Research Paper on Ebola Disease

Introduction

Ebola is a virus disease that is caused by the virus known as Ebola virus. The virus belongs to the family Filoviridae. Historically, Ebola was first detected in South Sudan and Democratic Republic of Congo in 1976. In the Democratic Republic of Congo, the disease was detected near the Ebola River and hence the name Ebola. After further research, it was found that the disease leads to diseases in both human and non-human primates. Although the risk of contracting Ebola is very low, the disease is a deadly hemorrhagic fever which kills within 6 to 16 days following the onset of the symptoms. It has an incubation period of 2 to 21 days. Ebola is characterized by muscle pain, sore throat, headache, intense weakness, and fever. The disease further causes vomiting, rash, impaired liver function, external and internal bleeding, diarrhea, and impaired kidney. The greatest risk of the disease is conning into contact with an Ebola patient since one may get into contact with infected bodily fluids or infected blood. Hence, the most vulnerable population is the care providers, burial workers, and mortuary attendants.

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Disease Prevalence

Causes of Ebola

Ebola is caused by the five species of Ebola viruses namely, Ebola-Ivory Coast virus, Ebola Bundibugyo virus, Ebola-Sudan virus, and Ebola-Zaire virus. However, the origin of the virus is bats which spread it to human beings. Although it has not been confirmed by researches to have originated from bats, WHO (2018) posits that bats are the carriers of Ebola virus and this spread to people through bodily fluids, organs, blood or secretions from an infected animal.

Symptoms

Ebola manifests itself through various symptoms that include fever, fatigue, vomiting, muscle pain, abdominal pain, severe headache, severe hemorrhage, and weakness. These symptoms appear from day 2 to 21 days after Ebola exposure. However, the average days are between 8 and 10 days. Once the symptoms start, the person becomes infectious.

Mode of Transmission

The Ebola virus is transmitted when the bodily fluids or the blood of an infected person comes into contact with that of an infected person. Imperatively, the fruit bats are known to be the natural host of the Ebola virus. The mode of transmission can be classified into two; direct and indirect contact. Direct contact occurs through human-to-human transmission. Indirect contact, the infection arises when one is in contact with the organs, blood, secretions, and other bodily fluids. On the other hand, indirect transmission occurs when one gets into contact with contaminated environments such as the needle. This mode of transmission was first experienced when the disease first occurred. The first person to contact the disease was admitted in hospital in Zaire but since it was known which disease it was, the nurse assumed that the fever was due to malaria and gave a quinine shot. After going home, the patient died and was buried in a traditional African burial. During the burial, the women who removed the blood from his body died shortly after the burial. Additionally, the caregivers who reused the needle used to inject quinine shot to the patient did not sterilize the needle. The virus spread to whoever came into contact with the unsterilized needle and died afterward. This shows that when people's blood and secretions contain the virus, they become infectious.

Complications

The complications of Ebola arises when the virus overcomes the ability of the immune system such that the antibodies cannot stop it from spreading. After the virus spreads in the body, it causes complications such as ocular complications, cardiovascular disease, severe headache, fever, anemia, Cardiopathy, scabies, and fatigue (Tiffany et al., 2016).

Treatment

There is no known treatment for the Ebola virus disease because the disease's natural reservoirs are not known. Hence, further spread of the disease must be avoided by separating the infected people from the rest of the patients and facility. The isolated patients are then given intensive supportive care and since they are dehydrated, they are given either oral or intravenous rehydration. Despite the challenges in treatment, the disease can be prevented through a series of practices. Prevention methods basically focus on hampering the mode of transmission and as such, contact with blood, secretions of any bodily fluid containing virus should be avoided. First, any materials such as medical equipment and personal protective equipment among others touched by an Ebola-infected patient. Other items that are non-disposable such as furniture, rubber boots, needles, and building structures should be decontaminated professionally. Secondly, one should observe both environmental and personal hygiene. Good hygiene entails washing hands using liquid soap or alcohol-based hand rub after touching mouth, nose or eyes. Thirdly, the food must be cooked thoroughly before served for consumption by human beings. Thorough cooking destroys the virus making it inactive and hence limiting the spread of the disease.

Demography of Ebola Virus Disease

According to the World Health Organization, around a population of 10,000 people had been infected with Ebola in the year 2014. The occurrence of Ebola in the African countries has marked a higher death rate as compared to the US because the states are always prepared to take the necessary principles and measures against Ebola. In the Asian regions, billions of individuals live in indigenous settings and are mainly powerless in as far as seeking wellbeing is concerned and therefore highly prone to Ebola infection. This implies that the probability that Asia will take a significant hit from the Ebola infection is very minimal.

The first case of this virus infection was reported in 1976 in Zaire, and presently in the Democratic Republic of Congo. Back then, there were 280 reported deaths and 318 cases. There was also 88% case fatality rates. The source of transmission was the use of needles which were contaminated in an outpatient clinic. The outbreak that was reported in 2014 in West Africa was the largest since the emergence of Ebola. Over 28000 cases were reported and over 11000 deaths during this outbreak (Mbala-kingebeni et al., 2018).

The latest outbreak was reported in DRC again in August 2018. There were 458 cases, 410 which were already confirmed and 48 of them susceptible. The deaths reported were 271 in the specific regions of DRC. This Ebola virus has led to the case fatality rate of 90% in the previously reported outbreaks. The case fatality rates in the 2014 outbreak were 64.3% in the recorded hospital admissions reducing to 31.5% in some treatment centers in the West African Countries and later falling to 20% according to the recorded data of those who sought treatment from outside West Africa.

Reporting of Ebola

Ebola virus disease rare but very deadly disease that has a significant impact on the affected populations. It is a notifiable disease that is reportable to the National Notifiable Disease Surveillance System. The early recognition is very important in as far as prevention and control are concerned. Persons suspected of having been infected by the Ebola virus are constantly put under evaluation by the responsible health providers and determine the patient's epidemiologic risk factor in the period of 21 days before the manifestation of symptoms (Mbala-kingebeni et al., 2018).

The incidence should be reported to the Centre of Disease Control within 42 days. The infected persons should be put in isolation and the healthcare personnel should be protected immediately. In case of suspected Ebola Virus disease, the local and state departments of health should be immediately contacted and assessment of contact identification initiated.

Determinants of Health

Determinants of health refer to the interrelationship between various factors that determine the health of individuals and therefore the entire population. These factors include the social and economic environment where an individual is based, the person's characteristics and the general physical environment. In most case. Individuals are not likely to control the determinants of their health. In this context, the focus is on how these factors contribute to the development of Ebola Virus Disease (Desclaux et al., 2018).

Cultural Beliefs and Behavioral Practices

High health risk behaviors have been identified in the previously affected parts of Africa. This is because of the adherence to the traditional practices of ancestral burial and funeral rites. For instance, in Liberia and Sierra Leone burial rites are highly reinforced by some of the secret societies. This is whereby the mourners have to take a bath in or anoint other members with the water used to rinse the corpse. The most prominent members of these secret societies are said to sleep and spend nights near corpse which is highly infectious with the belief the act will lead to the individual acquiring the powers.

Damaged Public Health Infrastructure

West African countries including Liberia and Sierra Leone are among the poorest globally. Therefore, transportation and telecommunication systems are still weak in the region and especially in rural settings. These factors really affect the transportation of the patients to the health centers and consequently delays communications and public education campaigns as well as transportation of the collected samples to the laboratories and reporting of the same.

Reliance on Traditional Healers

Africa has a long history of traditional medicine. The high fatality rate caused by Ebola made people perceive hospital as places of death and contagion. This lead to their lack of compliance with the advice to seek medical care. Treatment facilities which were highly secured and isolated were said to be more of prisons than healing and care places. Most new cases have a traced contact with the herbalist.

Epidemiologic Triangle of Ebola

Causative Agent

An epidemiological triangle consists of three sides denoting the connecting that exist between the agent, the host, and the environment as well as how the continuation of the disease can be prevented. The first vertex which consists of the agent provides the cause of the disease. Ebola disease is caused by the Ebola virus belonging to the family, Filoviridae (Sachdeva, Kaur, Jha & Sulania, 2017). The disease was initially known as the Ebola hemorrhagic fever. Ebola virus is a single-stranded negative Ribonucleic acid linear genome. RNA is nonsegmented and belong to the V group according to the Baltimore classification. Out of the five species, one occurs in the non-human primates while the other four occur in human beings. Additionally, the five species are named based on the region they were first detected. The four Ebola viruses that have caused disease in humans include the Ebola Bundibugyo virus, Ebola-Sudan virus, Ebola-Zaire virus, and Ebola-Ivory Coast virus (Sachdeva, Kaur, Jha & Sulania, 2017). Among the four viruses, Ebola-Zaire virus has the greatest threat to human and animals in sub-Saharan Africa. It is known to have a fatality rate of 90%. On the other hand, the Ebola-Reston virus is known to have caused the disease to primates and not human beings. All the five species of Ebola virus have genomes that are different in sequence, number, and location of gene overlaps.

Host Factors

Ebola disease is not dependent on gender or age, it can infect anybody irrespective of age and gender. It works by inhibiting the immune responses. The Ebola infection alters the normal functioning of the innate immune system. The virus interferes with the ability of the cell to produce and respond to the interferon proteins; interferon-alpha, beta, and gamma. When this happens, the immune system becomes blunted su...