Category: 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 nation’s 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.

This paper presents a discussion of Ebola virus disease, a dangerous condition associated with a high mortality rate. In the report, the general information about the illness is stated, as well as the history of the disease and its symptoms and signs. Moreover, in the paper, Ebola virus disease is reviewed according to the epidemiological triangle and the factors contributing to its spread are also considered. Finally, the report features a discussion of the Healthy People 2020 objectives regarding the condition.

Ebola Virus Disease

Ebola virus disease is one of the deadliest illnesses on the planet with a mortality rate of up to 90% depending on its causes (Rivera & Messaoudi, 2015). It can be caused by various viruses; the most common are the Zaire Ebola virus, Bundibugyo Ebola virus, and Sudan Ebola virus. Non-specific symptoms that occur during the early stages of the disease make the diagnosis difficult, which increases the severity of the condition.

Treatment options include intravenous infusion of fluids and electrolytes, oxygen therapy, and the use of medication to eliminate symptoms (Centers for Disease Control and Prevention, 2017). Notably, currently, there are no antiviral treatment strategies approved by the Food and Drug Administration (FDA). There are various types of vaccines that have been successfully used as disease prevention methods. Other control measures for Ebola virus disease may include isolation of sick individuals, avoiding traveling if there is a risk of contamination, the high level of personal hygiene, changes in diets for tribal natives, and safe burial places.

History of the Disease

The history of Ebola started in 1976 when two cases of fatal hemorrhagic fever were reported in Central Africa (Centers for Disease Control and Prevention, 2018b). Notably, these outbreaks were caused by different viruses, Zaire ebolavirus, and Sudan ebolavirus, which spread independently and affected individuals living in two different locations. Scientists assume that the factors that caused the initial spread of Ebola include population growth and interaction with wildlife, for example, through the consumption of bushmeat (Centers for Disease Control and Prevention, 2018b).

As of today, the majority of Ebola virus disease cases occurred in Africa. However, in 2014-2016, the outbreak of the disease became a global epidemic and affected at least eight countries, causing more than 9,900 deaths (Centers for Disease Control and Prevention, 2018b; Rivera & Messaoudi, 2015). During that outbreak, the primary means of transmission was between family members.

Symptoms and Signs of Ebola

Ebola virus encodes glycoprotein, nucleoprotein, RNA-dependent RNA polymerase, and four structural proteins, including VP24, VP30, VP35, and VP40. (Rivera & Messaoudi, 2015). The Centers for Disease Control and Prevention (2018c) report that the symptoms of the disease include fever, muscle pain, severe headache, weakness and fatigue, vomiting, diarrhea, abdominal pain, and bleeding or bruising of unknown nature.

These signs may occur from two to 21 days after contamination and last for 8 to 10 days. Notably, these symptoms are common for other diseases as well, such as malaria or influenza (Centers for Disease Control and Prevention, 2018c). However, at the terminal stage of Ebola, some specific signs may occur; they include massive tissue injury, hemorrhage, vascular permeability, and dysregulation of the coagulation cascade (Rivera & Messaoudi, 2015). The disease can also lead to the loss of consciousness and coma. The primary causes of death are shock, major blood loss, and multiorgan failure.

Epidemiological Triangle

The agent factors of the disease include five genus viruses, Zaire Ebola virus, Bundibugyo Ebola virus, Sudan Ebola virus, Reston Ebola virus, and Tai Forest Ebola virus (Kaur, Sachdeva, Jha, & Sulania, 2017). Zaire Ebola virus poses the most significant threat to humans and animals. Nonhuman primates, as well as pigs, are considered the primary hosts of the disease; fruit bats are the reservoirs of the Ebola virus (Kaur et al., 2017).

Notably, mammals die as a result of the disease, while bats do not experience acute illnesses caused by viruses. The sources of infection include the contact with blood or body fluids of hosts or reservoirs. Human-to-human transmission is caused by contact with ill individuals’ body fluids, as well as needles, syringes, and other medical equipment contaminated with them. The contact with the body organs of the diseased person can cause the illness too. Environmental factors include high absolute humidity and low temperature.

Factors Contributing to the Spread of Ebola

Several factors can contribute to the spread of the disease. First, Kaur et al. (2017) note that seasonal migration of fruit bats may result in increased contact with animals and humans. Another factor is African cultural aspects; for example, during burial ceremonies, contact with the body of a deceased person often occurs. Moreover, the lack of personal hygiene and protective measures, such as the use of gloves by medical professionals, increases the risk of contamination and transmission of Ebola virus disease.

Notably, individuals’ daily activities may contribute to the spread of Ebola too. For example, hunting in the forests and consumption of bushmeat may increase the risk of contamination. It is necessary to note that individuals traveling to Africa may become the hosts of the condition and cause outbreaks in other areas. Thus, the lack of awareness of the possible risks of contamination is a significant factor contributing to the spread of the disease.

Healthy People 2020

Currently, the cases of the disease are reported in Africa. For example, in August 2018, the outbreak occurred in the Democratic Republic of Congo, following the one that happened in May 2018 (Centers for Disease Control and Prevention, 2018a). One of the objectives of Healthy People 2020 is to improve global health and national safety by the implementation of prevention and control strategies, as well as detection of global diseases (U.S. Department of Health and Human Services, 2018).

Centers for Disease Control and Prevention (2018a) note that the measures to control the spread of the disease are performed. They include providing technical means for surveillance, infection control, laboratory testing, contact tracing, and data management. Moreover, the U.S. government provides assistance in logistics and vaccination in affected areas. It means that currently, the actions aimed to control Ebola virus disease correspond to Healthy People 2020 objectives.

Conclusion

Ebola virus disease is a severe condition that may cause adverse symptoms and result in death. The mortality rate for the illness is high, which means that it is vital to control its spread and prevent cases of contamination. The virus is transmitted through body fluids, infected materials and medical equipment, and contact with body organs. Possible prevention methods include vaccination, avoiding contact with ill individuals, and proper personal hygiene.

References

Centers for Disease Control and Prevention. (2017). Treatment. Web.

Centers for Disease Control and Prevention. (2018a). 2018 the Eastern Democratic Republic of the Congo. Web.

Centers for Disease Control and Prevention. (2018b). History of Ebola virus disease. Web.

Centers for Disease Control and Prevention. (2018c). Signs and symptoms. Web.

Kaur, D., Sachdeva, S., Jha, D., & Sulania, A. (2017). Ebola virus disease in the light of epidemiological triad. Tropical Journal of Medical Research, 20. Web.

Rivera, A., & Messaoudi, I. (2015). Pathophysiology of Ebola virus infection: Current challenges and future hopes. ACS Infectious Diseases, 1(5), 186-197. Web.

U.S. Department of Health and Human Services. (2018). Global health: Objectives. Web.

Introduction

The assigned case study is about Ebola control in Sierra Leone and Northern Uganda, which are two countries in Africa affected by civil war. McPake et al. (2015) describe how conflict and wars have made it difficult to have a strong health care system in the two nations, thereby making it difficult for them to have a rapid and effective response to global epidemics, such as Ebola. Evidence is given to show how Sierra Leone and Northern Uganda suffered civil strife in the 1990s and how the conflicts made them ill-prepared for managing the Ebola crisis when it occurred. The response and role of global health institutions are also analysed to understand how they influenced the response of these countries to such epidemics. Comparing the management of Ebola in Northern Uganda (in 2001) to the management of the same epidemic in Sierra Leone (in late 2015 to early 2016), we find that the two countries had different success rates. The case study also highlights how international global health institutions and different elements of conflict in the affected societies came together to contain the disease, as it happened in Uganda in a matter of days, or as was the case in Sierra Leone where it took months.

This essay will provide a brief description of the case study and discuss different aspects of the health problem, including a succinct understanding of Ebola as a global epidemic, its transmission methods, and its preventive mechanisms. Backed by literature explaining how health agencies have controlled it in several conflict-affected areas, this essay will also highlight how different social, political and economic factors concerning conflict and wars affected Ebola control in Sierra Leone and Uganda. Lastly, this essay provides a conclusion and recommendation section, outlining the main points and solutions of our analysis.

Summary of the Case Study

Conflict and its aftermaths are some of the main reasons for the rapid spread of Ebola in Sierra Leone and Uganda, in 2001 and 2014/2015, respectively (McPake et al. 2015). The Sierra Leone conflict started in 1991 and lasted for 11 years. It left more than 50,000 people dead after opposing political and military forces fought for control of government (Ebenezer 2016). Affecting large swaths of territory to the northern and southern parts of the country, the civil war led to the collapse of the nation’s health infrastructure and the breakdown of health services in the country (O’Hare 2015). Many people fled their homes, livelihoods were disrupted, and sanitation services broke down (McPake et al. 2015). The same was true for Uganda because, for more than 20 years, the country suffered from a conflict, which saw many lives devastated, and the region’s health care system destroyed (IRIN 2017). More than 1.8 million people were displaced and tens of thousands mutilated, raped, or suffered other forms of travesty by the rag-tag militia group – Lord’s Resistance Army (LRA) (Jagielski 2012).

The conflict led to the outbreak of Ebola in Northern Uganda and Sierra Leone because the countries’ health care systems were too weak to detect, or even respond to the crisis (McPake et al. 2015). Furthermore, many of the residents in these countries were at risk of infection because their livelihoods were disrupted (Marc, Verjee & Mogaka 2015). The uncertainties associated with the 2001 case of Ebola in Northern Uganda highlight some of these problems because it was difficult to establish where the disease started, or who had been in contact with the affected persons in the first place (IRIN 2017). Lost records, a depleted workforce, poor health infrastructure and weak national and regional health governance systems are some of the problems associated with conflict that finally led to the rapid spread of the disease (O’Hare 2015).

Health reports show that Ebola-affected 425 people, but killed 224 in the 2001 Ugandan outbreak (McPake et al. 2015). Comparatively, there were 3,955 deaths in Sierra Leone, against a backdrop of more than 14,061 confirmed infections (Hoyt 2017). Based on the scale of infections and deaths in the two countries alone, we find that Northern Uganda contained the disease much better than Sierra Leone did. Part of the reason for this outcome is the existence of a functional government in the South of the country. In fact, IRIN (2017) says there was a well-coordinated response system at different levels of the country’s health care system that effectively managed the outbreak. Here, it is important to point out that Southern Uganda has not been affected by conflict. In fact, stable governance arrangements allowed effective coordination of international agencies to respond to the outbreak, thereby preventing the rapid spread of the disease (IRIN 2017).

Comparatively, aid-coordination problems affected the international response to Ebola in Sierra Leone. The West African country also lacked strong hospitals that would coordinate rapid response operations, thereby leading to the further spread of the disease (Hoyt 2017). In Uganda, there were non-governmental hospitals operating in the country, which could effectively respond to the outbreak (Namakula, Witter & Ssengooba 2016). For example, St. Mary’s Lacor Hospital, in Gulu, coordinated emergency efforts in Northern Uganda, thereby giving people an alternative to government hospitals, which were dilapidated and unable to contain the crisis (Namakula, Witter & Ssengooba 2016). Generally, the case study on Northern Uganda and Sierra Leone Ebola outbreaks have implications for the type of health investments that should be made towards responding to such health disasters at regional, national and international levels.

Discussion

What is Ebola?

According to the Centres for Disease Control and Prevention (2016), Ebola is a haemorrhagic fever caused by a virus that goes by the same name. The virus mostly attacks human beings but can have adverse health effects on primates, such as monkeys and chimpanzees, as well. It is mostly concentrated in several African countries (the first known case of infection happened in 1976 in the Democratic Republic of Congo) (SF Dept of Public Health 2016). Since the first case was reported, the virus has caused several sporadic epidemics in different parts of the continent. The World Health Organization (2016) says that there had been 24 outbreaks from 1976 to 2013. These outbreaks led to 1,716 cases of confirmed Ebola infections. The largest outbreak occurred in 2013 and lasted up to 2016 (World Health Organization 2016). Concentrated in West Africa, the epidemic led to more than 11,000 deaths, against a backdrop of more than 23,000 cases of infections (Marc, Verjee & Mogaka 2015).

Causes of Ebola

Ebola infections in human beings stem from four of the five strains of the virus. The four strains are Bundibugyo virus (BDBV), Sudan virus (SUDV), Taï Forest virus (TAFV) and Ebola virus (EBOV) (Centres for Disease Control and Prevention 2016). EBOV is known as the most deadly strain of the virus. In fact, experts attribute most of the outbreaks reported in Africa to the strain (SF Dept of Public Health 2016). The Reston virus is known as the least harmful strain because it mostly causes diseases in other primates, but not to human beings. The virus is transmitted through contact with fluids from an infected person. It would ordinarily enter a person’s body through broken skin and membranes in the eyes, nose or mouth (World Health Organization 2016).

Ebola Prevention and Control

Ebola is a deadly disease because it kills people quickly and there is no vaccine available to treat it. Therefore, the focus of all health agencies is to prevent transmission through quarantining infected patients and preventing uninfected people from getting into contact with fluids from infected parties (Hoyt 2017). The preventive measures also include restricting travel to affected areas. This precautionary measure was applied by many western countries during the 2016 Ebola outbreak by cautioning their citizens from travelling to West Africa. The precaution was also given to health care personnel to wear protective clothing, such as gloves, gowns and goggles when treating Ebola patients (Ellis 2015).

Using infection-control measures is a standard procedure for medical personnel operating in the affected zones. However, the availability of such equipment, or even citizen education about such practices, is a daunting task in countries ravaged by war and affected by health care system underfunding, as was the case in Sierra Leone and Northern Uganda (Hoyt 2017). International organizations often come to supplement health efforts whenever there are such inadequacies. However, even with such goodwill, there needs to be sufficient, steady and steadfast government support and health infrastructure to accommodate or absorb, such inputs from the international community (O’Hare 2015).

One factor that confounded Ebola management efforts in Sierra Leone was insufficient government goodwill. Bureaucratic red tape also failed to facilitate the integration of international help in the country’s Ebola control plan. For example, Nossiter (2014) reports that international well-wishers sent $140,000 worth of equipment (gowns, gloves and other protective equipment) to Sierra Leone at the height of the crisis. However, because of government ineffectiveness, they were left unused at the port for more than three months because of delays in cargo clearing. Ironically, reports showed that Sierra Leone health workers suffered severe shortages in equipment supply (Nossiter 2014). In fact, some reports show that some nurses had to wear street clothes (Nossiter 2014). This challenge showed weaknesses in the government’s ability to integrate international help in its Ebola management plan.

Education and Empowerment

Education and people empowerment are at the centre of many epidemics (Ness & Lin 2015). The same is true for Ebola, as was witnessed in Sierra Leone and Northern Uganda. For example, evidence from Sierra Leone showed that high levels of illiteracy were problematic for health workers and authorities when managing the disease because they could not effectively get the required health information needed from local populations to manage the crisis (Ness & Lin 2015). Conspiracy theories helped to fuel the spread of the disease because some locals thought that the disease was caused by witchcraft. Others believed that local remedies could help cure it, while their proponents thought that Ebola was a product of “bad spirits” (Kuriansky 2016). Some of them refused to acknowledge its existence and went on with their lives, as if nothing was happening, thereby aiding in its spread (Ellis 2015). Most of these problems are caused by high illiteracy levels that stem from a country that has a broken education system. A holistic view of this issue reveals that during the civil war, the country’s education system was broken, exposing a generation of people to illiteracy.

Reports by international observers show an even greater impact of the civil war on Sierra Leone’s education system, because, in 2001, close to 70% of children who were supposed to be in school could not get an education (Ness & Lin 2015). This situation explains the low literacy levels among adults in Sierra Leone, which is only pegged at a paltry 39.1% (Ebenezer 2016). Broadly, these statistics show that the civil war had a big impact on the education standards of Sierra Leone, thereby creating a fertile ground for the growth of conspiracy theories about Ebola. The war also undercut the potential talent the country had to offer in terms of educating and training health care service providers who would have helped improve the country’s health care response to the disaster. The situation is the same in northern Uganda because education standards are relatively low, compared to the Southern parts of the country where there are law and order (Namakula, Witter & Ssengooba 2016). However, what is unique to this region is not only the breakdown of education services but also the use of child soldiers to fight wars in the region. Jagielski (2012) says that 28,000 children were kidnapped to fight in the civil war. In fact, Independent reports show that 80% of the fighters in the LRA army were children (Jagielski 2012). With such statistics abound, there were minimal investments made in the health or education sectors in both countries. This reason mostly explains why populations were unable, or unwilling, to collaborate with authorities to control Ebola.

Health Investments

Northern Uganda managed to contain the 2001 Ebola epidemic better than Sierra Leone did, despite having the same conflict dynamics as the West African nation. The services offered to the citizens were cost-effective, relative to the resources, inadequacies and limited government support available to the region. Nonetheless, the cost of preventing an outbreak in Sierra Leone and Northern Nigeria should not be high if the right investments are made in the right areas, or in critical areas of education and health infrastructure. More importantly, the need for making proper investments in health services cannot be overemphasized.

Conclusion/Recommendations

In this paper, we have shown that Sierra Leone and Northern Uganda have been victims of Ebola outbreaks because they have weak health infrastructures and poor education systems that prevent them from detecting the disease early, or even containing it before it spreads. These problems come from decades of underinvestment in health care services, brought about by war and civil conflict. To address these challenges, both countries need to invest in their health infrastructure and possibly educate their citizens about Ebola and its prevention. The latter approach mostly means a greater investment in the education system. Sierra Leone needs to pay close attention to its bureaucratic policies for aid delivery and integrated health because international health agencies cannot supplement the government’s health response to future epidemics without political goodwill, or with the existing bureaucratic “red tape” in place. Broadly, Ebola control requires a concerted effort by all parties involved to manage future crises. However, this strategy needs to occur against a backdrop of proper investments in health and education.

Reference List

Centres for Disease Control and Prevention 2016, About Ebola virus disease. Web.

Ebenezer, C 2016, Primary and secondary education in Sierra Leone: an evaluation of 50 years of policies and practices, Sierra Leonean Writers Series, London.

Ellis, C 2015, Prepping for a pandemic: life-saving supplies, skills and plans for surviving an outbreak, Ulysses Press, New York.

Hoyt, D 2017, Operation Ebola: surgical care during the West African outbreak, JHU Press, New York.

IRIN 2017, Ebola lessons from Uganda. Web.

Jagielski, W 2012, The night wanderers: Uganda’s children and the lord’s resistance army, Seven Stories Press, London.

Kuriansky, J 2016, The psychosocial aspects of a deadly epidemic: what Ebola has taught us about holistic healing, ABC-CLIO, New York.

Marc, A, Verjee, N & Mogaka, S 2015, The challenge of stability and security in West Africa, World Bank Publications, New York.

McPake, B, Witter, S, Ssali, S, Wurie, H, Namakula, J & Ssengooba, F 2015, ‘Ebola in the context of conflict affected states and health systems: case studies of Northern Uganda and Sierra Leone’, Conflict and Health, vol. 9, no. 23, pp. 1-9.

Namakula, J, Witter, S & Ssengooba, F 2016, ‘Health worker experiences of and movement between public and private not-for-profit sectors—findings from post-conflict Northern Uganda’, Human Resources for Health, vol. 14, no.18, pp. 1-12.

Ness, D & Lin, C 2015, International education: an encyclopaedia of contemporary issues and systems, Routledge, London.

Nossiter, A 2014, Ebola help for Sierra Leone is nearby, but delayed on the docks. Web.

O’Hare, B 2015, ‘Weak health systems and Ebola’, The Lancet Global Health, vol. 3, no. 2, pp. 71-72.

SF Dept of Public Health 2016, Ebola virus disease. Web.

World Health Organization 2016, Ebola virus disease. Web.

Introduction

Ebola virus disease (EVD) is a lethal disease that presents a major concern to the World Health Organization. The disease is dangerous because physicians have not discovered a valid treatment yet, and the existent approaches are experimental. An epidemic caused socioeconomic disruptions and resulted in the loss of many lives, which created a need to present more effective ways to prevent any outbreaks of the disease.

Overview and Key Aspects

Ebola was first described in 1976 in the Democratic Republic of Congo, and the most affected regions throughout the years were Guinea, Liberia, and Sierra Leone (Years of Ebola virus disease outbreaks, n.d., para. 1). The largest Ebola epidemic occurred in 2014, and it started in southeastern Guinea. Ebola outbreak in the Democratic Republic of Congo, reported in June 2019, caused international interest due to the insufficient previous effort to fight the disease (Harris, 2019, para. 4). The outbreak has been classified as the level three emergency, which is considered to be the most serious one. People of all ages in the Republic were affected, that is why it requires an involvement of the World Health Organization. The emergency committee held four meetings since they declared an outbreak in August 2018.

Global health has become a significant international concern as an improvement of public health influences the national security and economic. Epidemics and diseases such as Ebola can create a financial burden as it requires many resources to handle the outbreaks. For instance, the Committee has to deal with transportation as they are required to keep transport routes and borders open to save the lives of people affected by the disease. The maintenance of global health contributes to political stability and economic prosperity, which assures economic growth worldwide.

Conclusion

Therefore, it is crucial to think of global health as economies become globalized, and international travel and commerce has become an essential part of globalization. Taking steps towards the eradication of epidemics such as Ebola contributes to the prevention of a worldwide spread of diseases. Such steps lead to the improvement of global health, which impacts the economy and strengthens the security of countries.

References

Harris, M. (2019). Ebola outbreak in the Democratic Republic of the Congo declared a public health emergency of international concern. Web.

Years of Ebola virus disease outbreaks. (n.d.). Web.

Introduction

Ebola virus disease is a contagious infection, which emerged in several outbreaks in Africa in recent years. A major epidemic, which broke out in several African countries, such as Guinea, Sierra Leone, and Liberia from February 2014 to December 2015, claimed the lives of more than 11 thousand people, the total number of those affected, including suspected and probable cases, accounted for more than 27 thousand people. The World Health Organization recognized the Ebola virus disease as a global menace on August 8, 2014.

It is vital to analyze up-to-date field studies to reduce the spread of the epidemic and to aid effective treatment. All the scholarly sources provided in this essay are evidence-based studies of the Ebola outbreaks in Western Africa with credible statistic data and its analysis. The articles were chosen from the past five years, and they included keywords, such as “Ebola”, “contagious”, and “treatment”. A search strategy was completed using databases, such as MEDLINE, CINAHL, and ProQuest. The themes in this synthesis are mortality rate, symptom prevalence, patients’ recovery, and managing risks for healthcare staff.

Mortality Rate

Ansumana et al. (2015) discussed the differences in statistical data on mortality rates in two healthcare centers. The authors analyzed the mortality rate decrease among Ebola virus disease (EVD) patients. They carried out a case study of 581 people, who “had either died or been discharged after testing negative for the Ebola virus in follow-up laboratory tests” (Ansumana et al., 2015, p. 587). Despite the fact that the researchers observed mortality rate reduction in one of the healthcare centers, its reasons remained unclear. That is why they implemented a package of various measures. In conclusion, this study revealed that the fatality decrease is noted under the given treatment protocol. However, the effectiveness of the approach, which was adopted in the selected facilities, should be further validated.

Symptom Prevalence

Skrable et al. (2017) made a retrospective study “The natural history of acute Ebola Virus Disease among patients managed in five Ebola treatment units in West Africa” to examine the difference in fatality rate among various age groups. The authors stated that all research on EVD that had been conducted previously reflected only one set of symptoms and did not take into account their transformation. These changes occur over time; that is why it was necessary to study patients in different age groups. In other words, the aim of the research was “to expand our understanding of the natural history of EVD from symptom onset to recovery or death” (Skrable et al., 2017, p. 2). This, in turn, may lead to improved observations and clinical management in the case of Ebola outbreaks in the future.

The authors studied 470 patients and divided them into several age blocks before the age of 45. Children younger than five years old were united in one group as the World Health Organization recognized them as an, especially vulnerable age range. After forming the age blocks, nurses and physicians documented patients’ symptoms and clinical signs at least once a day. Key findings of this study confirmed that “the most common signs/symptoms at triage were fever, asthenia (weakness), and anorexia (loss of appetite)” (Skrable et al., 2017, p. 5). However, among survivors, more than half of the patients suffered headaches and anorexia only at the very beginning of the illness. On the third day, fever and weakness increased and continued until the third week. After that, “the prevalence of most symptoms declined thereafter as patients recovered” (Skrable et al., 2017, p. 5). As for lethality cases, more than half of the patients suffered weakness every day of illness until death.

Patients’ Recovery

An article by Rabelo et al. (2016) discusses the emotional and mental conditions of Ebola survivors. This study is aimed at describing the distress experienced by EVD patients during hospitalization and rejoining their communities. The authors chose 17 participants between February and April in 2015 and formed three focus groups depending on patients’ gender. In addition, a “thematic analysis approach was applied to analyze the data” (Rabelo et al., 2016, p. 1). The first block included nine female survivors; the second and third focus groups consisted of male EVD survivors. At first, all the participants were interviewed over several themes, such as “mental health distress during treatment, coping strategies to overcome mental health distress, mental health distress and coping strategies after discharge” from treatment units (Rabelo et al., 2016, p. 2). After that, this data was analyzed, and the authors held discussions to enrich their understanding of the received information.

As a result, it was found that EVD patients often feel abandoned, and they cannot forget their families left their homes far away, while they are fighting for their lives. Moreover, Rabelo et al. (2016) state that “some of the survivors described a sense of numbness and failure to connect with the reality” inside the treatment unit (p. 3). As for coping strategies, a supportive attitude toward patients from the staff was encouraging when fighting the disease. Furthermore, it helps survivors lead a more active lifestyle after their recovery. That is why the most effective ways to reduce the distress of the EVD survivors are through building relationships, peer/community support, trust, and psychosocial care.

Carter et al. (2017) discussed another measure contributing to effective treatment – Community Care Centers (CCCs). They carried out a qualitative study “to understand the perceived impact that proximity to such Centers had on treatment-seeking behavior” (Carter et al., 2017, p.66). The authors collected data in the first half of 2015 on impediments and catalysts to a desire for seeking treatment in three districts of Sierra Leone, which was hardest hit by Ebola. Study participants expressed their concerns about the Ebola Virus Disease itself but also about the treatment system. For example, some people believed that “if you go inside the ambulance, you do not even arrive at the treatment Center; the ambulance will kill you first” (Carter et al., 2017, p. 68). More than that, they did not trust these centers as they were located far from their homes, and no one knew what was happening and who was working there.

The findings of the study demonstrate that physical proximity to Community Care Centers increased patients’ desire to seek treatment due to several reasons. Firstly, new CCCs were located within walking distance, which made it possible for patients to avoid ambulances. People were encouraged to attend Centers even if they did not have Ebola. As a result, it led to improved diagnostic and treatment opportunities. Furthermore, citizens received open access to patient information about their relatives and Centers’ functioning. It was essential for people as before the construction of new Community Care Centers, and they had to wait a long time to learn about their parents, children’s, or spouses’ deaths. Building CCCs near their homes made it possible “to pass messages on to patients, even if through a staff member, helped reduce fear around treatment” (Carter et al., 2017, p. 69). In addition, the founders of Community Care Centers engaged local people in their establishment. This factor contributed to patients’ increased trust in CCCs and encouraged them to attend these facilities regularly.

Healthcare staff risks

Andertun, Hörnsten, and Hajdarevic (2016) addressed the problem of managing contagion risks and developing care strategies for healthcare staff. The purpose of their descriptive and qualitative study was to focus on Norwegian healthcare workers’ involvement in treating EVD patients in Sierra Leone. Eight nurses and one physician with the background of working in Ebola care centers participated in this research. The findings revealed that “Ebola workers were relying highly on safety and used strategies to minimize risks of contagion” (Andertun, Hörnsten, & Hajdarevic, 2016, p. 8). Though they were aware of the risks, they regarded their work as motivating and critical. Appropriate preparedness and training of healthcare staff resulted in their inspiration and personal growth. Moreover, studies based on medical workers’ experiences may be useful for contributing new knowledge and improving the treatment system in other countries.

Conclusion

The synthesis of literature supported the need for a further careful examination of the Ebola Virus Disease. It is clearly identified that there are many efficient ways to eliminate negative factors during and after treatment, such as building new Community Care Centers relationships, enhancing peer and community support, trust, providing high-quality psychosocial care. Various guidelines are supported in this review and will be utilized in the creation and implementation of new programs aimed at helping EVD patients, training healthcare staff. More than that, the findings may be applied to future studies on changes in Ebola symptoms and risk factors.

References

Andertun, S., Hörnsten, Å., & Hajdarevic, S. (2016). Ebola virus disease: caring for patients in Sierra Leone – A qualitative study. Journal of Advanced Nursing, 73(3), 643–652. Web.

Ansumana, R., Jacobsen, K. H., Idris, M. B., Bangura, H., Boie-Jalloh, M., Lamin, J. M., … Sahr, F. (2015). Ebola in Freetown area, Sierra Leone — A case study of 581 patients. New England Journal of Medicine, 372(6), 587–588. Web.

Carter, S. E., O’Reilly, M., Frith-Powell, J., Kargbo, A. U., Byrne, D., & Niederberger, E. (2017). Treatment seeking and Ebola Community Care Centers in Sierra Leone: A qualitative study. Journal of Health Communication, 22(sup1), 66–71. Web.

Rabelo, I., Lee, V., Fallah, M. P., Massaquoi, M., Evlampidou, I., Crestani, R., … Severy, N. (2016). Psychological distress among Ebola survivors discharged from an Ebola treatment unit in Monrovia, Liberia – A qualitative study. Frontiers in Public Health, 4(142). Web.

Skrable, K., Roshania, R., Mallow, M., Wolfman, V., Siakor, M., & Levine, A. C. (2017). The natural history of acute Ebola Virus Disease among patients managed in five Ebola treatment units in West Africa: A retrospective cohort study. PLOS Neglected Tropical Diseases, 11(7). Web.

Introduction

Over the last year, a global health security problem has emerged. The Ebola virus disease (EVD), which, according to Arwady et al. (2015), had been previously known as an “exotic tropical disease”, suddenly became a worldwide concern during summer 2014, after a few outbreaks of it occurred in West Africa (p. 578, 583). In our paper, we will look at the crux of the issue, its importance, factors that might influence the scale of the problem, and make some claims about the possible origins of the problem and solutions to it.

The Essence and Significance of the Ebola Problem

EVD is a highly transmittable, perilous disease which has exceptionally high fatality rates. There exist five identified types of the virus of the Ebolavirus genus, three of which have a fatality rate varying from 40 to 90% (McElroy et al., 2014, p.1683). A single infected traveling person can spread the disease to a large number of people and unless the prevention measures are applied, an outbreak can emerge (Arwady et al., 2015, p. 583).

The problem of Ebola is of crucial importance. There is a great need for international humanitarian help and solidarity towards the affected countries. For instance, Liberia, a West African country, was one of the first struck by the epidemic in 2014. It had less than 200 doctors before the first outbreak began (for a total population of approximately 4 million people) (Arwady et al., 2015, p. 578). There were not nearly enough Ebola treating units (ETUs) in Liberia, and sick patients had to lie on the ground outside hospitals (Arwady et al., 2015, p. 582-583). By 15 August, 826 cases of EVD were reported in Liberia, 455 of them lethal (Arwady et al., 2015, p. 580). Due to the lack of beds, many patients have turned away from hospitals during the following months. By September 2014, EVD spread further across Liberia, cases of infection doubling every 15-20 days (Arwady et al., 2015, p. 583). In October 2014, EVD spread across Sierra Leone and Guinea (Rainisch, Shankar, Wellman, Merlin, & Meltzer, 2015, p. 446). The affected countries quickly ran out of medical supplies, such as gloves, disinfectants, and body bags (Arwady et al., 2015, p. 579).

In 2014, the deadly virus was also transmitted to some Western countries (the USA and Spain) (Rainisch et al., 2015, p. 444), which stimulated it’s becoming a global issue.

An acute necessity for further research exists. First, the natural reservoir of Ebola is not yet identified (Ebola, 2015, Transmission, para. 1), which complicates the disease’s prevention. Second, no specific FDA-approved medicines exist currently, and the disease is only treated symptomatically, which means that the development of effective anti-Ebola medications and vaccines is highly required (Ebola, 2015, Treatment, para. 1).

Factors Influencing the Problem at Different Levels

Several factors influence the chance of spreading EVD, and, consequently, the importance of the issue in perspective. Let us look into them in more detail.

Speaking about fighting Ebola at the intrapersonal and interpersonal levels, it can be noted that high levels of awareness of the specifics of the disease’s transmission ways, high attention to possible sources of the virus, and personal attempts to prevent the infection can decrease the chance of spreading the contagion. For example, on 20 July 2014, an infected man who traveled by air from Monrovia, Liberia to Lagos, Nigeria, caused 20 cases of infection, which “required pub­lic health authorities to follow up on nearly 900 contacts to successfully contain the outbreak” (Arwady et al., 2015, p. 583). This could have been prevented if necessary countermeasures were taken by the man and the people he came in contact with. It appears that little more can be done at a personal level, as poverty and the availability of medical services are problems that transcend this level.

According to Arwady et al. (2015), “the standard approach to controlling EVD epidemics depends on active case finding and isolation of patients, with identification and careful monitoring of their con­tacts and immediate isolation of any contacts who develop symptoms” (p. 582). It means that any organization sending people to areas where there is a risk of contracting EVD should provide their members with enough information on the issue, arrange special supplies for them and organize medical supervision. The same is true of communities where there exists a possibility of its members traveling to risky regions. A negative factor, in this case, might be the carelessness of organizations and their attempts to save money.

Speaking about the societal and international levels, possible countermeasures include “EVD surveillance; establishing… EVD patient care…; improving infection control practices; establishing an incident manage­ment system”, and implementing “EVD screening of departing passengers” (Arwady et al., 2015, p. 578). As we mentioned before, there is also a great need for international help and solidarity, for the primal source of the contagion is located in extremely poor countries, citizens of which do not have access to proper health service (or, often, to any health service at all); and there is the need to develop new medications. Needless to say, such measures require financing, and the lack of them might hurt the problem.

An Alternative Approach to the Problem

A possible approach to the emergence of the global problem of Ebola is to take into account a phenomenon that is sometimes labeled as “cultural racism”. The crux of it is that the problems of the Third World are perceived as unimportant until they pose a direct threat to the First World. In our case, it should be noted that “Ebola was first discovered in 1976 near the Ebola River… Since then, outbreaks have appeared sporadically in Africa” (Ebola, 2015, About Ebola, para. 1). Despite being a deadly disease, Ebola became the center of public attention only as a result of the outbreak in 2014, when EVD became a danger to the First World. Of course, the roots of this problem are economic: however deadly the contagion is, it is unprofitable for pharmaceutical companies to develop medications for a disease that is only spread in poor countries of Africa because citizens of these countries will not be able to compensate for the expenses of the development. It can easily be seen from the Ebola situation that cultural racism can lead to severe outcomes in all three Worlds. This is a global problem, though, and possible solutions also need to be global. These solutions might include or entail fighting world poverty, uneven distribution of resources, and looking for alternatives to the race for profit.

Conclusion

As we have seen, EVD is a dangerous, often deadly contagion that can potentially spread worldwide. To prevent this, special countermeasures should be taken. These countermeasures include health monitoring, developing medications, promoting personal awareness, and some others. Another approach might include fighting world poverty to help stop the current problem and prevent similar situations from emerging in the future.

Summary

The article addresses the recently emerged global health security problem, namely outbreaks of the virus Ebola in Africa and the possible spread of. After explaining the crux of the problem and its significance, factors that influence the problem at different levels of social organization (intrapersonal, interpersonal, organizational, the level of community, societal and international levels). Finally, an alternative approach to the problem is discussed.

References

Arwady, M. A., Bawo, L., Hunter, J. C., Massaquoi, M., Matanock, A., Dahn, B.,… De Cock, K.M. (2015, April). Evolution of Ebola virus disease from exotic infection to global health priority, Liberia, mid-2014. Emerging Infectious Diseases, 21(4), 578-584.

Ebola (Ebola Virus Disease). (2015). Web.

McElroy, A. K., Erickson, B. R., Flietstra, T. D., Rollin, P. E., Nichol, S. T., Towner, J. S., Spiropoulou, C. F. (2014, October). Biomarker correlates of survival in pediatric patients with Ebola virus disease. Emerging Infectious Diseases, 20(10), 1683-1690.

Rainisch, G., Shankar, M., Wellman, M., Merlin, T., & Meltzer, M. I. (2015, March). Regional spread of Ebola virus, West Africa, 2014. Emerging Infectious Diseases, 21(3), 444-447.

Article Summary

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.

Reference List

Ebola Characteristics and Comparisons to Other Infectious Diseases. (2014). Web.

Sullivan, P., & Ferris, S. (2014). New York Doctor Tests Positive for Ebola. Web.

Summary

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.

Background

A recent outbreak of the Ebola epidemic in West Africa presents Ebola as a global health issue, which requires concerted efforts of diverse health care systems across the world to tackle. In August 2014, the World Health Organization declared Ebola as a global health issue, which prompted health care systems globally to undertake emergency responses such as preparedness, reporting, and surveillance along with other responses (Gostin, Lucey, & Phelan, 2014). Therefore, Canadian Nurses Associations (CNA) should formulate emergency measures so that it can aid the Canadian health care system in responding to cases of Ebola in time to avert epidemic scenarios experienced in West Africa.

The Ebola epidemic is a global problem because it is a highly contagious disease with a high rate of mortality, yet it has no licensed medications or vaccines. According to Wiwanitkit (2014), the occurrence of the epidemic in West Africa shows that Ebola has the potential of causing a worldwide pandemic. Once it has infected an individual, the mortality rate of Ebola is very high because 55% or more of patients die (Gostin et al., 2014). Such a high rate of mortality shows that Ebola has the capacity to exterminate populations in epidemic and pandemic regions. Given that Ebola is an emerging viral disease, there are no licensed medications for its treatment or vaccines for its prevention (Gostin et al., 2014). Therefore, the aforementioned reasons elucidate why Ebola is a global health problem, which CNA needs to address.

The Ebola epidemic is linked to global forces because it is a viral disease, which spread easily across populations. Laupland and Valiquette (2014) state that globalization forces such as international travel and trade provide avenues through which Ebola can spread and engulf the whole world. In a bid to minimize the role of globalization forces in the transmission of Ebola, most countries issued travel advisories and undertook screening of people at the entry and exit points such as airports, ports, and borders. According to World Health Organization (2014), although Ebola started in Guinea, travelers spread it into Nigeria, Sierra Leon, and Liberia. Therefore, enhanced international travel and movement of products are global forces that promote the spread of Ebola, and thus, CNA should check global movement of people.

Ebola has significant health implications has it requires health care systems to equip their laboratories with advanced diagnostic equipment, acquire protective equipment for healthcare providers, construct isolation and quarantine units, train healthcare providers, and undertake safe burial of the dead (World Health Organization, 2014). Diagnosis of Ebola requires advanced diagnostic methods such as electron microscopy, enzyme-linked immunesorbent assay, and polymerase chain reaction. Given that Ebola is contagious, healthcare providers need protective equipment so that they can serve patients well without acquiring Ebola infection. To contain the spread of Ebola among populations, isolation and quarantine units are necessary for healthcare providers to deliver supportive care and monitor prognosis of patients closely. Gostin et al. (2014) state that training of healthcare providers is central in the containment of Ebola because they offer supportive care and shield the general populations from acquiring Ebola from patients.

Outbreak of Ebola reduces accessibility to healthcare in developing countries, as medical centers do not have essential equipment, have untrained healthcare providers, and lack isolation and quarantine units. Essentially, Ebola creates global health inequity because developed countries have enhanced capacity to handle cases of Ebola, while developing countries have basic capacity. Gostin et al. (2014) assert that Ebola overwhelmed West African countries because they have fragile health care systems, which do not have the capacity to handle healthcare emergencies. The assertion implies that developed countries are in a better position to handle Ebola than developing countries. Essentially, the global issue of Ebola epidemic is essential to nursing because nurses provide supportive care in isolation and quarantine units.

Policies and Actions to Address Ebola

The policy of case management is central in the prevention and control of Ebola outbreak. According to Public Health Agency of Canada (2014), case management comprise measures such as identification of Ebola cases, isolation of patients, provision of supportive care, contact tracing, quarantine, and safe burial practices. The policy of screening of people at entry and exit points such as airports, ports, and borders is an essential measure aimed at preventing global transmission of Ebola. Kalra et al. (2014) state that screening of travelers at exit and entry points has proved to be effective in prevention of Ebola from spreading from epidemic regions in West Africa. In essence, screening for Ebola is an active surveillance strategy that enables prompt response to cases of Ebola. Restriction of flights to West African countries, which have cases of Ebola, is a policy that aims to prevent the spread of Ebola via travelers. Bogoch et al. (2015) state that air travel restrictions to West African countries aided in the control and prevention of Ebola from spreading to different countries. Other policies involved are training of healthcare providers on how to use protective equipment when administering supportive care and education of people on how to protect themselves from acquiring Ebola from infected family members.

Basing on the aforementioned policies, global community should develop evidence-based guidelines of case management, which would enable healthcare providers to diagnose Ebola, isolate patients, offer supportive care, trace contact persons, quarantine persons under investigation, and carryout burials. To prevent global spread of Ebola, global community should restrict flights to countries, which are prone to Ebola as a short-term intervention, and undertake active surveillance by screening travelers at entry and exit points such as airports, ports, and borders (Bogoch et al., 2015). Global community needs to train healthcare providers on how to offer supportive care and protect general population from acquiring Ebola. Since healthcare providers are at risk of acquiring Ebola from the patients, global community should provide them with protective equipment. Community education is also an important action that global community needs to undertake and enhance the capacity of communities to control and prevent the spread of Ebola.

The Canadian government needs to develop capacity to manage cases of Ebola by acquiring essential equipment, training of healthcare providers, constructing isolation and quarantine units, and educating communities on how to control and prevent Ebola. To prevent global spread of Ebola, the Canadian government should undertake active surveillance by screening people from Ebola prone regions. Given that Ebola is a contagious disease, the Canadian government needs to educate its citizens so that they can acquire relevant skills that are pertinent in control and prevention of Ebola. To provide comprehensive address to Ebola, the Canadian government can collaborate with international bodies such as World Health Organization, Canadian Medical Association, Canadian Red Cross, and Centers for Disease Control and Prevention by developing effective guidelines and protocols, which are applicable in the management, treatment, and prevention of Ebola. In 2014, the Canadian government sent healthcare workers under the umbrella of Canadian Red Cross, deployed Canadian Armed Forces, and offered financial assistance to West African (Government of Canada, 2014). Hence, the Canadian government plays a significant role in the control and prevention of Ebola globally.

Advocacy Plan for CNA

The purpose of the plan is to enhance capacity of nurses to handle cases of Ebola globally. The specific goal of the plan is to reduce healthcare inequalities that occur in the aspect of nursing capacity to handle cases of Ebola. Buseh, Stevens, Bromberg, and Kelber (2015) state that fragile health care systems of West African countries contributed to Ebola epidemic and death of nurses for they do not have the capacity to handle cases of Ebola. While developed countries have enhanced nursing capacity to handle infectious disease, developing countries lacks the appropriate nursing capacity (Gostin et al., 2014). In this view, the audience that CNA targets are the Canadian government, Canadian health care system, Public Health Agency of Canada, Centers for Disease Prevention and Control, International Council of Nurses, and World Health Organization.

To persuade the target audience, CNA should employ advocacy actions such as advertisement in the media, collaboration with stakeholders, legislative reforms, bureaucratic advocacy, and health advocacy (Canadian Medical Association, 2014). Failure to employ these advocacy actions has implications, as CNA will not be in a position to influence major stakeholders in addressing the global issue of Ebola. In line with these advocacy actions, CNA advises the Canadian government and other target audience to enhance nursing capacity by training nurses so that they can handle cases of Ebola effectively (Gostin et al., 2014). Moreover, CNA advises the Canadian government and other target audience to provide protective equipment to nurses because they are at risk of acquiring Ebola. Lack of trained healthcare providers and protective equipment comprise major challenges that hinder emergency responses in West Africa (Buseh et al., 2015). Failure to follow these advices by training nurses and equipping them with protective equipment will reduce the capacity of nurses to handle cases of Ebola, and thus, predisposes them and the general population to Ebola.

References

Bogoch, I., Creatore, M., Cetron, M., Brownstein, J., Pesik, N., Miniota, J., … Kahn, K. (2015). Assessment of the potential for international dissemination of Ebola virus via commercial air travel during the 2014 West African Outbreak. Lancet, 385(9962), 29-35.

Buseh, G., Stevens, E., Bromberg, M., & Kelber, T. (2015). The Ebola epidemic in West Africa: Challenges, opportunities, and policy priority areas. Nursing Outlook, 63(1), 30-40.

Canadian Medical Association. (2014). Ebola Virus Disease. Web.

Gostin, L., Lucey, D., & Phelan, A. (2014). The Ebola Epidemic: A global Health Emergency. Journal of American Medical Association, 312(11), 1095-1096.

Government of Canada. (2014). Government of Canada Announces Additional Support to Help Global Efforts to Fight Ebola in West Africa. Web.

Kalra, S., Kelkar, D., Galwankar, S., Papadimos, T., Stawicki, S., Arquilla, B., … Jahre, J. (2014). The emergence of Ebola as a global health security threat: From ‘lessons learned’ to coordinated multilateral containment efforts. Journal of Global Infectious Diseases, 6(4), 164-177.

Laupland, K., & Valiquette, L. (2014). Ebola Virus Disease. The Canadian Journal of Infectious Diseases & Medical Microbiology, 25(3), 128-129.

Public Health Agency of Canada. (2014). Infection Prevention and Control Expert Working Group: Advice on Infection Prevention and Control Measures for Ebola Virus Disease in Healthcare Settings. Web.

Wiwanitkit, V. (2014). Ebola virus infection: What should be known? North American Journal of Medical Sciences, 6(11), 549-552.

World Health Organization. Ebola Virus Disease. Web.

One of the largest and the most disturbing subjects of the contemporary biology is the epidemic of Ebola virus that has been going through the people of West Africa like fire. The world’s community has been shaken by the news about the virus and the pace of its spreading. The news platforms all around the world focused on following and analyzing the events and their victims in West Africa, informing the society of the rest of the world about the latest research and the development of the epidemic.

After the fist Ebola victim outside of Africa died, the world, and the United States namely fell into panic. This man was Thomas Eric Duncan, and he died in the Texas hospital. His body was cremated according to the instructions of prevention of the virus spreading. Duncan’s son, girlfriend, her family and ten other people suspected to have had direct contact with the victim are currently isolated and monitored (Gambino and Dart par. 14).

The scientists believe that all the patients with symptomatic Ebola should be isolated immediately, because according to the research the peak f contagion happens within four days after the symptoms occur (American College of Physicians par. 4). The experts believe that the epidemic in Liberia could be eliminated through the isolation of the infected individuals.

Today, after around five thousand people of West Africa are dead from Ebola virus and the epidemic burst out of control and even managed to make its way to the United States of America, it turns out that the vaccine for this highly dangerous disease already exists. New York Times reports that the records about the development of Ebola vaccine date back to 2010 and 2011.

The vaccine proved to be one hundred per cent effective on monkeys, but has not been tested on people (Grady par. 1). The vaccine has never been licensed and no other products were developed only because until now the Ebola virus used to be rather rare, besides, the medications treating it were to be distributed to the countries with the limited paying abilities.

It is understandable that taking into consideration the current course of events and the great danger presented by the Ebola virus not only to Africa, but to the society of the whole world, the scientists and sponsors will focus on developing a maximally efficient vaccine and treatment to prevent the lethal virus from killing more patients and from travelling around the world and affecting more people.

Works Cited

American College of Physicians. “Prompt Isolation of Symptomatic Patients Is Key to Eliminating Ebola, Study Suggests.” ScienceDaily. 2014. Web.

Gambino, Lauren and Tom Dart. Texas Ebola Patient Dies as Officials Monitor Those Who Had Direct Contact. The Guardian. 2014. Web.

Grady, Denise. Ebola Vaccine, Ready for Test, Sat on the Shelf. New York Times. 2014. Web.