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Nairaland Forum / Nairaland / General / Health / Advice On Controlling Ebola: Lessons Learned From The Nigerian Story (709 Views)
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Advice On Controlling Ebola: Lessons Learned From The Nigerian Story by DrOpeayo: 11:40pm On Oct 04, 2014 |
It's quite disheartening to see how panic can be caused by not having the right information about situations, but it is particularly worse when it is spread because inaccurate information is spread. Case in point, the intake of large amounts of salt solution to "cure" Ebola in Nigeria which led to lots of deaths due to hypertension among people who were never in the first place at risk of contacting the virus. I am writing this post particularly because of the amount of inaccurate information circulating the media due to the case of Ebola in the US and hopefully it would help people deal with the situation better. One of the things that has been taught over the years in communicable disease control is passing on accurate information to the public about what is known and being sincere to say "we still do not understand the situation, though efforts are going on to learn more and understand how best to deal with it". The most important thing is to use the already known information at hand to understand the next steps to be taken in order to fix the problem so I would go ahead and state facts about the Ebola outbreak that are known and how it would help contain the outbreak. These were the same information used to eliminate the outbreak in Lagos, Nigeria, the most populous and densely packed city in the country. Firstly, it is a fact that the disease has a symptomatic spread. What this means is that the virus can only be passed on by someone who has fallen ill already unlike a disease like HIV/AIDS that the person does not have to show symptoms before it is spread. This is very important information because you can easily trace contacts of the sick person and monitor them for symptoms for the duration of the incubation period (typically 21 days) after which if no symptoms have developed, the person is Ebola-free. For these people, quarantine is not particularly necessary, just strict monitoring of symptoms, the first of which is a fever (so they are provided with thermometers), and they are educated to identify them and promptly report. The only other "people" who can infect others are those who died from the disease. Thus strict precautions must be taken when preparing the corpses and when burying them. Secondly, it has not been proven to spread through the air. Some studies, like was reported by Hana Weingartl et al in an article titled Transmission of Ebola virus from pigs to non-human primates in 2012, have suggested airborne spread but it is still not proven among humans. What has however been observed is that even if it is remotely airborne, it is not actually happening. This is because in Nigeria, none of the other passengers in the aircraft that the index case came into the country with came down with the virus. In addition, all cases were linked to direct contact with sick individuals and these were limited to the healthcare providers who attended to sick patients and spouses ONLY. This is very vital information, though not proven by trials or experiments, but it is the fact. An equivalent scenario that comes to mind with Ebola being airborne is HIV being transmittable through saliva. Theoretically, HIV can be transmitted through saliva but in reality it doesn't happen, else it would have been way more prevalent due to the number of casual kisses we all share, if that makes sense. Thirdly, the disease spread is very preventable without being panicky about it. The basic principles of good personal hygiene goes a long way to prevent spread and I am talking about simple hand washing and alcohol rub use. The virus, like I have said earlier, spreads from symptomatic patients and also, people who died from the disease, so if you really should be avoiding people, these are those you should be. Fourthly, the disease is “curable”. I know this sounds abnormal considering there is no known cure for Ebola. Like most viral infections, Ebola is treated symptomatically. This simply means to correct all the ill effects of the virus till the body deals with it itself. So things like fluid and electrolyte replacement for the profuse diarrhoea, blood transfusion for the blood loss and other things like that are the “cure” I mean. This point is really important because this means the virus does not remain in the body of a person who was previously infected and thus he/she would not spread the disease (there are suggestions that these people would actually have immunity to further infection, though this has also not been proven). This is very important to emphasize because people do not need to be stigmatized after they have been cured of the disease. But by far the most important piece of information is that early presentation to a healthcare facility greatly improves the chance of survival of the virus. Ebola kills mainly because the person loses a lot of fluid and the blood volume becomes insufficient to circulate, leading to many organs to fail and bleeding problems and all the other late symptoms. If one presents early, fluid and electrolyte replacement can be instituted early and the chances of survival is greatly improved. Let's not panic, especially our friends in the US. True, the disease is relatively unknown and not a type we are very prepared for. Let's learn from the Nigerian story, where even though the odds were against us (the outbreak occurred at a time when doctors were on strike in an already poor health system), effective public health principles of efficient contact tracing and early detection, treatment and management of cases eliminated the disease completely from the nation. I wish all affected quick recovery and hopefully we have enough information about the virus to help our brothers in Liberia, Sierra Leone and Guinea sort out the problem as soon as possible.
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Re: Advice On Controlling Ebola: Lessons Learned From The Nigerian Story by Emeka30: 3:54pm On Jan 16, 2015 |
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