NRS428VN Epidemiology Paper

Introduction

Ebola is a communicable disease and transmission can occur when a healthy person comes in direct contact with an infected person. In the year 2014–2016 the Ebola outbreak in West Africa was the largest Ebola outbreak since 1976 when the virus was discovered first. (Briand et al., 2014). The virus that causes Ebola disease is Ebolavirus and it belongs to the Filoviridae family. The virus is considered zoonosis, which means that an animal can get infected with Ebola and later has the potency to transmit the disease to humans. In this paper, a discussion will be made regarding the Ebola disease. (Shrivastava, Shrivastava & Ramasamy, 2015).  The paper will have a detailed discussion on the cause, symptoms, treatment, complication, and rate of occurrence of Ebola disease. The paper will further discuss the social determinants, epidemiological triangle, organizational role, and nurses’ role together with the effect of the disease globally. The paper discusses about the Ebola disease and its effect on an individual as well as the community and the role of nurses in combating the same.

Discussion

Description of Ebola disease and its treatment

Ebola is a life-threatening disease that is transmitted by a virus and at first, it was detected in Sudan in the year 1976. It is a communicable disease and it can be transmitted both from humans and animals. Briand et al., 2014).  The name Ebola was given after the River Ebola.  Until recently, the virus is found in Africa only. The virus that causes Ebola disease is Ebolavirus and it belongs to the Filoviridae family. The virus is considered zoonosis, which means that an animal can get infected with Ebola and later transmit the disease to humans. However, the way this transmission occurs in humans at the onset of an outbreak is still unknown.

The signs and symptoms of this disease are fever, pain, headache or muscle pain, loss of appetite, weakness, diarrhea, sore throat, fatigue, bruising, bleeding that is unexplained hemorrhage, and various gastrointestinal complications. Other symptoms are skin rash, red eyes, hiccups (late-stage). (Shrivastava, Shrivastava & Ramasamy, 2015).

As Ebola is a communicable disease, transmission can occur when a healthy person comes in direct contact with a person infected with the virus. Contact with body fluids like vomit, sweat, blood, etc. of an infected person or a person who has died recently due to Ebola infects a healthy person. (Shrivastava, Shrivastava & Ramasamy, 2015).

Ebola disease is associated with various neurologic complications like seizures, headaches, cranial nerve abnormalities, memory loss, tremors, etc. Ebola can also affect some immunologically privileged sites, like the central nervous system, and rarely does it lead to relapse. Ebola-associated hemorrhagic fever also has various complications like jaundice, delirium, organ failures, seizures, coma, severe bleeding, shock, and death (in 50% to 100% of the patients). (Shrivastava, Shrivastava & Ramasamy, 2015).

The treatment for Ebola includes Inmazeb and Ansuvimab-zykl (Ebanga). Inmazeb consists of 3 monoclonal antibodies (odesivimab-began, atoltivimab and maftivimab,). Ansuvimab-zykl (Ebanga) is a monoclonal antibody that is administered through injection. It helps to block the virus from attaching to the cell receptor, thus prohibiting its cell entry.  Nursing interventions include balancing and monitoring fluids and electrolytes, checking oxygen levels, administering blood pressure drugs as prescribed by the doctors, maintaining hygiene, etc. EVD is a deadly disease and the recovery of an EVD patient depends on his/her immune response as well as good supportive health care. (Kilgore et al., 2015).

The average rate of fatality for EVD is about 50%. In past outbreaks, the rate of fatality has varied from 25% to 90%. (World Health Organisation, 2019).  In the year 2014–2016 the Ebola outbreak in West Africa was the largest Ebola outbreak since 1976 when the virus was first discovered. The World Health Organization (WHO) explained the Ebola epidemic as the most severe public health emergency in western Africa in the year 2014–2015 that has been ever witnessed in modern times. (World Health Organisation, 2019).  Sierra Leone had the highest burden of infection, with 3956 death and with 8706 confirmed cases making the disease an outbreak. (Goss & Goss, 2015).

Any suspect of Ebola disease is immediately reported to the Office of Communicable Disease Epidemiology. It is also important to notify CDE of the exposed persons, like contacts of a case or travelers from an affected region.  Ebola virus disease (EVD) is a deadly disease that is very rare and it is to be reported to the National Notifiable Disease Surveillance System (NNDSS) in all states and territories of the United States.

The social determinants of health and factors contributing to the progression of EBV.

Social determinants of health (SDOH) are the conditions within environments where people live, play, work, worship, learn, born, and age affecting health, body functioning, and quality-of-life risks as well as outcomes. Large innovative organizations are profit-driven and look for incentives and they invest only in well-developed nations. (John, 2017).  This can lead to the progression of the disease as the people might not get medical resources within time leading to the quick spread of the disease within remote urban areas. Researchers have noted that if the Ebola virus had occurred in developed countries like the USA, the development and progression of the disease might have been controlled well. (John, 2017). The confinement of Ebola in African countries with few cases outside Africa might have resulted in delay. The vaccine development as well as public health management were not carried out well Ebola resulting in the outbreak. (Elston et al., 2017).

Impoverished nations have health disparity when compared to developed countries which is the most important social determinant. Because of various civil wars in the past, countries like Sierra Leone were devastated in terms of economic resources and health as there was one doctor for every 100,000 patients before the outbreak of Ebola. (Briand et al., 2014).  Thus Poverty can be a major challenge that contributes to illiteracy, poor sanitation, ill-health, lack of basic healthcare services unemployment, etc. thus it is highly important to construct policies and prioritize the social determinants.

Epidemiologic triangle and special notifications for the community and school children

The Epidemiologic Triangle is a model that are used by the scientists and have been developed to study the health problems, and to understandvarious about infectious diseases and the way they spresd. It consists of 3 corners that are called vertices. The first corner demonstrates the agent responsible for the disease. For the Ebola disease, the agent/microbe is an Ebola virus. The next corner is for the host or the organism that harbors the disease. The hosts for Ebola are humans and animals. The third corner is the environment or other factors that cause the transmission of disease. The human body fluid is the main cause of the spread of infection. The virus can survive in human blood and direct contact with an infected person through blood can lead to the spreading of infection from a diseased to a healthy one. (Darwiche & Bokor, 2016).

It is important to take preventive measures if a person is traveling to a place where Ebola is present. Also, the people of the community where Ebola is endemic should avoid coming in contact with the body fluids like vomit, blood, sweat, semen, feces, urine, saliva, etc. Avoid contact with a man’s semen if he has recently recovered from EVD. (Martínez et al., 2015). Avoiding burial practices that involve touching the deceased person's body who has died or has been suspected to have EVD. Contact with animals like bats, monkeys, forest antelopes, or preparing raw meat from these must be avoided. Frequent hand washing should be practiced especially before the consumption of a meal. The children of the school should be taught about the severity of the situation and they must be taught to avoid touching their nose, mouth, eyes, etc. It is also important to consume healthy foods and avoid street foods as they can be the source of infection. Washing hands or using sanitizer should be an important practice to avoid the spread of infection. Drinking plenty of fluids and getting enough sleep will help in boosting immunity. Use of face masks if a person has been infected in the family to prevent the other members of the family from getting infected. (Martínez et al., 2015).

The role of the community health nurse and use of demographic data

Community nurses play an important role in health care management and in controlling the spread of infections. The first role of the nurses is to find the cases of the Ebola virus within a particular community. The signs and symptoms of EBV need to be analyzed and the confirmation of a person being infected with EBV can be done with the help of diagnostic tests that include PCR and blood tests. The number of cases can be then collected through the data that will help in estimating the active cases, the recovery rate, effectiveness of medications that are being used, etc. All these will help in lowering the cases. (Baduge, Morphet & Moss, 2018; McMahon et al., 2017).

Record keeping involves details of non-Ebola deaths during the outbreak, like the treatment received by the deceased and the illnesses they had, and reporting all these to the authorities.  Community nurses also plan a supportive role in a healthcare team for guiding and supporting the infected patients through the development of a care plan. (McMahon et al., 2017). The promotion of personal hygiene, the use of medical resources, health literacy, healthy diet, monitoring the vital signs of the patient, and reporting the same to the doctors are the roles that are played by the nurses of the community that are infected with Ebola. (Baduge, Morphet & Moss, 2018). Along with these providing emotional support and helping the patient and their family in overcoming the situations is the main role that the nurse plays. (McMahon et al., 2017).

Demographic data is important to know about the number of death and recovery that is occurring within the region that has been infected with the virus. To check upon the severity of the issue and to respond accordingly, demographic data is needed. There might be some areas where the cases of Ebola are not high but still enough to be progressed and spread to other geographical locations. Thus to make restrictions and implement strategies based on the cases and to take preventive measures with the supply of the resource, etc. demographic data are required.

National agency or organization for addressing Ebola and its contribution in reducing its impact.

The International Rescue Committee (IRC) has been consistently fighting against the diseases and trying to reduce the progression of Ebola outbreak. (Jones, 2020). The American Red Cross utilizes a a dedicated network of volunteers and health professionals. The American Red Cross has been providing all necessary technical as well as financial support to the countries of West Africa affected by EBV. It had also opened an Ebola treatment center in Kenema, Sierra Leone. About 4,000 volunteers have been deployed for assisting prevention efforts, providing psychosocial services, and managing the burial procedures – which is important to make sure that the virus is prevented from being spread. The American Red Cross is helping others by managing and setting up a protocol for burial efforts of 97% in Guinea, which is a major step in limiting the spread of infection. The organization is creating an army of prepared and informed individuals who are ready to treat Ebola and prevent its progression. (Shucksmith-Wesley, 2020).

The United States has been responding both abroad and at home, by the implementation of a government strategy for leading a global effort to curb the epidemic. State and USAID are working with the Department of Defense (DoD), the Department of Homeland Security (DHS), the Department of Health and Human Services (HHS), and other agencies to limit the spread of EBV and restricting transmission to other countries. The combined strategize of U.S.  lies on 4 key lines of effort.  One is to control the pandemic, the next is to manage the secondary consequence of the disease outbreak, third is to develop the leadership of disease management and ensure health security. (U.S. Department of State, 2014).

Eliminating the epidemic and addressing the main causes that are responsible for putting everyone at risk in the first place are needed. The Department of State and USAID have requested $2.89 billion by an emergency funding request to address this situation with the supply of necessary resources like medicines. This will help in meeting the immediate requirements to control the Ebola epidemic and to address the capacity required for preventing its spread and make sure that future outbreaks will not become epidemics threatening the Americans. $792 million in contingency funding will help to address emerging needs whenever the epidemic evolves in the future. (Lindborg 2015; U.S. Department of State, 2014).

Global implication of the disease and ways of addressing the issue

Ebola has the potency to affect the economy of a nation throughout the globe. The economic crisis that might result from Ebola includes loss of gross domestic output, decrease in livelihoods, and reduced foreign investment, a threat to food security, a decrease in employment, etc. There is a reduction in the growth rate in Sierra Leone and most probably it will fall even further. Household income has declined, total financial reserves have been used and people have limited food. Because of the outbreak, the government of Sierra Leone has faced a high fiscal burden that is difficult to deal with alone due to the money spent on fighting against the Ebola outbreak, together with the reduced productivity and tax revenues. The outbreak has caused lower investment and a substantial loss in the growth of private sectors, lower rate of agriculture production, reduction in cross-border trade, etc. (Rohwerder, 2014).

In the year 2014–2016 in West Africa the Ebola outbreak was the largest Ebola outbreak. It was initiated in a rural areas of southeastern Guinea, which then spread to urban areas and across borders within weeks, and within months it became a global epidemic. (Briand et al., 2014).

The United States has donated about $2.3 billion for fighting against the Ebola epidemic and for funding response activities. Various countries like the United Kingdom and Germany and have also donated millions for the international Ebola response. In 2015, about $3 billion was spent fighting against the epidemic. (U.S. Department of State, 2014).

In the United States, about $25,000 to $50,000 a day is spent for Ebola patients. According to the CDC, in the United States in the year 2014 to 2016, 11 people were treated for Ebola . Despite the costs, there are ways for helping to strengthen and rebuild the communities. (U.S. Department of State, 2014).

The World Health Organization along with various other national and international organizations have come forward in supporting the areas where the outbreaks have occurred. In DRC along with hygiene education and providing clean water access, life-saving assistance is also provided which includes cash to the vulnerable populations. The national and international organizations are helping the epidemic areas or the areas where the outbreak has occurred by providing financial education and loans to the women for fostering economic opportunities. Helping the farmers by increasing their incomes and growing more food with the help of crop diversification, education as well as training. All these will help in boosting the economy of the nation as well as help the people globally with the increase of economy. Proving agricultural grants will help in the production of crops that will be helpful for the nation as well as the globe.  (Wenham, 2017).

Conclusion

Ebola is a deadly disease that has created life-threatening situations in the past. The disease can be prevented if every person becomes a responsible citizen and apply the preventive measures well. It is important to implement basic rules like hand washing, use of masks, avoid going to the places where a person has been infected with EBV, maintaining a healthy diet, etc. The international and national organizations act as a support to reduce the burden of the disease and thus helps in improving the economic status of a region where Ebola is epidemic. Community healthcare nurses play a vital role in health promotion and data collection to reduce the spread oF infection. Effective treatment, care, and support will help in early recovery and reduce the spread of infection leading to improved quality of life of the patient as well as the community.

References

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