Information for humanitarian aid workers

Information for humanitarian aid workers working in Ebola-affected countries in West Africa

Page last updated: 12 November 2014

Background information on Ebola

Ebola virus is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals. Once a person comes into contact with an animal that is infected with the virus, it can spread from human to human. Infection occurs from direct contact (through broken skin or mucous membranes) with the blood, or other body fluids (including stool, urine, saliva, semen) of infected people. Semen can contain virus for seven weeks after apparent recovery from the illness.

Infection can also occur if broken skin or mucous membranes of a healthy person come into contact with environments that have become contaminated with an Ebola patient’s infectious fluids such as soiled clothing, bed linen, or used needles.

The illness usually begins abruptly with fever, headache, joint and muscle pain, sore throat and intense weakness. Stomach pains, diarrhoea and vomiting may occur. Some individuals may develop a rash, red eyes, hiccups, and internal or external bleeding. In severe cases patients develop failure of the liver and kidneys.

Anyone who has close contact with a person infected with the virus, or someone who handles samples from patients is at risk. This includes hospital staff, family members and laboratory workers, all of whom are at risk if they do not use proper barrier nursing techniques. These precautions include wearing protective gowns, gloves, and masks, in addition to wearing eye protection (eg eye glasses) or a face shield. Ebola virus is not spread through routine, social contact (such as shaking hands) with asymptomatic individuals. The likelihood of contracting Ebola is considered very low unless there has been a specific exposure, such as direct contact with body fluids (eg blood, saliva, urine) of symptomatic infected persons or objects that have been contaminated with body fluids. A fever in persons who have travelled to Ebola transmission areas is more likely to be caused by a common infection, such as malaria or typhoid fever, but such persons should be evaluated by a healthcare provider to be sure.

If you travel to an area affected by an Ebola outbreak to work in the response, the following precautions are recommended:

Before you leave

  • Your organization should be able to provide you with all the relevant personal protective equipment (PPE) for you to safely carry out your duties, but check with them what will be available. A personal supply of surgical masks and disposable gloves could be useful, but this should be discussed with your organization
  • Discuss with your organization about what you should take with you, this will usually involve assembling a travel health kit containing basic first aid essentials, such as sunscreen, insect repellent (DEET), painkillers, anti-diarrhoeal tablets, a thermometer, household disinfectant, and alcohol-based hand rub for hand hygiene. Be aware that hand rubs do not provide protection from any infection if hands are visibly soiled, in which case washing with soap and water is required
  • Seek information about the current Ebola outbreak. This is an evolving situation so remain aware of up-to-date, reliable information on specific areas affected, noting these might change over time. For information, see links below
  • Be sure you are up to date with all routine immunisations and see your healthcare provider at least 4-6 weeks before travel to review your immunisation status and get advice on travel-related immunisations, medications (including malaria prophylaxis). If you are travelling last minute, it is still not too late to get travel health advice and anti-malarial tablets can be started just before you travel
  • If you are on prescription medicines, ensure you have sufficient supply to cover your time in the field. Discuss any pre-existing medical conditions with your doctor.
  • If you have travel insurance, check the policy to establish the duration of the trip you are covered for, whether emergency assistance is available, whether this type of trip would be covered, or get additional insurance that covers medical evacuation in the event of illness. Check your organisation’s health and safety policies and medical evacuation arrangements
  • Visit the Department of Foreign Affairs and Trade Smartraveller website for important information, including details of registering your travel.

While you are in an area where Ebola has been reported

Follow basic precautions, for example:

  • Avoid contact with ill or dead people unless wearing appropriate PPE
  • Avoid contact with ill or dead animals (especially primates and bats) as well as preparation and consumption of ‘bushmeat’
  • Adhere to safe sex practices including the use of barrier contraception

If you are involved in medical care you should maintain the general principles of infection control at all times, including:

  • Frequent hand washing with soap and water
  • Wearing gloves
  • Proper disposal of needles and other equipment and sterilization of non-disposable equipment
  • Proper disposal of body fluids and tissues from patients

Observe strict barrier techniques when in close contact with persons suspected or known to have Ebola. For healthcare workers working with Ebola patients in African healthcare settings, see the WHO’s “Interim infection Prevention and Control Guidance for Care of Patients with Suspected or Confirmed Filovirus Haemorrhagic Fever in Health-Care Settings, with Focus on Ebola”, updated in August 2014. This document includes direct patient care, laboratory activities, post mortem examinations, movement and burial of human remains, cleaning and waste disposal.

Vital barrier techniques include wearing protective gowns, gloves, masks and eye protection or face shields, and the careful removal of these are use.

If you think you have been exposed to Ebola in an affected area:

  • If you do not have any symptoms but think you have been exposed to Ebola (eg through a breach in PPE), contact your organization immediately for further advice
  • If you become unwell, visit a healthcare provider immediately and inform them that you have been in contact with Ebola. There may be a legal duty to report this and your organization should be aware of this requirement. When travelling to seek medical attention, limit contact with others. All other travel should be avoided.
  • The symptoms of Ebola can be non-specific, eg chills, muscle aches, sore throat. Other potential causes of illness should not be overlooked.

On return to Australia – at the border

All incoming passengers to Australian international airports are asked to declare their 21 day travel history, specifically whether it includes countries with widespread and intense transmission of Ebola virus disease. If you have been in the EVD affected countries during this time, you will undergo further screening through a structured interview and temperature checking. As a result of this screening, you will be referred to public health authorities and/or for medical evaluation from the border.

After your return

In addition to border screening, aid workers returning from an affected area will need to be assessed by state and territory public health authorities. This assessment will consider the type of work you carried out in West Africa and your risk of exposure to Ebola virus disease.

This assessment will determine the degree of follow up required by public health authorities and what activities are recommended or not recommended during the 21 monitoring period since leaving the Ebola-affected country. People are not considered infectious whilst asymptomatic but some activities may be restricted until you are past the maximum incubation period for Ebola (21 days).

You have a duty to undertake this assessment and follow the advice provided.

Your organization should provide your contact details to the Australian Government Department of Health when you return from your work in West Africa. The Australian Government Department of Health will pass these details onto the public health authorities (state and territory government health departments) in your home jurisdiction.

Your organization should also provide you with a list of relevant phone numbers so you can contact the public health authorities in your home jurisdiction at any time.

It is recommended that you contact the public health authority in your jurisdiction prior to departing Australia to clarify what to expect on return home. You can arrange this through your organization.

If you become unwell within the 21 day period after return to Australia

When you return to Australia you will be given a health information card at the airport.

Keep this card for up to 21 days after you have left the Ebola affected area as symptoms may take this long to develop.

If you develop any symptoms, including fever; headache; muscle aches; vomiting or diarrhoea within 21 days, call 1800 186 815 for help 24 hours a day.

Tell the health care worker that you have been in Africa, or if you have been in contact with someone infected with Ebola.

They will help you.

Information for the Public

Information For Travellers

Information For Health Professionals

Information for GPs

Information for Humanitarian Workers

Current Situation

List of Affected Countries