1976 Ebola Outbreak in Central Africa: Yambuku Mission Hospital as Patient Zero - Essay Sample

Introduction

Zaire in Central Africa was the region that reported the first case of Ebola in 1976. With little information about the disease, there were 318 cases of which 280 people died (Rothstein, 2015). In the search for patient zero, it was determined that the outbreak originated from Yambuku Mission Hospital as a result of the use of contaminated needles. There have been frequent Ebola cases in the central region of Africa. The most recent has been the 2,000 cases of Ebola reported in the Democratic Republic of Congo where there are 1,300 deaths since the outbreak in August 2018 (CDC, 2019). The disease is prevalent in West Africa, with few reports of I prevalent in other regions. The most tragic case was in 2014 where there were 28,000 cases and over 11,000 deaths (Bower et al., 2016). There have been ten outbreaks of Ebola virus so far. The disease spreads when a person comes into contact with an infected person. Infection has been established to have originated from primates such as gorillas, chimpanzees and monkeys. Symptoms of Ebola are severe headache, fever, muscle pain, vomiting, fatigue, stomach pain, diarrhea, and unexplained hemorrhage (CDC, 2019). The symptoms appear between 2 to 8 days after exposure, and the disease has no known cure. Community health nurses help to collect data and educate the public on methods of prevention while the CDC are working to come up with a vaccine and a cure.

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Ebola is a communicable disease caused by an infection of a virus of the Ebolavirus genus and the Filoviridae family. There are five known species that include the Sudan Ebolavirus, Zaire Ebolavirus, Bombali Ebolavirus, Reston Ebolavirus, Tai Forest Ebolavirus, and the Bundibugyo Ebolavirus (Bower et al., 2016). The most tragic outbreak of Ebola in 2014 was caused by the Zaire Ebolavirus. All of the species save for the Reston Ebolavirus are known to cause disease in humans (CDC, 2019). The Reston virus causes disease to pigs, chimpanzees, monkeys, and gorillas. The Bombali virus infects bats.

Ebola is transmitted through bodily or fluid contact with an infected animal that includes monkeys, chimpanzees, gorillas, antelopes, porcupines, and fruit bats. The fruit bats of the Pteropodidae family are assumed to be natural hosts of the Ebola virus (CDC, 2019). A human can contract Ebola when he or she comes into contact with any of these infected animals. The infection then spreads through direct contact of broken skin or mucous membrane in human to human transmission. Touching a body or fluid of a person with Ebola or has died of Ebola will lead to infection. Touching an object that is contaminated with fluids from an infected person will also lead to infection. It goes without saying that sexual contact with an infected person will lead to contraction of Ebola. There have been numerous instances where healthcare workers have contracted Ebola while attending to sick patients (Bower et al., 2016). It is because they do not practice safety precautions when coming into contact with the patients. There are also cases of Ebola infection where people have come into contact with a body during burial ceremonies. Therefore, Ebola virus remains active in infected fluids even after death.

There is an incubation period of 2 to 21 days for the symptoms of Ebola to manifest. Symptoms have to show before one can be able to spread the disease. The immediate symptoms of Ebola are fatigue, fever, muscle pain, sore throat and headaches (CDC, 2019). Preceding symptoms are rashes, vomiting, diarrhea, and internal and external bleeding. Blood can be visible in stools and also ooze from the gums. There are also cases of impaired liver and kidney functions. Laboratory results will show low platelet and white blood cell count including elevated liver enzymes (CDC, 2019). One needs to report immediately to a health facility once they experience any of the symptoms.

Diagnosis of Ebola is sometimes difficult due to the similarity of symptoms with typhoid, meningitis, and malaria. Several tests are available to ascertain Ebola infection and they include serum neutralization test, electron microscopy, antibody-capture enzyme-linked immunosorbent assay, virus isolation by cell culture, reverse transcriptase polymerase chain reaction assay, and antigen-capture detection test (CDC, 2019). Any of those tests can be done with the consideration of disease prevalence and incidence, technical specifications, and the medical and social implications of the test results. It is advisable to use diagnostic tests that have undergone international and independent evaluation. Specimens for tests include white blood cells from patients exhibiting symptoms that are collected in ethylenediaminetetraacetic acid (CDC, 2019). Oral fluids can also be used as specimens. The samples from infected patients are extreme biohazard risks, and such tests should be conducted under biological containment conditions. The samples are packaged using the triple packaging system to avoid any risk of contamination.

Treatment of Ebola is currently unavailable given there is no cure, but the symptoms of the disease can be effectively managed (CDC, 2019). Supportive care such as the use of intravenous fluids to rehydrate patients can help alleviate symptoms. Treatments such as drug therapy, immune therapy, and blood products have the potential to improve survival. There was a vaccine called rVSV-ZEBOV that was used in in a trial in Guinea in 2015 that proved effective against the Ebola virus disease (CDC, 2019). There were some cases of infection on those that did not receive the vaccine and no cases of Ebola on those that received the vaccine. The rVSV-ZEBOV vaccine is currently in use in the Ebola outbreak in the Democratic Republic of Congo.

Ebola can be prevented and controlled by applying some interventions such as social mobilization. Outbreaks can be quelled successfully through community engagement where people can learn about the risk factors, how to reduce human transmission, symptoms of illness, and how to seek medical attention (Rothstein, 2015). One should use protective gloves and clothing when handling animals. Cooking animal products thoroughly can reduce the risk of infection. People should also avoid coming into contact with symptomatic people or their body fluids. Protective clothing should always be worn when handling people infected with Ebola. Regular washing of hands and bathing can also help reduce transmission especially for people in close proximity to infected people. People should practice safe burial ceremonies where they avoid contact with persons that died from Ebola. Maintenance of a clean environment is also an important prevention method. People who have been identified to have been in contact with an infected person should be monitored for 21 days (CDC, 2019). It is also crucial to quarantine the sick to prevent further spread of the virus. The Ebola virus remains active in the body even after all the symptoms have abated. For this reason, male victims should practice safe sex 12 months after treatment since semen will still contain the virus.

Ebola epidemic has been largely concentrated in the West African region in and around the Democratic Republic of Congo. There were few incidents outside of the region and they were all contained (WHO, 2014) The spread of the Ebola virus in the West African region has proven to be a challenge, and there are still efforts to stop the spread and provide treatment since the August 2018 outbreak. Data shows the ages up to 35 years show a linear increase of infected persons. Older age groups show a consistent number of infections. The data states that infections increase with age up to the age of 35 where there is a flat consistency of infection incidences (Bower et al., 2016). Cases for fatality from Ebola are highest for older adults and young children, and lowest for persons 10 to 15 years of age. These statistics could result from reporting cases, the difference in susceptibility and exposure to the disease. Women are more susceptible because mostly it is they who care for the sick compared to men. Children are in most cases kept away from the sick and the dead hence fewer incidences. Children, however, can also be in danger of exposure when their caregivers are exposed to the virus.

Ebola is a reportable disease and as such one should contact the closest medical facility in case of any symptom or related incident (CDC, 2019). The CDC and the WHO are situated in the affected regions on alert for any report. The virus can take up to 21 days to show symptoms which is enough time for someone to contract and move around with the infection without detection. The infected traveler will be able to transmit the virus after symptoms have manifested. According to the WHO, there are no or should there be any travel restrictions or trade embargoes in the West African region (WHO, 2014). Nonetheless, WHO is collaborating with health ministries from neighboring countries to monitor the alert and respond to incidences of infection.

There are certain determinants of health that have contributed to the spread of Ebola. The disease has no vaccine so far and there have been delays in related research since the first outbreak in 1976 (CDC, 2019). The delays are attributed to the reasoning that pharmaceutical companies do not want to invest in a third world country disease that will have limited returns. The vaccine development and public health management in developed countries are swift as opposed to the slow response rate afforded to developing countries by the public health international organizations. An example is the response rate and treatment of the H1N1 virus outbreak where protective equipment was distributed almost immediately and vaccines were available within a short period (Rothstein, 2015). The health disparities in developing nations are the least of the worries in relation to the social determinants of health. Affected countries such as Liberia and Sierra Leone are in contact with civil war conflicts making it difficult to attend to the epidemic. There are few doctors and limited resources as a result of war, and this has aided in increased Ebola prevalence rates (Rothstein 2015). Poverty is more often a contributor to poor health. Additionally, illiteracy, unemployment, starvation, poor sanitation, and poor access to health facilities are social determinants of health that contribute to the spread of Ebola.

The Ebola virus is spread through contact with the body or fluids of an infected person or animal. Breaks on the skin and the mucous membrane are areas where the virus penetrates into the body (CDC, 2019). The virus subverts the immune system of the host, replicates itself in the cells and causes inflammation, liver dysfunction, gastrointestinal disease, and hemorrhage from leakage of the vascular. The virus spreads due to certain environmental factors such as lack of water, poor living conditions, lack of access to health care, and unsafe food (Bower et al., 2016). Community and schools should be notified of the causes, prevention, and treatment of Ebola in the affected areas.

A community health nurse has the role of case finding, reporting, data collection, data analysis, and follow up. Community health nurses provide treatment to Ebola patients by providing medication to treat symptoms (CDC, 2019). The nurses also educate the community on how to maintain their health so as to prevent the spread of Ebola. They can perform these tasks by walking around affected regions and setting up health camps where they invite people for a checkup and educational programs. Here they can find cases of Ebola and refer them to medical centers if they cannot administer treatment themselves. The community nurses collect the data within the affected communities and analyze...