For Official Use Only
UPDATE #64
Ebola Virus Disease (EVD)
30 November 2015
1.
NUMBER OF CASES AND FATALITIES
The World Health Organization (WHO) reported that as at 22 November 2015, there were 28,637
clinically compatible cases of Ebola acquired in West Africa, or related to the West African outbreak,
of which 15,249 were laboratory confirmed and 11,314 reported deaths (Source: World Health
Organization).1
The WHO reports that the case fatality rate amongst hospitalised cases with a reported definitive outcome is
50% for Guinea and Sierra Leone, based on data from May and June 2015.
Liberia has reported three new cases of Ebola. These are the first cases reported since Liberia was declared
Ebola free for a second time on 3 September 2015. The three cases are family members, however the source
of infection for the index case (a boy aged 15) in the family cluster remains unknown. There have been 149
contacts identified to date associated with the new Liberian cases, including 10 healthcare workers who had
contact with the index case prior to isolation.
In the week ending 22 November 2015, the WHO reported no new case of Ebola in Guinea, for a third week
in a row. If there are no further cases, Guinea could be declared free of Ebola transmission on or after
28 December 2015. The WHO has reported that there are no contacts under monitoring in Guinea and all
contacts have now completed their 21 day follow-up period. All contacts in affected areas of West Africa are
offered the trial vaccine.
On 7 November 2015, the WHO declared Sierra Leone free of Ebola. The country now enters a 90-day period
of enhanced surveillance which will run until 5 February 2016 and WHO will continue to support Sierra
Leone during this period. This new phase is critical for ensuring early detection of any possible new cases of
Ebola.
On 12 November 2015, the Chief Medical Officer approved the removal of border screening arrangements for
travellers from Sierra Leone. This change was implemented on 13 November 2015 along with the new
downscaled border screening measures.
In the week ending 22 November 2015, a total of 900 health worker infections have been reported in the three
intense-transmission countries, with 513 reported deaths.
1
The reported number of deaths is likely to be an underestimate of the true number of cases that are fatal, due to the delay between
onset and outcome, and a lack of follow-up of the outcome.
The information contained in this document uses the best currently available data. Given the rapidly changing nature of the incident,
recipients should be aware of the potential for later confirmation or clarification.
1 of 4
For Official Use Only
For Official Use Only
2.
AUSTRALIAN GOVERNMENT RESPONSE
International
Australia has made a significant, practical and timely contribution of more than $37 million to the
international Ebola response.
The Australian-managed and operated Ebola Treatment Centre (ETC) in Sierra Leone commenced operations
in December 2014, following the completion of construction by the United Kingdom. In total 216 patients
were admitted since the Hastings Airfield ETC opened. One hundred and fifty-six (156) were discharged
(36 Ebola and 120 non-Ebola cases) and 60 passed away (50 Ebola and ten non-Ebola related deaths). The
Centre has now been handed back to the Government of the United Kingdom, and will eventually be handed
over to the Government of Sierra Leone, to be used to respond to identified needs.
In addition to managing and running Hastings Airfield ETC in Sierra Leone, Australia’s support for the
international Ebola response included:
 $10 million to the UN Ebola Response Multi-Partner Trust Fund (a significant proportion of which
went to West Africa);
 The deployment of ten personnel through RedR Australia to priority non-clinical roles in the United
Nations’ Ebola response. The RedR Australia deployees have supported organisations such as the
World Food Programme (WFP) and WHO in their logistics and training efforts in Guinea, Liberia and
Sierra Leone;
 $2.5 million to Australian NGOs working in Sierra Leone and Liberia;
 $2 million to the United Kingdom in support of front line services in Sierra Leone;
 $3.5 million in support of the WHO’s consolidated regional response for West Africa;
 $2 million to support a regional Ebola response and preparedness package;
 $250,000 to UNICEF for Ebola preparedness activities in Ghana; and,
 USD 250,000 (approx. AUD 295,000) grant for WHO PNG Country Office to assist the PNG
government for Ebola preparedness.
This is in addition to more than $40 million that Australia provided to the WHO over the past year to support
global health activities.
Domestic
The Prime Minister the Hon Malcolm Turnbull MP has approved the downscaling of the Ebola Virus Disease
(Ebola) border screening measures at airports and seaports to reflect the decreased risk to Australia.
The strategy to downscale border screening measures was implemented at airports and seaports on
13 November 2015.
These revised border screening measures continue to identify people with health risks.
Passengers will see the following changes in border screening measures undertaken by the Departments of
Health, Agriculture and Water Resources (Agriculture) and Immigration and Border Protection (DIBP). In
particular:
 The DIBP will use existing pre-border screening tools to identify people travelling from an Ebola
affected country to Australia. These screening tools include assessment of travel visas and itineraries
to identify persons of concern (including health concerns), and documents of concern (eg. fraudulent
documents). Pre border screening provides an opportunity for DIBP and airline staff to ask
travellers questions about their exposure to Ebola (or other relevant issues) prior to boarding an
aircraft.
2 of 4
For Official Use Only
For Official Use Only



DIBP also has a number of “at border” screening measures to identify travellers who have been in an
Ebola affected country. These measures include establishing a specific profile rule, which will alert
DIBP to refer travellers to the Department of Agriculture for health assessments. These border
measures also incorporate intelligence from the United States of America, the United Kingdom,
Canada and New Zealand about any travellers from these countries with a history of being in an
Ebola affected country.
SmartGate clearance will continue to ask questions about travel to an Ebola affected country.
Finally, in addition to the above pre-programmed alerts, the Australian Border Force will more
closely scrutinise the Incoming Passenger Cards of travellers and ask further questions of people
who indicate recent travel to Africa (either in the past six days, or where the majority of their time
overseas was in Africa or one of the Ebola affected countries).
Any passengers identified through the above screening processes will be referred to a Biosecurity Officer
from the Department of Agriculture who will provide them with information about Ebola and record
passenger contact details, which will be provided to the Department of Health and state and territory public
health authorities for follow up as appropriate.
Exit screening is in place for people departing the three West African countries which have been affected by
Ebola, to ensure that people of high risk or displaying symptoms of Ebola are not able to board an aircraft.
A further de-escalation of these processes would also then be instituted once Africa is declared Ebola free by
the WHO.
For further information and frequently asked questions see the link attached.
http://www.health.gov.au/internet/main/publishing.nsf/Content/ohp-ebola-protect-measures-update.htm
3.
VISA ARRANGEMENTS
Ebola related visa measures continue to apply to travellers from Guinea – the one remaining country which
remains listed as EVD affected country.
On 24 November 2015, the Minister for the Department of Immigration and Border Protection, Hon Peter
Dutton signed a submission to revoke s499 Direction given:
 the reduced risks of Ebola infection reaching Australia;
 the WHO’s announcement of 7 November 2015 that Sierra Leone is now ‘Ebola free’;
 the Prime Minister’s decision of 3 November 2015 that Ebola border measures can be downscaled;
and
 advice from the Department of Health on 12 November 2015 that their Chief Medical Officer had
approved the removal of Sierra Leone from the list of Ebola affected countries.
To this end, processing of permanent and provisional visa applications from Ebola affected countries (now
only Guinea) returned to normal as of 24 November 2015 with current policy requirements for medical
examinations, chest x-ray and HIV serology to be undertaken. Only limited measures remain in place for
individuals applying for temporary visas from within Guinea, with immigration health examinations required
to be undertaken for clients coming for less than six (6) months as well as the usual requirements for those
coming longer.
Since the visa arrangements were introduced on 27 October 2014, there have been 282 citizens from Ebola
affected countries that have entered Australia following appropriate screening. This figure includes 42 arrivals
from nationals of Democratic Republic of Congo between 27 October 2014 to 24 November 2014 (at which
3 of 4
For Official Use Only
For Official Use Only
time the country was declared to be Ebola free), 75 arrivals from nationals of Liberia between 27 October
2014 to 9 May 2015 (at which time the country was declared to be Ebola free), and 165 arrivals of nationals of
Guinea and Sierra Leone combined.
4.
UPDATE ON SCREENING
Targeted screening of incoming travellers to Australia commenced on 9 August 2014, and currently focuses
on people who commenced their journey from Guinea. While the number of new cases of Ebola is
diminishing, the Australian Government continues to monitor the number of people entering Australia from
Guinea and continues to work with the State and Territory health authorities to ensure appropriate monitoring
arrangements are in place.
Noting that there have been no additional new cases reported in Liberia, there is no current need to amend
border screening measures.
5.
PLANNED ACTIONS
Australia’s Chief Medical Officer (CMO) meets with his counterparts in the states and territories as required
to share information on Australia’s preparedness measures, and also continues to engage with the International
Health Regulations Emergency Committee on Ebola to monitor the situation overseas.
Health is coordinating Ebola specific:
 Situation Updates.
6.
RISKS/ WHO
The likelihood of an imported case in Australia remains very exceedingly low given measures in place to
identify and assess those most at risk at the border.
The 7th meeting of the International Health Regulations Emergency Committee was held on
1 October 2015. The Committee agreed that the outbreak still constitutes a public health emergency of
international concern.
7.
FURTHER INFORMATION
Department of Health website www.health.gov.au/ebola
World Health Organization - http://www.who.int/csr/disease/ebola/en/
DFAT Smartraveller – www.smartraveller.gov.au
Health's National Incident Room is NOT currently activated with respect to Ebola.
Cleared by:
Sandra Gebbie, A/g Assistant Secretary, Health Emergency Management Branch,
Office of Health Protection (02) 6289 3428
4 of 4
For Official Use Only