The recent outbreak of Ebola in Western Africa was the major distressing outbreak that was witnessed in the past periods. The identification of Ebola Virus Disease (EVD) in West Africa in 2014 by World Health Organization (WHO) marked the start of Ebola epidemic in the region, making it the largest in history. The outbreak claimed several cases and resulted in deaths of thousands of people in West Africa. As such, since the outbreak, Ebola remains to be an area of interest to many healthcare systems concerning its causes, transmission, treatment, and prevention and thus contributing to the focus of immense activity of research
Therefore, this paper focuses on discussing the Ebola outbreak in West Africa 2014-2016 regarding its history, countries involved and dates the disease reached those countries, epidemiological determinants of the epidemic, disease transmission route, U.S. possible outbreak, and strategies of preventing it.
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History of Ebola and Countries Involved
According to Centers for Disease Control and Prevention (CDC, 2017), the initial patient index, or the case was reported in 2013 December where a boy of 18 months old from Guinea’s small village was believed to have a bats infection. After five other fatal diarrhea cases in the same area, the district health officials were issued by an official medical alert on 24 January 2014. The virus of Ebola soon spread to Conakry, the capital city of Guinea on 13 March 2014, and the Health Ministry again issued an alert for the unknown disease. Shortly after, the France Pasteur Institute confirmed the infection to be EVD caused by Zaire ebolavirus. After that, WHO officially declared the outbreak of Ebola in Guinea on 23 March 2014 after 29 deaths and 49 cases were confirmed in the area (CDC, 2017).
Due to poor infrastructure of public health and weak systems of surveillance, it was difficult to contain this outbreak, and as such, it quickly spread to the neighboring countries of Guinea. According to Shiwani, Pharithi, Khan, Egom, Kruzliak, Maher, and Egom (2017), the illness entered Sierra Leone and Liberia by May 2014, and by July 2014, the outbreak had spread to the three countries’ capital cities and also extended to Nigeria. In October 2014, the disease had entered Mali. This was the first time the virus spread from rural areas that are isolated into urban areas that are densely populated, thus providing an opportunity that is unprecedented (CDC, 2017).
As such, WHO on August 8, 2014, declared the deteriorating condition in West Africa a “Public Health Emergency of International Concern” (PHEIC), which is only designated for events with the risk of spreading internationally or which require a response that is coordinated internationally (CDC, 2017). Ultimately, the outbreaks in Guinea, Liberia, Nigeria, and Sierra Leona was declared over by 29th December 2015, 9 March 2015, 19 October 2014, and 7 November 2015 respectively. As a result, the WHO declared it was no longer a PHEIC on March 29, 2016 (Shiwani, Pharithi, Khan, Egom, Kruzliak, Maher, & Egom, 2017).
Epidemiological Determinants and Risk factors
Five types of Ebola have been identified across these countries of West Africa since the outbreak. Evidence from research indicates that Ebola is associated with small villages, that is, it tends to break out in tiny villages which are close to tropical rainforests. Additionally, the unprecedented spread of EVD in urban areas is attributed to increased border mobilization, and conflicts between basic control practices of infection and prevailing traditional and cultural practices in West Africa (Shiwani, Pharithi, Khan, Egom, Kruzliak, Maher, & Egom, 2017).
Route of Transmission
According to Shiwani, Pharithi, Khan, Egom, Kruzliak, Maher, and Egom,( 2017), epidemics of EVD are generally thought to start through contact with body fluids or meat of an infected person. However, for large-scale transmittance of human to take place, there has to be direct contact with bloody broken skin, or of mucous membrane, or bodily fluids of a person who is infected.
Hypothetical Outbreak in the United States
If there would be an outbreak of Ebola in the U.S., it may lead to loss of lives of some people and may disrupt the learning in schools in an attempt to curb it spreads. Additionally, there would be increased spending by local governments in public hospitals to try treat and prevent the disease. The increased local government and hospital spending would also be tailored towards an intensive campaign to create awareness through educating the public on prevention measures.
Strategies that are Recommended to Prevent the Outbreak
Patient education- because Ebola viruses remain in the body of patients, survivors are advised to use condoms when mating and to undergo screenings that are regular until the achievement of negative test results. Besides, women survivors are urged to suspend breastfeeding until and left their breasts to rest for 48 hours until undetected two consecutive results are obtained. Also, surviving patients are encouraged to continue with regular health assessment follow-up for not less than a year irrespective of whether they have had adverse health symptoms (Gautier, Houngbedji, Uwamaliya, & Coffee, 2017).
On the other hand, community education involves the community as a driver for behavior change where local communities are empowered to identify practices that are unsafe and find socially and culturally acceptable strategies for replacement (Gautier, Houngbedji, Uwamaliya, & Coffee, 2017). This includes four activities: development and disseminating of communication tools that are adapted locally, training monitoring committees to spread messages of sensitization, organizing sensitization close to public areas and health centers, and revision of preventive messages.
References
Centers for Disease Control and Prevention (CDC, 2017). 2014-2016 Ebola Outbreak in West Africa. Centers for Disease Control and Diseases . Retrieved June 6, 2018, from https://www.cdc.gov/vhf/ebola/history/2014-2016-outbreak/index.html
Gautier, L., Houngbedji, K. A., Uwamaliya, J., & Coffee, M. (2017). Use of a community-led prevention strategy to enhance behavioral changes towards Ebola virus disease prevention: a qualitative case study in Western Côte d’Ivoire. Global health research and policy , 2 (1), 35.
Shiwani, H. A., Pharithi, R. B., Khan, B., Egom, C. B. A., Kruzliak, P., Maher, V., & Egom, E. E. A. (2017). An update on the 2014 Ebola outbreak in Western Africa. Asian Pacific journal of tropical medicine , 10 (1), 6-10.
