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Fear of Ebola virus in Asia and Europe, but no confirmed cases

By Howard Lee

Countries in Asia and Europe are on alert following fears that the Ebola virus could get out of control. This is in the wake of serious outbreaks in Guinea, Liberia and Sierra Leone, although suspect cases reported outside of these countries have thus far tested negative for the virus.

International medical aid group Doctors Without Borders (MSF) has reported more than 1,000 cases and more than 600 deaths in the west African region.

"While the number of cases in Guinea has declined significantly, in neighbouring Sierra Leone and Liberia more and more people are being infected with the virus," said MSF. "With resources already stretched, health authorities and international organisations are struggling to bring the outbreak under control."

In Asia, Hong Kong has announced quarantine measures for suspected cases. It received one case arriving from Africa with possible symptoms, but eventually tested negative for the virus.

Other countries such as Britain have regarded the threat seriously - with one suspect case also testing negative - and have taken necessary precautions, while others have seen medical professionals who have worked in the affected regions quarantining themselves.

For now, the virus seems to be contained in west Africa, although MSF raised concerns that countries might not be able to deal with an outbreak should the virus spread.

An international spread of the virus could lead to restrictions on air travel, although no plans are currently considered.

Update: Singapore's Ministry of Health has issued an advisory on the Ebola outbreaks in west Africa, indicating that it currently "poses a low public health risk to Singapore". MOH also advised Singaporeans travelling to affected areas to maintain vigilance and adopt health precautions.

"MOH is in close contact with the World Health Organisation (WHO) and our counterparts internationally, and will continue to monitor the situation. Our hospitals will be vigilant in testing for Ebola where clinically indicated, such as in patients with the symptoms and a compatible travel history. All suspected and confirmed cases will be isolated. In addition, the Ministry will conduct contact tracing and all close contacts will be quarantined, if a case is detected."

 

Information from the World Health Organisation website

About the virus

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

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

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.

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.

Transmission

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.

Groups with higher risk of infection in an outbreak - 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.

Symptoms: 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.

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.

Detection and treatment

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

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.

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.

 

Image - Wikipedia Commons, Ebola virus virion by CDC/Cynthia Goldsmith - Public Health Image Library, #10816