Understanding EBOLA Virus Disease EVD  

A strange virus has appeared but it is no stranger to medical professionals. This is effectively the third major coming of Ebola. It’s shaped like a serpent with Mickey Mouse’s face but this time with a lot more venom, making a mockery of unprepared healthcare professionals as they take on it’s challenge in the battlefield of epidemiology and disease prevention. Ebola first appeared in 1976 in Nzara, Sudan, and in Yambuku, Democratic Republic of Congo. Yambuku is situated near the Ebola River.

Its first appearance did not get Ebola much attention as a major threat to human civilization. Surely, some professionals began their research work but, unfortunately, unless a virus gets a lot of bad press, healthcare professionals cannot do their jobs because, generally, the people who control research and development funds are not scientists, but rather politicians and bureaucrats.  The World Health Organization reported on September 14, 2014 that there is “No early end to Ebola outbreak in West Africa”. This did not make it as headline news in the world media, as usual.  The reported numbers of cases have now reached nearly 2000 with a close to 1100 deaths caused by the virus. By the time we have a handle on this epidemic; the numbers will be staggering and still elevating. The disease has spread from Liberia to Guinea, and Sierra Leone to Nigeria. Along with the World Health Organization (WHO), The Center for Disease Control and Prevention (CDC), UN World Food Program and many other organizations are monitoring and coordinating the efforts to keep the lid down on this fast spreading epidemic that could potentially engulf the World. It’s important to convey the facts surrounding this or any health threat but, more often than not, information gets lost in the translation from Medical Terminology, statistical data, and scientific lingo. Let’s understand what Ebola is;

 Ebola EVD definition by World Health Organization and CDC;

·         Ebola virus disease (EVD), formerly known as Ebola hemorrhagic fever (VHF) is a severe, often fatal illness in humans.

·         EVD outbreaks have a case fatality rate of up to 90%.

·         EVD outbreaks occur primarily in remote villages in Central and West Africa, near tropical rainforests.

·         The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission.

·         Fruit bats of the Pteropodidae family are considered to be the natural host of the Ebola virus.

·         Severely ill patients require intensive supportive care. No licensed specific treatment or vaccine is available for use in people or animals.

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Genus Ebola virus is 1 of 3 members of the Filoviridae family (filo virus), along with genus Marburg virus and genus Cueva virus. Genus Ebola virus comprises 5 distinct species:

1.      Bundibugyo Ebola virus (BDBV)

2.      Zaire Ebola virus (EBOV)

3.      Reston Ebola virus (RESTV)

4.      Sudan Ebola virus (SUDV)

5.      Taï Forest Ebola virus (TAFV).

BDBV, EBOV, and SUDV have been associated with large EVD outbreaks in Africa, whereas RESTV and TAFV have not. The RESTV species, found in Philippines and the People’s Republic of China, can infect humans, but no illness or death in humans from this species has been reported to date.

Symptoms

·        Sudden onset of fever, intense weakness, muscle pain. Headache or sore throat with fever.

·        This viral illness is further confirmed by nausea, vomiting diarrhea and skin rash. 

·         Internal and in some cases external bleeding & impaired renal functions are also a symptom.

·        Disorderly platelet counts and elevated liver enzymes, determined by lad tests

·        The incubation period can last between 2 to over 21 days. In other words, in some cases the symptoms may not appear for that long of a period.  

Known Transmission of Disease;

 

·        Ebola is introduced to human through close contact of blood and secretion from human and animals like bats, monkeys and pigs.

·        Contact or transplantation of other bodily fluids of infected organs of human and animals

·        Direct contact between the patients and their care takers through open/ broken skin in mucous membranes.

·        Indirect contact through the environment like the affected personal items of and the body of deceased or living human who have recovered from Ebola can be a potential cause.

·        It has been reported that even 7 weeks after recovery, a person can affect his partner through unprotected sexual contact.

Preventive measures

·        According to the professional opinion of Dr. Stephen Monroe, Deputy Director of CDC, National Center for Emerging & Zoonotic Disease, Ebola does not get transmitted by a casual contact.

·        Avoid sharing needles and sexual contact

·         "Avoid blood transfusion, touching open skin or secretions of the affected persons

·        If you are a caretaker of the patient, take all necessary and professional precautions, using protective gear like gloves and covering face and eyes.

·        EVD is a bio-safety level 4 virus, testing should be done following the protocols of controlled testing environment.

·        Upon the confirmation of diagnosis, healthcare professional should begin the “contact trail” process to further warn, test and protect other possible victims.  Contact tracing protocol mandate that at least 140 people be contacted who were in contact with the patient.

·        Last but not least- Common sense rules. Use good personal and environmental hygiene. Follow health rules not your sentiments when you come in contact with an EVD affected person in the family. Isolation of a patient is a necessary step that has to be taken to protect from spreading the disease.

·        Always keep your health check records and advise people in your sphere of influence the same. Always rely on facts from the professional sources and not the media.

·        For information contact me at the International School of Capital Medical University, Beijing; Najam@ccmu.edu.cn