How a deadly disease is spreading across West Africa and threatening to become a global epidemic.
The first cases were reported this spring in West Africa. Reports of deaths grew steadily as the virus spread to Nigeria, Guinea and Sierra Leone. Liberia’s president, Mrs. Ellen Sirleaf has declared a state of emergency for 90 days over the world’s worst ever outbreak of the virus. This week, the World Health Organization (WHO) had more than 1,000 recorded deaths since the outbreak. ‘This outbreak is spreading faster than our efforts to control it’, said Margaret Chan, chief of the WHO.
Ebola virus disease (EVD) is the world’s deadliest virus. Previously known as Ebola hemorrhagic fever, it has a fatality rate of 90 percent if not treated. The current outbreak has a mortality rate of 60 percent. It first appeared in remote villages of Sudan and in the Democratic Republic of Congo in 1976 in two simultaneous outbreaks. The virus is transmitted to humans by contact with blood, secretions, organs and other fluids of infected animals. The virus is then transmitted in the community through human-to-human contact of bodily fluids. Because the villages affected are very remote, seeking help is often very difficult. Social stigma, lack of awareness and even religious reasons keep people from seeking -and avoiding- medical care. It’s very hard to trace patients’ contacts with other people because of denial and resistance in communities.
Travel restrictions were imposed to stop the flow of people to Monrovia, the Liberian capital. The military blockade aiming to stop people from the Western region from entering the capital, but that means that counties, neighbourhoods and cities are cut off from their sole supply of goods. This is in an attempt to stop the infection from spreading in a densely populated urban center. Mrs. Sirleaf has ordered the closure of schools and businesses, including football stadiums. She also created a cleaning and disinfecting holiday last Friday. The head of police in the Eastern part of Sierra Leone said that police and soldiers had imposed a complete blockade on two districts.
Those on the frontline helping the sick are exposing themselves to the dangers of this disease. A nurse in Liberia has died from the virus, and five other hospital workers were infected after having treated a Liberian-American consultant who got sick after travelling between Monrovia, Liberia, and Nigeria. On July 20, he travelled from Liberia to Nigeria on a business trip, and was isolated at a hospital in Lagos as soon as he arrived. Five days later, he became the first American to die from the Ebola virus.
An American doctor, Kent Brantly, and his colleague, missionary Nancy Writebol, were infected while working for American relief aid agency Samaritan’s Purse. They were moved from Liberia to Texas to receive treatment and are in stable conditions. They are thought to be the first patients ever treated for Ebola in the United States. A Saudi businessman died in Jeddah last Wednesday. He presented symptoms of the hemorrhagic fever after travelling to Sierra Leone. He received intensive care, but didn’t make it. A Spanish priest also succumbed to the disease this week. He was airlifted back to Madrid from Liberia last week and received an experimental drug called Zmapp.
The lack of proper equipment, poor training, low pay and bad conditions make it very hard to treat the big influx of patients and keep the virus at bay. When there is a suspected case of Ebola, protocol demands that a surveillance team should be contacted so that blood samples can be collected. However, because of the high number of cases and limited resources, the hospital’s laboratory technicians are asked to draw samples, which can be very risky and has resulted in infections. The Zaire ebolavirus, the most deadly of the five strands of the virus, has the capacity of living for a number of days outside a host body, which makes it very important to dispose of the deceased correctly and sterilize the environment used to treat the patient. However, the chaotic conditions seen in West Africa have made it almost impossible to apply any damage control.
There is no vaccine or drug that is known to cure Ebola, so the scale of this outbreak is very worrying to the international community. The fear that the virus will spread to other countries outside Africa has led the WHO to declare the spread of Ebola in West Africa an international health emergency. The international airport in Lagos has started screening passengers for any signs of Ebola in order to ensure that the virus doesn’t get further out of control. After being exposed to the virus, it takes four to nine days for symptoms to develop. However, those that have been in contact with a sick person can be a virus carrier for up to 21 days before the symptoms show, according to WHO.
Therefore, it seems as if air travel is our biggest enemy at this moment. When the N1H1 (swine flu) virus outbreak happened in 2009, it spread very quickly because of air travel. Even though the swine flu has a much smaller fatality rate than Ebola, it didn’t take much time before many people around the world presented its symptoms. While measures are being taken to control the outbreak of Ebola, we should be vigilant. Infected mice that travelled in merchant ships from Asia to Europe transmitted the Black Death that killed millions of people in Europe in the 1300s. Medical knowledge wasn’t half as extensive as it is now, but we still don’t have the cure for the deadliest virus out there.
WHO officials said a coordinated international response was essential to stop and reverse the spread of the virus. Experimental drugs were used on two American citizens mentioned earlier, and they have been approved by WHO as the next option to treat patients. The organization has considered ethical the use of Zmapp, the same drug used on the Spanish priest. Liberia has announced that the drug, shipped from the US, will be given to two sick doctors, making them the first Africans to receive that kind of treatment. However, the producer of the drug has already announced that the supply has run out. The future then remains uncertain as the world experiences the most dangerous global epidemic in recent history.
Know the symptoms:
- 1-3 days; the person develops cold-like symptoms, and intense fatigue.
- 4-7 days; the person can vomit, feel nauseated, and have diarrhoea, headaches and low blood pressure.
- 7-10 day; there’s disorientation, internal and external bleeding, which leads to coma, shock and death.
Sources:
http://www.vox.com/2014/8/6/5971675/where-ebola-outbreak-will-go-next-africa
http://www.bbc.co.uk/news/world-africa-28690799
http://online.wsj.com/articles/nigerian-health-minister-says-nurse-died-of-ebola-1407325187
http://www.who.int/mediacentre/factsheets/fs103/en/
http://www.vox.com/2014/7/23/5930311/ebola-virus-disease-outbreak-africa-facts-guinea
http://edition.cnn.com/2014/08/06/health/africa-ebola-outbreak/index.html
http://www.bbc.co.uk/news/health-28700213
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