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January 27, 2023

Ebola, the epidemic that put the world on fire

The Ebola outbreak that started in Guinea and expanded to Sierra Leone and Liberia, in Western Africa, caused this year the death of at least 4,493 people from the total 8, 997 reported cases of infection, the World Health Organization announced recently. Deaths caused by the Ebola hemorrhagic fever were registered in Guinea, Liberia, Sierra Leone, Nigeria, Senegal, Spain and the United States.
This epidemic also represents a genuine danger for Romanians as well, and authorities already started preparations in order to face the possibility of Ebola cases on Romania’s territory.
Health Ministry Nicolae Banicioiu, referring to the measures taken concerning the Ebola virus, said that at ‘Matei Bals’ Institute an entire floor was reserved for a special laboratory to focus its research on Ebola. “A whole floor was especially equipped at the “Bals” Institute, with a separate entrance, so as not to affect the circuit within the institute. The laboratory is separate, in order not to interact with other departments of the institute, so things are well organized. The whole floor is isolated. Transportation is performed by special ambulances. We have everything covered”, Banicioiu said.
At this time, 18 Romanians who have returned from Ebola affected countries are being monitored by health authorities. The specialists of the Public Health Departments are monitoring them every two days.
“While it lacks all symptoms, the patient will be very closely monitored 21 days after he returns to the country. If the lightest symptom shows up, the patient will be hospitalized and quarantined”, Adrian Streinu-Cercel, manager of the “Matei Bals” National Institute for Infectious Diseases declared. “In airports, we have already distributed flyers, and all persons entering our country receive a flyer and a recommendation to call 112 for more information. A person who intently transmits this diseases may face a prison sentence of up to two years and a criminal fine”, the manager mentioned. “Unfortunately, we have a few experiences that keep worrying us, as, in one case, over 400 doctors caught the disease and 232 died. We wondered how that was possible and we started training our personal on putting on and off their protective equipment. The risk is higher when the personnel improperly removes the equipment”, the doctor explained.
The prevention of the virus will is regulated by a law
Adrian Streinu-Cercel also said that a mobile hospital is presently prepared. The unit will be functional in two weeks and will benefit of the services of the “Matei Bals” Institute and of the University Hospital staff. “We have to make a focused effort in order to control the epidemic, in order to prevent the disaster encountered in African countries and regions ravished by Ebola. If we do not do this, we may expect the disease to expand all over the African continent, then on the other continents. The virus does not care about borders”, Streinu-Cercel declared, adding that Romania is prepared, “as much as any country on this planet may be prepared, under the circumstances of an infection of such nature”.
State secretary in the Ministry of Health doctor Raed Arafat declared that the risk of any Ebola cases occurring in Romania is diminished. “We maintain the low risk by not having direct flights to and from countries affected by the epidemic and, thus, avoiding direct contact, but, normally, we cannot exclude that such cases might appear. Nonetheless, our risk is still low and, for the time being, the population has no reason to panic yet”, the official declared.
The Romanian Government granted a budget of RON 25 million to the Ministry of Internal Affairs, the Ministry of Health and the Ministry of Defence for providing protection equipments.
The diagnosis of the lethal Ebola virus and measures of combating was included in national health programs, according to a draft government decree issued for public discussions by the Ministry of Health (MS).
Global mobilization against Ebola
Numerous countries follow one another in announcing more strict and rigorous controls at the borders for travellers coming from countries most affected by the Ebola epidemic: Guinea, Liberia and Sierra Leone.
The epidemic expanded from Guinea starting by the end of December 2013, and exceeded the number of 4,000 victims on October 8, according to the latest report issued by the World Health Organization (OMS). A total number of 8,399 persons in seven countries were infected so far.
The United States started specific controls at the J. F. Kennedy Airport in New York. The same was applied by Canada, which also advised its citizens to leave these countries. In Spain – where nurse Teresa Romero, presently struggling against the disease, announced she was feeling better – great efforts are being made to prevent any expansion of the hemorrhagic fever epidemic and three more persons were hospitalized as a sign of precaution.
In Brazil, a citizen of Guinea was placed under quarantine, while Peru and Uruguay announced increased vigilance in sea ports and airports. Moreover, Mexico and Nicaragua announced the intention to control immigrants headed to the United States.
Also, because of the Ebola epidemic, the Moroccan government requested a postponement of the 2015 African Nations Cup football competition, initially scheduled during January 17 – February 8.
Recent Ebola casesreported in United States and Germany
In the USA, a second case of Ebola infection was recently confirmed in a woman who had travelled on a Frontier Airlines plane one day before her first symptoms showed. The person is part of the medical personnel that treated Liberian citizen Thomas Eric Duncan, who had caught Ebola most likely in Liberia and had died on October 8 at the Texas Health Presbyterian Hospital. Last Sunday, the American health official had confirmed the first case of Ebola contracted on the territory of the United States, the case of a 26-year-old nurse employed by the same hospital.
Despite prevention, Germany was also affected by Ebola recently. A Sudanese UNO employee aged 56, infected with Ebola and rushed to the hospital in Leipzig, in Eastern Germany, on Thursday, after having been brought from Liberia, died on Monday night. This man was one of the three patients contaminated with Ebola hosted by Germany so far. On October 4, the first patient, a Senegalese expert of the World Health Organization, left the hospital in Hamburg after being successfully cured.
Another patient, a Ugandan doctor working for an Italian charity organization, is presently receiving medical care in a hospital in Frankfurt, since October 3.
“The most severe medical emergency of the last years”
After the second case was confirmed in the US, a 75 minute video conference was summoned and attended by the American and the French presidents, Barack Obama and François Hollande, the German Chancellor Angela Merkel, and the Italian and British Prime Ministers, Matteo Renzi and David Cameron.
They described the Ebola virus as “the most severe medical emergency of the last years”. “The greatest leaders of the world decided that it was necessary for the international community to do more effort and to act faster in order to stop the spreading of the disease.
Anthony Banbury, the manager of the UNO mission destined to coordinate the emergency response to Ebola (UNMEER) recently declared that the world is about to lose the battle against the Ebola virus and is unable to control the lethal epidemic. “Ebola is a lot ahead of us. It advances faster than we do and is about to win the race”, the official warned during a reunion of the UNO Security Council dedicated to the epidemic. “Either we manage to stop Ebola now, or we will have to struggle with an unprecedented situation we have no plan for.”
The World Health Organization anticipates 5,000 to 10,000 weekly cases in Western Africa, starting in December.
Ebola begins like
a common cold
The incubation period – the time between getting infected and the appearance of the first symptoms – lasts from two to 21 days. The longer the incubation, the higher the risk of spreading the disease.
The first visible signs of Ebola are those of a common cold, but it continues with internal and external bleeding, pain and rashes. High fever, headaches and a swelled throat are the first obvious signs that we are dealing with the Ebola virus, which has attacked the cells of our immunity system while letting us think we  had just caught influenza.
Then, the Ebola-infected person will experience pain all over their body, chronic abdominal pain and vomiting. Afterwards, a rash will appear on their body, quickly expanding to their head, hands and feet.
As the illness progresses, the victims’ eyes redden, because small blood vessels break, causing bleeding in the eyes, ears, mouth and other orifices.  The virus damages the same cells as the ones targeted by HIV, though the Ebola infection is more aggressive, as it also eliminates the cells of the immunity system while they are forming.
In just a few days, the patient arrives to the critical point: the moment when he either starts recovering, or reaches the lethal stage of hemorrhagic fever.
Yet, survivors must make blood tests regularly, to make sure that the virus is no longer present in their bodily fluids.
Death rate: 90 per cent
The virus has a death rate of 90 per cent and is extremely contagious. It may be transmitted by direct human contact, close or prolonged, especially among family members, and more likely by contact with the blood or other bodily fluids.
Moreover, Ebola may be transmitted by direct contact with the blood, secretions, organs or bodily fluids of monkeys or other ill or dead animals.
So far, there is no vaccine to assure protection against the virus.
The natural source is a bat species
The infection with the Ebola virus is a zoonosis (an infectious disease of animals transmittable to humans and the other way around. The natural habitat of the Ebola virus was not established yet. In Africa, specialists think that fungivorous bats are the likely natural hosts of the Ebola virus.
The virus was found in gorilla, chimpanzee and antelope carcasses during the outbreaks of 2001 and 2003. These carcasses have become the source of human infections. Yet, primates are not considered to be primary hosts, but accidental victims of the virus, just like humans.
It first appeared in 1975, in Zaire
The first human infection with the Ebola virus appeared for the first time in 1976, in two simultaneous epidemic outbreaks, one of them in Zaire (The Democratic Republic of the Congo), caused by the Zaire species of the Ebola virus, and the other one in Sudan, caused by the Sudan species. The epidemic in Sudan registered 284 cases of infections, with a mortality rate of 53 per cent. The epicentre of the outbreak in Zaire was the city Yambuku, nearby the river Ebola, which gave the name of the new virus. This epidemic was more severe than the one in Sudan and it caused the death of 284 persons out of 318 officially declared patients (resulting in a mortality rate of 89 per cent.)
After an isolated case that appeared in 1977 in the village Tandala, in Zaire, a new outbreak of the Sudan species was registered in 1979, in the city Nzara, resulting in 34 cases of infections and 22 deaths.
After fifteen years lacking reports of any infection, the Ebola virus reappeared almost simultaneously in three countries. First, in June 1994, when a Swiss ethologist got contaminated while performing autopsy on an infected chimpanzee found dead in the Tai forest, in Ivory Coast.
A huge outbreak of the Zaire species spread all over the city Kikwit and the surrounding regions in 1995, in the Southern and Western regions of the Democrat Republic of the Congo. This outbreak, that has caused the death of 256 persons out of 315 infected, resulting in a mortality rate of 81 per cent, mostly affected medical personnel. Other three outbreaks of the Zaire species spread in the North-Eastern regions of Gabon successively from 1994 to 1997: the first in 1994, the second in 1996 (due to monkey meat consumption) and the third in 1996 and 1997.
The period of 2000 – 2008 registered outbreaks of the disease in countries such as Gabon, the Republic of Congo, Sudan and Uganda, apparently based on contact with infected carcasses of gorillas, chimpanzees and antelopes. Yet, the greatest outbreak of Ebola hemorrhagic fever is happening right now, in 2014.

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