“In the absence of effective treatment and a human vaccine, raising awareness of the risk factors for Ebola infection and the protective measures individuals can take is the only way to reduce human infection and death.” – World Health Organization
By ANNE MARXZE D. UMIL
MANILA – The Philippines is still safe from the deadly Ebola Virus Disease (EVD), said the Department of Health. But with the number of Filipinos working in West Africa where four of its countries – Guinea, Sierra Leone, Liberia and Nigeria – have an outbreak of the virus, the Philippine government is still taking preventive measures to keep the EVD from entering the country.
The Department of Foreign Affairs (DFA) said there are 880 Filipinos in Guinea, 1,979 in Sierra Leone, 632 in Liberia and 7,000 in various states of Nigeria. The agency is preparing to raise Alert Level 4 or mandatory repatriation for Filipinos in Guinea, Sierra Leone and Liberia – countries that were hardly hit by the Ebola outbreak.
The latest report by The Wall Street Journal said Ebola has killed 1,426 out of the 2,615 people infected by the disease. The report said nearly half of the deaths are in Liberia.
The World Health Organization (WHO) describes Ebola as one of the world’s most virulent diseases with fatality rate of up to 90 percent. The WHO Emergency Committee said the EVD outbreak is currently the largest ever recorded. They also declared the Ebola outbreak as an international public health emergency.
There are seven OFWs who returned from Sierra Leone this month who are being closely monitored by the DOH. They will be declared safe from the virus after 30-day incubation period. So far, according to DOH, the seven OFWs have not shown any symptoms of Ebola.
The DOH has also dispatched quarantine personnel at the Philippine airports to ensure that all travelers and Filipinos coming from the affected countries will go through thermal scanners. Those who will manifest symptoms of EDV will be immediately brought to the Research Institute for Tropical Medicine (RITM).
In an article, Dr. Ludovico Jurao of the Philippine Society for Microbiology and Infectious Diseases urged Filipinos returning from Ebola-affected countries in West Africa to fully disclose their health condition and their whereabouts upon arrival. He said this is a key to keep the virus from entering the country. He also advised returning Filipinos to observe precautionary measures so that they do not become the cause of the spread of the deadly Ebola in the country.
WHO also released an infographic for travelers on how to prevent Ebola virus from spreading.
What is Ebola virus and how does it spread?
The Ebola virus disease, formerly known as Ebola hemorrhagic fever, is a severe, often fatal illness. It is not an airborne disease and can only be acquired by direct contact with a person infected by Ebola.
The U.S. Center for Disease Control and Prevention (CDC) said Ebola virus causes viral hemorrhagic fever that affects multiple organ systems in the body and is often accompanied by bleeding.
The first Ebola outbreak recorded by WHO was in 1976, in a village near the Ebola River in the Democratic Republic of Congo and another, in a remote area of Sudan. The WHO said the origin of the Ebola virus is unknown. But based on available evidence, fruit bats (Pteropodidae) are considered the likely host of the virus.
There are five strains of the virus according to the WHO. These are Bundibugyo ebola virus, Zaire, Reston, Sudan and Tai Forest. The Bundibugyo, Zaire and Sudan strains of Ebola have been associated with large EVD outbreaks in Africa, whereas RESTV and TAFV have not. “The RESTV species, found in the Philippines and the People’s Republic of China, can infect humans, but no illness or death in humans from this species has been reported to date,” said WHO.
The WHO said infection occurs from direct contact through broken skin or mucous membranes with the blood, or other bodily fluids or secretions (stool, urine, saliva, semen) of infected people. Infection can also occur if broken skin or mucous membranes of a healthy person come into contact with environments that have become contaminated with an Ebola patient’s infectious fluids such as soiled clothing, bed linen, or used needles.
“Generally, a person must come into contact with an animal that has Ebola and it can then spread within the community from human to human,” the WHO said in their website.
Because the disease is highly infectious, the WHO strongly recommends that any family member who may manifest symptoms of the virus should immediately seek treatment in a hospital or any treatment center staffed by doctors and nurses qualified and equipped to treat Ebola virus victims. This is to prevent further infection and transmission of the disease to other family members and the rest of the community.
Even health workers are at risk of being infected by the virus; that is why those who are designated to take care of patients with Ebola wear protective gears to spare them from getting the virus.
The virus can still be transmitted even when the carrier has died from the virus. The WHO said additional transmission has occurred in communities during funerals and burial rituals. “Burial ceremonies in which mourners have direct contact with the body of the deceased person have played a role in the transmission of Ebola. Persons who have died of Ebola must be handled using strong protective clothing and gloves and must be buried immediately.”
The WHO recommends that those who died of the disease be handled and buried by trained case management professionals, who are equipped to properly bury the dead.
Men who have recovered from the illness are also advised to avoid sexual intercourse for at least seven weeks after recovery because they can still spread the virus to their partner through their semen. If sex cannot be avoided, WHO advised men to wear condoms while still recuperating from the disease.
According to WHO, people are infectious as long as their blood and secretions contain the virus. Infected patients are closely monitored by medical professionals to ensure that the virus is no longer circulating in their systems before returning home.
There is also no animal vaccine against Reston strain of Ebola virus according to WHO. “Routine cleaning and disinfection of pig and monkey farms (with sodium hypochlorite or other detergents) should be effective in inactivating the virus.”
If there is a suspected outbreak of Reston Ebola virus, WHO said the premises should be quarantined immediately. “Culling of infected animals, with close supervision of burial or incineration of carcasses, may be necessary to reduce the risk of animal-to-human transmission. Restricting or banning the movement of animals from infected farms to other areas can reduce the spread of the disease.”
The WHO also said as Reston Ebola virus outbreaks in pigs and monkeys have preceded human infection, it is essential to establish an active animal health surveillance system to detect new cases to provide early warning for veterinary and human public health authorities.
What are the symptoms and how is it treated?
Early symptoms to watch out for include sudden onset of fever, intense weakness, muscle pain, headache and sore throat. These early symptoms can progress to vomiting, diarrhea, rash, impaired kidney and liver function, and in some cases, internal and external bleeding will also be experienced by the patient.
The WHO says early symptoms can be mistaken for signs of diseases such as malaria, typhoid fever, meningitis or even the plague. To be sure, a suspected person with symptoms of Ebola must undergo laboratory tests. Laboratory findings include low white blood cell and platelet counts, and elevated liver enzymes in persons infected.
The incubation period, or the time interval from infection to onset of symptoms, is from two to 21 days. The WHO said patients become contagious once they begin to show symptoms. They are not contagious during the incubation period.
The most dreading fact is that there are no specific medical treatments for Ebola. There is also no licensed medicine or vaccine for Ebola virus disease. But, WHO said several products are under development. Recently, two Americans who contracted the disease in Liberia have recovered after being given an experimental drug called ZMapp. A Liberian doctor meanwhile died of Ebola despite taking ZMapp.
According to the CDC, since the product is still in an experimental stage, it is too early to know whether ZMapp is effective. “The manufacturer of this experimental treatment continues to research and evaluate the product’s safety and effectiveness,” the CDC said.
The WHO said severely ill patients needed intensive supportive care. “Patients with Ebola are frequently dehydrated and need intravenous fluids or oral rehydration with solutions that contain electrolytes. Some patients will recover with the appropriate medical care. To help control further spread of the virus, people that are suspected or confirmed to have the disease should be isolated from other patients and treated by health workers using strict infection control precautions.”
“In the absence of effective treatment and a human vaccine, raising awareness of the risk factors for Ebola infection and the protective measures individuals can take is the only way to reduce human infection and death,” WHO said.
The WHO website also provides information on the risks of getting the virus and its recommendations for travelers, the transportation sector and health care facilities on how to handle patients suspected to have symptoms of the virus.
Meanwhile in the Philippines, the DOH also released an Ebola advisory. To avoid getting the disease, the DOH reminds all Filipinos to always wash their hands; do not touch anybody who is suspected of having symptoms of Ebola or any other contagious disease without using gloves; avoid touching any part of your face without washing your hands first.