This deadly disease
that have just been shipped into our country must be tackled with immediate
alacrity or else we will begin to fight another issue that may engulf and sip
our money like the known age long HIV virus .The medical personnel’s involved
must be very careful not to be agents in
the spread of this forest imported disease. It is so deadly that it does not
allow its bearer time for atonement. Therefore it becomes pertinent and pivotal
for all hunters to cook their meat properly before eating.
Nigeria must
question the activities of those at the quarantine. They should be effective in
their duties to check migrants coming into the country not minding their
purpose and status. In an introductory and eye opening way, I will through the findings
done explain on the history of this ugly life threatening disease.
- In 1976, Ebola named after the
Ebola River in Zaire first emerged in Sudan and Zaire. The first outbreak
of Ebola was in Sudan where it infected over 284 people, with a mortality
rate of 53%. Fortunately, the few people who were infected with EBOR
(seroconverted) never developed Ebola hemorrhagic fever (EHF). It has
different strains due to its place of discovery as follows
- Ebola Cote d'Ivoire
- Ebola Reston
- Ebola Sudan
- Ebola Zaire
- 1999 Marburg Outbreak
- Ebola Sudan
- 1976. Nzara and Maridi, Sudan.
Infected 284, killed 150 (53% mortality).
- 1979. Nzara, Sudan. Infected
34, killed 22 (65% mortality).
- Ebola Zaire
- 1976. Yambuku, Zaire. Infected
318, killed 280 (88% mortality).
- 1977. Tandala, Zaire. Infected
and killed 1.
- 1994. Minkebe and Makokou,
Gabon. Infected 44, killed 28 (63%).
- 1995. Kikwit, Zaire. Infected
317, killed 247 (78%).
- 1996. Mayibout, Gabon. Infected
37, killed 21 (57%).
- 1996. Booue, Gabon (and
transported to Johannesburg, South Africa (2 cases, 1 fatal)). Infected
62, killed 41 (66%).
- Ebola Cote d'Ivoire
- 1994. Tai Forest, Cote
d'Ivoire. 1 non-fatally infected.
- 1995. Liberia transported to
Cote d'Ivoire. 1 non-fatally infected.
Symptoms typically start
two days to three weeks after contracting the virus, with a fever, throat and
muscle pains, and headaches. There is then typically nausea, vomiting, and diarrhea,
along with decreased functioning of the liver and kidneys. At this point, some
people begin to have problems with bleeding.
The disease is usually acquired
when a person comes into contact with the blood or bodily fluids of an infected
animal such as a monkey or fruit bat. Fruit bats are believed to carry and
spread the virus without being affected by it. Once infection of a human
occurs, the disease may be spread from one person to another. Male survivors
may be able to transmit the disease via their semen for nearly two months. To
make the diagnosis, typically other diseases with similar symptoms such as malaria,
cholera and other viral hemorrhagic fever are first excluded. The blood may
then be tested for antibodies to the virus, or the viral RNA, or the virus
itself, to confirm the diagnosis.
Prevention
includes decreasing the spread of the disease from infected monkeys and pigs to
humans. This may be done by checking these types of animals for infection and
killing and properly disposing of the bodies if the disease is discovered.
Properly cooking meat and wearing protective clothing when handling meat may
also be helpful, as is wearing protective clothing and washing hands when
around a person who has the disease. Samples of bodily fluids and tissues from
people with the disease should be handled with special caution.
There is no
specific treatment for the virus. Efforts to help persons who are infected
include giving them either oral rehydration therapy or intravenous fluids. The
disease has a high mortality rate: often between 50% and 90% of those who are
infected with the virus. The disease was first identified in the Sudan and the Democratic
Republic of the Congo. It typically occurs in outbreaks in tropical regions of Sub-Saharan
Africa. Between 1976, when it was first identified, and 2014, fewer than 1,000
people a year have been infected. The largest outbreak to date is the ongoing 2014
West Africa Ebola outbreak, which is affecting Guinea, Sierra Leone, and Liberia.
Efforts are ongoing to develop a vaccine; however, none exists as of 2014.
Experimental
therapies
Hyper immune
equine immunoglobulin raised against EBOV was used in Russia to treat a
laboratory worker who accidentally infected herself with EBOV. The treatment,
however, was unsuccessful in saving her life. Experimentally, recombinant vesicular
stomatitis Indiana virus (VSIV) expressing the glycoprotein of EBOV or SUDV has
been used successfully in nonhuman primate models as post-exposure prophylaxis.
Such a recombinant post-exposure vaccine was also used to treat a German
researcher who accidentally pricked herself with a possibly EBOV-contaminated
needle. Treatment might have been successful as she survived. However, actual
EBOV infection could never be demonstrated without a doubt. Other promising
experimental therapeutic regimens rely on antisense technology. Both small
interfering RNAs and Phosphorodiamidate Morpholino Oligomers (PMOs) targeting
the EBOV genome could prevent disease in nonhuman primates.
Searching through
various material, it became very obvious to say that many lives will be lost if
this is not curbed properly. The medical professionals should go to their
drawing boards.
Transmission
According to
World Health Organization (WHO), Ebola is introduced into the human population
through close contact with the blood, secretions, organs or other bodily fluids
of infected animals. In Africa, infection has been documented through the
handling of infected chimpanzees, gorillas, fruit bats, monkeys, forest
antelope and porcupines found ill or dead or in the rainforest.
Ebola then
spreads in the community through human-to-human transmission, with infection
resulting from direct contact (through broken skin or mucous membranes) with
the blood, secretions, organs or other bodily fluids of infected people, and
indirect contact with environments contaminated with such fluids. Burial
ceremonies in which mourners have direct contact with the body of the deceased
person can also play a role in the transmission of Ebola. Men who have recovered
from the disease can still transmit the virus through their semen for up to 7
weeks after recovery from illness.
Health-care
workers have frequently been infected while treating patients with suspected or
confirmed EVD. This has occurred through close contact with patients when
infection control precautions are not strictly practiced.
Among
workers in contact with monkeys or pigs infected with Reston Ebola virus,
several infections have been documented in people who were clinically
asymptomatic. Thus, RESTV appears less capable of causing disease in humans
than other Ebola species.
However, the
only available evidence available comes from healthy adult males. It would be
premature to extrapolate the health effects of the virus to all population
groups, such as immune-compromised persons, persons with underlying medical
conditions, pregnant women and children. More studies of RESTV are needed
before definitive conclusions can be drawn about the pathogenicity and
virulence of this virus in humans.
Signs and
symptoms
Sudden onset of fever, intense weakness, muscle pain, headache and sore
throat. This is followed by vomiting, diarrhea, rash, impaired kidney and liver
function, and in some cases, both internal and external bleeding. The incubation
period (interval from infection to onset of symptoms) varies between 2 to 21
days. During Ebola outbreaks, the case-fatality rate has varied from outbreak
to outbreak between 25% and 90%.
Diagnosis
Other
diseases that should be ruled out before a diagnosis of EVD can be made
include: malaria, typhoid fever, shigellosis, cholera, leptospirosis, plague,
rickettsiosis, relapsing fever, meningitis, hepatitis and other viral hemorrhagic
fevers.
Ebola virus
infections can be diagnosed definitively in a laboratory through several types
of tests:
- antibody-capture enzyme-linked
immuno sorbent assay (ELISA)
- antigen detection tests
- serum neutralization test
- reverse transcriptase polymerase
chain reaction (RT-PCR) assay
- electron microscopy
- Virus isolation by cell culture.
Samples from
patients are an extreme biohazard risk; testing should be conducted under
maximum biological containment conditions.
Vaccine
and treatment
No licensed
vaccine for EVD is available. Several vaccines are being tested, but none are
available for clinical use.
Severely ill
patients require intensive supportive care. Patients are frequently dehydrated
and require oral rehydration with solutions containing electrolytes or
intravenous fluids. No specific treatment is available. New drug therapies are
being evaluated.
Natural
host of Ebola virus
In Africa,
fruit bats, particularly species of the genera Hypsignathus monstrosus,
Epomops franqueti and Myonycteris torquata, are considered possible
natural hosts for Ebola virus. As a result, the geographic distribution of
Ebola viruses may overlap with the range of the fruit bats.
Controlling
Reston Ebola virus in domestic animals
No animal
vaccine against RESTV is available. Routine cleaning and disinfection of pig or
monkey farms (with sodium hypochlorite or other detergents) should be effective
in inactivating the virus.
If an outbreak is
suspected, the premises should be quarantined immediately. Culling of infected
animals, with close supervision of burial or incineration of carcasses, may be
necessary to reduce the risk of animal-to-human transmission. Restricting or
banning the movement of animals from infected farms to other areas can reduce
the spread of the disease.
As RESTV
outbreaks in pigs and monkeys have preceded human infections, the establishment
of an active animal health surveillance system to detect new cases is essential
in providing early warning for veterinary and human public health authorities.
Reducing the risk of Ebola infection in people
In the
absence of effective treatment and a human vaccine, raising awareness of the
risk factors for Ebola infection and the protective measures individuals can
take is the only way to reduce human infection and death.
In Africa,
during EVD outbreaks, educational public health messages for risk reduction
should focus on several factors:
- Reducing the risk of
wildlife-to-human transmission from contact with infected fruit bats or
monkeys/apes and the consumption of their raw meat. Animals should be
handled with gloves and other appropriate protective clothing. Animal
products (blood and meat) should be thoroughly cooked before consumption.
- Reducing the risk of
human-to-human transmission in the community arising from direct or close
contact with infected patients, particularly with their bodily fluids.
Close physical contact with Ebola patients should be avoided. Gloves and
appropriate personal protective equipment should be worn when taking care
of ill patients at home. Regular hand washing is required after visiting
patients in hospital, as well as after taking care of patients at home.
- Communities affected by Ebola
should inform the population about the nature of the disease and about
outbreak containment measures, including burial of the dead. People who have
died from Ebola should be promptly and safely buried.
Pig farms in
Africa can play a role in the amplification of infection because of the
presence of fruit bats on these farms. Appropriate bio-security measures should
be in place to limit transmission. For RESTV, educational public health
messages should focus on reducing the risk of pig-to-human transmission as a
result of unsafe animal husbandry and slaughtering practices, and unsafe
consumption of fresh blood, raw milk or animal tissue. Gloves and other
appropriate protective clothing should be worn when handling sick animals or
their tissues and when slaughtering animals. In regions where RESTV has been
reported in pigs, all animal products (blood, meat and milk) should be
thoroughly cooked before eating.
Controlling
infection in health-care settings
Human-to-human
transmission of the Ebola virus is primarily associated with direct or indirect
contact with blood and body fluids. Transmission to health-care workers has
been reported when appropriate infection control measures have not been
observed.
It is not always possible
to identify patients with EBV early because initial symptoms may be
non-specific. For this reason, it is important that health-care workers apply
standard precautions consistently with all patients – regardless of their
diagnosis – in all work practices at all times. These include basic hand
hygiene, respiratory hygiene, and the use of personal protective equipment
(according to the risk of splashes or other contact with infected materials),
safe injection practices and safe burial practices.
God help us!!!
References
https://web.stanford.edu/group/virus/filo/history.
http://en.wikipedia.org/wiki/Ebola_virus_disease
http://www.who.int/mediacentre/factsheets/fs103/en
