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Ebola and travel to Africa: Is it safe?

Posted: Wednesday, September 17, 2014

NOTE: I wrote this specifically for women who are signed up for our Kilimanajaro Climb and Safari next February, but I hope it is useful for anyone planning to travel to Africa in the next year. -- Marian

Safety is always our first priority at Adventures in Good Company, and we are constantly evaluating the safety of the places we go and the activities we're doing. While adventure travel often has inherent risks that are different than those of conventional travel, we believe that preparation and knowledge can minimize unnecessary risks. 

With constant stories about Ebola in the news, it is easy to wonder if you should be scared. If you are planning to climb Kilimanjaro this winter and you hear statements that the Ebola epidemic is out of control, and you have seen the movie Contagion, it is impossible not to have images of Kate Winslett dead in a body bag 24 hours after she started coughing. And the movie, with a little dramatic license, did accurately portray how a highly infectious respiratory virus could spread quickly around the world, causing panic and social chaos. One of these days a strain of bird flu may mutate and cause something similar.

But Ebola is not that virus. And speaking from my training as an epidemiologist (my career before starting Adventures in Good Company), when evaluating the risk of travel to Africa, particularly to Tanzania, it's important to understand the following points.

  1. Part of the reason that Ebola is so scary is the very high mortality rate associated with it. Although so far it seems less lethal than previous outbreaks, when 90% of victims died, 50% is still very high.

  2. We understand from previous experience how to control Ebola outbreaks. It takes public education, decent quarantine facilities where people who are sick can get treated and given some hope of recovery, and adequate manpower to track down and quarantine every one who comes in close contact with anyone who is sick. Nigeria has, so far, been successful in doing this;  at this point, all their cases are directly attributable to the Liberian who flew into the airport at Lagos and collapsed. Guinea, Sierra Leone, and Liberia are poor and fragile countries whose efforts have been unsuccessful. In those three countries, Ebola is indeed out of control and the resources necessary to control it only now are being marshalled.

  3. There are two very important characteristics of Ebola that do not receive enough emphasis, but in fact make it very unlikely that it will cause a worldwide pandemic.

    Ebola is not contagious until a person develops symptoms. If someone looks and feels well, it is possible that they are infected and incubating the virus, but they will not pass it on.

    Ebola is spread through direct contact with infectious bodily fluidssuch as blood and sweat. Those fluids are highly infectious and the closer the person is to death, the more infectious they are. But it is not spread through the air, and simply being on the same airplane or in the same room as an Ebola victim does not expose you to risk.

    Ebola is actually more like HIV than it is the bird flu. They are both spread through contact with bodily fluids, although Ebola is more infectious than HIV. However, HIV is infectious before people develop symptoms and it is a much more widespread problem in Africa than Ebola. But because we understand how to protect ourselves from it, it is less scary.

  4. Africa is a huge continent. The Ebola epidemic is in West Africa, Tanzania is in East Africa. The distance between Monrovia, Liberia and Arusha, Tanzania is 3300 miles, basically a little more than the distance between Maryland and California.

  5. In every epidemic, much of the damage is caused by fear. We see that with some villagers stoning the guys in yellow suits, convinced they are coming to drag people away to die. But we also see it with the government in South Africa predicting a 40% drop in tourism next year.

  6. Could the virus mutate and become more infectious? Yes, viruses can always mutate and that could substantially elevate risks. But some viruses are more prone to mutate than others and, so far, Ebola has not demonstrated a high likelihood to mutate.

Everyone always has to decide their personal comfort level for themselves. But you can be assured that if a case of Ebola appeared in Arusha or Moshi, we would cancel our trip before we received the first email requesting it.

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