As a General Practitioner sat in my surgery in the UK, the Ebola virus cannot feel further away. I content myself with battling diseases of lifestyle such as diabetes or high blood pressure, yet thousands of miles away my medical colleagues have a completely different fight on their hands.
The constant flow of bad news from around the globe risks drowning out the misery and suffering of those in West Africa. We become almost immune to despair.
With each passing week, the news from west Africa appears all the more bleak. At the present moment, Sierra Leone, Liberia, Guinea and Nigeria are bearing the brunt, with cases reported in Senegal and more recently the United States.
The Ebola virus first appeared in 1976, with outbreaks in Sudan and the Democratic Republic of Congo, taking its name from the Ebola River. Outbreaks of the disease have been reported in every decade since its discovery, including a case in the UK in 1976 resulting from accidental exposure in a laboratory. The unfortunate recipient of a needle-stick injury thankfully made a full recovery.
The current outbreak is the largest ever known, with more deaths in the than all the others combined. Originating in fruit bats, the virus jumped the species barrier in the late 1970’s through close contact of the bodily fluids of infected animals. Once established in our species, it is spread by direct contact through broken skin or mucous membranes (lining of respiratory, genitourinary or gastrointestinal tracts). As a healthcare worker, we are often the first to succumb in such an outbreak. The incubation period is from 2 to 21 days, meaning it could take up to three weeks from the initial infection for symptoms to develop. Such symptoms include fever, lethargy, headache and sore throat, very much the symptoms of many respiratory tract infections.
Prevention is a case of good basic hygiene such as hand washing, protective equipment for healthcare works, and avoiding close contact, either with the infected or the recently deceased. Historically, Ebola has been fatal in up to 90% of cases.
Ebola is a particular problem in under-resourced countries. Nations already wracked with poverty have a limited abilty to respond to everyday medical problems, let alone severe, contagious and rapidly fatal conditions. Yet these are the very countries where the toll taken by Ebola is at its greatest, but we know that fastidious hygiene, containment and what we call in the trade “best supportive care”, are sufficient to save lives. In the UK, intravenous fluids, oxygen and nutrition are available, but for many of the countries in west Africa, such facilities are but a pipe dream.
What are the chances of Ebola spreading to the UK? Given the nature of global travel, no country is safe. At present, the risk to the UK is low, providing the international medical community mount a concerted and robust response. With the recent “Defeating Ebola in Sierra Leone” conference of the past week, we might finally be seeing this response, some six or so months since the initial outbreak. Its amazing what an every increasing threat will do to galvanise action. Better late than never.