Community Outbreak

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 23 March 2014 in the forested rural region of Southern Guinea. This was after there were 49 confirmed cases and 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 and Sierra Leone. The epidemic further raised concerns about crossing the international borders in July 2014 after a Liberian-American lady with symptomatic Ebola traveled 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 et al., 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.  

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 on 30 September  2014 from a man who had traveled from West Africa to Dallas. Sierra Leone had its first person die of the virus on 26 May 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 29 August 2014. Mali had its first case of the virus on 23 October 2014. The UK reported its first case on December 29, 2014, Italy 12 May 2015, and Spain 5 August 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 not enough capacity in the clinical setting, which prompted the use of community-based care instead of 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. The health systems in these countries lacked the infrastructure and enough preparation for prompt reaction to the epidemic. Guinea, Liberia and Sierra Leone have been reported in a WHO Health report to have the weakest health system infrastructure across the globe (Shoman, Karafillakis, & Rawaf, 2017).

Approximately 881 health workers had been infected with about 60% not surviving. It has been indicated that in Guinea, Liberia, and Sierra Leonne, there was inadequate number of skilled health workforce, a factor that was compounded by the civil wars that these countries had been engaging in. Some of the healthcare workers lacked basic infection prevention and control measures knowledge which exposed them to higher risk of infection (Shoman et al. 2017). 

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, or contact with an infected body during the preparation and burial. There is no any risk with an 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 play the role of primary caregivers which exposes them to 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 bat and porcupines are the natural host of the virus and can easily spread it. In the human-to-human transmission, the transmission may result from direct contact with the persons who are symptomatic or infected dead bodies. 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 as compared to fluid contact (Wambani, Ogola, Arika, Rachuonyo, & Burugu, 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 make them unable to match the demand for the health care 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 bring people from different backgrounds and areas, which may provide an ideal environment 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 the reduced flow of people thereby resulting in low sales, as people would avoid activities that expose them to the disease. 

Reporting Protocol

In case of an Ebola attack in the community, it would always be on the lookout for any signs and symptoms including fever, severe headache, muscle pain, vomiting, diarrhea, hemorrhage. Such a person would need to be reported to the individual in charge of some diseases. The reporting protocol should adopt the use of clinical criteria and exposure criteria leading to either confirm or a being suspected of the infection. This would be followed by more episodes of testing

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 hand hygiene. This would be carried out through the 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 persons. 

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., Brown, C. M., Alvarado-Ramy, F., Bair-Brake, H., Benenson, G. A., Chen, T. H., Demma, A. J., … Cetron, M. S. (January 01, 2016). Travel and Border Health Measures to Prevent the International Spread of Ebola. Mmwr Supplements, 65(3), 57-67. Fallah, M., Skrip, L. A., d’Harcourt, E., & Galvani, A. P. (2015). Strategies to prevent future Ebola epidemics. The Lancet, 386(9989), 131.

Khaleque, A., & Sen, P. (2017). An empirical analysis of the Ebola outbreak in West Africa. Scientific Reports, 7, 42594.

Shoman, H., Karafillakis, E., & Rawaf, S. (2017). The link between the West African Ebola outbreak and health systems in Guinea, Liberia and Sierra Leone: a systematic review. Globalization and Health, 13, 1. 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 Diagn, 1(103), 2.