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Ebola: The Enemy at Your door

By Sola Ogundipe

Ebola Virus Disease, EVD, is a contagious illness that has been reported in several African countries, including Uganda, Gabon, Democratic Republic of the Congo, Liberia, Sierra Leone, Guinea and Nigeria. It is caused by an infection with the Ebola virus, and is often lethal in humans and non-human primates (such as monkeys and gorillas). Since 1970, there have been at least 25 confirmed outbreaks of EVD. In the latest outbreak in West Africa, around 1,200 infections and 730 deaths have been reported.

Three of four identified subtypes of the Ebola virus are known to cause Ebola in humans. Although researchers do not know exactly how an outbreak of Ebola starts, it has been hypothesised that the first patient becomes infected with Ebola virus through contact with an infected animal. While the specific cause of the first case in an Ebola outbreak is unknown, researchers do know that Ebola is transmitted from human to human.

Since 1976, when the Ebola virus was first recognised, there have been at least 25 confirmed outbreaks of the illness. To date the only confirmed case of EVD in Nigeria is that of the late Patrick Sawyer, the Liberian who died on July 25, 2014, at First Consultants Hospital, Lagos. Although there are a number of other reported cases, they are still considered suspected cases and are subject to confirmation.

Common Symptoms
Symptoms of Ebola can appear as soon as two days, or as long as 21 days, after infection with the Ebola virus. When a person becomes infected with Ebola virus, the virus begins to multiply within the body. After four to six days on average, Ebola symptoms can begin. The period between infection with the virus and the start of Ebola symptoms is called the incubation period. The Ebola incubation period can be as short as 2 days or as long as 21 days.

The start of Ebola symptoms is usually abrupt. Common symptoms can include: Fever, sore throat, weakness, severe headache, joint and muscle aches, diarrhoea, vomiting, dehydration, hacking cough and stomach pain.
A rash, red eyes, hiccups, and internal and external bleeding may be seen in some patients. When the rash develops on dark skin, it is often not recognised until the rash begins to peel. In pregnant women, abortion (miscarriage) and heavy vaginal bleeding are common Ebola symptoms. Death usually occurs during the second week of Ebola symptoms. Death in Ebola victims is usually from massive blood loss.

Ebola prevention
When it comes to Ebola, prevention involves avoiding direct contact with the body fluid of infected people. Also, it’s important to avoid direct contact with the body of an Ebola victim who has died. For healthcare workers and the general public in Nigeria and other affected countries in Africa, who are most likely to encounter cases of EVD, prevention focuses on being able to recognise cases of the disease when they appear, as well as using barrier isolation techniques to avoid direct contact with infected people.

Once an Ebola outbreak begins, the effects of the virus can be devastating. There is no Ebola cure, and once a person develops an Ebola virus infection, the chance of death can be as high as 90 percent.
Because there is no Ebola vaccine that is currently licensed, EVD prevention focuses on preventing direct contact with body fluids of those infected with the virus. Another aspect of EVD prevention involves avoiding direct contact with the body of an Ebola victim who has died as a result of the virus.

EVD prevention presents many challenges. Because the identity and location of the animal host of the Ebola virus are unknown, there are few established primary Ebola prevention measures.

The rule, generally is that if cases of Ebola do appear, current social and economic conditions often favour the spread of an epidemic within healthcare facilities; therefore, healthcare providers must be able to recognise a case of Ebola should one appear. They must also have the capability to perform Ebola diagnostic tests and be ready to employ practical Ebola isolation precautions or barrier nursing techniques.

These techniques include the following:
• Complete sterilisation of equipment
• Isolation of patients with Ebola Virus disease from contact with unprotected people
• Wearing of protective clothing, such as masks, gloves, gowns, and goggles.
• Proper and strict hygiene measures including hand-washing with soap and water.
• Avoid consumption of wild animals particularly bush meat, bats

Time as an Ebola “cure”
There are persons who have been infected with Ebola and survived over time. It is not known for certain if they are “cured” in the real sense.
When Ebola first strikes, a person will not feel sick for several days to a few weeks after being infected with the Ebola virus. When symptoms do develop, healthcare providers can only offer supportive care that involves treating symptoms and complications of Ebola while the body fights the infection.

Supportive care for Ebola can include: Good nursing care, oxygen and devices that help with breathing, intravenous (IV) fluids to maintain fluids and electrolytes, Medications to control fever, help the blood clot, and maintain blood pressure And antibiotics to prevent secondary infections. Despite supportive care, 50 to 90 percent of Ebola patients do not survive the infection.

Ebola vaccine in humans
Some Ebola research scientists have focused their efforts on developing a new Ebola vaccine. Since 2003, a research study began that is evaluating the safety of an experimental vaccine for Ebola in humans. The trial vaccine, which is a type of DNA vaccine, is similar to other investigational vaccines that hold promise for controlling such diseases as AIDS, influenza, malaria, and hepatitis.

This vaccine may prevent Ebola Virus disease from developing, but will not be a cure for Ebola. Once infected with the virus, there is no treatment that will cure the infection once it begins; therefore, preventing the spread of the virus is crucial to containing outbreaks. This is one reason why research scientists are actively studying a possible Ebola vaccine. At this point, there is not a licensed vaccine for humans; however, an Ebola vaccine has shown to be effective in monkeys.

This research has enormous public health implications, not only because it might be used to limit the spread of Ebola virus, which continues to emerge in West Africa, but also because this vaccine strategy may be applied to other highly lethal viruses – such as the Marburg and Lassa fever viruses, and the SARS coronavirus – that cause acute disease outbreaks and require a rapid response

Importance of hand washing
Handwashing is like a “do-it-yourself” vaccine—it involves five simple and effective steps (wet, lather, scrub, rinse, dry) you can take to reduce the spread of illness such as EVD. Regular hand-washing is one of the best ways to remove germs, avoid getting sick, and prevent the spread of germs to others. ?Knowing when and how to wash your hands, the importance of using soap and water, and what you can do if soap and clean, running water are not available is crucial.

Hands being washed How to wash your hands
•Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
•Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between your fingers, and under your nails.
•Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
•Rinse your hands well under clean, running water.
•Dry your hands using a clean towel or air dry them.?


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