Virus Vs Us
Ebola had a sort of comforting, faraway otherness to it until October 9 when six Bangladeshi passengers from Ebola-affected Liberia entered the country without the knowledge of immigration, the medical team at the airport and the airline concerned. Luckily, none of the six were infected with the virus. If they were, they might have set off a mini-epidemic in Dhaka or other cities. Under what circumstances did the authorities fail to report the passengers?
“We have an agreement with airlines to inform us if they are carrying any passenger from a West African nation,” says Professor Mahmudur Rahman, director of IEDCR. “These passengers probably began their journey from other countries.” IEDCR or Institute of Epidemiology, Disease Control and Research is the national institute for conducting disease surveillance and outbreak investigation.
For all latest news, follow The Daily Star's Google News channel. According to Health ministry officials, Bangladesh is a low-risk country as it has no direct flights with West African nations. But what if one or more of the six passengers actually had the virus? Are we prepared for that scenario? This is a good question to ask when we lack in basic elements of public health like clean water, hospital beds, ambulances, doctors, nurses and simple things like sanitization soap.
“Medical teams have been posted at twenty five entry points including three international airports,” the IEDCR director says. “Passengers coming from West African countries are being followed up for twenty one days. At the Kurmitola General Hospital a 20-bed isolation ward with ICU facilities has been opened up.”
Professor Rahman sounds cool, focused and determined—attributes in short supply in many parts of the world where the fear of Ebola has spread faster than the virus itself.
Employees at a day-care centre on New York's Staten Island have begun wearing latex gloves simply because many of the students belong to a Liberian community. Attendance at schools in Dallas has fallen by 10 percent. US president Obama has ordered stepping up Ebola screening at airports in both the US and West African countries. That will include taking temperatures of all passengers going to the US from countries worst-hit by the deadly virus. Time magazine called it “a move that might calm nerves but would reveal nothing about any infected people in the symptom-free incubation phase.”
On the other side of the Atlantic, in the UK, when a woman arriving from London collapsed and vomited after arriving at Liverpool, all passengers on the bus sprinted away from the scene. Medical staff wearing protective gear and face masks removed the elderly woman who had high fever and symptoms of stroke, but not Ebola. The woman is from Africa.
These are responses driven by panic which manifests itself in a lot of ways—some of them quixotic, in polite terms. For example, an indiscriminate ban—as proposed by some politicians in many countries including the US—on travel to West Africa would make it impossible for aid workers to reach the most widely affected areas, deepening the medical and humanitarian crisis. It may also encourage travellers to pass through other countries, confounding efforts to track their origin.
Here at home, Ebola is a non-issue. There may be two reasons for that. Either we are more rational than others or we are guided by a belief that it won't affect us. Whatever it is, we seem to have managed the fear better than many other nations. “If you look at history, you will see that we are always quick responders to crises like this,” Dr Rahman says. “We have already trained more than 3,000 doctors, nurses and other staff. Sufficient amount of fluids, antibiotics has been stockpiled for general management of the virus. We have also ordered heavy duty protective gear which we will receive very soon.”
In addition, the government plans to set up archway thermal scanners at all three international airports in the country to record temperatures of arriving passengers. But can't low-grade fevers be concealed with antipyretics like Paracetamol or Tylenol? More important, by the time an Ebola carrier has a fever, he or she is already in an infectious phase and may have exposed many others to the virus. “That's why we have proposed and implemented multiple strategies to contain the entry and spread of Ebola in Bangladesh,” Professor Rahman says. “Thermal scanners are a part of our response.”
Panic won't stop the spread of the fatal virus that has so far sickened more than 9,000 people and claimed more than 4500 lives. Neither will it help the people who are stricken already. Better management and compassion will. A draft of an internal WHO report obtained by the Associated Press shows that there was a series of pivotal blunders in the fight to contain Ebola since it emerged in West Africa. Senegal offers hope. On Friday the country was declared Ebola-free by WHO. Cuba, a country of just 11 million people, sent 165 health professionals and plans to send 300 more to the region to fight the contagion.
In the words of Siddhartha Mukherjee, the Pulitzer Prize-winning professor of medicine at Columbia University, USA, “Ebola is an ingenious virus. To fight it, we need to be just as ingenious.”
The doctors and nurses who are working frantically to snuff out the burning Ebola in Africa have the same panic circuits that we all do. Yet they overcame their fear and rushed to hand life to strangers.
A virus does not have a mind. We do.
Ebola Fact Sheet
! The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission.
! The name Ebola comes from Ebola River in the Democratic Republic of Congo.
! The most severely affected countries are Guinea, Sierra Leone and Liberia.
! People remain infectious as long as their blood and body fluids, including semen and breast milk, contain the virus.
Source: WHO, NHS
The Tale of a Fatal Virus
What is Ebola virus disease?
Ebola virus disease is a severe, often fatal illness, with a death rate of up to 90 percent. Ebola first appeared in 1976 in two simultaneous outbreaks, one in a village near the Ebola River in the Democratic Republic of Congo, and the other in a remote area of Sudan.
The origin of the virus is unknown but fruit bats (Pteropodidae) are considered the likely host of the Ebola virus.
Symptoms
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 (eg oozing from the gums, blood in the stools). Laboratory findings include low white blood cell and platelet counts and elevated liver enzymes.
Treatment and vaccines
There is as yet no proven treatment. Supportive care-rehydration with oral or intravenous fluids-and treatment of specific symptoms, improves survival. Two 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, good laboratory services, safe burials and social mobilisation. Community engagement is the key. Raising awareness of risk factors for Ebola infection and protective measures that individuals can take is an effective way to reduce human transmission.
Controlling infection in health-care settings
Health-care workers should always take standard precautions when caring for patients.These include basic hand hygiene, respiratory hygiene, use of personal protective equipment (to block splashes or other contact with infected materials), safe injection practices and safe burial practices.
How not to catch Ebola?
! Avoid direct contact with sick patients as the virus is spread through contaminated body fluids
Wear goggles to protect eyes
! Clothing and clinical waste should be incinerated and any medical equipment that needs to be kept should be decontaminated
! People who recover from Ebola should abstain from sex or use condoms for three months
Source: WHO, BBC
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