Q&A: Ebola and the health implications for the EU

The current Ebola outbreak affecting the West Africa region is the worst such outbreak on record. The World Health Organisation (WHO) has declared it a Public Health Emergency of International Concern, calling for a co-ordinated international response. As of 10 October, there have been more than 8,399 reported cases, including 4,033 deaths from the disease, according to the WHO.

To date, 10 patients have been repatriated to the EU/EEA with confirmed or suspected Ebola and the first secondary case of Ebola in Europe has been confirmed on 6 October.

What is the risk for European health workers in the affected areas? What help can they expect from the EU?

Ebola poses the greatest risk to the European citizens who are currently present in the affected countries, most notably to the health staff and volunteers helping to stop the spread of Ebola. In their case, the European Commission, upon discussion in the European Health Security Committee (HSC), has agreed on the crucial importance of reliable systems of medical evacuation for humanitarian staff and medical workers in the affected countries to maintain an effective international response on the ground.

Accordingly, the Commission launched work to develop a European mechanism for medical evacuations. The European Commission’s Emergency Response Coordination Centre (ERCC) facilitates the transport of relief items to West Africa and will, if necessary, fund and co-ordinate the evacuation of international staff from Liberia, Guinea and Sierra Leone.

Is the repatriation of Ebola patients a public health risk for the EU?

The first secondary case of Ebola in Europe was confirmed on 6 October. The patient is a nurse who took care of an Ebola patient who had been repatriated to Spain for medical care after contracting the virus in Liberia, and subsequently died. This case demonstrates that bringing Ebola patients to the EU for treatment is not absolutely risk free. However, the risk of Ebola viruses spreading from an Ebola patient who arrives in the EU as result of a planned medical evacuation is considered low by the European Centre for Diseases Prevention and Control (ECDC).

Should there be obligatory screening tests for Ebola in European airports?

The possibility of a traveller with Ebola returning to the EU before becoming sick or while sick remains low, but cannot be excluded.

Exit screening is already in place in airports in the affected countries. Discussions are ongoing on whether there is an added value in screening incoming travellers at EU borders. This issue is being discussed within the HSC with a view to exchanging information, ensuring that any national measures are complementary and co-ordinated. In the meantime, one member state has introduced entry screening.

Is the EU prepared for more Ebola cases in Europe?

The Commission has been working on preparedness and co-ordination of risk management together with member states and with the support of the ECDC and the WHO since the outbreak began. The HSC is co-ordinating the exchange of information and co-ordination of preparedness in response to Ebola in the EU.

So far, during the outbreak, the HSC has:

• activated networks for secure hospital facilities;
• activated networks for high security laboratories to ensure all member states can access such laboratories to diagnose Ebola;
• endorsed information for travellers which is published in all EU languages;
• approved key media messages, which have been translated into all EU languages;
• undertaken work on procedures for airports and health authorities on handling possible cases of Ebola identified during a flight and on preparedness of health systems for treating Ebola cases; and
• endorsed a case definition allowing for identification of Ebola cases in the EU.

How well are individual EU countries equipped to treat a patient with Ebola?

According to the analysis by ECDC of the information provided by national authorities, most member states seem to be well prepared. The most challenging issues concern the evacuation from affected countries and treatment in the affected countries.

There are potentially further challenges for some member states in access to treatment facilities, transport of patients, availability of laboratories, expertise and resources. In the spirit of solidarity, the HSC is co-ordinating the sharing of certain key resources that member states have offered to put at the disposal of other countries if required. These include offers of support on medical evacuation, treatment and diagnostic facilities.

Could Ebola reach the same proportions in Europe as in West Africa?

This would be highly unlikely, first, because of the specific conditions for transmission of the Ebola virus as described below, that is direct contact with a symptomatic patient’s bodily fluids. Furthermore, it is important to consider that the EU has very high standards of healthcare and preventive care.