Task 2: Community Outbreak- Ebola

  1. Introduction

    The Ebola virus is a fatal and very serious condition that affects human and non-human primates. It is one of the most recent viral haemorrhagic fevers which are cause by an infection with a virus of genus Ebolavirus which belongs to the filovidae Family.  From the time it was discovered, the fatality rates continue to adjust depending on the strain. For example  in Zaire, the Ebola virus is reported to have fatality rates of up to 90 percent, while the Ebola- Reston has never been known to cause any human fatalities to date (Kangbai & Koroma, 2015). The Ebola virus is also classified as being communicable since it is transmitted through direct contact with body fluids, the blood and tissues of the infected person.  In most cases, the ill patient will require to have a very intensive supportive type of care.

    Among some of the symptoms associated with the Ebola virus include the abrupt onset of intense weakness, fever, headache, muscle pain and sore throat. In most cases that have serious Ebola conditions, it tends to spread quickly through families and friend since they are the ones that can directly be exposed to the infections secretions especially during the time they are caring for a person carrying the virus. The most calculated time for intervals of Ebola infection to the onset of the symptoms will range from between 2-21 days (Kangbai & Koroma, 2015).


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    Epidemiology

    The first Ebola Virus disease outbreak was discovered in a remote village in central part of Africa, near the tropical forest. However, the 2014-2016 outbreak was discovered in Western part of Africa, which mostly affected the Major urban areas together with the rural ones. Just like the previous illnesses, the virus causes an acute serious illness that leads to fatality when untreated. The disease however, first appeared in 1976 in two different outbreaks (Kangbai & Koroma, 2015). There was one that was found in Yambuku in Democratic republic of Congo and another in Nzara part of southern Sudan. The one in Yambuku occurred in a village near river Ebola, and this is where the disease got its name.  During the 2014-2016 outbreak in western part of Africa, the outbreak of the decrease was referred to as the most complex part of the Ebola outbreak ever recorded since the first time the virus was discovered in 1976. This is because the country reported more case of death in during this outbreak that all the others combined (Anon, 2017). The outbreak also spread between various countries which included Guinea and moved across Liberia and the borders of Sierra Leone. 

    There are actually three generations of the virus family which includes; Marburgvirus, Cuevavirus and Ebolavirus.  Inside the Ebolavirus genes, there are five species identified in Sudan, Zaire, Budibugyo, Reston and Tai Forest.  There have however been large outbreaks in Sudan, Zaire and Bundibugyo Ebolaviruses in African than other parts of the world. The 2014-2016 virus is largely related to the Zaire virus (WHO, 2018).

    Routine of Transmission

    According to various statistics it is often thought that fruit bats from the Pteropidadae family are the main hosts of the Ebola virus. However, when it comes to the human population, it will be transmitted when an individual comes in close contact with secretions, blood, organs or other body fluids of an infected animal like gorillas, chimpanzee, monkeys, fruit bats, porcupines or forest antelopes which are found either ill, or dead or living in the rainforest. After being in contact, the virus will then spread through the human to human contact through the mucous membrane or via the skin, and this is why it is referred to a communicable decease (Kangbai & Koroma, 2015). As discussed, other common transmission include human organs, secretions, blood, and fluids of infected individuals or with surfaces and materials that have been in contact with the infected individual. This also includes clothing and bedding which are contaminated with theses fluids. In most case, healthcare workers will be infected as they continue with treating patients who are confirmed or are suspected have the Ebola virus disease. In most cases this will occur when the nurse or healthcare worker is in close contact with the infected individual or the infection control measures have been ignored. Other commonly ignored places of transmission have been in burial ceremonies where families and friends become in direct contact with the infected body, which has seen individual continue to become infected so long us they are within these contexts.

    Impact to the community

    The impact of Ebola virus cannot be ignored which goes beyond the devastating health effects. As country, the Ebola virus is bound to have a lot of social and economic impact, since it wipes away manpower and increases cost of treatment in the communities. For example, according to the 2014 World Bank projections, it is estimated that a total of $ 2.2 billion was lost by 2015 in the gross domestic product of Liberia, Guinea and Sierra Leone due to the Ebola outbreak (UNICEF, 2016).  The virus will also see the reduction of investment and loss in the private sector, low production of agriculture will is a main concern regarding food security, reduction in the growth of the private section and restriction of movements of goods from the infected country for fear of spread of the disease, this in turn affected the cross border trade (Kangbai & Koroma, 2015).

    Also the country’s healthcare system will be affected, because the healthcare works who look after the infected are at high risk of contracting the disease. This leads to reduced manpower in the healthcare system of affected communities and country. For example in 2015, it was estimated that a total of 881 healthcare workers were infected and 513 died from the disease in Liberia, Guinea and Sierra Leone.  Liberia alone, lost 8% of its doctors to the virus, while Sierra Leone lost 7% and 1% of other healthcare workers to the virus respective.  There are also high infant mortality rates associated with the virus where about 20% of all Ebola cases are reported in children under 15 years due to the fact that they are in close contact with their infected parents (UNICEF, 2016). It is estimated that about 173000 children have also been orphaned due to the virus in Liberia, Guinea and Sierra Leone (UNICEF, 2016).

    Reporting Protocol in case of an outbreak

    The reporting protocol for Ebola virus indicates that as a healthcare service provider or a person’s working in a healthcare facility, it is important to immediately notify the local health jurisdiction. This will ensure that the infected region is visited and laboratory test are performed after submission of a specimen. Most usually positive specimens are required to establish danger.  The local health jurisdiction will then notify the Department of health and the office of Communicable Disease Epidemiology, the (CDE), for further action (UNICEF, 2016)).

    Education strategy for Ebola Prevention

    For the patient, the best strategy would be to educate them about the disease and how it is spread. It will also be important to quarantine all infected patients so that the disease is not spread to the unknowing.  All healthcare works should follow the required protocol in attending the patient including wearing protective gear (Sarah Monson, 2017). The cloths and beddings of the patient should be burnt to stop an epidemic. For the community education strategy, the use of audio visuals would be very relevant in demonstrating to the individuals how the disease is spread and ways that this can be prevented from the community perspective (Sarah Monson, 2017). All non-infected persons should be moved to a safe environment and they infected region should be quarantined.


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