Video: Health Minister On Ebola Measures

Good afternoon,

Thank you all for coming today to help me share crucial information with the public about Ebola preparedness and overseas travel.

We have all seen the international news reports about Ebola, and many of us have questions. How is Bermuda protecting itself? What can I do to keep myself and my family safe? Where can I go for reliable up-to-date information about communicable diseases such as Ebola, MERS CoV and Chikungunya? These are all questions I want to address here today.

In terms of where to go for dependable information, I would advise people to consult sources such as the Centers for Disease Control and Prevention (CDC). That website address is www.cdc.gov.

There is a lot of sensational misinformation out there right now regarding Ebola in particular. It is important to seek out scientific, evidence-based websites for answers to your questions.

The CDC website posts worldwide travel advisories on issues ranging from political conflict, malaria and yellow fever, to Ebola. By going to www.cdc.gov/travel, you can learn what steps you can take if you are planning on traveling to a region where there is a current outbreak of ‘a disease of public health significance’. For diseases which pose a special risk, such as Ebola, it is critical to get up to date and accurate prevention information before you travel.

The Department of Health website www.health.gov.bm also posts reliable accurate Bermuda-relevant information. And the Caribbean Public Health Agency (CARPHA) website, www.carpha.org provides valuable regional information.

I would like to urge all travelers to visit these websites and make themselves aware of current travel health issues and learn about how they can remain safe at this time of heightened international public health threats.

When traveling, I urge people to always think about the risk involved in traveling to a particular destination.

In keeping with WHO guidance, the Department of Health urges all residents to avoid non-essential travel to Liberia, Guinea, and Sierra Leone because of unprecedented outbreaks of Ebola in those countries. Basically, if you don’t have to go, don’t go at this time.

In these countries there is still widespread and intense transmission of Ebola. In two other western African countries, Senegal and Nigeria, there was an initial case or cases with localized transmission. Fortunately, in these two countries there was a swift and successful public health response, and the outbreak was contained. As of October 17th in Senegal and October 19th in Nigeria, the WHO declared the Ebola outbreak over in these countries. As of October 23rd, there has been a single case of Ebola reported in a child in Mali. This situation is still evolving.

The CDC recommends that travelers to any countries where there is widespread Ebola transmission must protect themselves by avoiding contact with the blood and body fluids of people who may be sick with Ebola.

The fact to remember is that non-essential travel to areas of west Africa where there is widespread and intense transmission of Ebola virus should be avoided at this time.

Separately, there is an (unrelated) outbreak of a different strain of Ebola in the Democratic Republic of the Congo. Incidentally, you would also be aware that there has been local transmission of Ebola in healthcare settings in the United States and Spain.

The airport authorities will be reviewing the travel history of incoming passengers, and if you are entering Bermuda from a country with an on-going Ebola outbreak, the Customs officer on duty will direct you to a Public Health professional who will provide you with additional health information and advice.

The Public Health professional will see all travelers who have been to countries with an active Ebola outbreak in the past 21 days, give them a brief health screening and take their contact information for follow up as required.

Asymptomatic travelers (that is, travelers who do not appear to be sick upon arrival in Bermuda) with a travel history to countries with an active Ebola outbreak will be asked to provide local contact information and will be referred for active monitoring by the Community Health Nurse during their stay on island, or for 21 days, whichever is longer.

Travelers from Ebola outbreak countries who display symptoms will be handled according to CDC guidelines to ensure the safety and security of everyone involved.

Symptoms of Ebola include: fever, severe headache, muscle pain, vomiting, diarrhea, stomach pain, severe weakness, fatigue, and unexplained bleeding or bruising.

Call a doctor if you have been to an Ebola outbreak country and develop a fever and have any other symptoms, and tell the doctor where you have traveled and that you might have been exposed to Ebola.

Again, do not just turn up at your doctor’s office or the Emergency Room. Always call ahead to discuss. This is to prevent the spread of a possible serious infection to others in the healthcare setting.

While Bermuda has not ruled out establishing a travel ban for countries with active Ebola transmission, it is important for the public to realize that travel bans can give rise to a false sense of security. They alone cannot eliminate the risk of exposure of the population to Ebola. Local residents are exempt from travel bans and can import the disease as a result of their travels. Therefore, individual responsibility for protecting yourself and our island from Ebola is essential.

To repeat, in, times of a public health emergency of international concern, Bermuda residents should avoid non-essential travel to countries with active transmission of Ebola.

So perhaps you have not traveled and do not plan to go to Western Africa, but you know of people who have been or plan to go to these regions. We are asking that you share this information with them too. Tell them to watch out for symptoms if they have been to any of these places I have just mentioned.
The Ministry remains in daily communication with international and regional public health advisors and, as such, is following the latest advice from the World Health Organization (WHO), the Pan American Health Organization (PAHO) and the Caribbean Public Health Agency (CARPHA).

In addition to the ongoing efforts within the Department of Health, the Bermuda Hospitals Board has established an Ebola Management Plan based on guidelines from the CDC and WHO. A BHB Ebola Preparedness Sub-Committee has been meeting regularly and coordinates with the Department of Health.

In the event of a case of Ebola on island, there are isolation resources available in the hospital’s Intensive Care Unit, and there is an outbreak plan that could be scaled up to involve the Urgent Care Centre, if necessary. The new Emergency Department also has isolation rooms and all patients arriving at the Emergency Department or the Urgent Care Centre are now asked about their travel over the last three weeks.

The Ministry has also provided training for point of entry personnel at the L.F. Wade International Airport (including Housekeeping, Airport Operations Duty Officers, Bermuda Police Service and H.M. Customs Bermuda) as well as other agencies. Travel health information and advisories will shortly be provided to arriving passengers at the airport.

The World Health Organization (WHO) defines certain disease outbreaks as Public Health Emergencies of International Concern. Highly contagious and life-threatening diseases are of particular public health interest. In addition to the Ebola outbreak in West Africa, the outbreak of Middle East Respiratory Syndrome-CoV (MERS-CoV) in the Arabian Peninsula, has been classified as Public Health Emergencies of International Concern

Chickungunya is a disease that has had an impact in the Caribbean region. Infections with the Chickungunya Virus are not typically life-threatening, but can cause significant illness and making the effort to protect yourself from this disease is also important.

Special precautions should be taken to avoid the risk of becoming infected, and non-essential travel to areas where there is active transmission of these diseases should be avoided.

Let me take a moment to provide travel information on each of these diseases.

I will start with MERS-CoV.

If you are going to the Arabian Peninsula, the risk of MERS-CoV to most travelers is low, but you should take the following steps to prevent the spread of germs while you are there:
• wash your hands often;
• avoid touching your face; and
• avoid close contact with sick people.

Symptoms of MERS include fever, cough, and shortness of breath. If you get sick with severe respiratory symptoms within 14 days of being in the Arabian Peninsula, call a doctor and tell them where you have traveled. Again, CALL first, do not just turn up to your doctor’s waiting room as this can unnecessarily expose other patients.

Now to Chikungunya.

If you are going to the Caribbean, be careful about being bitten by mosquitoes, as they can spread diseases such as Chikungunya and Dengue. You can prevent mosquito bites by faithfully using insect repellent. For more information on what you can do to prevent mosquito bites while traveling, or to learn which countries are affected, visit www.cdc.gov/travel.

If you were recently in the Caribbean, watch out for fever with joint pains or rash occurring in the two weeks following your travel. If you get sick with these symptoms, see a doctor and tell them that you have traveled to the Caribbean.

The Public Health professional stationed at the airport will see all travelers who have been to countries with an active MERS-CoV outbreak in the past 21 days, give them a brief health screening and take their contact information for follow up as required.

Passengers arriving from an area with an active Chikungunya outbreak will NOT be seen by the Public Health professional (unless they appear unwell) but will, instead, be given a travel card with information for follow up should they become ill.

So I would like to advise the public not to be alarmed when the Customs Officer asks you about your travel history and would encourage you to answer truthfully. Your cooperation is needed to protect you, your family and the island from serious infectious diseases.

In closing, the Ministry of Health, Seniors and Environment can confirm that no cases of Ebola have occurred in Bermuda thus far.

With everyone’s full cooperation and ongoing efforts we will optimize our chances of staying safe.
Thank You.

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