The Pertinent Information In regards to the ongoing Ebola outbreak, - PowerPoint PPT Presentation

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The Pertinent Information In regards to the ongoing Ebola outbreak, there are four concepts organizations should consider when developing risk mitigation plans:  Understand the risk: Why Ebola is spreading  Prepare personnel against risk  Monitor risks and advise personnel on any changes  Have a response mechanism in place 1 Aon Risk Consulting | Global Risk Consulting | WorldAware Solutions

What is Ebola Virus?  Zoonotic virus – bats the most likely reservoir, although species unknown  Spillover event from infected wild animals (e.g., fruit bats, monkey, duiker) to humans, followed by human-human transmission 2 Aon Global Risk Consulting | Crisis Management Consulting

What is Ebola Virus?  Ebola Virus Disease (EVD) or Ebola Hemorraghic Fever (EHF) first emerged in Sudan and Zaire on the continent of Africa in the 1970’s  >20 previous Ebola and Marburg virus outbreaks since emerged – NONE as severe as the current outbreak in West Africa.  2014 West Africa Ebola outbreak caused by Zaire ebolavirus species (five known Ebola virus species)  2 separate outbreaks of EVD: – Western Africa – Dec 2013 • Guinea • Liberia • Sierra Leone • Nigeria (localized transmission) • Senegal (travel-associated) • Mali – Central Africa – Aug 2014 • Democratic Republic of Congo 3 Aon Global Risk Consulting | Crisis Management Consulting

Ebola Free?  42 DAYS since last case tested negative twice – 11/21/2014 – Democratic Republic of Congo Ebola free • Total Case Count: 66 • Laboratory Confirmed Cases: 38 • Total Case Deaths: 49 – West Africa • Total Cases: 21,206 • Laboratory-Confirmed Cases: 13,430 • Total Deaths: 8,386 4 Aon Global Risk Consulting | Crisis Management Consulting

Outbreak Distribution Map: 1976 - 2014 5 Aon Global Risk Consulting | Crisis Management Consulting

West Africa Distribution Map 6 Aon Global Risk Consulting | Crisis Management Consulting

West Africa Distribution Map 7 Aon Global Risk Consulting | Crisis Management Consulting

West Africa Outbreak – Cases Update (Jan 10, 2015) Laboratory- Country Total Cases Total Deaths Confirmed Cases Countries with Widespread Transmission Guinea 2,799 2,508 1,807 Liberia 8,278 3,123 3,515 Sierra Leone 10,094 7,766 3,049 Total 21,171 13,397 8,371 Countries with Initial Case or Cases and/or Localized Transmission Mali 8 7 6 United Kingdom 1 1 0 Total 9 8 6 Previously Affected Countries Nigeria 20 19 8 Senegal 1 1 0 Spain 1 1 0 United States 4 4 1 Total 26 25 9 8 Aon Global Risk Consulting | Crisis Management Consulting

Why Ebola is Spreading – West Africa  Lack of Healthcare Infrastructure/Faulty Protocols – Ebola pathogens are highly concentrated in the blood, vomit, and fecal matter of those infected. Access to basic medical supplies (gloves, gowns, etc.) that aid in reducing risk of spreading the virus is limited in West Africa. Faulty protocols, or the faulty implementation of protocols, have resulted in the spread of the virus outside West Africa (e.g. USA)  Lack of Education – Not understanding how Ebola is spread – Not understanding appropriate quarantine measures  Cultural Practices – Burial practices that include ritual bathing of the deceased (handling of infected corpses) – Belief in ‘healers’ and miracle remedies 9 Aon Risk Consulting | Global Risk Consulting | WorldAware Solutions

Ebola – Signs and Symptoms 10 Aon Global Risk Consulting | Crisis Management Consulting

Ebola – Signs and Symptoms  Symptoms appear approximately 2-21 days after exposure to the virus. – The average is 8-12 days – For the current outbreak it is 9-11 days  Human-to-human transmission by direct contact – No human-to-human transmission via inhalation (airborne) – No transmission before symptom onset 11 Aon Global Risk Consulting | Crisis Management Consulting

Ebola – Signs and Symptoms  A person MUST have signs and symptoms in order to be contagious. They are: – Fever (>100.4˚F) AND • Severe headache • Muscle pain • Weakness • Diarrhea • Vomiting • Abdominal (stomach) pain • Unexplained hemorrhage (bleeding or bruising) 12 Aon Global Risk Consulting | Crisis Management Consulting

Treatment  No FDA-approved vaccine or medicine (e.g., antiviral drug) is available for Ebola.  Symptoms of Ebola and complications are treated as they appear. – The following basic interventions, when used early, can significantly improve the chances of survival: • Providing intravenous fluids (IV) and balancing electrolytes (body salts). • Maintaining oxygen status and blood pressure. • Treating other infections if they occur.  Experimental vaccines and treatments for Ebola are under development, but they have not yet been fully tested for safety or effectiveness. 13 Aon Global Risk Consulting | Crisis Management Consulting

CDC Increasing PPE Supply  $2.7 million in new personal protective equipment (PPE) to increase Strategic National Stockpile (SNS)  Configured into 50 kits that can be rapidly delivered to hospital – impermeable gowns, coveralls, and aprons; boot covers; gloves; face shields and hoods; N95 respirators; powered-air purifying respirator systems and ancillaries; and disinfecting wipes  Hospitals coordinate with State Public Health Depts if additional PPE needed 14 Aon Global Risk Consulting | Crisis Management Consulting

Travel Management – Prepare Personnel Against Risk  Risk Assessment – Establish a risk tolerance as an organization  Create a safe travel policy  Determine whether all but essential travel should be deferred  Create benchmarks for evacuation/relocation  Establish an Ebola Task Force  Educate employees on Ebola (e.g. symptoms, methods of transfer, etc.)  Establish risk mitigation/prevention measures – Infectious Disease Protocols / Bloodborne Pathogens – Body heat screening test 15 Aon Risk Consulting | Global Risk Consulting | WorldAware Solutions

CDC Travel Notice – Ebola affected countries LEVEL 3 16 Aon Global Risk Consulting | Crisis Management Consulting

CDC Travel Notice Definitions Warning Level 3, Avoid Nonessential Travel Alert Level 2, Practice Enhanced Precautions Watch Level 1, Practice Usual Precautions 17 Aon Global Risk Consulting | Crisis Management Consulting

CDC Travel Notice Definitions Notice Traveler Action Risk to Traveler Outbreak/Event Example Level Level 1: Reminder to follow Usual baseline risk Dengue in Panama-Outbreak Watch: usual precautions for or slightly above Because dengue is endemic to Panama, this notice most likely would signify that Watch this destination baseline risk for there is a slightly higher rate of dengue cases than predicted. Travelers are to follow “usual” insect precautions. destination and limited impact to the traveler Olympics in London-Event Watch: There may be possible health conditions in London that could impact travelers during the Olympics, such as measles. Travelers are to follow usual health precautions making sure they are up to date on their measles vaccine, follow traffic safety laws and use sunscreen Follow enhanced Increased risk in Yellow Fever in Brazil-Outbreak Alert: Level 2: precautions for this defined settings or Because an outbreak of yellow fever was found in areas of Brazil outside of the Alert reported yellow fever risk areas, this would be a change in “usual” precautions. destination associated with Travelers should follow “enhanced precautions” for that risk area by receiving the specific risk factors yellow fever vaccine. Flooding in El Salvador-Event Alert: There are possible conditions that could affect the health of the traveler and parts of the destination’s infrastructure could be compromised. Travelers are to follow special precautions for flooding Avoid all non-essential High risk to travelers SARS in Asia-Outbreak Warning: Level 3: travel to this Because SARS spread quickly and had a high case fatality rate, a warning notice Warning destination signifies there was a high chance a traveler could be infected. Travelers should not travel if possible. Earthquake in Haiti-Event Warning: The destination’s infrastructure (sanitation, transportation, etc.) cannot support travelers at this time. 18 Aon Global Risk Consulting | Crisis Management Consulting

Have a Response Mechanism in Place  No response organizations will evacuate a symptomatic person from infected areas unless coordinated with government approval for immediate treatment  Most commercial international airlines will not fly into Ebola-infected countries.  Some response organizations have medical personnel on the ground who can assist  Self-Monitor/Quarantine  Alert Public Health Officials 19 Aon Risk Consulting | Global Risk Consulting | WorldAware Solutions

Travel Management “… international evacuation of patients with Ebola or other Viral Hemorrhagic Fevers is highly complex. International evacuation for patients with active clinical symptoms of Ebola is extremely limited and may not be achievable if patients have any uncontrolled body fluids, such as vomiting, diarrhea or bleeding.” 20 Aon Risk Consulting | Global Risk Consulting | WorldAware Solutions