All W’African Nations Exposed To Ebola Infection, Says WHO

“THE Ebola outbreak in the West African region remains uncontained with number of cases and deaths still increasing.”

With these words, the World Health Organisation (WHO) at the weekend stressed that all the countries in the region remain at the risk of “importation” of the virus.       

   The organisation stressed that it had sent a team of experts to Lagos to work with the Federal and State Governments in putting in place necessary measures to contain the outbreak.

A statement from the body listed members of the team to include its regional and headquarters experts, made up of an epidemiologist and a case management specialist .

   “With this assistance, WHO has since made available its guidelines and tools as well as use them to assist in training various categories of health workers on contact tracing, surveillance, laboratory diagnosis, Ebola case management, infection prevention and control and public health education using WHO Standard Operating Procedures, to support the country’s efforts in containing further spread of Ebola virus,” they noted.

   It added: “The WHO tools provided also include, job aids, database software and training aids.

“WHO also provided personal protective equipment (PPE) and thermometers to supplement on those being sourced by the government. The team remains in Lagos to provide technical guidance and assist in closely monitoring the situation.”

   Already,  West  African countries have begun regional efforts to contain the spread of Ebola.   

  From today a four-man delegation will be visiting Togo to put in place epidemiological surveillance centres for beneficiary countries under the West African Disease Surveillance (WARDS) project.    Other tasks in this regard are expected to follow in the coming weeks.

  But the region, comprising 15 member states would need among others, to invest a minimum of $50 million to stand a chance of “prosecuting an effective response.”

   The campaign against the virus is being hampered by the realisation that the financial resources needed to respond to epidemic outbreaks are not within the reach of any single country within the region.

    According to the West African Health Organisation (WAHO), besides measures already announced by the various health ministers, the countries must even without the financial outlay, manage to “implement synchronised cross-border interventions.” 

   Other urgently needed measures include strengthening of preventive and control measures, active surveillance of cases, treatment and care of suspected cases, multi-sectorial coordination and collaboration, beefing up of logistic and material support, social mobilisation in Guinea, Liberia and Sierra Leone.

    In its intervention statement made available to The Guardian at the weekend, by the Burkina Faso-based organisation,  also needed is  “a strengthening of epidemiological surveillance, organisation of rapid assessments, social mobilisation, training of medical personnel etc. within all countries of the region.”

     The WHO wants the over 260 million citizens across the region to key into the safety precaution and curtailment measures as the best rampart against the virus. 

   Responding to The Guardian’s enquiry in Abuja on what the regional group was doing to ensure  the success of  collaborative measures , the Economic Community of West African States (ECOWAS) director of information, Mr. sunny Ugoh said: “Apart from what has been announced, the epidemiological situation in the three most affected countries is monitored weekly and emerging information is widely shared. Regular coordination meetings are held in the countries as well as the pursuit of advocacy visits to European Union delegation, Embassies of China, and France including USAID with the aim of securing assistance for affected countries. Meetings are also held with laboratories notably Pasteur Institute, CDC with a view to strengthening diagnostic capabilities.” 

  “The commission has in addition always drawn attention to the letter sent to ECOWAS Ministers of Health reminding them of the need to comply with the provisions of the International Health Regulations governing the issue of border closures during epidemics and preventive measures to take at points of entry in their respective countries during the ongoing Ebola epidemic. Of course, letters were also addressed to the President of the ECOWAS Commission and Partners advocating  mobilisation of additional resources to support affected countries.” 

  He added : “When the 45th ECOWAS Summit of Heads of State and Governments held in Accra,  Ghana, last month, Nigeria announced a total financial support of $3.5 million to assist affected countries. Guinea, Liberia and Sierra were given $1 million each while WAHO had $500,000 to enable the organisation  to respond appropriately to epidemics.”

   But despite the absence of a vaccine or curative therapy, Ebola outbreaks could most certainly be contained by early detection and isolation of cases, contact tracing and monitoring of contacts, and rigorous procedures for infection control, according to the WHO.

   The Director-General of WHO, Dr. Margaret Chan, in an overview of the Ebola situation delivered to the Presidents of Guinea, Liberia, and Sierra Leone said she had convened an Emergency Committee that would meet on August 6, 2014, to assess the international implications of West Africa’s outbreak, under the provisions of the International Health Regulations.

    The Guardian learnt that the United States (U.S.) government will begin testing an experimental Ebola vaccine on humans as early as next month

   According to a report published in DailyMailUK Online, the drug, which is currently being developed, has seen positive results in clinical trials when used to treat primates.

   USA Today said it had prompted the U.S. government to move towards testing the possible life-saving vaccine on people for the first time.    According to the report, the National Institute of Health’s infectious (NIH) disease unit has been working with the Food and Drug Administration (FDA) to put the vaccine through trials as quickly as possible. 

   Chan said: “Finally, despite the absence of a vaccine or curative therapy, Ebola outbreaks can most certainly be contained. Bedrocks of outbreak containment include early detection and isolation of cases, contact tracing and monitoring of contacts, and rigorous procedures for infection control.

   “Moreover, we do have some evidence that early detection of cases and early implementation of supportive therapy increases the chances of survival. This is another message that needs to be communicated to the public.”

   On the Emergency Committee, Chan said: “Under the provisions of the International Health Regulations, I have convened an Emergency Committee that will meet on 6 August to assess the international implications of West Africa’s outbreak.

   “I am relying on the experts in this Committee, including those from West African nations, to heighten international awareness of the magnitude of this outbreak and the many challenges that need urgent support from the international community.

   “I am also here to learn first-hand your specific concerns and needs for support.

   “As I said, Ebola outbreaks can be contained. Chains of transmission can be broken. Together, we must do so.”

  The director of the infectious disease unit, Anthony Fauci, said the paper results could be available early next year. 

   Despite moves to begin testing potential vaccines on humans, experts predict the first commercially-available preventative jab, sanctioned for use on the general population, is likely to take two to six years.

   A lack of funding could hamper vital clinical trials, researchers have said. At least four new drugs are at the developmental stage in labs across the U.S. with trials involving primates yielding positive results.

    But researchers warn a lack of funding threatens the speed at which the first preventative jab could be available for human use. Dr. Thomas Geisbert of the University of Texas said he believed a vaccine would be approved in the next two to six years.

   Geisbert, whose lab is working on some of the drugs, said: “There are at least four vaccines that can protect against Ebola (in monkeys). But how do you take this to the next level?”

   He said he believed a vaccine would be available from two to six years. “I hate to say this, but it really depends on financial support for the small companies that develop these vaccines. Human studies are expensive and require a lot of government dollars. With Ebola, there’s a small global market - there’s not a big incentive for a large pharmaceutical company to make an Ebola vaccine, so it’s going to require government funding.”

    Geisbert, who has studied the Ebola virus since 1988, told Scientific American there were three to five preventative vaccines that looked promising, having yielded positive results when tested on primates.

    He said many of the drugs in development were at the stage where research teams were trying to get the funds to carry out human studies.

   He said: “The hang-up point with these vaccines is the phase I trials in humans. That’s where scientists get frustrated because we know these vaccines protect animals and we don’t quite understand the regulatory process of why things can’t move faster. I can’t give you an answer as to why it’s taking so long.”

   According to Chan, accurate and detailed mapping of the outbreak is urgently needed and all affected and at-risk countries need a national response plan, and these plans need to be regionally coordinated.

   She said facilities for isolation and supportive therapy needed to be properly equipped and adequately staffed and some facilities lacked such essentials as electricity and a safe supply of running water.

   Chan said existing numbers of national and international response staff were woefully inadequate and personal protective equipment was absolutely essential, but it was hot and cumbersome, limiting the time that doctors and nurses could work on an isolation ward.

   WHO DG said: “Work is also emotionally very stressful. For national staff, salaries need to be paid.

  “Dignified burial makes an essential contribution to public trust and eases family grieving, but this must be done safely. Traditional funeral practices are a well-documented spark that ignites further chains of transmission.

   “Contact tracing is a formidable challenge, for reasons I have mentioned. Again, more staff are needed.”

   According to Chan, public awareness of the facts about this disease needs to increase dramatically and messages from presidents and community and religious leaders are important, but this outbreak needs professionally designed and implemented campaigns, again with help from external experts.

    She said depending on the epidemiological situation, governments might need to impose some restrictions, for example, on population movements and public gatherings.

   Chan said governments might need to use their police and military forces to guarantee the safety and security of response teams and that some were already doing so.

   The WHO DG added: “West Africa is facing its first outbreak of Ebola virus disease. This is an unprecedented outbreak accompanied by unprecedented challenges. And these challenges are extraordinary.

   “West Africa’s outbreak is caused by the most lethal strain in the family of Ebola viruses.

   “The outbreak is by far the largest ever in the nearly four-decade history of this disease. It is the largest in terms of numbers of cases and deaths, with 1,323 cases and 729 deaths reported to date in four countries. 

   “It is the largest in terms of geographical areas already affected and others at immediate risk of further spread. It is taking place in areas with fluid population movements over porous borders, and it has demonstrated its ability to spread via air travel, contrary to what has been seen in past outbreaks. Cases are occurring in rural areas, which are difficult to access, but also in densely populated capital cities.

  “First, this outbreak is moving faster than our efforts to control it. If the situation continues to deteriorate, the consequences can be catastrophic in terms of lost lives but also severe socioeconomic disruption and a high risk of spread to other countries. As I said before, this meeting must mark a turning point in the outbreak response.

   “In addition, the outbreak is affecting a large number of doctors, nurses, and other health care workers, one of the most essential resources for containing an outbreak. To date, more than 60 health care workers have lost their lives in helping others.   Some international staff are infected. These tragic infections and deaths significantly erode response capacity.

  “Second, the situation in West Africa is of international concern and must receive urgent priority for decisive action at national and international levels. Experiences in Africa over nearly four decades tell us clearly that, when well managed, an Ebola outbreak can be stopped.

   “This is not an airborne virus. Transmission requires close contact with the bodily fluids of an infected person, also after death. Apart from this specific situation, the general public is not at high risk of infection by the Ebola virus.

  “At the same time, it would be extremely unwise for national authorities and the international community to allow an Ebola virus to circulate widely and over a long period of time in human populations.

  “Constant mutation and adaptation are the survival mechanisms of viruses and other microbes. We must not give this virus opportunities to deliver more surprises.

  “Third, this is not just a medical or public health problem. It is a social problem. Deep-seated beliefs and cultural practices are a significant cause of further spread and a significant barrier to rapid and effective containment. This social dimension must also be addressed as an integral part of the overall response.

  “Fourth, in some areas, chains of transmission have moved underground. They are invisible. They are not being reported. Because of the high fatality rate, many people in affected areas associate isolation wards with a sure death sentence, and prefer to care for loved ones in homes or seek assistance from traditional healers.

  “Such hiding of cases defeats strategies for rapid containment. Moreover, public attitudes can create a security threat to response teams when fear and misunderstanding turn to anger, hostility, or violence.

   “Let me assure you, you are not alone in facing this unprecedented outbreak with all its unprecedented challenges.

    “Affected countries have made extraordinary efforts and introduced extraordinary measures. But the demands created by Ebola in West Africa outstrip your capacities to respond.

    “I have made myself personally responsible for coordinating international response efforts under WHO leadership, and personally responsible for mobilising the support you need, on the most urgent basis possible.”

Are you at risk of catching the incurable, deadly ebola virus?

What is Ebola virus disease?

    Ebola is a severe, often fatal illness, with a death rate of up to 90 per cent. The illness affects humans as well as primates, including monkeys, gorillas and chimpanzees.

How do people become infected with the virus?

    Ebola is transmitted through close contact with the blood, secretions, organs or other bodily fluids of infected animals.

    In Africa infection in humans has happened as a result of contact with chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead in the rainforest.

     Once a person becomes infected, the virus can spread through contact with a sufferer’s blood, urine, saliva, stools and semen. A person can also become infected if broken skin comes into contact with a victim’s soiled clothing, bed linen or used needles.

    Men who have recovered from the disease, can still spread the virus to their partner through their semen for seven weeks after recovery. The Ebola virus is fatal in 90 per cent of cases and there is no vaccine and no known cure.

Who is most at risk?

  Those at risk during an outbreak include:

. Health workers;

. family members or others in close contact with infected people;

. mourners with direct contact with the bodies of deceased victims; and

. hunters in contact with dead animals.

What are the typical signs and symptoms?

    Sudden onset of fever, intense weakness ,  muscle pain, headache and sore throat. That is followed by vomiting, diarrhoea, rash, impaired kidney and liver function and internal and external bleeding.

   The incubation period is between two and 21 days. A person will become contagious once they start to show symptoms.

When should you seek medical care?

     If a person is in an area affected by the outbreak, or has been in contact with a person known or suspected to have Ebola, they should seek medical help immediately.

What is the treatment?

    Severely ill patients require intensive supportive care. They need intravenous fluids to rehydrate them.

    But there is currently no specific treatment for the disease. Some patients will recover with the appropriate care.

Can Ebola be prevented?

  Currently, there is no licensed vaccine for Ebola. Several are being tested but are not available for clinical use.

Is it safe to travel to affected areas?

    The WHO reviews the public health situation regularly, and recommends travel or trade restrictions if necessary. The risk of infection for travellers is very low since person-to-person transmission results from direct contact with bodily fluids of victims.


Source: The Guardian