By Wajihah Rufaidah Tuah & Noriha Muda
Ebola – What do you feel when you heard this word? For some countries, just simply uttering this word is enough to make a person shivering and trembling or perhaps living in fear. In this day and age where people are eager in pursuit of modernisation, who would expect that a disease can be infectious from animals to human beings and spread to almost the entire world.
Ebola issues have become a public concern nowadays as the cases reported are increasing from day to day, and the mortality rate is getting higher which are 5,420 deaths, according to World Health Organisation (WHO) in their report recently.
According to WHO (2014), basically Ebola virus disease (EVD) which used to be called Ebola haemorrhagic fever when first identified appeared in 1976. From the investigation, it shows that this disease has taken two simultaneous outbreaks, one in Yambuku, Democratic Republic of Congo and the other in Nzara, Sudan. This virus later on occurred in a village near the Ebola River, where the word ‘Ebola’ originated.
The virus is transmitted from wild animals like chimpanzees, gorillas, monkeys, forest antelopes and porcupines to people and it is spread among human populations through human-to-human transmission where the average EVD case fatality rate is around 70%. The first EVD outbreak occurred in remote villages in Central Africa which is in Guinea on 23 March 2014 that is near to the tropical rainforest. But recently, the outbreak in West Africa has involved not only in rural area but also in major urban area (WHO Media Centre, 2014).
Later, the WHO declared the outbreak as public health emergency of international concern on 8 August 2014 (WHO Ebola Response Team, 2014). As of 14 September 2014, there were 4507 cases, including 2296 deaths from EVD had been reported from five countries in West Africa which are Guinea, Liberia, Nigeria, Senegal, and Sierra Leone (WHO Ebola Response Team, 2014).
WHO (2014) reported that “West Africa 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 is believed that the spread of this virus started in Guinea and then spread across land borders to Sierra Leone and Liberia, to Nigeria through the air and also to Senegal by land through the traveller. Thus, WHO also reported that the most severely affected countries are Guinea, Sierra Leone and also Liberia (WHO, 2014).
Fauci and M.D (2014) outlined several factors of the epidemic of Ebola have grown dramatically in Sierra Leone, Guinea and Liberia. First, these countries are generally known as resource-poor country where they need to cope with the major health challenge and due to this, it made them confused between the Ebola and Malaria or other endemic disease. Secondly, these countries are also limited in essential supplies like personal protective equipment, plus their health worker and health care infrastructure is insufficient. Next, it is believed that their traditional practices of the bathing corpse before burial also have a tendency to transmit the virus to the people.
The Department of Health and Human Services of USA (2014) stated that Ebola continued spreading through human-to-human transmission through direct contact like broken skin or unprotected mucous membranes such as eyes, nose or mouth with body fluids or blood of a person that are positively suffering from the Ebola virus. For example, people who are involved in burial ceremonies who have direct contact with the body of a deceased person will have the tendency to get Ebola.
Numerous preventions have been made to overcome the problem occurring especially in three most affected countries in West Africa. On 3 October 2014, Obama has imposed a travel ban toward West Africa in order to hinder Ebola as the White House adviser Lisa Monaco said: “Right now we believe those types of steps actually impede the response” (Reuters).
They also have developed a new screening at the airport to scan those travellers who landed at the United States airport. In fact, people who are leaving Ebola-affected countries are asked to fill out a questionnaire on whether they have symptoms like a high fever and whether or not they have had any contact with someone who was diagnosed with Ebola.
Besides the U.S., other countries including Jamaica, Guyana, and Panama also have taken several precautions like banning of persons who are travelling directly or indirectly, from or through three West African countries and they will quarantine those people who come from the countries within 28 days in order to make sure that they are clear of the disease. “Persons ordinarily resident in Guinea, Liberia and Sierra Leone as well as persons who have travelled to or transit through Guinea, Liberia and Sierra Leone, within 28 days of having departed from these countries,” said the government statement.
In addition, they have stopped giving out visas to citizens of Guinea, Liberia, Sierra Leone and Nigeria as announced by the Foreign Affairs Minister of Guyana on October 16, 2014 (Reuters).
Centres for Disease Control and Prevention or CDC have outlined several precautions for travellers out there who are travelling to affected area in order to prevent them from getting infected by the Ebola virus. CDC (n.d) has stressed to the travellers to always practice a thorough hygiene. For example, they need to always wash their hands with clean water and soap or else using alcohol-based hand sanitiser. Besides that, CDC also reminds travellers not to manage or handle any items that have possibly come in contact with blood or body fluids of the infected person. Such items are blanket, clothes, needles and also their medical equipment.
In addition, the travellers are advised not to attend any funeral rituals which need them to make contact with the corpses who died because of Ebola and also should avoid from taking any food prepared from animal that is infected by Ebola. The most important thing is all travellers need to do health monitoring for 21 days after they returned from travelling and immediately seek for medical care if they are having Ebola symptoms (CDC, n.d).
Apart from that, CDC has shown their concerns by coming out with a number of preventions for healthcare workers who are having a high tendency to being infected by the Ebola virus. CDC (n.d) stated that for the healthcare workers, they must always make sure that they wear appropriate personal protective equipment when they are dealing with the patient and avoid or should not make any direct as well as unprotected contact with the corpse of Ebola virus.
As workers who always deal with the patients, they need to practice proper infection control to make sure they are free from the virus. If there is any worker who had a direct contact with the body fluids like vomit, urine, semen and also blood of a person who are suffering from Ebola, he or she needs to notify the health officials immediately.***
Photo taken from NBC News