The following is the summary of the article titled, Ebola Virus Outbreak 2014: Clinical Review for Emergency Physicians. The outbreak that took place in West Africa in 2014, is one of the largest Ebola outbreak reported in the history of the disease. Ebola virus causes a serious infection that is characterized by coagulopathies and septic shock. As of today, there is no effective cure for Ebola. The management of the disease is mainly through supportive therapy. The article aims to support physicians working in areas of Ebola outbreak with the essential information about the disease management, control and prevention. Ebola is a category A bioterrorism agent. Though it is a contagious disease, people do not become contagious till they express the symptoms. The article provides details of virus types, its reservoirs, route of transmission, pathophysiology, symptoms, clinical and laboratory diagnosis, treatment and preventive measures. It also provides epidemiology and WHO updates of the disease. (Meyers, Frawley, Goss, & Kang, 2015)
The relationship between causal agent, susceptible person and the environment: The epidemiological triad is used to describe the relationship between these 3 causal factors of an outbreak: agent, host and environment. The virulence and infectious nature of the infectious agent, the susceptibility of the host and the presence of a risky environment, will decide the infection and disease outbreak. All the three components are necessary for an outbreak. Thus preventive measures aim to remove one or more components in the triad, so as to prevent infection. For example, vaccination can improve the immune system of the host and reduces host susceptibility. The lack of an effective vaccine to protect the host and the virulence of Ebola virus that infected people in West Africa were identified as reasons for the outbreak. Though Ebola was endemic to the African regions, it rarely caused such serious infection and mortality in a large number of people. Environmental scientists also propose that the new virus has evolved from animal strain, so as to adapt in a human body. The change in environment like deforestation could have altered the ecosystem. Monkeys and bats are a common reservoir for this virus. Certain African communities have the culture of consuming these animals as food, thus providing the needed environment that brings the infectious agent closer to the host.
Role of BSN nurses in addressing an outbreak: Outbreaks result from a chain reaction of that involve the following steps: infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host and once again infectious agents. By knowing the components in the infection cycle, nurses can adopt measures to prevent infection. Even during the Ebola outbreak, nurses were working at the front line in treating the patients and educating them on the necessary precautions that need to be taken to break the infection cycle.
Health promotion/health protection strategies that can be done to mitigate the outbreak: Ebola virus does not spread through aerosol route, but through direct contact with fluid containing the virus. Thus, it is comparatively feasible to control its transmission, by avoiding direct contact with patient fluids and fomites that have the potential to transmit infection. The person’s blood and body fluids, are extremely infectious. Thus, direct contact with these, can help to prevent outbreaks. Animals act as reservoira of Ebola; avoiding consumption of raw meat and avoiding direct contact with animals like bats and monkeys can be beneficial in reducing risk. Practicing good hand hygiene and using disinfectants to clean hand and body, can be beneficial in reducing the risk of infection. Ebola was detected in the semen of the infected man and thus there is probability that it can spread through coitus with the infected man. The engagement of the community in the prevention efforts is very important in controlling outbreaks. Intervention in disease control, involves case management, surveillance, tracing contacts, laboratory services, safe burials and social mobilization.
References
Meyers, L., Frawley, T., Goss, S., & Kang, C. (2015). Ebola Virus Outbreak 2014: Clinical Review for Emergency Physicians. Annals of Emergency Medicine, 65(1), 101-108. http://dx.doi.org/10.1016/j.annemergmed.2014.10.009
