Ebola Virus Disease, EVD or Ebola as it is now better known is a severe, fatal illness. The outbreak started in remote villages of Central and West Africa near tropical rainforests. The virus transmitted to people from wild animals and then spread through human-to-human transmission. Fruit bats of the Pteropodidae family are said to be natural host of Ebola virus. Severely ill patients need intensive supportive care and no licensed specific treatment or vaccine is available for treatment. Ebola outbreaks have a case fatality rate of up to 90%.
Ebola affected the human population through close contact through blood, secretions, organs and other bodily fluids of infected animals. It then spread in communities through human-to-human transmission by direct contact through broken skin or mucous membranes through blood, secretions, organs or other bodily fluids of infected people. It indirectly spreads through contact with environments contaminated with such fluids. Burial ceremonies also affect mourners who come in direct contact with the body of deceased. Men who recover can still transmit the virus through their semen for up to 7 weeks after recovery.
EVD is a severe acute viral illness characterized by sudden onset of fever, intense weakness, muscle pain, headache and sore throat. This is followed by vomiting, diarrhea, 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. People are infectious as long as their blood and secretions contain the virus. Ebola virus was isolated from semen 61 days after onset of illness in a man who was infected in a laboratory.
The incubation period, that is, the time interval from infection with the virus to onset of symptoms, is 2 to 21 days. No licensed vaccine for EVD is available. Several vaccines are being tested, but none are available for clinical use. Severely ill patients require intensive supportive care. Patients are frequently dehydrated and require oral rehydration with solutions containing electrolytes or intravenous fluids. No specific treatment is available. In the absence of effective treatment, raising awareness of the risk factors for Ebola infection and recommending protective measures is the only way to reduce human infection.
The disease is causing palpable panic. Ebola outbreak may hit India with passengers arriving from African countries where deaths have been reported due to the disease. With every arrival the situation gets grim. At least twelve persons found to having fever and sore throat associated with Ebola were quarantined at the Airport Health Organization (APHO), a special health centre run by health ministry to screen international passengers for deadly diseases. They have sent passengers blood sample for tests who have also been made to undergo detailed health screening. None seemed to have symptoms of the disease.
State governments too are tracking and monitoring passengers arriving from countries where Ebola outbreaks are being reported. Such passengers are screened through local health facilities and local health authorities ensure follow up on a day-to-day basis for a month. 773 passengers have been tracked this way in Maharashtra, Kerala and Tamil Nadu. Ebola suspects are made to wear suit and face mask as they deplane. Aircrafts carrying suspected passengers are sequestered and fumigated and luggage of suspects is also isolated.
With due care being taken it remains the responsibility of travelers coming from affected countries to protect themselves from getting affected. The primary means of preventing Ebola involves avoiding direct contact with the body fluid of infected people, as well as anyone who has died from the disease. We all have to be well-prepared to identify and deal with any potential cases of Ebola, though as yet none have been reported in our country. Any patient with suspected symptoms needs to be diagnosed within 24 hours and should be isolated at a dedicated unit to keep the public safe.