Be on the Alert: Ebola Information

In a public post on the Jamaica Infomation Service (JIS) website Jamaica should be on the lalert for ebola. There are no reported cases of the Ebola virus in Jamaica at this time. The Ministry of Health has ultimate oversight for the surveillance and response strategies to any possible cases of the virus in Jamaica.

What is Ebola?
Ebola, formerly known as Ebola haemorrhagic fever, is a viral illness that is often severe and fatal in humans. According to the World Health Organisation, WHO, the initial symptoms include fever, weakness, muscle pain and sore throat, all of which can be overlooked as symptoms of common illnesses.

However as the virus spreads through the body the symptoms become more acute and include vomiting, diarrhoea and – in some cases – both internal and external bleeding.

Ebola has a mortality rate of 90%.

While Ebola outbreaks usually occur in remote villages in Central and West Africa, near tropical rainforests, accelerated global travel has increased the risk for the virus to present itself in countries where Ebola was not previously a health risk.

As a result several countries are making preparations to respond to any possible Ebola cases to prevent further human-to-human transmission.

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How is Ebola spread?

 Animal-to-Human

Fruit bats of the Pteropodidae family are considered to be the natural host of the Ebola virus. In Africa, the virus is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals, usually infected chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest.

Human-to-Human

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. The virus can also be transmitted from deceased Ebola patients to mourners who have direct contact with the body during burial ceremonies. Men who have recovered from the disease can still transmit the virus through their semen for up to 7 weeks after recovery from illness.

Symptoms

Initial symptoms of Ebola include:

• Sudden fever
• Intense weakness
• Muscle pain
• Headache
• Sore throat

This is followed by:

• Vomiting
• Diarrhoea
• Rash
• Impaired kidney and liver function
• Internal and external bleeding

Persons should bear in mind that even after someone has commenced treatment for the virus or has ceased to experience these symptoms, they can still transmit the virus. People are infectious as long as their blood and secretions, including semen, contain the virus. Ebola has an incubation period, i.e. time between infection and symptoms, of two to 21 days.

Prevention

Here are some steps that can be taken if there is an Ebola alert in your area:

• 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.
• People who have died from Ebola should be promptly and safely buried.

For healthcare workers:

• 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 as initial Ebola symptoms may be non-specific.

• These include basic hand hygiene, respiratory hygiene, 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.

• Health-care workers caring for patients with suspected or confirmed Ebola virus should step up infection control measures to avoid any exposure to the patient’s blood and body fluids.

• When within 1 metre of patients with Ebola, health-care workers should wear face protection (a face shield or a medical mask and goggles), a clean, non-sterile long-sleeved gown, and gloves (sterile gloves for some procedures).

• Samples taken from suspected human and animal Ebola cases for diagnosis should be handled by trained staff and processed in suitably equipped laboratories.

Treatment

Standard treatment for Ebola is still limited to supportive therapy. This consists of:

• balancing the patient’s fluids and electrolytes
• maintaining their oxygen status and blood pressure
• treating them for any complicating infections

Timely treatment of Ebola HF is important but challenging since the disease is difficult to diagnose clinically in the early stages of infection. Because early symptoms such as headache and fever are nonspecific to Ebola, cases of Ebola HF may be initially misdiagnosed.

Current Global Situation

• An epidemic of Ebola virus disease (EVD) is ongoing in West Africa. It is the most severe outbreak of Ebola yet recorded in regard to the number of human cases and fatalities, since records began in 1976. The outbreak began in Guinea in December 2013 but was not detected until March 2014, after which it spread to Liberia, Sierra Leone, and Nigeria.
• In August 2014, the World Health Organization (WHO) reported a total to date of 1,975 suspected cases and 1,069 deaths (1,176 cases and 660 deaths being laboratory confirmed), and formally designated the outbreak as a public health emergency of international concern.
• This is a legal designation used only twice before (for the 2009 H1N1 (Swine Flu) pandemic and the 2014 resurgence of polio) and invokes legal measures on disease prevention, surveillance, control, and response, by 194 signatory countries.
• Researchers believe that the first human case of the Ebola virus disease leading to the 2014 outbreak was a two-year-old boy who died on 6 December 2013, a few days after falling ill in the Guinean village of Guéckédou. The virus went on to kill his mother, grandmother and siblings.