In 1976, the Ebola virus was first exposed. It happened in the areas in northern Zaire and southern Sudan when two outbreaks of hemorrhagic fever occurred (Cenciarelli et al, 2015). Ebola Virus Disease (EVD) is the origin of hemorrhagic fever and said to be one of the most severe viral disease with 40-50% high case-fatality rate (Cenciarelli et al, 2015). According to World Health Organization, Ebola virus belongs to the virus family of Filoviridae which has a diameter of 80 nm and characteristic of pleomorphic filamentous morphology. This Filoviridae family has three genera which are Ebolavirus, Cuevavirus, and Marburgvirus. There were six species in genus Ebolavirus that have been discovered these are Zaire, Bombali, Bundibugyo, Sudan, Reston and Taï Forest (World Health Organization [WHO], 2014).
In the West Africa, there was a tense outbreak of the Ebola virus during summer of year 2014 up until 2016 specifically in the areas of Guinea, Liberia and Sierra Leone (Hsieh, 2015). The virus that was causing the outbreak belongs to the Zaire ebolavirus species. According to numerous studies, the affected countries during 2014 epidemic in West Africa were ill-equipped to manage because they have lacked resources, inadequate funds and were poorly governed (Huynh, 2019). There was a report at the end day of December 2014 that a total of 20200 were confirmed cases of Ebola virus. According to a statistical report, there were total of 2707 infected Ebola virus cases including 1708 deaths reported in Guinea, in Liberia there were 8018 infected Ebola virus cases including 3423 deaths, and in Sierra Leone a total of 9446 infected Ebola virus cases including 2758 deaths were reported (Cenciarelli et al, 2015).
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In the first weeks of Ebola virus outbreak it started in Guinea. It was unnoticeable until the serious symptoms and febrile illness appeared and observed (Ellerbrok et al, 2017). During the Ebola virus outbreak, analyses were performed on different animal species and discovered that the possible virus reservoir of Ebola virus was from the infected animals such as chimpanzees, fruit bats, monkeys, forest antelope or porcupines, and gorillas. There were several proofs that indicate Filoviruses as zoonotic, which is the virus can be transmitted from animals to human beings. This virus can be transmitted when an individual has close contact with the infected animal secretions, blood, organs or other body fluids. It can also be transmitted within person-to-person contact wherein it is contagious if there is a broken skin or wound that is directly in contact with the infected individuals’ body fluids such as their urine, semen, saliva, and feces. The transmission airborne spread through aerosols among human individuals has not been confirmed (Cenciarelli et al, 2015). The symptoms that the victims can experience are headache, sore throat, muscle and joint pain/weakness, vomiting, diarrhea, rash, and complications with the gastrointestinal tract. It is between 2 and 21 days incubation period and then after, the febrile illness starts to develop. Hemorrhagic indications can represent the major form of clinical manifestations of Ebola virus and this can be particularly observed in the complications of gastrointestinal tract (WHO, 2014).
Assessments and evaluations that the symptoms were triggered by Ebola virus infection there were diagnostic methods implemented. These diagnostic methods were the antibody-capture enzyme-linked immunosorbent essay (ELISA), serum neutralization test, antigen-capture detection tests, electron microscopy, reverse transcriptase polymerase chain reaction (RT-PCR) assay, and virus isolation by cell culture. According to World Health Organization, there was still no proven cure available for Ebola virus diseases. However, there were variety of potential treatments being evaluated such as immune remedies, blood products or transfusion, and drug analyses (WHO, 2014). On August 2014, the World Health Organization (WHO) considered the use of the experimental drugs which is the ZMapp. This drug was developed by the Mapp Biopharmaceutical Inc. and this experimental drug was given to three medical doctors who were infected with Ebola in Africa. There were signs of healing on the beginning however, there was no scientific proof that the improvement of their health was related to the administration of the experimental drugs (Cenciarelli et al, 2015). On 2015, there was a trial vaccine that proved to be highly effective against the Ebola virus. This vaccine is called rVSV-ZEBOV vaccine and this is being used up until now to treat Ebola virus disease (WHO, 2014).
The Ministry of Health (MOH) and World Health Organization (WHO) took actions to implement measures to control and prevent the advance spread of infection of the Ebola virus during the outbreak. There were plenty of difficult problems that were faced by the local and international response to eliminate the Ebola virus outbreak. Such problems that were faced during the outbreak were inadequate training of the health-care officials to manage the suspected and confirmed Ebola cases; experienced struggle to trace individuals who are contacted and probable affected by the virus; and there were new outbreaks of infection procedures that needs to be followed (Cenciarelli et al, 2015).
In 2014, when the Ebola virus outbreak started, the isolation facilities were the first one to respond to control the spread of the virus and to provide assistance to those individuals who were suspected and have confirmed cases (Hsieh, 2015). The Global Outbreak Alert and Response Network (GOARN) sent professionals and experts to provide some of the facilities such as epidemiology and surveillance, more and advanced infection prevention and control measures, operational incident managements, medias to spread the outbreak information and to warn people living on the nearby affected areas, and social transportations (WHO, 2014). The World Health Organization (WHO) started to give more training and education to the health and community professionals to identify, notify, and manage assumed and confirmed Ebola virus cases. If there will be community engagements it will lead to success control of the outbreak. Awareness to the risk factors for Ebola infection is an efficient way to eliminate human transmission (Hsieh, 2015). The risk reductions that the community of Africa can do will be reducing the threat of the transmission between wildlife and humans, transmission between humans and human beings, outbreak containment measures, and reducing the risk of transmission during sexual intercourse (WHO, 2014). The health care workers should take standard precautions when assisting patients, nevertheless of their assumed diagnosis. These standard precautions include proper hand and respiratory sanitization, use of the personal protective equipment, safe injection protocols, and safe practices in the burial. If a health care worker or someone who has a contact within 1 meter with the infected individual, they should wear face shield, a gown and gloves. Especially the laboratory workers they are in risk so they should properly be trained so that they can handle the infected samples carefully and processed the samples accurately (WHO, 2014).
The Ebola virus outbreak was underestimated during the year 2014. West Africa was not prepared about the outbreak so the residents there only have limited knowledge or nothing at all on how to handle that certain outbreak. The health care professionals have insufficient resources during the outbreak. The resources needed to improve the critical situation like this are additional diagnostic capability, health personnel, experts, vehicle for transportation and treatment facilities (Cenciarelli et al, 2015). The health care workers trainings should also be prioritized because this is the most important essential for the response to this kind of situation. A lot of people died from the summer 2014 Ebola virus outbreak, the public communications were used so it is also the responsibility of every individual to take standard precaution on the ongoing situation. The simplest way to prevent contamination of the virus is to have a proper hand hygiene. Adults or parents must educate their children on the proper way to wash their hands. Personal protective equipment such as gloves and masks should be given to all the residents in Africa, this serves as the barrier in the continuous spread of the pathogens around the area. It was reported that another relevant crisis that has been faced was that too many cross-border movements were happening that time. So, it means that the people who are infected may spread the virus to the other countries in Africa. There have been incidents that the community did not participate and did not take seriously on what was happening and the health care teams were forced to face the aggression of the population. Hence, the government must implement a stronger and better infection control and prevention measures like night time curfew and quarantine places. Also, I believe that there should be more researchers in exerting efforts in experimenting to find more effective treatments or vaccines to fight for the Ebola virus. The Ministry of Health with collaboration with World Health Organization should seek help in other countries for new techniques and upgraded tools to improve the detection of confirmed cases and the biological agents that is causing this virus. There must be new methodologies in managing the spread of pathogens like more education to the health care workers and as well as to the residents.
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