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The purpose of this advisory is to notify travellers about the Ebola outbreak and inform them about measures they can take to minimize the risks of contracting the disease.

What is Ebola?
Ebola is a rare and deadly disease. It is caused by infection with one of the Ebola viruses (Ebola, Sudan, Bundibugyo or Tai forest virus). It is spread by direct contact with a sick person's blood or body fluids. It is also spread by contact with contaminated objects or infected animals.

What are the symptoms?
Symptoms include fever, headache, joint and muscle aches, sore throat, and weakness, followed by diarrhoea, vomiting and stomach pain. Skin rash, red eyes, and internal and external bleeding may be seen in some patients.

Who is at risk?
Travellers could become infected if they come into contact with blood or body fluids from someone who is sick or has died from Ebola, sick wildlife or meat from an infected animal. Health care providers caring for Ebola patients, family and friends in close contact with an ill person are at highest risk because they may come into contact with blood or body fluids.

What is the Department of Health doing about it?
As part of enhanced precautionary measure to prevent the spread of Ebola into South Africa, the Department of Health is issuing a travel advisory for travellers both South African residents and non-residents coming into South Africa from or through Liberia, Guinea, Sierra Leone as well as those coming from non-affected countries.

All South Africans are hereby advised to avoid non-essential travel to Liberia, Guinea or Sierra Leone. South Africans are not restricted from travelling to these countries, however all returning travellers from these countries will be subjected to rigorous screening and medical assessments before being allowed entry into the country.

The following additional measures will be instituted:
1.         All travellers and crew members arriving into South African Points of Entry must have completed a Travel Health questionnaire upon arrival. If found to have any of the symptoms or signs suggestive of Ebola, they will be referred to one of the designated hospitals for further investigations and management.

2.         Passengers who travelled from or through Guinea, Liberia or Sierra Leone within the last month of arrival into South Arica must undergo additional screening at the Points of Entry.

2.1    For those who display symptoms related to Ebola: Travellers will be escorted to the clinic at the Point of Entry for further examination. Where there is no clinic at the Point of Entry, travellers will be kept apart in an identified area where there is no direct contact with other people until such time as the emergency services arrive for further examination or evacuation of the traveller.

2.2    For those with no symptoms: Travellers will be provided with health information on Ebola and subjected to quarantine surveillance i.e. required to report body temperatures daily to the Department of Health. They will also be required to report details of any symptoms such as fever, headache, achiness, sore throat, diarrhoea, vomiting, stomach pain, rash or red eyes.

3.      Travellers from non-affected countries:

3.1    Those that show symptoms will be subjected to the same process as in paragraph 2.1.
3.2    Those that do not show symptoms will be cleared to follow the normal immigration procedures.

4.      If any of the travellers referred to the Point of Entry clinic are found to fit the case definition for the EVD, the necessary infection control measures should be implemented while awaiting evacuation of the traveller to the designated health facility.

5.      Those without symptoms or signs will be provided with information on Ebola and followed up for 21 days. Information will also be provided on phone numbers to call in case of development of fever, headache, achiness, sore throat, diarrhoea, vomiting, stomach pain, rash or red eyes.

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 to these countries, please make sure to do the following:

• Practice careful hygiene. Avoid contact with blood and body fluids of sick persons.
• 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 or with bush meat.
• Avoid hospitals where Ebola patients are being treated.
• The South African Embassy or consulate is often able to provide advice on facilities that are suitable for your needs.
• Seek medical care immediately if you develop fever, headache, achiness, sore throat, diarrhoea, vomiting, stomach pain, rash, or red eyes.
• Limit your contact with other people when you travel to the doctor. Do not travel anywhere else.
• Pay attention to your health after you return to South Africa, by doing the following:

o      Inform the Port Health official of your occupation and travel history on arrival in South Africa.

o      Monitor your health for 21 days if you were in an area with an Ebola outbreak, especially if you were in contact with blood or body fluids, items that have come in contact with blood or body fluids, wild animals or bush meat, or hospitals where Ebola patients are being treated.

o      Seek medical care immediately if you develop fever, headache, achiness, sore throat, diarrhoea, vomiting, stomach pain, rash, or red eyes. Tell the doctor about your recent travel and your symptoms before you go to the examination/emergency room or surgery. Advance notice will help the doctor care for you and protect other people who may be in the room

Special recommendation for Health Care Workers
Health care workers who may be exposed to people with the disease should follow these steps:

• Wear protective clothing, including masks, gloves, gowns, and eye protection.
• Practice proper infection control and sterilization measures. For more information, see “Infection Control for Viral Hemorrhagic Fevers in the African Health Care Setting.”
• http://www.who.int/csr/resources/publications/ebola/whoemcesr982sec1-4.pdf
• Isolate Ebola patients from unprotected people.
• Avoid direct contact with the bodies of people who have died from Ebola.

o      Notify health officials if you have been exposed to someone with Ebola.

o      Inform the Port Health official of your occupation and travel history on arrival in South Africa.

Issued by Government Communications (GCIS) on behalf of Department of Health