Tips for taming the ebola spread

The war on Ebola can only be won if preventive and control measures are in place to contain the virus in just one place and only among the infected ones. This step taken by Nigeria is in line with the World Health Organization (WHO) Statement on the Meeting of the International Health Regulations Emergency Committee […]

The war on Ebola can only be won if preventive and control measures are in place to contain the virus in just one place and only among the infected ones. This step taken by Nigeria is in line with the World Health Organization (WHO) Statement on the Meeting of the International Health Regulations Emergency Committee that took place in Geneva on 8 August 2014.
The statement has advised the following;
1.      The Ebola outbreak in West Africa constitutes an ‘extraordinary event’ and a public health risk to other States.
2.      The possible consequences of further international spread are particularly serious in view of the virulence of the virus, the intensive community and health facility transmission patterns, and the weak health systems in the currently affected and most at-risk countries.
The statement observed that the current Ebola outbreak began in Guinea in December 2013. This outbreak now involves transmission in Guinea, Liberia, Nigeria, and Sierra Leone. As at 4 August 2014, countries have reported 1 711 cases (1 070 confirmed, 436 probable, 205 suspect), including 932 deaths. This is currently the largest Ebola outbreak ever recorded. In response to the outbreak, a number of unaffected countries have made a range of travel related advice or recommendations.
Several challenges were noted for the affected countries:
1.      Their health systems are fragile with significant deficits in human, financial and material resources, resulting in compromised ability to mount an adequate Ebola outbreak control response;
2.      Inexperience in dealing with Ebola outbreaks; misperceptions of the disease, including how the disease is transmitted, are common and continue to be a major challenge in some communities;
3.      High mobility of populations and several instances of cross-border movement of travellers with infection;
The meeting has provided the following advice which is expected to be taken very serious by the affected countries.
1.      The States with Ebola transmission are expected to declare a national emergency; personally address the nation to provide information on the situation, the steps being taken to address the outbreak and the critical role of the community in ensuring its rapid control; provide immediate access to emergency financing to initiate and sustain response operations; and ensure all necessary measures are taken to mobilize and remunerate the necessary health care workforce. It is good to note that Nigeria has responded positively to this recommendation.
2.      Health Ministers and other health leaders should assume a prominent leadership role in coordinating and implementing emergency Ebola response measures, a fundamental aspect of which should be to meet regularly with affected communities and to make site visits to treatment centres.
3.      States should ensure health care workers receive: adequate security measures for their safety and protection; timely payment of salaries and, as appropriate, hazard pay; and appropriate education and training on IPC, including the proper use of PPEs.
4.      States should conduct exit screening of all persons at international airports, seaports and major land crossings, for unexplained febrile illness consistent with potential Ebola infection. The exit screening should consist of, at a minimum, a questionnaire, a temperature measurement and, if there is a fever, an assessment of the risk that the fever is caused by Ebola Viral Disease (EVD). Any person with an illness consistent with EVD should not be allowed to travel unless the travel is part of an appropriate medical evacuation
5.      There should be no international travel of Ebola contacts or cases, unless the travel is part of an appropriate medical evacuation.
To minimize the risk of international spread of Ebola;
·         Confirmed cases should immediately be isolated and treated in an Ebola Treatment Centre with no national or international travel until 2 Ebola-specific diagnostic tests conducted at least 48 hours apart are negative.
·         Contacts (which do not include properly protected health workers and laboratory staff who have had no unprotected exposure) should be monitored daily, with restricted national travel and no international travel until 21 days after exposure;
·         Probable and suspect cases should immediately be isolated and their travel should be restricted in accordance with their classification as either a confirmed case or contact.
·         States should ensure funerals and burials are conducted by well-trained personnel, with provision made for the presence of the family and cultural practices, and in accordance with national health regulations, to reduce the risk of Ebola infection.
·         States with a potential or confirmed Ebola Case, and unaffected States with land borders with affected States
·         Unaffected States with land borders adjoining States with Ebola transmission should urgently establish surveillance for clusters of unexplained fever or deaths due to febrile illness; establish access to a qualified diagnostic laboratory for EVD.
The following recommendations are very important as they are capable of dousing tension related to travels. All States are expected to do the following;
·         There should be no general ban on international travel or trade; restrictions outlined in these recommendations regarding the travel of EVD cases and contacts should be implemented.
·         States should provide travelers to Ebola affected and at-risk areas with relevant information on risks, measures to minimize those risks, and advice for managing a potential exposure.
·         The general public should be provided with accurate and relevant information on the Ebola outbreak and measures to reduce the risk of exposure.
If both the affected and non-affected countries should follow these simple measures, it is to my understanding that we will tame Ebola spread and win the battle.
All comments to Dr Aminu Magashi at [email protected]