EbolaContaining the international spread of Ebola

By Sanjaya Senanayake

Published 15 August 2014

The West African Ebola virus outbreak is already the largest of its kind, both in terms of numbers and geography. And with the most distant parts of the world less than a day’s flight away, it isn’t too difficult to imagine Ebola virus spreading. During the SARS outbreak, both exit and entry screening strategies failed to detect many cases. The virus spread from Asia to various parts of the world, especially to Canada. But despite the limited detection rate of the airport screening process during the SARS outbreak, it was still thought to be a useful way to educate incoming travelers about what to do and where to go if they became sick.

The West African Ebola virus outbreak is already the largest of its kind, both in terms of numbers and geography. And with the most distant parts of the world less than a day’s flight away, it isn’t too difficult to imagine Ebola virus spreading.

If someone infected with Ebola virus vomits, bleeds, or has diarrhea on a flight, there is an opportunity to transmit the infection to others on the plane.

Air travel has already introduced Ebola virus into Nigeria’s bustling metropolis of Lagos. The sick passenger died in Lagos at the end of July but the infection had already spread to nine other people.

Some countries, such as the Ivory Coast and Saudi Arabia have banned incoming flights from Guinea, Sierra Leone, and Liberia, the Ebola-affected countries. Other countries may follow.

The World Health Organization (WHO) does not recommend a general ban on travel to countries not affected by Ebola. But ease of access to air travel means all countries, including Australia, need to be vigilant for possible imported cases.

The illness
Knowing the incubation period of an infectious illness is important to determine if it is safe to bring a suspected case out of quarantine.

The incubation period of an infection refers to the time interval between becoming infected and becoming sick. Some infections have an incubation period of only a few days while others can last for years, such as tuberculosis. For Ebola virus infection, the incubation period is between two and twenty-one days.

Ebola virus infection has a fearsome reputation among the general population for quickly causing uncontrolled and ubiquitous bleeding. But while this can occur, infection usually begins as a flu-like illness with fevers, muscle aches, and generally feeling lousy. Australians with seasonal influenza would report similar symptoms.

In West Africa, malaria presents in this way. If health-care workers didn’t know there was an Ebola virus outbreak going on, they would almost certainly attribute these symptoms to another illness.

As the infection progresses, people can develop a variety of symptoms ranging from diarrhea, vomiting, abdominal pain, a cough, breathing difficulties, red eyes, and swelling. Around day five of illness, a rash may appear.