7 PM | The threat of Ebola | 19th July, 2019

Context:Ebola and its outbreak in Congo.

More in News: The World Health Organization has declared the Ebola virus disease outbreak in the Democratic Republic of the Congo a Public Health Emergency of International Concern.

What is Ebola?

• Ebola virus disease (formerly known as Ebola haemorrhagic fever) is a rare but severe, often fatal , often fatal illness, with a death rate of up to 90% in humans caused by the Ebola virus, a member of the filovirus family. Death rates have varied from 25% to 90% in past outbreaks.
• The Ebola virus was first identified in 1976 when 2 simultaneous outbreaks occurred, 1 in Yambuku, a village not far from 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 current evidence suggests that fruit bats (Pteropodidae) may be a host.

How it spreads?

• Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals, chimpanzee, gorilla, fruit bats, monkeys, forest antelopes and porcupines. 
• Human-to human transmission, with infection resulting from direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and indirect contact with environments contaminated with such fluids, Health-care workers have frequently been infected while treating patients with suspected or confirmed EVD.

Present Ebola outbreak in Congo:

• This Ebola outbreak began last summer. In August 2018, the Ministry of Health of the Democratic Republic of Congo declared an outbreak of Ebola virus disease in the country’s North Kivu province.
• More than 2,500 people have been infected and two-thirds of them have died.
• It took 224 days for the number of cases to reach 1,000, but just a further 71 days to reach 2,000.
• About 12 new cases are being reported every day.

Previous outbreaks:

Public Health Emergency of International Concern:

• Some serious public health events that endanger international public health may be determined under the Regulations to be public health emergencies of international concern (PHEIC). The term Public Health Emergency of International Concern is defined in the International Health Regulations (IHR) (2005) as “an extraordinary event which is determined, as provided in these Regulations:
  • to constitute a public health risk to other States through the international spread of disease; and
  • to potentially require a coordinated international response”. This definition implies a situation that: is serious, unusual or unexpected; carries implications for public health beyond the affected State’s national border; and may require immediate international action.
• The responsibility of determining whether an event is within this category lies with the WHO Director-General and requires the convening of a committee of experts – the IHR Emergency Committee. This committee advises the Director General on the recommended measures to be promulgated on an emergency basis, known as temporary recommendations. Temporary recommendations include health measures to be implemented by the State Party experiencing the PHEIC, or by other States Parties, to prevent or reduce the international spread of disease and avoid unnecessary interference with international traffic.
• The PHEIC emergency provision is the highest level of alarm the WHO can sound and has only been used four times previously:
  • the H1N1 influenza virus pandemic (2009),
  • the resurgence of wild poliovirus (2014),
  • the west Africa Ebola virus outbreak (2014),
  • the Zika virus outbreak (2018). 

WHO’s Measures :

• A day after Congo declared an outbreak, WHO, and the Ministry of Health set up a specialized cold chain to store the vaccine in the provincial capital Mbandaka.
• The first batch of more than 4,000 doses of vaccine was provided to Congo.
• This mark the first time vaccines were available so early in a response.
• Vaccination of health workers as well as people in contract with Ebola began in Mbandaka.
• In total , 3,330 people were vaccinated.
• In 2014, Wet African epidemic, WHO’s Emergency Committee convened only after some thousand death cases confirmed.  This time around, it convened 10 days after the outbreak was declared.
• The WHO released $1 million from its Contingency Fund for Emergencies.
• It multidisciplinary team began an active search for cases and people who had come in contract with those who were infected.

Ebola in India:

• During the Ebola outbreak in 2014, as many as 36,460 passengers have been screened for Ebola in India so far and 700 are being currently tracked by Integrated Disease Surveillance Programme (IDSP), as per a statement issued by the Ministry of Health and Family Welfare. Of the 700 passengers being tracked, most are in Maharashtra, Kerala, Tamil Nadu, Gujarat, West Bengal and Delhi.
• The National Centre for Disease Control, Delhi, and National Institute of Virology, Pune, are the nodal testing agencies for testing the Ebola virus and are testing the medium and high risk cases. Overall, more than 100 samples have been tested at these two laboratories. Ten additional laboratories have been identified by the Indian Council of Medical Research for testing the virus.
• India is not adequately prepared to deal with the Ebola pandemic due to inadequate health care facilities to deal with a fast-spreading virus. There have been doubts on whether the public hospitals in India have trained health care workers to administer care and treatment.
• According to 2010 World Bank data, India has one nurse per 1,000 people compared to 1.6 nurses that Nigeria has or 10 per 1,000 in the US. In addition, India with a burgeoning population and overburdened medical response systems faces greater challenges of the inadequate ability to quarantine.

Way Forward: Despite the challenges, effective and timely steps can prevent Ebola from becoming a pandemic. The first step in this regard would be to act rapidly in terms of spreading awareness. The Department of Health & Family Welfare, Ministry of Health & Family Welfare, Government of India has issued several guidelines for controlling any Ebola outbreak. These guidelines are primarily meant to raise awareness level of the risk factors for Ebola infection. The guidelines issues protective measures individuals can take as the only way to reduce human infection and death. In addition, India has undertaken measures for effective environmental infection control. Environmental surfaces or objects contaminated with blood, other body fluids, secretions or excretions should be cleaned and disinfected using standard hospital detergents/disinfectants. India has also put in place safety measures for waste management and handling of human remains. At the international level, India has agreed to extend $12 million for countering the epidemic. In keeping with its tradition of fighting global pandemics like AIDS, India has urged the international community must support research and development of a vaccine to cure Ebola.

Source:https://www.thehindu.com/opinion/editorial/the-threat-of-ebola/article28563917.ece