Communicable Diseases: Ebola Virus Disease (Term Paper Sample)

Communicable Diseases: Ebola Virus Disease
[Name]
[Date]
Communicable Diseases: Ebola Virus Disease
Background
Ebola virus disease EVD), known previously as Ebola hemorrhagic fever, refers to a rare, but dire, often fatal ailment in humans. It is transmitted from animals to people and then spreads across the human populace through human-to-human transference (World Health Organization, 2020). EVD became known to scientists in 1976 when two consecutive spates of fatal hemorrhagic fever happened in different regions of Central Africa (Baseler et al., 2017). The first breakout was reported Yambuku, in former Zaire, the Democratic Republic of Congo (DRC), in a village close to the Ebola River, which lent the bug its name. Immediately after, roughly 850 km or 500 miles away, the second outbreak occurred in what is the present Nzara, South Sudan. At first, the assumption of public health officials was that the outbreaks were a lone event linked to an infected individual who ostensibly traveled between the two regions. However, researchers later revealed that the two spates were the result of two genetically discrete viruses: Sudan ebolavirus and Zaire ebolavirus (Centers for Disease Control and Prevention, 2018). Following the discovery, scientists resolved that the virus originated from dissimilar sources, spreading autonomously to humans in both the affected regions.
Viral and epidemiological statistics suggest that the virus was ion existence long before the first recorded outbreaks. Attributes such as intrusion into forested expanses, direct interaction with bush meat or wildlife, and population growth might have spurred the spread of the deadly virus (Baseler et al., 2017). It is essential to analyze EVD in detail to understand its epidemiology.
Identification of Host, Causes, and Mode of Transmission
After the discovery of EVD, scientists explored thousands of animals, plants, and insect species to find its source, known by virologists as a reservoir. After determining that chimpanzees, gorillas, and other mammals were “dead-end” hosts, the scientists focused on reservoir host animals that could host EVD without experiencing acute infection despite the presence of the virus in their blood, tissues, and organs. While there is no conclusive evidence, scientists have pinpointed African fruit bats belonging to the Pteropodidae family as having the highest probability of spreading the virus or even being the reservoir host (Centers for Disease Control and Prevention, 2018). EVD is introduced to humans through coming into close contact with the secretions, blood, bodily fluids, or organs of infected animals, which include fruit bats, monkeys, gorillas, porcupines, forest antelopes, or chimpanzees found dead or ill in the rainforests. The virus then spreads
Consequently, the Ebola virus spreads via human-to-human transference through direct contact, which could be through mucous membranes or broken skin (World Health Organization, 2020). Besides coming into contact with infected animals, humans can contract EVD by handling contaminated objects like feces, vomit, and blood from the bodies of patients. In addition, burial ceremonies conducted devoid of proper protective equipment can escalate incidences of EVD transmission. Humans remain infectious for as long as they have the virus in their blood. Pregnant women with acute EVD may still harbor the virus in their breast milk or in fluids and tissues related to the pregnancy. The implication could be a transmission to the unborn baby or other people. According to the World Health Organization (2014), the virus has also been discovered in semen and urine. For instance, in a convalescent male, it can persevere in semen for no less than 70 days, with another study indicating that it could persist for even ninety days. While tears and saliva might also carry risk, the studies implicating them have been extremely constrained in sample size, with results being inconclusive. Contrary to some beliefs, EVD is not an airborne contagion.
The symptoms of EVD are usually sudden. During the initial stages, Ebola manifests itself as the flu or related illnesses (Centers for Disease Control and Prevention, 2018). Typically, the signs commence between two and twenty-one days post-infection and include headache, high fever, stomach pain, weakness, fatigue, sore throat, lack of appetite, and joint and muscle pains. As the illness becomes worse, it leads to bleeding within the body, in addition to the nose, ears, and eyes. Some individuals will cough or vomit blood, develop a rash, or have bloody diarrhea. In various cases, there are signs of impaired liver and kidney function, internal bleeding, and blood discharging from the gums. In such stages, the laboratory findings might return tests of low platelet and red blood cell counts and higher liver enzymes.
Demographic Interest
Exposure patterns for EVD are likely to differ by sex and age, which are because of dissimilarities in susceptibility to infection, variations in exposure, variances in recognition, diagnosis, and reporting of incidents. According to Bower et al. (2016), women may be at higher risk of contracting EVD because they tend to care more for the sick while the men tend to be more involved in carrying the sick to clinical facilities. For children that need to be cared for, fed, and held, the likelihood of contracting EVD is higher because separating young children from EVD-affected households often proves to be difficult.
In order to obtain a clearer picture of the incidents of EVD related to population-level and environmental predictors of the virus, Zinszer et al. (2017) conducted a study across Guinea, Liberia, and Sierra Leone using covariates like secondary education, waterway density, average rainfall accumulation, and female-headed households. Sierra Leone, possessing the highest waterway and road density, had the highest tally of confirmed EVD cases (see table 1). Guinea and Liberia had similar case burdens, while Liberia had the biggest percentage of the households led by females and without toilets.
Table SEQ Table \* ARABIC 1: Country-Level summaries
Source: Zinszer et al. (2017)
In terms of incidences of occurrence between the genders, countries exhibited different results (see Table 2).
Table SEQ Table \* ARABIC 2: EVD incidences among all ages
Source: Source: Zinszer et al. (2017)
In the tens of EVD outbreaks that have happened in seven African nations since the virus's discovery, it has demonstrated mortality rates fluctuating between 22 percent and 88 percent (Sakukhan, 2016). The rates depict EVD’s manifestation as a more deadly disease than it is contagious. In the 2016 outbreak, its average case fatality reached 50 percent, despite lethality changing between patients and in the course of the outbreak. Recent studies have indicated that mortality is directly correlated with viremia, which is the patient’s virus load (Sakukhan, 2016). The prevalence of EVD infection among individuals who have come into close contact with those infected remains unclear.
Reporting Protocol
EVD is a reportable disease. It is a deadly viral ailment that has to be reported to the National Notifiable Disease Surveillance System (NNDSS) across all American states and territories (Centers for Disease Control and Prevention, 2018). Prompt recognition of the disease is essential for infection control. It is imperative for healthcare providers to remain alert and examine patients with suspicion of having the virus. The reporting process involves healthcare facilities, providers, and laboratories notifying the local health jurisdictions, which in turn, notify the state's Department of Health. Ultimately, the state transfers the data to the Centers for Disease Control and Prevention. Laboratories have to submit a positive specimen to the local health jurisdiction within two business days after confirmation, while the jurisdictions are required to suggest infection control precautions immediately if the agent is communicable.
Pathogenesis
The virus enters the body through breaks in the human skin, mucous membranes, or parenterally. It infects many types of cells, including macrophages, monocytes, endothelial cells, dendritic cells, hepatocytes, fibroblasts, epithelial cells, and adrenal cortical cells (Baseler et al., 2017). The incubation period is normally related to the route of infection, for example, ten days for contact and six days for injection. The virus moves from the starting point of infection to the regional lymph nodes and then to the spleen, adrenal gland, and liver. Despite not being infected by the virus, lymphocytes experience apoptosis leading to diminished lymphocyte counts. Subsequently, hepatocellular necrosis takes place and is linked to the dysregulation of clotting factors and ensuing coagulopathy. Also, adrenocortical necrosis can be established and is related to hypotension and compromised steroid synthesis. The Ebola virus acts to trigger the release of pro-inflammatory cytokines with vascular leak and compromise of clotting, eventually leading to multi-organ shock and failure.
Social Determinants of Health and their Contribution to EVD
According to the World Health Organization, the social determinants of health describe the conditions where individuals are born, raised, work, reside, and age, inclusive of their healthcare system (Houéto, 2019). For the effectiveness of any population health intervention, it has to aim at altering the undesirable elements within the social contexts that affect health. The undesirable elements could include, devoid of necessarily being constrained to, avoida...