ORIGIN OF EBOLA VIRUS DISEASES
Ebola, which was named after the river near the site of its first recorded outbreak in Zaire in 1976. Ebola virus (EBOV, formerly designated Zaire Ebola virus) is one of five known viruses within the genus Ebola virus. Four of the five known Ebola viruses, including EBOV, cause a severe and often fatal hemorrhagic fever in humans and other mammals, known as Ebloa virus disease. Ebola virus has caused the majority of human deaths from EVD, and is the cause of the 2013- 2014 Ebola virus epidemic in West Africa, which has resulted in at least over 18,059 suspected cases and over 6,809 confirmed deaths. Ebola viruses are the causative agents of a severe form of viral haemorrhagic fever in man, designated Ebola haemorrhagic fever, and are endemic in regions of central Africa. The exception is the species Reston Ebola virus, which has not been associated with human disease and is found in the Philippines. Ebola virus constitutes an important local public health threat in Africa, with a worldwide effect through imported infections and through the fear of misuse for biological terrorism. Ebola virus is thought to also have a detrimental effect on the great ape population in Africa. Case-fatality rates of the African species in man are as high as 90% with no prophaylaxis or treatment available. Ebola virus infections are characterized by immune suppression and a systemic inflammatory response that causes impairment of the vascular, coagulation, and immune systems, leading to multiorgan failure and shock, and thus, in some ways, resembling septic shock.
The disease has a high risk of death, killing between 25 percent and 90 percent of those infected with the virus, averaging out at 50 percent. This is often due to low blood pressure from fluid loss, and typically follows six to sixteen days after symptoms appear. The virus spreads by direct contact with blood or other body fluids of an infected human or other animal. Infection with the virus may also occur by direct contact with a recently contaminated item or surface. Spread of the disease through the air between primates, including humans, has not been documented in either laboratory or natural conditions. The virus may be spread by semen or breast milk for several weeks to months after recovery. Fruit bats are believed to be the normal carrier in nature, able to spread the virus without being affected by it. Humans become infected by contact with the bats or with a living or dead animal that has been infected by bats. After human infection occurs, the disease may also spread between people. Other disease such as malaria, cholera, typhoid fever, meningitis and other viral hemorrhagic fevers may resemble EVD. Blood samples are tested for viral RNA, viral antibodies or for the virus itself to confirm the diagnosis.
HISTORY OF EBOLA
Liberian Diplomat Patrick Sawyer, the man credited with ‘importing’ Ebola Virus Disease to Nigeria, ‘knew he was sick’ with the virus before entry to Nigeria. He was also advised by the Liberian Health Ministry not to travel out of the country but he ignored the instruction, flew to Nigeria and died here transmitting the virus to Nigerian medical personnel who offered medical services to him.
Barely 24 hours before his death, Patrick Sawyer had a rather strange- and in the words of medical and diplomatic sources here, “Indiscipline” encounter with nurses and health workers at First Consultants Hospital in Obalende, one of the most crowded parts of Lagos, a population of some 21 million inhabitants.
Looking to get to the bottom of Sawyer’s strange ailment on the Asky Airline flight, which Sawyer transferred on in Togo, hospital officials say, he was tested for both malaria and HIV AIDS. However, when both tests came back negative, he was then asked whether he had made contact with any person with the Ebola virus, to which Sawyer denied. Sawyer’s sister, Princess had died of the deadly virus on Monday, July 7, 2014 at the Catholic Hospital in Monrovia. On Friday, July 25, 2014, 18 days later, Sawyer died in Lagos.
Back in Lagos, authorities at the First Consultants Hospital in Obalende decided that despite Sawyer’s denial, they would test him for Ebola, due to the fact that he had just arrived from Liberia, where there has been an outbreak of the disease with more than 100 deaths.
The hospital issued a statement that week stating that Sawyer was guaranteed immediately after he was discovered to have been infected with the deadly virus. In addition, a barrier nursing was implemented around Sawyer and the Lagos State Ministry of Health was immediately notified. Hospital authorities also requested the Federal Ministry of Health for additional laboratory test based on its suspicion of Ebola. In the aftermath of Sawyer’s death, both federal and state authorities in Lagos have instituted measures to curb the spread of the disease and quarantining all those who came in contact with Sawyer.
In total, Sawyer reportedly came in direct contact with 59 persons, 44 of whom were at the hospital he was taken to when he fell ill, according to the Lagos State Government.
After serious battle with the spread of Ebola virus, Nigeria was declared Ebola free by World Health Organization on 20th October, 2014.
MODE OF TRANSMISSION
It is thought that fruit bats of the Pteropodidae family are natural Ebola virus hosts. Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals such as chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest.
Ebola then spreads through human-to-human transmission via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e.g bedding, clothing) contaminated with these fluids. Health-care workers have frequently been infected while treating patients with suspected or confirmed EVD. This has occurred through close contact with patients when infection control precautions are not strictly practiced.
Burial ceremonies in which mourners have direct contact with the body of the deceased person can also play a role in the transmission of Ebola. People remain infectious as long as their blood and body fluids, including semen and breast milk, contain the virus. Men who have recovered from the disease can still transmit the virus through their semen for up to 7 weeks after recovery from illness.
TREATMENT AND VACCINES
Supportive care-rehydration with oral or intravenous fluids- and treatment of specific symptoms,, improves survival There is as vet no proven treatment available for EVD However, a range of potential treatments including blood products, immune therapies and drug therapies are currently being evaluated. r licensed vaccines are available yet, but 2 potential vaccines are undergoing human safety testing
PREVENTION AND CONTROL OF THE SPREAD IN RURALAREAS EBONYI
It is general believe That prevention is better than cure Good outbreak control relies on apply& a package of interventions, namely case management, surveillance and contact tracing, a good laboratory service, safe burials and social mobilization. Community engagement is key to successfully controlling outbreaks. Raising awareness of risk factors for Ebola infection and protective measures that individuals can take is an effective way to reduce human transmission. Risk reduction messaging should focus on several factors:
- Reducing the risk of wildlife-to-human transmission from contact with infected fruit bats or monkeys/apes and the consumption of their raw meat. Animals should be handled with gloves and other appropriate protective clothing. Animal products (blood and meat) should be thoroughly cooked before consumption.
- Reducing the risk of human-to-human transmission from direct or close contact with people with Ebola symptoms, particularly with their bodily fluids. Gloves and appropriate personal protective equipment should be worn when taking care of ill patients at home. Regular hand washing is required after visiting patients in hospital, as well as aftertaking care of patients at home.
- Outbreak containment measures including prompt and safe burial of the dead, identifying people who may have been in contact with someone infected with Ebola, monitoring the health of contacts for 21 days, the importance of separating the healthy from the sick to prevent further spread, the importance of good hygiene and maintaining clean environment
- Maintaining proper hygiene by washing hands with soap or using hand sanitizer. Apart from this, keeping the environment clean is highly recommended.
CONTROLLING INFECTION IN HEALTH-CARE SETTINGS
Control of outbreaks requires coordinated medical services, along with a certain level of community engagement. The medical services include: rapid detection of cases of disease, contact tracing of those who have come into contact with infected individuals, quick access to laboratory services, proper care and management of those who are infected and proper disposal of the dead through cremation or burial. Prevention includes limiting the spread of disease from infected animals to humans. This may be done by handling potentially infected bush meat only while wearing protective clothing and by thoroughly cooking it before consumption. It also includes wearing proper protective clothing and washing hands when around a person with the disease. Samples of body fluids and tissues from people with the disease should be handled with special caution.
Health-care workers should always take standard precautions when caring for patients, regardless of their presumed diagnosis. These include basic hand hygiene, respiratory hygiene, use of personal protective equipment (to block splashes or other contact with infected materials), safe injection practices and safe burial practices.
Vanguard news paper (20th October, 2014)