The Centers for Disease Control (CDC) elevated its international travel health notice for three West African countries – Guinea, Liberia and Sierra Leone – to “Level 3: Warning” on August 1 due to the unchecked Ebola hemorrhagic fever epidemic in these countries, the severity of the disease, the gradual evacuation of some foreign volunteers, the implementation of numerous controlling measures in the region and the limited local medical capacity therein. Citizens should not go there unless absolutely necessary. 

According to data published by the World Health Organization (WHO), a total of 1,323 cases of Ebola hemorrhagic fever have been reported in the three countries – Guinea, Liberia and Sierra Leone – as of July 27, 2014, which caused 729 deaths; the fatality rate is 55% and infections have continued in the community and within medical institutions. Although the WHO has not currently imposed any special restrictions on the economic, trade and travel activities of the abovementioned countries, we elevated the travel health notice for Guinea, Liberia and Sierra Leone to “Level 3: Warning” on August 1 to protect nationals’ health, because incidents of foreign and major medical personnel being infected were reported, and some resident volunteer groups have been evacuated. Also, controlling measures, such as restrictions on public activities and large-scale gatherings, community-wide quarantine inspections, etc. have been implemented. These measures are going to impact the medical manpower and allocation of resources in those countries. Citizens are advised not to go to these countries unless absolutely necessary. 

Ebola hemorrhagic fever is caused by the Ebola virus, with an incubation period ranging from two to 21 days. Patients are not infectious during the incubation period and only become infectious when symptoms emerge. People are infected through contact with a patient’s blood, secretions, organs, or seminal fluid. Clinical symptoms include: sudden fever, discomfort, muscle pain and headache, followed by sore throat, vomiting, diarrhea, maculopapular rashes and hemorrhaging. In serious cases, these symptoms are combined with liver damage, kidney failure, injury to the central nervous system, complications due to shock with multiple organ failure. The disease has a high fatality rate and deceased patients may also be infectious. Moreover, human beings may get infected through contact with infected animals. 

The CDC warned citizens against going to epidemic areas in West Africa. If traveling there is unavoidable, caution should be taken regarding personal hygiene and cleanliness. Also, contact with infected or dead animals should be avoided and wild animals should not be eaten, especially apes, monkeys and flying foxes. Contact with other patients should also be avoided when making medical consultations there. Travelers should carefully monitor their own health for 21 days after returning to Taiwan. If symptoms such as fever, vomiting, diarrhea, skin rashes or other symptoms appear, consult a doctor as soon as possible and take the initiative to inform him or her of your travel history. Doctors coming across patients returning from West Africa should also determine if there are other patients with similar symptoms by asking about their recent travel history, contact history, occupation, family status, work environment, etc. If a suspected case of Ebola hemorrhagic fever is found, the patient should receive treatment in isolation immediately. Since early symptoms of the disease are not definitive, medical personnel should also stay alert and wear standard protective gear when taking care of all patients. Infection control measures should be implemented, including washing hands, maintaining respiratory tract health, avoiding contact with body fluids, etc. For information relating to the disease, please visit the CDC website (http://www.cdc.gov.tw), or call the domestic toll-free prevention hotline 1922 (or 0800-001922).