THE government has issued a 90-day health alert for the Ebola virus in Bangladesh. Medical teams are to be deployed at all points of entry into the country. Going by what has been published in media; we are informed that a special 20-bed unit has been opened up at Kurmitorla General Hospital to quarantine and treat suspected Ebola-patients. These are positive steps. Although less than 2,000 people have died globally from Ebola, there is every suspicion that the disease could very well reach alarming levels unless steps are taken to contain it. And although we may think we have taken requisite steps to prevent Ebola-carrying passengers from entering the country and mingling with the mainstream population, our lack of expertise in dealing with this particular disease cannot be overlooked.
The Ebola hemorrhagic fever has been around since 1976, with the first recorded case reported in the Democratic Republic of Congo (DRC) with some 318 reported cases. The disease was spread by close personal contact and by the use of contaminated needles in syringes in hospitals and clinics. Indeed, if one looks at Ebola outbreaks since then, it has spread from Africa to the United States and travelled across to Europe and South Asia. Though there were no fatalities in the US or elsewhere in the few stray incidents throughout the '80s, the situation evolved in the '90s when Ebola started to kill in Africa. In 1994, the Ebola virus claimed some 31 lives in Gabon, i.e. 60% of the victims died. A year later, it struck again in the DRC with some 250 out of 315 people contracting the disease dying.
The rate of fatalities has risen and fallen from country to country and there is no set pattern on how and where Ebola has struck. But what is known is that close contact with the blood, secretions, organs or other bodily fluids of infected animals causes the first contracting of the disease. Thereafter, human-to-human transmission, “with infection resulting from direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and indirect contact with environments contaminated with such fluids. Burial ceremonies in which mourners have direct contact with the body of the deceased person can also play a role in the transmission of Ebola.” Men who have recovered from the disease can transmit the disease on to their partners for up to
seven weeks after recovery from the illness.
As Ebola has been around for nearly four decades, its diagnosis is possible provided laboratory facilities and trained medical staff are available. The problem lies in the fact that no licensed vaccine for the Ebola virus is available currently. Though several vaccines have been tested, none are ready for mass market launch. Hence, critically ill patients require intensive support care. As mentioned before, Ebola is a communicable disease that is often spread through families and friends because they come in close contact with “infectious secretions when caring for ill persons.” This makes the disease particularly dangerous as treating an infected patient can spread at record speed within a clinic or hospital unless proper precautions are taken. In the event, hospital staff are not wearing proper protective equipment like gowns, masks and gloves, the probability of their getting infected and starting a chain reaction to a wider population cannot be ruled out.
According to the WHO, all countries in West Africa are on alert. Countries like Ghana and Togo are collaborating with the WHO to prevent and monitor potential cases. Again, no system is foolproof. With so many people travelling locally and internationally, it is a nightmare scenario for health authorities to contain the situation at the source. For a country like Bangladesh, that has a sizeable non-resident Bangladeshi population, including hundreds of personnel -- both military and civilian -- in Africa, it becomes imperative to take the matter seriously. Though till now the outbreak has not moved across any country border and medical facilities are up and running in most western ports of entry, the same cannot be said for developing nations like ours.
Effectively screening incoming passengers on international flights, checking the disembarking sailors in our ports, looking for possible infected patients among the thousands of travellers who use the land entry points into the country present a mammoth task for our health authorities and medical practitioners. Just because no major outbreak has been reported in any neighbouring country is hardly room for comfort. Yes, the resources required for an operation such as this is going to be mindboggling and hardly possible to field without external assistance.
The WHO is one agency that has comprehended the potential of Ebola to reach endemic status within a very short time unless a global initiative is jointly undertaken by governments around the world, and that means commitments in terms of both financial and physical resources. The good news is that Ebola can be quarantined by isolating anyone with symptoms while testing is carried out. Taking proper precautions while providing medical care and methodically tracking down all those they were in close contact with at the time of getting sick. Bangladesh does not have the resources of Central Disease Control of the United States, but it has extensive experience in handling many diseases over decades. What is required is to coordinate with international agencies to set up facilities and train personnel to deal with this menace before it hits mainstream population. At the end of the day, prevention is better than cure.