At the beginning of the month, health authorities in the Democratic Republic of the Congo (DRC) issued a warning about a high-mortality outbreak caused by a previously unknown disease in the municipality of Mongbwalu, in Ituri province. THE scenario even included deaths among health professionals.
About 10 days later, the National Institute for Biomedical Research in Kinshasa, capital of the DRC, analyzed 13 blood samples taken in the Rwampara district. THE laboratory evaluation confirmed the presence of the Bundibugyo virusa type of Ebola, in eight of the total samples collected.
Last Friday (15), the DRC Ministry of Public Health, Hygiene and Social Welfare officially declared the 17th Ebola outbreak in the country. Simultaneously, the Ministry of Health of Uganda, a neighboring country, confirmed an outbreak of Bundibugyo, after identify an imported case: a Congolese man who died in the capital, Kampala.
The following day, the Director-General of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, after consulting both Member States where outbreaks had been identified, determined that Ebola was caused by the Bundibugyo virus in both the DRC and Uganda.
A WHO explains that community engagement is critical to the successful control of any outbreak.
“[Isso] it depends [também] the use of a range of interventions, such as clinical assistance, surveillance and contact tracing, laboratory services, infection prevention and control in healthcare facilities, safe burials.”
Coping measures include sending rapid response teamsproviding medical supplies, strengthening surveillance, laboratory confirmation, infection prevention and control assessments, creating safe treatment centers, and community engagement.
The disease
O Ebola is classified by the WHO itself as serious, often fatal, affecting humans and other primates.
The virus is transmitted to humans by wild animals such as fruit bats, hedgehogs and non-human primates, and passes from person to person through direct contact with secretions, blood, organs or other bodily fluids of infected patients.
O Contagion also occurs through contact with surfaces and materialssuch as bedding and clothing, contaminated with fluids.
The average fatality rate for the disease is around 50%. In previous outbreaks, according to the WHO, fatality rates reached 90%.
Outbreaks
The WHO classifies the Ebola outbreak recorded between 2014 and 2016 in West Africa as the largest and most complex since the virus was discovered in 1976.
At the time, there were more cases and deaths than in all other outbreaks combined. The disease has also spread between countries, starting in Guinea and crossing land borders to Sierra Leone and Liberia.
Symptoms
The incubation period for Ebola – the time interval between infection by the virus and the onset of symptoms – varies from two to 21 days. According to the WHO, the An infected person does not transmit the disease until they develop symptoms.
Physical changes include fever, fatigue, malaise, muscle aches, headache and sore throat. Then appear vomiting, diarrhea, abdominal pain, skin rashes and symptoms of impaired kidney and liver function. In less frequent cases, there may be internal and external bleeding.
The WHO itself assesses that it may be difficult Clinically distinguish Ebola from other infectious diseasessuch as malaria, typhoid fever and meningitis. For this reason, several diagnostic tests have been developed to confirm the presence of the virus.
Treatment and prevention
Early intensive treatment, including rehydration with oral or intravenous fluids, and treatment of specific symptoms, according to the WHO, improve patient survival.
Specifically for the disease caused by the Ebola virus (EDV), the WHO recommends treatment with monoclonal antibodies. For other diseases caused by Ebola, such as the Bundibugyo virus, there are no approved therapies.
Two vaccines have been approved for DEV: Ervebo and Zabdeno and Mvabea. The Ervebo vaccine is recommended by the entity as part of the rresponse to identified outbreaks.
To guide the population, the WHO prepared a list of the main questions and answers about Ebola.
What is Ebola?
It is a rare but serious disease caused by a virus belonging to the Orthoebolavirus genus, from the Filoviridae family. Mortality rates ranged from 25% to 90%.
Six species of Orthoebolavirus have been identified to date, with three known to cause large outbreaks: Ebola, Sudan and Bundibugyo.
The animal reservoir of the viruses is unknowno, but current evidence suggests that fruit bats (Pteropodidae) may be hosts.
What are the typical symptoms of the disease?
Symptoms can come on suddenly and include:
- Fever;
- Fatigue;
- Muscle pain;
- Headache and sore throat.
These symptoms may be followed by:
- Vomiting;
- Diarrhea;
- Skin wounds;
- Internal and external bleeding.
How long does it take for symptoms to appear?
The time interval between infection and the onset of symptoms varies from two to 21 days. People only become contagious after developing symptoms.
It can be difficult to clinically distinguish Ebola from other infectious diseases, such as malaria, typhoid fever, dengue fever, or Marburg virus disease.
Even when people develop Ebola-like symptoms, only one laboratory examination can confirm whether the cause is the virus.
How does Ebola spread?
The virus most commonly spreads from person to person through exposure to the blood or other bodily fluids (primarily feces, vomit, sweat, and saliva) of an infected person, living or dead.
This occurs when the virus enters the body through injured skin or from mucous membranessuch as the eyes, nose, or mouth, usually when someone is caring for a patient or touching the body of someone who has died from the disease.
Transmission also occurs through contact with or handling objects contaminated with bodily fluids from a sick person or someone who has died from Ebola.
In rare cases, the transmission from a recovered man to his sexual partner has been documented. This happens because the virus can persist for some time in the semen of some men who have recovered from the disease.
What measures to protect yourself during outbreak episodes?
- Avoid physical contact with individuals suspected or confirmed with Ebola;
- Do not handle the bodies of people who showed symptoms of Ebola and died without taking appropriate precautions;
- Wash your hands regularly, following best practices recommended by local authorities for hand washing.
What should people do to contain animal infection?
- Avoid eating dead animals or touching them without protective measures, especially during an Ebola outbreak;
- Wash your hands thoroughly before and after touching any animal or product of animal origin;
- Cook products of animal origin (blood and meat) well before consumption.
Who is most at risk?
- Health and social care professionals in close contact with patients;
- Caregivers, family members or other people in direct physical contact with infected people;
- Grieving people who have direct physical contact with bodies during funerals or burial rituals.
What measures to take after physical contact with infected people?
If a person had direct physical contact with someone infected or suspected of having Ebola, you may be at risk of developing the disease. The advice is to contact your doctor or local health center to understand the next steps.
Once the person is identified as “contact”your health will be monitored for 21 days after exposure. Local authorities or healthcare professionals will guide you about recommended behaviors and encourage you to:
- Accept daily visits from the contact tracing team to monitor health;
- Allow the temperature to be measured;
- Answer all questions as accurately as possible and resolve all doubts;
- Report symptoms (if any) as soon as you develop them;
- Avoid travel unless travel has been discussed with the local health authority;
- Get the vaccine, if available.
Is there a treatment for Ebola?
There are two approved treatments for adults and children with Ebola virus disease: Ansuvimab and Inmazeb. Based on these drugs, new potential treatments, according to the WHO, are being evaluated for other orthoebolavirusesbut have not yet been fully tested.
Is it possible to treat the disease at home?
A OMS does not recommend that families or communities care for people with Ebola at home. People with symptoms should seek care at a health center. Early treatment at a referral center is essential and can increase the chances of recovery.
If a person dies at home with suspected Ebola, the community and family members should avoid handling or preparing the body for burial. THE advice is to contact the authorities immediately local health services to carry out a safe and dignified burial, in accordance with the family’s wishes.
What to do if you need to travel?
The WHO does not, to date, recommend commercial or movement restrictions, such as confinements or quarantines, in areas affected by Ebola.
However, travel by people who have had close contact with Ebola cases should be minimized or postponed whenever possibleto prevent the spread of the virus.
If the travel of a person who has had contact with the virus is necessary, it must be discussed and supervised by public health authorities to ensure adequate monitoring in the destination area.
