HNB3004 Nursing For Chronic Illness And Continuing Care

Ebola virus disease is a very rare but usually deadly infection that is brought by one of the five Ebola Virus strains. According to World Health Organization, it was first seen in the year 1976 in Democratic Republic of Congo and Sudan and thereafter there have sporadic outbreaks. The West Africa outbreak that occur in 2014-2016 was the largest and most complex Ebola outbreak since its first discovery (Dixon & Schafer, 2014). Whole Health Organization stated that it had more deaths and cases as compared to all other combined. It spread between countries whereby it started in Guinea then moved past land borders to Sierra Leone and Liberia (Gatherer, 2014).

     The 2014-2016 West African outbreak was caused by virus belonging to Zaire ebolavirus species. In humans, virus enters through mucosal surfaces, skin breaks and abrasions and even parenterally. Full genome sequencing of Ebola Virus isolates from Sierra Leone and other molecular sequencing studies that were done suggested that the one spillover from the reservoir of wildlife lead to West African outbreak followed by sustained transmission from human to human. Various bat species are also linked to Ebola virus. Some have been of focus attention concerning the West African case: the straw-colored fruit bat, the little collared fruit bat and the hammer-headed fruit bat (Ogawa et. al.2015). Some bats like the straw-coloured fruit bat can migrate long distances even as long as 2,500 kilometres. Therefore, spread of the Ebola virus through the bat colonies would have likely occurred from the Central Africa into West Africa (Leendertz, Gogarten, Düx, Calvignac & Leendertz, 2016). Likewise, the reservoir host may have contained the virus for some time but the spillover conditions did not occur earlier.

     Spread of Ebola virus to wildlife species is seen to have occurred due to eating of fruits that had been infected with the feces or saliva of fruit bat infected with Ebola virus. In addition, the hunting of chimpanzee has linked to the spread of Ebola since they could go scavenging from place to place. Therefore, the consumption of bush meat also caused infection.

War, poverty, growing population and poor health services and other social factors also likely added up to the unexpected spread of Ebola virus epidemic in West Africa. The region has experienced dramatic growth in population. Therefore, there has been increased rural to urban migration which greatly contributed to the spread of the endemic Ebola virus. Individuals infected moved faster from their villages to other parts and this led introduction of the virus into popular urban centers by human. Travel from affected regions also led to regional extension of the outbreak.

     Intensity and complexity of Ebola outbreak on individual country makes it difficult for it to handle, it even makes it worse if it’s between three countries, and it requires a coordinated approach. The movement of goods and people freely in the region and close ties of community makes it hard to handle the outbreak, it also limits capacity to deal with the outbreak internally in terms of people, operational, financial and logistic capacity. When the outbreak is not addressed wholly, the implementation of sustainable developmental goals for example ability to eradicate poverty and hunger and provision of primary education will be tampered hence people will be put a risk. The inequitable distribution of human, financial resources, political instability and weak health and physical infrastructure has limited the response to the epidemic. Due to ignorance lack of knowledge and ignorance professionals misdiagnose Ebola virus because its early symptoms resembling other diseases which contributes to silent spread of the disease. Health workers were frightened to provide care and the infected people were hesitant to report to the healthcare facilities for treatment. Due to food security impact, prevalence of undernourishment among the people increased. There was wide spread job loses, reduced community cohesion and education loss.

     The health sector was adversely affected due to high demand, death of healthcare workers, lack of resources and health facilities closure. Fear of Ebola by healthcare workers led to reduce in trust in health system. Access to healthcare was also compromised. There was reduction in utilization of healthcare services (Brolin, Saulnier, Eriksson & von Schreeb, 2016). Women and children who attended public health facilities for antenatal care, delivery services and immunization reduced significantly during Ebola epidemic. Very little number of women achieved at least three antenatal care visits. Vaccination completion during Ebola epidemic reduced across all vaccine types for example polio, measles, tetanus, hepatitis B and pertussis. The Ebola virus causes symptoms such as fever, fatigue, headache and sore throat and muscle pain, followed by vomiting and diarrhea, rash and organ failure which causes both internal and external bleeding. It causes long-term effects such as hair loss, body aches, insomnia, muscle and nerve damage. Survivors experience eye pain, vision loss, physical disability and loss of memory.

     Many Africans traditional norms and practices were disrupted. Traditional burial rituals involving physical contact were altered in order to reduce transmission. Traditional healers were banned to encourage infected patient to report to the nearest health facilities. The family structure was disrupted due to death of family members. Ebola survivors reported acute fear and depression. They also were rejected and stigmatized by fellow members of the society.

     In conclusion, the 2014-2016 Ebola outbreak not also affected those countries or individuals who got infected with the virus but also affected other countries globally since its spread was wide and rapid. The effects were felt far and wide and this even led to most countries joining up to curb the spread of the diseases. Thereafter, several measures have also been put in place by different governments to help reduce future outbreak of the disease. The World Health Organization is also working hand in hand with all countries worldwide not also to prevent outbreak of Ebola virus but also to curb other diseases that might erupt and spread rapidly or cause high mortality. Despite this, each and every individual should also be on the watch and join hands health workers in prevention and treating of diseases so as to promote health worldwide.

References

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Baize S, Pannetier D, Oestereich L, Rieger T, Koivogui L, et al. (2014) Emergence of Zaire Ebola virus disease in Guinea—preliminary report. New England Journal of Medicine 371: 1418–1425.

Brolin Ribacke, K. J., Saulnier, D. D., Eriksson, A., & von Schreeb, J. (2016). Effects of the West Africa Ebola virus disease on health-care utilization–a systematic review. Frontiers in public health, 4, 222.

Dixon MG, Schafer IJ (2014) Ebola Viral Disease Outbreak—West Africa, 2014. MMWR Morb Mortal Wkly Rep 63: 548–551. [PMC free article] [PubMed]

Du Toit A (2014) Ebola virus in West Africa. Nat Rev Micro 12: 312–312.

Frieden TR, Damon I, Bell BP, Kenyon T, Nichol S (2014) Ebola 2014—New Challenges, New Global Response and Responsibility. New England Journal of Medicine 371: 1177–1180

Gatherer, D. (2014). The 2014 Ebola virus disease outbreak in West Africa. Journal of general virology, 95(8), 1619-1624.

Leendertz, S. A. J., Gogarten, J. F., Düx, A., Calvignac-Spencer, S., & Leendertz, F. H. (2016). Assessing the evidence supporting fruit bats as the primary reservoirs for Ebola viruses. EcoHealth, 13(1), 18-25.

Ogawa, H., Miyamoto, H., Nakayama, E., Yoshida, R., Nakamura, I., Sawa, H., … & Kajihara, M. (2015). Seroepidemiological prevalence of multiple species of filoviruses in fruit bats (Eidolon helvum) migrating in Africa. The Journal of infectious diseases, 212(suppl_2), S101-S108.

Urbanowicz, R. A., McClure, C. P., Sakuntabhai, A., Sall, A. A., Kobinger, G., Müller, M. A., … & Ball, J. K. (2016). Human adaptation of Ebola virus during the West African outbreak. Cell, 167(4), 1079-1087.