CDC Travel Advisories: Monkeypox, Ebola & More

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Over the past 6 weeks we've seen 3 exported cases of Monkeypox from Nigeria (2 to the UK, 1 to Israel), resulting in at least 1 secondary infection in a UK Hospital Worker.

Nigeria reported their first Monkeypox outbreak in nearly 4 decades in the fall of last year, but had stated it was winding down last winter, and issued their last outbreak update in epi week 9 of 2018.

Following the first two exported cases, the Nigerian CDC released their first Monkeypox update in more than 6 months (see Nigeria: CDC Monkeypox Update Epi Week 37), indicating only low levels of detection over the spring and summer.

 Nigeria CDC - Epi Week 37
 

Although the Nigerian CDC website hasn't updated their Monkeypox situation in almost a month, late this week the CDC updated their travel advisory page with the following notice:

Monkeypox in Nigeria

Alert - Level 2, Practice Enhanced Precautions

Key Points

• An outbreak of monkeypox has been ongoing since September 2017 in Nigeria.
• Monkeypox is spread through contact with an infected person or animal (alive or dead), or with material contaminated with the virus. It can also be spread through droplets when infected people cough, sneeze, or talk.
• Travelers to Nigeria should protect themselves from monkeypox by washing hands often with soap and water, and avoiding contact with animals or people that may be sick.

What is the current situation?

As of September 2018, health officials in Nigeria have reported more than 100 confirmed cases of monkeypox, including multiple deaths. As of October 2018, three cases of monkeypox have been reported in travelers to the United Kingdom (2) and Israel (1), including one to GeoSentinel (a global travel surveillance network).

What is monkeypox?

Monkeypox is a rare disease that occurs throughout remote parts of Central and West Africa, often near tropical rainforests. It is spread through contact with the monkeypox virus from an animal or human (alive or dead) or with materials contaminated with the virus. Symptoms begins with fever, headache, muscle aches, swollen lymph nodes and exhaustion, and is followed by a rash. Patients are usually ill for 2-4 weeks. Monkeypox is fatal in as many as 10% of people who get it.

How can travelers protect themselves?

Because monkeypox is spread by contact with animals or humans that have monkeypox, travelers to Nigeria should take steps to prevent illness:

• Wash your hands often with soap and water.
• Don’t touch your eyes, nose, or mouth. If you need to touch your face, make sure your hands are clean.
• Avoid close contact with people who are sick.
• Avoid contact with wild animals or wild animal products and meat that could harbor the virus (including animals that are sick or that have been found dead in areas where monkeypox occurs).
• Avoid contact with any materials, such as bedding, that has been in contact with a sick person or animal.
  

If you feel sick and think you may have monkeypox:

• Seek medical care right away.
• Before you go to a doctor’s office or emergency room, tell the doctor about your recent travel and your symptoms.
• Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.

Traveler Information
CDC Monkeypox Homepage
Clinician Information
Monkeypox Information for Health Care Professionals
Monkeypox Information for Veterinarians

The CDC also has an updated Level 2 Travel Alerts for Ebola in the DRC.

Ebola in Democratic Republic of the Congo
 
Alert - Level 2, Practice Enhanced Precautions

Key Points

• There is an outbreak of Ebola in the North Kivu (Kivu Nord) and Ituri provinces in the the northeastern part of the Democratic Republic of the Congo (DRC).
• The outbreak is in a part of the country identified by the U.S. State Department as a “do not travel” zone because of armed group activity and major outbreaks of violence targeting civilians.
• The armed conflict and violence in the outbreak area is hampering response activities including early identification of cases, and monitoring of "contacts" (people who may have been exposed to Ebola).
• Travelers to this area could be infected with Ebola if they come into contact with an infected person’s blood or other body fluids.
• Travelers should seek medical care immediately if they develop fever, headache, body aches, sore throat, diarrhea, weakness, vomiting, stomach pain, rash, or red eyes during or after travel.

        (Continue . . . . )


You'll find more than 40 current LEVEL 2 ALERTS on the travel page, covering such health risks as Zika, Polio, Yellow Fever, and Extensively Drug Resistant Typhoid Fever around the globe.

You'll also find two LEVEL 3 warnings:

Warning Level 3, Avoid Nonessential Travel

• Updated  Earthquake and Tsunami in Indonesia October 11, 2018 Because of the recent earthquake and tsunami that struck Indonesia on September 28, travelers to the province of Central Sulawesi may experience serious health and safety risks, and medical care may not be available. CDC recommends that travelers avoid all nonessential travel to the province of Central Sulawesi, Indonesia. Read More >>
• Health Infrastructure Breakdown in Venezuela May 15, 2018 CDC recommends that travelers avoid all nonessential travel to Venezuela. The country is experiencing outbreaks of infectious diseases, and adequate health care is currently not available in most of the country. Read More >>

Along with several dozen Watch Level 1, Practice Usual Precautions reminders.

Before you travel, always visit the CDC Traveler's Health Advice Page for information on current health threats, and any recommended vaccinations.