NSA Security/Health Update – Ebola Outbreak. Protection / prevention / travel. Updated on the 22.10.2014

The Ebola outbreak in Sierra Leone, Guinea and Liberia is continuing to escalate. Out of some almost 10.000 infected people, approx. half have died so far, according to the WHO. The situation in Nigeria and Senegal on the other hand is completely different. Both the countries have been declared Ebola-free. A total of 21 cases and 8 dead have been reported in Nigeria. One person was infected in Senegal. A smaller Ebola outbreak in DRC is not related to the major outbreak in the three most affected countries.Port calls and travel to and from Sierra Leone, Liberia and Guinea are affected by restrictions that various countries impose. These are sometimes ad hoc and based on fear, as much as objective information.

The Norwegian Shipowners’ Association, in consultation with the Norwegian Institute of Public Health, suggests a list of simple and effective personal protective equipment (PPE) kits and measures for crew in affected areas. The PPE kits can be useful in other areas where infectious diseases may pose a health risk for crew, eg. while handling large numbers of refugees during SAR operations in the Mediterranean. Status The latest figures from the World Health Organization (WHO) report a total of 9191 cases and 4546 deaths due to Ebola in Guinea, Liberia and Sierra Leone. The total number of cases (including other countries) is 9216 and 4555 deaths. The situation in the three most affected countries is severe. Nigeria and Senegal have now been declared Ebola free by the WHO. A total of 20 cases and 8 deaths have been confirmed in Nigeria. A case was confirmed in Senegal, but no deaths. International response Liberia has called for intensified response by UN agencies and member states. The cost to curb the spread of the disease is estimated by the UN to be $1 Billion. The US has so far deployed 500 out of 3000 planned troops to Liberia to provide logistical support, build healthcare facilities and transport health workers into the most affected areas. US troops are in Senegal to provide airlift assistance to the affected countries. The WHO has been criticized for not having acted rapidly enough to the spread of the virus. The organization has announced a road map to stop Ebola transmission in affected countries within 6-9 months and prevent international spread which it is currently following. Request from the UN to maintain supply links The UN Security Council has called upon countries to lift border restrictions on the affected countries, which is leading to their isolation and could undermine the efforts to assist. The Security Council also explicitly stated that transport companies should maintain links the affected countries. The WHO has warned against exaggerated measures that effectively isolate the affected countries and block air, sea and land transportation of goods, including emergency relief goods. Travel advice: Liberia, Guinea and Sierra Leone: The Norwegian Ministry of Foreign Affairs has introduced a travel advisory for Liberia, Guinea and Sierra Leone, advising against all travel to the three countries due to the Ebola outbreak. The advisory is issued based on an overall assessment of the situation. Health facilities in the affected countries are under pressure and have limited resources. It can prove difficult to receive adequate health treatment at facilities in the three affected countries and there is a contagion risk at hospitals. The World Health Organization (WHO) requests that the affected countries screen all persons at border points to ensure that they are not infected with Ebola. This means that leaving the country can prove to be difficult for people with any type of fever. There are a number of advisories issued by maritime authorities and flag states for ships calling at ports in these countries. Some of these can be found in our previous report here. Some flights to and from the countries have been suspended. British Airways has prolonged its suspension of flights to Liberia and Sierra Leone until 31st December. For more information on flight suspension see our previous report. Note that the situation can change on short notice. The US has introduced travel restrictions on passengers arriving directly from Guinea, Sierra Leone and Liberia. All flights from these countries will have to re-routed to one of the following airports: Washington Dulles International Airport, Chicago’s O’Hare International Airport, New York’s John F. Kennedy International Airport, Newark Liberty International Airport and Hartsfield-Jackson Atlanta International Airport and will have to go through screening. For more information please see the US department of home security. Nigeria: The country has been declared as Ebola-free by the WHO. Nigeria has been commended for its rapid response and containment of the Ebola virus. The country had 20 confirmed cases and 8 deaths in Lagos and Port Harcourt. All confirmed cases have been traced back to a Liberian-American national that flew from Liberia to Lagos. Note that despite the fact that the country has been declared Ebola-free, some countries could still be restricting entry of vessels that have made port calls in Nigeria. Nigeria has also introduced bans against vessels that have called in ports that have no Ebola virus. Please check for latest updates on restrictions when calling at several ports in Africa and see attached overview. Senegal: Senegal has been declared Ebola free. An affected Guinean student crossed over the border to Senegal to stay with family in Dakar. He has survived, after treatment. The Democratic Republic of Congo: The Democratic Republic of Congo (DRC) has confirmed an Ebola outbreak that has so far claimed 41 lives according to latest figures from WHO, deep inside the country. However this outbreak is not related to the ongoing outbreak in West Africa. It is believed that the initial case involved a pregnant woman who prepared and ate bush meat. All casualties so far can be linked back to this case. No travel restrictions due to Ebola have been imposed in Nigeria, DRC or Senegal by Norwegian or other European/US authorities. However the Norwegian Institute of Public Health (FHI) and other health authorities advise travelers to all affected countries to implement preventive measures and to stay updated. Previous NSA Updates on the Ebola outbreak: 19.09 - NSA Update: Ebola outbreak – 18.08.2014 - NSA Ebola Update - 04.08.2014 - NSA Security/Health Update – Ebola outbreak in West Africa – 4th July 2014 Your comments and questions are welcome. With kind regards Norwegian Shipowners’ Association, Contingency Planning Secretariat beredskap@rederi.no Crisis Management Support +47 90095001 Haakon Svane, Director: Email - hs@rederi.no, Mob: +47 901 99 082 Line Falkenberg Ollestad, Consultant: Email - lfo@rederi.no, Mob: +47 924 41 860