Global impact and prevention of Ebola

Is Ebola Only in Africa?

First identified in 1976 in what is now the Democratic Republic of Congo (then Zaire), Ebola is most commonly found in West African countries. It can also be spread throughout the world by travelers carrying infected body fluids.

Most outbreaks occur in villages near dense, forested areas where fruit bats live. These animals are the natural reservoir host for ebolaviruses.

Symptoms

Ebola is a severe and often fatal viral hemorrhagic fever. Early symptoms resemble flu and include fever over 38°C, headache, joint and muscle pain, weakness, loss of appetite, diarrhea, vomiting, and a rash that appears as discoloured elevations on the skin (maculopapular). In some cases the virus causes internal and external bleeding.

The incubation period, the time between exposure and the onset of symptoms, can range from 2 to 21 days, although eight to ten days is common. Many people die from the disease because they do not get timely medical care. Cultural beliefs that encourage family and friends to care for ill patients, along with burial practices that bring mourners into contact with the bodies of the deceased, increase the risk of spreading the disease.

Health practitioners can diagnose Ebola by asking questions and doing tests, such as a blood test or an oral swab. They will need to isolate you for up to 21 days and monitor you closely for signs of the illness.

Transmission

Ebola is spread by direct contact with body fluids of an infected person, including saliva, blood, sweat, feces, vomit, breast milk and semen. The virus can also be transmitted by touching an object that has come into contact with these fluids. Health care workers and people caring for sick relatives are at particular risk. Proper use of personal protective equipment greatly reduces this risk.

Until recently, most EVD outbreaks were confined to rural areas in Africa. However, the 2014-2016 outbreak impacted heavily urbanized Guinea, Liberia and Sierra Leone. Weak public health infrastructure and damage to road systems, transportation networks and telecommunication made it difficult to respond to the outbreak quickly. Furthermore, distrust in government led to attacks on healthcare workers, which contributed to the transmission of the disease.

Ebola belongs to a family of viruses known as filoviruses and causes hemorrhagic fever. The virus is native to Africa and has been associated with lethal outbreaks of hemorrhagic fever since 1976. The virus is named after the Ebola River in Democratic Republic of Congo. Scientists believe that fruit bats are the natural reservoir for the virus.

Treatment

Health-care workers can get infected with Ebola if they are exposed to the virus when treating patients and do not follow strict infection control procedures. Pregnant women who are infected can also pass the virus on to their unborn babies or in breastmilk. Survivors can remain infectious for up to 21 days after they recover.

The Ebola epidemic in West Africa illustrates the need for countries to build up their own health care systems to deal with disease outbreaks. These include the training of health workers and adequate funding for health infrastructure. The 2014-2016 outbreak in Sierra Leone, Guinea and Liberia was exacerbated by years of civil conflict that undermined public health systems and weakened economies.

International aid support for repairing and strengthening health-care systems in these areas is vital. Such support should not be tied to restrictions on travel or trade. Instead, it should focus on improving the capacity of developing countries to respond quickly to emerging threats.

Prevention

As the outbreak in Guinea, Liberia and Sierra Leone demonstrated, the success of any efforts to contain Ebola hinges on community-level factors. These include a strong culture of communal living in many African societies, where people look to their communities for support and guidance. Therefore, any intervention aimed at changing behaviours that lead to the spread of disease must have the support of local leaders and elders.

In addition, the countries most affected by the Ebola outbreak were emerging from civil conflict. This led to damaged health care systems, with only a small number of medical workers to serve the population.

The successful control of the epidemic required a range of public health measures including fever surveillance, patient identification, isolation and tracking of contacts. These strategies, together with community understanding and safe burial practices, have been shown to be effective in stopping the spread of the virus. Despite the successes achieved so far, further progress in preventing and controlling the disease will require sustained international investment in sub-Saharan Africa.

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