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Forum: General Commission 3 Issue: Prevention and control of epidemic and pandemic diseases with special emphasis on the Zika and Ebola virus Student Officer: Emir Eskicioğlu Position: President Introduction A Pandemic is an epidemic of infectious disease that has spread through human populations across a large region; for instance multiple continents, or even worldwide. A widespread endemic disease that is stable in terms of how many people are getting sick from it is not a pandemic. Further, flu pandemics generally exclude recurrences of seasonal flu. Throughout history, there have been a number of pandemics, such as smallpox and tuberculosis. An epidemic is the rapid spread of infectious disease to a large number of people in a given population within a short period of time, usually two weeks or less.Ziku and Ebola are two different pandemic/epidemic diseases that have harmed and still continues to damage many committees around the world specifically Africa. Definition Of Key Terms EVD- Ebola virus disease Ebola HF- Ebola hemorrhagic fever Infection- an infecting with germs of disease, as through the medium of infected insects, air, water, or clothing. Background Information Ebola The Ebola virus causes an acute, serious illness which is often fatal if untreated. Ebola virus disease (EVD) first appeared in 1976 in 2 simultaneous outbreaks, one in what is now, Nzara, South Sudan, and the other in Yambuku, Democratic Republic of Congo. The latter occurred in a village near the Ebola River, from which the disease takes its name. The current outbreak in West Africa, (first cases notified in March 2014), is the largest and most complex Ebola outbreak since the Ebola virus was first discovered in 1976. There have been more cases and deaths in this outbreak than all others combined. It has also spread between countries starting in Guinea then spreading across land bord ers to Sierra Leone and Liberia, by air (1 traveller) to Nigeria and USA (1 traveller), and by land to Senegal (1 traveller) and Mali (2 travellers). Zika Zika virus is a mosquito-borne flavivirus that was first identified in Uganda in 1947 in monkeys through a network that monitored yellow fever. It was later identified in humans in 1952 in Uganda and the United Republic of Tanzania. Outbreaks of Zika virus disease have been recorded in Africa, the Americas, Asia and the Pacific. From the 1960s to 1980s, human infections were found across Africa and Asia, typically accompanied by mild illness. The first large outbreak The first large outbreak of disease caused by Zika infection was reported from the Island of Yap (Federated States of Micronesia) in 2007. In July 2015 Brazil reported an association between Zika virus infection and Guillain-Barré syndrome. In October 2015 Brazil reported an association between Zika virus infection and microcephaly. Preventing Disease Protection against mosquito bites is a key measure to prevent Zika virus infection. This can be done by wearing clothes (preferably light-coloured) that cover as much of the body as possible.For regions with active transmission of Zika virus, all people with Zika virus infection and their sexual partners (particularly pregnant women) should receive information about the risks of sexual transmission of Zika virus. For Ebola prevention, Reducing the risk of wildlife-to-human transmission from contact with infected fruit bats or monkeys/apes and the consumption of their raw meat.Outbreak containment measures, including prompt and safe burial of the dead, identifying people who may have been in contact with someone infected with Ebola and monitoring their health for 21 days Treatment Zika virus disease is usually mild and requires no specific treatment. People sick with Zika virus should get plenty of rest, drink enough fluids, and treat pain and fever with common medicines. If symptoms worsen, they should seek medical care and advice. There is currently no vaccine available. For Ebola, Supportive care-rehydration with oral or intravenous fluids- and treatment of specific symptoms, improves survival. There is as yet no proven treatment available for EVD. However, a range of potential treatments including blood products, immune therapies and drug therapies are currently being evaluated. No licensed vaccines are available yet, but 2 potential vaccines are undergoing human safety testing. WHO Response WHO aims to prevent Ebola outbreaks by maintaining surveillance for Ebola virus disease and supporting at-risk countries to developed preparedness plans. The document provides overall guidance for control of Ebola and Marburg virus outbreaks. WHO is supporting countries to control Zika virus disease by taking actions outlined in the “Zika Strategic Response Framework":Define and prioritize research into Zika virus disease by convening experts and partners. Enhance surveillance of Zika virus and potential complications.Strengthen capacity in risk communication to engage communities to better understand risks associated with Zika virus. Timeline Of Important Events Ebola 22 March 2014 Guinea reports that the fever has been confirmed as Ebola, and has already killed 59 people. There are already concerns that it may have spread to neighbouring Sierra Leone. 26 May 2014 Ebola has reached Sierra Leone, the World Health Organization (WHO) confirms. 27 July 2014 Liberia shuts down most of its border crossings. Dr Sheik Umar Khan, who played a pioneering role in Sierra Leone’s response to the virus, dies two days later after becoming infected. 8 August 2014 The WHO declares Ebola an “international health emergency”. Four days later, the death toll exceeds 1,000. 5 September 2014 With the pace of the epidemic accelerating, WHO figures suggest that 2,100 people have died from a total of around 4,000 who are thought to have been infected. 14 October 2014 WHO announces that the fatality rate from Ebola has reached 70%, with the total number of deaths so far topping 4,447. Ziku 1947: Scientists researching yellow fever in Uganda's Zika Forest identify the virus in a rhesus monkey 1948: Virus recovered from Aedes africanus mosquito in Zika Forest 1952: First human cases detected in Uganda and Tanzania 2007: Zika spreads from Africa and Asia, first large outbreak on Pacific island of Yap 2012: Researchers identify two distinct lineages of the virus, African and Asian 2013-14: Zika outbreaks in French Polynesia, Easter Island, the Cook Islands and New Caledonia. Retrospective analysis shows possible link to birth defects and severe neurological complications in babies in French Polynesia Nov. 11: Brazil declares public health emergency November 2015-January 2016: Cases reported in Suriname, Panama, El Salvador,Mexico, Guatemala, Paraguay, Venezuela, French Guiana, Martinique, Puerto Rico, Guyana, Ecuador, Barbados, Bolivia, Dominican Republic, Nicaragua Feb. 1: World Health Organization (WHO) declares public health emergency of international concern. Possible Solutions Patient placement Patients should be placed in a single-patient room (containing a private bathroom) with the door closed. A log of persons entering the room should be maintained. Facilities may consider posting personnel at the patient’s door to ensure appropriate and consistent use of PPE by all persons entering the room. Healthcare provider protection Healthcare providers should wear protective clothing at a minimum to include masks, gloves, gowns (fluid resistant or impermeable), and eye protection. Additional PPE, such as double gloving, disposable shoe covers or leg coverings, might be required in certain situations, e.g., copious amounts of blood, other body fluids, vomit, or feces present in the environment. Proper training and competency in donning and doffing of PPE key for safety. Aerosol-generating procedures Avoid aerosol-generating procedures. If performing these procedures, PPE should include respiratory protection (N95 filtering facepiece respirator or higher) and the procedure should be performed in an airborne isolation room. Environmental infection control Diligent environmental cleaning and disinfection and safe handling of potentially contaminated materials is paramount, as blood, sweat, emesis, feces and other body secretions represent potentially infectious materials. The CDC recommend the use of a U.S. Environmental Protection Agency (EPA)-registered hospital disinfectant with a label claim for a non-enveloped virus (e.g.,adenovirus, poliovirus) to disinfect environmental surfaces in rooms of patients with suspected or confirmed virus infection. Bibliography 1. http://solutionsdesignedforhealthcare.com/ebola 2. https://ebolaresponse.un.org 3. https://www.cdc.gov/zika/