Ebola Epidemic Raises Preparedness Concerns

The recent outbreak of a particularly lethal strain (Zaire) of the Ebola virus has raised concerns about a wider spread of the disease. The largest outbreak of the Ebola virus to date is disrupting communities and economies in Guinea, Liberia, Sierra Leone, and Nigeria.

The World Health Organisation (WHO) notes that there is a high risk that the Ebola virus will spread to bordering countries and a moderate risk that other West African countries will be affected. To help prevent its spread, authorities in Guinea, Sierra Leone, Liberia, and Nigeria have established screening, quarantine, and self-identification/health declaration protocols in Ebola-virus-infected areas, at borders, airports, and other points of entry as part of the “Ebola Virus Disease Outbreak Response Plan in West Africa” (WHO and Governments of Guinea, Liberia, and Sierra Leone).

According to the WHO and other health authorities, the risk of a wider global outbreak is low given the nature of the transmission of the virus (that is, physical contact as opposed to airborne) and the range of resources available to handle even a suspected case in many countries outside West Africa.

Ebola Virus Overview

Transmission
People can become infected through contact with infected animals, either through the slaughtering process or by consuming blood, milk, or raw or undercooked meat. The virus passes from person to person through direct contact with the blood or other bodily fluids of infected persons, or from contact with contaminated needles or other equipment or objects.

Symptoms
The Ebola virus is a severe acute viral illness with a fatality rate as high as 90%. It is often characterised by sudden onset of fever, intense weakness, muscle pain, headache, nausea, and sore throat, followed by vomiting, diarrhoea, impaired kidney and liver function, and in some cases, both internal and external bleeding.

The incubation period from infection to the onset of symptoms is two to 21 days. People remain infectious as long as their blood and secretions contain the virus, a period reportedly as long as 61 days after the onset of illness. Definitive diagnosis of the Ebola virus is made through laboratory testing using maximum infection control procedures, due to the infection risk posed by patient samples.

Taking Precautions

With some health authorities now recommending that nonessential travel to the region be curtailed, any organisations with colleagues near, or travelling through affected areas should take precautions. Marsh Risk Consulting (MRC) recommends that you and your organisation consider the following:

• Monitor developments via the websites of the WHO, Centers for Disease Control and Prevention (CDC), your national health authority, and local health authorities.
• Educate yourself and colleagues about Ebola’s transmission and infection-control measures.
• Unless it is business-critical, consider curtailing travel to affected countries or locations.
• If you are considering travel to affected areas, you may want to reconsider your itinerary or plans. If you are in an affected area, avoid high-risk activities such as contact with ill people or the bodies of people who have died from Ebola, with sick or dead wildlife, or with bush meat.
• Pay strict attention to hygiene. Frequently wash your hands or use hand sanitiser, avoid touching your face, and avoid close contact with an obviously sick person.
• Be aware that screening and isolation measures are already or may be put into place. Travellers suspected of being sick or in contact with an infected person could be quarantined.
• If you get sick in any affected country and have symptoms similar to Ebola (i.e. malaria), it may prove more difficult than usual to travel regionally or internationally for medical treatment. Also, if you happen to fall ill while travelling, avoid medical facilities treating Ebola cases.
• Authorities could close down borders to combat the disease, thereby stranding you or other colleagues in country.
• If you travel to a suspect area or come in contact with a suspect person or contaminated object, monitor your health and seek medical attention if you feel sick (i.e. fever, headache, achiness, sore throat, diarrhoea, vomiting, stomach pain, rash, or red eyes).

Preparedness Measures

MRC can support your efforts to reinforce corporate preparedness and resiliency in light of the current Ebola epidemic or future pandemic outbreaks by:

• Addressing the continuity requirements of any vital processes that must be maintained for the normal operation of the organisation, or a vulnerable central location such as a call centre or outsourced manufacturing site.
• Reviewing the corporate structure necessary to manage the impact and consequences of a pandemic event.
• Confirming that crisis management and business continuity plans include detailed pandemic protocols and that needed technology, infrastructure, and other requirements are addressed in advance.

In addition, for those organisations with local employees or employees travelling to affected areas, Marsh can assist with insurance policy reviews to determine applicable coverage or if any exclusions might be in effect.