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Introduction
In 1976, a very fatal and dangerous Virus started to infect people in a small village in DRC (Democratic Republica of Congo) and leaded to multiple deaths. People was deteriorating very fast, all having similar symptoms of Fever, bloody vomiting, diarrhea and then deaths. This deadly new virus was called Ebola virus referring to the Ebola River where the first outbreak happened.
The Ebola Virus was thought to be transmitted from animal to humans then from human to human transmission. The Virus acquired the ability to be transmitted between humans, a characteristic mark for any virus to cause global pandemic. The Ebola through to be transmitted to humans from the barely cooked meats of infected animals.
Since 1967 until 2014, the Ebola Virus diseases or what is formally known as Ebola Hemorrhagic disease killed less than 1000 people only. The Health care [image: ]providers specialized in combating pandemics controlled the disease very well by isolating the sick people from the healthy ones. In 2014, the unexpected happened, hundreds of people went to the hospital with symptoms similar to those with Ebola virus diseases. It was then proved that Guinea and the whole world was on the brink of a newly and deadly outbreak of Ebola virus that threatened the life of 7 billion people living in this planet.
Ebola virus is a member of a virus family called Filoviridae and 6 species of this family was identified until now. They are: 1- Zaire 2- Bundibugyo 3- Sudan 4- Tai Forest 5- Reston 6- Bombali
The new outbreak that occurred in 2014 belongs to Zaire Ebola Species.
Transmission
The natural host of Ebola virus is thought to be the fruits bats which lived in west Africa. Human were infected with they have contacted with the blood, body secretions, organs and the flesh of the infected animals. Animals like chimpanzees, gorillas, monkeys and bats can be infected too and can spread the infection directly to humans.
Human-to-human infection occurs when the healthy individuals are contacted with blood, vomiting, urines, stool and secretions of infected individuals. They can even get the infection if they have contacted with the fluids of the infected dead individuals. Health workers are frequently infected when they are treating the sick people with Ebola when the precautions criteria are not followed strictly. They are also at risk of infection in burial ceremonies.
Symptoms
The symptoms of Ebola are not very specific and Ebola is highly suspected when the symptoms took place in location near of the outbreak or the person has recently visited the countries which suffers from Ebola outbreaks. The window period of Ebola virus symptoms is 2 to 21 days. This means when the person has [image: ]got the infection, the time between getting the infection and the appearance of the symptoms are ranging between 2 to 21 days maximum. 21 days are the number of days required to confirm that the individual suspected to be infected with Ebola is free from the infection. Unlike HIV, individuals with Ebola virus infection are not contagious in the window period until the [image: Image result for ebola virus]appearance of symptoms. The symptoms of Ebola virus are
- Fever
- Generalized tiredness
- Muscle ache
- Headache
- sore throat
These symptoms then followed by
- Diarrhea and bloody vomiting
- Skin rash
- Deterioration of kidney and liver function with elevation of liver enzymes, low platelets and low WBC
- External bleeding like nose and gum bleeding and internal bleeding like bloody stool.
Diagnosis
Diagnosis of Ebola virus is very tricky and difficult. it is hard to distinguish between Ebola virus symptoms and other infectious diseases like Malaria, typhoid fever and other hemorrhagic diseases. In order to diagnose Ebola we need to use one of these following methods:-
- ELISA test
- Antigen detection test
- PCR
- electron Microscopy
Viral isolation
Samples like whole blood and body fluids are preferred for the infection. These samples should be handled with extreme caution because it is highly contagious. These samples when transported internationally, should be transported with triple packaging system to insure protection.
Treatment
There is no yet a specific treatment for Ebola virus, the only treatment we have is the treatment of the symptoms occurred in Ebola infected individuals. Unfortunately Ebola is a very devastating diseases and it kills 50% to 90% of individuals infected with Ebola virus. Rehydration with Iv fluids, blood transfusion and plasma transfusion are some treatment options to control the symptoms.
RvS-ZEBOV is a name of a vaccine used in the countries that have high Ebola infection rate. The vaccine is available since 2015 and initial data indicated that the vaccine is highly effective in the protection of Ebola. But due to the multiple strains of Ebola and the lack of availability of the vaccine to all people, we still face some challenges.
Prevention and Control
There are multiple factors that help us to perfectly control any outbreaks. These factors relies on a good community awareness of the disease, good case management, surveillance and infection tracing and having a good laboratory services. In addition to that we need to have a very professional medical staff that handle and control the cases, and also we need good isolation system to help isolate the infected people from the healthy ones. Also we need to have a very professional burial system because as we know, dead bodies are also a source of the infection. Risk reduction should also focus on 4 important aspects
Reduce human contact with animals which causes the infection, that can be done by handling and dealing with the cadavers of these animals with protective measures like gloves. Also increasing the awareness of people to not consume the raw meat of any animal and cook it very well before consumption.
Reducing the risk of human to other human infection, this can be done by using the preventive measures when dealing with infected people like gloves and masks. In addition by isolating the infected individuals from the healthy one. Also by washing the equipments used in treating Ebola infected individuals.
Following the outbreak strict measurements , following any individuals who were in contact with infected people for at least 21 days. Focusing on Hygiene and isolation.
Increase the awareness of safe sexual practices, because Ebola virus are also found in the semen of infected people so using safe sexual methods like wearing condoms can reduce the infection rate.
Controlling the infection of Health Workers dealing with Ebola
Taking care of people who recovered from Ebola, people recovered from Ebola may continue having many complications from the infection including phycological and mental health issues. Ebola virus may persists in some places of the body even after the disappearance of the symptoms. it can persist in the placenta of the women and in the semen of males and even in the breast milk. People survived from Ebola infection should be encouraged to perform safe sex and use condoms until 12 months from the symptoms or when their semen tested negative twice from the infection.
Ebola and UAE
United Arab Emirates remains free from the devastating virus. This is because of the strict health measures that UAE follows in cooperation with the international health organizations. UAE was prepared with the laboratories that is equipped to detect, manage and deal with Ebola virus. UAE was working closely with the world health organization and was following every new updates about diagnosis and management of the diseases. People who travel to places near the outbreak were provided by very explained details about the protective measures needed to avoid Ebola virus. UAE also suspended all the flights to the area were the Ebola virus infection is active.
References
- World Health Organization, (2019). Ebola Virus disease. Retrieved September 22,2019. From https://www.who.int/news-room/fact-sheets/detail/ebola-virus-disease
- Wikipedia Writer, (2019). Ebola Virus Disease. Retrieved September 20, 2019. https://en.wikipedia.org/wiki/Ebola_virus_disease
- CDC ,(2019). Ebola.https://www.cdc.gov/vhf/ebola/transmission/index.html
- Adam Rizvi, (2014).Watchful UAE is free of Ebola virus.https://www.thenational.ae/uae/health/watchful-uae-is-free-of-ebola-virus-1.256056
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