Ebola Virus Response and Resource Management Plan
Ebola Outbreak
Ebola Virus
Symptoms
Diagnosis
Transmission
Implications for Public Health
Communication Management
Resources Required
Social and Mental Health Programs
Precautions for Healthcare Providers
This paper develops a response and resource management plan for Ebola virus. The paper would provide general information about the virus. In addition to that it will also highlight the incident command structure, resource requirements, communication and dead-body management, health and mental programs, and the precautionary measures that would be incorporated in the plan.
Ebola Virus Response and Resource Management Plan
Introduction
The Ebola epidemic, which began on the year 2014, is the largest epidemic that has been witnessed in the history, in its initial stages the Ebola virus affected a large number of people in West Africa, but it continued to grow and now poses a significant threat to various nations of the world.(Staff Members of the National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology, 2014) This paper, therefore, will develop a response and resource management plan that will highlight the basic facts regarding the virus, and the health care implications associated with it. In addition to that, it will also put light on the command and communication structure, resource requirements, social and mental health programs, dead body management, and precautionary measures that are associated with the epidemic.
2. Ebola Virus
Ebola, which was previously referred to as Ebola hemorrhagic fever, is a rare and dangerous disease that is caused by infection, which consists of one of the species of the Ebola virus. Ebola virus has the tendency to cause diseases in both human as well as non-human primates, such as gorillas, monkeys and chimpanzees. In the year 2014, the Ebola viruses hit a number of African countries. The virus, however, was first discovered in the year 1976 near the Ebola River, which is situated in the Democratic Republic of the Congo. After this discovery, the African region witnessed various intermittent outbreaks of this virus. (Staff Members of the National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology, 2014)
The concerned authorities have been unable to identify the natural reservoir host of Ebola viruses. The researchers have, on the basis of evidence and study of the similar diseases, have indicated that it is an animal borne disease and bats may be the reservoir for this disease. This is because around four out of the five types of the virus occurred in an animal host, who was an African native. As the researchers have not identified the natural reservoir yet, hence the manner in which the disease appears in the humans at the time of first outbreak is also not known. The researchers, however, have indicated that the humans may get infected because of the contact with an infected animal, which may include a non-human primate or a fruit bat. (Staff Members of the National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology, 2014)
2.1. Symptoms
Ebola virus does not become contagious until and unless the symptoms begin to appear in the infected person. The most common signs and symptoms of Ebola virus include the following: fever, fatigue, severe headache, muscle pain, weakness, vomiting, diarrhea, abdominal (stomach) pain, and unexplained hemorrhage, which consists of bleeding or bruising. The symptoms may become evident in time period ranging from 2 to 21 days once a person is exposed to the virus. The average time period for the appearance of symptoms, however, is 8 to 10 days. (Staff Members of the National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology, 2014)
The two main determinant of the success and pace of recovery from Ebola virus are: the immune system of the affected individual; and the quality of the supported clinical care that is provided to him or her. People who manage to fight the virus and recover from it develop anti-bodies, which may last for a time period of ten years or more. It has, however, not been identified yet that whether the people who recover from the virus are immune to it for the entire life time or if they can become infected with other species of the Ebola virus. It has also been observed that some of the people who recovered from the Ebola virus developed a number of complications, including muscle and joint pain, and vision problems.(Staff Members of the National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology, 2014)
2.2. Diagnosis
It is very difficult for the medical officials of diagnose Ebola in an individual who has been infected for a few days only. This because the symptoms associated with the early stage of Ebola virus, including fever, are not specific to the Ebola virus only and are commonly associated with a number of other diseases such as malaria and typhoid. However, if the individual under consideration has fever as a symptom and the healthcare officials have reasons to believe that he or she has Ebola then the individual shall be isolated and the public healthcare professionals shall be notified immediately.(Staff Members of the National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology, 2014)
The healthcare professionals can collect and test the blood samples of the affected individual to confirm the presence of virus. Ebola virus can be detected in the blood of an individual only after the appearance of symptoms, other than fever, which accompany the increase in the circulation of the virus to the other of body. The appearance of the symptoms, which may take the virus to a detectable level, may take about three days. (Staff Members of the National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology, 2014)
The laboratory tests that are used to diagnose Ebola Virus are demonstrated by the following table:
Timeline for the Disease
Diagnostic Test
In the early stages of the disease
Antigen-capture enzyme-linked immunosorbent assay (ELISA) testing
IgM ELISA – Polymerase chain reaction (PCR)
Virus isolation
Later in the course of disease or after the recovery
IgM and IgG antibodies
In the deceased person, for investigation purposes
Immunohistochemistry testing
PCR
Virus isolation
(Staff Members of the National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology, 2014)
2.3. Transmission
When a person gets infected with the Ebola virus, he or she can transmit the virus to other individuals in a wide variety of ways. Ebola virus spreads when an individual gets in direct contact, either because of broken skin or unprotected mucous membranes that are present in eyes, nose and mouth, with:
The blood or other body fluids, which may include but are not limited to saliva, feces, sweat, vomit, urine, breast milk, and semen, of a person who is infected with Ebola
Objects such as needles and syringes that are contaminated with the Ebola virus
Fruit bats or primates, including apes and monkeys, which are infected with the Ebola virus.(Staff Members of the National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology, 2014)
It shall, however, be kept under consideration that Ebola virus does not generally spread through air, water, or food. In Africa, on the other hand, one of the factors that lead towards the transmission and spread of the Ebola virusis the handling of “bush meat,” which can be defined as the wild animals that are hunted for food. In addition to that, the contact with bats infected with Ebola also spreads the disease. There is, however, no evidence, that the contact with mosquitos or other insects may also act as a source for the transmission of Ebola virus. (Staff Members of the National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology, 2014)
The researchers have also indicated that only a limited number of species of mammals, including bats, monkeys, apes, and humans, have the tendency to become infected with Ebola virus. It has also been indicated that once the infected people recover from the virus they do not pose any threat to the community as they can no longer spread the virus in the community. Even though the virus was detected in the semen of the affected individuals after the patients had recovered from the virus, it has not been identified that whether the virus could spread through sex, which includes oral sex as well. The health care professionals, therefore, advice the infected men, who have recovered from the Ebola virus, to refrain from sex for a period of three months after recovery, as a precautionary measure. However, if it is not possible for the affected individuals to refrain from sex then the use of condoms may help in preventing the spread of disease from one person to another. (Staff Members of the National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology, 2014)
2.4. Treatments
Currently any FDA-approved vaccine or particular treatment, which may include antiviral drug, is not available for Ebola virus. The healthcare professionals treat the symptoms and complications associated with the Ebola virus as they appear in the affected individual. The basic interventions which, if used at the early stages, enhance the chances of survival in a significant manner are listed below:
The provision intravenous fluids and balancing body salts, also referred to as electrolytes
Effective maintenance of blood pressure and oxygen in the body
Appropriated treatment of other viruses if they occur in the course of Ebola
The experimental vaccines and other drugs for the treatment of Ebola virus are currently in the development stage but these have not been tested for safety and effectiveness by the scientists yet.(Staff Members of the National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology, 2014)
3. Implications for Public Health
The increase in the spread of this disease has raised a number of concerns regarding public health. It is, therefore recommended, that informative programs shall be conducted which educate the people regarding the practice of careful hygiene, for example, the people may be educated to wash their hands with soap or alcohol-based sanitizers whenever they come in contact with blood or body fluids, to avoid handling objects that might have come in contact with blood or body fluids, toavoid attending funerals of the people infected with Ebola, to avoid getting in contact with bats, non-human primates, their body fluids, blood, and raw meat.In addition to that, people shall also be restricted from travelling to Africa where there has been a massive outbreak of Ebola virus. Furthermore, after their visit from Africa, people shall monitor their health for 21 days and shall contact the healthcare officials immediately if any of the symptoms of Ebola virus appear.(Staff Members of the National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology, 2014)
4. Incident Command Structure
In order to effectively manage the treatment and control of virus, an incident command structure would be used by the concerned authorities. The unified command group under this condition would be a compendium of medical specialists. The command staff would consist of the safety officers, consisting of public healthcare professionals as well as the policy makers. In addition to that, selected people from the government health agencies, would act as public information officers, who will be responsible for transmitting information to the general public, and will be a part of the command staff. The command staff would ensure that all the members are ready and trained to manage the emergency situation. In addition to that, it will also coordinate with the external stakeholders and agencies for ensuring effective inflow and outflow of information. (Fish, 2014; Staff Members of the Department of Health and Social Services, State of Alaska, 2015; Staff Members of the Governor’s Office of Homeland Security and Emergency Preparedness, State of Louisiana, 2014; Staff Members of the United Nations Office for the Coordination of Humanitarian Affairs, 2015)
The general staff, on the other hand, would consist of the finance section chief, logistic section chief, operations section chief, and the planning section chief. The general staff would be responsible for ensuring that the effective resources are available for the management of the emergency. In addition to that, the general staff would also be responsible for the acquisition of funds. The staff would also plan, according to the specification of the unified command group, about the acquisition and use of resources in a manner that would not hinder the appropriate and timely management of the emergency.(Fish, 2014; Staff Members of the Department of Health and Social Services, State of Alaska, 2015; Staff Members of the Governor’s Office of Homeland Security and Emergency Preparedness, State of Louisiana, 2014; Staff Members of the United Nations Office for the Coordination of Humanitarian Affairs, 2015)
5. Communication Management
In order to maintain the peace within the community and pacify the feeling of fear associated with the virus the channels of mass communication would be deployed. Through mass communication people will be informed about the measures that have been taken by the local authorities to control the transmission this disease in the community. In addition to that, people will also be informed about the degree to which the local authorities exert control over the situation at hand. Apart from that, people will also be provided with the information regarding the response centers and they will be ensured that they will be provided with timely support and assistance. (Fish, 2014; Staff Members of the Department of Health and Social Services, State of Alaska, 2015; Staff Members of the Governor’s Office of Homeland Security and Emergency Preparedness, State of Louisiana, 2014; Staff Members of the United Nations Office for the Coordination of Humanitarian Affairs, 2015)
In addition to the mass communication channels, which include paid television content, the local authorities would also arrange workshops that would be directed towards spreading awareness about the virus. The workshops would educate the people about the characteristics of the virus, its symptoms, transmission, treatment, and risk exposure. By educating the people, the local authority would empower them to take precautionary measures at individual level so as to minimize the spread and transmission of the disease. Apart from that, this would also reduce the fear of the unknown, and would aid the authorities in maintaining peace and calm in the community. (Fish, 2014; Staff Members of the Department of Health and Social Services, State of Alaska, 2015; Staff Members of the Governor’s Office of Homeland Security and Emergency Preparedness, State of Louisiana, 2014; Staff Members of the United Nations Office for the Coordination of Humanitarian Affairs, 2015)
6. Resources Required
The management of this situation would require three basic types of resources, namely physical resources, human resources, and financial resources. The financial resources would include all the funds required for the treatment and eradication of this disease from the community. The physical resources would include the hospital equipment, laboratories, medicines media, and other machinery and supplies that would be deployed by the staff for the management of this disease. The human resource, on the other hand, would include all the individuals, ranging from the medical staff to the operational staff, that would be involved in the management of this situation. (Fish, 2014; Staff Members of the Department of Health and Social Services, State of Alaska, 2015; Staff Members of the Governor’s Office of Homeland Security and Emergency Preparedness, State of Louisiana, 2014; Staff Members of the United Nations Office for the Coordination of Humanitarian Affairs, 2015)
7. Social and Mental Health Programs
As indicated above, the unified command group would consist of a compendium of medical specialists, including psychologists and mental health therapists. The command structure would incorporate counselling sessions and therapies. These therapies would go hand in hand with the treatment process so as to ensure that the affected individual does not deteriorate psychologically and has a sound mental health. In addition to that, these programs would also address the family members of the affected individuals so as to reduce their depression and to ensure that they might not suffer from any critical psychological disorder. (Fish, 2014; Staff Members of the Department of Health and Social Services, State of Alaska, 2015; Staff Members of the Governor’s Office of Homeland Security and Emergency Preparedness, State of Louisiana, 2014; Staff Members of the United Nations Office for the Coordination of Humanitarian Affairs, 2015)
8. Dead-body Management
It has been indicated by a number of studies that Ebola virus can transmit from the dead body in the post-mortem settings because of inappropriate handling of the remains. The local authorities would, therefore, ensure that the concerned personnel are effectively trained to handle the infected remains. In addition to that, it will also be ensured that the concerned staff wears necessary equipment while removing the infected parts.The staff would also be condemned from removing any inserted medical material from the body, as it may transmit the infection. Furthermore, the body would not be washed, cleaned, or embalmed. Moreover, autopsy would not be performed, and if necessary CDC would be consulted for precautions. Apart from that, it is also recommended that the body should be cremated. However, if it is not possible to cremate the body then it would be buried in a metal casket or other comparable material.(Fish, 2014; Staff Members of the Department of Health and Social Services, State of Alaska, 2015; Staff Members of the Governor’s Office of Homeland Security and Emergency Preparedness, State of Louisiana, 2014; Staff Members of the United Nations Office for the Coordination of Humanitarian Affairs, 2015)
9. Precautions for Healthcare Providers
The healthcare providers who would be dealing with people infected with Ebola will take the following precautionary measures
All of the staff would deploy appropriate PPE.
Personnel would use infection control and sterilization measures before and after handling the patients.
The patients with Ebola will be isolated from other patients
The personnel would not have direct contact with the dead bodies of the people who have died of Ebola
The personnel shall inform the concerned authorities, in an immediate manner, if they have had a direct contact with blood or body fluids of the patients infected with Ebola virus.(Staff Members of the National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology, 2014)
References
Fish, L. (2014). Ebola Outbreak Preparedness, pp. 2-20. Bloomington: Indiana University. Retrieved from http://marionprepares.org/wp-content/uploads/2014/10/Ebola-Summit-Medical-Break-Out-Session.pdf
Staff Members of the Department of Health and Social Services, State of Alaska, (2015). Alaska Department of Health and Social Services Ebola Virus Disease Response Plan, pp. 3-36. Anchorage: Department of Health and Social Services, State of Alaska. Retrieved from http://www.epi.hss.state.ak.us/id/dod/ebola/EbolaResponsePlan.pdf
Staff Members of the Governor’s Office of Homeland Security and Emergency Preparedness, State of Louisiana, (2014). Louisiana Ebola Virus Disease Response Plan Governor’s Office of Homeland Security and Emergency Preparedness, pp. 4-73. Baton Rouge: Governor’s Office of Homeland Security and Emergency Preparedness, State of Louisiana. Retrieved from http://gohsep.la.gov/plans/2014_Louisiana_Ebola_Response_Plan_Annex.pdf
Staff Members of the National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology, (2014). Ebola, pp. 1-3. Atlanta: National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology. Retrieved from http://www.cdc.gov/vhf/ebola/pdf/ebola-factsheet.pdf
Staff Members of the United Nations Office for the Coordination of Humanitarian Affairs, (2015). Ebola Virus Disease Outbreak, pp. 2-33. New York: United Nations Office for the Coordination of Humanitarian Affairs. Retrieved from https://docs.unocha.org/sites/dms/cap/ebola_outbreak_sep_2014.pdf
