Infectious disease: (Ebola virus)
Murphy, Lori
Ebola is defined as a hemorrhagic fever caused by the Ebola filovirus. The signs and symptoms of Ebola include fever, headache, joint and muscle aches, sore throat, and weakness, followed by diarrhea, vomiting and stomach pain. A rash, red eyes, hiccups, and internal and external bleeding have been seen in some patients. A recent group project was conducted to compare the similarities and differences of Ebola in two geographical locations. Sudan and Zaire were the countries selected to compare. The purpose of this paper is to discuss patterns of morbidity and mortality of Ebola and factors that have influenced the disease such as spread, treatment, political, social and economic factors. Also, interventions at all levels of prevention and universal precautions will be highlighted.
Patterns of Morbidity and Mortality
The first outbreak of Ebola that occurred in Sudan was in 1976. This outbreak occurred in Nzara, Maridi and the surrounding area. Ebola was spread in this outbreak due to close personal contact with individuals that had the disease in hospitals. The mortality rate for this outbreak was 53% and the morbidity rate was 284. Many medical personnel were infected. In 1979, there was another outbreak in Sudan that occurred in Nzara, which was a recurrent outbreak from the 1976 outbreak. The mortality rate for this outbreak was 65% and the morbidity rate was 34 (Center for Disease Control (CDC), 2002, table 1).
The first outbreak of Ebola that occurred in Zaire was in 1976 also. This outbreak occurred in Yambuku and the surrounding area. This outbreak was spread by close personal contact and by the use of contaminated needles and syringes in hospitals and clinics. This outbreak was also the first recognition of the disease. The mortality rate for this outbreak was 88% and the morbidity rate was 318. The second Ebola outbreak in Zaire occurred in 1977 in the village of Tandala. This outbreak was also due to close personal contact The mortality rate for this outbreak was 100% and the, morbidity rate was 1. The third outbreak in Zaire occurred in 1995 in Kikwit and the surrounding area. This outbreak was spread through families and hospitals. The mortality rate for this outbreak was 81% and the morbidity rate was 315. It should also be noted that there was a very recent outbreak of the Ebola virus in Zaire in 2002, but no statistical data is available on the outbreak at this time (Center for Disease Control (CDC), 2002, table 1). Excluding the most recent outbreak, approximately 1,500 cases with over 1,000 deaths have been documented since the virus was discovered (World Health Organization (WHO), 2002, para. 2).
Factors Influencing Spread and Treatment
Political factors that have influenced the spread and treatment of the Ebola virus include! Sudan government lacked coherent national disease control policies and Civil War in Sudan destroyed nearly all medical facilities. Social factors include; lack of education to the public for prevention and widespread malnutrition due to famine. Economic factors included; resources were scarce, the health care infrastructure was underdeveloped and deteriorating and the re-use of hypodermic needles in the treatment of patients.
The Ebola virus is a major threat to populations. Ebola can be transmitted by direct contact with blood, secretions, organs or semen of infected persons. Transmission can also occur by handling ill or dead monkeys. Health care workers are frequently infected while attending patients.
Interventions
Primary preventative measures related to the Ebola virus are scarce. There is currently no vaccine for the virus and few primary prevention measures have been established. Travelers should avoid areas where Ebola outbreaks are occurring. This could prevent contracting the disease and spreading it throughout other countries.
Secondary preventative measures are as follows. Early diagnosis could be helpful in order to isolate patients and notify local and state health department and the CDC. Ebola is diagnosed via the ELISA test, polymerase chain reaction (PCR), and virus isolation.
Tertiary preventative measures include supportive therapy because there is no specific treatment available at this time. This may include keeping the patient comfortable and free from pain.
Suspected cases of the Ebola virus should be isolated from other patients in the hospital. Strict barrier nursing techniques should be used while providing care to infected patients.such as gloves, gowns and masks and do not re-use these materials. Educating all hospital personnel and health care workers about the disease and routes of transmission would be very important in the identification and treatment of the disease. Any person who comes in contact with an infected client should be kept under strict surveillance. Any equipment used should be sterilized promptly and any patients who die from the disease should be promptly buried or cremated because the disease would still have transmission capabilities.
Conclusion
The Ebola virus is a very devastating disease that has very strong effects on a persons’ health and usually leads to death. No vaccination or treatment is available at this time making primary prevention the key in prevention of the Ebola virus.
References
Ebola Fever in the Sudan 1976: Epidemiological Aspects of the Disease. (n.d.). Retrieved September 30, 2002, from http://www. lcweb2.loc.gov/frd/cs/sdtoc.htm.
Ebola Hemorrhagic Fever. (n.d.) Retrieved September 23, 2002, from http://www.who.int/inf-fs/en/fact103.html.
Ebola Hemorrhage Fever Facts. (n.d.). Retrieved September 23, 2002, from http:/ /www.astdhpphe.org/infect/ebola.html. Special Pathogens Branch Diseases-Ebola Hemorrhagic Fever
(n.d.) Retrieved September 23, 2002, from http:// www.cdc/gov/ncidod/dvrd/spb/mnpageses/dispages/ebola/htm.
Cultural Diversity is a regular feature of The
Kentucky Nurse Dr. Cora Newell-oLv, RN, MPH DSN, FAAN is the editor of the Cultu ral Diversity Column and welcomes manuscripts for publication consideration. Manuscripts for the column may be submitted directly to: Dr. Cora Newell-Withrow, RN, MPH, DSN, FAAN at 113 Bryon Ave., Berea, KY 40403.
Lori Murphy, BSN Student and Rebecca Newcomb, BSN Student
College Health Science Department of Baccalaureate and Graduate Nursing Program
Eastern Kentucky University
Richmond, KY 40475
Copyright Kentucky Nurses Association Jan-Mar 2003
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