West Africa Ebola Outbreak Investigative Methodology Powerpoint

West Africa Ebola Outbreak 1

West Africa Ebola Outbreak

Joseph Toole

Principles of Epidemiology PHE 5015 S01

12 Jun 2016

Introduction

Around two years ago, there was worldwide uproar concerning Ebola. The outbreak had occurred in West Africa with individuals nations’ health departments stretched to the limit while trying to cope with the situation. Well wishing nations had to volunteer in terms of health practitioners and funds among other ways in order to assist the nations. Ebola is an infectious disease that is deadly discovered in Zaire in 1976. It is caused by Ebola virus which can be spread via contact with an infected person. Its spread it’s fast since contact with an infected person’s blood or body fluids. This paper will cover an overview of outbreak in 2014 in West Africa, observations, recommendations and conclusion.

Overview, Investigative methodology and rationale for the topic

The first outbreak of the epidemic was discovered in early 2014. It was reported in countries of West Africa namely: Sierra Lone, Guinea and Liberia. The three countries were the huge victims of the epidemic. Most of the victims of the outbreak died with a few survivors (CDC, 2016 n.d. - a). The reported symptoms among the victims were fatigue, fever, severe headaches, diarrhea, vomiting, abdominal pain and unexplained bleeding (CDC, 2016 n.d.-b). The symptoms are discovered roughly between 2 -21 days after infection. The methodology employed in order to determine the magnitude the outbreak encompassed different aspects. There was laboratory tests, study design and patients, data analysis and ethical considerations played a vital role. Study was carried out around the suspected victims. Lab tests were done via use of victim’s blood or oral swap. Ethical considerations were employed to determine the response of public health to the outbreak and contain it. Data analysis was vital in order to relate each case to a certain geographical location. Data from center for disease, World health Organization, European center for Disease prevention and control, National Institute of health will play a critical role in this paper since it will back up the facts presented. The rationale behind choosing the topic is to assist in comprehending the methods employed by epidemiologists in order to understand diseases in populations determine what disease is affecting the population and finally employ measures to treat as well as prevent its future occurrence.

Ebola in West Africa

Outbreaks in Africa have been reported as early as 2007. The ailment was previously known as Ebola hemorrhagic fever which is capable of affecting both humans and primates. It has a couple of species which include the Sudan virus, Reston virus, Bundibugyo virus, Tae Forest virus and Ebola virus. Reston is common in the monkey species. Few cases have been reported regarding the outbreak since it was discovered ranging from around 1-400 annually. For instance, in Gulu village in Uganda, there were 425 deaths following a small outbreak. In 2014 however, the course changed with 28,652 cases being reported by March 2014. As many people as 11, 325 succumbed to death according to reports in April 2016. There is no standard vaccine that can be used to combat the virus hence treating the virus depending on symptoms displayed in each case. Some treatment methods such as treating symptoms, intravenous fluids, maintenance of blood pressure and oxygen status are the common (CDC, 2016 n.d.-a).

Epidemiological methods used were an Ebola Response team which encompassed Incident Management System to control outbreak as well as coordinate with other committees in the outbreak control. The team included management teams, social mobilization teams, contact tracing teams, security, communication teams, case investigators and surveillance teams. The Ebola Response team was thus a taskforce which aimed at early identification of infection and control (PLOS, 2015). The World Health Organization had carried out a research in order to make certain that the outbreak and does not reach the rest of the world according to United States House of Representatives (2015). The concept of rapid spread from contact was what led to the research in order to come up with measures to control the spread. Mathematical methodology was employed to control the spread. Calculations were done of the areas in high risk of infection in order to employ early preventive measures. There were other methods used in order to understand Ebola, cure and control its spread. Studies done classified the virus in genus Ebola Virus and Filovirida and its control was termed as hard as only a short duration is required for the infection to react. An infected person can spread the virus to a population living around within 24 hours such as in a public gathering. Movement of infected population thus a good measure in order to curb the spread

In West Africa, the incubation period observed was between 9-12 days. In the past EVD as noted in the earlier part of the paper was around three weeks after coming into contact with the virus. An episode of the disease is reported after no new cases are recognized within 42 days after the last EVD case. By looking at each type of virus, the Ebola Zaire infection resulted to 69 to 88% infection rate. The Ebola Sudan, CFR of outbreaks extended from 53% to 69%. The Ebola Bundibugyo, the CFR episodes scaled from 34% to 42%. Roughly 70% of the affirmed cases wren due to Ebola Zaire with variations observed amongst the three most infected nations that is, Guinea, Sierra Leone and Liberia. In the Equatorial regions of West Africa, 69 affirmed cases were reported between the months July to October 2014 in Democratic Republic of Congo with CFR of 74% (WHO, 2016).

Pre-Ebola Performance

Prior to Ebola, the nations that were to later become victims were making progress in terms of economy. The countries exhibited rapid economic development as the countries were recuperating from the civil wars that were rampant in the countries. Liberia and Sierra Leone were some of the countries faced with the worst form of civil wars which caused the nation’s economy. Most of the citizens back then were living in poverty due to wars that destroy property and hindered recovery. The countries were thus faced with issues hence it was a time when they were recovering and building their economy while trying to catch up the lost time during the civil war. Liberia and Sierra Leone had previously been among the top ten in terms of GDP growth in the world. Such a move shows that the country was already putting effort towards the economy growth agenda. Guinea was not growing at the same rate but it was promising owing to the projects that it had undertaken. For example, the Simandou iron ore project was set to benefit the country where it would draw investors in iron mining to the country. Ebola outbreak thus created distraction from the development as resources were redirected towards containing the outbreak. According to IMF, the prospected GDP growth from Sierra Leone, Liberia and Guinea was 11.3%, 5.9%, 4.5% respectively which was fairly good for the economy of the countries. The outbreak led to revision in the rates where the percentages given was 8.0%, 2.5% and 2.4% respectively which is quite low from the previous projections (WHO, 2016). The projections depicted a slow down in the economy due to the outbreak.

Apart from the wide suffering and deaths of victims, the economy of the nations was greatly affected. The outbreak came during the planting season in countries which have agricultural output as the backbone of the economy. That means planting never happened as it should have or none happened at all. The yields from the agricultural fields were low such as yields in crops such as rice and maize. The economy was thus incurring a lot handling recurrent expenditure without any income from the expected areas. In response, the agricultural products rose in price to around 150% in line with the law of demand depicting a potential economic disaster. Less mining activities were carried given that mining played a critical role in the economy. Aspects such as travel restrictions slowed down the economic activities. There was massive decline revenues both in households and nationwide. Individuals could hardly engage in income generating activities as usual due hindrances brought about by the outbreak. For instance, less labor supplies, movement restrictions among others. At the national level, taxes, duties as well as tariffs reduced thus the government hardly had the income as it relied to such sources of revenue (Sy, 2014). Fiscal imbalances were evident due to need to fund health initiatives. At the international level, countries had already started banning travel to and from the areas. That means among others that tourism was greatly affected given the countries rely on tourism as a source of income.

Recommendations

To reduce the spread, it’s vital to have a few considerations. It’s vital to have knowledge of the symptoms and easy it is to control. The health practitioners involved should thus be well informed on the above information. Signs and symptoms such as vomiting, fatigue, and muscle pain, headaches, and fever are what the practitioners should be cautious about. Monitoring the virus is vital to take intone consideration. Individual immune system is a determiner given that persons with strong system may sustain the virus for a while before displaying the symptoms. It is thus vital to take ach case study differently. It is preferable for infected persons to stay away from the rest in order to eliminate the chances of spreading the virus. In addition to that, research should be done in order to define the pattern of the infected persons. Pattern such as location where such a person interacted with others is vital as it’s a possible point of infection. It is thus possible to know the areas to be potentially infected and take measures to control (Bah Marc, et al 2015).

Ebola is infectious especially after one comes into contact with the virus especially from interaction with an infected person. For instance, a family member can get it as a result of taking care of a sick person. Similarly, a doctor can get infected if the doctor fails to take the measures that are required in handling the patients. It is thus advisable for health care personnel to take measures before getting into contact. In terms of patient placement in a hospital facility, its advisable to have each patient housed in private room which has the entire patient requires such as bathrooms and such a room properly closed. A log should be maintained of all persons that are going into the room in order to make it easier to detect the infection at the early stages. In terms of equipment, Proper medical equipment should be employed in the health care provision. The most preferred equipment is the disposable ones since they reduce the risk of infection. In a situation where non-disposable equipment are used, it’s vital to properly disinfect and clean according to health facility policy or the description outlined by the manufacturer. The move will prevent infection from contact via equipment. When it comes to patient care considerations, use of sharp objects should be limited such as needles in order to avoid the contact with blood. In case the objects are supposed to be produced, the objects should be handled with care and disposed in a sealed container which can’t leak. In an EVD case, Aerosol Generating Procedures are highly not recommended and if used, measures to reduce exposure are advisable in order to curb the spread. Environmental surface cleaning is also required for proper infection control. Hand hygiene is required and should be frequent before and after contact with patient and infected material (Dramowski, 2015). A health care facility should ensure supplies to ensure hand hygiene are readily available. Each case of infection should be handled differently. Potentially infected personnel should be monitored. Persons who have come into contact with infected body fluid or blood should wash the exposed areas with water and contact health care personnel immediately. The move will assist in employing post-exposure measure such as testing and evaluation. Such a person should comply with required measures until declared free of infection. Follow up of the 21 days in required in order monitoring the health of the person. Visits to infected person should be avoided unless with permission from health care personnel which differ on case to case basis.

Conclusion

In conclusion, Ebola is one of the most deadly outbreaks that have led to widespread suffering in Africa and particularly West Africa. Countries such as Liberia, Sierra Leone, and Guinea among others have counted huge negative impacts. The three were the most affected nations. There are various species of Ebola namely: Ebola Zaire, Ebola Sudan, Ebola Bundibugyo and Tae Forest Ebola and Reston Ebola. In West Africa, the most notable species was Ebola Zaire which accounted for around 70%. Fatalities cases were around 11,000 with infection cases of around 28,000 persons reported (WHO, 2016). The effect of the virus was also felt in other areas such as economy with economic slow down in the affected areas due to hindrances of the outbreak. The outbreak led to creation of Ebola Response team which had the mandate to identify, treat, control and prevent possible infection. Some of the recommendations are advisable both at health care facility level and individual level. Health care personnel should be well versed with its symptoms and control prevention strategies. Hygiene is key with proper cleaning of contact surfaces and disinfection advised. Disposal of infected material should be following the policies and minimal contact with infected persons should be followed. With such measures followed, it’s possible to control the spread of the virus and eliminate it completely.

References

Bah Marc, A., Verjee, N., Mogaka, S., & World Bank. (2015). the Challenge of Stability and Security in West Africa. Retrieved from http://www.worldbank.org/en/topic/fragilityconflictviolence/publication/the-challenge-of-stability-and-security-in-west-africa

CDC (2016 n.d a). 2014 Ebola Outbreak in West Africa. Retrieved from http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/index.html

CDC (2016 n.d b). Signs and Symptoms. Retrieved from http://www.cdc.gov/vhf/ebola/symptoms/index.html

CDC (2016). 2014 Ebola Outbreak in West Africa. Retrieved from http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/index.html

Dramowski, A. (2015). Ebola Prevention and Control. Stellenbosch: Bettercare.

PLOS (2015). Epidemiological and Surveillance Response to Ebola Virus Disease Outbreak in Lofa County, Liberia. Retrieved from http://currents.plos.org/outbreaks/article/epidemiological-and-surveillance-response-to-ebola-virus-disease-outbreak-in-lofa-count-liberia-march-september-2014/

Sy, A. (2014). Understanding the Economic Effects of the 2014 Ebola Outbreak in West Africa. Retrieved from http://www.brookings.edu/blogs/africa-in-focus/posts/2014/10/01-ebola-outbreak-west-africa-sy-copley

United States House of Representatives. (2015). Combating Ebola in West Africa: The International Response: Hearing before the Committee on Foreign Affairs. Retrieved from http://docs.house.gov/meetings/FA/FA00/20141113/102732/HHRG-113-FA00-Transcript-20141113.pdf

WHO | Origins of the 2014 Ebola epidemic. (2016). Who.int. Retrieved from http://www.who.int/csr/disease/ebola/one-year-report/virus-origin/en/