Community Outbreak

Description of the Outbreak of the Disease

The communicable disease to be analyzed in this essay will be the Ebola virus. The essay will involve an analysis of the outbreak of the 2014-2016 Ebola epidemic in West Africa. The World Health Organization (WHO) reported the cases of Ebola virus on 23th March 2014 in the forested rural region of Southern Guinea. This was after there were 49 confirmed cases as 29 deaths. These cases marked the commencement of the West Africa Ebola epidemic, which is by far the largest in history. The countries affected by this outbreak included Liberia, Sierra Leone. The epidemic further raised concerns about crossing the international borders in July 2014 after a Liberian-American lady with symptomatic Ebola travelled from Liberia, to Nigeria via Togo. This contributed to an outbreak in Nigeria after it spread to another city by air travel after 20 people where indicated to have confirmed or probable cases. 8 people died from this leaving 900 individuals exposed (Cohen, Brown, Alvarado, Brake, Benenson, Chen, Demma, Holton, Kohl, Lee, McAdam. Pesik, Roohi, 2016). One major difference of this outbreak from the others in history is that this was being experienced in densely populated cities which increased the chances of transmission unlike the past where the Ebola epidemics were mostly confined in the isolated rural areas. 

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During the duration of this epidemic, the Ebola virus had expanded to seven more countries including Italy, Mali, Nigeria, Senegal, Spain, United Kingdom, and the United States. The first case was reported in the United States in September 30 2014 from a man who had travelled from West Africa to Dallas. Sierra Leone had it first person die of the virus on May 26, 2014. In Liberia cases were reported as early as March 2014 and by 24 October all districts in Liberia had reported Ebola cases. Senegal’s first and only case was announced on August 29, 2014. Mali had its first case of the virus on October 23, 2014. UK reported its first case in December 29, 2014, Italy May 12, 2015, and Spain August 5, 2014 (Khaleque& Sen, 2017). 

Epidemiological Determinants of the Ebola Virus

In the 2014-2016 Ebola epidemic, the outbreak was more severe in Western Africa, where it started before spreading to other regions. The outbreak was the first ever Ebola epidemic to hit the urban cities generally characterized by high population density. This facilitated the fast transmission of the virus. During this epidemic, there was no enough capacity in the clinical setting which promoted the use of community-based care relative to hospitalization. The focal point for the virus during this epidemic was in Guinea from where it spread to other countries such as Liberia, Sierra Leone, Nigeria and Mali. WHO reported that during this epidemic approximately 28,500 cases were detected, with over 11000 deaths reported. Approximately 881 workers had been infected with about 60% not surviving.

Risk Factors for Ebola

There are three major risk factors for Ebola namely; close contact with an infected person in the later stages of infection, caring for an infected person, and during the preparation and carrying out of a decent burial for the diseased. There is no any risk with asymptomatic person. Also, little risks exist during the incubation period and in the first week of symptomatic illness. Adulthood is a risk factor that arises due to the fact that most adults are the primary care givers thereby exposing themto risks of infection (Wambani, Ogola, Arika, Rachuonyo, Burugu, 2016). There is a higher risk of transmission to family members providing care to their loved ones and with a higher risk being experienced where the care is provided at home. The risk of infection is also much higher for healthcare workers.

Transmission of Ebola

The three forms of transmission include contact with infected animals from family Pteropodidae, human contact, and viral pathogenesis. Infected animals such as gorilla, chimpanzees, fruit batand porcupines are natural host of the virus and will easily spread it. In the human to human transmission, the transmission may result from coming into direct contact with the persons who are symptomatic or those who died of the disease. The major infectious fluids through which the transmission of the virus may occur include semen, urine, vaginal fluid, saliva, breast milk, blood, vomit, feces. Direct skin-skin contact may lead to transmission but has a lower risk relative to fluid contact (Wambani, et al. 2016). 

Impact of an Outbreak to the Community

An outbreak of such a virus would cause a strain in the hospitals. The nature of the hospital would makethem unable to match the demand for the healthcare providers and other resources. This is likely possible to cause a strain on the facilities. It would be almost certain that schools would be closed. Schools brings together people from different backgrounds and areas which may be the perfect recipe for transmission. The Local government would strive to put up control measures as well as fund the initiatives to fight the disease. Businesses would be affected in terms of reduced flow of people thereby resulting to low sales as people would avoid activities that expose you. 

Reporting Protocol

The community reporting protocol indicates the structure and procedure for implementation of an effective community even-based health surveillance system. At the community level, are community health monitors who reside within the community and tasked with responsibility of identifying Ebola suspicious-event triggers and report them to the community health supervisors for further inquiry. The surveillance system is also placed at the health care facilities to detect patients presenting symptoms suspected to be of Ebola virus. In case there is a suspected case of Ebola, a team should be sent to the site. This should be an investigative team equipped with necessary protective equipment. It is tasked with the responsibility of investigating any rumor, evaluate the risk of an outbreak, gather specimen and send them to national reference laboratory for further analysis. They also have a responsibility to put in place initial control measures until the laboratory results are available. If the case of Ebola is confirmed, response team should be mobilized to carry out multisectoral outbreak control strategy. There should be creation of a surveillance system for an active Ebola case, means to place surveillance of contacts for a period of 21 days after individuals last known exposure. Individuals who become ill should be referred to an isolation ward. There should be promotion of social and behavioral intervention programs meant to enlighten the public and enhance carrying of practices that may reduce the rate of community transmission. 

Strategies to Prevent the Outbreak

An important strategy in preventing an outbreak of Ebola disease would be community education strategies. One of the things that need to be highlighted to the community would be on the need of practicing good hand hygiene. This would be carried out through washing of hands and sanitizing them. The members of the community need to be sensitized on the proper manner to carry out the burials of the infected disease. 

Another strategy that would be effective in preventing such an epidemic would be promoting the healthcare standards and the welfare standards of the healthcare practitioners. This strategy would include equipping the healthcare facilities with more advanced equipment. The healthcare teams should also have an emergency team dealing with such issues (Fallah, Skrip, Harcout, Galvani, 2015).

References

Cohen, N. J. (2016). Travel and border health measures to prevent the international spread of Ebola. MMWR supplements65.

Fallah, M., Skrip, L. A., d’Harcourt, E., & Galvani, A. P. (2015). Strategies to prevent future Ebola epidemics. The Lancet386(9989), 131.

Khaleque, A., & Sen, P. (2017). An empirical analysis of the Ebola outbreak in West Africa. Scientific Reports7, 42594.Wambani, R. J., Ogola, P. E., Arika, W. M., Rachuonyo, H. O., &Burugu, M. W. (2016). Ebola virus disease: A biological and epidemiological perspective of a virulent virus. J Infect Dis Diagn1(103), 2.

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