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Can the deadly Ebola virus come to India?

Last updated on: August 08, 2014 15:32 IST

With Ebola claiming at least 932 lives and infecting more than 1,700 people since breaking out in west Africa earlier this year, the World Health Organisation has declared it to be a “public health emergency of international concern.” The disease has no vaccine and no specific treatment.

Here’s a lowdown on the deadly virus:

1. Can India be affected by the virus?

As of now, Health Minister Harsh Vardhan said there is no reported case of the virus in the country and the government is taking all precautions. He said, “As of today, this moment, there is no Ebola case reported in India. There is no need to panic.”

The minister said the government was taking all precautions well in advance and keeping a close watch on the movement of people into India from countries affected by the virus.

The minister said that there are close to 45,000 Indians in affected countries and if the situation worsened in these countries, there could be possibility of Indians staying there travelling back to India.

Mandatory self reporting by the passengers coming from or transiting through the affected countries would be required at immigration check, Vardhan had said, adding in-flight announcements regarding this would also be made by the airlines. He also asked Indians to defer non-essential travel to that region.

2. What is Ebola virus disease?

Ebola virus disease (formerly known as Ebola haemorrhagic fever) is a severe, often fatal illness, with a death rate of up to 90 percent. The illness affects humans and non-human primates (monkeys, gorillas, and chimpanzees).

Ebola first appeared in 1976 in two simultaneous outbreaks, one in a village near the Ebola river in the Democratic Republic of Congo, and the other in a remote area of Sudan.

The origin of the virus is unknown but fruit bats (Pteropodidae) are considered the likely host of the Ebola virus, based on available evidence.

3. How do people become infected with the virus?

Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals.

In Africa, infection has occurred through the handling of infected chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest.

It is important to reduce contact with high-risk animals (i.e. fruit bats, monkeys or apes) including not picking up dead animals found lying in the forest or handling their raw meat.

Once a person comes into contact with an animal that has Ebola, it can spread within the community from human to human. Infection occurs from direct contact (through broken skin or mucous membranes) with the blood, or other bodily fluids or secretions (stool, urine, saliva, semen) of infected people. Infection can also occur if broken skin or mucous membranes of a healthy person come into contact with environments that have become contaminated with an Ebola patient’s infectious fluids such as soiled clothing, bed linen, or used needles.

Health workers have frequently been exposed to the virus when caring for Ebola patients. This happens because they are not wearing personal protection equipment, such as gloves, when caring for the patients. Health care providers at all levels of the health system -- hospitals, clinics and health posts -- should be briefed on the nature of the disease and how it is transmitted, and strictly follow recommended infection control precautions.

Burial ceremonies in which mourners have direct contact with the body of the deceased person can also play a role in the transmission of Ebola. Persons who have died of Ebola must be handled using strong protective clothing and gloves, and be buried immediately.

People are infectious as long as their blood and secretions contain the virus. For this reason, infected patients receive close monitoring from medical professionals and receive laboratory tests to ensure the virus is no longer circulating in their systems before they return home. When the medical professionals determine it is okay for the patient to return home, they are no longer infectious and cannot infect anyone else in their communities. Men who have recovered from the illness can still spread the virus to their partner through their semen for up to 7 weeks after recovery. For this reason, it is important for men to avoid sexual intercourse for at least 7 weeks after recovery or to wear condoms if having sexual intercourse during 7 weeks after recovery.

4. Who is most at risk?

During an outbreak, those at higher risk of infection are:

* health workers;

* family members or others in close contact with infected people;

* mourners who have direct contact with the bodies of the deceased as part of burial ceremonies; and

* hunters in the rain forest who come into contact with dead animals found lying in the forest.

More research is needed to understand if some groups, such as immuno-compromised people or those with other underlying health conditions, are more susceptible than others to contracting the virus.

Exposure to the virus can be controlled through the use of protective measures in clinics and hospitals, at community gatherings, or at home.

5. What are typical signs and symptoms of infection?

Sudden onset of fever, intense weakness, muscle pain, headache and sore throat are typical signs and symptoms. This is followed by vomiting, diarrhoea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding.

Laboratory findings include low white blood cell and platelet counts, and elevated liver enzymes.

The incubation period, or the time interval from infection to onset of symptoms, is from 2 to 21 days. The patients become contagious once they begin to show symptoms. They are not contagious during the incubation period.

Ebola virus disease infections can only be confirmed through laboratory testing.

6. When should someone seek medical care?

If a person has been in an area known to have Ebola virus disease or in contact with a person known or suspected to have Ebola and they begin to have symptoms, they should seek medical care immediately.

Any cases of persons who are suspected to have the disease should be reported to the nearest health unit without delay. Prompt medical care is essential to improving the rate of survival from the disease. It is also important to control spread of the disease and infection control procedures need to be started immediately.

7. What is the treatment?

Severely ill patients require intensive supportive care. They are frequently dehydrated and need intravenous fluids or oral rehydration with solutions that contain electrolytes. There is currently no specific treatment to cure the disease.

Some patients will recover with the appropriate medical care.

To help control further spread of the virus, people that are suspected or confirmed to have the disease should be isolated from other patients and treated by health workers using strict infection control precautions.

8. What can I do? Can Ebola be prevented?

Currently there is no licensed vaccine for Ebola virus disease. Several vaccines are being tested, but none are available for clinical use right now.

Raising awareness of the risk factors and measures people can take to protect themselves are the only ways to reduce illness and deaths.

Ways to prevent infection and transmission

While initial cases of Ebola virus disease are contracted by handling infected animals or carcasses, secondary cases occur by direct contact with the bodily fluids of an ill person, either through unsafe case management or unsafe burial practices. During this outbreak, most of the disease has spread through human-to-human transmission. Several steps can be taken to help in preventing infection and limiting or stopping transmission.

* Understand the nature of the disease, how it is transmitted, and how to prevent it from spreading further. 

* Listen to and follow directives issued by your country’s respective Ministry of Health.

* If you suspect someone close to you or in your community of having Ebola virus disease, encourage and support them in seeking appropriate medical treatment in a care facility.

* If you choose to care for an ill person in your home, notify public health officials of your intentions so they can train you and provide appropriate gloves and personal protective equipment (PPE), as well as instructions as a reminder on how to properly care for the patient, protect yourself and your family, and properly dispose of the PPE after use.

* When visiting patients in the hospital or caring for someone at home, hand washing with soap and water is recommended after touching a patient, being in contact with their bodily fluids, or touching his/her surroundings.

* People who have died from Ebola should only be handled using appropriate protective equipment and should be buried immediately.
Additionally, individuals should reduce contact with high-risk infected animals (i.e. fruit bats, monkeys or apes) in the affected rainforest areas. If you suspect an animal is infected, do not handle it. Animal products (blood and meat) should be thoroughly cooked before eating.

9. What about health workers? How do they protect themselves from the high risk of caring for sick patients?

Health workers treating patients with suspected or confirmed illness are at higher risk of infection than other groups.

* In addition to standard health care precautions, health workers should strictly apply recommended infection control measures to avoid exposure to infected blood, fluids, or contaminated environments or objects – such as a patient’s soiled linen or used needles.

* They should use personal protection equipment such as individual gowns, gloves, masks and goggles or face shields.

* They should not reuse protective equipment or clothing unless they have been properly disinfected.

* They should change gloves between caring for each patient suspected of having Ebola.

* Invasive procedures that can expose medical doctors, nurses and others to infection should be carried out under strict, safe conditions.

* Infected patients should be kept separate from other patients and healthy people, as much as possible.

10. What about rumours that some foods can prevent or treat the infection?

WHO strongly recommends that people seek credible health advice about Ebola virus disease from their public health authority.

While there is no specific drug against Ebola, the best treatment is intensive supportive treatment provided in the hospital by health workers using strict infection control procedures. The infection can be controlled through recommended protective measures.

Information courtesy: World Health Organisation