CENTRAL AMERICA NEWS (Diaologo-Americas) — Central American countries are coordinating their efforts and exchanging information to prevent outbreaks of the deadly Ebola virus.

Social welfare officials from the region developed strategies to fight its spread during the 30th Meeting of the Health Sector of Central America and the Dominican Republic (RESSCAD), which was held on October 17 and 18 in San Salvador. In recent months, they had also discussed ways to stop the deadly virus in several video conferences. The preparation has positioned health to deal effectively with Ebola.

Fighting Ebola: Professionals from the International Health Surveillance Office (OSVI) at Toncontín International Airport in Tegucigalpa monitor arriving passengers for possible Ebola infection. It is one of the measures Honduras is taking to prevent an outbreak of the deadly virus. [Photo: AFP/Orlando Sierra]
Fighting Ebola: Professionals from the International Health Surveillance Office (OSVI) at Toncontín International Airport in Tegucigalpa monitor arriving passengers for possible Ebola infection. It is one of the measures Honduras is taking to prevent an outbreak of the deadly virus. [Photo: AFP/Orlando Sierra]
“With what we have now, we are prepared [to] prevent a person with symptoms of the Ebola virus from causing an epidemic,” Ricardo Cea Rouanet, director of the Salvadoran Social Security Institute (ISSS), said during the RESSCAD conference.

A low risk remains that the virus could be introduced into the region, but health authorities are remaining vigilant and taking the necessary actions.

“Each country must take steps within their jurisdiction, with the resources available,” Carissa Etienne, Director General of the Pan American Health Organization (PAHO) said after the opening of RESSCAD.

Recommendations to prevent an Ebola outbreak

PAHO recommendations for the region include creating an Ebola emergency fund, surveillance to detect suspected cases in health centers, isolation for patient management, laboratory tests following biosafety protocols, and risk communication – with the public and communicators positioned to publicize information about the disease.

The Nicaraguan government has already set up an emergency office to counter the epidemic. The country’s health officials will quarantine anyone who in the past 30 days has visited a country with confirmed cases of Ebola; undocumented immigrants and others suspected of infection will also be isolated. The quarantine will last for at least 21 days, which is the incubation period during which symptoms would be apparent in an infected person.

“[Ebola is] a real threat to the entire world,” Rosário Murillo, coordinator of the country’s Communication and Citizenship Council, said October 11.

The Nicaraguan emergency plan also recommends strict health controls at 10 sensitive points of entry to the country. One of them is Peñas Blancas, on the border with Costa Rica, which is sometimes used by African migrants to enter Nicaragua and continue to the United States. Other emergency measures include isolating planes with suspected cases of Ebola and prohibiting people from getting off ships where someone aboard is suspected of being infected with the virus.

Surveillance of Ebola at airports

Honduran health officials have been making their own preparations. To monitor suspected cases of Ebola, Honduras set up the International Health Surveillance Office (OSVI) at the Toncontín International Airport in Tegucigalpa. Such offices will also be installed at airports in the cities of San Pedro Sula, La Ceiba and Roatán. The initiative is part of a national emergency plan, according to a statement from PAHO, which provides technical support to Honduran officials.

The government of Guatemala is also working to fight Ebola at airports: it has installed thermal cameras at La Aurora International Airport, in the capital of the country, to detect the body temperature of passengers. A team of agents will work with the equipment 24 hours a day; if they identify someone with a fever, they’ll check the person’s passport to see whether the person had been in Africa, and then send them for a clinical exam. Depending on the case, the traveler may be quarantined, reported Guatemala’s Ministry of Health.

“We believe that [La Aurora airport] is one of the most likely places for entry by people infected with the virus. Therefore, we are taking basic health care and control measures,” the President of Guatemala, Otto Pérez Molina, told reporters during a visit to the airport to check on the surveillance cameras on October 13.

Panamá and Costa Rica ready to deal with Ebola

Meanwhile, in Panamá and Costa Rica, health authorities are also confident they are ready to respond to cases of Ebola.

The Panamanian government recently allocated $10 million (USD) to adapt the health system for possible cases of the disease. The goal of health authorities is to isolate patients so they pose no risk to the community, according to a statement by the Panamanian Health Ministry.

“Although Panamá is a transit country, the probability that a person with Ebola reaches our territory is quite low,” Panamá’s Health Minister, Francisco Javier Terrientes, said during a working visit to the city of Metetí, in the Darién province, on October 16.“Our ports, airports and borders are being monitored by health officials to identify people who are suspected of potentially having the disease, in order to disprove that possibility.”

Costa Rican has also made preparations: investing in biosafety equipment, designating reference healthcare centers, upgrading surveillance protocols, training health technicians, and conducting public information campaigns.

“Costa Rica has faced epidemics of cholera, H1N1 and outbreaks of dengue fever – which, despite generating many cases, has one of the lowest mortality rates in Latin America,” said María del Rocío Sáenz, president of the Costa Rican Social Security Administration (CCSS). “This is due to the efforts we make in early detection.”

Rigorous controls in the Dominican Republic and Suriname

Like many of its Central American regional neighbors, the Dominican Republic is working to stop Ebola at its borders. The country has adopted an official resolution banning the “entry of people to national territory who, in the last 30 days, have visited any of the countries affected by endemic cases of Ebola and any new countries that the World Health Organization (WHO) may identify.”

The Caribbean country also requires that ships and airlines inform employees at ports and airports of any passengers onboard who have visited countries affected by the disease in the last month. Anyone who presents any symptoms of the disease such as a fever, vomiting or muscle aches will be taken to a “thoroughly equipped” medical facility.

Suriname is another country barring the entry of travelers who have visited Ebola risk areas. Foreigners who have been in Sierra Leone, Guinea, or Liberia up to 21 days before the date of travel are prohibited from entering the country unless they present an internationally recognized certificate proving they do not carry the disease. Foreigners who have been in the at-risk countries and have already entered Suriname will be monitored or quarantined by health officials on a case by case basis.

False alarms

The World Health Organization (WHO) has reported more than 9,900 cases of Ebola infections. More than 4,500 of those patients have died; almost all of the infections occurred in West Africa. As of late October, however, Central America remains free of the virus — despite several false alarms.

For example, in El Salvador, health officials investigated in recent weeks four suspected cases of Ebola involving people who had arrived from Africa. The four people included two Salvadoran soldiers who had joined a peacekeeping mission in Liberia and two nuns from the Democratic Republic of Congo.

Following WHO protocols, Salvadoran health officials quarantined the returning soldiers in August and September, and the Congolese missionaries in September and October. But none of the four were found to be infected with Ebola.