Ebola: Keep­ing a close watch

Daily Trust - - HEALTH - By Ruby Leo & Judd Leonard Okafor

Ebola, a deadly hem­or­rhagic vi­ral dis­ease, is presently hold­ing gov­ern­ments and med­i­cal au­thor­i­ties to ran­som in three West African coun­tries.

Gam­bian health au­thor­i­ties said they were “aware and mon­i­tor­ing” out­break, but not with­out adding two chill­ing words: “se­ri­ous and con­ta­gious.”

Its first out­break in West Africa has killed some 83 people—out of 127 in­fected—in one week alone. The med­i­cal char­ity Doc­tors With­out Borders called it “un­prece­dented”.

Pre­vi­ous out­breaks have been in Sudan, Congo, Uganda, since the virus first emerged as a threat in 1976, killings hun­dreds each time be­fore pe­ter­ing out.

Now Ebola has crawled into Guinea, Gam­bia, Sierra Leone, Liberia and Nigeria’s great­est con­cern about the speed of the virus’ progress is to en­sure that the virus does not sneak in through the coun­try’s por­ous borders.

Nigeria’s prox­im­ity to its West African neigh­bours and the in­evitabil­ity of cross-bor­der trav­els is cause for worry and op­por­tu­nity to re­as­sure the pop­u­la­tion that it is “pre­pared to cur­tail any out­break,” in­for­ma­tion min­is­ter Labaran Maku an­nounced af­ter last Wed­nes­day’s meet­ing of the Federal Ex­ec­u­tive Coun­cil where Ebola was on agenda.

“So far, there is noth­ing like Ebola fever in Nigeria and the coun­cil was re­as­sured that ev­ery step has been taken to get our coun­try ready just in case in­fected per­sons come into the coun­try from our neigh­bour­ing coun­tries which have un­for­tu­nately been re­port­edly af­fected,” Maku added.

Re­ports—later re­ported to be dengue fever—of a case forced Nige­rian Cen­tre for Dis­ease Con­trol to up­grade sur­veil­lance. Sim­i­lar alert is sweep­ing across the sub-re­gion.

Min­is­ter of State for Health Khaliru Al­has­san has warned “Nige­rian cit­i­zens trav­el­ling to these coun­tries should be care­ful and should re­port any ill­ness with the above symp­toms to the near­est health fa­cil­ity.”

The warn­ing is cru­cial. When it comes to Ebola, tak­ing chances is deadly.

There are still many unan­swered ques­tions with the virus. It is trans­mit­ted from wild an­i­mals to hu­mans—through han­dling, con­tact, bod­ily flu­ids—and spreads among hu­man pop­u­la­tions through con­tact.

Ac­cord­ing to the World Health Or­gan­i­sa­tion, which com­piles data on Ebola virus dis­ease, out­breaks of EVD can achieve fa­tal­ity rates of up to 90%--that is, of ev­ery 10 in­fected, nine ac­tu­ally die from the dis­ease.

The Min­is­ter of Health, Pro­fes­sor Chris­tian Onye­buchi Chukwu stress­ing the im­por­tance of be­ing alert to any sit­u­a­tion said, “No spe­cific treat­ment or vac­cine is avail­able for use in people or an­i­mals” though sev­eral are be­ing eval­u­ated.

He ham­mered that only sup­port treat­ment was avail­able, which com­pounds the wor­ries of many due to the high mor­tal­ity level of the virus.

Once a per­son is in­fected, it takes 2 to 21 days for symp­toms to show: sud­den on­set of fever, in­tense weak­ness, mus­cle pain, headache and sore throat, says WHO.

Next to fol­low: vom­it­ing, di­ar­rhoea, rash, im­paired kid­ney and liver func­tion, and in some cases, both in­ter­nal and ex­ter­nal bleed­ing. Symp­toms are sim­i­lar for most haem­or­rhagic fevers, hence some con­fu­sion with dengue and Lassa fevers.

People are in­fec­tious as long as their blood and se­cre­tions con­tain the virus, warns WHO.

Health au­thor­i­ties have spo­ken of ready­ing medicines if the virus does jump into Nigeria. But treat­ment of pa­tients se­verely ill with EVD fo­cuses on fight­ing se­vere EVD caused de­hy­dra­tion with so­lu­tions and in­tra­venous flu­ids to en­sure re­hy­dra­tion and bal­ance body elec­trolytes (the ions in your body that do ev­ery­thing: con­duct en­ergy, trans­port nu­tri­ents, sup­port mus­cle and men­tal func­tion, con­vert calo­ries to en­ergy).

The key is preven­tion and ex­treme cau­tion with things nor­mally taken for granted, and far dif­fer­ent from tight­ened bor­der checks.

Head of NCDC, Dr Ab­dul­salami Na­sidi, has warned hunters against con­tact with bush meat killed in hunt­ing and for the pub­lic to be “ex­traor­di­nar­ily” care­ful with bush and smoked meat in line with riskre­duc­tion guide­lines set forth by the WHO, to re­duce an­i­mal-to-hu­man trans­mis­sion.

Re­as­sur­ing Nige­ri­ans on the strate­gies put in place, Na­sidi said, “En­hanc­ing our sur­veil­lance in ar­eas of high prob­a­bil­ity like for­est ar­eas; ar­eas where they eat bush meat, ar­eas where you have lots of bats and mon­keys. Sec­ondly, at this time any­body suf­fer­ing from malaria or not malaria, would be closely mon­i­tored.

He con­tin­ued, “Sur­veil­lance of­fi­cers play a key role in the preven­tion of Ebola. They used to go to the bush and any­where they see mon­key dy­ing, bats and some an­i­mals, they raise an alert, do their work there and nip it in the bud.

“I am not cau­tion­ing against bush meat in­take. I am cau­tion­ing against the hunt­ing, be­cause those who hunt for it, process it, can get the dis­ease. But those who eat smoked bush meat, not cooked one might get the virus. So eat­ing the bush meat as it were; needs to be cooked. But those who process it, those who catch it and those who like eat­ing it smoked, might end up with the virus.”

He added that it takes be­tween 2,3,4 days to al­most 21 days to see symp­toms of the dis­ease say­ing, “How­ever, if you have the virus and you don’t have the symp­toms like any nor­mal per­son, you could pass the port pro­to­col. But the mo­ment you be­come ill and you’re ar­riv­ing, the ports pro­to­col will ar­rest you. That is what hap­pened in Canada last week. A pa­tient came from West Africa and had tem­per­a­ture. They didn’t wait to check whether its malaria, they just iso­lated him and started look­ing for symp­toms of Ebola virus. So that’s how to raise red alert.”

To re­duce risk of hu­manto-hu­man trans­mis­sion in the com­mu­nity aris­ing from di­rect or close con­tact with in­fected pa­tients, par­tic­u­larly with their bod­ily flu­ids, WHO warns close phys­i­cal con­tact with Ebola pa­tients should be avoided.

Gloves and ap­pro­pri­ate per­sonal pro­tec­tive equip­ment should be worn when tak­ing care of ill pa­tients at home and reg­u­lar hand wash­ing is re­quired af­ter vis­it­ing pa­tients in hospi­tal, as well as af­ter tak­ing care of pa­tients at home.

For hy­giene, it warns com­mu­ni­ties af­fected by Ebola should in­form the pop­u­la­tion about the na­ture of the dis­ease and about out­break con­tain­ment mea­sures, in­clud­ing burial of the dead.

People who have died from Ebola should be promptly and safely buried.

PHOTO: AFP

There is no known cure or vac­cine for Ebola.

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