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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 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.