TRAVEL HEALTH SERVICE

Cholera is an acute bacterial intestinal infection caused by toxigenic Vibrio cholera O1 or O139. The disease often causes profuse watery diarrhea, vomiting, circulatory collapse, and shock. Many infections are associated with milder diarrhea or have no symptoms at all but if left untreated severe cholera cases up to 50% can be deadly.

Cholera is endemic to 50 countries primarily found in South and Southeast Asia and Africa but currently, other destinations including countries in the Caribbean and Middle East have active Cholera Transmission.

As the bacteria can be found in fresh and salty water the infections are mostly acquired from untreated drinking water or the feces of an infected person. Other common vehicles include raw or undercooked food, especially fish and shellfish.

People who do not follow hand washing recommendations, and/or do not use latrines or other sanitation systems are at increased risk for infection. Travelers with the greatest risk for exposure & infection are those going to endemic or outbreak areas, humanitarian aid workers, refugees and internally displaced people.

What are the symptoms of cholera Infection?

Infection is often mild or asymptomatic, but severe cholera occurs in about 10% of cholera episodes and is characterized by profuse watery diarrhea, described as rice-water stools, often accompanied by nausea and vomiting that can rapidly lead to severe dehydration, and death within hours.

Apart from clinical diagnosis laboratory confirmation is made using numerous diagnostic methods including rapid diagnostic tests and RT-PCR.

Treatment 

Timely rehydration therapy is the basis of cholera treatment with oral rehydration solution and, if necessary intravenous fluids and electrolytes. Antibiotics will also reduce fluid requirements and duration of illness and are indicated in conjunction with rehydration treatment.

Prevention

Travelers most importantly should follow the way to prevent cholera infection by practicing safe food and water handling precautions and frequent hand washing.

Cholera is a vaccine-preventable disease and generally, routine vaccination is not recommended for travelers if you are not at the greatest risk for exposure & infection (i.e., humanitarian aid workers, going to endemic or outbreak areas, and health care workers in direct contact with cases) and currently, no country or territory requires vaccination against cholera as a condition for entry.

Useful tips

• Cholera is an acute watery diarrheal disease with a high fatality if left untreated.
• Choler is endemic in South and Southeast Asia, Africa, the Middle East, and the island of Hispaniola.
• Travelers who consistently observe safe food, water, sanitation, and hand hygiene precautions have virtually no risk of infection
• Cholera is a vaccine-preventable disease.
• While in Ethiopia, for any inquiries please call toll-free 8335 or visit https://ephi.gov.et/travel-health-service/

What is Marburg virus disease?

Marburg virus disease (MVD) is a rare but severe hemorrhagic fever caused by the Marburg virus, members of the filovirus family.

Marburg virus was first recognized in 1967, when outbreaks of hemorrhagic fever occurred simultaneously in laboratories in Marburg and Frankfurt, Germany and in Belgrade, Yugoslavia (now Serbia). The first people infected had been exposed to Ugandan imported African green monkeys or their tissues while conducting research. That same year, an American traveller developed MVD after returning to the US from Uganda and recovered. Both travellers had visited a well-known cave inhabited by fruit bats in a national park.

The reservoir host of Marburg virus is a type of cave-dwelling fruit bat native to Africa called the Egyptian rousette bat. Bats infected with Marburg virus do not show obvious signs of illness. Primates (including people) can become infected with Marburg virus, which can cause serious illness or death. Many past outbreaks started with male mine workers in bat-infested mines and then spread within their communities.

What are the symptoms of MVD?

After an incubation period of 2-21 days, symptom onset is sudden and marked by fever, chills, headache, myalgia (Muscle pain) and non-itchy rash. Severe watery diarrhea, abdominal pain and cramping, nausea and vomiting can begin on the third day. Symptoms become increasingly severe and can include jaundice, inflammation of the pancreas, severe weight loss, delirium, shock, liver failure, massive hemorrhaging, and multi-organ dysfunction.

Clinical diagnosis of Marburg virus disease (MVD) can be difficult, as early nonspecific manifestation of the disease may mimic other infectious diseases such as malaria, typhoid fever and meningitis or viral haemorrhagic fevers that may be endemic in the area (such as Ebola). Confirmation is made using numerous diagnostic methods including RT-PCR.

Prevention and treatment of MVD

Preventive measures against Marburg virus infection include avoiding fruit bats and sick non-human primates and precautions to prevent the secondary transmission (person-to-person) including wearing of personal protective equipment’s (PPEs). Better awareness can lead to earlier and stronger precautions against the spread of Marburg virus.

Currently there are no vaccines or antiviral treatments approved for MVD. However, supportive care including rehydration with oral or intravenous fluids and treatment of specific symptoms, improves survival.

Useful tips

• MVD is preventable disease, but it kills in a short time.
• MVD is a disease that can easily be transmitted from person to person through contact with the body fluids of an infected person.
• MVD can be prevented by washing hands regularly with soap and water.
• Report any suspected cases of MVD to the nearest health facility
• While in Ethiopia , for any inquire please call toll free 8335 or visit https://ephi.gov.et/travel-health-service/

What is Ebola virus disease (EVD) 

Ebola virus disease is a deadly hemorrhagic disease caused by Virus called Ebola virus. The disease often causes high fever and bleeding from various body holes. The current outbreaks of Ebola viral disease in Uganda is caused by species Sudan Ebolavirus disease. Outbreaks by the species of Sudan virus first reported in southern Sudan in June 1976, since then seven outbreaks, four in Uganda and three in Sudan have been reported.

The virus is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals such as fruit bats, chimpanzees, gorillas, monkeys, forest antelope or porcupines found ill or dead or in the rainforest.
The virus then spreads through human-to-human transmission via direct contact (through broken skin or mucous membranes) with either blood or body fluids of a person who is sick with or has died from EVD or objects that have been contaminated with body fluids (like blood, feces, vomit) from a person sick with EVD or the body of a person who died from EVD.

The incubation period ranges from 2 to 21 days. People infected with Sudan virus cannot spread the disease until they develop symptoms, and they remain infectious as long as their blood contains the virus.

What are the symptoms of Ebola?

Symptoms of EVD can be sudden and include fever, fatigue, muscle pain, headache, and sore throat later followed by vomiting, diarrhea, rash, symptoms of impaired kidney and liver function. In some cases, the patient might present both internal and external bleeding (for example, bleeding from the gums, or blood in the stools).

The diagnosis of EVD can be difficult, as early nonspecific manifestation of the disease may mimic other infectious diseases such as malaria, typhoid fever and meningitis. Confirmation is made using numerous diagnostic methods including RT-PCR.

Prevention and treatment of EVD

Supportive care – rehydration with oral or intravenous fluids – and treatment of specific symptoms improve survival.

There are no licensed vaccines or therapeutics for the prevention and treatment of Sudan virus disease.

Useful tips

• Ebola is preventable disease, but it kills in a short time.
• Ebola is a disease that can easily be transmitted from person to person through contact with the body fluids of an infected person.
• Ebola can be prevented by washing hands regularly with soap and water.
• Report any suspected cases of Ebola to the nearest health facility
• While in Ethiopia , for any inquire please call toll free 8335 or visit https://ephi.gov.et/travel-health-service/

What is mPox (Monkey pox)?

mPox is a viral zoonosis disease (Animal origin) caused by infection with mPox virus. Previously mPox occurs in central and West Africa but the current outbreak is occurring around the world in areas where mPox is not usually found.

The mode of transmission is Human-to-human to animal-to-human transmission. Human-to-human transmition occurs from close contact with respiratory secretions and skin lesions of an infected person or recently contaminated objects. Transmission can also occur via the placenta from mother to fetus or during close contact during and after birth.

Animal-to-human transmission can occur by bite or scratch of infected animals and from direct contact with the blood or other bodily fluids and lesions of infected animals.

Symptoms of mPox

People infected with mPox develop a rash that can look like pimples or blisters and the rash may be painful or itchy, similar to those seen in the past in smallpox patients, although it is clinically less severe.

The symptoms of mPox can include Fever, Headache, Muscle and back pain, swollen lymph nodes, Chills, Exhaustion and Respiratory symptoms (e.g. sore throat, nasal congestion, or cough). The illness typically lasts from 6 to 13 days but can range from 5 to 21 days.

Who is at risk?

Anyone in close contact with a person with mPox can get it and should take steps to protect themselves.

Prevention and treatment Measures

There is no specific vaccine and treatment developed for mPox but some clinical studies demonstrated that Smallpox vaccine is about 85% effective in preventing the disease.

Travelers can protect themselves against infection by taking the following steps.

• Avoid close, skin-to-skin contact including kissing, hugging, or having sex with people who have a rash that looks like mPox.
• Wash your hands often with soap and water or use an alcohol-based hand sanitizer; especially before eating or touching your face and after you use the bathroom.
• In Central and West Africa, avoid contact with animals that can spread mPox virus, usually rodents and primates.

Useful tips

• If you have symptoms of MPox or had close contact with someone who has mPox, talk to your healthcare provider.
• If you have symptoms, do not travel until you recover or confirm you do not have mPox.
• While in Ethiopia , for any inquire please call toll free 8335 or visit https://ephi.gov.et/travel-health-service/

What is yellow fever?

Yellow fever (YF) is a serious illness caused by the YF virus. YF is usually passed on to humans by the bite of an infected mosquito. YF can vary from a flu-like illness that gets better on its own over several days to a severe illness with fever, jaundice (turning yellow), bleeding and organ failure. There is no specific medicine to treat YF. Up to 5% of infected people will die if they are not treated immediately.

Occurrence of YF disease?

The disease in Africa and Latin America in 44 countries. It causes with a estimation of 200,000 illnesses and up to 30,000 deaths, and the data shows the YF proved to be found in some places in our country.

The main symptoms of yellow fever

Many people do not experience symptoms, but when these do occur, the most common are:

• Fever,
• Muscle pain with prominent backache,
• Headache,
• Loss of appetite, and
• Nausea or vomiting.

A small percentage of patients, however, enter a second phase, more toxic phase within 24 hours of recovering from initial symptoms. High fever returns and several body systems are affected, usually the liver and the kidneys. In this phase people are likely to develop jaundice (yellowing of the skin and eyes, hence the name ‘yellow fever’), dark urine and abdominal pain with vomiting. Bleeding can occur from the mouth, nose, eyes or stomach.

How to Prevent?

• Prevention of mosquito bites
  • Wearing long -sleeved shirts and
  • Insect repellents,
• Vaccination
  • The travelers should have the vaccine at least 10 days before you travel
  • The vaccine provides lifelong protection

Note: Travelers to YF areas should do both things

What is the Treatment?

A person who feels the above symptoms should immediately go to the health center and get the necessary professional advice and examination. If a person infected with yellow fever does not get early diagnosis and medical help, it can lead to death.

Useful tips

• Take the vaccine before Travel
• Any persons with high fever and yellow eyes should seek to a health facility as they may have yellow fever; Notify the nearest health office or governing body immediately.
• While in Ethiopia , for any inquire please call toll free 8335 or visit https://ephi.gov.et/travel-health-service/