Jamaicans are on high alert following the news that the dreaded Ebola virus has reached our great neighbour to the north, the United States. Yesterday, the US Centres for Disease Control (CDC) confirmed the case in Texas. The patient, now identified as Thomas Eric Duncan, had recently travelled from Liberia, one of the West African countries currently being ravaged by the Ebola virus. He had sought treatment for his symptoms at a Dallas hospital last week and was sent home with antibiotics.
This news comes on the heel of a scare last week, when reports were circulating that someone in Jamaica had been diagnosed with the virus, prompting the Ministry of Health to strongly deny the claim. It also comes amidst an ongoing Chikungunya outbreak that already has the population on edge.
What do you need to know about Ebola? We’ve compiled some vital information below.
What is Ebola?
According to the World Health Organisation (WHO), Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, is a severe, often fatal illness in humans.
Ebola virus disease (EVD) first appeared in 1976 in two simultaneous outbreaks, one in Nzara, 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 occurrence 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 borders to Sierra Leone and Liberia, by air (one traveller only) to Nigeria, and by land (one traveller) to Senegal.
The virus is transmitted to people from wild animals and spreads through human-to-human transmission. The virus can be spread in several ways, including:
- direct contact (through broken skin or mucous membranes) with the blood or secretions of an infected person
- exposure to objects (such as needles) that have been contaminated with infected secretions
- from deceased Ebola patients to mourners who have direct contact with the body during burial ceremonies
The CDC’s fact sheet states: “During outbreaks of Ebola HF, the disease can spread quickly within health care settings (such as a clinic or hospital). Exposure to ebolaviruses can occur in health care settings where hospital staff are not wearing appropriate protective equipment, such as masks, gowns, and gloves.
Proper cleaning and disposal of instruments, such as needles and syringes, is also important. If instruments are not disposable, they must be sterilized before being used again. Without adequate sterilization of the instruments, virus transmission can continue and amplify an outbreak.”
Signs and symptoms
The incubation period (the time interval from infection with the virus to onset of symptoms) is two to 21 days. Humans are not infectious until they develop symptoms, which include:
- sudden onset of fever
- joint and muscle aches
- weakness and fatigue
- stomach pain
- lack of appetite
- sore throat
Some patients may also experience:
- a rash
- red eyes
- chest pain
- difficulty breathing
- bleeding inside and outside of the body
It can be difficult to distinguish EVD from other infectious diseases such as malaria, typhoid fever and meningitis. Thus, confirmation of Ebola requires a number of tests.
According to the CDC, the standard treatment for Ebola “is still limited to supportive therapy. This consists of:
- balancing the patient’s fluids and electrolytes
- maintaining their oxygen status and blood pressure
- treating them for any complicating infections”
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.
Prevention and control
Good outbreak control relies on applying a package of interventions, namely case management, surveillance and contact tracing, a good laboratory service, safe burials and social mobilisation. 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 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 after taking 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 a clean environment.
- Controlling infection in health-care settings: Any area affected by an outbreak should be immediately quarantined and patients treated in isolation. Healthcare workers need to avoid contact with the bodily fluids of their infected patients by taking the following precautions:
- wear face masks, goggles, gowns and gloves
- take extra care when handling blood, secretions and catheters and when connecting patients to a drip
- disinfect non-disposable medical equipment before re-use
- sterilise and dispose of used needles and disposable equipment carefully
- properly dispose of any secretions or body waste from the patient
- carefully and frequently wash hands with soap and water (alcohol hand rub if soap isn’t available)
- wash disposable gloves with soap and water after use, dispose of them carefully, then wash hands