Continuing coverage of the Ebola Epidemic affecting West Africa with the potential to spread to a wider region. The 1st article in the series can be found here.
The Fight Ramps Up
The 2014 Ebola outbreak “is moving faster than our efforts to control it..this is an unprecedented outbreak accompanied by unprecedented challenges. And these challenges are extraordinary,” said Margaret Chan, director-general of the World Health Organization (WHO) in response to the continued devastation in Africa where the outbreak has claimed at least 932 lives, including that of Sierra Leone’s leading Ebola expert Dr. Sheikh Umar Khan, and over 1700 cases. The WHO announced on August 6th that it will convene a special panel to deliberate the use of experimental drugs in an attempt to control the outbreak with innovative measures.
The US Centers for Disease Control (CDC) has raised its Emergency Operations Center Response to the Ebola epidemic to a Level One, its highest level of response. Level One has occurred only 2 other times in the CDC’s history: Hurricane Katrina in 2005 and the H1N1 Outbreak in 2009. The CDC has 240 staff members working on the Ebola response and 30 members in the affected regions with more en route.
Many organizations such as US Peace Corps have already evacuated hundreds of volunteers from the most severely affected areas in West Africa. The situation has garnered international concern and the World Health Organization recently announced allocation of $100 million in funds to provide much needed supplies and officials to reverse the disease’s overwhelming tide and plans to send another 50 specialists to West Africa to help control the outbreak. But as efforts are escalated to treat those infected, containment protocols have also been expanded:
– The CDC has issued a Level 3 travel warning (highest level) for US citizens that severely discouraged from all nonessential travel to those countries hardest hit by the virus: Guinea, Sierra Leone and Liberia
– In Sierra Leone the government has announced plans to quarantine the hardest hit regions and to deploy security personnel to assist healthcare workers in their efforts to combat the disease
– Liberia has declared that all non-essential government personnel will be placed on a thirty-day long complusory leave and is making plans to close all schools temporarily
– Meanwhile from Nigeria to New York, vigilance has been increased at airports for passengers arriving from endemic regions with symptoms consistent with the Ebola virus. Dr. Jay Varma, deputy commissioner for disease control at the New York health department has reassured the public that any such affected individual would be briefly quarantined at the airport before being transported to an area hospital for further evaluation.
Infected Americans Return Home
One of the two American healthcare workers infected with the Ebola virus, Dr. Kent Brantly, arrived August 2nd from Liberia for treatment. Dr. Brantly, 33, will be treated in Atlanta at Emory University’s Clifton Road Hospital in its isolation unit. The unit was constructed in collaboration with the CDC and is only one of four of its kind in the US. Dr. Brantly’s fellow healthcare worker, Nancy Writebol, 59, who is also infected with the virus, arrived August 5th at the specially constructed isolation wing of Emory University Hospital. Both Dr. Brantly and Ms. Writebol received an experimental drug for the virus in Liberia, and the drugs were developed by San Diego-based Mapp Biopharmaceutical and Canada’s Defyrus. The treatment combines ZMapp from Mapp and ZMAb from Defyrus. The treatment has not been approved by the US Food and Drug Administration (FDA) and had previously been tested only on monkeys. ZMapp is manufactured in Nicotiana plants, the genus that includes tobacco plants.
Can Ebola Spread within the United States?
The evacuation of the two American aid workers has raised fears among the American public of a possible outbreak here in the United States. However, experts are quick to allay these fears. On Thursday, CDC Director Thomas Frieden said that the virus poses “little risk” to the American population and that the chance of an outbreak in the United States are minimal. That’s partially because though the virus is extremely aggressive with a high mortality rate among affected patients and no known vaccine or treatment, it is not very contagious. It is only spread via bodily fluids when the affected patient is actively symptomatic. Dr. Frieden has also pointed out that the United States public health delivery system is equipped to respond swiftly and decisively to such an outbreak. “The plain fact is, we can stop it from spreading in hospitals, and we can stop it from spreading in Africa, which is really the source of the epidemic and where we’re surging our response,” he said on a recent appearance on CBS’s “Face the Nation.”
Humanitarian workers should refer to the CDC guidelines and follow the steps below for prevention and/or in the case of possible infection:
– before you leave for an endemic area make sure you assemble a kit containing basic first aid medical supplies. Make sure you pack a thermometer, household disinfectant, gloves, and face masks as well in case extra supplies are needed during a potential outbreak
– be up-to-date on all immunizations and make sure to schedule a visit with your primary care provider 4-6 weeks before scheduled departing date to check if you need any additional immunizations
– when in the presence of patients with suspected Ebola or any other hemorrhagic fever disease make sure to observe strict barrier precautions. Wear gowns, gloves, and masks at all times in addition to eye protection such as face shields
– hand-washing! hand-washing! hand-washing! one of the best methods to prevent spread of Ebola is to wash your hands with soap and water – before and after interacting with patients
– avoid contact with ill or dead animals – especially primates. Do not consume bushmeat
– after returning from an endemic area, monitor for your health for 10 days if you WERE NOT exposed to the body fluids of a symptomatic infected patients. Monitor your health for 21 days if you WERE exposed to the body fluids of an infected symptomatic individual
– if you develop symptoms, please call your provider and discuss your condition before presenting to the clinic or emergency room so arrangements can be made to prevent transmission to other individuals
For more please visit the CDC website which is constantly being updated with the most recent figures and news from the front-lines of the Ebola outbreak.
Report written by Dr. Saadiyah Bilal.