AFRICA COUGHT A FLU

THE EBOLA VIRUS

What everyone who wants to come to Africa be it for business,leisure or any of those a thousand and one reasons is to acquire him/herself knowledge about the Ebola virus. According to the WHO & CDC Ebola is,"  Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, is a severe, often fatal illness in humans."

Key facts

• The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission.
• The average EVD case fatality rate is around 50%. Case fatality rates have varied from 25% to 90% in past outbreaks.
• The first EVD outbreaks occurred in remote villages in Central Africa, near tropical rainforests, but the most recent outbreak in west Africa has involved major urban as well as rural areas.
• Community engagement is key to successfully controlling outbreaks. Good outbreak control relies on applying a package of interventions, namely case management, surveillance and contact tracing, a good laboratory service, safe burials and social mobilisation.  
• Early supportive care with rehydration, symptomatic treatment improves survival. There is as yet no licensed treatment proven to neutralise the virus but a range of blood, immunological and drug therapies are under development. 
•  There are currently no licensed Ebola vaccines but 2 potential candidates are undergoing evaluation.

Background

 

The Ebola virus causes an acute, serious illness which is often fatal if untreated. Ebola virus disease (EVD) first appeared in 1976 in 2 simultaneous outbreaks, one in Nzara, Sudan, and the other in Yambuku, Democratic Republic of Congo. The latter occurred in a village near the Ebola River, from which the disease takes its name.
The current outbreak in west Africa, (first cases notified in March 2014), is the largest and most complex Ebola outbreak since the Ebola virus was first discovered in 1976. There have been more cases and deaths in this outbreak than all others combined. It has also spread between countries starting in Guinea then spreading across land borders to Sierra Leone and Liberia, by air (1 traveller only) to Nigeria, and by land (1 traveller) to Senegal.
The most severely affected countries, Guinea, Sierra Leone and Liberia have very weak health systems, lacking human and infrastructural resources, having only recently emerged from long periods of conflict and instability. On August 8, the WHO Director-General declared this outbreak a Public Health Emergency of International Concern.
A separate, unrelated Ebola outbreak began in Boende, Equateur, an isolated part of the Democratic Republic of Congo.
The virus family Filoviridae includes 3 genera: Cuevavirus, Marburgvirus, and Ebolavirus. There are 5 species that have been identified: Zaire, Bundibugyo, Sudan, Reston and Taï Forest. The first 3, Bundibugyo ebolavirus, Zaire ebolavirus, and Sudan ebolavirus have been associated with large outbreaks in Africa. The virus causing the 2014 west African outbreak belongs to the Zaire species. 

Transmission

 
It is thought that fruit bats of the Pteropodidae family are natural Ebola virus hosts. Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals such as chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest.
Ebola then spreads through human-to-human transmission via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e.g. bedding, clothing) contaminated with these fluids.
Health-care workers have frequently been infected while treating patients with suspected or confirmed EVD. This has occurred through close contact with patients when infection control precautions are not strictly practiced.
Burial ceremonies in which mourners have direct contact with the body of the deceased person can also play a role in the transmission of Ebola.
People remain infectious as long as their blood and body fluids, including semen and breast milk, contain the virus. Men who have recovered from the disease can still transmit the virus through their semen for up to 7 weeks after recovery from illness.

 Symptoms of Ebola virus disease

The incubation period, that is, the time interval from infection with the virus to onset of symptoms is 2 to 21 days. Humans are not infectious until they develop symptoms. First symptoms are the sudden onset of fever fatigue, muscle pain, headache and sore throat. This is followed by vomiting, diarrhoea, rash, symptoms of impaired kidney and liver function, and in some cases, both internal and external bleeding (e.g. oozing from the gums, blood in the stools). Laboratory findings include low white blood cell and platelet counts and elevated liver enzymes

 Diagnosis

 It can be difficult to distinguish EVD from other infectious diseases such as malaria, typhoid fever and meningitis. Confirmation that symptoms are caused by Ebola virus infection are made using the following investigations: 

•  antibody-capture enzyme-linked immunosorbent assay (ELISA) 
•  antigen-capture detection tests
•  serum neutralization test
•  reverse transcriptase polymerase chain reaction (RT-PCR) assay
•  electron microscopy
•  virus isolation by cell culture.

 Samples from patients are an extreme biohazard risk; laboratory testing on non-inactivated samples should be conducted under maximum biological containment conditions.

Treatment and vaccines

 
Supportive care-rehydration with oral or intravenous fluids- and treatment of specific symptoms, improves survival. There is as yet no proven treatment available for EVD. However, a range of potential treatments including blood products, immune therapies and drug therapies are currently being evaluated. No licensed vaccines are available yet, but 2 potential vaccines are undergoing human safety testing.

Prevention and control

 
Good outbreak control relies on applying a package of interventions, namely case management, surveillance and contact tracing, a good laboratory service, safe burials and social mobilisation. Community engagement is key to successfully controlling outbreaks. Raising awareness of risk factors for Ebola infection and protective measures that individuals can take is an effective way to reduce human transmission. Risk reduction messaging should focus on several factors:

•  Reducing the risk of wildlife-to-human transmission from contact with infected fruit bats or monkeys/apes and the consumption of their raw meat. Animals should be handled with gloves and other appropriate protective clothing. Animal products (blood and meat) should be thoroughly cooked before consumption.
•  Reducing the risk of human-to-human transmission from direct or close contact with people with Ebola symptoms, particularly with their bodily fluids. Gloves and appropriate personal protective equipment should be worn when taking care of ill patients at home. Regular hand washing is required after visiting patients in hospital, as well as after taking care of patients at home.
•  Outbreak containment measures including prompt and safe burial of the dead, identifying people who may have been in contact with someone infected with Ebola, monitoring the health of contacts for 21 days, the importance of separating the healthy from the sick to prevent further spread, the importance of good hygiene and maintaining a clean environment.

 

Table: Chronology of previous Ebola virus disease outbreaks

Year	Country	Ebolavirus species	Cases	Deaths	Case fatality
2012	Democratic Republic of Congo	Bundibugyo	57	29	51%
2012	Uganda	Sudan	7	4	57%
2012	Uganda	Sudan	24	17	71%
2011	Uganda	Sudan	1	1	100%
2008	Democratic Republic of Congo	Zaire	32	14	44%
2007	Uganda	Bundibugyo	149	37	25%
2007	Democratic Republic of Congo	Zaire	264	187	71%
2005	Congo	Zaire	12	10	83%
2004	Sudan	Sudan	17	7	41%
2003 (Nov-Dec)	Congo	Zaire	35	29	83%
2003 (Jan-Apr)	Congo	Zaire	143	128	90%
2001-2002	Congo	Zaire	59	44	75%
2001-2002	Gabon	Zaire	65	53	82%
2000	Uganda	Sudan	425	224	53%
1996	South Africa (ex-Gabon)	Zaire	1	1	100%
1996 (Jul-Dec)	Gabon	Zaire	60	45	75%
1996 (Jan-Apr)	Gabon	Zaire	31	21	68%
1995	Democratic Republic of Congo	Zaire	315	254	81%
1994	Cote d'Ivoire	Taï Forest	1	0	0%
1994	Gabon	Zaire	52	31	60%
1979	Sudan	Sudan	34	22	65%
1977	Democratic Republic of Congo	Zaire	1	1	100%
1976	Sudan	Sudan	284	151	53%
1976	Democratic Republic of Congo	Zaire	318	280	88%

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 EFFECTS OF THE VIRUS IN THE FOLLOWING AREAS

1. African Economy

    

   Ebola outbreak could cost West African economy $32.6bn, World Bank warns

    

   Bank says failure to adequately contain the virus would have potentially catastrophic consequences for the economy
   Global response has ‘failed miserably’, says World Bank chief
    
   
   

 World Bank president Jim Yong Kim has urged the international community to respond decisively to the Ebola outbreak.

The outbreak of Ebola could cost the West African economy $32.6bn (£20.3bn) by the end of 2015 unless the epidemic is quickly contained,the World Bank has warned.
The Bank said the future path of Ebola was highly uncertain and failure to adequately contain the virus would have potentially catastrophic consequences for the economy.
More than 3,400 people have died after contracting Ebola in the three most greatly affected countries: Guinea, Liberia, and Sierra Leone.
Jim Yong Kim, the president of the World Bank, said the virus posed a global threat and urged the international community to respond decisively.

 

 

“With Ebola’s potential to inflict massive economic costs on Guinea, Liberia, and Sierra Leone and the rest of their neighbours in West Africa, the international community must find ways to get past logistical roadblocks and bring in more doctors and trained medical staff, more hospital beds, and more health and development support to help stop Ebola in its tracks,” he said.
“The international community now must act on the knowledge that weak public health infrastructure, institutions, and systems in many fragile countries are a threat not only to their own citizens but also to their trading partners and the world at large.
“The enormous economic cost of the current outbreak to the affected countries and the world could have been avoided by prudent ongoing investment in health systems-strengthening.”
The Bank said it was generating $400m in emergency financing for the three countries hardest-hit by the crisis. It said that successful containment of Ebola in Nigeria and Senegal was evidence that it is possible to limit the spread of the virus with existing health system capacity and a resolute policy response.
It added that the economic impact of the outbreak could be limited if action was taken now to stop the epidemic and the “aversion fear” which had driven neighbouring countries to close their borders, and airlines and other regional and international companies to suspend their commercial activities in Guinea, Liberia, and Sierra Leone.
The Bank said that after the epidemic had been contained, effort would be needed to continue work to strengthen an early warning network for the virus and encourage investments in health systems.
“Taken together, the containment effort, the fiscal support, the restoration of investor confidence, and the expanded disease surveillance, diagnostic and treatment capacity promise to first stem the Ebola epidemic, and then help to reverse as quickly as possible the aversion behaviour that is causing so much economic damage,” it noted in a report.
Fears are mounting about the spread of Ebola beyond West Africa after a nurse in Spain contracted the virus. UK investor confidence was hit by the news from Spain, sending shares in holiday and airline companies tumbling for a second day on fears that the arrival of the virus in Europe will hit travel and tourism.
On Tuesday, around £1.6bn was wiped off the stock market value of holiday and travel groups and shares in the sector extended their falls on Wednesday.
Tui Travel dropped 2.5% while shares in easyJet were 1% lower. British Airways’ parent company, International Airlines Group, and the cruise company Carnival also lost about 1%.
The World Health Organisation has said it is ready to provide support for Spain as the authorities attempt to contain the first case of Ebola infection within Europe. The Spanish nurse, who is in quarantine, helped care for two elderly Spanish missionaries who died after being evacuated to Madrid for treatment.
More than 12 million British nationals visit Spain each year.
Tony Shepard, an analyst at Charles Stanley, said easyJet was the second biggest airline at Paris airports behind Air France and that France was the European country most exposed to Ebola because of its links to West Africa. IAG owns Iberia, which could face problems if the Spanish travel market dips.
The airlines are stronger than they were in 2003, when the Sars virus hit routes in Asia, because Sars arrived at the same time as the Iraq war and high fuel prices, Shepard said.
But he added: “Health concerns are one of the many factors which can affect the demand for air travel ... although Ebola has had no impact on the financial results of the airlines to date, it is possible to envisage a situation where the disease gets out of control. If investors want to take safety precautions they could lighten holdings.”

  2. Entertainment scene

Beckham to lead campaign to stop spread of deadly Ebola virus in Africa 

David Beckham is set to lead a campaign to stop the spread of the deadly Ebola virus in Africa.

As part of his role as a Unicef ambassador, the former England captain will appear in a video which highlights ways to prevent the spread of the virus and will be broadcast across West Africa.

The 39-year-old will explain how cleanliness is crucial in controlling the epidemic in Sierra Leone, Liberia and Guinea as the death toll rises to 4,033.

His role in the outbreak was revealed by Sierra Leone Football Association president Isha Johansen to the Sun on Sunday.

She said: 'To have David Beckham involved in this campaign is massive for us and we are so grateful to him. In Sierra Leone football is a religion.