- What is Ebola?
Ebola (formerly known as Ebola haemorrhagic fever) is a severe, often fatal viral illness, with a death rate of up to 90%. The illness affects humans, monkeys, gorillas, and chimpanzees. Ebola first appeared in 1976 in a village near the Ebola River in the Democratic Republic of Congo. The origin of the virus is unknown but fruit bats are considered the likely host of the Ebola virus, based on available evidence.
- How do people become infected with the virus?
In the current outbreak in West Africa, the majority of cases in humans have occurred as a result of human to human transmission. When an infection does occur in humans, there are several ways the virus can be spread to others. These include:
o direct contact with the blood or body fluids (including but not limited to feces, saliva, urine, vomit and semen) of a person who is sick with Ebola
o contact with objects (like needles and syringes) that have been contaminated with the blood or body fluids of an infected person or with infected animals
The virus in the blood and body fluids can enter another person’s body through broken skin or unprotected mucous membranes in, for example, the eyes, nose, or mouth. During outbreaks of Ebola, the disease can spread quickly within healthcare settings, such as clinics or hospitals. Exposure to Ebola can occur in healthcare settings where hospital staff are not wearing appropriate protective clothing including masks, gowns, gloves, and eye protection. Infection can also occur if broken skin or mucous membranes of a healthy person come into contact with environments that have become contaminated with an Ebola patient’s infectious fluids such as soiled clothing, bed linen, or used needles.
- Who is most at risk?
During an outbreak, those at higher risk of infection are:
o Health workers;
o Family members or others in close contact with infected people; and
o Mourners who have direct contact with the bodies of the deceased as part of burial ceremonies.
Exposure to the virus can be controlled through the use of protective measures in clinics and hospitals, at community gatherings, or at home.
- What are typical signs and symptoms of infection?
Sudden onset of fever, intense weakness, muscle pain, headache and sore throat are typical signs and symptoms. This is followed by vomiting, diarrhoea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding.
Laboratory findings include low white blood cell and platelet counts, and elevated liver enzymes.
The incubation period, or the time interval from infection to onset of symptoms, is from 2 to 21 days. The patient becomes contagious once they begin to show symptoms. They are not contagious during the incubation period. Ebola virus disease infections can only be confirmed through laboratory testing.
- When should someone seek medical care?
If a person has been in an area known to have Ebola virus disease or in contact with a person known or suspected to have Ebola and they begin to have symptoms, they should seek medical care immediately.
Any cases of persons who are suspected to have the disease should be reported to the nearest Corporation health officer, without delay. Prompt medical care is essential to improving the rate of survival from the disease. It is also important to control spread of the disease and infection control procedures need to be started immediately.
- How do you diagnose Ebola?
Diagnosing Ebola in a person who has been infected for only a few days is difficult because the early symptoms, such as fever, are not specific to Ebola infection and are seen often in patients with more commonly occurring diseases, such as malaria and typhoid fever. However, if a person has symptoms of Ebola and had contact with blood or body fluids of a person sick with Ebola, contact with objects that have been contaminated with blood or body fluids of a person sick with Ebola or contact with infected animals, the patient should be isolated and public health professionals notified. Samples from the patient can then be collected and tested to confirm infection.
- What is the treatment?
Severely ill patients require intensive supportive care. They are frequently dehydrated and need intravenous fluids or oral rehydration with solutions that contain electrolytes. There is currently no specific treatment to cure the disease. Some patients will recover with the appropriate medical care.
To help control further spread of the virus, people that are suspected or confirmed to have the disease should be isolated from other patients and treated by health workers using strict infection control precautions.
- How can the disease be prevented? Is there a vaccine?
Currently, there is no licensed medicine or vaccine for Ebola virus disease, but several products are under development.
Ways to prevent infection and transmission
While initial cases of Ebola virus disease are contracted by handling infected animals or carcasses, secondary cases occur by direct contact with the bodily fluids of an ill person, either through unsafe case management or unsafe burial practices. During this outbreak, most of the disease has spread through human-to-human transmission. Several steps can be taken to help in preventing infection and limiting or stopping transmission.
o Understand the nature of the disease, how it is transmitted, and how to prevent it from spreading further.
o Listen to and follow directives issued by your country’s respective Ministry of Health.
o If you suspect someone close to you or in your community of having Ebola virus disease, immediately encourage and support them in seeking appropriate medical treatment in a healthcare facility.
o Appropriate infection control procedures include:
- isolation of patients with Ebola from contact with unprotected persons
- wearing of protective clothing (including masks, gloves, impermeable gowns, and goggles or face shields) by persons caring for Ebola patients
- the use of other infection-control measures (such as complete equipment sterilization and routine use of disinfectant)
- avoid touching the bodies of patients who have died from Ebola
N.B. WHO does not recommend home care and strongly advises individuals and their family members to seek professional care in a treatment centre.
o When visiting patients in the hospital or caring for someone at home, hand washing with soap and water is recommended after touching a patient, being in contact with their bodily fluids, or touching his/her surroundings.
o People who have died from Ebola should only be handled using appropriate protective equipment and should be buried immediately by public health professionals who are trained in safe burial procedures.
- What about health workers? How should they protect themselves while caring for patients?
Health workers treating patients with suspected or confirmed illness are at higher risk of infection than other groups. During an outbreak a number of important actions will reduce or stop the spread of the virus and protect health workers and others in the health-care setting. These actions are called “standard and other additional precautions” and are evidence-based recommendations known to prevent the spread of infections. In addition to standard health-care precautions, health-care workers should strictly apply recommended infection control measures to avoid exposure to infected blood, fluids, or contaminated environments or objects – such as a patient’s soiled linen or used needles. All visitors and health-care workers should rigorously use what is known as personal protective equipment (PPE). PPE should include at least: gloves, an impermeable gown, boots/closed shoes with overshoes, a mask, and eye protection for splashes (goggles or face shields).
- What about rumors that some foods can prevent or treat the infection?
WHO strongly recommends that people seek credible health advice about Ebola virus disease from their public health authority. While there is no specific drug against Ebola, the best treatment is intensive supportive treatment provided in the hospital by health workers using strict infection control procedures. The infection can be controlled through recommended protective measures.
- Is it safe to travel to West Africa on business or to visit family and friends?
The risk of a tourist or businessman/woman becoming infected with Ebola virus during a visit to the affected areas and developing disease after returning is extremely low, even if the visit included travel to the local areas from which primary cases have been reported. Transmission requires direct contact with blood, secretions, organs or other body fluids of infected living or dead persons or animal, all of which are unlikely exposures for the average traveler. In any event, tourists are advised to avoid all such contacts. If you are visiting family or friends in the affected areas, the risk is similarly low, unless you have direct physical contact with a person who is ill or who has died. If this is the case, it is important to notify public health authorities and engage in contact tracing. Contact tracing is used to confirm you have not been exposed to EVD and to prevent further spread of the disease through monitoring.
WHO’s general travel advice
o Travelers should avoid all contact with infected patients.
o Health workers traveling to affected areas should strictly follow WHO-recommended infection control guidance.
o Anyone who has stayed in areas where cases were recently reported should be aware of the symptoms of infection and seek medical attention at the first sign of illness.
o Clinicians caring for travelers returning from affected areas with compatible symptoms are advised to consider the possibility of Ebola virus disease.
This article displayed in public interest, is aimed at educating the public on ‘Ebola’. The views and opinions expressed or implied in the article is of the author and do not necessarily reflect the opinion of the institution. Therefore, the Institution does not take any responsibility for the result of any action taken by the reader.