MERS. Ebola. Bird Flu. They are the abbreviated names of three nasty viruses – Middle Eastern Respiratory Syndrome–Coronavirus, Ebola virus disease (EVD), and A(H7N9) avian influenza.
Right now, each one is causing concern and even some alarm in the international medical community, as well as for the governments and people of the regions where they are occurring – Ebola in West Africa, MERS in the Middle East, and bird flu in Asia, particularly China.
Much remains unknown about all 3 viruses, and the concern they are generating is understandable because:
- Each has demonstrated the ability (albeit limited to this point) to jump the species barrier from animals to humans.
- Death rates are high, although transmission rates are relatively low.
- There are no effective vaccines or specific treatment medication, although scientists around the world are racing to create them.
They should NOT prevent travel
But, just how much of a health risk do they present for the average Australian traveller – even those visiting destinations where cases are being reported?
The answer is ‘extremely low’.
Should they stop Aussies from holidaying in the affected countries?
The answer is ‘no’.
People with certain chronic medical conditions, pregnant women, the very young and old, and those staying for long periods may be at slightly higher risk of infection – especially if outbreaks occur where they’re staying or living. They should get expert medical advice before they go, ideally from a doctor experienced in travel medicine.
And, to avoid infection from any of this trio, all travellers should take a few simple precautions that should be second nature to anyone heading to any overseas destination.
So, let’s put each of these headline-making viruses in focus – and perspective.
MIDDLE EAST RESPIRATORY SYNDROME – CORONAVIRUS (MERS-CoV)
Its history – MERS-CoV is a viral respiratory illness caused by a coronavirus, which generally result in mild infections of the upper and lower respiratory tract. In fact, they are one of the many viruses that can cause of the common cold. But, they can be severe: They can lead to individual cases of pneumonia, and one caused the SARS epidemic of 2003, which killed 774 people. MERS has been diagnosed in 11 countries, but all patients were infected in Saudi Arabia*. Worryingly, the Saudi Ministry of Health count of 261 cases and 81 deaths marks an increase of 98 cases and 17 deaths this month.
How MERS spreads – MERS-CoV has been shown to spread to people who were in very close contact with an infected person, including family members or those in a healthcare setting, such as a hospital.
How to avoid it – Taking some simple precautions can help prevent MERS – as well as colds, flu, traveller’s diarrhoea, and other illnesses. Most importantly, wash your hands often with soap and water, or use an alcohol-based hand sanitiser, and avoid (1) touching your eyes, nose, and mouth to prevent germs spreading, or (2) coming into close contact with a sick person.
Being up-to-date with any childhood or travel vaccinations recommended will help you stay healthy while overseas. Call Travelvax Australia’s free advisory service on 1300 360 164 for country-specific information on recommended vaccinations and see your travel doctor or GP at least 4–6 weeks before departure.
* NB – Muslims from across the globe travel to Saudi Arabia each year to attend the Hajj and Umrah religious celebrations. As a precautionary measure, Saudi Arabia recommends that certain people avoid making a pilgrimage this year, including: people over 65 years old; children under 12; pregnant women; people with chronic diseases (such as heart disease, kidney disease, diabetes, or respiratory disease); people with weakened immune systems, or with cancer or a terminal illness.
See a doctor if… you develop a fever and symptoms of lower respiratory illness, such as cough or shortness of breath, within 14 days after travelling from Saudi Arabia or other countries in Arabian Peninsula. Tell your doctor about your recent travel.
EBOLA VIRUS DISEASE
Its history – Ebola was introduced into the human population through close contact with the blood, secretions, organs, or other bodily fluids of infected animals - mainly chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines which are captured or found ill or dead in rainforests. Ebola virus disease is rare, severe, and often fatal in humans, with a death rate of up to 90%. There have 24 outbreaks across Central Africa since it was first reported, resulting in around 2161 official cases and 1590 deaths, according to the WHO. The latest outbreak is the first in West Africa and is a new strain of the virus. To date there have been 208 cases, including 136 deaths in Guinea and 34 confirmed or suspected cases and 11 deaths in Liberia, according to the latest WHO data.
How Ebola spreads – It is transmitted through direct contact with blood or other bodily fluids (e.g. saliva, urine) from infected people or animals – dead or alive. Even people who have recovered can transmit the virus through unprotected sexual contact for up to seven weeks. Ebola is NOT transmitted through the air like other viruses, such as flu or measles.
How to avoid it – Even if you are living in, or have travelled to, affected areas, the risk of infection with Ebola virus is extremely low. Only those in close contact with an infected person with severe illness and displaying tell-tale symptoms are at risk of infection. Unlike flu and measles, the Ebola virus survives only a short time on hard surfaces.
YOU CANNOT CATCH EBOLA FROM:
- Casual contact in public places with infected people without symptoms.
- Mosquito bites.
- Handling everyday items like money or groceries.
- Swimming in a pool.
The following preventive measures will help travellers to regions of West Africa where outbreaks are occurring to avoid infection:
- Practice careful hygiene, including thorough hand washing after using the toilet and before eating.
- Avoid direct contact with blood or bodily fluids, or with objects possibly contaminated with them.
- Avoid close contact with wild animals. (Don’t eat ‘bush meat’ – some wild animals can carry the virus.)
- Avoid unprotected sex.
Seek medical care if… you develop fever, headache, achiness, sore throat, diarrhoea, vomiting, stomach pain, rash, or red eyes.
A(H7N9) AVIAN INFLUENZA (BIRD FLU)
Its history – There are several strains of avian flu virus which cause illness in humans. Symptoms include fever, cough, shortness of breath, headache and muscle aches. The first human case of H7N9 was reported in March, 2013. Since then, 428 people have been infected and 129 have died – all but one in China. Almost all of those infected with H7N9 had direct contact with infected poultry or contaminated environments, such as live bird markets.
How A(H7N9) spreads – Most H7N9 infections were the result of touching infected poultry, or from indirect contact while in places where infected poultry has been kept or slaughtered (i.e. live bird markets). Experts agree the virus does not pass from person to person easily and relatively few cases have occurred this way.
How to avoid it – There is currently no vaccine to prevent H7N9. To avoid infection travellers visiting areas where outbreaks are occurring should follow the following guidelines:
DO NOT – Touch birds, pigs, or other animals – alive or dead; Visit bird or poultry markets, and farms; Eat food that isn’t served hot and fully cooked (i.e. still pink); Eat soft-boiled eggs; Dishes containing blood or raw eggs; Eat at street stalls.
DO – Wash your hands often using soap and water (or, if not available, use hand sanitiser containing at least 60% alcohol); Avoid touching your face without cleaning your hands first; Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing; Avoid close contact, such as kissing, hugging, or sharing eating utensils or cups, with people who are sick.
See a doctor if … you become sick with fever, coughing, or shortness of breath during or after travel to China.
For more information on these and other travel health issues, including vaccinations for your next overseas trip, please call Travelvax Australia’s travel health advisory service on 1300 360 164. You can also make a booking for a pre-travel medical consultation at a Travelvax clinic.