The Bahamas Are On-Alert for Ebola’s Arrival - Vax Before Travel

The Bahamas Health Department says it remains on “high alert” for the Ebola virus's potential arrival in international visitors.

Since Hurricane Doran passed over the Bahamas in September 2019, personnel from the international support community have traveled to the Bahamas to provide relief assistance. 

This influx of visitors has led The Bahamas Ministry of Health to closely evaluate the travel history of these international visitors.

In an interview with Eyewitness News Online on October 28, 2019, the Minister of Health Dr. Duane Sands said, “We have been in the process of doing a number of sensitization training sessions with customs, airport, immigration, and health personnel.”

“If you have been in an area where there is an Ebola outbreak, such as central Africa, red flags go off,” the health minister said.

The airport screening process includes historical information, presence or absence of fever, and any of the symptoms typically associated with Ebola.

“When you combine (screening) with travel history, that’s when a person may be infectious.”

“But If they have a combination of symptoms and fever and travel history, then yes, we will act,” said Dr. Sands.

These concerns remain valid, given the situation in Central Africa.

As of October 29, 2019, there have been 3,268 Ebola Zaire cases confirmed in Central African countries, with a case fatality ratio of 67 percent, confirmed by the World Health Organization (WHO).

Moreover, the WHO continues to classify the current Ebola outbreak as a global emergency. 

But, the recent WHO risk assessment concluded that the global risk levels remain low for the Ebola virus spreading to other countries.

However, the Bahamas Ebola concern is prudent since the new Global Health Security Index recently suggested that not a single country in the world (195) is fully prepared to handle a disease epidemic. 

Regardless, the Bahamas is being proactive with its Ebola detection options.

A previous, real-world example justifies the Bahamas apprehension of the Ebola virus arriving along with international visitors.

During the Ebola outbreak in 2014, 11 individuals were treated for Ebola in the United States. And 2 nurses who cared for a sick Ebola patient contracted the disease, which marked the first known transmission of Ebola virus disease in the USA.

As Dr. Sands told the Nassau Guardian in July, the actual risk is reduced by the travel requirements.

“For instance, there are no direct flights from Central Africa to The Bahamas. So somebody would have to penetrate through typically Europe…and then they could come directly on British Airways, but typically they would come through the United States or some other port, and all of these ports have checks and balances.”

The good news is Dr. Sands may soon have an innovative tool to help screen travelers arriving at the Bahamian airports.

On October 11, 2019, the US Food and Drug Administration (FDA) announced the marketing approval of a rapid diagnostic test (RDT) to detect Ebola virus antigens in human blood. 

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The OraQuick Ebola Rapid Antigen test provides a rapid, presumptive Ebola diagnosis. This new test is the first RDT the FDA has allowed to be marketed in the USA. Furthermore, a negative test result does not rule out Ebola virus infection.

This innovative screening test is intended for use by experienced personnel who have documented device-specific training offered by OraSure Technologies Inc., in the correct use of recommended personal protective equipment and expertise in infectious disease diagnostic testing, including the safe handling of clinical specimens potentially containing Ebola virus.

Additionally, there are various travel guidelines and actions being taken around the globe.

The current WHO standard is not to restrict travel for persons who have been in Ebola endemic areas.

The WHO continues to advise against any restriction of travel to, and trade with, the Democratic Republic of the Congo (DRC).

But, the Kingdom of Saudi Arabia set its own plans in motion on July 26, 2019. Saudi Arabia stopped issuing visas to people from the DRC, related to their concerns of the ongoing Ebola Zaire virus outbreak. 

From a treatment perspective, there was some good news regarding access to an Ebola Zaire medication.

On September 20, 2019, the US Department of Health and Human Services’ Office announced funding support to Ridgeback Biotherapeutics, who is manufacturing the Ebola therapeutic, mAb114.

The mAb114 is a single monoclonal antibody that binds to a virus protein, reducing the ability of the virus from infecting human cells. 

Currently, mAb114 is being offered to Ebola patients in the DRC, under an expanded access protocol led by the WHO.

And from an Ebola prevention perspective, on October 18, 2019, the European Medicines Agency (EMA) human medicines committee recommended a conditional marketing authorization in the European Union for Ervebo (rVSVΔG-ZEBOV-GP) vaccine, which is intended for the active immunization of individuals aged 18 years and older, at risk of infection with the Ebola virus.

Ervebo (v920) is a genetically engineered, replication-competent, attenuated live vaccine. 

To alert US citizens of their Ebola risks, the US Centers for Disease Control and Prevention (CDC) updated its Level 2 Travel Alert on October 29, 2019, reaffirming the risk for contracting the Ebola virus is low for most travelers to DRC.

But, the risk of exposure to other diseases, including measles, yellow fever, cholera, malaria, and chikungunya, remains high. 

The CDC says before you leave for DRC, see a travel medicine provider to discuss medical options:

• Make sure you are protected fully against measles.
• Get the yellow fever vaccine.
• Because of ongoing active cholera transmission in South Kivu, North Kivu, Haut-Katanga, Tanganyika, Haut-Lomami, and Kasai Oriental, CDC recommends travelers going to these provinces get the cholera vaccine, such as Vaxchora. 
• Start taking medicine to prevent malaria.

During your visit to the DRC:

• Keep taking medicine to prevent malaria.
• Avoid bug bites.
• Follow food and water precautions. 
• Take other steps to stay healthy and safe.

After returning to the USA from the DRC:

• Finish taking medicine to prevent malaria.
• Seek medical care if you felt ill during travel or after you got home, and tell the doctor where you traveled.

Further information is available in the WHO recommendations for international traffic related to the Ebola Virus Disease outbreak in the Democratic Republic of the Congo.

Ebola News published by Vax-Before-Travel

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