Ebola: Epidemiology and Role of the Community Health Nurse

Introduction

Dangerous communicable diseases have ceased to carry a big fear for both doctors and patients over the past few decades. The fact is that the developments of healthcare and progress in this sphere have caused quite strong protection of the population against possible severe ailments. However, even today, some infections practically do not lend themselves to treatment and are especially dangerous because of it. It is quite difficult to imagine that some diseases can cause mass death of the population in the 21st century. Nevertheless, recently, such an infection has appeared, and the whole world knows it under the name of the Ebola virus. This affliction has become a real disaster for the countries of Africa and, in particular, its western part. Its rapid spread among the population is so dangerous that the governments of many developed countries are doing everything possible to prevent the spread of the infection beyond this continent. Despite the fact that it recently announced that the epidemic is ending, the risk of another outbreak is quite high. Therefore, it is essential to know the symptoms of Ebola, its effect on the human body in the context of various factors, as well as possible nursing interventions that can be useful in caring for the disease.

Description of Ebola and the Demographics of Interest

Ebola fever is a viral infection that occurs with the defeat of various organs and systems under the influence of the syndrome of disseminated intravascular coagulation (DVS-syndrome) (Leligdowicz et al., 2016). The essence of the infection lies in the development of intravital necrosis of various tissues, that is, a person is still alive, and affected organs are already dead. In fact, there is an entire rotting and decomposing organ in the body, which releases a great number of toxic substances provoking severe intoxication. In addition, a second feature of the infection, for which it was called hemorrhagic, is the development of the DIC syndrome because of the destruction of all blood cells, including platelets responsible for its coagulation (Leligdowicz et al., 2016). Constant bleeding caused by the complete absence of blood clotting occurs in any of the smallest wounds. The blood oozes from the human body outwards. However, bleeding can be not only external but also internal. As a rule, death comes from internal bleeding or multiple organ failures. The mortality rate in West Africa is incredibly high and is 40-90% (Leligdowicz et al., 2016, p. 1). This illness is quite hard to call a reportable as the number of infected is continually growing and changing, and the formation of the countries in the west of Africa does not allow establishing a clear controlling system. Therefore, many developed states send their volunteers to solve this problem.

Mode of Transmission, Symptoms, and Treatment

The Ebola virus is transmitted to the human population because of close contact with blood, various secretions, organs, or biological of infected people and animals. The incubation period of the Ebola fever varies from two to twenty-one days (Leligdowicz et al., 2016). During this time, the virus that has entered the body actively multiplies in lymph nodes, spleen, and other organs, and afterward, it enters the blood flow in large quantities (Leligdowicz et al., 2016). When virus particles penetrate into the blood, an incubation period is over, and the beginning of the clinical course of the Ebola fever starts.

The disease is a severe viral infection that begins acutely with a sudden rise in temperature, the appearance of severe weakness, pain in muscles and throat, and headaches. Then, such symptoms are added as vomiting, diarrhea, a hemorrhagic red rash that is similar to measles or scarlet fever, and constant bleeding, both external and internal. According to Alexander et al. (2015), there is no specific and tested treatment of Ebola fever. Currently, only symptomatic therapy aimed at replenishing fluid loss by the body is used. Therefore, a person who suffers from Ebola fever should be in intensive care where he or she is intravenously injected with electrolytes and blood preparations.

Social Determinants of Health and Their Contribution to the Ebola Development

The quality of life of the population and the conditions in which the urban and rural infrastructure is mainly located determine a sanitary and epidemiological situation in any country. If it is about West Africa, as it is known, the level of economic development here is not high enough, which, in turn, is the cause of poverty. Quite often, residents of these regions live in unsanitary conditions that are favorable for the development of dangerous diseases, including Ebola. For example, spoiled food, the lack of constant access to water, and a poor level of healthcare are the primary reasons for the emergence of this dangerous infection. Social determinants of health are important to consider when it is about severe infections that can cause epidemics, and the living conditions of the population being studied are favorable for the development of such a disease as the Ebola fever.

Epidemiologic Triangle

The epidemiological triangle is a traditional model of the onset of an infectious disease. It includes three factors: host, agent, and environments that bring the host and agent together. In this model, the external environment affects the pathogen, the host, and the route of transmission of the pathogen from the source to the host.

Agent Factors

The pathogen is usually understood as a microorganism capable of causing infection; it may be a virus, bacterium, protozoan, or other organisms (Heymann, 2015). As a rule, the presence of an agent is mandatory for the onset of the disease. The presence of pathogens is necessary but not always sufficient cause of a communicable disease. Since the time when methods of epidemiology began to be used to study non-communicable illnesses, the concept of the causative agent in this model has been expanded to include chemical and physical factors of the disease. In the context of the Ebola fever, the situation is also examined from various points of view, including both traditional and innovative methods.

Host Factors

The features of the host are factors that determine the susceptibility of the organism to the causative agent. The causes of predisposition to communicable diseases can be different. Age, race, gender, socioeconomic status, behavioral patterns (smoking, drug use, sedentary lifestyle, etc.), particularly sexual behavior, the use of contraceptives, eating habits are just some of the many factors that affect the likelihood of being exposed harmful effects.

Environmental Factors

Environmental factors are those that influence the pathogen and the possibilities of its transmission. Typically, they include physical factors, such as geological features of the terrain, climate, and an artificial environment (for example, a nursing home or a hospital) (Alexander et al., 2015). They may also be biological factors, such as insects that are carriers of the pathogen or socio-economic causes, such as the state of sanitary facilities or the availability of medical services. All these three factors interact complexly, leading to human diseases. Their balance is different for various ailments. In order to find practical and efficient measures for prevention and control, it is necessary to take into account all the three components and analyze their interaction in the search for causal relationships (Alexander et al., 2015). If it is about Ebola fever, the population should be warned about all the factors that may cause this severe illness. Children and adults should be aware of the reasons for the disease and the ways to prevent it. Otherwise, its consequences can be fatal.

Role of the Community Health Nurse

As it is known, most medical workers voluntarily go to countries suffering from dangerous communicable diseases, wanting to help suffering people. The recent outbreak of the epidemic in West Africa led to the coming of medical personnel with different skills and qualifications from various parts of the world. Undoubtedly, when working in such conditions, both epidemiologists and experienced nurses’ activities are essential. These specialists provide comprehensive care to all those in need.

The task of the nurse, in this case, can be to identify cases of the disease, conducting surveys among the local population, and monitoring the state of health. Also, collecting necessary data, junior medical staff can compile statistical reports, where it is possible to indicate various causes of the disease, symptoms, as well as overall dynamics. According to this information, thorough analyses can be conducted to identify, for example, the most vulnerable populations or the principal causes of infection.

Also, as McMahon et al. (2017) claim, nursing committees in the affected area can play a significant role in assisting the needy and act as a competent authority for monitoring and recording essential data. The activities of medical personnel can provide substantial assistance in the fight against any dangerous communicable disease, including Ebola. Work after the identification of vulnerable cases can include the preparation of reports and useful plans to improve the situation in a specific region.

National Agency Addressing Ebola

Different competent bodies that control the work of their subordinate organizations have the possibility of influencing the most vulnerable territories and controlling changes that take place in the healthcare sector. According to Yadav and Rawal (2015), the role of national and international agencies is to not monitor the health status of specific regions but also to ease a psychological crisis to some extent. Therefore, the task of such bodies is essential at different levels.

One of the most famous organizations in the world, which monitors the spread of Ebola and the dynamics of the disease, is the International Federation of the Red Cross. As Yadav and Rawal (2015) remark, this agency not only monitors public health in countries where the risk of infection is considerable but also conducts other active work. For example, many volunteers who come to the infected regions are envoys of the International Federation of the Red Cross. In addition, this agency regularly collects humanitarian aid for residents who need support and cannot independently cope with the severe consequences of the disease. Therefore, the role of such an organization is significant, especially when it is about to such a dangerous illness as the Ebola fever.

Global Implication of Ebola

The consequences of Ebola are relevant not only for African countries where the fever has its greatest spread but also for other parts of the world. Residents of different continents regularly monitor the level of danger, and the media continually brings new statistics regarding the infection and the level of its spread. Many governments and charities take an active part in helping the affected regions. At the same time, for most ordinary people who are not doctors, entry to countries with an increased risk of the Ebola fever is often closed.

It is due to the fact that even insignificant contact with infected people can lead to the development of the disease that may have an extended incubation period. As Patel and Phillips (2014) note, endemic areas deserve even closer attention from the authorities. For example, the region of West Africa may well be called such an area as the prevailing conditions of local people’s lives and the customs that they adhere to are often the causes of the Ebola fever. In order to avoid being infected, it is essential to review these countries’ policies concerning public health and the way of life of local people. In case any useful measures are not taken, the countries of this region will remain dangerous for tourists and will have a reputation for contamination zones.

Conclusion

Thus, it is significant to be aware of the symptoms of Ebola, its effect on the human body in the context of various factors, as well as possible nursing interventions that can be useful. Different features of this communicable disease require increased attention from the authorities and strict control over the lifestyle and habits of the people living in those areas where the illness is endemic. National and international organizations’ participation can be of considerable help for improving the current situation. The role of nursing care is essential, and much useful work can be done on the basis of junior medical personnel’s observations and records.

References

Alexander, K. A., Sanderson, C. E., Marathe, M., Lewis, B. L., Rivers, C. M., Shaman, J.,… & Eubank, S. (2015). What factors might have led to the emergence of Ebola in West Africa? PLoS Neglected Tropical Diseases, 9(6), 1-26.

Heymann, D. L., Chen, L., Takemi, K., Fidler, D. P., Tappero, J. W., Thomas, M. J.,… & Rannan-Eliya, R. P. (2015). Global health security: The wider lessons from the west African Ebola virus disease epidemic. The Lancet, 385(9980), 1884-1901.

Leligdowicz, A., Fischer, W. A., Uyeki, T. M., Fletcher, T. E., Adhikari, N. K., Portella, G.,… & Fowler, R. A. (2016). Ebola virus disease and critical illness. Critical Care, 20(1), 217-230.

McMahon, S. A., Ho, L. S., Scott, K., Brown, H., Miller, L., Ratnayake, R., & Ansumana, R. (2017). “We and the nurses are now working with one voice”: How community leaders and health committee members describe their role in Sierra Leone’s Ebola response. BMC Health Services Research, 17(1), 495-504.

Patel, M. S., & Phillips, C. B. (2015). Health security and political and economic determinants of Ebola. The Lancet, 386(9995), 737-738.

Yadav, S., & Rawal, G. (2015). The current mental health status of Ebola survivors in Western Africa. Journal of Clinical and Diagnostic Research, 9(10), LA01-LA02.

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