Download EVD - EBOLA VIRUS DISEASE West Africa

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INFO LETTER
Occupational Health and Safety
Document:
Document may not be disclosed to any
third party without the prior approval of the
management.
of:
1
Release:
EVD / EBOLA Virus West Africa
2
onset April 2014 / update September 2014
19.09.2014
EVD
EBOLA VIRUS DISEASE
West Africa
2nd Release
Release No.1
Release No.2
16.April 2014
19. September 2014
This information is considered as a preventive and proactive measure at the present stage of the
outbreak of EVD / Ebola and shall ensure the information flow towards the crew.
Updates will be sent, if considered necessary and available at the ECDC.
Information on EVD Ebola Virus Disease
ECDC European Centre for Disease Prevention and Control / WHO
Background
ECDC Epidemiological update, 11.April 2014
An outbreak of Ebola virus disease (EVD) with onset in early February 2014 continues to evolve in West Africa. This is the first
such outbreak in the region. Two countries, Guinea and Liberia, have reported confirmed cases. The first cases were reported
from the forested region of south-eastern Guinea in Guéckédou prefecture near the border with Liberia and Sierra Leone. Results
from sequencing of part of the outbreak virus’ L-gene has shown that it is 98% homologous with an Ebola virus last reported in
2009 in Kasai-Occidental Province of the Democratic Republic of Congo.
ECDC Update as of 15. September 2014
An outbreak of Ebola virus disease (EVD) has been ongoing in West Africa since December 2013, affecting Guinea, Liberia,
Sierra Leone and Nigeria. The overall situation of the Ebola outbreak in the affected countries remains critical. As of 6 September
2014, 4 291 cases including 2 296 deaths have been reported from the affected countries. To date, no cases have been found to
be positive outside Guinea, Liberia, Nigeria or Sierra Leone with the exception of one case in Senegal in a Guinean national.
Ebola Virus Disease Outbreak - the Democratic Republic of the Congo (DRC): Between 28 July and 4 September 2014, 72
cases of EVD, including 48 deaths, have been identified. The outbreak in DRC is unrelated to the ongoing outbreak in West
Africa. The epidemiological features of this outbreak are consistent with previous outbreaks of EVD involving Zaïre ebola virus.
The viral strain isolated from this outbreak is distinctly different from the strain isolated in the ongoing West Africa outbreak, and
there is no epidemiological evidence linking the two events
WHO: EBOLA RESPONSE ROADMAP UPDATE (EXTRACT) 16 September 2014
Following the roadmap structure, country reports fall into two categories: those with widespread and intense transmission
(Guinea, Liberia, and Sierra Leone); and those with an initial case or cases, or with localized transmission (Nigeria, Senegal)
1. COUNTRIES WITH WIDESPREAD AND INTENSE TRANSMISSION
4963 (probable, confirmed and suspected) cases and 2453 deaths have been reported in the current outbreak of Ebola virus
disease as at 13 Sep.2014 by the Ministries of Health of Guinea and Sierra Leone, and as at 9 Sep. by the M.o.H. of Liberia.
2. COUNTRIES WITH AN INITIAL CASE OR CASES, OR WITH LOCALIZED TRANSMISSION
Two countries, Nigeria and Senegal, have now reported a case or cases imported from a country with wide-spread and intense
transmission. In Nigeria, there have been 21 cases and eight deaths. In Senegal, there has been one case, but as yet there have
been no deaths or further suspected cases attributable to Ebola. Contact tracing and follow-up is ongoing in both countries. In
Nigeria, 470 contacts have completed 21-day follow-up. Of the 402 contacts who are still being monitored in Nigeria, 373 (93%)
were seen on 13 September. In Senegal, all 74 contacts are still under surveillance; 73 were seen on 13 September.
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Occupational Health and Safety
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INDEX
01. Background Information ECDC
02. Factsheet
03. Factsheet
04. Definition / Affected Areas / Prevention
05. Prevention
Organizational
06. Prevention
Organizational
Hygiene Hand
07. Prevention
Hygiene
Public Area Food
08. Prevention
Hygiene
Medical Care
09. Prevention
10. Appendix
Personal
Hygiene + Personal Attention
FACTSHEET
Basic info: 1
What is EBOLA ?
Ebola is a severe infectious and often-fatal disease in humans and nonhuman primates (monkeys,
gorillas, and chimpanzees) caused by infection with Ebola virus. It is very infectious, kills in a short time
BUT can be prevented. The disease is called Ebola virus disease (EVD), formerly known as Ebola
hemorrhagic fever.
What is the source and how can it spread ?
The natural reservoir of the virus is not specifically known but specific fruit bats are considered to be
the natural host of the virus. Usually, the first person gets infected through contact with an infected
animal. The virus spreads in the human population through human-to-human transmission.
Infection by: 1
How can I get EBOLA ?
 contact with the blood, secretions, organs or other bodily fluids of infected animals:

direct contact:
through broken skin or mucous membranes.

indirect contact:
environments contaminated with such fluids, e.g. tissues.

droplet infection:
airborne infection with infectious fluids.

food:
meat of infected or contaminated animals. Fruits and vegetables.
 contact with the blood, secretions, organs or other bodily fluids of infected human persons:

direct contact:
through broken skin, mucous membranes and eyes, needle stick.

indirect contact:
environments contaminated with such fluids.

droplet infection:
airborne infection with infectious fluids (e.g. coughing).
 contact with deceased bodies of animals or humans.
 infection via health workers.
Incubation period: 1
Key hazard:
Direct person-to-person transmission via mucous membrane, broken skin contact
including needle stick and cuttings and sexual contact.
Transmission:
The virus is highly transmissible and can survive in liquid or dried material for a
number of days.
The incubation period is usually:
4 to 10 days.
The period can vary from:
3 to 21 days.
1 Source: ECDC European Center for Disease Prevention and Control, WHO, WHO afro. [April 2014]
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Signs + Symptoms: 1
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What are the signs and symptoms if someone is infected with EBOLA ?
A sudden onset with early flu-like symptoms:
 fever
 intense weakness / fatigue
 sore throat
 joint and muscle aches
 headache
Followed by symptoms of the organ system:
 stomach pain
 vomiting
 diarrhea
 measles like rash
 a rash, red eyes, hiccups and bleeding from body openings may be seen in some patients
 internal / external bleeding
 impaired kidney and liver function
 neurological (confusion, intense headache)
 respiratory system (cough, chest pain, shortness of breath).
It is not always possible to identify EVD Ebola, because the initial symptoms may be non-specific and
may indicate likewise diseases. During the first week, patients may deteriorate suddenly, while diarrhea
and vomiting are getting worse
Likewise diseases: 1
What are likewise signs and symptoms of other diseases ?
Signs and symptoms can appear likewise to other diseases and must be ruled out by medical attention.
This could be for example: malaria, typhoid fever, shigellosis, cholera, leptospirosis, plague,
rickettsiosis, relapsing fever, meningitis, hepatitis and other viral hemorrhagic fevers.
Definitive Diagnosis: 1
Ebola virus infections can be diagnosed definitively in laboratory tests. Indications can be low white
blood cell and platelet counts and elevated liver enzymes.
Being infectious: 1
People and animals are infectious as long as their blood, fluid and secretions contain the virus. Patients
are infectious up to two months after medical recovery.
Vaccine prevention: 1
Are vaccine prevention measures available for EVD (Ebola) ?
No vaccine for EVD is available.
Treatment: 1
Is a special treatment available ?
No specific treatment and no specific therapies are available.
How do I get treated? 1
Intensive supporting care is required.
 Patients are mostly dehydrated and require rehydration (oral, intravenous fluids).
Suspicious cases: 1
What do I have to do if I assume that I am ill ? What to do if I consider another person as being ill ?
Contact your Medical Officer and/or Master on board. Refer to further measures which will be specified.
Risk for seamen: 1
The risk for seamen is considered low (April 2014) as longs as the some elementary precautions are
followed, e.g. avoiding physical contacts. Please refer to the Chapter PREVENTION.
Risk for travelers: 1
The risk for travelling seamen is considered low (April 2014) as longs as some elementary precautions
are followed during travelling. Please refer to the Chapter PREVENTION.
1 Source: ECDC European Center for Disease Prevention and Control, WHO, WHO afro. [April 2014]
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DEFINITION
General:
EVD- high risk area:
The definition is based on an internal standard of the Company.
Considered as a high risk areas are:
 Ports of countries which have confirmed EVD Ebola cases since early 2014 (WHO / ECDC).
 Ports of countries which have suspected EVD Ebola cases since early 2014 (WHO / ECDC).
 Ports for which an official warning exists by the WHO, ECDC, government or other legal bodies.
EVD- risk area:
Considered as risk areas are:
 Ports of neighboring countries considered and defined as high risk areas.
 Ports of countries which can be a potential hazard including the second strain of Ebola disease at
the Demo. Republic of Congo.
AFFECTED AREAS
Status:
EVD- high risk area:
19.September 2014
Considered as high risk areas are:
Guinea
Sierra Leone
Liberia
Nigeria
Senegal
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



EVD- risk area:
Considered as risk areas are:
Ivory coast (Cote d`Ivoire)
Gambia, Guinea-Bissau,
Ghana, Togo, Benin
Cameroun, Equatorial Guinea, Gabon
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



Update:
Congo, Angola (due to the second strain of EVD).
The areas are frequently reviewed and assessed by the Company. Updates of the areas will be sent as
appendix to this information.
PREVENTION
Prevention on board:
The risk of transmission and infection can be reduced and minimized on board by considering some
important measures:
ON-BOARD PREVENTION
Organizational
Hygiene
SHORE LEAVE
HAND
PROVISION
CREW CHANGE
TRAVELLING
Familiarization
Risk Assessment
Stowaways
Access Control
n.o.s.
PERSONAL
ATTENTION +
AWARENESS
PERSONAL
PUBLIC AREA
FOOD
Medical CARE