October 14, 2014 - Office of Risk Management Advisory on Ebola

The 2014 Ebola epidemic is the largest in history, affecting in West Africa, mainly Sierra Leone, Liberia and Guinea. Countries with travel-associated cases of Ebola include Senegal, the US and Spain. On October 12, a patient with Ebola-like symptoms was taken to Beth Israel Deaconess Medical Center to determine whether Ebola was a possible cause of the patient’s symptoms.

The Boston Public Health Commission (BPHC) determined the patient did not meet the criteria to be considered someone at high risk for Ebola. The BPHC will continue to monitor the situation. They encourage the public to take all the suggested safety precautions, found at bphc.org/Ebola , and to remain calm, but vigilant.  

The BPHC reports that the likelihood of someone arriving in Massachusetts infected with the Ebola virus is very low, and the potential for transmission within the U.S is even lower.   

However, those traveling to or from West Africa must exercise caution.         

Travel Advisory    

Recognizing that locations within our archdiocese have clergy, employees, students and volunteers traveling to and from West Africa, the Office of Risk Management, following recommendations from the Centers for Disease Control and Prevention (CDC), urges all personnel, students and volunteers to avoid nonessential travel to the following countries where the disease is widespread:

• Guinea  
• Liberia  
• Sierra Leone          

Nigeria has cases of localized transmission of the disease: a small number of Ebola cases were reported in Lagos and Port Harcourt. However, the government of Nigeria quickly responded, and this outbreak was contained to a small number of cases. For this reason, the CDC has issued a travel watch for Nigeria. A travel watch advises travelers to practice the usual hygiene precautions when traveling.

Monitor the Situation     

Some countries have put in place procedures regarding the travel of individuals from the affected countries, including complete travel bans. Changes to these procedures may occur with little or no notice. Please consult your airline or the embassy of your destination country for additional information. Regularly monitor the State Department’s website, where you can find current Travel Warning and Travel Alerts, and the Worldwide Caution, and read the Country Specific Information for your destination countries.  Current information on safety and security can also be obtained by calling 1-888-407-4747 toll-free from within the United States, or 1-202-501-4444 from other countries.  These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays). 

Returning Home     

Travelers are being screened at airports in West Africa to look for signs of Ebola and to ascertain if people have been exposed to Ebola, even if they are not sick. Those who have been exposed to Ebola or are sick with symptoms of Ebola will not be allowed to travel on commercial flights to the United States and potentially to other countries.

Travelers should be prepared for screeners to check temperatures and look for signs and symptoms of illness. Travelers will also be asked to answer questions about possible exposures to someone with Ebola. After the screening, authorities will decide if and when the traveler can continue his/her trip.    

• If you have symptoms of Ebola or have been exposed to Ebola - even if you are not sick - you will not be allowed to travel on commercial transportation.  
• If you have symptoms of Ebola, you may need to be medically evacuated to receive needed care.  
• If you have been exposed to Ebola but are not sick, you will either have to arrange a charter flight home or stay in your location for at least 21 days until authorities ensure it is safe for you to travel.  
• Please note neither the Department of State’s Bureau of Consular Affairs nor the U.S. Embassy have authority over quarantine issues and cannot prevent a U.S. citizen from being quarantined should local health authorities require it.  

Ebola in the US     

On September 30, 2014, the CDC confirmed the first travel-associated case of Ebola to be diagnosed in the United States. Thomas Eric Duncan contracted the virus in Liberia and received treatment at a hospital in Texas until his death on October 8. On October 12, a Dallas nurse who treated Mr. Duncan became the first person to contract Ebola within the U.S. This case has raised fears in the U.S. that the Ebola epidemic could readily take hold across the nation.

The CDC and other health organizations are taking precautions to prevent the spread of Ebola within the United States. The CDC is working with other U.S. government agencies, the World Health Organization (WHO), and other domestic and international partners and has activated its Emergency Operations Center to help coordinate technical assistance and control activities with partners.    

Symptoms of Ebola Include the Following:     

• Fever (greater than 38.6°C or 101.5°F)  
• Severe headache  
• Muscle pain  
• Weakness  
• Diarrhea  
• Vomiting  
• Abdominal (stomach) pain  
• Unexplained hemorrhage (bleeding or bruising)  

Symptoms may appear anywhere from 2 to 21 days after exposure to Ebola, but the average is 8 to 10 days. Recovery from Ebola depends on good supportive clinical care and the patient’s immune response. People who recover from Ebola infection develop antibodies that last for at least 10 years.  

Transmission     

When an infection occurs in humans, the virus can be spread in several ways to others. Ebola is spread through direct contact (through broken skin or mucous membranes in, for example, the eyes, nose, or mouth) with blood or body fluids (including but not limited to urine, saliva, sweat, feces, vomit, breast milk, and semen) of a person who is sick with Ebola, and through objects (like needles and syringes) that have been contaminated with the virus. Ebola is not spread through the air or by water, or in general, by food.

Healthcare providers caring for Ebola patients and the family and friends in close contact with Ebola patients are at the highest risk of getting sick because they may come in contact with infected blood or body fluids of sick patients. During outbreaks of Ebola, the disease can spread quickly within healthcare settings (such as a clinic or hospital). Exposure to Ebola can occur in healthcare settings where hospital staff are not wearing appropriate protective equipment, including masks, gowns, and gloves and eye protection.  

Liturgical Directives     

At this time, the Office of Divine Worship is not recommending any changes to the sign of peace or communion under both species. However, pastors may choose to suspend the practice, which is their right to do under liturgical law. 

General Recommendations     

As always, we recommend at this time of year that you advise your staff, volunteers, students and clients to do the following to avoid the spread of viruses and respiratory infections:

• Get the seasonal flu shot.    
• Wash your hands often. Use plain old soap and water, and wash for at least 20 seconds. Soap and water is preferred over alcohol-based hand sanitizers, but the most important thing is to make sure that hands are cleaned frequently and thoroughly. Hands should be washed before preparing food or eating, and after using the bathroom.    
• Avoid touching eyes, nose, or mouth with unwashed hands.    
• Avoid kissing, and sharing cups or eating utensils with people who are sick. Regular washing with hot water will kill the germs on dishes.    
• Disinfect frequently-touched surfaces, such as toys and doorknobs, on a consistent basis. Toys that children may put in their mouths should be cleaned and disinfected after any mouth contact, and at least once a day.    
• To the extent possible, stay at least 3 to 6 feet away from people who have respiratory illness.      
• People sick with any illness, particularly respiratory or gastrointestinal illness, should not care for an infant or baby.    
• Sick children should not go to school or early childcare programs until 24 hours after major respiratory symptoms and any fever have resolved (without the use of fever reducing medicine). Ill adults should also stay home to avoid spreading illness to others.     
• Everyone should cover their cough and sneeze with a tissue which should be discarded after use. If tissues are not available, use the inside of the elbow or upper arm. Hands should not be used.                

Resources
As we pray for the victims of Ebola, the ORM will continue to monitor the situation and issue updates via Risk Alerts as needed.  

For more detailed information on the Ebola virus, please see the CDC Ebola Fact Sheet .            

Other resources include:    

• CDC Website                         
• World Health Organization Website  
• Boston Public Health Commission