Ebola in Mali

Warning - Level 3, Avoid Nonessential Travel

Alert - Level 2, Practice Enhanced Precautions

Watch - Level 1, Practice Usual Precautions

Updated: November 16, 2014

The purpose of this alert is to notify travelers that a few Ebola cases have been reported in Bamako, Mali, and to inform travelers of actions they can take to reduce their risk of getting the disease.

CDC recommends that travelers to Mali protect themselves by avoiding contact with the blood and body fluids of people who are sick, because of the possibility they may be sick with Ebola. Although the current cluster of cases has been reported only in Bamako, travelers to all parts of Mali should be alert for reports of possible further spread within the country.

At a Glance

Total Cases: 4
Laboratory-Confirmed Cases: 3
Total Deaths: 3

What is the current situation?

As of November 12, 2014, the World Health Organization reported a cluster of Ebola cases in Bamako, Mali (see box for case counts). The cluster in Bamako is linked to a man who had been in a clinic in Bamako after becoming sick in Guinea. Since that time, a small number of Ebola cases linked to this patient have been reported in Bamako. (An unrelated death from Ebola occurred in Kayes, Mali on October 24, 2014 and no additional cases related to that person have been reported.) The Malian government has taken actions to contain further spread of Ebola. CDC recommends that travelers to Mali avoid contact with the blood and body fluids of people who are sick and follow the other recommendations listed below, in order to protect themselves from Ebola.

The cases of Ebola in Bamako, Mali, are related to an ongoing Ebola outbreak that has been occurring since March 2014 in Guinea, Liberia, and Sierra Leone and is the largest outbreak of Ebola in history.

For more information about the ongoing outbreak in West Africa, visit 2014 Ebola Outbreak in West Africa on the CDC Ebola website.

What is Ebola?

Ebola is a rare and deadly disease. The disease is caused by infection with one of the Ebola virus species (Zaire, Sudan, Bundibugyo, or Tai Forest virus). Ebola is spread by direct contact (through broken skin or mucous membranes in, for example, the eyes, nose, or mouth) with

blood or body fluids (such as urine, saliva, sweat, feces, vomit, breast milk, and semen) of a person who is sick with Ebola,
objects (like needles and syringes) that have been contaminated with the virus, and
infected fruit bats or primates (apes and monkeys).

Signs of Ebola include fever and symptoms such as severe headache, fatigue (feeling very tired), muscle pain, vomiting, diarrhea, stomach pain, or unexplained bleeding or bruising.

Who is at risk?

Travelers could be infected if they come into contact with blood or body fluids from someone who is sick or has died from Ebola. Healthcare workers and the family and friends in close contact with Ebola patients are at risk of getting sick because they may come in contact with infected blood or body fluids.

People also can become sick with Ebola if they come into contact with infected wildlife or raw or undercooked bushmeat (wild animals hunted for food) from an infected animal.

What can travelers do to prevent Ebola?

There is no approved vaccine or specific treatment for Ebola, and many people who get the disease die. Therefore, it is important to take steps to prevent Ebola.

How can I be exposed to Ebola?

You can be exposed to the Ebola virus if you have contact with blood or body fluids (such as urine, saliva, sweat, feces, vomit, breast milk, and semen) of a person sick with Ebola without wearing the right protective clothing and equipment. For healthcare workers, this includes wearing a face shield or goggles, a medical mask, double gloves, a waterproof gown or coveralls, an apron, and waterproof boots.

This kind of exposure can happen if you —

Are stuck with a needle or splashed in the eye, nose, or mouth with blood or body fluids of someone sick with Ebola.
Handle blood or body fluids of a sick Ebola patient.
Touch a person who is sick with Ebola.
Touch the body of someone who died from Ebola.
Care for or live with a person who is sick with Ebola.
Spend a long amount of time within 3 feet (1 meter) of a person who is sick with Ebola.

If you are traveling to Mali, please make sure to do the following:

Before your trip, review your health insurance plan to determine what medical services it would cover during your trip. Consider purchasing travel health and medical evacuation insurance.
Practice careful hygiene. For example, wash your hands frequently with soap and water or use an alcohol-based hand sanitizer.
Avoid contact with blood and body fluids (such as urine, saliva, sweat, feces, vomit, breast milk and semen).
Do not handle items that may have come in contact with an infected person’s blood or body fluids.
Avoid contact with dead bodies, including participating in funeral or burial rituals.
Avoid contact with animals (such as bats or monkeys) or with raw or undercooked meat.
Do not eat or handle bushmeat (wild animals hunted for food).
Avoid hospitals in West Africa where Ebola patients are being treated. The US Embassy or consulate is often able to provide advice on facilities that are suitable for your medical needs. The US Embassy in Bamako can be reached at (+223) 20 70 25 05. The after-hours emergency number is (+223) 20 70 23 01 or 20 70 23 02.
Seek medical care immediately if you develop fever (100.4°F / 38°C or above) or other symptoms such as severe headache, fatigue (feeling very tired), muscle pain, vomiting, diarrhea, stomach pain, or unexplained bleeding or bruising.

Special Recommendations for Travelers Who Will Be Working in Healthcare Settings

If you will be working in a healthcare setting while in Mali, you should be prepared to care for patients in a region where resources are limited and the healthcare system is strained.

Healthcare workers who may be exposed to people with Ebola should be sure to follow these steps:

Wear the recommended personal protective equipment (PPE).
Use proper infection control and decontamination measures.
Isolate patients with suspected, probable, or confirmed Ebola from other patients.
Avoid direct contact with dead bodies without wearing recommended PPE.
Immediately notify your organization, health officials, and the US embassy or consulate in Mali if you think you have been exposed to someone with Ebola but were not wearing recommended PPE.

See CDC’s resources on the Ebola: Non-US Healthcare Settings webpage and the CDC Safety Training Course for Healthcare Workers Going to West Africa in Response to the 2014 Ebola Outbreak. The World Health Organization also has advice in their Infection prevention and control guidance for care of patients in health-care settings, with focus on Ebola

document.

Returning to the United States

Entry Screening

The United States now requires all travelers to the United States whose trip starts in Guinea, Liberia, or Sierra Leone to enter through one of five US airports (JFK in New York, Newark in New Jersey, Dulles in Virginia near Washington D.C., Hartsfield-Jackson in Atlanta, and O’Hare in Chicago). Beginning November 17, 2014, air travelers to the United States whose trip starts in Mali will also be required to enter the United States through one of these five airports. These airports have enhanced entry screening, which helps identify travelers who may be sick with Ebola or may have had an exposure to Ebola and ensure that these travelers are connected with a health department and given medical care, if needed.

If you are traveling from Mali to the United States,

You should be prepared for screeners to check your temperature and look for signs and symptoms of illness. You will also be asked to answer questions about possible exposures to someone with Ebola.
You will be given a CARE (Check and Report Ebola) Kit with information about Ebola and tools to help you check your temperature and symptoms each day for 21 days.

Symptom Monitoring and Movement Restrictions

You will be connected to a health department in your final destination. Public health workers will assess your health and Ebola risk level to decide how best to monitor you for symptoms and what other restrictions may be needed.

All returning travelers will be actively monitored, which means that public health workers are responsible for checking at least once a day to see if you have a fever or other Ebola symptoms. This will continue for 21 days after the last possible exposure (such as 21 days after leaving Mali).
You will be asked to take your temperature 2 times a day and watch yourself for Ebola symptoms.
A public health worker will tell you how to report your temperature and any symptoms each day. You might do this by phone, during a daily visit, or online.
The public health worker will also tell you what to do if you have a fever (temperature of 100.4°F/38°C or above) or other symptoms (severe headache, fatigue [feeling very tired], muscle pain, vomiting, diarrhea, stomach pain, and unexplained bleeding or bruising).
- If you have a fever or other symptoms, it is very important that you get medical care right away. Follow the directions the public health worker tells you. But if you cannot reach someone right away, you can contact your state health department or call CDC at 1-800-232-4636. If you have a medical emergency, call 911.
Based on your level of possible exposure to Ebola, your travel and public activities may be limited.

See CDC’s Monitoring Symptoms and Controlling Movement to Stop Spread of Ebola Factsheet and theQuestions and Answers about CDC’s Ebola Monitoring & Movement Guidance to learn more.