Ebola, the Deadly Virus–Traveler & Expat Guide

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By J. E. Hinners, MD MPH


Most likely, if you’re at all in touch with the news, you’ve heard of the Ebola outbreak that has just recently begun wildly spreading in West Africa. As of September 5, 2014, the number Ebola deaths worldwide since March has reached 2,105, making this Ebola outbreak the largest in history.

Ebola is a fatal disease in 53% of cases reported in this recent outbreak, according to the World Health Organization. Currently, there is no cure for the disease, and no drugs or vaccines have been yet approved for Ebola treatment. Knowing the risks, prevention measures, and management protocol for Ebola is thus critical–particularly for those at higher risk of contracting the disease.

Travelers, expats, and those local to Ebola-concentrated countries are at increased risk for contracting Ebola Virus.

Ebola: What is it?

Ebola is a deadly Viral Hemorrhagic Fever of sudden onset, caused by the Ebolavirus of the Filoviridae family. There are actually five subspecies of Ebolavirus, and four out of those five subspecies cause disease in humans (the fifth only appears to affect primates). The first species was discovered in 1976 near the Ebola River in the Democratic of Congo; outbreaks since this time have been intermittent. While the natural reservoir host of ebolaviruses is not absolute, Ebola appears to be a zoonotic disease primarily originating from animals hosts native to Africa (with special mention to bats).

 Ebola Signs & Symptoms – occurring 2-21 days after exposure

Fever > 101.5 F or 38.6 C

Unexplained bruising or bleeding

Stomach aches


Muscle pain



Ebola Treatment

There is no effective cure for Ebola; no Ebola drugs or vaccines are approved at this point. Treatment is symptomatic (fluids, electrolytes, and care for other simultaneously occurring infections). Early recognition of the disease is important, but prevention of contracting the disease in the first place is the best health goal–with the avoidance of Ebola-concentrated countries being the most effective first prevention measure.

Where is Ebola?

Guinea, Liberia, Sierre Leone, and Nigeria are the primary countries where Ebola is spreading right now. CDC has issued a level 3 travel warning for Guinea, Liberia, and Sierre Leone; travelers should avoid all non-essential travel to these countries. A level 2 travel warning has been issued for Nigeria; travelers are advised to take heightened precautions for preventing the disease. The latest travel notices from CDC may be found here.

Ebola locations
Ebola-concentrated Countries

What is the projected future spread of Ebola?

PLOS Current Outbreaks projects Ebola spreading patterns by looking at international flight patterns. Nigeria appears to be the primary hub for spreading Ebola by air travel, while European countries appear to be on the greatest receiving end of airline passengers from the primary Ebola source countries.

Air Traffic Connections From Ebola-concentrated Countries

Updates on the continued spread, news, and management efforts for Ebola may be found on World Health Organization’s Ebola Virus Outbreak site.

 How could I contract the virus?

  1. By direct contact–when your mucous membranes or broken skin come into contact with the bodily fluids (saliva, vomit, urine, feces, semen) and blood of an infected person or contaminated object (such as a needle); those who have died of Ebola may also still be contagious
  2. By sexual contact–not only with currently infected individuals but also with those who have recovered from the disease (semen can retain the virus for up to three months post-recovery, and sexual contact even with condom use is highly discouraged)
  3. Handling infected bats or “bushmeat” (food from wild animal hunting) may spread the virus
  4. Air, water, and food DO NOT transmit the virus (with the exception of bushmeat above)
  5. Mosquitos DO NOT appear to spread the virus
  6. Contact with Ebola-infected individuals who don’t show symptoms yet DOES NOT spread the virus

How can I keep safe from Ebola?

  • Do not travel to the Ebola-concentrated countries right now (Guinea, Liberia, Sierre Leone, and Nigeria)
  • Do not touch blood or bodily fluids of an infected person or a contaminated object
  • Do not touch dead bodies from those who were infected with Ebola
  • Do not have sexual relations (even with condom use) with someone who either currently has or had Ebola within the last 3 months
  • Do not handle non-human primates or bats, particularly in high-risk areas
  • Do not touch or eat bushmeat (food from wild animal hunting), especially in high-risk areas
  • Practice good hygiene and regularly wash hands
  • Try to choose hospitals where Ebola patients are not being treated (U.S. Embassies or Consulates can help here)
  • Particularly if you are located in or have traveled recently, seek medical attention as soon as you develop fever (101.5 F / 38.6 C) plus any of the other symptoms listed above (unexplained bruising/bleeding, headaches, stomach aches, muscle pain, diarrhea, or vomiting)

The CDC has also developed some special guidance for:

  1. Those living abroad 
  2. Humanitarian workers
  3. Healthcare workers
  4. Airline crews, cleaning, and cargo personnel


Ebola 101

Intrigued by Ebola? Check out some of the most highly reviewed Ebola-related books on Amazon!


2 thoughts on “Ebola, the Deadly Virus–Traveler & Expat Guide

    Joe said:
    October 24, 2014 at 6:56 am

    Great infographics! Since you wrote this post, we have obviously seen a huge surge in the amount of infected people and the death toll rising. If Ebola develops into a virus which can pass through food etc – all importing and exporting ports need to review all processes when bringing in fruit and veg from West Africa. Do you know how much help is being given to expatriates in the affected countries in West Africa?

      barre live said:
      October 24, 2014 at 8:24 am

      Hi Joe, thanks for your comment, I appreciate it! Fortunately, Ebola is only spread through direct contact with bodily fluids and is not really a concern, as far as being transmitted through objects such as food. The virus needs to be in liquid to survive, so I don’t really see the regulation of food imports/exports being affected by Ebola (it probably would be a waste of effort, given the nature of the virus). I do not know how much help is currently being given to expatriates in the affected countries, but that is an excellent question I would like to investigate a little more. As far as treatment goes – I would contact the local embassy of my nationality and find out which hospital/care center they would recommend (keep in mind, that it’s better to go to hospitals that don’t currently have a huge population of Ebola patients, if possible). But I strongly recommend prevention efforts first. If it were me, I would probably choose not to live in a country that is heavily affected by Ebola. If that weren’t possible, then I would carefully follow the prevention recommendations outlined by CDC in the article above. Hope that helps!

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