The Ebola threat

WITH WORLD Health Organization director-general Dr. Margaret Chan issuing an ominous warning that the Ebola virus outbreak in West Africa is moving faster than efforts to contain it, the world may be on a verge of global outbreak that has only been seen in movies.

With 729 deaths from the virus—as of last official published count—and almost 1,500 with confirmed and suspected infections, the virus has spread in at least five countries. Efforts to curb the spread has been very hard for health officials as some health workers end up being infected as well. Add to this the statement of Dr. Chan that the outbreak is “caused by the most lethal strain in the family of Ebola viruses.”

According to the WHO factsheet, “Ebola virus disease (formerly known as Ebola haemorrhagic fever) is a severe, often fatal illness, with a death rate of up to 90%. The illness affects humans and nonhuman primates (monkeys, gorillas, and chimpanzees). It first appeared in 1976 in two simultaneous outbreaks, one in a village near the Ebola River in the Democratic Republic of Congo, and the other in a remote area of Sudan. The origin of the virus is unknown but fruit bats (Pteropodidae) are considered the likely host of the Ebola virus, based on available evidence.”

Human infection of the virus, the factsheet continued, is “through close contact with the blood, secretions, organs or other bodily fluids of infected animals. In Africa, infection has occurred through the handling of infected chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest. Once a person comes into contact with an animal that has Ebola, it can spread within the community from human to human. Infection occurs from direct contact (through broken skin or mucous membranes) with the blood, or other bodily fluids or secretions (stool, urine, saliva, semen) of infected people. Infection can also occur if broken skin or mucous membranes of a healthy person come into contact with environments that have become contaminated with an Ebola patient’s infectious fluids such as soiled clothing, bed linen, or used needles. Health workers have frequently been exposed to the virus when caring for Ebola patients. This happens because they are not wearing personal protection equipment, such as gloves, when caring for the patients. Health care providers at all levels of the health system—hospitals, clinics and health posts—should be briefed on the nature of the disease and how it is transmitted, and strictly follow recommended infection control precautions. 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. Persons who have died of Ebola must be handled using strong protective clothing and gloves, and be buried immediately. People are infectious as long as their blood and secretions contain the virus. For this reason, infected patients receive close monitoring from medical professionals and receive laboratory tests to ensure the virus is no longer circulating in their systems before they return home. When the medical professionals determine it is okay for the patient to return home, they are no longer infectious and cannot infect anyone else in their communities. Men who have recovered from the illness can still spread the virus to their partner through their semen for up to 7 weeks after recovery. For this reason, it is important for men to avoid sexual intercourse for at least 7 weeks after recovery or to wear condoms if having sexual intercourse during 7 weeks after recovery.”

The symptoms for infected with the virus include: sudden onset of fever, intense weakness, muscle pain, headache and sore throat are typical signs and symptoms. This is followed by vomiting, diarrhea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding.

Laboratory findings include low white blood cell and platelet counts, and elevated liver enzymes. The incubation period, or the time interval from infection to onset of symptoms, is from 2 to 21 days. The patient becomes contagious once they begin to show symptoms. They are not contagious during the incubation period. Ebola virus disease infections can only be confirmed through laboratory testing.

The Ebola outbreak is only one of the various viral outbreaks that seem to be happening at a break neck speed. However, this is one of the most serious as it has a fatality rate of 90%. Though international health officials have stopped short of cancelling flight to affected areas, several airlines have voluntarily stopped their flights to the Ebola outbreak countries. As it is, Philippine—as well as Ilocos Norte—health and airport officials should now also be more vigilant, especially if flights have either originated or stopped over the affected countries. Contingency plans should also now be drafted as it is really always better to be safe than sorry.