While viral hemorrhagic fevers caused by filoviruses like Ebola and Marburg are serious diseases, the risk to most travelers in Africa remains low if proper precautions are taken. Understanding these viral illnesses and how they spread can help you stay safe on your Africa trip.
What Are Filoviruses Like Ebola and Marburg?
Filoviruses, including Ebola virus and Marburg virus, belong to a family of viruses known for causing severe and often fatal hemorrhagic fevers in humans. These viruses are notorious for their ability to damage both the inner and outer linings of blood vessels, leading to internal and external bleeding.
While Ebola and Marburg viruses are the most well-known members of this virus family, others include Bundibugyo, Reston, and Sudan viruses.
Symptoms — The symptoms of Ebola and Marburg infections are frighteningly severe, encompassing a range of debilitating effects on the body. Individuals infected with these viruses may experience:
Fever
Headache
Muscle pain
Weakness
Fatigue
Abdominal pain
Diarrhea
Vomiting
Complications — Additionally, as the diseases progress, patients may suffer from critical complications, including:
Internal bleeding
Critically low blood pressure (shock)
Damage to multiple organs such as the liver, pancreas, kidneys, and brain
Mortality Rates — Without prompt and effective treatment, Ebola and Marburg infections carry staggeringly high fatality rates. Ebola virus disease typically results in a mortality rate of around 50%, while Marburg virus disease can be even more deadly, with mortality rates reaching as high as 80%.
How Are Filoviruses Transmitted?
Ebola and Marburg viruses are primarily transmitted through specific modes.
Animal-to-Human Transmission — Filoviruses typically originate in animal hosts, with fruit bats being a common reservoir. Transmission to humans occurs through direct contact with infected animals, their body fluids, or tissues.
Human-to-Human Transmission — Once the virus is introduced to human populations, it spreads through direct contact with body fluids of infected individuals. These fluids include blood, saliva, urine, vomit, and feces.
Burial Ceremonies — Traditional burial practices involving close contact with deceased victims can also facilitate the transmission of filoviruses. Handling bodies during funeral rites increases the risk of exposure to the virus.
Who Is at Risk for Filovirus Infections While Traveling?
While most tourists have a very low risk of exposure to Ebola and Marburg, certain individuals may be at higher risk, particularly those engaged in specific activities or occupations.
Occupational Risk — Those working closely with bats, primates, or in healthcare settings treating viral hemorrhagic fevers are at elevated risk of exposure. Healthcare workers, researchers, and animal handlers fall into this category.
High-Risk Activities/Exposures:
Cave Exploration — Visiting caves or mines inhabited by fruit bat colonies poses a higher risk of exposure to filoviruses due to the potential for direct contact with bat saliva, urine, or feces.
Bushmeat Consumption — Hunting, butchering, or consuming bushmeat from primates, bats, or other wildlife increases the risk of transmission, as these animals can serve as reservoirs for filoviruses.
Medical Care — Providing medical care without proper protective equipment, particularly in areas where filovirus outbreaks have occurred, puts healthcare workers at risk of infection through direct contact with patients' body fluids.
Preventing Filovirus Infections When Traveling
Protecting yourself from filovirus infections, such as Ebola and Marburg, requires proactive measures and awareness of potential risks.
Here are essential tips to minimize your risk of exposure.
Avoid Direct Contact – Steer clear of contact with blood, body fluids, and any items contaminated by the infection. This includes avoiding handling remains of humans or animals who may have died from a filovirus infection.
Stay Clear of Wildlife — Keep your distance from bats, nonhuman primates like monkeys/apes, and their habitats. Refrain from engaging in activities that involve close contact with these animals to reduce the risk of transmission.
Avoid Bushmeat Consumption — In regions where filoviruses are endemic, such as parts of Africa, resist the temptation to consume or obtain bushmeat. This includes meat from primates, bats, or other wildlife, as it can carry the virus.
Practice Good Hygiene — Wash your hands frequently with soap and water, especially after visiting public places or coming into contact with potentially contaminated surfaces. If soap and water are unavailable, use alcohol-based sanitizers to disinfect your hands.
Funeral Attendance — Exercise caution when attending funerals or ceremonies that involve contact with the deceased, particularly if filovirus transmission is suspected in the area. Consider alternatives to in-person attendance if possible.
Seek Medical Attention — If you develop symptoms suggestive of a filovirus infection, such as fever, headache, muscle pain, weakness, or vomiting, seek prompt medical attention. Inform healthcare providers of your travel history and potential exposures for accurate diagnosis and treatment.
Ebola Reservoir Study and the Vaccine
Researchers believe bats are the most likely host of the Ebola virus. The CDC has partnered with Njala University in Sierra Leone to screen fruit bats for Ebola virus. Determining the reservoir species will help issue stronger guidance on Ebola's origins and transmission, better preparing for future outbreaks. Understanding how Ebola emerges from its animal host is crucial for enhanced prevention and containment strategies.
Meanwhile, in the fight against Ebola, a major breakthrough has been the development of an effective vaccine called rVSV-ZEBOV, manufactured by Merck. This vaccine has proven remarkably successful, even when given after infection occurs.
According gavi.org, a recent study on the 2018-2020 Ebola outbreak in the Democratic Republic of Congo has shown positive impacts of the vaccine:
A single dose of rVSV-ZEBOV halved the risk of death from Ebola, even in those already infected before vaccination
The death rate was just 27% among those vaccinated within 2 days of symptoms appearing, compared to 56% in unvaccinated individuals
Vaccinated patients had lower overall virus levels, likely a key factor in their protection
With an efficacy rate of 95%, it played a vital role in ultimately containing the epidemic. Remarkably, this Ebola vaccine can stimulate the immune system to fight harder against an existing infection, beyond just preventing illness.
Stay Informed, Plan Ahead With Away Clinic
Although serious filovirus infections are not a common risk for tourists, being prepared is crucial. Talk to a travel health specialist at Away Clinic before your Africa trip to get personalized advice, medical counseling and any needed vaccinations or medications. Proper planning can provide peace of mind to safely explore Africa.
By understanding the risks and taking reasonable precautions, you can safely experience Africa's incredible natural wonders, vibrant cultures and diverse wildlife!