Ebola virus disease essay
Introduction
Ebola virus disease, commonly known as Ebola, is a viral hemorrhagic fever that affects human beings and other primates like monkeys, chimpanzees, and gorillas. The condition is prevalent in the western and central African countries like the Democratic Republic of Congo, Cameroon, Nigeria, Sierra Leone, and Liberia. It is a rare but severe and acute illness, which is usually fatal if it is not treated on time. In this paper, we shall discuss in detail the Ebola virus disease, its causes, symptoms, epidemiology, and social determinants of health as well as the global implication of the disease.
Causes
The etiology of the infection are viruses of the genus ebolavirus. Some of the virus’s species are found in different countries, and they cause different strains of Ebola in those countries. Some of these species include the Sudan virus, Ebola virus, Bombali, Bundibugyo virus, Reston virus, and Tai forest. Of these species, only the Tai forest, Ebola, Sudan, and Bundibugyo virus causes infection in human beings. Reston virus causes infection in pigs and primates, while Bombali causes disease in bats but not people (Uyeki et al., 2016). Since the discovery of Ebola in 1976 near the Ebola River in the DRC, the virus has continued to cause outbreaks in various African countries, accounting for the deaths of thousands of people.
Symptoms
The signs and symptoms of Ebola appear within a period of 21 days after individuals contact the virus, with the average incubation period being 8 to 10 days. The pathogenesis of the disease in humans progresses from the dry symptoms to the wet symptoms. The dry symptoms include aches, fever, and fatigue, while wet symptoms are vomiting, diarrhea, and vomiting. Therefore the initial signs of the infection are fever, pains, and aches such as headaches, joint pains, and stomach pains. There is also fatigue, weakness, gastrointestinal signs like vomiting and diarrhea, and in advanced severe cases, there is hemorrhage, bruising, and bleeding. Here individuals show blood in their vomit, stool, and cough and from other body openings such as eyes and sites of needle injections. Other symptoms may include skin rash, red eyes, and hiccups in later stages. These signs make it a severe and fatal infection with minimal recovery, which depends on appropriate supportive care therapy and the patient’s immune response.
Mode of transmission
Ebola is a very contagious disease that can easily get transmitted from an animal to a person and from a person to another via various modes of transmission. The natural Ebola virus hosts include the Pteropodidae family of bats and some primates where the virus causes no harm. Ebola virus gets transmitted from an animal to a person through close contact with body secretions, organs, and fluids from infected animals such as gorillas, fruit bats, chimpanzees, porcupines, and forest antelope found in the equatorial forest.
Ebola then spreads from one individual to another via close contact with body fluids and secretions like saliva, urine, and blood of an Ebola-infected or dead person. It can also get transmitted via direct contact with contaminated objects like feces and vomit from an infected person or one who died from Ebola. Many healthcare professionals, like nurses and doctors, get infected while treating patients through close contact without applying then necessary precautions. Semen and breast milk from infected people has also shown to have the presence of the virus, and hence anyone who engages in sex or breastfeeds on milk from these people can also get infected. Even after recovery from the infection, people become carriers of the disease for some weeks, and close contact with their fluids can still cause transmission.
Many of the outbreaks in the affected African countries become had to manage because the relatives and friends engaged in cultural activities such as washing the dead and frequent touching of the deceased person’s things (Spengler et al., 2016). This way, many people got infected. The occurrence of the disease in those countries was significant because of the consumption of monkey and chimpanzee’s meet by indigenous communities in the rainforest countries.
Treatment
The infection gets diagnosed through laboratory tests because of its difficulty in diagnosing it clinically because of many other diseases like malaria, typhoid as well as meningitis exhibit similar signs. Some of the diagnostic methods used are antigen-capture detection tests, electron microscopy, serum neutralization tests, reverse transcriptase-polymerase chain reaction, Elisa tests, and viral isolation.
The infection, like many other viral infections, has no specific treatment because of the continued replication, mutation, and sequencing of viruses. The disease is usually treated using supportive care therapy where there is rehydration through intravenous and oral fluids and the treatment of specific signs and symptoms (Shultz et al., 2016). Here signs are treated as they occur whereby there is fluid therapy for rehydration, oxygen therapy for the difficulty in breathing, blood pressure support and others like giving drugs against fever, vomiting as well as diarrhea.
The FDA administration in the US hasn’t licensed any drug to treat Ebola. However, in the 2018 Ebola virus disease outbreak in the DRC, four strains of medicines were used to treat people on experimental and controlled procedures. Of these four, two drugs, namely mAb114 and Regeneron (REGN-EB3), showed positive results of high survival. After that, these antivirals remain in use in Ebola patients. These drugs work by stopping the virus from replicating itself, making it easy for its elimination in the body.
Demographic of interest
The West African EVD outbreak has infected over 21832 people in Guinea, Senegal, Sierra Leone, Nigeria, Mali, and elsewhere. Outside West Africa, the infection has also been seen in the US and Spain in Europe, causing a worldwide panic. In the West African outbreak, the disease caused mortality of 8690 people, and its fatality rate was at 50%. The Zaire ebolavirus species had a fatality rate of 90% in its patients (Spengler et al., 2016). The disease is not immunogenic or with any natural seasonality, but it can spread at any time of the year, as indicated by previous outbreaks. In the 2018 Ebola outbreak in DRC, which is still ongoing, there has been a total of 3461 cases, 2279 deaths, and 1169 survivors’ at least according to the data provided by the World Health Organization.
Since Ebola Virus Disease is a rare but fatal disease whose chances of survival get high if detected and treated early, medical practitioners must get notified early. Ebola is a reportable infection in the United States, where it is reported to the National Notifiable Disease Surveillance System in the US and all its territories. Any person who shows consistent symptoms such as unexplained hemorrhage, fever, fatigue, and vomiting with the presence of an epidemiological factor in 21 days becomes a person of interest (Shultz et al., 2016). The patient gets isolated, and laboratory tests are then conducted to confirm the presence of infection. If the diagnosis is positive, then the local health department gets notified, which further reports the case to the CDC emergency operations center. Afterward, the individual is carefully monitored, and contact tracing begins. In Europe, reporting gets done to the Early Warning and response system.
Social determinants of health and their contribution to Ebola virus disease
The spread, management, and control of an infectious disease like Ebola depend primarily on the various factors that are related to the society where the condition has occurred. These factors are the social determinants of health, which are elements that determine the health of individuals or populations. The health of people in any society is highly under the influence of the interactions between socioeconomic factors as well as the physical, individual, and environmental aspects around the person. These factors play hand in hand in influence an individual’s health and chances of getting, healing, or dying from a disease. Some of the social determinants of Ebola include poverty and income status of people. In most of the countries affected by Ebola in West Africa, many people are poor, and the WHO director was once quoted saying that poverty was the mother of Ebola (Spengler et al., 2016). The social fragility of his country was significant as a result of corruption and the extractive economic institutions. The poverty of this country made many people engage in activities such as eating bush meat, which is cheap when compared to conventional meals and hence increased risk of getting infected. The poverty of people and the countries also meant that they could not afford to have proper medical equipment or procedures of the screen, diagnosis, and treatment. Many people opt to stay and at home instead of going to the hospital due to poverty. This way, the infection continues to spread, and many people die.
The other social determinant that contributes to the development of this disease is the culture. The spread of many infectious diseases is a result of the lifestyle of the people involved. The development of Ebola in most of the West African countries is attributed to their social-cultural behaviors of these people. Many of the ritual practices of most people in West African countries went against the set down guidelines on the prevention of Ebola. Practices such as sharing plates of meals, sharing handwashing basins, hunting and eating bush meat, and odd burial rituals contribute to the development of the infection (WHO Ebola Response Team, 2015). In one West African community, the burial rituals included cleaning and washing the corpses, touching body parts of the dead such as the face and hands, using a common bowl to wash hands, and even lying on the dead to get their blessings. Even after education on the effects of these practices, many people continued to practice such rituals to prevent the repercussions that came with the non-practice of these rituals, such as getting harassed by the dead. Many people got infected with Ebola when the rituals got practiced on a person who died from Ebola.
The other social determinant is education and literacy. Many people were illiterate on the disease itself, signs and symptoms, how it spread, treatment, and control. At the onset of the infection, many people perceived it was common fever, and they continued taking care of the patients and ended up getting infected. The diseases also developed in many health practitioners due to a lack of adequate knowledge about the infection.
The physical environment also plays a fundamental role in the development of Ebola. The physical environment, such as the presence of the rainforest that harbors a lot of bats and primates, increased the susceptibility of people getting infected in the central and West African regions who live near the rainforest. Other physical environment elements such as roads and human settlements, such as slums, make it hard to prevent the spread of the infection. In the slums, people are close, which makes transmission easy.
Ebola epidemiological triangle
The epidemiological triangle is essential in studying health problems to understand a given disease and how it spreads. In the epidemiological triangle of Ebola, the agent is an RNA virus from family Filoviridae and the genus Ebola virus. The virus is easily transmitted, and they are found in the body fluids, feces, and meat of infected animals (Shultz et al., 2016). The Pteropodidae bats are the natural reservoirs of the Ebola virus, while the intermediate hosts are apes, monkeys, and pigs. The intermediate hosts get the infection or virus from bats. All ages and sex are susceptible to infection. In humans, the virus interferes with the ability of cells to respond to interferon-alpha proteins. It also spreads quickly in host bodies. The host of the virus is bats, apes, and when infected to humans, the infected person becomes a host. The environment of African countries, which has high humidity and low temperature, is associated with the onset of Ebola outbreaks. The seasonal migration of bats has been associated with increased human-animal contact that increases infection. The environmental factors increase the spread of the disease coupled with host factors and virulence of the virus.
The role of the community health nurse
Community health nurses play a fundamental in the detection, treatment, and control of this infection. They have a particular position to conduct surveillance for the signs and mobilizing communities in case of an outbreak. The nurses provide health education to people on disease signs and mitigation procedures. In the communities, they work while attending to people they detect cases by looking at symptoms and report people of interest to authorities to conduct further diagnostic units. They also perform data collection and analysis, which is fundamental in contact tracing, treatment, and prevention (WHO Ebola Response Team, 2015). When this demographic data is availed to the authorities, it provides insights on how the infection is getting controlled. It also provides data on the susceptibility of the occurrence of the infection at a particular place and the readiness of a region to control the disease.
National organizations addressing the Ebola virus outbreak
The CDC has played a crucial role in addressing Ebola in many ways by controlling the disease in African and preparing the United States against such an epidemic. The organization deployed its staff into Ebola-stricken countries to research on the infection and assisted local officials to combat the disease (Shultz et al., 2016). It improved contact tracing, case detection, diagnosis, and strengthened response capacities and surveillance. They also worked on a vaccine against the same infection called rVSV-ZEBOV to fight the disease. This way, they reduced the impact of the virus.
The global implication of the EVD
EVD has brought a lot of economic damages to affected countries such as loss of gross domestic output since people are sick, food security threat, the decline in employment and reduction in foreign investments since the economy is not functional and many foreigners are afraid of entering those countries (WHO Ebola Response Team, 2015). Countries such as Sierra Leone and DRC have been significantly affected. It has also resulted in traveling restrictions to those countries which have affected trade and tourism. The disease seems to be endemic in the areas in the rainforest region, such as DRC. However, there have been cases in the US and Spain, which had origins from Africa.