Friday, October 3, 2014

#Ebola...The 411.../.

Ebola, previously known as Ebola hemorrhagic fever is a rare but deadly disease caused by the virus of the family Filoviridae. Ebola has manifested fatally in humans and nonhuman primates {such as monkeys, gorillas} alike. There are 5 different strains of the virus primarily and they have caused devastation in different countries at different times The first identified strain of Ebola was discovered near the river Ebola in Zaire, now the Democratic Republic of Congo in 1976, hence the name Ebola. Since then, there have been sporadic outbursts here and there, but the current outbreak is the deadliest ever. The natural reservoir host of the virus remains largely unknown. However, based on available evidence, it is thought the host is animal, while the bat is the most likely culprit. Because of the usual sketchy information surrounding the first case in an outbreak, it is often very difficult to determine how the first infected human came in contact with the virus. The general consensus is through contact with an infected animal

When an infection does occur in humans, there are several ways to spread the virus during an outbreak
1)      Direct contact with blood or body fluids (including but not limited to feces, saliva, urine, vomit and semen of persons sick with Ebola
2)      Contact with objects like needles and syringes that have been contaminated with the blood or body fluids of a person sick with Ebola
During an outbreak this can spread fairly rapidly within the healthcare setting especially those where proper precautionary protocols are not in place, or not adhered to as a standard practice. Secondly, family members of the persons sick with Ebola as they are mostly likely to come into contact with the body fluids of Ebola patients
Dedicated medical equipment, preferably disposable where possible, should be used by healthcare personnel providing care to persons sick with Ebola. Where disposable items are not possible, proper sterilization techniques have been known to help. In fact, the deadly nature of this outbreak is secondary to the ease with which it can be transmitted.

Signs and Symptoms…/.
A person infected with the Ebola virus is NOT contagious until symptoms appear. Such symptoms include
1)      Inexplicable fever in the region of 101.5o F
2)      Severe headache
3)      Muscle pain
4)      Vomiting
5)      Diarrhea
6)      Stomach pain
7)      Inexplicable bleed or bruising
Symptoms can develop between 2 – 21 days post exposure to the Ebola virus, but the average is 8 – 10 days. Recovery from Ebola depends on the patient’s immune response. Persons who recover from Ebola go on to develop antibodies that last for at least 10 years

Diagnosing Ebola in a person who has been infected for only a few days is difficult because the early symptoms exhibited such as fever are no specific to Ebola virus infection. Several infections show similar early symptoms such as malaria fever, and typhoid fever. However, if a person has symptoms of Ebola and have had contact with blood or body fluids of a person sick with Ebola, or come into contact with objects that have been contaminated with blood or body fluids of persons sick with Ebola, the person should be isolated and public health officials notified at once, while awaiting results of test on samples from the person.
Currently there are no vaccines or medicines such as antivirals available in the market to treat Ebola. However, there have been successful cocktail of medicines used to manage the signs and symptoms of Ebola. The symptoms are treated as they occur. The following basic interventions when instituted in a timely manner will help reduce the mortality associated with Ebola outbreak. They are
1)      Providing IV fluid and balancing electrolyte {salts}
2)      Maintaining oxygen status and blood pressure
3)      Treating other infections if they occur
A stitch in time they say, saves nine. Whenever there is an outbreak of Ebola as we have on our hands now, healthcare workers are often at risk, as well as family members that are in close proximity to the Ebola patient. Measures include, but not limited to;
1)      Isolate all Ebola patients as well as those with common symptoms and have come into contact with persons sick with Ebola
2)      Don protective garment when caring for persons sick with Ebola
3)      Observe other universally acceptable protective measures as deemed necessary
4)      Avoid  touching the bodies of persons who have died from Ebola
5)      Contact tracing: Finding everyone who has come into direct contact with sick Ebola patients. These contacts are watched for 21 days from the contact date. If they develop fever or other cardinal symptoms consistent with Ebola infection, they are in turn isolated or quarantined, tested and provided corresponding care.
Every outbreak of the Ebola virus since 1967 has been a major threat to our healthcare delivery systems worldwide, especially the African countries. It is a constant test of our resiliency and ability to contain the outbreak. It seems like it is mother-nature’s “drill” to ensure we don’t rest on our oars, and we are always prepared to handle disasters. It’s obvious the best measure to counter this is prevention and early detection. The international community in partnership with organizations as WHO & CDC are harnessing their resources to addressing this and perhaps come up with a vaccine in the next couple of months. With the ever expanding role of the pharmacists in the community coupled with the immunization responsibilities, the pharmacy may be the first port of call for patients exhibiting early symptoms. We should be cognizant of the fact that the patient’s social history is equally important, such as recent travel history. All hands need to be on deck here as we deal squarely with this outbreak…/.

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