How has Ebola Infected the United States

Abstract

It’s extremely hazardous to your heath if your Local community health officials continue to maintain ignorance of disease outbreaks that occur in other parts of our globe. With the increased mobility of travel that exists today, diseases can spread from one continent to another in a matter of hours, the United States receives 200 million foreign visitors annually and anyone of them can be a carrier of disease. (bts.gov, 2018) These global health issues present new problems for community health officials, they have no choice, officials need to stay vigilant and stay current on global outbreaks.

In the Bentonville simulation we analyzed how influenza impacted the community, in this task, the Ebola virus outbreaks and its impact will be analyzed. As the notes for task 2 pointed out, the measles came to United States via the Philippines. Analyzing the Ebola Virus is important for our local community since Ebola has infected The United States in then past and well again. We need to know how to cope with the virus if it does.

Birth of Ebola Virus

Ebola was discovered in 1976 near the Ebola River which gives the virus its name. Ebola river is found in Africa it was is now the Democratic Republic of Congo. The virus has emerged periodically since then and scientist cannot figure out the source, why these recurrences. It has mainly infected countries in central Africa. (CDC.gov, 2018)

 In that first outbreak, it manifested itself as hemorrhagic fever in two places at the same time, one in the Democratic Republic of Congo and the other in South Sudan, cities that were 500 miles apart. At first it was thought to be part of the same outbreak, that an infected person carried the disease between the two cities. This initial belief of it being the same disease was discredited later when the genetic analysis of the virus was completed and determined the two outbreaks were caused by genetically different viruses. It was two separate sources that spread independently to people in each of the affected areas. Further study of the virus indicated that it had been in existence a long time prior than the first outbreak. This suggest that a change on human side changed such as population growth population growth, moving into forest areas not lived in before or direct interaction with new wildlife. (CDC.gov, 2018)

 Following the discovery, scientists went on a hunt to find the source of the virus. They obtained samples from thousands of animals, insects, and plants, initially gorillas, chimpanzees, and other mammals were thought to be the source, but they were just getting infected like the humans.  One theory today is that all mammals, including humans, as a set, are the reservoir, this is because some mammals do not experience acute illness despite the virus being present in its organs, tissues, and blood. Thus, the virus is likely maintained in the environment by spreading from host to host or through intermediate hosts or vectors. We know the virus can be transferred via bodily fluids such as tears, semen and blood. The African fruit bats are also believed to play some role in the spread of Ebola virus and may even be the source animal, however there’s no conclusive evidence of the bat’s role in transmission of Ebola. The hunt for the source continues.

The map above shows the distribution of the Ebola virus in Africa from its discovery in 1976 through the latest outbreak that ended in 2016. The table shows the data of the Ebola events. (cdc.gov, 2018) As of October 10th, 2018, Ebola Virus Disease cases were 153 confirmed and 35 probable. These cases have been reported in eastern Democratic Republic of Congo (DRC). Since the current Ebola Zaire outbreak in eastern DRC has a high case fatality rate, individual patients are being offered investigational therapeutics on an emergency basis outside clinical trials and as part of protocols for compassionate use. The hope is that these new treatments will prove effective in the combat against Ebola.  (Who.int, 2018)

Route of Transmission

Initial outbreaks were exacerbated though the use of contaminated needles and syringes. During the first outbreak in Zaire (Democratic Republic of Congo), nurses reportedly used five syringes for 300 to 600 patients a day. Next in transmission was coming in close contact with infected blood and not using proper nursing techniques. Airborne transmission was initially thought to be a contributor, this has not proven to be the case for transmission among human. Scientists continued to increase their understanding of the virus spreads, leading to effective changes in reducing transmission. The change was to change the behavior and local culture to ensure the community adhered to the proper use of the standard health care protocols.

To arrest the continued spread of the virus, 1.  the local community was educated on how the disease spreads; 2. the hospital was properly staffed and stocked with necessary equipment; 3.the healthcare personnel was trained on disease reporting, patient case identification, and methods for reducing transmission in the healthcare setting. (CDC.gov, 2018)

Data that shows these measures are working, 1. In the Ebola outbreak in West Africa in 2014, healthcare workers represented only 4% of all confirmed and probable cases of Ebola in all affected African countries combined. In the initial outbreaks, a high per cent of healthcare workers were being infected, around 25%. After all the recommended changes were put into place, the disease was spreading mostly between family members. In addition to family members, the people mourning or burying the dead, that came in to direct contact with dead bodies were the ones with high risk of getting the disease. Some of this was due to local customs, the outbreak was controlled once changes in these behavior were adopted.

Ebola Local Impact

“On 30 September 2014, the Pan American Health Organization / World Health Organization (PAHO/WHO) was informed of the first confirmed imported case of Ebola Virus Disease (EVD) in the United States”. (Who.int, 2018). With the people nowadays traveling across the Globe and coming in contact with thousands of others It’s not a stretch to imagine that the next Ebola outbreak in the United States can be in my local community; particularly living in an area of the country with one of the busiest airports in the country (Miami international airport). If it were to happen in my local community, the CDC guidelines would be the recommended action to put in place “identify, isolate and inform” (cdc.gov, 2018).

Reporting Protocol

The hospitals have been the frontlines to receive a possible patient with Ebola virus, the first role should be to “identify, isolate and inform” (cdc.gov, 2018). Putting emergencies rooms on high alert to identify and quarantine possible cases. The hospital receiving the possible affected patients would be responsible to alert the local, state and federal government officials of a possible outbreak. Through proper chain of command and in non-alarming way inform the public about a possible outbreak through the local health department and through mass media via TV, radio and cell phone messages. (nowadays there is emergency text to inform the population about a possible natural disaster or a virus outbreak).

Recommended Strategies

The first strategy should be mandatory training of healthcare workers in how to handle the Ebola virus (annual competences); with hospital protocols in place to address a possible outbreak (having a plan for quarantine, and designated employees to handle Ebola patients - an outbreak virus team). Proper use of Personal Protective Equipment (PPE) is the paramount for healthcare workers.

PPE that covers the clothing and skin and completely   protects mucous membranes is required when caring for patients with Ebola. Personnel providing care to patients with Ebola must be supervised by an onsite manager at all times, and a trained observer must supervise each step of every PPE donning/doffing procedure to ensure established PPE protocols are being adhered. Individuals unable or unwilling to adhere to infection control and PPE use procedures should not be allowed to provide care for patients with Ebola. (CDC.gov, 2018)

The second strategy should be the education and preparation of the people on the frontline of a community, the Emergency Medical Services (EMS), police officers a, airports employees and airlines employees to name a few.  A vigilant and prepared community could halt a deadly disease outbreak such as the Ebola virus. Educating on the importance of simple hygiene habits (hand washing) and signs of a virus outbreak focusing in areas of US Customs and mass transit stations. My local government contains an international airport with over 800,000 passengers arriving on international flight monthly. (miami-airport.com, 2018). Screening people who travels to Ebola affected areas and education that specific population in ways to protect themselves from the virus.

References

1.   Airline Traffic Data. (n.d.). Retrieved from https://www.bts.gov/newsroom/2017-traffic-data-us-airlines-and-foreign-airlines-us-flights
2. County, M. (n.d.). Airport Statistics. Retrieved from https://www.miami-airport.com/airport_stats.asp
3. Ebola (Ebola Virus Disease). (2017, December 27). Retrieved December 12, 2018, from https://www.cdc.gov/vhf/ebola/history/2014-2016-outbreak/index.html
4. Ebola virus disease – United States of America. (2015, June 21). Retrieved from https://www.who.int/csr/don/01-october-2014-ebola/en/

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