Besides Mali's first confirmed Ebola case in a 2-year-old girl who fell sick after arriving in the country from Guinea in October, 2014, 5 recently reported Ebola cases in Bamako, Mali’s capital, have been linked to a clinic cluster. Thus far, at least a total of 384 contacts are being monitored and followed up. As the risk for community transmission in Mali is thus elevated, the Taiwan Centers for Disease Control (Taiwan CDC) recommends the public to avoid all non-essential travels to Mali. Taiwan CDC has raised the travel notice for Ebola virus for Mali to Level 2: Alert, advising travelers visiting Mali to take actions to reduce their risk of Ebola infection. In addition, Taiwan CDC has also heightened the screening for travelers from Mali, requesting passengers who have visited Mali to voluntarily report to the quarantine officer at the airport upon their arrival in Taiwan. The new version of “Ebola Declaration Card” will include Mali as one of the Ebola-affected countries, which will be forwarded to relevant organizations and airline companies for distribution on board all flights arriving in Taiwan from Europe and Dubai. Passengers are urged to fill out the form truthfully in order to prevent the spread of the disease.

Since the implementation of the “Ebola Declaration Card”, which is a travel history declaration form for Ebola screening, as of November 17, Taiwan CDC has received a total of 31,487 completed forms and a total of three incoming passengers reported having visited the Ebola-affected country in West Africa. Taiwan CDC has assisted the three passengers in completing the 21-day monitoring period. One of them completed the monitoring period and departed from Taiwan on November 7. The other two passengers respectively completed their 21-day monitoring period on November 8 and 13. None of them had developed fever or Ebola symptoms during their monitoring period.

On November 17, the World Health Organization (WHO) announced that 4 confirmed Ebola cases (2 healthcare workers) and 1 probable Ebola case, including 4 deaths, had been reported in Mali. All these 5 recently reported cases have been linked to a 70-year-old Muslim male who arrived in Mali from Guinea. Currently, 384 contacts, including 96 healthcare workers, are being followed up and monitored. A cumulative total of 6 confirmed and probable Ebola cases, including 5 deaths, have been reported in Mali. In addition, on November 14, WHO also announced that a cumulative total of 14, 413 case of Ebola virus disease (EVD), including 5,177 deaths, had been reported in Guinea, Liberia, Sierra Leone, Mali, Nigeria, Senegal, the United States of America and Spain. According to WHO, the Ebola mortality rate is approximately 70%.

Taiwan CDC advises travelers to follow its “Two Don’ts and One Do” advice in protecting themselves against Ebola: (1) Do not travel to Ebola-affected areas in West Africa; if you must travel to an area with an Ebola outbreak, avoid contact with and consumption of wild animals such as fruit bats and primates, (2) Do not visit hospitals or have direct contact with patients, and (3) Pay attention to personal hygiene and take preventive measures such as washing hands frequently and wear a mask when coughing. In addition, travelers are urged to monitor their own health for 21 days after their return to Taiwan. If symptoms such as fever, vomiting, diarrhea or rash develop, please call the toll-free hotline 1922(or 0800-001922) and voluntarily inform the doctor of any recent travel and exposure history to facilitate diagnosis and treatment. On the other hand, physicians are advised to stay vigilant for suspected cases, inquire about such patients’ travel and exposure history, and notify the health authority immediately of any suspected cases to facilitate implementation of subsequent measures such as case reporting, specimen collection, isolation of patients, and placing contacts in quarantine in order to prevent further transmission of the disease. Furthermore, healthcare workers are urged to stay alert, don on appropriate personal equipment while attending to patients because initial signs and symptoms are atypical of Ebola, and follow infection control and prevention guidelines such as washing hand frequently, paying attention to respiratory hygiene, avoiding splashing of body fluids. For more information, please visit the Taiwan CDC’s website at: www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Consultation Hotline, 1922 (or 0800-001922).