Tuesday, 16 September 2014

Ebola Virus Disease - What You Need To Know




News about Ebola Virus Disease (EVD) and the increasing death toll are streaming in from all newsrooms. It is sad to read about how many people have so far succumbed to EVD. The government of Kenya has called on its citizens to take necessary precaution to prevent infection. In addition, Kenya is taking many more measures such as closing its borders to travellers from West African countries affected by the growing EVD outbreak. But this is what the government is doing; what about us? Is there anything we need to know or do in order to protect ourselves from getting infected? To be able to fully protect ourselves, we need to understand the disease, its causes, how it is transmitted, its signs and symptoms as well as how to protect ourselves from getting infected.

Ebola Virus Disease

Ebola virus disease (EVD) is a killer disease caused by a virus. The disease which was formerly known as Ebola haemorrhagic fever, is one of the world’s most virulent diseases with a case fatality rate of up to 90%. It was first experienced in 1976 where 2 simultaneous outbreaks occurred in Nzara, Sudan, and in Yambuku, Democratic Republic of Congo. In Yambuku, the outbreak occurred near a river called Ebola River, hence the name Ebola. Ebola outbreaks have until recently occurred primarily in remote villages near tropical rainforest in the West and Central African countries. Though the disease is severe and fatal, it can be controlled through the use of recommended protective measures such as wearing protective gear while handling sick animals and humans as well as seeking and receiving expert care in an appropriate healthcare facility.

Transmission of Ebola

Unlike the flu, the risk of Ebola transmission is low and can be easily prevented when the right measures are put in place. It spreads through direct contact with wounds and fluids like blood, saliva, vomit, faeces or urine of an infected person. It also spreads through the use of unsterilised needles and skin piercing instruments and directly touching someone who has died of Ebola. It can also spread through indirect contact with environments contaminated with bodily fluids. Men who have recovered from Ebola can still transmit the virus through their semen for up to 7 weeks after recovery from illness. Ebola is primarily transmitted to people from wild animals and spreads in the human population through human-to-human transmission. However, nearly all the current cases of EVD are a result of human-to-human transmission. Although the origin of Ebola is unknown, there is evidence to prove that infections in Africa originated from the handling of infected animals such as fruit bats, gorillas, chimpanzees, monkeys, forest antelopes and porcupines.

Signs and Symptoms

It takes between 2 to 21 days from the date of infection, for the symptoms to begin to show. The following are the signs and symptoms of Ebola Virus disease:

Initial signs and symptoms
  1. Sudden onset of fever
  2. Intense weakness
  3. Muscle pain
  4. Headache
  5. Sore throat
Later stages
  1. Vomiting
  2. Diarrhoea
  3. Rash
  4. Impaired kidney and liver function
  5. In some cases, both internal and external bleeding
  6. Low white blood cell, platelet counts and elevated liver enzymes in the blood
       
It is important to note that one remains infectious (can spread disease to others) as long as their blood and secretions contain the virus.     Men have been know to carry the virus in their semen for up to 61 days after being cured from Ebola.   

Diagnosis

Since there are so many other diseases that present with the same symptoms as Ebola, the doctors will usually exclude all other possibilities before they diagnose Ebola. Such other diseases include: malaria, typhoid fever, cholera, meningitis, hepatitis and other viral haemorrhagic fevers.

A definite diagnosis is through laboratory findings where the virus is found in the blood through a test called ELISA. There are also other laboratory test that can be performed to diagnose Ebola such as the following:
  1. Antigen detection tests
  2. Serum neutralization test
  3. Reverse transcriptase polymerase chain reaction (RT-PCR) assay
  4. Electron microscopy
  5. Virus isolation by cell culture


It is important to note that even a suspected case of Ebola should be handled with utmost care and safety precautions nevertheless applied to prevent spread of Ebola.

Vaccine and Treatment   

So far, there is no licensed vaccine available to prevent Ebola.

Since it is a viral disease, there is no specific treatment available and care is mainly supportive. Sick patients are given intensive supportive care which includes rehydration, pain management and other relevant supportive care measures. At the health facility, sick persons are closely monitored and put under quarantine to prevent the spread of the disease and increase their chances of survival.

It is important that all sick or suspected cases of Ebola are immediately taken to a health care facility. With appropriate care, chances of survival are up to 47%. However, these chances are next to nil if the sick persons are not taken to a health facility, not to mention the risk of spreading it to others.

You Are at Risk If

  1. You come into direct contact with body fluids such as blood, saliva, vomits, urine, and other secretions from an infected person. This may occur while caring for an infected person at home or at a health facility. Healthcare workers are at the top of the list of persons at risk.
  2. You are involved in cleaning and dressing the body of a person who has died of Ebola.
  3. You are a mourner who gets into direct contact with the body of a person who has died of Ebola as part of burial rituals or ceremony.
  4. You are handling animals infected with Ebola virus such as chimpanzees, gorillas, forest antelopes, monkeys or bats.

Prevention and Control

  1. Ebola can be prevented by avoiding direct contact with body fluids, blood, saliva, vomit, urine and stool of an infected person by wearing protective equipment such as masks, gowns, goggles and gloves. Ensure all parts of your body are completely covered by the protective material.
  2. It is important that all sick persons are treated in a hospital or treatment centre staffed by doctors and nurses qualified and equipped to treat Ebola virus victims. It is not advisable to take care of an infected person at home as this can greatly reduce their chances of survival as well as increase the spread of Ebola.
  3. Do not touch wounds of an infected person without gloves and other protective materials and do not use skin piercing instruments that have been used on a patient suffering from Ebola.
  4. The body of someone who has died from Ebola can still be infectious if not properly covered. WHO recommends that people who have died from Ebola be handled using appropriate protective equipment and should be buried immediately by public health professionals who are trained in safe burial procedures.
  5. Health workers are at the top of the list of persons at risk of Ebola infection especially during an outbreak. WHO in conjunction with CDC has developed  guidelines to be used in the healthcare setting to prevent infection and spread of Ebola. It is important that health workers access these guidelines and follow them strictly as they are evidence based and can prevent infection and spread of Ebola.
  6. Like many other diseases, handwashing with soap and running water is of essence especially after handling an infected person.
  7. Do not eat monkey meat or handle dead or sickly animals especially in the tropical rainforest.


Attribution: Avallain

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