Application of Community Health and Population-Focused Nursing - Research Paper

Introduction

Ebola Virus Disease (EVD) is one of the most dangerous diseases that are currently in existence. The disease is caused by the Ebola virus, which affects humans as well as other types of primates. According to WebMD (2017), there are five different strains of the Ebola virus. There is no recognized or approved treatment for Ebola now, but the available procedures make use of palliative care. Researchers have developed an experimental serum that destroys infected cells (WebMD, 2017). There is also no known vaccine for Ebola. Nevertheless, healthcare organizations such as the Centers for Disease Control (CDC) and World Health Organization (WHO) do issue travel advisories to areas that have had Ebola outbreak. As for those who are already in the regions with Ebola outbreak, they are supposed to avoid contact with animals such as bats as well as primates like baboons and monkeys. As for healthcare workers, a mask, goggles, and gloves while dealing with cases of Ebola are necessary. Although the Ebola virus is considered rare, the disease remains deadly due to its ease of infection. The disease is spread through contact with an infected person's body fluids or skin. Its mode of transfer makes it highly contagious but not as much as other diseases such as colds. The virus can't be spread through food, water or air. The condition is known to cause body aches, fever, diarrhea and sometimes internal and external bleeding. As the Ebola virus spreads through the body, it damages the organs along with the immune system (WebMD, 2017). The infection also reduces the blood clotting capability in the body hence leading to uncontrollable bleeding. Despite these visual symptoms, it is quite difficult to determine that a person has Ebola by merely looking at them. Medical practitioners may conduct tests to eliminate other diseases such as malaria or cholera. However, the analyses of tissue and blood can diagnose Ebola.

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The most widespread outbreak of the Ebola virus happened between December 2013 and June 2016. According to the CDC, a patient index had already been reported in December of the previous year (CDC, 2019). The initial case was an 18-year-old boy who lived in a village in Guinea. The boy is thought to have contracted the virus from bats. The official medical alert was issued on January 24th of 2014 after five more cases of fatal diarrhea were reported from the area. In the next two months, the disease had spread to Guinea's capital, Conakry. Guinea's ministry of health issued an alert for an unknown illness on March 23rd, 2014. The Pasteur Institute in France confirmed the virus is Ebola caused by Zaire ebolavirus (CDC, 2019). WHO officially declared the event an Ebola outbreak on 23rd March 2014, after the disease had claimed 29 lives and had 49 confirmed cases.

According to the CDC, some weak surveillance systems combined with poor public health infrastructure allowed the disease to spread to neighboring countries of Liberia and Sierra Leone (CDC, 2019). The first cases of the disease were reported in Liberia in late March of 2014. The first Ebola-related fatality in Sierra Leone was reported on 26th May 2014. As of July 2014, the disease had spread to the capital cities of three other countries. It was the first time that the Ebola virus had spread beyond its isolated rural areas into urban areas, which provided a good opportunity for its spread. Nigeria reported its first case of Ebola outbreak in July of 2014. Spain reported its first case, a volunteer from Liberia, a few months later on 5th August of the same year. On 8th of August 2014, WHO elevated the events in West Africa from merely an outbreak to a Public Health Emergency of International Concern (PHEIC). The PHEIC status is reserved for outbreaks that have the potential for intercontinental spread or required international efforts to contain. On 29th of August 2014, Senegal reported its first Ebola incidence during the epidemic. The United States officially declared its first Ebola case, a Liberian citizen who had traveled to Dallas, on 30th of September 2014. The spread of the Ebola virus continued as Mali confirmed its Ebola case on 23rd October of the same year.

Over the next few months, EVD quickly spread to other countries including those in Europe and the Americas. On 29th December 2014, the United Kingdom had the first case of Ebola through an aid worker who had traveled back to Glasgow from Sierra Leone. Italy was the last country to report an Ebola case on 12th May of 2015. The situation in Italy involved a nurse who had returned to the island of Sardinia from working in Sierra Leone. However, the outbreak was limited in western countries because the authorities managed to contain it. The fast spread of the disease was attributed to its circulation into urban centers such as Lagos and Conakry.

Epidemiological Determinants

For the EVD to spread across borders and continents, individual components were necessary. These components are called the chain of infection. They begin when the responsible agent leaves its reservoir and is conveyed through some means to the susceptible host. The gestation period for the virus is between two to 21 days. Fortunately, the infected parties remain non-contagious until the onset of the signs and symptoms. According to Galas (2014), EVD is thought to be a zoonosis. Studies have indicated that bats are the likely reservoirs of the Zaire EV because primates are susceptible to the disease. Although some documented cases have pointed to monkeys, chimpanzees, porcupines, gorillas, and antelopes as the sources of the epidemic (Galas, 2014). An earlier outbreak in the democratic republic of Congo emerged from the reuse of needles. That incidence gave researchers evidence that blood plays a significant role in the transmission of Ebola virus or may even be a significant mode of transmission. However, further evaluation pointed out several factors in the areas associated with the EVD outbreaks. Lack of clean running water, lack of routinely practiced nursing barriers, a limited supply of caps, masks and gowns in hospitals and routinely sterilized nursing equipment (Galas, 2014). The studies identified close contact as direct physical contact with an infected person as the primary risk factor in the spread of the disease during the early stages of the disease or in the hospital during the advanced stages of Ebola disease. Other risk factors for the Ebola outbreak included contact with the body fluids of the infected person, being an adult family member and sharing beds, meals, and even conversations with the infected parties (Galas, 2014). As it happened in Sierra Leone, cadaver toughing, ritual hand washing during a funeral and communal meal during funeral were the main risk factors that lead to the spread of the Ebola Virus in the country. Currently available does not indicate any natural resistance to Ebola virus infection. Vaccination is the only viable treatment option

The Outbreak in my Community

According to Galas (2014), it is highly unlikely that the Ebola virus has a reservoir in North America or Europe. Therefore any cases of the outbreak in my community would most likely be an imported case. The signs and symptoms for Ebola resemble those of common cold and flu, and the first victim will most likely ignore the warnings. That would provide the virus with a lot of time to spread through hosts who are the community members. Since it is an imported case, the victim would most likely be an adult. However, his or her condition would worsen after a few days, and they would visit the hospital. The hospitals in my community have enough supply of gloves, masks, goggles and hospital gowns. Therefore, the risk associated with doctors or nurses contracting the virus while treating the patient is significantly reduced. On the other hand, the CDC has listed the Ebola Disease among the diseases with mandatory reporting. Therefore, the hospital would move quickly to report the case to the CDC the moment they suspect it to be an Ebola infection. The CDC would proceed to try and quarantine the area by tracing the people who the victim came in contact with after entering the United States.

The outbreak would affect my local community systems by disrupting daily activities. Schools would be canceled until further notice to minimize the spread of the disease. People would rush to their local food stores to stock up their food and water reserves. However, since the local stores were not prepared for the outbreak, they will quickly run out of products hence forcing them to close shop. Panick would cripple the community members preventing most people from going to work. Hospitals would go into an emergency mode in preparation to receive the victims. The local mayor will declare a state of emergency within his jurisdiction hence allowing emergency units to conduct their activities efficiently. Most government offices would remain closed along with the services they offer except for the essential ones such as emergency services. Hospitals would, however, remain operational due to the fundamental nature of their services.

The reporting protocol for the disease would follow the path stipulated by the CDC. As a healthcare professional, on is supposed to assess if the patient had traveled or resided in the country with widespread Ebola transmission within the previous 21 days before the onset of the illness (CDC, Ebola Virus Disease(Ebola), 2014). If indeed the patient has previously traveled to the affected regions then the patient will have to be isolated in a single room with its bathroom and no access to the hallway. The nurses will then be required to implement regular contact and droplets precaution. The practitioner is then supposed to notify the hospital's infection control program and other appropriate staff. The hospital's infection control program would evaluate any risk exposures to Ebola and then immediately report to the health department. The step to be taken by the health department will depend on the level of exposure. A no known exposure level will warrant a review case with the health department. Also, a low-risk exposure, such as household members of an Ebola patient, will require a review case from the health department. However, in cases of high-risk exposure, such as direct skin contact with body fluids or skin of an Ebola patient, the department will move to arrange for the transport and testing of the specimen at a Public Health laboratory and CDC (CDC, Ebola Virus Disease(Ebola), 2014). The health department will then guide the hospitals, in consultation with the CDC, on aspects of patient care and management.

In matters concerning outbreak prevention, there are two strategies that I would use. The first one is the community education strategy. Diseases such as the Ebola virus thrives on misinformation. It is essential to educate the community members on the risk factors associated with the disease and how they can reduce the risk of exposure. As it stands, there is no known vaccine or recognized treatment for Ebola and it essential to make them understand that fact. The education program would also focus on hygiene to encourage them always to clean their hands using antiseptics. For those that experience any symptoms associated with Ebola virus, they should report to the nearest medical facility. Also, those who have come into contact with the infected parties to report to the nearest health centers for testing and avoid coming in contact with the ot...