Ebola Outbreak in Africa: Challenges and Control Measures

Recent Ebola Outbreak in Africa

The current outbreak in DRC began with a girl who visited a health center with fever, headache and physical weakness. She was admitted and treated for malaria.

To control a disease outbreak, strong local health systems are essential. Uganda has trained health care workers and established a community network of volunteer Village Health Team members.

Background

A deadly outbreak of Ebola virus swept through West Africa in 2014, killing more than 11,300 people. The disease is a severe, often fatal illness that results from direct contact with blood or secretions from an infected person or animal.

During the Ebola epidemic, many countries in the region experienced damaged public health systems. This made it difficult to detect and respond quickly to the outbreak.

Cultural beliefs and practices also contributed to the spread of the disease. For example, some people rushed to help sick patients without wearing protective gear. Others followed traditional funeral and burial practices that put family members in contact with the body, possibly spreading the virus. This is why a comprehensive approach to outbreak control is necessary: vaccinations, infection prevention and control practices, contact tracing, laboratory services and social mobilization.

Cases

Since 1976, 34 outbreaks have occurred in 11 African countries. Most of these outbreaks involved the Zaire strain of Ebola virus, which can be spread from person to person through close contact.

The most recent outbreak in the Democratic Republic of Congo (DRC) was triggered by the death of a girl in North Kivu and Ituri provinces on September 5, 2021. The girl died after being admitted to a local health center with fever and weakness.

The outbreak was complicated by the fact that contacts of this girl’s family were largely unidentified and not followed up properly. This led to accumulating chains of transmission that were difficult to trace. In addition, the country’s quarter-century-old conflict slowed efforts to contain the disease. In spite of these challenges, this outbreak was brought under control within just 70 days.

Symptoms

The disease is spread through direct contact with blood or body fluids (such as urine, feces, saliva, sweat, and semen) of someone who has the illness. People can also be infected through touching objects that have come into contact with a sick person’s blood or body fluids, including clothes, bedding and medical equipment.

Health-care workers are often infected during the care of Ebola patients, especially when infection control measures are not strictly followed. Survivors of the disease can also infect others by sexual transmission or through breast milk.

The outbreak in the Democratic Republic of Congo is complicated by damaged public health systems and high population mobility. In addition, the country is a major transit point for travellers to and from Africa and U.S.-bound travellers undergo extensive screening at five airports to ensure they do not bring the disease home.

Treatment

With vaccines available and an adequate supply of other medical tools to treat Ebola patients, limiting outbreaks is possible. However, the high rate of human-to-human transmission, a lack of healthcare infrastructure and the fact that people easily cross borders in West Africa make containment difficult.

Besides health interventions, communities must also understand and accept messages about treatment. Beliefs and myths about the disease impede acceptance of public health messages; for example, some communities believe that hospitalization means death.

To address these challenges, the Uganda government has set up district outbreak response teams whose members are elected local leaders with a mandate from the affected communities. These committees are supported by onsite technical officers from the national taskforce. Additionally, the country has rolled out a network of community health workers called Village Health Teams (VHTs) to support implementation of public health interventions in the affected areas.

Prevention

Vaccination, enhanced personal hygiene and improved health care delivery are key. Local capacity to monitor and report cases needs to be built up. And communication is crucial: all political, religious and cultural leaders should pass on messages about Ebola prevention to their followers.

In the future, it’s important to stop outbreaks before they spread out of control. Restricting travel may feel like a protective measure, but it can actually backfire by hampering the ability to identify and respond effectively.

Deforestation across Africa’s tropics is also making it more difficult to identify animal reservoirs of the virus. This could make it easier for the disease to move from isolated areas into urban centers. And high rates of migration in the region create a constant challenge for authorities to contain health threats.

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