential travel to Liberia, Guinea, and Sierra Leone.
- If you must travel, please make sure to do the following:
- Practice careful hygiene. Avoid contact with blood and body fluids of people who are sick with Ebola.
- Do not handle items that may have come in contact with an infected person’s blood or body fluids.
- Avoid funeral or burial rituals that require handling the body of someone who has died from Ebola.
- Avoid contact with wild animals and with raw or undercooked meat (bushmeat).
- Avoid hospitals where Ebola patients are being treated. The US Embassy or consulate is often able to provide advice on facilities that are suitable for your needs. The US Embassy in Freetown can be reached at +(232) 76-515-000.
- Seek medical care immediately if you develop fever, headache, achiness, sore throat, diarrhea, vomiting, stomach pain, rash, or red eyes.
- Limit your contact with other people when you travel to the doctor. Do not travel anywhere else.
After your return to the United States
If you were exposed to Ebola during your trip, call your doctor even if you do not have symptoms. Your doctor should evaluate your exposure level and symptoms if you have them and consult with public health authorities to determine whether actions, such as medical evaluation and testing for Ebola, monitoring, or travel restrictions are needed.
Pay attention to your health after you return, even if you were not exposed to Ebola during your trip.
- Monitor your health for 21 days if you were in an area with an Ebola outbreak.
- Take your temperature every morning and evening.
- Watch for other Ebola symptoms: severe headache, muscle pain, vomiting, diarrhea, stomach pain, or unexplained bleeding or bruising.
- If your temperature is above 101.5°F (38.6°C) and you have any other Ebola symptoms, seek medical care immediately.
- Tell the doctor about your recent travel and your symptoms before you go to the doctor’s office or hospital. Advance notice will help the doctor care for you and protect other people who may be in the doctor’s office or hospital.
- Limit your contact with other people when you travel to the doctor; avoid public transportation.
- Do not travel anywhere except to the doctor’s office or hospital.
- During the time that you are monitoring your health, you can continue your normal activities, including work. If you get symptoms of Ebola, it is important to stay apart from other people and to call your doctor right away.
Special Recommendation for Health Care Workers
If you will be working in a health care setting while in Sierra Leone, you should be prepared to care for patients in a region where resources are limited and the health care system is strained. Refer to the Interim Infection Prevention and Control Guidance for Care of Patients with Suspected or Confirmed Filovirus Hemorrhagic Fever in Health Care Settings, with a Focus on Ebola document, even if you do not plan to work directly with Ebola patients.
Although the following is not a full list, health care workers who may be exposed to people with Ebola should be sure to follow these steps:
- Wear the right protective clothing, including masks, gloves, gowns, and eye protection when in patient care areas.
- Use proper infection prevention and control measures.
- Follow cleaning and disinfection protocols for reusable medical equipment, practice proper disposal of needles and other disposable equipment, and practice proper disposal of patient excretions.
- Wash your hands often, using soap and water (or alcohol-based hand sanitizers when soap and water are not available) to remove potentially infectious materials from your skin and help prevent disease transmission.
- Do not reuse gloves. Instead dispose of gloves according to recommended infection control precautions. Wash your hands after disposing of the gloves.
- Learn the signs and symptoms of Ebola and develop a triage system so Ebola patients can be identified and properly handled.
- Avoid direct contact without recommended personal protective equipment with the bodies of people who have died from Ebola.
- Immediately notify your organization and the US embassy or consulate in Sierra Leone if you think you have been exposed to someone with Ebola but were not wearing recommended personal protective equipment.
- 2014 Ebola Outbreak in West Africa
- CDC Ebola website
- Health Information for Travelers to Sierra Leone
- Advice for Humanitarian Aid Workers Traveling to Guinea, Liberia, Nigeria, or Sierra Leone during the Ebola Outbreak
- Ebola Information for Health Care Workers
- CDC Health Advisory: Guidelines for Evaluation of US Patients Suspected of Having Ebola Virus Disease
- Health Information for Travelers to Sierra Leone
Information for Airline Personnel