Should Bangalore worry about Ebola?

Ebola scare has hit the world, after World Health Organisation declared it as an outbreak. What care should be taken by you, the citizen of Bengaluru? Read on.

The first thing that hits you, when someone who comes out from airport happens to sneeze or feel feverish is this: Could this be Ebola? And one is careful with those who come from Ebola-affected countries, for they might even be Ebola-affected!

However, what is the real situation about Ebola? Do we, the Bangaloreans, have a reason to worry? Citizen Matters explores.

Ebola has no known remedy, still many cured

Ebola virus (EBV) has no known cure, though some trial drugs appear to work. The mortality rate is 90% according to World Health Organisation. Death toll in the southern African countries due to Ebola has crossed 1546, with more than 3052 confirmed cases.

According to reports a pharmaceutical company had found cure for Marbug, a virus similar to Ebola, on August 20th 2014. An experimental drug was used to cure 16 monkeys suffering from Marbug virus. However, it is yet to become an official cure for Ebola.

Recovered patients are not a danger to public health, as once the virus dies, it does not generally relapse. Two Ebola patients who were cured and discharged from an American hospital are back with their families after spending two weeks in isolated medical care. Their blood shows no presence of Ebola virus, reports Wall Street Journal. Here is the story of how they recovered, where doctor claims there was no proof of any effect of the experimental drug on the patients.

A vaccine for Ebola is yet to be invented. As of now, there has been no confirmed cure for EBV. Survival of the affected depends on thee treatment provided by doctors to the symptoms shown by the infected, not the elimination of the virus itself. It is best not to get affected by Ebola. Prevention is better than cure. So take the necessary precautions.

How are sick travellers screened in KIAL?

Dr. R T Venkatesh, says that not all the passengers of airports are screened. Only the ones who voluntarily step up or are suspected to suffer from illness are screened.

However, blood or urine samples are taken only when the doctors at routine screening centers feel it is important. These samples will be tested at the National Institute of Virology in Pune.

Currently though there is no specific treatment for Ebola, with intensive supportive care, the mortality can be brought down and spread of the disease can be prevented by adopting specific control practices, states the guidelines on EBV.

Along with 24-hour screening centres, doctors and paramedical doctors, the Airport Health Officer has collaborated with the District Health Officer, Devanahalli, for an exclusive ambulance (GVK-EMRI 108) for transportation of quarantined passengers within 30 minutes of a call.

Dr. Manoranjan Hegde, BBMP Health Officer, West Zone, project incharge of Communicable Diseases, said that as per the State Health Department’s direction all medical officers in the city have been briefed about EBV. Anyone suspected to be positive is immediately taken to Rajiv Gandhi Institute of Chest Diseases (RGICD), Bangalore.

A ward with 15 beds has been booked for the quarantined patients from the airport at RGICD, but till date there has been no positive results in the screening.

Kempe Gowda International Airport doesn’t have direct flights to South African countries. So most of the passengers hailing from the affected countries come to Bangalore via Delhi and Mumbai International airports. These two cities have direct connecting flights. Therefore Karnataka Health Minister U T Khader has written to Prime Minister Narendra Modi requesting for a intensive check at the two airports Delhi and Mumbai.

How much should Bangalore worry?

Now, how much should we care? Ebola broke out in March 2014, but World Health Organisation declared it as an epidemic on August 8th. In between there were reports of people coming out of African Ebola-affected countries.

Karnataka’s Health Minister felt that Bangalore need not worry as we do not have direct flights from Africa. Deputy Director of Surveillance unit of Directorate of Health and Family Welfare, Karnataka, Dr. R T Venkatesh told Citizen Matters: “Mumbai and Delhi airports have the data of the airport passengers travelling from the various countries, they will inform us if anyone from those countries have come to Bangalore.”

After the Ebola-alarm went off, all international airports in India were put on high alert. Special screening centres were set up. Three Nigerians visiting Bangalore after Ebola declaration by WHO were quarantined immediately when they reported some sickness, and were released after being kept under observation.

Venkatesh said that seven people are under observation. Five people who returned from the countries in question are also under observation, though there are no symptoms of illness. A strict vigil is kept on the persons suspected to be Ebola-affected and released after the sceening, as the incubation period is 2 – 21 days. Health reports are sent to the Central Ministry of Health and Family Welfare every day in such cases, and the patients are followed up every day to ensure there is no problem. During the screening period, the patient will be under 24 hours of observation under many doctors deputed by the State Health Department.

What is EBOLA?

EBV was formerly known as Ebola Hemorrhagic Fever — a fever that can be fatal. This is the 25th outbreak since 1976 in South African countries. Fruit bats have been suspected to be responsible for the origin of the virus. It is said that they are natural hosts of Ebola viruses in Africa.

A study done by Pierre Rollin and colleagues at the Special Pathogens Branch at the US Center for Disease Control and Prevention in 2009 said the Fruit bats are the origin of the virus. However this study was not endorsed by any other medical research institute. Therefore the hunt for the origin is still on. Other non-human primates like monkeys, gorillas and chimpanzees are known to be accidental hosts, just like humans.

Ebola has never known to be found in India so far. You need not worry about getting Ebola unless you happen to visit one of the affected places like Geneva, Sierra Leone, Liberia, Nigeria or have come in contact with any affected person during travel.

What are the symptoms?

World health organization has accepted that it is difficult to diagnose Ebola in a person, as the incubation period is 2 to 21 days. It is often characterized by the sudden onset of fever, intense weakness, muscle pain, headache, sore throat, vomiting, diarrhoea, rashes, impaired kidney and liver function, and in some cases, both internal and external bleeding.

Low white blood cell and platelet counts and elevated level of liver enzymes are also its symptoms. These symptoms are similar to dengue or malaria.

How to take care in case of infected persons around?

Ministry of Health and Family Welfare of India has published guidelines and preventive care that individuals and hospitals can take to prevent EBV from spreading.

  • Ebola virus is not an airborne disease, so you will not get it through breathing the air near thee infected individual. One cannot contract Ebola virus by handling money, groceries or swimming in a pool, if there is no contact with the body fluids/ secretions of the infected individual on all these.
  • EBV spreads only with direct contact of blood, secretions, sweat, organs or other bodily fluids of infected humans or animals. Contact with open wounds of affected persons should be avoided.
  • Since it is a type of a hemorrhagic fever, it may lead to rupture of multiple organs, broken skin and mucous membranes. Therefore it is recommended not to touch an affected person without protection, and maintain a minimum distance of 1 meter from the affected person.
  • If objects like needles or clothing get contaminated with infected secretion, it should be discarded in safe manner.
  • As other animals such as infected fruit bats or monkeys/apes can affect other animals, consumption of raw meat or uncooked meat should be avoided. Ministry of Health and Family Welfare has recommended to cook all animal products thoroughly before consumption.
  • While handling any infected or dead animals or humans, ensure that you are wearing gloves and other protective clothing to avoid direct contact.
  • If you happen to contact with Ebola virus-infected person or person showing any of the above symptoms, Ministry says that it can easily be killed by soap, bleach, sunlight, or drying. Ebola virus survives only a short time on surfaces that have dried in the sun.

Dr. Venkatesh says such patients should first visit their local doctors, if the symptoms persist only then visit Rajiv Gandhi Institute.

What precautions should hospitals take?

It is well-known by now that two doctors who were treating Ebola patients also contracted the disease. To avoid such disasters, the Ministry has warned all the health care workers in hospitals or laboratories to apply standard precautions consistently with all patients at all times.

  • Hospitals or dispensaries have been asked to adopt all the preventive measures like wearing gloves, masks while checking patients. It is to be noted that virus can also be transmitted through semen of affected person up to seven weeks after recovery from illness. It is not always possible to identify patients with Ebola early, because initial symptoms may be non-specific. For this reason, it is important that health care workers apply standard precautions consistently with all patients always.
  • Precautions include basic hand hygiene, respiratory hygiene, use of personal protective equipment (to avoid the risk of splashes or other types of contacts with infected materials), safe injection practices and safe handling after death of infected patient.
  • Health care workers caring for patients with suspected or confirmed Ebola virus should apply, in addition to standard precautions, other infection control measures to avoid any exposure to the patient’s blood and body fluids and direct unprotected contact with the possibly contaminated environment. When in close contact (within 1 metre) of patients with EBV, health care workers should wear face protection (a face shield or a medical mask and goggles), a clean,non-sterile long sleeved gown, and gloves (sterile gloves for some procedures).
  • Read the detailed guideline here.

 Advisory to the families or travellers living/ returning from affected countries

  • Wash hands with soap and water for at least 30 seconds after assisting sick travelers or coming in contact with body fluids or surfaces that may be contaminated.
  • An alcohol-based hand cleaner is an alternative to hand washing but will not be effective if hands are visibly soiled.
  • Avoid touching your mouth, eyes, and nose with unwashed or gloved hands.
  • Stay away from infected persons to avoid close contact
  • Use tissues or face mask to prevent contact with respiratory secretions/ mucus.
  • In case you develop symptoms on flight, report to the airlines crew. After disembarkation, report to airport health officer.
  • In case you suffer from any such illness after reaching home, immediately report to the nearest designated health facility for prompt management.
  • WHO says that travelling from the Ebola-affected countries is not a cause for worry, even as many countries ban flights from those countries.

EBola info-graphic issued by World Health Organisation.

More resources on Ebola

  • To know what is happening on Ebola front globally, follow the official communication channel of World Health Organisation (WHO).
  • To read the frequently asked questions and answers, click here.
  • To read the Government of India advisory to airports in India, click here.
  • Interim guideline on tracing and management of Ebola virus, released by Ministry of Health and Family Welfare can be read here.
  • International Ebola Responses Roadmap released by WHO, to be followed by all countries, can be read here.

 

How are sick travellers screened in KIAL?

Dr. R T Venkatesh, says that not all the passengers of airports are screened. Only the ones who voluntarily step up or are suspected to suffer from illness are screened.

However, blood or urine samples are taken only when the doctors at routine screening centers feel it is important. These samples will be tested at the National Institute of Virology in Pune.

Currently though there is no specific treatment for Ebola, with intensive supportive care, the mortality can be brought down and spread of the disease can be prevented by adopting specific control practices, states the guidelines on EBV.

Along with 24-hour screening centres, doctors and paramedical doctors, the Airport Health Officer has collaborated with the District Health Officer, Devanahalli, for an exclusive ambulance (GVK-EMRI 108) for transportation of quarantined passengers within 30 minutes of a call.

Dr. Manoranjan Hegde, BBMP Health Officer, West Zone, project incharge of Communicable Diseases, said that as per the State Health Department’s direction all medical officers in the city have been briefed about EBV. Anyone suspected to be positive is immediately taken to Rajiv Gandhi Institute of Chest Diseases (RGICD), Bangalore.

A ward with 15 beds has been booked for the quarantined patients from the airport at RGICD, but till date there has been no positive results in the screening.

Kempe Gowda International Airport doesn’t have direct flights to South African countries. So most of the passengers hailing from the affected countries come to Bangalore via Delhi and Mumbai International airports. These two cities have direct connecting flights. Therefore Karnataka Health Minister U T Khader has written to Prime Minister Narendra Modi requesting for a intensive check at the two airports Delhi and Mumbai.

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