Ebola virus was first detected in the world in 1976 and since then the number of cases and the fatality rate associated with the disease has been on the rise. The most recent of the outbreak occurred in Guinea in 2013 and has spread to many countries including the Middle East. By the end of September 2014, there were around 7192 EVD cases and 3286 deaths. The case fatality rate of the disease has been reported to be near a whopping 90%. This means that in a group of 100 persons suffering from the disease, 90 persons will eventually die.
Transmission of EVD
Humans get infected through close contact with wild animals harbouring the virus. Examples of such animals include Chimpanzees, Gorillas, Monkeys, Fruit bats etc. Blood, secretions, organs of these animals are the medium through which the virus spreads to humans. Human to human transmission also happens through direct contact with contaminated bodily fluids, organs, blood. Contact with materials contaminated with an infected person’s secretions (like bedding, clothing) is also enough for transmission to take place. No transmission takes place through air, food or water.
Virus enters into our body through broken skin or through our mucous membranes (in nose, eyes, mouth). The virus remains in the blood and body fluids of the dead body even after death and hence there is a chance for infection even from corpses if proper precautions are not taken. This is also one of the main reasons why healthcare workers are more prone to the disease than the general population.
Symptoms of EVD
Initial symptoms of the EVD are just like a flu with fever, malaise, headache, sore throat. Then diarrhoea, vomiting can occur followed by rashes, muscle pain, joint pain. Some cases are characterised by both internal and external haemorrhages (bleeding) with symptoms of blood in stool, gum bleeds etc. The Incubation Period (the time taken from the entry of the virus into our body to the presentation of first symptom) is 2 to 21 days. Confused? It simply means that if a person comes in contact with an infected person (EVD case), it can take up to 21 days for the symptoms of EVD to appear in the first person.
Tests for EVD
Clinical signs of liver and kidney damages along with laboratory work up can help in diagnosing the disease. Low platelet and white blood cell count is usually seen. The usual confirmatory tests of EVD are the ELISA test, Electron Microscopy test, RT-PCR test etc.
|Electron Microscope view of Ebola virus
Image courtesy – CDC
Treatment of EVD
One of the modt unfortunate things about EVD is that no proven treatment is available as of this day. Strict isolation of the patient is a must before treatment. Conservative and symptomatic treatment are the current management options. Rehydration of the patient with oral or intravenous fluids is necessary. Blood products are also required in case of bleeding tendencies. No effective vaccines have been found yet.
Ebola vs India
Some of the facts which every Indian should know are as follows :-
- India is a densely populated nation with an estimated 1.28 billion inhabitants.
- India has never had an outbreak of EVD and hence our population has no immunity of any sorts against the virus.
- There are an estimated 45000 Indians living in the Ebola hit countries which includes Liberia, Sierra Leone and Nigeria.
Keeping these facts in mind, let us now learn how to prevent the virus importation.
How to prevent the import of Ebola virus to India?
Apart from this New Delhi airport incident, no case of EVD has been reported in India so far. Some of the basic measures which needs to be implemented includes –
- All major airports and seaports should be equipped with proper resources for the screening and quarantine of suspected persons returning home from the Ebola hit countries.
- Separate buildings or facilities needs to be setup for the quarantine of persons with EVD like symptoms.
- They should strictly be quarantined until their blood diagnostic tests results comes as negative.
- Health education about EVD is also necessary inorder to make the community aware of their responsibilities.
Controlling an Outbreak
May the merciful God be kind enough to protect us from an Outbreak because if an outbreak does happen, 9 lout of 10 affected persons will die. In case of an outbreak, the following steps needs to be considered –
- First thing that needs to be done is to isolate the patients and manage them in a separate facility.
- Contacts of all these patients should be traced and their health should be monitored for 21 days.
- Proper Universal precautions should be strictly followed by all the healthcare workers. Extra personal precautions should be taken when giving care to proven cases of EVD.
- Proper burial systems needs to be implemented.
- A good laboratory where sample testing can be done accurately is vital.
- Community awareness programmes needs to be carried out and healthy persons in the community should be separated from the suspected/infected persons.
By following the steps mentioned in the “How to prevent the import of Ebola virus” and “Controlling an Outbreak” any nation can prevent this deadly disease. On May 9th of 2015, WHO declared Liberia as Ebola free. Let us not wait for an outbreak to happen and then try to control it. Let us act well in advance and be prepared so that when that dreadful day comes, we have the guns and cannons to defeat the “Ebola” .