Public health authorities in the Dominican Republic said that they don’t want to alarm the population but it is time to straighten contingency measures to identify suspicious cases and train the health work force, given the fact there are direct flights from Africa to Haiti.

The Dominican Republic, according to the Public Health ministry, is still fighting to content Chikungunya, which affected more than 350.000 people (70% of the cases in the Caribbean) and are very sensitive to have to cope with a new epidemic.

NPHI advises all visitors to be proactive and prepared before travelling to any of the countries where we work.

Being proactive means: get informed, visit your doctor, have your vaccines up to date, follow standard hygiene measures (personal, food and repellent against mosquitos).

More than 900 people have died since the virus broke early this year in five countries in West Africa.

• Two patients with confirmed diagnosis were repatriated in US and one in Spain.
• Saudi Arabia reported that a patient who had travelled to Sierra Leona died on August 6th.
• United Kingdom is monitoring a woman from Cardiff who travelled to Africa and has been in contact with contagious patients.

The possible consequences of further international spread are particularly serious in view of the virulence of the virus, the intensive community and health facility transmission.

Key facts

• Ebola virus disease (EVD), formerly known as Ebola hemorrhagic fever, is a severe, often fatal illness in humans.
• EVD outbreaks have a case fatality rate of up to 90%.
• EVD outbreaks occur primarily in remote villages in Central and West Africa, near tropical rainforests.
• The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission.
• Fruit bats of the Pteropodidae family are considered to be the natural host of the Ebola virus.
• Severely ill patients require intensive supportive care. No licensed specific treatment or vaccine is available for use in people or animals.

Summary of epidemiological facts and experience

• The incubation period of Ebola virus disease (EVD) varies from 2 to 21 days. Person-to-person transmission by means of direct contact with infected persons or their body fluids/secretions is considered the principal mode of transmission. In a household study, secondary transmission took place only if direct physical contact occurred. No transmission was reported without this direct contact. Airborne transmission has not been documented during previous EVD outbreaks.
• There is no risk of transmission during the incubation period and only low risk of transmission in the early phase of symptomatic patients. The risk of infection during transport of persons can be further reduced through use of infection control precautions (see paragraphs 3.2 and 3.3).
• In the current outbreak, infected travellers have crossed land borders with neighbouring countries and there is a possibility that other cases might occur in neighbouring countries.
• Historically, several cases of haemorrhagic fever (Ebola, Marburg, Lassa, Crimean Congo haemorrhagic fever) disease were diagnosed after long distance travel but none developed the symptoms during the international travel. Long-distance travellers (e.g. between continents) infected in affected areas could arrive while incubating the disease and develop symptoms compatible with EVD, after arrival.

More info at :

cdc.gov/vhf/ebola/outbreaks/guinea/qa.html
cdc.gov/vhf/ebola/outbreaks/…/qa-experimental-treatments.html
cdc.gov/travel/page/survival-guide html