The largest Ebola epidemic in history began with a simple act of caring for a child. Soon, it spread from the child's remote village in Guinea. Scientists predict as many as 1.4 million people could be infected. Critics say reaction to this epidemic has been too slow or efforts to fight its have been too scattered. The little boy died after suffering from four days with an unidentified hemorrhagic fever. The mother died seven days later and the sister pasted away the following week.
Ebola is a potentially deadly virus that can be transmitted either by directly via contact with a contaminated environment surface, or object. Blood, feces, and vomiting are the most infectious bodily fluids, with a risk of saliva and tears being infected. (World Health Organization, 2014). Basic intervention can be used if the virus is caught early enough to increase the chances of survival, which is currently about 50 % ( World Health Organization, 2014). On September 25th, 2014, days after returning to the U.S. from Liberia, a patient sought medical attention at Texas Health Presbyterian Hospital regarding a fever, adnominal pain, and a headache. The patient was released do to a sinusitis problem. Three days late the patient returned to the hospital by ambulance with the previous symptoms accompanied by diarrhea. The patient was admitted and tested for Ebola. On September 30th, 10 days after returning to the U.S. the patient was officially diagnosed with Ebola (Center for Disease Control, 2014).
Ebola was considered an epidemic in Guinea, Liberia, and Sierra Leone, accounting for 11,300 deaths (CDC-Newsroom, 2016). The health care system in West Africa is extremely limited study finds. Liberia has 0.014 physicians per 1,000 people; Sierra Leone's is 0.022 and Guinea's is 0.1 physicians per 1,000 people. In contrast, the United States, has 2.5 doctors per 1,000 people. Tom Geisbert, a professor of microbiology and immunology at the University of Texas Medical Branch, Galveston, gets a 26 million grant from the National Institutes of Health to study treatments for Ebola and Marburg viruses.
Two and a half months go by, and it is only now that hospitals and public health services alert the Ministry of Health in Guinea and Medicines sans (MSF) also known as Doctors without Borders about the disease clusters. The Guinea Health Ministry starts tracing the outbreak in Macenta . They take blood and stool samples but not in a "systematic fashion" non with patients consent. They search for the animals that was the origin of the virus, fruit bats are suspected. Senegal closed the borders with Guinea. MSF sends 60 field workers to Guinea to help stop the outbreak as a part of their emergency response. Some 24 doctors, nurses, logisticians, hygiene and sanitation experts are already in country working with the epidemic. As of June 30, MSF has sent more than 300 staff members and 40 tons of equipment and supplies to the region to help fight the epidemic. Uganda announces new measures to screen arriving from Ebola-affected countries.
The CDC emphasizes there is little risk from Ebola to the U.S. general population, but with global travel in mind, it send a health alert notice. The notice reminds health care workers to take precautions, to prepare for the remote possibility that one of those travelers could get Ebola and return to the U. S. while sick. Health car workers should ask about a patient's travel history, know the symptoms of Ebola and know about infections control. A panel of global experts, convened by the Harvard Global Health Institutes and the London School of Hygiene and Tropical Medicine strongly criticized the WHO saying it mishandled the response to the Ebola outbreak. They called the response an, "egregious failure" and pointed to a delay in sounding the alarm.
References:
Christensen, J & Goldschmidt, D. "Out of Control", How the World reacted as Ebola spread, CNN
CDC-International Infection Control Team
CDC-Division of Global Migration and Quarantine and International Border Team
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Response TWO
Ebola Virus Disease (EVD) is an acute, serious illness which is often fatal if untreated. This disease first appeared in 1976 in 2 simultaneous outbreaks in Nzara, South Sudan, and the other in Yambuku, Democratic Republic of Congo. The disease takes its name from the latter outbreak which occurred in a village near the Ebola River. Transmission to humans occurs through close contact with the blood, secretions, organs or other bodily fluids of infected animals such as chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest. Ebola then spreads through human-to-human transmission via direct contact (through broken skin or mucous membranes) with blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials contaminated with these fluids (Nault, 2014).
An outbreak in West Africa in 2014-2016 was the largest and most complex Ebola outbreak since the virus was first discovered in 1976. In this outbreak the cases and deaths were more than all other outbreaks combined and it spread between countries, starting in Guinea then moving across land borders to Sierra Leone and Liberia. On September 30, 2014 the CDC confirmed that 1 patient in Dallas, Texas, who had returned to the United States after traveling to Liberia days earlier, tested positive for the Ebola virus. 4 patients in all were diagnosed with the Ebola virus in the United States and one died. Three of those diagnosed were health care workers, two whom provided intensive care to the first patient diagnosed in the United States (Karwowski et al., 2014).
In reading about the Ebola scare in the United States I had many questions about the investigation and whether the public health and medical professions involved followed proper protocol. Although some best practices were used by the public health and medical professions such as placing the first patient in a private room, using standard droplet and contact precautions, identifying those potentially exposed, monitoring of contacts etc., multiple opportunities existed for transmission of the Ebola virus to healthcare workers. An investigation of this outbreak found three findings that were identified as missed opportunities for transmission of the Ebola virus. First, failure of the hospital to quickly identify patients with Ebola virus caused delay in transfer to Ebola treatment units (ETU). Secondly, it was found that the hospital failed to monitor the ETU staff for fever and symptoms and therefore health care workers could become infected and it go undetected. Third finding was that all hospital staff including ETU staff had access to hospital facilities such as eating areas, bathrooms, showers, and work stations and physical contact between staff members in this area was reported. These areas should have been segregated as transmission between an infected but undetected coworker could occur. Following this investigation several action items were identified such as prompt identification of possible Ebola virus patients and safe isolation, training of health care workers to recognize symptoms of Ebola, availability of personal protective equipment to staff that is suitable in protecting themselves from the transmission of the virus. Also identified were the need to separate ETU and hospital staff to minimize transmission of Ebola to health care workers and to monitor ETU staff for fever and symptoms of Ebola virus. Preventing transmission of Ebola by rapidly identifying and isolating patients is essential to prevent further transmission. Hospitals must prevent exposures of health care workers and reduce the risk for Ebola virus infection of health care workers. This must continue to be a high priority in halting the transmission of Ebola and maintaining adequate care for Ebola patients (Forrester et al., 2014).
References
Forrester, J. D., Hunter, J. C., Pillai, S. K., Arwady, M. A., Ayscue, P., Matanock, A., … DeCock, K. M. (2014). Cluster of Ebola Cases Among Liberian and U.S. Health Care Workers in an Eb...: Multi-Search.Morbidity and Mortality Weekly Report, 63(41), 925–929. Retrieved from https://eds-a-ebscohost-com.ezproxy.snhu.edu/eds/pdfviewer/pdfviewer?vid=4&sid=370114a1-abf9-4fa2-ab24-0303bc1c59e6%40sessionmgr4009
Karwowski, M. P., Meites, E., Fullerton, K. E., Ströher, U., Lowe, L., Rayfield, M., … Van Beneden, C. (2014). Clinical inquiries regarding Ebola virus disease received by CDC--United States, July 9-November 15, 2014. MMWR: Morbidity & Mortality Weekly Report, 63(49), 1175–1179. Retrieved from http://ezproxy.snhu.edu/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103865283&site=eds-live&scope=site
Nault, D. S. (2014). EBOLA: What Nurses Need to Know. Michigan Nurse, 87(6), 10–15. Retrieved from http://ezproxy.snhu.edu/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103862637&site=eds-live&scope=site
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