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Wednesday, August 27, 2014

Ebola causing panic and under reporting cases appears dangerously preventing isolation and infection control

The World Health Organization (WHO) describes Ebola. It first appeared in 1976, in 2 simultaneous outbreaks, in Nzara, Sudan, and in Yambuku, Democratic Republic of Congo. The latter was in a village situated near the Ebola River, from which the disease takes its name.

Unfortunately, the only known way to prevent the rapid spread of the deadly Ebola virus is to identify those who have the infection and to isolate them while they are treated with fluids.  

Instead, what's happening in African nations where Ebola is spreading is that governments are in panic mode, while access to infection control and isolation treatments are hard to identify. 

In the absence of preventive interactions, like universal precautions and isolation, the disease will continue to spread and kill people who have no access to curative treatment. In fact, there is no definitive curative treatment for Ebola; but at least fluid monitoring and isolation can prevent secondary infections and reduce the risk or the virus from infecting others.

Now, more health care workers are at risk for contracting Ebola because the universal precautions required to reduce their exposure are not available. There are reports of universal precautions, like rubber gloves and masks being unable to reach those who need them, probably the result of corrupt customs officials looking for bribes. For whatever reason, the supplies are not getting where they are desperately needed.

CNN reports: CNN) -- "It's even worse than I'd feared," Dr. Tom Frieden, director of the Centers for Disease Control and Prevention, said Wednesday of the Ebola outbreak rampaging through West Africa. "Every day this outbreak goes on, it increases the risk for another export to another country.

"The sooner the world comes together to help Liberia and West Africans, the safer we will all be."

Frieden spoke to CNN's Nima Elbagir in Monrovia, Liberia, where fear and anger over the largest Ebola outbreak on record has grown as health officials put up quarantines around some of the capital city's poorest areas.

More than 2,600 people have been infected by Ebola in Liberia, Guinea, Sierra Leone and Nigeria since the outbreak began in December, according to the World Health Organization. Nearly 1,500 have died.

A CDC staff member was recently flown home to the United States on a private charter after spending time in close proximity with another health care worker who tested positive for Ebola in Sierra Leone.

The CDC worker is reportedly healthy and has shown no symptoms of the deadly virus. He or she is simply rotating back to the United States as previously scheduled, according to the CDC. It is CDC policy that people who have been exposed to Ebola and are traveling long distances do so on a private plane in the three weeks after exposure to lower the risk of spreading the infection.

"We think it's the right thing to do, to bring them home," CDC spokesman Tom Skinner said. "They want to come home. Their tour of duty was up, and we've made it crystal clear that if they go over there and have something like this happen and want to go home, we're going to bring them home."

The staff member will be monitored for 21 days -- the longest known incubation period -- for Ebola symptoms, but he or she currently "poses no Ebola-related risk to friends, family, co-workers, or the public," the CDC said in a statement.

Inside the Ebola outbreak with the CDC


The other health care worker, who tested positive for Ebola, has been flown to Germany to recover, Skinner said.

The World Health Organization said Monday that 120 health care workers have died in the Ebola outbreak, and twice that number have been infected.

Public health experts say several factors are to blame, including a shortage of protective gear and improper use of the gear they do have.

The fact that the disease has killed so many people working to care for infected patients is making it increasingly hard to combat the virus in West Africa, WHO said.

"It depletes one of the most vital assets during the control of any outbreak. WHO estimates that in the three hardest-hit countries, only one to two doctors are available to treat 100,000 people, and these doctors are heavily concentrated in urban areas."

Another outbreak

On Tuesday, the Ministry of Health for the Democratic Republic of Congo notified WHO of another possible Ebola outbreak.

Health officials say a woman in the Central African country became ill with symptoms of Ebola after butchering a bush animal that had been given to her by her husband. She died on August 11. Since then health care workers, relatives and other individuals who came in contact with her body have developed symptoms and died.

Between July 28 and August 18, a total of 24 suspected cases of an unidentified hemorrhagic fever, including 13 deaths, have been identified, WHO said.

Samples have been sent to laboratories to confirm that these illnesses are being caused by the Ebola virus and to identify the strain. As none of the people involved has been to the four countries affected by the other Ebola epidemic, health officials believe this to be a separate outbreak.

The Democratic Republic of Congo has seen six smaller Ebola outbreaks since the 1970s, according to the CDC.

Unfortunately, the African governments are incapable of coordinating a response to this deadly Ebola. It's impossible to say if the virus is infecting people outside of the identified cases in Western Africa, because of reports that people are actually hiding the victims.

Consequently, while universal precautions are not finding their way to those in desperate need, and governments are incapable of coordinating a response, while under reporting includes hidden victims....the outcome of this deadly trivecta are clear. Ebola will eventually spread to become a pandemic, maybe it has already reached this threshold, fueled by panic and governments unable to coordinate a pandemic response.  Ebola infections are growing while the world response is one of recoil from effective prevention.
In a world already totally consumed with war in the Middle East and millions of refugees, the Ebola virus has not received much attention.....but it's going to keep killing people until something is done to stop the spread.

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