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Introduction
The chosen community outbreak is Ebola Virus Disease (EVD), which is a hemorrhagic fever. The causative microorganism is a virus belonging to the Filoviridae family (Coltart et al., 2017). Currently, a total of five strains have been identified. They include Sudan, Zaire, Bundibugyo, Reston, and Tai Forest. The disease was first identified in 1976 in a village situated around the Ebola River in the Democratic Republic of Congo, which was formerly known as Zaire. EVD spread to 17 different countries over the years resulting in more than 11,000 fatalities. Data from the Centers for Disease Control and Prevention (CDC) indicate that the dissemination of the disorder occurred in different countries as follows: Sudan and the United Kingdom in 1976, the Philippines in 1989, USA (1990), Gabon (1994), Cote dIvoire (1994), South Africa (1996), Russia (1996), Uganda (200-2001), Guinea (2014), Liberia (2014), Sierra Leone (2014), Nigeria (2014), Senegal (2014), Spain (2014), Mali (2014), and Italy in 2015 (Health Intelligence, 2014; Coltart et al., 2017).
Epidemiological Determinants
The epidemiological determinants for EVD outbreaks depend on several factors such as climatologic changes, including sudden shifts from dry to wet conditions, low temperature, and elevated absolute humidity (Fischer et al. 2015). There is increased animal contact during the dry season, which promotes the spread of the virus within bat species and non-human primates. Demographic factors such as population density, poor infrastructure, poverty, and rural-to-urban migration have contributed to disease spread in endemic regions. Other epidemiological determinants are behavioral and cultural practices such as bushmeat consumption (Alexander et al., 2015). The stability of the virus on moist, warm surfaces also contributes to infectivity.
Route of Transmission
Zoonotic transmission has been documented in EVD. Retrospective epidemiological data indicate that bat species are natural reservoirs of EVD with other animals such as non-human primates acting as intermediary hosts (Coltart et al., 2017). The Reston strain of the virus was identified in the US in chimpanzees brought in from the Philippines. Infected pigs have also led to asymptomatic dissemination to six individuals who were tending to the animals. EVD is spread to humans by direct contact with the body fluids of an infected animal. The infected human develops the disease and can spread it to other people who come into direct contact with contagious body fluids or blood. Contagion occurs during the symptomatic phase of the disease. In the initial outbreaks, reusing contaminated needles in hospitals was responsible for the transmission of the virus. Symptoms develop within 2 to 21 days of infection, with the average incubation period being 11.4 days.
Risk Factors
Risk factors for EVD include traveling to areas with the outbreak, contact with animal reservoirs, touching a sick person, or their body fluids as well as the corpse of a deceased individual. Communal practices such as sharing meals, beddings, and ritual handwashing during funeral rites increase the indirect risk of infection. Caring for infected people poses a risk of infection, particularly during the advanced stages of the disease. Morticians are at a high risk of getting the illness during the preparation of corpses for burial (Coltart et al., 2017). Researchers who perform animal studies using monkeys imported from Africa or the Philippines are at risk of contracting EVD.
How Ebola Outbreak Can Affect a Community
An Ebola outbreak would affect the community in various ways, for example, physically, economically, and mentally. The symptoms of the disease include fever, intense bleeding, headache, muscular pain, and diarrhea, which often lead to death. Therefore, EVD is a devastating illness because of the severity of its symptoms and high mortality rates. Consequently, such information poses a threat to the psychological well-being of affected communities. Furthermore, preventive measures include strategies such as isolation and social distancing that could have negative effects on mental health (Van Bortel et al., 2016). If an outbreak occurs, vast financial resources would be needed to prevent its spread, thereby leading to economic losses.
Reporting Protocol
The National Outbreak Reporting System has developed universal forms for guidance on making outbreak reports for submission to CDC. The form contains different checkboxes specifying the primary mode of disease transmission, investigation methods, dates, geographic location, the number of primary cases and their outcomes (deaths, hospitalizations, or recoveries), etiology, incubation period, signs and symptoms, secondary cases, and whether or not traceback was performed (CDC, 2017). However, the CDC (2015) has compiled a list of precise monitoring and screening policies that differ slightly from state to state. In Coles County, the monitoring and reporting standards for Illinois apply (Illinois Department of Public Health, 2015). People with a high index of suspicion should be reported to the CDCs emergency contact numbers by the county health department.
Prevention Strategies
Public health education is the most effective preventive strategy in curbing EVD. The masses should be informed about infection control measures such as isolation of patients, hand hygiene using soap and water, or sanitizers containing at least 60% alcohol and use of personal protective equipment such as face masks and gloves. There should be the avoidance of contact with body fluids from EVD patients and sharing of personal items. Safe sex and burial practices should be adopted. Contacts with infected persons, as well as the occurrence of fever, should be done, followed by quarantine if necessary. The outbreak would disrupt learning in schools as well as normal business operations as social distancing is implemented. Hospitals would be overwhelmed with sick patients and forced to implement stringent infectious control measures. Conversely, local governments would be compelled to spearhead public health awareness campaigns and provide funding to procure adequate personal protective equipment for healthcare workers.
References
Alexander, K. A., Sanderson, C. E., Marathe, M., Lewis, B. L., Rivers, C. M., Shaman, J., Drake, J.M., Lofgren, E., Dato, V.M., Eisenberg, M.C., & Eubank, S. (2015). What factors might have led to the emergence of Ebola in West Africa? PLoS Neglected Tropical Diseases, 9(6), 1-26.
CDC. (2015). Interim table of state* Ebola screening and monitoring policies for asymptomatic individuals.
Coltart, C. E., Lindsey, B., Ghinai, I., Johnson, A. M., & Heymann, D. L. (2017). The Ebola outbreak, 20132016: old lessons for new epidemics. Philosophical Transactions of the Royal Society B: Biological Sciences, 372(1721), 1-24.
Fischer, R., Judson, S., Miazgowicz, K., Bushmaker, T., Prescott, J., & Munster, V. J. (2015). Ebola virus stability on surfaces and in fluids in simulated outbreak environments. Emerging Infectious Diseases, 21(7), 1243-1246.
Health Intelligence. (2014). Chronology of Ebola Virus Disease outbreaks, 1976-2014.
Illinois Department of Public Health. (2015). Updated interim guidance for monitoring and movement of persons with potential Ebola virus exposure.
Van Bortel, T., Basnayake, A., Wurie, F., Jambai, M., Koroma, A. S., Muana, A. T., Hann, K., Eaton, J., Martin, S., & Nellums, L. B. (2016). Psychosocial effects of an Ebola outbreak at individual, community and international levels. Bulletin of the World Health Organization, 94(3), 210-214. Web.
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