Emergence of the Ebola Virus Disease in West Africa

2017 ◽  
pp. 163-177
Author(s):  
Samir Dervisevic
Keyword(s):  
West Africa ◽  
Ebola Virus ◽  
Virus Disease ◽  
Central Africa ◽  
Ebola Virus Disease ◽  
World Health ◽  
Viral Haemorrhagic Fever ◽  
The World ◽  
Viral Illness ◽  
Health Organization

This chapter gives an overview on the recent outbreak of Ebola Virus Disease in West Africa which has lasted for over seventeen months. The Ebola virus has been implicated as a causative agent of viral haemorrhagic fever occurring in Central Africa over the last thirty-nine years. However, the Ebola virus has not previously been recognised as an endemic virus causing outbreaks of viral illness in West Africa. The start of what was to become the largest Ebola virus disease (EVD) outbreak in known history was first reported to the World Health Organization (WHO) on the 23rd of March 2014 and since then it has transformed into an unprecedented and severe epidemic affecting the three countries of West Africa (Guinea, Liberia and Sierra Leone). The emergence of this lethal virus in a setting of profound poverty, a dysfunctional public-health and a weak government infrastructure alarmed the wider world and caused dread from an uncontrollable spread.

Reconsidering the Ethical Permissibility of the Use of Unregistered Interventions against Ebola Virus Disease

2015 ◽  
Vol 24 (3) ◽  
pp. 366-369 ◽  
Author(s):  
JOSHUA T. LANDRY ◽  
THOMAS FOREMAN ◽  
MICHAEL KEKEWICH
Keyword(s):  
Ebola Virus ◽  
Virus Disease ◽  
Ebola Virus Disease ◽  
World Health ◽  
Ethical Considerations ◽  
Ethical Imperative ◽  
The World ◽  
Considerable Debate ◽  
Health Organization ◽  
Do So

Abstract:Ethical considerations for the use of unregistered interventions for Ebola virus disease have sparked considerable debate among academic and clinical ethicists. In August 2014 the World Health Organization (WHO) convened a panel of experts to discuss approaches to the outbreak in West Africa, with the goal of determining "whether it is ethical to use unregistered interventions with unknown adverse effects for possible treatment or prophylaxis”.1 The panel concluded that there would be an ethical imperative to provide such unregistered interventions if specific criteria could be met. This paper evaluates the WHO conclusion and argues that although it may be reasonable to provide unregistered interventions considering the circumstance, there is no clear ethical imperative to do so.

scholarly journals The 2014 Ebola virus disease outbreak in West Africa

2014 ◽  
Vol 95 (8) ◽  
pp. 1619-1624 ◽  
Author(s):  
Derek Gatherer
Keyword(s):  
West Africa ◽  
Ebola Virus ◽  
Virus Disease ◽  
Single Case ◽  
Atlantic Coast ◽  
Urban Setting ◽  
Ebola Virus Disease ◽  
World Health ◽  
The Republic ◽  
Health Organization

On 23 March 2014, the World Health Organization issued its first communiqué on a new outbreak of Ebola virus disease (EVD), which began in December 2013 in Guinée Forestière (Forested Guinea), the eastern sector of the Republic of Guinea. Located on the Atlantic coast of West Africa, Guinea is the first country in this geographical region in which an outbreak of EVD has occurred, leaving aside the single case reported in Ivory Coast in 1994. Cases have now also been confirmed across Guinea as well as in the neighbouring Republic of Liberia. The appearance of cases in the Guinean capital, Conakry, and the transit of another case through the Liberian capital, Monrovia, presents the first large urban setting for EVD transmission. By 20 April 2014, 242 suspected cases had resulted in a total of 147 deaths in Guinea and Liberia. The causative agent has now been identified as an outlier strain of Zaire Ebola virus. The full geographical extent and degree of severity of the outbreak, its zoonotic origins and its possible spread to other continents are sure to be subjects of intensive discussion over the next months.

The Cuban Response to the Ebola Epidemic in West Africa

2016 ◽  
Vol 47 (1) ◽  
pp. 134-149 ◽  
Author(s):  
Enrique Beldarraín Chaple ◽  
Mary Anne Mercer
Keyword(s):  
West Africa ◽  
Ebola Virus ◽  
Direct Care ◽  
World Health ◽  
First Case ◽  
The World ◽  
Medical Teams ◽  
Social Disaster ◽  
Health Organization ◽  
Work Done

In December 2013 the first case of Ebola appeared in Guinea. In September 2014 the United Nations (UN) and its specialized agency the World Health Organization (WHO) issued a call for medical collaboration in response to the medical crisis and social disaster caused by the Ebola virus epidemic in West Africa. Cuban authorities responded immediately to the call by offering specialized help for the epidemic, in collaboration with WHO. A group of 256 Cuban doctors, nurses and other health professionals provided direct care during the Ebola epidemic in Sierra Leone, Liberia and Equatorial Guinea from October 2014 to April 2015. This paper explains the main features of the Cuban health system, describes the development of Cuba's international medical cooperation approach, and highlights the work done by Cuban health collaborators in addressing the damage caused by the Ebola epidemic. Information used includes reports and documents of the Ministry of Public Health of Cuba, reports of WHO and PAHO, and articles published in scientific journals and newspaper articles. The response of the Cuban medical teams to the Ebola epidemic in West Africa is only one example of the Cuban efforts to strengthening health care provision in areas of need throughout the world.

scholarly journals Descriptive analyses and risk of death due to Ebola Virus Disease, West Africa, 2014

2015 ◽  
Vol 9 (12) ◽  
pp. 1298-1307 ◽  
Author(s):  
Folorunso Oludayo Fasina ◽  
Olubukola T. Adenubi ◽  
Samuel T. Ogundare ◽  
Aminu Shittu ◽  
Dauda G. Bwala ◽  
...  
Keyword(s):  
West Africa ◽  
Sierra Leone ◽  
Healthcare Workers ◽  
Ebola Virus ◽  
Virus Disease ◽  
Healthcare Delivery ◽  
Ebola Virus Disease ◽  
World Health ◽  
Public Healthcare ◽  
Risk Of Death

Introduction: Since the first case of Ebola virus disease (EVD) in Guinea in 2013, major outbreaks have been reported in West Africa. Methodology: Cases and fatalities of EVD caused by Zaire Ebola virus (ZEBOV) were evaluated, and the risks of dying in the general population and in healthcare workers were assessed. Results: The case fatality rate estimated for EVD was 76.4% in 20 studies. Cumulative proportion of fatal cases in West Africa was 42.9%, 30.1%, and 64.2% in Liberia, Sierra Leone, and Guinea, respectively. The proportion of total deaths in Liberia, Sierra Leone, and Guinea was 42.5%, 35.8%, and 21.6%, respectively. Healthcare workers were at higher risk of dying compared with the general public, and the same applied to intense transmission countries and to countries with sufficient bed capacities. The declaration of a health emergency “out-of-control” situation by the World Health Organization on 8 August 2014 reduced the risk of death among patients. Factors including deplorable healthcare delivery infrastructure in war-ravaged regions of Africa, the impotence of governments to enforce public health regulations, and the loss of confidence in public healthcare delivery programs were key among others factors that enhanced the spread and magnitude of outbreaks. Conclusions: The findings underscore the need for an overall re-appraisal of the healthcare systems in African countries and the ability to cope with widespread epidemic challenges. Outbreaks like that of Ebola diseases should be handled not just as a medical emergency but also a socio-economic problem with significant negative economic impacts.

scholarly journals Early transmission dynamics of Ebola virus disease (EVD), West Africa, March to August 2014

2014 ◽  
Vol 19 (36) ◽  
Author(s):  
H Nishiura ◽  
G Chowell
Keyword(s):  
Sierra Leone ◽  
Ebola Virus ◽  
Reproduction Number ◽  
Virus Disease ◽  
Ebola Virus Disease ◽  
World Health ◽  
Primary Case ◽  
Specific Data ◽  
Health Organization ◽  
Country Specific

The effective reproduction number, Rt, of Ebola virus disease was estimated using country-specific data reported from Guinea, Liberia and Sierra Leone to the World Health Organization from March to August, 2014. Rt for the three countries lies consistently above 1.0 since June 2014. Country-specific Rt for Liberia and Sierra Leone have lied between 1.0 and 2.0. Rt<2 indicate that control could be attained by preventing over half of the secondary transmissions per primary case.

scholarly journals Incorporating health workers’ perspectives into a WHO guideline on personal protective equipment developed during an Ebola virus disease outbreak

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 45 ◽  
Author(s):  
Saskia Den Boon ◽  
Constanza Vallenas ◽  
Mauricio Ferri ◽  
Susan L. Norris
Keyword(s):  
Public Health ◽  
West Africa ◽  
Personal Protective Equipment ◽  
Ebola Virus ◽  
Expert Panel ◽  
Health Workers ◽  
Virus Disease ◽  
Ebola Virus Disease ◽  
World Health ◽  
Protective Equipment

Background: Ebola virus disease (EVD) health facility transmission can result in infection and death of health workers. The World Health Organization (WHO) supports countries in preparing for and responding to public health emergencies, which often require developing new guidance in short timelines with scarce evidence. The objective of this study was to understand frontline physicians’ and nurses’ perspectives about personal protective equipment (PPE) use during the 2014-2016 EVD outbreak in West Africa and to incorporate these findings into the development process of a WHO rapid advice guideline. Methods: We surveyed frontline physicians and nurses deployed to West Africa between March and September of 2014. Results: We developed the protocol, obtained ethics approval, delivered the survey, analysed the data and presented the findings as part of the evidence-to-decision tables at the expert panel meeting where the recommendations were formulated within eight weeks. Forty-four physicians and nurses responded to the survey. They generally felt at low or extremely low risk of virus transmission with all types of PPE used. Eye protection reduced the ability to provide care, mainly due to impaired visibility because of fogging. Heat and dehydration were a major issue for 76% of the participants using goggles and for 64% using a hood. Both gowns and coveralls were associated with significant heat stress and dehydration. Most participants (59%) were very confident that they were using PPE correctly. Conclusion: Our study demonstrated that it was possible to incorporate primary data on end-users’ preferences into a rapid advice guideline for a public health emergency in difficult field conditions. Health workers perceived a balance between transmission protection and ability to care for patients effectively while wearing PPE. These findings were used by the guideline development expert panel to formulate WHO recommendations on PPE for frontline providers caring for EVD patients in outbreak conditions.

scholarly journals Clinical and epidemiological features of the disease caused by the Ebola virus, at the present stage: pathogenetic basis of therapy

2015 ◽  
Vol 20 (1) ◽  
pp. 32-39
Author(s):  
O. I Kiselev ◽  
L. M Tsybalova ◽  
E. G Deeva ◽  
V. V Tsvetkov ◽  
G. S Golobokov ◽  
...  
Keyword(s):  
West Africa ◽  
Coming Out ◽  
Ebola Virus ◽  
Virus Disease ◽  
Disease Outbreaks ◽  
Multiple Organ ◽  
World Health ◽  
Pathogenetic Therapy ◽  
Sporadic Cases ◽  
Health Organization

Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever is severe acute infectious diseases accompanied by the development of severe systemic inflammatory response followed by the addition of disseminated intravascular coagulation and multiple organ failure. Since 1976 in Africa regularly observed disease outbreaks among humans caused by different types of Ebola virus. Modern epidemic in West Africa began in Guinea in February 2014 and is still going on, coming out of the country and distributed in Liberia, Sierra Leone and Nigeria. According to the World Health Organization (WHO) on December 14, 2014 recorded 18,603 cases of them confirmed EVD 11807, fatal 6915. From July 2014 to currently registered sporadic cases EVD among health care workers caring for patients, as well as among tourists returning from countries affected by the epidemic is already outside of West Africa. Due to the limited use of specific antiviral therapy with special attention to the management ofpatients with EVD should be paid to the intensive and timely pathogenetic therapy. Today, the only way to reduce morbidity and mortality among people from EVD is awareness on the risk factors of infection and the use ofpersonal protective measures.

scholarly journals Incorporating health workers’ perspectives into a WHO guideline on personal protective equipment developed during an Ebola virus disease outbreak

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 45 ◽  
Author(s):  
Saskia Den Boon ◽  
Constanza Vallenas ◽  
Mauricio Ferri ◽  
Susan L. Norris
Keyword(s):  
Public Health ◽  
West Africa ◽  
Personal Protective Equipment ◽  
Ebola Virus ◽  
Expert Panel ◽  
Health Workers ◽  
Virus Disease ◽  
Ebola Virus Disease ◽  
World Health ◽  
Protective Equipment

Background: Ebola virus disease (EVD) health facility transmission can result in infection and death of health workers. The World Health Organization (WHO) supports countries in preparing for and responding to public health emergencies, which often require developing new guidance in short timelines with scarce evidence. The objective of this study was to understand frontline physicians’ and nurses’ perspectives about personal protective equipment (PPE) use during the 2014-2016 EVD outbreak in West Africa and to incorporate these findings into the development process of a WHO rapid advice guideline. Methods: We surveyed frontline physicians and nurses deployed to West Africa between March and September of 2014. Results: We developed the protocol, obtained ethics approval, delivered the survey, analysed the data and presented the findings as part of the evidence-to-decision tables at the expert panel meeting where the recommendations were formulated within eight weeks. Forty-four physicians and nurses responded to the survey. They generally felt at low or extremely low risk of virus transmission with all types of PPE used. Eye protection reduced the ability to provide care, mainly due to impaired visibility because of fogging. Heat and dehydration were a major issue for 76% of the participants using goggles and for 64% using a hood. Both gowns and coveralls were associated with significant heat stress and dehydration. Most participants (59%) were very confident that they were using PPE correctly. Conclusion: Our study demonstrated that it was possible to incorporate primary data on end-users’ preferences into a rapid advice guideline for a public health emergency in difficult field conditions. Health workers perceived a balance between transmission protection and ability to care for patients effectively while wearing PPE. These findings were used by the guideline development expert panel to formulate WHO recommendations on PPE for frontline providers caring for EVD patients in outbreak conditions.

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