C228- Community Health Nursing
A. Communicable Disease
The Communicable disease chosen is Ebola. This is a rare but deadly virus that causes fever, diarrhea, body aches and at time it can also lead to internal bleeding and external bleeding from its victims (CDC, 2019). As the virus continues to spread through the body, the victim’s immune system and organs will be affected. Eventually it will lead to high levels of blood clotting cells drop. This will also motivate the severe uncontrolled bleeding. Several studies indicate that the Ebola virus is known to kill up to 90% of those infected.
B. Description of the Outbreak
The Ebola virus disease brings one of the most frightening communicable diseases to the mind of many. The virus disease is one of the thing that can be said to be dreamt by many horror writers. This is because of the symptoms that is associated with the virus, where the victims are bleeding from their eyes, nose and ears, and at an autopsy it is found that the individual has been bleeding in almost all of the necrotic organization. This shows that the Ebola disease is a severe illness which is responsible for the Ebola virus (CDC, 2019). As it is communicable, the virus is highly infectious, very fatal with a guaranteed death rate of about 90% though this can be prevented.
According to the World Health Organization (WHO, 2019), the first Ebola virus outbreak was recorded in 1976 in Sudan and Zaire, which is currently the Democratic Republic of Congo. Since then, the world continued to witness multiple outbreaks in central part of Africa with the largest incidents occurring between 2000-2001, which involved 425 infected. The outbreak of the Ebola virus has also occurred in many instances in Uganda, the Democratic republic of Congo, Gabon and South Sudan from 1976, the world has been able to report over 1,500 cases of death (WHO, 2019). In most cases, the spread of the disease is caused by the close members of the family of the filovirus or Ebolavirus. In this regard five different species of the virus have been recorded which includes Tai Forest Ebolavirus, Bundibugyo Ebolavirus, Zaire Ebolavirus, Sudan Ebola virus and the Reston Ebola virus. Ebola is also the first outbreak ever recorded in Africa and especially West Africa. By the month of early May 2018, about 236 new cases were reported with around 158 deaths only in guinea. Some of the serious case have also been reported in the neighboring countries like Liberia. As regards the previous outbreaks, the healthcare workers and families of the first victims have often been the main victims due to close contact, in fact the virus has claimed around 16 deaths of healthcare workers.
B1. Epidemiological Determinants and Risk factors
According to an article titled ‘ Epidemiology of Ebola virus disease transmission among health care workers in Sierra Leone, May to December 2014: a retrospective descriptive study’ by Olu, O., Kargbo, B., Kamara, S., Wurie, A. H., Amone, J., Ganda, L., … Kasolo, F. (2015); the authors describe the determinants and the risk factors that are associated with the spread of the Ebola virus. From their study, the researcher were able to discover that the Ebola virus is commonly spread by the sick people, since this is a communicable disease. It means that those who are in close contact to the person who has the virus, or contaminated environment are likely to contract the virus. In this regard, some people contracted the virus by being in contact with the sick in funeral homes, while providing care for someone who is sick among other environmental factors (Olu et al., 2015). According to the studies of many of the people who they included in the research, it was reported that they had been in contact with the body of the victim in the hospital. Some of these things also occurred within a period of one month that the patient began to reveal symptoms. Also the other risk associated with the virus is whether the individual had been the primary caregiver of the patient or the infected. As much as there was some cases of which the patient had reported no contact with any sick person, and no evidence of them being in any funerals. There is actually no evidence to show that they had actually not been in these environments at some point, or may have crossed paths with the sick individual and in the process contracted the virus. This study also concluded that when the person is in contact with the body of an individual who is living with the virus, sick from the virus or deceased, is a very important factor in the contraction of the Ebola virus (WHO, 2019). That is why as was discovered by researcher, health worker are often at high risk situation, and that is why the virus was able to spread to other regions.
This study concurs with previous reports of the spread from the World health organization, there were 25 new case reported from the laboratory as Ebola Virus disease ( EVD) in the democratic republic of Congo. The newly confirmed cases of the virus have also been reported in Oicha, Beini and Mabalako health zones, Mandima Health Zones (Ituri Province). However, statics also indicate that all transmission and exposure events have been linked to Mabako which is the outbreak epi-centre (Olu et al., 2015). Beyond the outbreak of the Ebola virus disease, the democratic republic of Congo still remain to be in one of the most complex humanitarian crisis in regard to the concurrent epidemic rocking the region. By 22nd of august 2018, reports indicate that there was a total of 103 new Ebola case of which 76 were confirmed while 27 remained probable. This also included 63 deaths of which 36 were confirmed and 27 probable. All of these case were reported in five health zones that included North Kivu (Butembo, Beni, Oicha, Museinene and Mabalako), the other one include one health zone found in Ituri (Mandima). There were also other majority case that were reported from Mabalako with the area health zones of about 62 confirmed and 21 probable. By 22nd august 2018, six new cases were pending in the laboratory confirming the Ebola virus disease. Also 88 case and probable ones were reported in regard to age and gender. In this regard, the median age of infections were between groups of 32 years, with 30-39 yeas accounting for about 28% of the cases. Also 50% of all cases were said to be female (WHO, 2019).
B2. Route of Transmission
According to the center for Disease control, the Ebola virus is spread with the uninfected persons comes to direct contact with the individual that has been infected with the virus. This contact also include a deceased person who had the virus, and this is why most people have been reported to have contracted the virus during funeral ceremonies (Olu et al., 2015. The virus is also spread through the contact of human body fluids like semen, saliva, open wounds, sharing of utensils, kissing, mucus membranes like the nose, eyes, vagina and mouth or sneezing. The virus spreads through having a direct contact with blood, and urine among others, from the infected individual. The virus can also be spread when a person has contact with linen soiled by the infected person’s body fluids (WHO, 2019). This also means that the Ebola virus can easily be eliminated with alcohol based products, heat, calcium hypochlorite (bleaching powder) or sodium hypochlorite (bleach) with appropriate concentrations.
Other studies have also show that the spread of Ebola is common in the semen of a man, which can linger for a while to the extent that one can transfer the virus from an infected women to the other since the virus can survive in the semen for quite some time, making the disease easy to be passed. With regard to the spread of the virus to other regions, this has mostly been attributed to the family members as well as healthcare workers. According to a study by World health organization, in 2018, there were fourteen reported cases of the spread of Ebola virus among healthcare workers, of these cases thirteen were confirmed by the laboratory, also one healthcare worker sadly died from the virus. In addition, most of the reported healthcare workers are likely to have been infected in the clinic as they exchanged beddings, cared for the sick especially be the declaration of the new outbreak, and not in the Ebola treatment centers. It thus become important for healthcare worker to create partnership with communities to increase awareness of the infection, prevention and control so as to avoid the outbreak (WHO, 2019). It is also important that those at risk of infection are vaccinated.
B3. Impact of the virus to the community
It is evident that the continued spread of the Ebola virus is going to have a social and economic impact to the community, given the fact that the virus is not so common in the united western countries. In this regard, I feel that there incidence of the virus being reported will lead to a lot of panic from member of the community given the information they have about the deadly virus impact in Africa. With this in mind, it also means that the government will have to order all the social connections including schools, clubs, institutions of higher learning and sporting events to be shut down to prevent the spread. The region reported to have evidence of the virus will also be quarantined. Just recently the United States had some of its schools shut down due to the reported communicable disease known as influenza and norovirus. These are just but some of the illnesses that the country has had to deal with (WHO, 2019). In this regard, I feel that Ebola virus would definitely affect the healthcare institutions around the region, due to the fact that most of these institutions may not be well prepared to deal with the virus, including having a ready space to secure as a quarantine for reported cases. Also the hospitals will need to receive and implement new guidelines including possible quarantine zones before air travel as some of the measures taken to contain the virus in one region in the country. In this regard, my community will need to adjust their day to day lifestyle until the situation is put under control.
B4. Reporting Protocol
The most instrumental tools for reporting the outbreak of the Ebola virus has been the mainstream media which is the first place that people in my community would rely on for issues of concern. Given that I stay in a peri-urban environment, I make my personal business to always watch health related news affecting my neighborhood. In addition, bad news like the spread of a virus would spread fast in the region through other tools like the social media pages, word of mount among other platforms/ however, it is still important to verify information spread through the social media since most of it is based on rumors and is incomplete as it has no facts. This means that to get the right information regarding a disease outbreak it is best to get it from the center for disease control, which also uses the mainstream media (Television, radio and newspapers) as an outlet for information (WHO, 2019). This information is also spread through newsletters in school, leaflets in public places, especially with advice on prevention. This makes the mainstream media the right instrument for an Ebola outbreak.
B5 Prevention Strategies
In regard to Ebola virus, the first strategy that the community and healthcare institutions can use for preventing the spread would be to introduce an education aspect for patients already infected and their families. The type of education they will be given will be around the risk factors, causes and important of quarantine. The family of the victims will need to be taught on the first thing that they need to do if they believe that they may have contracted the virus, or depict symptoms of the virus. To implement this way, I can suggest adding such information I the discharge summary, where patient are given bulleted advice with subheadings on cause, prevention and treatment for the Ebola virus. This is currently done with other diseases like signs and symptoms of sexual transmitted infections; of which we have been able to educate a lot of young men and women on the treatment and prevention of sexual transmitted infections.
The second strategy would be to conduct community awareness program about the Ebola virus. This would be instrument for ensuring that panic is contained in case there are reports about the virus, or there is need to quarantine a particular region to contain the spread of the virus or other virus in that case. The best instruments for community awareness strategy will be both the mainstream media and the social media. This will entail having a public announcement at several intervals in popular radio and television stations. Billboards will also be set around the country, including community awareness events to educate people about the virus, prevention and treatment (Olu et al., 2015). There will also be distribution of leaflets with information about the virus which will be very helpful in the long run. I believe that when the community is provide the right education, they will be well informed to avoid or prevent the spread of the virus. Thus community education and personal responsibility are among the best instruments for ensuring the community is safe from the spread of this deadly virus.
CDC. (2019, March 29). Transmission. Retrieved from https://www.cdc.gov/vhf/ebola/transmission/index.html
Olu, O., Kargbo, B., Kamara, S., Wurie, A. H., Amone, J., Ganda, L., … Kasolo, F. (2015). Epidemiology of Ebola virus disease transmission among health care workers in Sierra Leone, May to December 2014: a retrospective descriptive study. BMC Infectious Diseases, 15(1). doi:10.1186/s12879-015-1166-7
WHO. (2019, April 19). Ebola virus disease ? Democratic Republic of the Congo. Retrieved from https://www.who.int/csr/don/24-august-2018-ebola-drc/en/