An American doctor by the name Craig Spencer tested positive for Ebola after returning from West Africa. Spencer was working in Africa whereby he treated different Ebola patients. Craig Spencer was working in West Africa with Doctors Without Borders (DWB). The positive test caused a lot of concern in the country. The New York Government was also scrutinizing every individual who had interacted with Spencer in an attempt to deal with the disease (Sullivan & Ferris, 2014, p. 1). The article also explains how different New York officials began to prepare for the crisis. According to the article, the government was also identifying new measures to treat every Ebola patient in the country. The government also sent specialized teams from Centers for Disease Control and Prevention (CDCP) to New York. The American government was also undertaking new measures in order to deal with the disease. The government was monitoring every traveler from Ebola hit regions for a period of three weeks (Sullivan & Ferris, 2014, p. 2). According to Sullivan and Ferris (2014, p. 2), over 9,200 Ebola cases had been confirmed in eight nations across the globe . The highly hit nations included Guinea, Sierra Leone, and Liberia (Sullivan & Ferris, 2014, p. 2).
Relevance to Global Health Policy
The world is currently unable to deal with the problem of Ebola. The U.S. government has identified new measures and strategies that can address this global crisis (Ebola Characteristics, 2014). The article explains why the World Health Organization (WHO) and other international agencies s0.hould produce new treatment regimes for Ebola. Every government should promote the best health practices and control measures (Sullivan & Ferris, 2014, p. 1). The United Nations (UN) should revisit its Millennium Development Goals (MDGs) in order to deal with this threat. New researches will make it easier for the globe to support every country affected by this disease.
This article dwells upon the most recent trends in treating Ebola. Researchers have acknowledged the need to start trying several drugs in the treatment of patients suffering from Ebola to speed the development of effective drugs. The disease has already caused the deaths of 5,000 West Africans (Associated Press, 2014). It is still unknown which drugs will be used in the experiment but it is expected that researchers will agree on the matter during the American Society of Tropical Medicine and Hygiene conference that will take place In New Orleans in November 2014. It is expected that such an approach will help understand which drugs help and which harm patients. It is also noted that some scientists and healthcare professionals will be banned from coming to the conference due to safety reasons. These will be professionals who traveled to certain areas in West Africa during the last twenty-one day. Some of these professionals note that such measures are counterproductive as they contribute to the development of fear among people and this is the most dangerous thing. Ironically, fear makes people less attentive and more vulnerable. Moreover, the fear leads to various maternal issues, as many doctors in the area are afraid to do Caesarean sections since they are afraid of associated blood exposure.
Relevance to Global Health Policy
Ebola is one of the deadliest diseases as it kills between 25% and 90% of infected people. It also spreads rather quickly and is now found in such West African countries as Guinea, Liberia, and Sierra Leone. Due to globalization, the spread of such a virus is possible and there have been several cases in the United States and Europe. It is important to find an effective cure for this disease and prevent its spread.
Reference List
Associated Press. (2014, November 6). Health officials unveil a plan to test multiple Ebola drugs at once. Fox News.
The threat of Ebola has recently become one of the major concerns for many American medical workers and public administrators who want to eliminate even the minor risk of epidemic outbreak in the country. The instances of this disease have already been registered in the United States and this issue is widely discussed in various news reports.
One should note that these events have increased the concerns of many people who want to safeguard themselves against possible risks. On the whole, this case demonstrates that a healthcare problem can have profound implications for society and political life of the country.
In particular, the threat of Ebola has significantly increased peoples sense of insecurity. To some extent, this situation can be explained by the influence of mass media because journalists can profoundly shape the views of many people. Additionally, this risk has prompted governmental officials to consider restricting travel to and from countries which are badly affected by Ebola. So, this issue has affected the decisions of policy-makers.
On the whole, this issue has highlighted the need for cooperation between healthcare professionals and public administrators because these professionals have sufficient knowledge and expertise to address this problem. Moreover, this case illustrates the role of mass media that can shape the opinions of many people; yet, their influence may not be always beneficial. These are the main questions that should be discussed in greater detail.
It should be mentioned that in the early nineties, Ebola has been described as one of the major health risk, especially in the world that was becoming more and more globalized (Leach 488). There were many films that highlighted the dangers of this virus. For instance, it is possible to mention such works as The coming Plague and The Hot Zone (Leach 488).
One should keep in mind that the risks of Ebola did not attract much attention of people living in advanced countries because it could be observed primarily in African countries (Leach 488). Nevertheless, the situation changed dramatically, especially at the time when a patient infected with this virus came to the United States. Similar cases were registered in European countries as well. This is one of the reasons why this topic has attracted the attention of various stakeholders.
Thus, at the beginning, this problem only affected West African countries. However, it later became clear that even the United States cannot safeguard itself against the risks of this contagious disease. It should be mentioned that several years ago, Ebola was perceived mostly as a local disease (Leach 488). However, this situation has changed dramatically over the last two months.
Therefore, it is possible to argue that various diseases continue to have significant social implications that should not be disregarded by various stakeholders. One should also mention that some American policy-makers intend to impose bans on travel from countries such as Sierra Leone, Liberia, and Nigeria (U.S. Passports & International Travel). Thus, this issue has changed the relations between the United States and other countries. Thus, social and political impacts of Ebola cannot be disregarded by public administrators.
One should also point out that such events normally attract more attention of the mass media, even though there are more serious healthcare concerns such as malaria. Moreover, in many cases, journalists prefer to overlook the idea that the symptoms of Ebola can also be attributed to other diseases because this interpretation may not be of great interest to the public (Bergstrom 140).
Thus, reporters should remember about the impacts of their activities on the society, especially peoples behaviors. One should keep in mind that panic can often lead to hostility or even violence (Bergstrom 140). Certainly, journalists should help people make informed decisions; nevertheless, they should make sure that they do not mislead the audience into panic that can become even a greater threat to many people. This is one of the points that can be made.
Currently, medical workers want to make sure that people affected by this disease are identified as quickly as possible. Their main task is to limit the spread of this disease in the country (Centers for Disease Control and Prevention). In turn, this task can become particularly challenging in a very urbanized country such as the United States.
In particular, one should isolate each of the patients before he/she can contract a great number of people. If this goal is not achieved, the disease can spread at a very rapid rate. However, healthcare professional argue that this disease can be effectively localized (Centers for Disease Control and Prevention). Additionally, medical workers suggest that American citizens should refrain from travelling to West Africa.
One of the main threats is that in these countries, a person cannot always gain access to efficient medical assistance. As a rule, such individuals are at a greater risk of acquiring this disease that can be very deadly. In particular, they should bear in mind that currently there is no effective cure for Ebola (Centers for Disease Control and Prevention). These are the main details that can be distinguished because they are important for understanding the impact of Ebola on people living in the United States.
This threat has not affected me directly; nevertheless, I am familiar with people who seem to be too much concerned about Ebola. In particular, they tend to believe that practically every form of ailment such as high temperature or headache can be attributes to Ebola. It seems that me that such behavior is not always rational because there are greater threats than Ebola.
For instance, it is possible to mention the risk of cardiovascular diseases or diabetes that may also cause many deaths in the United States as well as other countries. Nevertheless, people seem to be less concerned about these issues. This is one of the points that can be distinguished because it can throw light on the irrationality of group behavior which is not necessarily based on logic and empirical evidence (Bergstrom 140).
Certainly, a person cannot remain indifferent of this issue, but one should not become obsessed with it. In turn, healthcare professionals also state that the fears of Ebola must not prevent medical workers from addressing other important problems such as HIV, malaria, tuberculosis, and other contagious diseases (Leach 489).
Thus, it is important to use resources very efficiently because this efficiency is vital for protecting public health. Moreover, researchers argue that the risks of panic can also be rather dangerous (Bergstrom 140). In some cases, this panic can result in the discrimination against people who may come from African countries (Bergstrom 140).
In the past, this behavior was observed in other countries, for instance, one can mention Canada where many African immigrants could face discrimination (Bergstrom 140). This is one of the pitfalls that should be avoided because it can result in many violent conflicts.
Overall, Ebola has highlighted the dangers of the modern health issues. The problem is that modern countries no longer seem to be isolated from one another. Due to the economic cooperation between countries, various contagious diseases can easily cross boundaries. This is one of the challenges that should not be overlooked. This is why it is important to provide necessary resources to people who struggle against such diseases.
These healthcare professionals are able to protect various stakeholders who may be living in different countries. Currently, they need to develop and implement procedures that reduce the threat of the epidemic outbreak. For instance, one can speak about EVD (Ebola Virus Disease) screening that can identify people who have acquired this disease (U.S. Passports & International Travel). This is one of the details that can be identified.
On the whole, this discussion indicates that the threats of epidemic can profoundly influence the experiences of many people. This situation can be partly explained by the fact that the threats of Ebola were widely publicized in mass media. The threats of Ebola can be effectively addresses provided that that medical workers use the necessary safety procedures in order to detect the cases of this disease at an early stage.
To a great extent, these professionals are also responsible for curbing panic and fears. This is one of the tasks that these people should perform to minimize the risk of various hostilities. Apart from that, the threats of Ebola have influenced the political and social life of the country. In particular, it increased peoples sense of insecurity and shaped the decisions of policy-makers. These are the main arguments that can be put forward.
Works Cited
Bergstrom, Kelly. Deadly fever: Racism, disease and a media panic. Canadian Journal of Communication, 38.1 (2013): 139-140. ProQuest.
Politics and the securitization of the threat of the Ebola virus have influenced responses in different ways. Decades of civil war in countries most affected by Ebola made the situation worse. Several villagers lack faith in governments and foreign healthcare workers. In Sierra Leone, the government is associated with corrupt practices, non-transparent dealings, and lies.
Some civilians claimed that both the government and healthcare workers were intentionally spreading the virus; the government wants to sell their blood or conduct rituals with patients body parts. Some claimed that the chlorine could be used to spread the virus, or the government simply invented the disease to get more donations. Other villagers chased away healthcare workers, rejected education on Ebola, and insisted on burying their dead according to the tradition.
Such suspicions complicated Ebola control and management.
When villagers feared that government and healthcare workers were part of the Ebola epidemic, they undermined all efforts to control the spread of the virus through isolation of infected persons. Even the WHO could only offer estimates on the numbers of Ebola casualties because it could not get actual data from any sources.
Hence, its power was equally limited. The WHO had provided the required recommendations to combat Ebola and outlined appropriate security measures to protect healthcare workers and patients. The government, however, did little or nothing to implement recommendations, protect healthcare workers, and quarantine areas.
In this case, politics and securitization play critical roles in responses to Ebola. The government reacted by declaring a state of emergency that was meant to impose strict quarantine. In many locations, however, the quarantine was not imposed as expected as villagers continued to roam freely and failed to understand its meaning.
The international community reacted in different ways. For instance, the US CDC (Center for Disease Control) provided regular updates on Ebola. Canada announced that it would not allow foreigners from Ebola-hit countries to enter its borders. Governors of New York, Illinois, and New Jersey declared their intentions to quarantine healthcare workers from West African countries with Ebola cases, while others opted for strict border controls.
The US also sent its military as a part of the securitization of Ebola. The role of the military is to ensure strict enforcement of quarantine. Consequently, many villagers could not understand why they were prohibited from moving.
In the case of West Africa, a lack of education made securitization worse. It led to a lack of trust between villagers and other stakeholders. As a result, many villagers shunned healthcare centers and providers. Securitization of Ebola did not take into account the culture of West Africans associated with touching the dead irrespective of the outcomes.
The responses offer critical implications for future approaches. Ignorance, misconception, and a lack of education were responsible for the widespread of Ebola. Effective, coherent politics and securitization of Ebola could have targeted these factors. There was a need to create awareness and educating the public about Ebola. A lack of information, behavior change, and attitudes hampered interventions. The public did not understand the facts about Ebola or practices that could have exposed them to infection.
It is the responsibility of the international community and the national stakeholders to ensure better practices in creating awareness and educating the public. There was a need for widespread education about Ebola, its existence, and its consequences. This is a targeted and responsible securitizing strategy, which could have reduced distrust between villagers and the government and foreign health workers and enhanced the global awareness about Ebola.
The Ebola virus is an elongated and filamentous virus, whose length ranges from 800nm to 1000nm. However, its length can extend to 14000nm as a result of concatamerization. The virus has a diameter of 80nm, which is normally uniform. The virus has a helical nucleocapsid, which has a diameter of between 20-30nm and a central axis.
On the outside, the virus is covered by a helical capsid that has a diameter of between 40-50nm and cross-striations measuring 5nm. The viral fragments are polymorphic in nature and can have varying shapes, some taking a U shape, a 6 shape, or they can be circular. These fragments are enclosed in a lipid membrane. Each virion always contains a negative-sense genomic viral RNA that is single-stranded.
Transmission
Whenever a new Ebola outbreak occurs, it is believed that the first patient that developed the disease must have had contact with an animal that was infected. Transmission between persons occurs when an uninfected individual has close personal contact with an infected person or body fluids from the affected person. Transmission normally occurs at the late stage of the disease or following the death of the affected individual. The risk of infection is high following handling deceased humans, mainly during funeral preparations.
In a controlled lab setting, exposure of non-human primates to aerosolized ebolavirus isolated from pigs resulted in an infection. However, no evidence has ever been published to show airborne transmission between primates. Viral shedding has also been described in rectal swabs and nasopharyngeal secretions of pigs when the animal was experimentally inoculated.
The disease has an incubation period of between 2-21 days, with an infectious dosage of between 1-10 organisms in non-human primates. In terms of disease communication, the disease can be spread as long as the body fluid, organs, or blood contains the virus. The virus has also been extracted from semen within 61-82 days following the onset of the disease. Transmission via semen has been shown to occur even seven weeks after total recovery from clinical symptoms.
The natural reservoir for the virus is still not known. However, the discovery of antibodies against the virus in the serum samples from wild cats and domestic guinea pigs suggests that these animals could be the reservoirs; however, this has not shown any relationship with the human transmission. Some species of bats are also thought to be natural reservoirs, as viral RNA and antibodies against the virus have been isolated from them.
The advantage of this disease and its mode of transmission is that it can only be transmitted by symptomatic patients. This is helpful because it allows health workers and the public, in general, to identify the affected persons, quarantine them, and handle them with uttermost caution.
This eventually minimizes incidences of new infections and rates of transmission, unlike the spread of diseases that are transmitted by asymptomatic patients, such as HIV/AIDS. The spread of such diseases is very high and difficult to control because the patients cannot be identified.
Signs and Symptoms
The virus enters the cells of the host organisms through the process of endocytosis. After entry into the cell, the virus starts its replication in the cytoplasm of the host cells. The virus impairs the host immune and coagulative blood systems following a successful infection, leading to fatal immunosuppression. The initial signs of the disease are always flu-like and non-specific.
They may include an acute onset of fever, headache, asthenia, myalgia, severe diarrhea, vomiting, abdominal pains, and arthralgia. Other symptoms that are likely to occur, though less often, include bleeding, sore throat, conjunctival injection, and development of rashes. Co-infections, such as cerebral edema, secondary bacterial infection, shock, and coagulative disorders, may occur in the later stages of the infection.
Almost all species of the virus, with the exception of Reston, result in hemorrhagic fever in both non-human primates and humans. These hemorrhagic fever symptoms always set in after 4-5 days following infection.
The symptoms include oral ulceration, pharyngitis, hemorrhagic conjunctivitis, bleeding gums, melena, hematemesis, epistaxis, hematuria, and vaginal bleeding. Other symptoms are likely to occur include marrow suppression, such as leucopenia and thrombocytopenia, hepatocellular damage, proteinuria, and transaminase elevation.
Terminally-ill patients always present with cases of anuria, tachypnea, obtundation, shock, ocular diseases, arthralgia, and normothermic to hypothermia symptoms. Hemorrhagic diathesis is often associated with renal failure, multi-organ failure, nervous system involvement, hepatic damage, and terminal shock.
Physical contact with the virus also results in other symptoms like malaise, acute viral illness, and maculopapular rash. If the infection occurs during pregnancy, the affected mother will always experience copious bleeding, followed by abortion of the fetus. The disease has a fatality rate that ranges between 50 and 100%. Most affected persons die from multisystem failure and hypovolemic shock.
Diagnosis and Treatment
Diagnosis can be either by the use of direct or indirect diagnostic tools, provided the lab is equipped appropriately. Indirect diagnosis involves the detection of antibodies against the virus, rather than the virus itself. Examples of such measures include the use of ELISA techniques to detect antibodies against the Ebola virus and indirect immunofluorescence to detect the anti-Ebola antibodies.
Direct diagnostic methods entail the detection of the actual virus or viral particles. Such methods include the use of RT-PCR to identify the viral RNA, and immuno-electron microscopy to identify the viral particles in the cells of body tissues. However, care should be taken to distinguish between the Ebola virus and Marburg virus because the two are very difficult to distinguish. Great caution should also be taken when handling the samples, as the virus is highly hazardous.
The main treatment strategy for Ebola is the provision of supportive care aimed at maintaining the functions of the body organs, maintaining the electrolyte balance, and combating associated shock, as well as hemorrhage. Up to date, there is no developed vaccine against the virus, with no effective antiviral treatment. There is no known prophylaxis; thus, management of the disease is limited to barrier-nursing and isolation.
Ebola in Texas
The first reported case of Ebola in the US revealed how health systems could make mistakes regarding the disease, which may contribute to its spread. At the Texas Health Presbyterian Hospital, for instance, the medical fraternity did give the condition the seriousness it deserved, despite the knowledge that the patient travelled from Ebola-hit countries.
Two serious mistakes were then committed. First, they allowed the patient to go back to the general public, even after showing Ebola-like symptoms. After indications that the case could be Ebola, they still admitted the patient in general wards, only to isolate the patient two days later. Such mistakes could have resulted in the spread of the condition to other American citizens.
Epidemiology
Currently, the disease is present in West African countries, namely Guinea, Sierra Leone, and Liberia. Other nations that had the disease, but are currently free from the hemorrhagic fever include Nigeria, Mali, Senegal, Spain, United Kingdom, and the United States of America. Normally, a nation is said to be Ebola-free when 42 days (a period that is twice the virus incubation period) pass without any new case of Ebola transmission being reported.
The days are counted from the time when the last patient that was quarantined tested negative for the virus. The US is confident that the Ebola virus will never be experienced in the nation again due to the nations improved surveillance programs, better preventive measures, including vigorous screening at the ports of entry, thorough training of medical staffs and public health officers, as well as confidence that a new vaccine against the virus will soon be discovered.
The spread of the disease will be high if the virus undergoes mutation and becomes airborne because even quarantine cannot contain a virus that can be carried around easily by free-flowing air. However, reporting of this possibility by a CNN News reporter is totally irresponsible because the reporter has no single evidence or fact to elaborate this assumption. Also, owing to the large proportion of people reached worldwide through CNN, such information can cause unnecessary anxiety among persons.
Reintegration of Ebola Survivors in the Community
The survivors of Ebola disease are always in fear of rejection and discrimination from the general public. Consequently, it is important for the survivors to undergo constant counseling before they are released back to their homes. There is also the need for the community to be informed thoroughly about the facts of Ebola through established programs to accept the victim back with confidence.
An example of such a program is the one applied by the Firestone District in Liberia. Preparedness is enhanced by teaching the community on the intentions of bringing the survivor back. The community members are also assured of their safety by answering questions from the general public. It also develops the required confidence to help the community fully integrate the victim. In the end, the survivor is welcomed and accepted fully in the community.
Ebola, as well as other health epidemics have always been put under control through the use of technology. In West Africa, information communication technology (ICT) played a significant role in the prevention and control of the virus. However, this technology was not fully utilized given the potential that it has. This paper will therefore expound on how ICT can be used in West Africa and the whole world in general to control future outbreaks of Ebola and other diseases by using approaches such as mapping and geomapping, digital training and data collection, wireless communication, and social media.
Introduction
Developing nations face a number of health challenges, including failure to control preventable diseases that result in premature deaths. In West Africa, for instance, the eruption of the Ebola virus resulted in the death of thousands of people before it could be put under control (Chetley, 2006). This high level of casualty is a result of inequality in the access to health care services, poor service delivery in the health care industry due to underfinancing, poor allocation of health care resources that tend to be scarce in these regions and the lack of proper coordination among key stakeholders in the process of identifying and controlling preventable diseases (Chetley, 2006).
Application of ICT in Health Care
The 20th century saw the introduction of ICT. However, it is in the 21st century, this technology has grown through innovative and creative advances. Technologies such as mobile communications, computing and broadband internet have made it possible to devise various epidemic and response strategies (Chetley, 2006). As asserted earlier, the health care industry has highly relied on technology to control and prevent health predicaments. However, the recent outbreak of Ebola in Western Africa showed the potential that ICT has in controlling and preventing predicaments. As asserted by Chetley (2006), the application of ICT cannot curb the spread or cure diseases, however, if it can be used effectively to educate, warn, and empower individuals regarding a specific disease, hence significantly reducing its spread and overall impact in a given society. This paper will cover five areas in which ICT can be used to achieve the above goals.
Mapping and Geolocation
The main challenge in previous health outbreaks has been the process of identifying patient zero, the places where infected individuals have visited and the individuals they have been in contact with. This was the case with the recent Ebola outbreak in West Africa. This is where geographical information systems techniques can be effectively applied. Through the use of mapping and geolocation, it is possible to get data with regards to the places and individuals whom infected individuals have been in contact with. This information is important in isolating individuals to safe environments, hence controlling the spread of an infectious disease (Luege, 2014).
Digital Training and Data Collection
In the process of collecting relevant information on a given health epidemic, it is important to conduct interviews. In the case of the Ebola outbreak in West Africa, this process was conducted manually and then the data was then entered into a computer (Luege, 2014). From a critical point of view, it is evident that this process is slow, tedious, and prone to errors. To overcome this challenge in future, digital forms have been developed. These digital forms are effective and efficient since enumerators can fill them using their mobile phones and can transmit this data remotely to tallying stations saving time and reducing errors.
At the same time, technological advancement in mobile computing has made it possible to train health workers remotely. This can be achieved using applications such as Oppia browser and e-Buddie that enables direct exchange of information (Koeleman, 2015). At the same time, the use of voice and video calls also play an integral part in the training exercise saving time and money as compared to direct training. This ensures that health workers have up to date knowledge, information, and skills that are necessary not control and prevent the spread of an infectious disease.
Wireless Communication
Outbreaks are usually characterized by intense isolation. This in turn makes it difficult, and so some extent impossible for loved ones who are isolated to communicate through each other. Given the fact that communication amongst individuals, especially loved ones is essential, it is important to ensure that various channels of conveying messages are available (Wilkins, 2014). The use of mobile messaging, wireless calls (VOIP) and social media can greatly enhance communication in such situations. In developing nations, however, access to such technologies might be difficult, hence local Wi-Fi networks can be set up to facilitate communication within specific areas.
Decimation of Epidemic Information
Various kinds of SMS sending and receiving information can be set up to ensure that real time information with regards to the spread of a given epidemic is conveyed within and out of the crisis zone. In West Africa, mHero was set up to convey Ebola updates among health workers within this region (Luege, 2014). This system works in conjunction with UNICEFs RapidPro system. The presence of effective and efficient communication systems is important, especially in ensuring ease of decimation of critical information. In an event of an Ebola outbreak, for instance, it is key to convey to the local population information on the appropriate precautions that they need to put in place to control and prevent the spread of the virus. Consequently, this portal can be used to send reminder messages to the local population on the same issue over and over again. Therefore, the use of SMS services will ensure that precise information is conveyed directly to the target population and appropriate measures taken.
The Use of Social Media
Social media is the most used platform by individuals and corporations for communicating and interaction purposes. Given the coverage that it has, social media can be influential in preventing and controlling the spread of health epidemics such as Ebola. At the present moment, however, only a small proportion of the West African population access to the internet, therefore making it not to be a useful tool as it should be for this purpose. Despite this fact, most of these individuals have huge diasporas. For instance, Liberia alone has approximately 450,000 diasporas living in the USA alone (Luege, 2014). These individuals have access to the internet and social media platforms and therefore, they are in a position to use social media to air the current situation in epidemic areas hence seeking international support.
Conclusion
While ICT cannot directly stop the spread of an epidemic, this approach can be used to significantly control this spread by generating and decimating critical information that can be useful in education and empowering individuals hence reducing the overall impact. Advances in ICT such as mapping and geolocation, the digital training and data collection, wireless communication, and the use of social media are examples of means through which this new avenue can be used to curb the spread of an epidemic by providing relevant information that on one part will enhance the preparedness of health workers to put under control the epidemic and on the other hand improve the preparedness of the local population educating and training them on the necessary precautions that they can take to prevent its spread.
References
Chetley, A. (2006). Improving health, connecting people: The role of ICTs in the health sector of developing countries: A framework paper. Web.
Koeleman, D. (2015). Four ways technology can help fight future epidemics. Web.
The emergence of new infectious diseases such as the Ebola virus has always put pressure on the health care systems resulting in high fatality rates. This disease is contagious and whose transmission depends on the interaction between the human host and an agent (CDC, 2021). This virus is classified in the filioviridae family and is responsible for destroying the blood clotting cells and weakening the immune system when someone is infected. Ebola was a contagious epidemic that affected many nations, including the Democratic Republic of Congo (DRC), Sierra Leone, Gabon, and Italy (CDC, 2021). Therefore, Ebolas pathophysiology, its negative impact on the community and remediation are elaborated.
Analysis of the Ebola Virus Disease
Ebola is a deadly disease that exhibits symptoms such as fever, body aches, diarrhea, external and internal bleeding. The infection is transmissible through direct contact with body fluids such as saliva, sweat, and blood. The virus was traced in the Ebola River in DRC after natives consumed the African fruit bat, which was identified as a reservoir for the virus (CDC, 2021). Considering the fact that the disease is contagious, it spread rapidly to other nations in that year, such as England and later on to Cote DIvoire, Senegal, Mali and Nigeria. This data indicates that this outbreak was a global pandemic that put pressure on the health system.
Various epidemiological and risk factors contributed to the spread of this virus. Among them was a lack of preparedness to counter an emergency and public health literacy on the best preventative measures. When Ebola hit the DRC, the country was underdeveloped and lacked the specialized equipment and infrastructure to contain the spread of infection (CDC, 2021). For instance, the traditional prevention method such as holistic care was practiced, making the tracing process impossible. For example, during the initial outbreak of the virus, nurses in one of the hospitals known as Yambuku mission hospital reused needles when the numbers of infected people kept surging due to a lack of equipment to contain its spread (CDC, 2021). Additionally, the treatment, management and evidence-based interventions to maintain safety were unknown.
Public health literacy was also a significant challenge considering that citizens did not know the transmission channels and were overly exposed to the transmitters. For example, even after the fatality rate increased, people still hunted for wild meat for consumption and fulfilled cultural ceremonies and rituals (CDC, 2021). This interaction still exposed them to the infection resulting in more deaths and infections. In addition, cultural practices such as burials exposed the people to the virus since many bathed their dead by hand and dressed them for burial without putting on protective clothes (CDC, 2021). The international health organizations quickly disregarded such practices, but the new measures were not observed.
Ebola virus diseases transmission route was the African fruit bat which carried the host, and when consumed, it caused the infection. Another transmission channel was the dead infected animal corpse which exposed the people to the virus when they came into contact with secretions, body fluids, and organs (CDC, 2021). Humans also transmitted the disease through direct contact with the infected persons blood, saliva, and mucous membrane.
The consequences of this infection on the community were detrimental, considering it deteriorated the peoples social, economic, and psychological wellness. When the infection rate became uncontrollable, many businesses closed down, and inflation became the new norm. In addition, most families could not fend for themselves, considering the majority of them lived below the poverty line (CDC, 2021). Such factors contributed to high rates of game meat hunting for survival, which worsened the situation. Another factor was a stigma for survivors who joined back after recovery since they were isolated and discriminated against as they were considered agents of transmission.
This negative stereotype affected mental wellness since many people became depressed for being isolated by the community. Additionally, the surge in the rate of infections put a strain on the healthcare system, with many health care providers experiencing burnout and uncertainty for their health, considering many hospital staff also got infected (CDC, 2021). The aftermath of this infection had consequences that took long before the country could recover from the negative impact. Fortunately, specific interventions could help curb the spread of the disease, including using the Integrated Disease Surveillance and Response (IDSR), enhancing public health literacy and promoting better health practices.
One viable reporting system is the IDSR that enables the health departments and concerned individuals to report any infectious disease outbreaks. The system is anonymous and actively operational, indicating that it is accessible to everyone. Other prevention strategies include public health literacy educating natives on the transmission channels, the symptoms, signs and possible interventions to ensure they seek help at the early stages of infection (CDC, 2021). Additionally, encouraging better health practices such as avoiding consumption of game meat, washing hands regularly, avoiding contact with infected individuals and places may help reduce future outbreaks (CDC, 2021). The government should also invest in personal protective equipment to help protect healthcare workers from infections when such pandemics occur. These interventions will ensure that people know the basics of maintaining safety to curb the spread during an outbreak.
Ebola Virus Disease (EVD) is an acute natural focal zoonotic viral infection characterized by febrile intoxication syndrome, phenomena of universal capillary toxicosis with a severe hemorrhagic syndrome, multiple organ lesions, and a high mortality rate. According to the antigenic properties of glycoproteins (GP), there are five types: Bundibugyo ebolavirus (BDBV), Reston ebolavirus (RESTV), Sudan ebolavirus (SUDV), Tai Forest ebolavirus (TAFV), and Zaire ebolavirus (EBOV) (Hu et al., 2017). Four of them cause diseases of different severity in people in Africa (TAFV lethality 0%, BDBV lethality up to 30%, SUDV lethality up to 50%, EBOV lethality up to 90%) (Caviness et al., 2017). Zaire ebolavirus is considered a type species of the genus. Manifest cases of RESTV disease, highly pathogenic for monkeys, have not been identified in humans.
People become infected with the Ebola virus through either contact with infected animals (usually after slaughtering, cooking, or eating) or contact with body fluids from infected people. Most cases are caused by human-to-human transmission, which occurs when blood, other fluids, or secretions (feces, urine, saliva, semen) from an infected person enter a healthy person through damaged skin or mucous membranes. Infection can also occur when damaged skin or mucous membranes of a healthy person come into contact with objects or the environment contaminated with an infected persons body fluids. These can include soiled clothing, bedding, gloves, protective equipment, and medical waste, such as used hypodermic syringes.
Classification
Class: Monjiviricetes
Order: Mononegavirales: RNA viruses with contiguous genomes
Family: Filoviridae
The Ebola virus belongs to the filoviridae family. The family name comes from lat. Filum, a filament, and reflects the morphology of virions. The family includes two genera: Marburgvirus and Ebolavirus. Viruses of this family cause severe hemorrhagic fevers, often fatal. The filoviridae virion has a lipid envelope and the form of twisted filaments 600800 nm long and 50 nm thick. The nucleocapsid is a complex of viral RNA and four structural proteins: NP (nucleoprotein), VP30 (viral polymerase co-factor), VP35 (phosphoprotein), and L (viral RNA-dependent RNA polymerase) (Kuhn et al., 2019). Three structural proteins are associated with the virus membrane. Two of them, VP24 and VP40, are located on the inner side of the membrane and play the role of matrix proteins, while the surface GP-complex, consisting of two subunits (GP1 and GP2), forms the outer spines of the virion (Kuhn et al., 2019). The filoviridae genome is a single-stranded RNA of negative polarity, about 19,000 base pairs in size, flanked by conserved non-coding regions. The genome contains seven open reading frames one for each gene.
Species: Ebolavirus
The virion has the form of long filaments, variously twisted (V-shapes, the shape of the number 6 or spiral shapes), 70-100 nm in diameter, and 974-1086 nm in length. The nucleocapsid consists of a central axial filament with a diameter of 40-50 nm. The genome is represented by a single-stranded negative RNA (18959-18961 nucleotides) surrounded by a lipoprotein membrane with spikes 7-10 nm long. The virus contains seven structural proteins (NP, VP35, VP40, GP, VP30, VP24, L) (Zinzula et al., 2019). Viruses from the genus Ebolavirus are similar in morphology to Marburg marburgvirus but differ in antigenic structure. The viruses are highly variable: under laboratory conditions, cultures of the pathogen are maintained by the passage in cell culture of guinea pigs and Vero with a mild cytopathic effect (Caviness et al., 2017). Viruses have an average level of resistance to damaging environmental factors. The virus persists at -20 ° C throughout the year (Caviness et al., 2017). At 4 ° C (in the refrigerator when storing donor blood), viruses pathogenic properties do not decrease within five months. Viruses are resistant to ultraviolet radiation. They are reliably inactivated by formalin and 0.5% chloramine B when mixed with culture 1: 1.
References
Caviness, K., Kuhn, J. H., & Palacios, G. (2017). Ebola virus persistence as a new focus in clinical research. Current opinion in virology, 23, 43-48. Web.
Hu, J., Jiang, Y. Z., Wu, L. L., Wu, Z., Bi, Y., Wong, G.,& & Zhang, Z. L. (2017). Dual-signal readout nanospheres for rapid point-of-care detection of ebola virus glycoprotein. Analytical chemistry, 89(24), 13105-13111. Web.
Kuhn, J. H., Amarasinghe, G. K., Basler, C. F., Bavari, S., Bukreyev, A., Chandran, K.,& & Griffiths, A. (2019). ICTV virus taxonomy profile: Filoviridae. The Journal of general virology, 100(6), 911-916. hWeb.
Zinzula, L., Nagy, I., Orsini, M., Weyher-Stingl, E., Bracher, A., & Baumeister, W. (2019). Structures of ebola and reston virus VP35 oligomerization domains and comparative biophysical characterization in all ebolavirus species. Structure, 27(1), 39-54. Web.
The population that is most impacted by the Ebola virus disease (EVD) includes the residents with the lower socio-economic status of underdeveloped countries of West Africa. This selected population resides in such countries as Sierra Leone, Liberia, Guinea, Senegal, Nigeria, and other countries in the western part of Africa. These countries are highly populated and demonstrate a continuously high birth rate.
The majority of people dwell in rural locations, which are distributed unevenly across the land; however, the number of urban inhabitants rises (“West Africa: Land use and land cover dynamics,” n. d.). The population pyramid characterizing these countries is wide at the basis and narrows toward the top, which indicates the prevalence of younger individuals. People from West Africa are highly mobile in terms of crossing borders, follow customs and traditions, and adhere to traditional healing methods.
Disease Description
The EVD is a severe infectious disease that has a high level of rapid inflammation and is characterized by a high rate of mortality. The symptoms of the illness include fever, significant fluid loss, diarrhea, and vomiting. The EVD prevails in vulnerable populations, including those inhabiting tropical countries and those of lower-income status. The rates of fatal cases vary from 41% to 84%, depending on a type of virus and a country (Okeke, 2019, p. 1).
The aftermath of the Ebola outbreak in 2014-2016 demonstrates that 11,325 deaths were registered worldwide (Okeke, 2019, p. 2). The animal-borne virus is transmitted from human to human. According to Alexander et al. (2015), “virus invasion in humans appears to occur through mucosal surfaces, breaks, and abrasions in the skin, or parenteral introduction” (p. 3). Thus, it is a viral disease that imposes a significant threat to global health.
Description of Potentially Relevant Cultural Factors Related to the Disease
Among cultural factors that might contribute to the outbreak of the EVD are several issues specific to the selected population. Firstly, since in West Africa women commonly act as caregivers to the ill, they become more exposed to the infection (Okeke, 2019). Secondly, the majority of West African residents seek health care from traditional healers, which leads to the neglecting of the symptoms, inadequate treatment, and further spread of the illness. Thirdly, the burial customs that involve washing corps and rinsing with that water is a substantial determinant of the EVD transmission (Okeke, 2019). Finally, the overall fear of people being stigmatized due to being infected leads to their concealing of the symptoms and ultimately causes a viral spread of the disease.
Environmental and Social Factors
Some determinants derived from the environment, economy, and infrastructure are also associated with the disease spread. The tropical climate characterized by high temperatures contributes to the vital conditions necessary for the virus to survive. As for socio-economic determinants, poverty imposes significant constraints to the treatment options, as well as exposes people to living in unsanitary conditions that facilitate the spread of the infection (Alexander et al., 2015).
As Richards et al. (2015) state, the continuous civil conflicts on the territories of West Africa constrain the development of the health care system, among other issues, and aggravate the problem. Also, the prevalence of rural areas of inhabitance is a significant environmental factor because once the EVD infects people of an isolated village, insufficient care is provided, and the spread of the disease is enforced (Richards et al., 2015). Finally, the combination of rapid population growth and inadequate health care infrastructure does not allow for implementing necessary preventative and curing interventions to avoid the fatalities caused by Ebola (Okeke, 2019). Thus, it is essential to consider all these factors when tackling the problem of EVD in the defined population.
References
Alexander, K. A., Sanderson, C. E., Marathe, M., Lewis, B. L., Rivers, C. M., Shaman, J., … & Eubank, S. (2015). What factors might have led to the emergence of Ebola in West Africa? PLoS Neglected Tropical Diseases, 9(6), e0003652, 1-26.
Okeke, A. (2019). Socio-cultural determinants of spread of Ebola outbreak in West Africa 2014-2016: Lessons learnt. Asian Journal of Research in Infectious Diseases, 2(2), 1-6.
Richards, P., Amara, J., Ferme, M. C., Kamara, P., Mokuwa, E., Sheriff, A. I., … & Voors, M. (2015). Social pathways for Ebola virus disease in rural Sierra Leone, and some implications for containment. PLoS Neglected Tropical Diseases, 9(4), e0003567, 1-15.
West Africa: Land use and land cover dynamics. (n. d.). Web.
The ELISA test on the “Ebola virus” was performed. In general, 25 students’ “blood” samples were tested. Initially, only two of them contained “the infection”. However, after samples mixing “Ebola virus” became spread among half of the population. For the determination of “infected” samples, the standard indirect ELISA protocol was used. Positive and negative controls confirmed the veracity of the obtained results. The purpose of the analysis was to estimate the initially “infected” samples. Accomplishing this, the analysis of the samples’ mixing scheme was conducted.
Methods
As a material, “blood” samples were used. Each student has a sample. Only two of them were infected with the “Ebola virus”, while 23 were free from viral infection. Each student randomly mixed his “blood” sample with three other students’ samples, which resulted in the “Ebola virus” spreading among the population. Table 1 shows the scheme of sample mixing. Afterward, ELISA analysis was performed for testing all the samples on “the infection”.
Table 1.
The Scheme of Students’ Samples Mixing
No of the Sample
No of student’s partners
No of the Sample
No of student’s partners
The 1st
The 2nd
The 3rd
The 1st
The 2nd
The 3rd
1
23
8
21
14
21
6
15
2
22
10
11
15
8
5
14
3
18
25
9
16
25
4
17
4
6
16
20
17
24
12
16
5
9
15
7
18
3
13
6
6
4
14
18
19
12
20
25
7
13
24
5
20
11
19
4
8
15
1
23
21
14
22
1
9
5
11
3
22
2
13
21
10
23
2
12
23
10
1
8
11
20
9
2
24
17
7
25
12
19
17
10
25
16
3
24
13
7
18
22
–
–
–
–
The standard indirect ELISA protocol was used for the analysis. One 12-well strip was used for two students: three wells for the positive control, three wells for the negative control, and three wells for each student’s sample. In the first stage, 50µl of controls and samples were added to the appropriate wells. After 5 min of incubation, the strip was washed two times with 100µl of wash buffer. Before adding the buffer, liquid from the wells was removed from the paper. After washing, 50µl of the first antibody solution from the green tube was added to each well. After 5 min of the incubation and washing two times, 50 µl of the second antibody solution from the orange tube was added. After 5 min of incubation, the strip was carefully washed three times with the purpose to remove unbounded antibodies. Finally, 50 µl of enzyme-substrate was added. The results of the analysis could be observed after 5 min. Positive results were blue, negative ones were colorless.
Results
Figure 1 shows the results of the ELISA test of one team’s samples. According to Figure 1, both students’ “blood” was “infected” with the “Ebola virus”. The liquid in wells from the 7th to the 12th was colored, which means that the analysis was positive. The liquid in positive controls wells was blue, while the negative controls wells remained colorless. Positive and negative controls confirm the correctness of the ELISA analysis procedure and obtained results.
Table 2 demonstrates the results of the ELISA for the whole group’s samples. According to it, a part of students’ “blood” became “infected” after the procedure of mixing, while the rest of them remained free of “virus”. Wells with “infected” samples were blue after the reaction, and wells with “non-infected” samples were colorless. Positive and negative controls also were correct. According to Table 2, twelve samples were colored and contained “Ebola virus”, and thirteen samples were free from the “viral infection”.
Table 2.
Results of the ELISA Analysis
No of the Sample
Result
No of the Sample
Result
1
Positive
14
Negative
2
Negative
15
Negative
3
Negative
16
Negative
4
Negative
17
Negative
5
Positive
18
Positive
6
Positive
19
Negative
7
Positive
20
Negative
8
Positive
21
Positive
9
Negative
22
Positive
10
Negative
23
Positive
11
Negative
24
Positive
12
Negative
25
Positive
13
Positive
–
–
Discussion
The ELISA test shows the presence of the “viral particles” in the sample. If “blood” was “infected”, “viral particles” bounded with the specialized antibodies to them. The second antibodies solution contained the antibodies to the anti-viral antibodies. In the final stage, the enzyme solution was added. This solution changed its color in the case of the second antibody’s presence in the well. Thus, this analysis allows detecting the “infected” samples.
Initially, only two “blood” samples contained the “Ebola virus”. After samples were mixed, the “virus” was spread, and half of the population became “infected”. For the determination of the primary infected samples, connections between participants of the experiment should be studied. First of all, all the samples with negative results should be excluded, as well as the samples, they had contacts with. After this procedure, only three numbers of possible “infected” samples remained: No 1, 7, 13. However, sample No 7 could be excluded because it was mixed with No 24 and 5 and did not spread “the infection” to them. It could be assumed that sample No 7 received “the infection” after mixing with sample No13. Therefore, it could be concluded that samples No 1 and 13 were initially “infected”, and they contaminated all other samples.
