The Ebola virus disease outbreak in the Democratic Republic of the Congo

In a press release of 17 July 2019 the WHO has declared the EVD outbreak a Public Health Emergency of International Concern. The decision is based on the recent geographical expansion of the virus including the first confirmed case in Goma, a city of almost two million people on the border with Rwanda.

The WHO has assessed the public health risk to be very high at the national level and high at the regional level. The health risk to seafarers and on a global level is still considered low, due to the inaccessibility of the affected areas and its remoteness to major international ports.

According to the WHO’s latest numbers as of 21 July 2019:

• A total of 2592 EVD cases, including 1743 deaths – a fatality ratio of 67%, have been reported.

• Most cases have been reported in the North Kivu and Ituri provinces in DRC.

• In Uganda, as of 24 June, there have been a total of three confirmed cases of Ebola Virus Disease. All three had recently travelled to the DRC.  There currently are no new confirmed cases of Ebola in Uganda.

Recommendations

Vaccination is in its infancy with no licensed vaccine presently available, hence the focus is on the prevention of infection. It is unlikely that seafarers will be exposed to potential infection, but Members and clients should consider the following recommendations and pass such on to their vessels:

• The Master should ensure the crew members are aware of the risks, how the virus can spread and how to reduce the risk.

• The ISPS requirements on ensuring that unauthorized personnel do not board the vessel should be strictly enforced throughout the duration of the vessel being in port.

• The Master should give careful consideration to granting any shore leave whilst in impacted ports.

• The shipowner/operator should avoid making any crew changes in the ports of an affected country.

• After departure the crew should be aware of symptoms and report any occurring symptoms immediately to the person in charge of medical care.

Practical steps to minimize the possible transmission include:

• Avoid shaking hands and minimize bodily contact with local personnel in endemic areas. Use of effective hand sanitizers are to be encouraged, especially when in port.

• If a crew member requires medical or dental attention, other than for EVD, it should be considered whether it is safe for them to remain on the ship until the next port of call and to seek medical attention there.

• Eating bushmeat should be avoided.

• Stowaways will pose more risk to the shipowner, and security searches prior to departure should be increased. Any stowaway from an infected country can pose a risk to the crew and will be difficult to disembark at a later stage if their health status is uncertain as they will be considered a potential threat to public health.

• In the event of a suspected diagnosis of EVD onboard, immediate expert medical opinion should be sought, and the event must be reported as soon as possible to the next port of call by the Master.

Summary

The risks to seafarers in ports in countries in which EVD is known to exist is not particularly high if the necessary precautions are in place and complied with, to secure the vessel and to minimize the potential exposure.

The WHO continues to advise against the application of any travel of trade restrictions to the DRC. However, some port health authorities may, as a precautionary measure, be in a heightened state of alert in order to identify crew displaying relevant symptoms.

Members and clients trading to ports in West and Central Africa, and in the DRC in particular, are advised to monitor the situation closely by consulting webpages maintained by the WHO and other relevant authorities as well as obtaining relevant advice from their local agents well before arrival at the next port of call.

We would like to thank The Marine Advisory Medical Service in the UK for their advice and recommendations.

Relevant sources of information

• WHO: Ebola Virus Disease overview

• CDC: Ebola (Ebola Virus Disease)

• WHO: 

  • Recommendations for international traffic related to the Ebola Virus Disease outbreak in the Democratic Republic of the Congo of 19 July 2019

  • Travel and transport risk assessment: Interim guidance for public health authorities and the transport sector of September 2014 (Chapter 4.2.4 contains guidance for ships and shipping companies)

• Gard Insight: Charterparty clauses dealing with risks from Ebola and other diseases at ports of call of September 2014