October 10, 2014

Michaela Whitbourn
 Investigations reporter SMH

 Fewer than 200 people have arrived in Sydney from Ebola-affected countries in western Africa over the past two months, according to health authorities, and measures are in place to ensure people are assessed for symptoms before they leave the airport.

Vicky Sheppeard, director of the NSW Health communicable diseases branch, said there was no requirement for routine arrivals in Sydney from those countries  – Sierra Leone, Liberia, Guinea and Nigeria – to enter home quarantine for the 21-day incubation period for Ebola.

However, health care workers returning from missions in those countries were required to do so under an agreement between Médecins Sans Frontières, the Red Cross and the health department. They were also required to report daily to their public health unit.

Dr Sheppeard said that 162 people had arrived in Sydney from countries affected by Ebola over the two months from August 9 to October 1. There are no direct commercial flights to Australia from any of the countries.

“Arrivals from these countries are questioned about their health,” Dr Sheppeard said. ” If they have any symptoms they are immediately referred to NSW Health. If they are well and have no symptoms, they are given information about [Ebola] symptoms and what to do if symptoms develop.”

Sydney’s Westmead Hospital is the designated treatment hospital for Ebola in NSW because it is equipped with isolation rooms and a highly secure laboratory where doctors can test for the virus.

It has been conducting drills to prepare for a potential outbreak, while information about how to manage suspected cases has been sent to emergency departments, clinicians and GPs across the state.

Raina MacIntyre, professor of infectious diseases epidemiology at the University of NSW, said it was “good to have designated Ebola hospitals and we’re doing reasonably well on that front”.

But she warned that people were likely to turn up to their GP in the first instance and local doctors needed to be prepared.

A person who presented with Ebola would be isolated for treatment and health authorities would conduct a “contact tracing” exercise, retracing the patient’s steps to find other people who may have been infected by them. Those people would then be placed in quarantine.

There is no vaccine for Ebola and the fatality rate is about 50 per cent of people who contract the disease. In the case of some outbreaks, the casualty rate has been as high as 90 per cent.

But Professor MacIntyre said it was impossible to say what the fatality rate was in developed countries because there had only been a handful of cases.

“It looks like it’s still a high case fatality rate because there have been several people who have died in developed countries from the few cases that have occurred. But I would imagine with proper supportive care your chances of survival are better.”

Keeping patients hydrated and replacing their electrolytes was one of the “really important steps in clinical care” because they lost a lot of fluids through vomiting and diarrhoea.

The first symptoms of Ebola include fever, muscle pain, severe headache and sore throat, while diarrhoea, vomiting and internal and external bleeding are expected in the later stages.

The federal health department said on Friday that the risk of an Ebola outbreak in Australia was “low” and “very few” people travelled to Australia from West Africa.

A spokesperson from the department said border staff at the country’s international airports assessed people arriving from Guinea, Liberia, Sierra Leone and Nigeria as well as the Democratic Republic of the Congo.

Between the start of the screening process on August 9 and October 1, officials had interviewed 651 people, “six of whom were referred for further consideration by human quarantine officers, none of whom required any specific action to be taken”.

Blog Editors Comment 

162 too many….why are they allowed into the country?

This may be the single most important — and blatantly honest — research report released by any official body since the beginning of the Ebola outbreak. The WHO’s “Ebola situation assessment” report, found here, explains that only 95% of Ebola infections experience incubation within the widely-reported 21-day period.

Here’s the actual language from the report:

95% of confirmed cases have an incubation period in the range of 1 to 21 days; 98% have an incubation period that falls within the 1 to 42 day interval.[1]

Unless the sentence structure is somehow misleading, this passage appears to indicate the following:
• 95% of Ebola incubations occur from 1 – 21 days
• 3% of Ebola incubations occur from 21 – 42 days
• 2% of Ebola incubations are not explained (why?)

If this interpretation of the WHO’s statistics are correct, it would mean that:
• 1 in 20 Ebola infections may result in incubations lasting significantly longer than 21 days

• The 21-day quarantine currently being enforced by the CDC is entirely insufficient to halt an outbreak
• People who are released from observation or self-quarantine after 21 days may still become full-blown Ebola patients in the subsequent three weeks,even if they have shown no symptoms of infection during the first 21 days.

Read more at freedom out post

Both the USA and now Australia seem to have the ‘HOPE and SEE’ approach with Ebola. It’s not like the flu, or even Sars… this is Ebola!



Sydney Morning Herald