Ebola – Is it Safe to Visit Africa?

Well it’s now late October, we are 11 months into this outbreak, and I just returned from an incredible 24 day Southern Africa safari.

So is it safe to visit Africa? It’s not a simple question to answer however there are many reasons to breathe easy. The response from governments, airlines, tour operators, and hospitals has matured over the last few months and from what we are hearing things are getting more under control. Many more cases are expected in the next few months however containment within West Africa should be much higher.

Margaret Chan, director-general of WHO, said recently “the level of fear in the U.S. is up here,” raising her hand above her head. “It should be down here,” she added, moving her hand below her chest.

Here are my thoughts having both lived and worked in Africa, and having run a safari company for close to 20 years.

The African continent is enormous – roughly the size of the United States, China, India, Spain, Germany, Italy, France, the U.K. and Eastern Europe combined. The Ebola outbreak is centered in 4 countries in a relatively small part of West Africa: Guinea, Liberia, Mali, and Sierra Leone.

Many cities in Europe are actually closer to the Ebola outbreak than are cities in eastern and southern Africa. European cities also have many more flight connections to the area.

Here is a link to a really great piece about Africa’s size and the Ebola outbreak from the Washington Post

Although the distance from safari areas to the outbreak is great I do think we could see a few isolated cases in Johannesburg, South Africa or Nairobi, Kenya over the next few months.

Ebola is not easy to get. In fact Ebola is much less contagious than many other more common diseases and good infection-control practices easily stop its spread.

Tens of thousands of travelers have been on safari throughout both Eastern and Southern Africa this year without incident. Of the 22 Ebola outbreaks in West and Central Africa since 1976 no safari tourist has ever been infected.

A writer for NBC, Maggie Fox, has written a good piece on how Ebola does, and doesn’t, spread. I think this is pretty realistic:

Ebola only spreads via bodily fluids: The virus lives in vomit, diarrhea, blood and sweat. Heat kills it, it doesn’t survive being dried out, and it doesn’t travel through the air. It also doesn’t appear to stick to surfaces much.

Ebola patients cannot infect others before they are sick themselves: No one has been documented to have spread the virus before showing symptoms such as a high fever, vomiting and diarrhea. The virus builds up in the body as patients get sicker. In fact, people in the early stages of Ebola infection often test negative for the virus, because there’s not very much in their blood. While the virus is found in sweat and that might make people wary of public transport, what’s meant by that is that it’s found in the profuse sweat of very ill patients and unlikely to be in the normal perspiration of an otherwise asymptomatic person.

Ebola does not spread through casual contact: The people most at risk of Ebola are caregivers and health care workers, who are physically touching Ebola patients at their sickest. In 40 years of studying Ebola outbreaks, no one has seen a mystery case. People are infected by direct contact with others — not casual contact on airplanes, buses, trains or in the street.

Thomas Eric Duncan, the first person to die of Ebola in the United States, didn’t infect his girlfriend or other people who were in an apartment with him after he became ill. Close to 50 people who had some sort of contact with him all have passed the 21-day incubation period without disease. He did infect two nurses who had been intensively caring for him when he was very ill.

Ebola has to get inside you to infect you: Unlike measles or tuberculosis, you can’t just breathe in Ebola virus and get infected. It doesn’t float in the air like those germs do. It must get into the eyes, nose or mouth, or get past the very strong barrier that is human skin, carried by a needle or perhaps through a fresh cut. Soap and water quickly removes Ebola virus and bleach or alcohol kills it quite effectively.

The CDC currently does not recommend that travelers avoid visiting other African countries. Ebola is a very low risk for most travelers who can protect themselves by avoiding sick people and hospitals in West Africa where patients with Ebola are being treated.

People, I believe, are most worried about being aboard a flight when someone becomes sick. The European Center for Disease Prevention and Control says “sharing a sitting area or public transportation” with an infected person poses a “very low or no recognised risk” of catching the disease. That’s due in large part to the fact a person must be highly symptomatic to spread ebola and it is is not spread through the air.

In addition airplane air is much fresher than you may think. Modern commercial jets continuously pull fresh air into the cabin from outside the aircraft. The cooled air reaches you through overhead ducts that run the length of the plane. It leaves through grills along the sidewalls, near the floor. Because the air flows from the top of the plane to the bottom—not from front to back—each passenger shares the air with a few neighbors. When the air is pulled into the grills in the floor, pilot Patrick Smith writes in Cockpit Confidential, about half is expelled from the plane. The rest is filtered and recycled with fresh air from the compressors. High efficiency particulate air filters, installed on every commercial airliner made since the late 1980s, remove up to 99.97% of all microbes, and “there’s a total changeover of air every two or three minutes,” Smith writes. According to the WHO, “under normal conditions cabin air is cleaner than the air in most buildings.”

Looking at the Ebola cases that have occurred within the USA and Europe most of the infected persons traveled by air yet no other air travelers have become ill.

Based on airline traffic from West Africa statistics show that the United States and the United Kingdom — along with four other European nations — are more likely to see an Ebola case than most countries in Africa. Having noted this many airlines have restricted flights or modified flight schedules:

Air France suspended flights to Sierra Leone from 28 August.
Kenya Airways have suspended services to Liberia and Sierra Leone.
British Airways has extended their suspension of flights to Liberia and Sierra Leone until March 31, 2015
Emirates Airlines has suspended flights to Guinea.
Senegal Airlines has suspended flights to and from Guinea until further notice.

Other airlines have modified their routes but are still operating regular scheduled services. These include:
Royal Air Maroc
Brussels Airlines

That means it is incredibly difficult to get from the areas of the outbreak to anywhere else in Africa.

All safari countries have enacted strict precautionary measures and as there currently are no Ebola cases the risk of infection is zero.

Botswana has suspended entry for travelers who have visited Liberia, Guinea, Nigeria and Sierra Leone within the last 30 days.

Kenyan authorities have suspended entry of passengers travelling from and through Guinea, Liberia and Sierra Leone, excluding health professionals supporting efforts to contain the outbreak and Kenyan citizens.

In Tanzania, all major border posts have mandatory health screening in place, including all international airports.

Rwanda has banned entry to travellers who have visited Guinea, Liberia or Sierra Leone in the 22 days prior to travel.

South Africa refuses to admit foreign citizens arriving from Ebola-affected countries in West Africa, while South African citizens will be allowed to re-enter, but only after being subject to strict screening.

For Zambia any tourists who has been to an Ebola infected area (Guinea, Sierra Leone, Nigeria or Liberia) within the past 30 days will be denied entry. Returning residents from Zambia may be subject to quarantine if they have travelled through the aforementioned high risk countries.

In Zimbabwe, all travelers from West Africa are put under 21-day surveillance. Health officials regularly visit those travelers to check their condition.

Namibia’s foreign ministry on September 11 announced that foreigners travelling from countries affected by Ebola would be prohibited from entering the country.

And further to the above:
Gambia has banned the entry of flights from Guinea, Liberia, Nigeria and Sierra Leone.
Gabon has banned the entry of flights and ships from countries affected by Ebola.
Senegal has banned flights from Guinea, Liberia and Sierra Leone.
Cameroon has banned flights to and from Nigeria.Chad has suspended all flights from Nigeria.
Nigeria has suspended flights to the country operated by Gambian national carrier Gambia Bird.
Côte d’Ivoire has now lifted the ban on passenger flights from Guinea, Liberia and Sierra Leone.
Cape Verde will deny entry to non-resident foreigners coming from countries with ‘intense Ebola transmission’ – Sierra Leone, Guinea and Liberia – or who have been to those countries in the previous 30 days.
Mauritius has banned entry to all travellers who have visited Nigeria, Sierra Leone, Guinea, Liberia, Senegal and Congo (DRC) in the last two months, rather than just citizens of those countries, as was the case previously.
Seychelles has suspended entry to travellers who have visited Sierra Leone, Liberia, Guinea-Bissau, Guinea, Nigeria or Congo (DRC) 28 days prior to their journey, with the exception of Seychellois citizens.
South Sudan has placed a ban on travellers coming from Guinea, Sierra Leone, Liberia or Congo (DRC), or those who have travelled to those countries in the preceding 21 days.
Gambia has suspended entry of persons who have visited Guinea, Liberia, Sierra Leone or Nigeria in the 21 days prior to travel.
Côte d’Ivoire announced that it had closed its land borders with Guinea and Liberia.
Gabon stated that it is restricting the issuance of entry visas to travellers from Guinea, Liberia, Sierra Leone and Nigeria on a case-by-case basis.
Senegal has closed its land border with Guinea, while the country’s sea and air borders will also be closed to vessels and aircraft from Guinea, Liberia and Sierra Leone.
Chad closed its land border with Nigeria at Lake Chad. The country previously reportedly banned the entry of any travellers originating or transiting through Guinea, Liberia, Nigeria or Sierra Leone, with airlines serving the country reportedly rerouting flights.

Since the above Nigeria and Senegal have been cleared of Ebola.

Beginning October 22 in the USA, travelers from Liberia, Sierra Leone and Guinea will be required to fly into one of five U.S. airports with enhanced screening protocols already in place: New York City’s JFK International Airport, Newark, Dulles, Atlanta and Chicago. Thesefive airports account for 94% of travelers who fly into the U.S. from the affected countries. The 6% of travelers affected by the new restrictions are responsible for contacting airlines for rebooking their flights. There are currently no direct, non-stop commercial flights from the three countries to anywhere in the U.S.

Due to what many would say is an exagerrated level of fear, and a misunderstanding of Africa’s geopraphy / size, tour operators / lodges / hotels / camps in Africa have acted. Most have put in place policies allowing travelers to cancel their current arrangements and rebook for a different time if an Ebola outbreak or travel warning were to occur within the country a traveler is booked to visit.

And last but certainly not least… Africa’s wildlife and wilderness. Back in the day governments, through National Parks, supported most of Africa’s wildlife and wilderness areas. Today Africa’s wilderness areas and wildlife are mostly protected through tourism where the tourist presence keeps poachers at bay and tourist dollars support an incredible number of wildlife and wilderness projects. With a huge downturn in tourist arrivals the monies needed to protect Africa’s wildest areas will dry up leaving the animals vulnerable. A sad unintended consequence of Ebola occurring 4,000 miles away.

Stay well,

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Ian Proctor
Ultimate Africa founder and president

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