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Transcript
Things you need to know about Ebola…
Port of Spain, Trinidad and Tobago, October 17, 2014. The Ebola virus has claimed about
4,500 lives during the current epidemic in West Africa, the largest outbreak since the virus was
discovered nearly 40 years ago. According to the World Health Organization (WHO), nearly
9,000 people have been infected during the outbreak. Ebola is a serious infectious illness which
often proves fatal. The virus, which is thought to have originated in fruit bats, was first detected
in 1976 in an outbreak near the Ebola River in what is now the Democratic Republic of Congo.
Ebola virus disease
Key Facts
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There is no confirmed case of the Ebola Virus in Trinidad and Tobago and the Ebola
virus is not airborne infection.
Ebola virus disease, formerly known as the Ebola Hemorrhagic Fever, is a severe illness
that affects both human and non-human primates (such as monkeys, gorillas, and
chimpanzees).
The mode of transmission of the virus to human is from wild animals and human to
human transmission. Additionally, the transmission of the virus can be stopped with case
identification, isolation of infected patients, contact tracing, infection control, and proper
burial of the dead.
In recent outbreaks, the case fatality of the Ebola virus ranges from 50% to 70%.
The first case was reported in Germany in 1967 while similar outbreaks were described in
two neighboring locations: Sudan and Zaire (Sudan Ebola Virus and Zaire Ebola Virus)
in Africa.
Currently, there is no FDA-approved vaccine or treatment but potential candidates are
being developed.
Background
The Ebola virus is regarded as viral hemorrhagic fever, causing fatal illness and high fatality
rate. The first outbreak of the virus appeared in 1976 simultaneously in Sudan and Zaire (now
known as the Democratic Republic of Congo). Eventually, it was named the Ebola virus after a
small river located in the northwestern region of the Democratic Republic of Congo. The
Ebolavirus is sub-divided into five species: Zaire ebolavirus (ZEBOV), Sudan ebolavirus
(SEBOV), Tai Forest ebolavirus (TAFV), Bundibugyo ebolavirus (BDBV), and Reston
ebolavirus (REBOV). However, only the Reston ebolavirus is the only specie that doesn’t affect
humans. The virus causing destruction in 2014 belongs to the Zaire specie.
The World Health Organization was notify of the Ebola Virus Outbreak on the 23, March 2014
and it is described as the largest and the most complex, in comparison in previous outbreaks. The
current outbreak is so severe that there are more cases and death now than all other outbreaks
combined. As of the 5 October 2014, there are a total of 8033 cases with 3865 deaths. Countries
mostly affected are Guinea, Liberia and Nigeria but cases have been identified in Senegal, Sierra
Leone, United States of America, and Spain. Due to the intermingling among cross-borders of
the infected populations, insufficient resources, other health challenges such as malaria being
misdiagnosed for the Ebola virus, and distrust of governmental officials such as health
professionals has facilitated in the spread of the disease causing an epidemic that is inevitable. It
was also noted that the Ebola virus can affect approximately 20,000 persons before it is
contained.
Transmission
An experiment conducted in the regions of Gabon and the Republic of Congo, suggested that
fruit bats are believed to be the reservoir for the Ebola virus. And it can be transferred to other
hosts such as humans and gorillas. Additional host of the virus are small rodents, duikers, nonhuman primates and shrews. The virus is highly contagious which is transmitted to individuals
by direct or close contact with bodily fluids (the most infectious being blood, faces, vomit and
even mucus) from an infected persons or animals. The virus has been identified in breast milk,
urine and semen whereas saliva and tears carry a low risk for transmission. The virus can be
transmitted indirectly from contaminated surface but is it low. Additionally, exposure to disease
can be attributed from contaminated objects such as needles. Therefore, it is important that
instruments such as needle or syringes should be sterilized if necessary. The current outbreak in
Guinea, Liberia and Sierra Leone, Nigeria showed that the greatest mode of contracting the virus
is human to human transmission. It must be emphasized that the Ebola virus is not an airborne
infection.
Numerous health care workers (mainly nurses) have been infected with the virus while treating
suspected or confirmed patients. This occurs through close contact with infected patients when
the required precaution is not strictly practice such as the wearing of masks, gloves and gowns.
Contact with family and friends can harbor the spread of the disease because they come in
contact with secretions, when caring for infectious patient. Persons that are at the greatest risk for
infection of the Ebola virus during an outbreak are scientist, health care workers, relatives and
those in close contact with ill individuals and deceased patients.
Signs and Symptoms
The incubation period for the Ebola Virus is within 2 to 21 days which is described as the period
from infection to the onset of symptoms. Humans are not infectious until they develop
symptoms. The disease is characterized with symptoms and signs resulting in a sudden onset of
high fever (first symptom), headache, fatigue, loss of appetite, vomiting, muscle pain, diarrhea,
abdominal pain and internal/external bleeding (e.g. oozing from gums, blood in the stools).
Diagnosis
The diagnosing of the Ebola virus is difficult because it can be mistaken for other infectious
diseases such Malaria, typhoid fever and meningitis that may display similar characteristic of the
virus. Examples of diagnostic testing available for the confirmation of the Ebola virus are
Antigen-capture enzyme-linked immunosorbent assay (ELISA) testing, IgM Elisa, Polymerase
chain reaction (PCR), Virus Isolation, serum neutralization test and antigen-capture detection
tests. However, if early symptoms of the Ebola virus are seen in patients but there is no reason to
suspect that is the case, then the patient should be isolated, samples taken and tested by medical
professional to confirm.
Vaccines and Treatment
Standard treatment procedures for an Ebola infected patient include the use of rehydration
methods of balancing the patient’s fluids and electrolytes, and treatments of any complication
experience by patients.
Currently, there is no licensed or approved vaccine or therapeutics for the Ebola virus while the
disease is spreading quickly. However, potential vaccines are undergoing clinical trials for
human safety.
Prevention
During an outbreak, measures such as surveillance, case tracing, proper laboratory services
available and proper burial practices must be administered. The involvement of the community is
one of the key to successfully controlling an outbreak. Educating the public and the practicing of
protective measures are effective ways in reducing human transmission. Additionally, basic
hygienic practices can be cultivated in the prevention of the Ebola virus such as regular washing
of hands and the changing of attire before and after in contact with infected animals or humans.
Some keys pointers to help in reducing the risk of transmission of the virus: Firstly, decreasing
transmission (Wildlife to human or human to human): preventing contact with infected animals
and the consumption of raw meat. Also, the prevention of direct contact with infected
individuals, especially bodily fluids. This entails the wearing of protective equipment such as
gloves, masks and gowns. Secondly, active surveillance systems in place as to identify persons
who may have come into contact with infected persons and proper burial procedures of the dead.