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Ebola cases climb, include American aid workers

Tuesday July 29, 2014
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According to the World Health Organization, as of July 27, the number of cases attributed to Ebola virus disease stood at 1,323, including 729 deaths, involving cases in Guinea, Liberia and Sierra Leone. Two American healthcare workers, contracted the virus in Liberia.

Kent Brantly, MD, of Fort Worth, Texas, medical director for the Samaritan’s Purse care center serving the Liberian capital of Monrovia, and Nancy Writebol, of Charlotte, N.C. who is part of the joint Serving In Mission Samaritan’s Purse team, were caring for Ebola patients in Liberia before contracting the deadly virus.They are currently undergoing intensive treatment at an isolation center at ELWA Hospital in Paynesville City, Monrovia, Liberia, according to the Samaritan's Purse website.

In addition, the Ministry of Health of Nigeria has reported its first probable case of EVD, according to a July 27 WHO update. Nigeria authorities said the case is a 40-year-old Liberian male national who recently traveled to Nigeria where he presented in hospital with symptoms of Ebola. The patient traveled by air and arrived in Lagos, Nigeria, July 20 via Lomé, Togo. He was symptomatic while traveling, and was admitted to a private hospital immediately on arrival and died July 25.

“The surge in the number of new EVD cases in Guinea after weeks of low viral activity demonstrates that undetected chains of transmission existed in the community,” according to the July 27 WHO update. “This phenomenon is retrogressive to the control of the EVD outbreak, and calls for stepping up outbreak containment measures, especially effective contact tracing."

Those at highest risk during an Ebola outbreak include healthcare workers. “One of [the] priority areas of work is to train healthcare workers in affected countries on how they can protect themselves as they provide care for the sick,” Pierre Formenty, one of WHO’s experts in Ebola, said in an April news release.

However, Brantly said there was no breach of his safety gear while treating Ebola patients, “so it is possible his infection came from exposure to the general population in Liberia away from the hospital,” according to a USA Today article.

Symptoms
Ebola is a severe acute viral illness that can have a case fatality rate of up to 90%. No vaccine is available, nor is there any specific treatment. It is characterized by sudden onset of fever, intense weakness, muscle pain, headache, nausea and sore throat. These symptoms can be followed by vomiting, diarrhea, impaired kidney and liver function and, in some cases, both internal and external bleeding, according to WHO. Severely ill patients require intensive supportive care.

How the disease spreads
Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals such as chimpanzees, gorillas, fruit bats and other wild animals, according to WHO. 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 also can 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, according to WHO.

Direct contact with the body of a deceased person who had Ebola can also play a role in the transmission of the disease.

Infected patients must be closely monitored and laboratory tests must confirm the virus is no longer circulating in their systems before they return home. Men who have recovered from the illness can still spread the virus to their partner through their semen for up to seven weeks after recovery, according to WHO.


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