Group SHE

Basel, August 2014

SHE Information 2014/5
Ebola

The current outbreak of Ebola virus disease in West Africa (abbreviated as EVD, formerly known
as Ebola haemorrhagic fever) has raised questions and concerns.
With this SHE Information we are addressing the most frequently asked questions.

What is Ebola Virus Disease (EVD)?
EVD is a severe often fatal disease in humans and non-human primates (certain monkeys) caused
by infection with Ebola virus. It is very infectious but infection can be prevented.
Symptoms of the disease are fever, vomiting, diarrhoea, sore throat, joint and muscle aches,
stomach pain, headache measles-like rash, red eyes as well as internal and externally visible
bleeding. Various laboratory tests for diagnosis are available.
It is believed that the natural reservoir of the virus is in certain fruit bats (Pteropodidae). These
animals sometimes do not become ill but when primates including humans handle these animals or
their excretions, Ebola virus can be transmitted. Humans can become infected by handling dead or
sick monkeys, and other animal species have also but rarely been reported to have become infected
such as forest antelope and porcupines.
Larger outbreaks such as the current one are then caused by subsequent human-to-human
transmission. Transmission is caused by direct contact of broken skin or (also intact) mucous
membranes with the blood, organs or other bodily fluids or infected people. It can also be
transmitted via broken skin or mucous membranes from contaminated surfaces where the virus can
survive at ambient temperature for several days.
Do not touch sick people, avoid all contact with infected patients.
EVD is not an airborne infection. It is not possible to catch EVD without close contact to infected
material. EVD can also not be transmitted by food unless uncooked material from infected animals
is consumed.
EVD has an incubation time (time from infection to outbreak of the disease) of 2 to 21 days. As long
as a person is healthy, no transmission of the disease is possible even though this person may
already be infected (carry the virus). A person becomes infectious (capable of transmitting the
disease) with the first disease symptoms.

SHE Info 2014/5 page 2
EVD and the business traveller
Those at risk of infection in an outbreak are health care workers, family members of infected people
and hunters in the forest. It is extremely unlikely that a business traveller will become infected with
Ebola virus. It is sufficient to avoid the situations leading to transmission of the virus described
above. Good personal hygiene, especially frequent hand-washing should be common practice
anyway whenever one travels in areas with suboptimal general hygiene standards.
On the other hand, the disease has put a significant burden on the public health systems of the
affected countries and this may lead to consequences if medical care is needed in such a country for
whatever reason. Also, there have been reports of some airlines having restricted their service to a
few of the affected destinations. This is essentially because some passengers departed from the EVD
outbreak area by air when they were already ill or in their incubation period, leaving the airline with
significant logistic problems such as tracking fellow passengers and decontaminating the aircraft.
A state of emergency has been declared in the most affected countries. The details of what this
means are not known, but the measures in place may limit the freedom to move about.
Roche does not issue health-based travel warnings and restrictions that are independent of those
issued by health authorities. Roche follows and asks its employees to strictly respect any
recommendations or restrictions imposed by any national health authority. For international travel,
this authority is the WHO.
Currently, the WHO has not issued a travel warning for the affected countries in West Africa
(Liberia, Guinea, Sierra Leone and Nigeria were affected at the beginning of August 2014). As the
situation can change, please consult the WHO website frequently if you plan to travel to or are
travelling in West Africa. http://who.int/en/ Search with the keyword Ebola, and you can find all
relevant information easily.
If during or after travel to such an area where you respected the recommendations made above, you
become ill, it is very unlikely that you will have been infected with Ebola. Nonetheless, in such a
case, you should contact the nearest reputable hospital with an infectious disease department or an
institute of tropical medicine to receive advice by telephone before you leave your home.

EVD and the Diagnostics Division
Group SHE has received numerous enquiries from the country organisations of the Diagnostics
Division. They were mainly about additional safety measures for the case that infected blood
samples would be analysed on one of our pieces of equipment or blood or other samples would be
received from the area in West Africa currently affected.
EVD is a matter of very high concern to the health authorities in any country, and these authorities
should be consulted for advice in these situations. These authorities will decide whether dedicated
labs will be operated for such analyses, what will be the fate of an instrument that has accidentally
been contaminated, what additional safety measures may be necessary and whether there should be
restrictions regarding the import of samples of biological material from the outbreak area.
Dr. Andreas Flckiger