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| LETTER TO EDITOR |
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| Year : 2015 | Volume
: 4
| Issue : 2 | Page : 141-142 |
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Ebola epidemic in West Africa: Identified challenges and recommended measures
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Chennai,Tamil Nadu, India
| Date of Web Publication | 16-Jun-2015 |
Correspondence Address:
Saurabh RamBihariLal Shrivastava
3rd Floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur Guduvancherry Main Road, Sembakkam Post, Kancheepuram - 603 108, Tamil Nadu
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/2278-0521.157901
How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Ebola epidemic in West Africa: Identified challenges and recommended measures. Saudi J Health Sci 2015;4:141-2 |
Dear Sir,
The Ebola virus disease was first reported in 1976 in Central Africa, and since then almost 20 such outbreaks have been reported by its five different species (Sudan, Zaire, Bundibugyo, Reston, and Tai Forest). [1] The 2014 outbreak of Ebola originated in the first quarter of the year in Guinea, and since then, the disease has spread to Sierra Leone, Liberia, Nigeria, Senegal, and the Democratic Republic of Congo (unrelated outbreak). [1],[2] Owing to its enormous burden (viz. 5833 confirmed cases) and high case fatality rate (viz. 2833 Ebola attributed deaths) within a span of 6 months, the current outbreak has been declared as an international public health emergency in August 2014. [3],[4] However, the worst part of the epidemic is that even the healthcare professionals (viz. doctors, nurses, outreach workers, laboratory technician, etc.) are not spared from the disease. [1],[3]
Although history suggests that all previous outbreaks of Ebola disease were contained easily, the current outbreak has shown enormous potential to spread wide across the globe. [3],[4] This has been attributed to multiple loopholes and inherent shortcomings in the health system, namely absence of preparedness; delayed initial response; weak public health infrastructure (viz. minimal laboratory support/no isolation wards, treatment centers/no logistics support); poor socioeconomic status of the people residing in affected regions; migration of infected people across the land borders in search of jobs; international travel; extreme shortage of health professionals; either absence or incomplete follow-up of contacts; poor awareness among masses about the disease dynamics (viz. infectiousness/period of infectivity/mode of transmission/high risk behavior/preventive strategies); minimal trust on public authorities; development of a sense of fear about the disease among people; approaching traditional healers for their ailments; no precise estimates about the magnitude of the disease (as most of them are utilizing services of the public health sector); long-term funeral rituals involving extensive body contact with the deceased; and existence of no specific treatment or vaccine for the disease. [1],[5],[6],[7],[8],[9]
In order to address these shortcomings and save lives of health personnel/masses, a wide range of interventions has been proposed to eventually control the disease. [7],[8] These measures comprise strengthening of the public healthcare delivery system; steps to neutralize socioeconomic disparities across the globe; exhaustive case finding through the World Health Organization (WHO)-approved laboratories; isolation of patients and their contacts; symptomatic treatment of the confirmed cases; contact tracing and monitoring each contact for 21 days after exposure; infection control in healthcare settings (viz. adopt standard precautions for all patients regardless of the their clinical presentation, assign only trained personnel for isolation wards, ensure the usage of personal protective equipments by healthcare givers, safe disposal of biomedical wastes, maintain hand hygiene, safe processing of laboratory samples, prompt evaluation, and management of any health professional or person exposed to any infectious body fluid); implementing measures to increase the level of awareness about important aspects of disease and to discontinue the ritual of burial till the disease is active; avoiding handling of bush meat and contact with bats; compliance with recommended guidelines at times of international travel; fostering linkage with international agencies; and development of an effective drug and vaccine. [1],[5],[6],[7],[8],[9],[10],[11],[12]
To conclude, strengthening of public health infrastructure and adoption of necessary preventive measures can play a crucial role in reducing the burden of the disease in affected regions.
| References | |  |
| 1. | |
| 2. | Baize S, Pannetier D, Oestereich L, Rieger T, Koivogui L, Magassouba N, et al. Emergence of Zaire Ebola virus disease in Guinea. N Engl J Med 2014;371:1418-25.  |
| 3. | World Health Organization. WHO Response to the Ebola virus disease outbreak: Update by the WHO regional director for Africa. Geneva: WHO press; 2014. |
| 4. | Centers for Disease Control and Prevention. Outbreaks chronology: Ebola virus disease. Atlanta: CDC; 2014. Available from: [Last accessed on 2014 Oct 8]. |
| 5. | Chan M. Ebola virus disease in West Africa-no early end to the outbreak. N Engl J Med 2014;371:1183-5. |
| 6. | Briand S, Bertherat E, Cox P, Formenty P, Kieny MP, Myhre JK, et al. The international Ebola emergency. N Engl J Med 2014;371:1180-3. |
| 7. | Frieden TR, Damon I, Bell BP, Kenyon T, Nichol S. Ebola 2014-new challenges, new global response and responsibility. N Engl J Med 2014;371:1177-80. |
| 8. | |
| 9. | Cheng Y, Li Y, Yu HJ. Ebola virus disease: General characteristics, thoughts, and perspectives. Biomed Environ Sci 2014;27:651-3. |
| 10. | World Health Organization. Communication for behavioural impact (COMBI): A toolkit for behavioural and social communication in outbreak response. Geneva: WHO press; 2012. |
| 11. | World Health Organization. WHO interim guidance for Ebola event management at points of entry. Geneva: WHO press; 2014. |
| 12. | Marzi A, Feldmann H. Ebola virus vaccines: An overview of current approaches. Expert Rev Vaccines 2014;13:521-31. |
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