Ebola - Taming a Killer Virus
The 1995 Hollywood blockbuster movie Outbreak -- starring Dustin Hoffman, imagined the outbreak of a fictional Ebola–like virus called ‘Motaba’ in Zaire (now the Democratic Republic of Congo) and its spreading to a small town in the United States. The film raised various what-if scenarios that, although highly dramatized and fictional, have basis in reality.
The current Ebola outbreak in Guinea risks spreading to neighboring countries. If it happens, it could have devastating consequences in this West African country of ten million people and for its neighbors such as Liberia and Sierra Leone. Communities, in the border areas between Guinea, Liberia, and Sierra Leone, are particularly vulnerable. Sierra Leone imports many of its goods from Guinea and the Guinea capital, Conakry, is a key trading hub.
A combination of public health, health education, and communication is necessary to stop the spread of the deadly virus. Thankfully, today, the world should be well-positioned to stop its spread.
A Deadly Virus - A Doctor’s Nightmare
Once contracted, the Ebola virus (the type associated with hemorrhagic fever) attacks the body and overwhelms the immune system; it attacks every organ and tissue of the human body except the bones and skeletal muscles. Bleeding then occurs from body orifices and gaps in the skin. Huge loss of blood, renal failure, or shock leads to death—all these can happen between 2 to 21 days. The battle against Ebola is a battle against time.
Fever, intense weakness, muscle pain, headache, and sore throat are some of the symptoms. In a ‘hot zone’ with confirmed Ebola cases, these symptoms must be taken seriously and reported to health authorities immediately. Any delay can lead to further spread.
The bad news is there are no medicines and vaccines to cure Ebola; it kills between 25 % and 90% of its victims. In the outbreak in Guinea, a total of 87 suspected cases of viral hemorrhagic fever have been recorded. Of those, 61 people died.
Prevention is Better
The disease is transmitted by direct contact with blood, feces, sweat, sexual contact, or unprotected handling of contaminated corpses. Avoiding contact with those who are infected with Ebola is the best way to contain the spread. Sadly, practices such as touching or hugging bodies of Ebola victims during their funeral (common in parts of West Africa) are often direct sources of more infection. Media have reported that Sierra Leone authorities are investigating the case of a 14-year-old boy who died in the town of Buedu, eastern Kailahun District. The boy had travelled to Guinea to attend the funeral of one of the outbreak's earlier victims.
Raising awareness of infection risks and prevention measures are vital. Public health messages should focus on:
- Reducing wildlife-to-human transmission; cooking all animal food by-products thoroughly
- Avoiding close physical contact with Ebola patients -- particularly bodily fluids
- Regular hand washing and using gloves and personal protective equipment when taking care of patients, handling animals, and samples
- Prompt and appropriate burial of those who have died from Ebola
- Disinfection of farms; immediate quarantine of those infected; restricting/banning livestock movement
Fight the Battle Over Airwaves, Text Messages, and Social Media:
When Ebola was first detected in the 1970s, health workers armed with megaphones and loud speakers used to visit villages to spread public health messages, often putting their own lives at risk. I recollect a similar experience while involved in coordinating a response to a ‘Plague’ (relatively less lethal compared with Ebola) outbreak in India in 1994.
Fast forward to 2014. Today, thanks to the penetration of mobile phone technology and radio waves into remote villages in Guinea, there are safer and better opportunities to get the health messages across without getting into contact with ‘hot zones.’
Ebola is a doctor’s nightmare and not child’s play. The flip-side of developments in transportation and aviation mean that people are much more transient and there are more flights and movements in and out of countries – potentially moving the disease further afield. Media and mobile phone technology are useful tools to fight this disease. Guinea has many mobile phone users. According to the International Telecommunication Union, a UN specialized agency for information and telecommunication technologies, Guinea had some 4.7 million mobile phone subscribers in 2012. Each one of them -- both young and old -- can be a soldier in the battle that needs to be fought using airwaves and text messages.
Public Health - A Shock Absorber
Prevention is better than cure. This maxim applies for all disasters, including public health crises such as an Ebola outbreak. Better awareness, strong preparedness measures, targeted work with vulnerable groups and spots (such as border towns), and active involvement of communities and general public to spread messages of prevention and public health are the essential ingredients.
This is better done through a robust public health system -- perhaps the only shock absorber in such crises. The country spends approximately 1.6 % of its GDP on public health. In comparison, France spends 8.9 % . The crisis should serve as a catalyst to invest better in public health measures and improve disaster preparedness measures.
*Dr. Unni Krishnan is Head of Disaster Preparedness and Response, Plan International.
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