Monday 20 October 2014

Deadly ebola virus now out of control, claim medics

Fear is spreading across the affected countries as humanitarian agencies become overwhelmed.

Barbara McCarthy

Published 03/08/2014 | 02:30

A Médecins Sans Frontières (MSF) Ebola Treatment Centre in Sierra Leone
Ebola virus survivor

'Lots of people in my family are dead. I left my home and I don't know what to do," said a Guinean ebola refugee last week." Claiming over 730 lives and infecting over 1,300 people, the world's biggest outbreak of ebola is creeping across West Africa. Despite a recent lull, the pandemic is now worse than ever.

Sheik Umar Khan, a leading ebola expert died of the disease, two American medics were infected in Liberia and man collapsed and later died after a flight to Lagos, Nigeria where 69 people are now being held under observation to ensure the virus doesn't get amongst the city's 21 million population.

Sierra Leone, Guinea and Liberia have been struggling to fight the deadly virus since March this year. According to Medecins Sans Frontieres, who deployed 552 staff in hotspots across the region, the epidemic is now officially 'out of control.'

The medical humanitarian organisation is building a quarantine unit in Kenema, Sierra Leone, to where Irish doctor Gabriel Fitzgerald has just travelled. He says his team is overwhelmed with new ebola patients. "The sooner a person receives treatment, the better their chances of recovery. People are dying in their villages without access to medical care," he said.

Unease and panic were unleashed across the globe as people feared the disease, thought to be passed on by fruit bats, could take to the skies and end up anywhere in the world, even Ireland.

"The chances of that happening are slim. It's not airborne. You can only catch the disease from close personal contact with someone through blood or bodily fluids. Its not like TB, which you can catch if you are sitting seven rows in front of an infected person on a plane," says Dr Graham Fry, founder of the Tropical Medical Bureau.

"Though in most cases it takes less than 21 days for symptoms including fever, headache and vomiting to take hold," he says.

"It mostly happens within days. So if someone were to board a plane in Freetown, Sierra Leone, a few days after contracting the disease, chances are symptoms like fever or vomiting will take hold during transit in London and the patient will be quarantined before they could make it to Ireland."

If it does arrive on our shores, the HSE promise to be prepared, while the chances of an epidemic in Europe are nigh on impossible. We have the medical means to fight it, experts have assured people.

When a friend of mine's 23- year-old sister brought Lassa fever, an almost identical haemorrhagic fever which is spread by rodents, to mainland Europe on a flight from Accra in Ghana via Lisbon, and onto Frankfurt some years back, none of her fellow passengers or people who came in direct contact with her got the disease.

She went to visit her father upon arrival in Germany and fell ill at his deathbed. He died on the top floor, while she was put into an isolation ward below. It was a huge media story and people on the flight and family members were sent to a special unit to receive close examination. She died after massive internal bleeding and was never buried, she was cremated so that the disease wouldn't spread.

It's a horrible disease by all accounts and symptoms can include bleeding from the eyes, ears and mouth. Doctors can do little for sufferers other than give them rehydration fluids and painkillers before up to 90pc of them die.

I have been in touch with friends I met while working in Sierra Leone last year. Some of them live in the east of the country, the epicentre of the disease. I was last informed two weeks ago that there was much suffering and fear amongst locals, but have heard nothing since.

Its sad that the people in this region, who have recovered so well from a brutal civil war that claimed the lives of 50,000 and only ended 12 years ago, now have a new deadly and unpredictable threat on their doorstep.

The Sierra Leoneans are amongst the friendliest people in Africa and when I was there, school children would run towards me and grab my hands and smile and laugh. Most of them live in rural parts of the country, with little communication to the outside world.

They are very tactile and when they bury their dead, they kiss the body and wash it. It's a tradition in the region and I saw it at many funerals in towns and villages. Unfortunately if the deceased has ebola, the risk of transmission is highest on these occasions and tradition can be blamed for much of the spread of the disease, which is now affecting an area crossing 1,200km.

"People in rural areas are still very ill-informed about ebola and traditionally turned to witchdoctors, voodoo and used superstition to overcome diseases," says Dr Fry. "This is the first outbreak in the region, so many people are unsure how to cure it and are not medicating themselves properly."

Locals have hindered foreign aid workers in space suits coming into villages as many believe they are spreading the disease not trying to contain it. Others have gone into hiding when they thought they had the ebola, with the help of their families.

In one case, the husband of a nurse who died hid after he realised that all the medical people who washed her body died, alongside the Imam who prayed over her corpse. Another sufferer went missing in Freetown in Sierra Leone after her family members got her from a hospital.

Medical staff in the region are completely overstretched. They not only have to endure searing heat in rubber boots and impermeable body suits, but they are short of resources both medical and human.

Dr Fitzpatrick says he will go to rural villages to do contract tracing. "This means following people who have been in contact with patients, then if they show symptoms, referring them back to our ebola treatment centre where they can receive medical care. This is crucial to stopping the transmission of the virus."

When asked what still needs to be done in the region, Jane-Ann McKenna, Director of Medecins Sans Frontieres Ireland says, "In a nutshell, everything. When you have a cluster of ebola cases in one location, you have to set up treatment centres; train care providers and all support staff, set up surveillance; introduce an effective alert and referral service; do health promotion in the community and ensure infection control in local health facilities."

While the World Health Organisation promised €75m towards the crisis and border control is being stepped up, a lack of education amongst locals is still the biggest issue and many fear the virus, which can reproduce within eight hours creating millions of new viruses, will get worse before it gets better.

Sunday Independent

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