Dr Tonny Kipsandui, Programme Manager at Amref Health Africa in Uganda answers your questions on Ebola. Dr Kipsandui is a public health expert and trained in the prevention of diseases epidemics and pandemic potential which also includes Ebola.
How is the Ebola virus transmitted and who is at risk of being infected with the virus?
Ebola virus disease is a serious and often deadly disease. It is transmitted through direct contact with the following: soiled clothing of infected persons; unsterilised equipment used by infected persons (needles, other sharp instruments); handling without protective gear the dead bodies of persons who died from confirmed/suspected Ebola disease; handling infected animals whether dead or alive; and handling body fluids such as saliva, vomitus, blood, urine, faeces, the sweat of an infected person. All people are at risk of contracting Ebola.
What are the symptoms?
Signs and symptoms include sudden onset headache, fever, and muscle pain, intense body weakness, bleeding from body openings (mouth, nose, anus, and ears), sore throat, vomiting (including with blood), bloody diarrhoea and bloody urine.
What is the treatment for Ebola virus disease?
The suspected person must go immediately to the nearest health facility for assessment and treatment. Ebola virus disease does not have a known medical cure. However, medical management is very important and focuses on symptomatic relief. Although people do die from Ebola some patients recover. The chances of survival are greater the earlier the treatment begins. Treatment interventions include lowering the fever, reducing the pain, providing good nutrition, rehydration and ensuring infection control. There are vaccines developed that have demonstrated efficacy in preventing infection from the Ebola virus disease. Where applicable and available, the healthcare workers may administer the vaccine.
How can we prevent it?
Ebola virus disease can be prevented by the following approaches:
- Persons who are suspected to have died from Ebola must be buried immediately, by a trained burial team to prevent the spread of Ebola.
- Wash your hands thoroughly with soap and clean water after handling a patient infected with Ebola or the body of a person who has died from Ebola.
- Avoid communal washing of hands during funeral rites.
- Disinfect the bedding and clothing of any person suspected to have died from Ebola.
- Persons suspected to be suffering from Ebola should be taken to the nearest health facility immediately.
- Avoid direct contact with the body fluids of a person suspected to be suffering from Ebola by using protective materials e.g. gloves and masks.
- Persons handling the body of a person who is suspected to have died of Ebola should wear strong protective materials like gloves and masks.
- Avoid contact with or eating bush meat, especially from monkeys, bats, baboons, gorillas and chimpanzees
What is being done to keep people who may have the virus from entering other countries?
The Ministry of Health in Uganda is working on distributing assessment questionnaires to all travellers entering Uganda. Health Officers at the points of official entrance into Uganda have been trained on Ebola and are able to identify any suspicious cases on arrival.
What are the gaps in the prevention and control of the Ebola virus in Uganda?
The major gap is in funding to implement risk communication, awareness and surveillance to scale. The other gap is in urgently equipping frontline health workers with PPEs and relevant medical supplies for effective management of cases in areas of outbreaks.
Is there anything WHO is doing about it? What role should the international community play?
Yes, the WHO country office is actively working with the ministry of health and together with UNICEF, USAID and UKAID; they have supported the development of “The Booklet on Frequently Asked Questions on Ebola”. They have also supported setting up national and sub-national level task forces to handle the outbreak. Specifically, WHO has consistently joined MOH to do joint press releases and media briefings on situational updates on the Ebola outbreak in Uganda.
How can African countries be better prepared for future outbreaks?
- Plan ahead and always have an emergency fund for disease outbreaks.
- Decentralise surveillance and management of outbreaks as much as possible.
- Invest more in community sensitisation and awareness programmes.
Should countries prioritise the protection of health workers? Why?
Yes, countries should prioritise the protection of health workers. They form the first line of prevention and management of outbreaks. They are also the most exposed and vulnerable when it comes to outbreaks as they respond to provide screening and medical treatment.
How should the affected countries address misconceptions and misinformation about the virus?
- Develop a booklet on Frequently Asked Questions, including myths and misconceptions and widely disseminate it.
- Plan for and conduct sensitisation meetings with important stakeholders such as religious leaders, school authorities and community-based organisations in order to reach the rural population with correct information.
- Develop and disseminate communication materials such as posters, leaflets and fact sheets.
- Conduct talk shows on TV and Radio and utilises other print and e-media to reach rural communities.
- African governments should collaborate with international and national health organisations and partners.
Is there anything else you think our readers should know about this disease?
Stigma is one of the most challenging issues to tackle when it comes to outbreaks whose management may require isolation/quarantine. The other concern is psychosocial support for people infected and affected by the outbreaks. Governments should always plan and implement interventions that are inclusive of these challenges.
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