Ebola-too little too late?


The World Health Organisation has declared the Ebola Outbreak as an international public health emergency. With a cumulative number of deaths reported in Sierra Leone, Liberia and Guinea currently at 1036 and a fatality rate of up to 90%, immediate action is required to control and prevent the further spread of infection.

The Ebola virus Disease (EVD) is a severe and often fatal illness initially transmitted to humans through close contact and handling of blood, secretions, bodily fluids and organs of dead animals such as gorillas, fruit bats, monkeys and chimpanzees. The early presented symptoms make it difficult for Ebola to be diagnosed definitively as it shares common symptoms with diseases such as malaria, meningitis, hepatitis and cholera.

Ebola Virus Disease was identified simultaneously in Sudan and the Democratic Republic Congo in 1976 where there were a total of 431 deaths. Since then, inadequate surveillance systems have been implemented, monitoring the progress of EVD. AHPN urges surveillance teams to increase their monitoring of the incidence rates of EVD in neighbouring countries, as early identification of potential EVD epidemic areas help to reduce fatality rates among the population, early intervention ensures good hygiene practices are put into practice by the population therefore reducing infection rates. Although there has been some monitoring of subsequent outbreaks in humans, not enough emphasis has been placed on monitoring EVD outbreaks in Animals. Increased focus needs to be placed on monitoring animal infection in areas where contact is high as transmission to humans from animals is very common.

Since the most recent outbreak in 2014, policy makers have been working on effective ways of controlling and preventing further infection of Ebola, The World Health Organisation has stated that it could be several years until a safe and effective vaccine is developed. With such a long prospected date of access to effective vaccines AHPN fears that this will have come much too late. While vaccines are being developed, further infections will occur and without the implementation of adequate national and cross border preventative measures, transmission to neighbouring countries is an inevitable consequence. Interim measures need to be taken whilst vaccinations are developed and positive behavioural changes should be supported. The fact that the Ebola virus can be relatively easily eliminated through the use of heat, bleach and alcohol based products means that preventative measures should be relatively easy to implement. With the help of health care professionals and community leaders guidance on good hygiene practices can be developed.

A WHO assessment of the outbreak response in Liberia identified several gaps and challenges to effective infection control such as: low coverage of contact tracing; persisting denial and resistance in the community; weak data management; inadequate infection prevention and control policies especially in peripheral health facilities; weak leadership and coordination at sub- national levels. Underpinning these challenges were limited financial resources and human technical capacity. Limited financial resources is an important issue which is crucial to the prevention and sustained control of EVD. Although UNESCO has named Sierra Leone, Liberia and Guinea (countries most affected by EVD) as Least Developed Countries where support is given for financial and economic growth, not enough support appears to be given to strengthen the healthcare systems and to develop an effective one health approach. Support of this type is urgently required in order to ensure self sufficiency so further crises does not develop.