Lower respiratory infections are now the world’s number one killer. Nearly three million people die from the disease each year, about  half of them children under the age of five.

HIV/AIDS comes in at number two, but is responsible for less than half the number of deaths caused by lower respiratory infections with around 1.3 million deaths reported last year.

The number of deaths from diarrhoeal diseases is at number three with tuberculosis close behind at number four.

Estimates suggest that one-third of the world’s population have been infected by TB but are not ill with the disease, at least not yet, with over 95 per cent of deaths reported in developing countries”.

The WHO (World Health Organisation) has declared Nigeria officially free of Ebola after six weeks with no new cases reported, adding that this was a ‘spectacular success story’. The country’s health authority was praised for its swift reaction when a Liberian diplomat was found to be infected after bringing the disease into the country during July.

The Ebola outbreak has now killed more than 4,500 people in West Africa, mostly in Liberia, Guinea, and Sierra Leone where an estimated 70% of those infected have died.

The WHO officially declared Senegal Ebola-free on Friday.

Authorities in Saudi Arabia have reported further cases of Middle East respiratory syndrome coronavirus (MERS-CoV).

With the annual pilgrimage of Hajj having recently taken place, Member States are being asked to continue their surveillance for acute respiratory infections and report any unusual patterns.

General hygiene measures such as regular hand washing before and after touching animals and avoiding contact with sick animals, should be adhered to. Food hygiene practices should be observed. People should avoid drinking raw camel milk or eating meat that has not been properly cooked.

Until more is understood about MERS-CoV, those with diabetes, renal failure, chronic lung disease and immunocompromised are considered to be at high risk of severe disease from MERS-CoV infection.

The CDC (Center for Disease Control) has announced enhanced screening of passengers in 5 U.S airports (JFK,  Newark, Atlanta, Washington-Dulles, and Chicago O’Hare) that receive the majority of travelers from West  Africa.

Patients arriving from Sierra Leone, Guinea and Liberia, whether directly or in transfer, will be screened by  customs officials supported by supplemental CDC personnel. Temperatures will be measured, signs of illness  evaluated and interviews about recent activity conducted in an isolated area.

All outbound passengers from the 3 affected countries undergo airport screening for temperature, sings of  illness and questioning. In the last 2 months, 36,000 passengers have been screened resulting in 77 passengers  held aside for further assessment. None has proven to be infected with Ebola; some other diagnoses such as
malaria have been identified that pose no risk to fellow passengers.

Aside from the single traveler who arrived in Dallas and who was not symptomatic nor infectious during his  1/4 travels, there has been no other case of a Ebola transmitted by a commercial airline passenger outside of Africa.  Canada will strengthen its screening of passengers coming from West Africa because of the Ebola virus, said the  Health Minister of Canada.

The EU (European Union) for its part has decided to strengthen the information to travelers and health  professionals to prevent the penetration of the Ebola virus in the European territory.  France for its part is working on getting strengthened controls at the departure from countries affected by the  epidemic. According to the French Ministry of Health, controls at the arrival of assengers being not the “miracle  solution.

According to Downing Street, the United Kingdom has announced an enhanced screening of passengers at  Heathrow and Gatwick airports as well as Eurostar terminals for people from Liberia, Sierra Leone and Guinea.  On a medical side, National Institutes of Health IH began initial human testing of an investigational vaccine to  prevent EVD in early September and is working with a company to develop an antiviral drug to treat Ebola.  U.S. Department of Defense has funded two companies that are developing drug therapies for Ebola and is  working with another company to develop an Ebola vaccine.

Please, remind we clearly recommend avoiding or interrupting all travel to the three countries of Guinea,  Sierra Leone and Liberia.

Cai Glushak
International Chief Medical Officer
AXA Assistance

The number of deaths as a result of the Ebola virus outbreak has now risen to over 4,447 cases according to the World Health Organisation, with the majority of victims coming from Sierra Leone and Liberia in West Africa

Experts are suggesting that there could be up to 10,000 new cases identified each week by the end of the year if efforts to control the spread of the virus are not stepped up even though the rate of new infections in some areas has slowed down.

Sue, Steve and Annette from ALC Health’s Spanish office joined the RCM again last Sunday 5th October for their annual Charity Mountain Walk in support of Hogar Betania in La Linea.

La Linea is one of the poorest areas in Spain and has an increasing problem with homelessness of men, women and children.  For several years Begonia Arana Alvarez has run a hostel but now has a larger building, a disused old people’s home.  It requires a great deal of renovation and RCM is amongst those helping to supply materials, fences, gates, doors and kitchen equipment.  The home is due to open on Saturday 15th November.

Begonia participated in the walk with her new husband (a policeman), and her adopted daughter.  She is an extraordinary person who has been nominated for the Rotary Humanitarian Award 2014.

ALC Health was delighted to be invited by the RCM to participate in a 12 km walk to the Cruz de Juanar to see the breathtaking views of North Africa, Gibraltar, Marbella and Estepona, and the legendary cross, which  commemorates the safe return of fishermen.

The walk took 4 hours and gave us a chance to experience the beauty of the forest and the magnificence of the mountains.

It was great to see the RCM members again and to share such a memorable day!

Several commercial airlines have announced that they have stopped all flights to the region and there are reports of countries not allowing air ambulances to make refuelling stops, further complicating the medical evacuation option that many companies provide for their employees in high risk affected areas such as Sierra Leone and Liberia.

One medical evacuation company, International SOS, has also announced that they will no longer provide emergency medical evacuation services for patients with Ebola symptoms stating that “International evacuation should not be considered as feasible for patients with active clinical symptoms of Ebola,” in a statement on its website last updated on Thursday. “International evacuation of patients with Ebola or other viral haemorrhagic fevers is highly complex, and may not be achievable,”