Ebola Haemorrhagic Fever

 

                                                             Ebola virus 

Ebola is a deadly virus causing Ebola Haemorrhagic Fever. It was first discovered in 1976 in the Democratic Republic of Congo in a young patient who died of a viral illness. It has been rearing its ugly head over the past 40 years but in the outbreak in 2013/2014 it has caused over 4000 deaths in Liberia, Senegal, Guinea, Mali, and Nigeria. The WHO has now declared Nigeria Ebola- free.

                                           Affected areas in West Africa 

 Chimpanzees and other monkeys and bats carry the virus. Bats are eaten as delicacies in parts of Africa. The virus is spread by contact with the bodily fluids of an affected person entering the buccal mucosa or conjunctiva of a contact but aerial spread is not possible.

                                  Fruit bat, which carries Ebola 

The virus enters the human cell, takes over the ‘machinery’ and replicates itself.  New copies of the virus are produced and released into the blood stream.

Patients have fever, haemorrhage, muscle-pain and exhibit dehydration. Death occurs in 50 to 90 percent of cases. There is no known cure although the drug IMAP has been tried. One or two who received this may have recovered due the supportive therapy of fluid replacement and other measures. Isolation of patients is very important. And caregivers have to barrier- nurse the patient. Careful disposal of dead bodies is mandatory to stop spread.

Important points in the Management of Ebola:

  *Isolation

  * Treatment of patients within closed units by caregivers              

     using barrier methods

  *Dialysis when needed

  * Education of people about Ebola

  *Contact management (screening up to 21 days)

  * Safe burial of the dead in sealed containers and carried

     away by trained staff.

In these days of freedom to travel, countries have adopted a policy of screening visitors from affected areas arriving at airports of Ebola- free countries. 21 day monitoring of returning staff, establishment of contact phone lines for answering questions of those concerned about exposure, are other measures.

How does screening at airports work? 

Passengers are asked:

• Have you been with a patient with severe illness or who died of an unknown cause?

• Have you been vomiting or been generally unwell?

• Have you had contact with a dead body or been to a funeral?

• Have you taken a patient with Ebola to a hospital?

 

                                                              Screening at airports 

In the UK, passengers at high risk but no symptoms may be contacted daily. Travelers are told to phone and what to do if they become unwell.

Medicines Sans Frontiers  (MSF or Doctors Without Borders) have been closely involved in treatment and the volume of work has been so large that the system is in danger of breaking down unless more help arrives.

In affected areas, over crowding is proving a problem. In the past the outbreaks occurred in rural areas but this epidemic has been in the urban setting thus explaining the rapid spread.

Why has Ebola not been ‘taken seriously’ over 40years?

One can only say, it has never proved to be a problem of the present scale up to now. The countries concerned have not had the resources to study the condition or develop drugs or a vaccine. But with this outbreak new machinery has sprung into action, not least due to care givers from the US, UK and Spain being affected and been treated in their home countries.

Glaxo Smith Kline is working on a vaccine and the projection is that it will be available in late 2015. 

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Put together by Zita Perera Subasinghe from articles appearing in the BBC I-player and BBC news of the past few months.