EBOLA-PUBLIC HEALTH EMERGENCY OF INTERNATIONAL CONCERN

BY-DR.Chetan Kumar JevoorHouse surgeon

GUIDE-DR.Laxmikant Lokare

Associate proffessorDept. of PSM

The Ebola outbreak in West Africa constituted an ‘extraordinary event’ Countries affected to date simply did not have capacity to manage an outbreak of this size on their own.

There was need of support from international community to help regarding this.

With 1,711 confirmed and suspected cases ,and 932 deaths till 4th august ,it makes Ebola outbreak a public health risk.

WHO Statement on the Meeting of the International Health Regulations Emergency Committee Regarding the 2014 Ebola Outbreak in West Africa

The first meeting of the Emergency Committee conducted by the Director-General under the International Health Regulations (2005) regarding the 2014 Ebola Virus Disease outbreak in West Africa was held on 6 August and on 7 August 2014.

These meetings stressed upon measures taken to implement rapid control strategies, existing gaps and challenges in outbreak response.

EMERGENCY COMMITTEE adviced to consider following before declaring Ebola outbreak as PHEIC

STATES WITH EBOLA TRANSMISSION •The head of state should declare a national emergency.•Health ministers and other health leaders should assume leadership role in coordinating response to Ebola outbreak.•States should activate their national disaster and emergency management mechanisms.

•Ensure health care workers receive adequate security measures for their safety and protection , training on IPC and PPEs.•Essential strong supply pipeline be estlablished to ensure that sufficient medical commodities like PPEs are available.

States with a potential or confirmed Ebola case,and unaffected states with land borders with affected states.•Surveillance for unexplained fever cases and deaths.•New state degtecting suspected or confirmed case or contact, should treat it as health emergency.

All states•No general ban on international travelling and trading.•Should be prepared to detect ,investigate, and manage Ebola case.•General public should be given health education about the disease.

On 8th August 2014,WHO chief Dr.Chan declared West African Ebola outbreak as “PUBLIC HEALTH EMERGENCY OF INTERNATIONAL CONCERN”.

It is the largest,most severe and most complex outbreak in the nearly four decade history of disease.

Factors that led to the situation being labelled as Public Health Emergency of International Concern

• Scope of the disease in West Africa and the threat to other nations.

• The seriousness of the infections.• Intensive community and health facility

transmission patterns.• Weak health systems in currently affected and

most at risk countries.• Need for a coordinated international response

to stop and reverse the spread of disease.

Threat to other countries

•Fragile health systems with deficits in human, financial and material resources to mount an adequate Ebola outbreak control response.•Inexperience in dealing with Ebola outbreak ,misperceptions of disease.•High mobility of populations and several instances of cross-border movement of travellesrs with infection.

DELAY BY WHO

Despite the first attack that came to be recognized as early as in March, the outbreak came to be declared as international world health emergency only in August because of numerous factors which included,

• Experimental techniques to contain the outbreak like transmission barriers, drugs and Z-map--all of which nevertheless were ineffective.

• Hesitation on the part of authorities to accept in its true form the enormity and the seriousness of the outbreak.

Other recent public health emergencies of international concern

• Wild poliovirus outbreak on 5th May 2014.• H1N1 pandemic on 25th April 2009.

BIOSAFETY LEVEL and EBOLA

A biosafety level is a level of biocontainment precautions required to isolate dangerous biological agents in an enclosed facility. The levels of containment range from the lowest biosafety level 1 to level 4.– Level 1& 2: basic laboratories – Level 3: containment laboratories

– Level 4 : high containment laboratories

BSL-4•Lethal, pathogenic agent.•Readily transmittable-direct, indirect.•Effective treatment and preventive measures not usually available.•EBOLA, LASSA and MARBURG

Ebola falls under BSL-4

BIOTERRORISM and EBOLA

• Bioterrorism is terrorism involving the intentional release or dissemination of biological agents.

• These agents are bacteria, viruses, or toxins, and may be in a naturally occurring or a human-modified form.

• These agents responsible for bioterrorism are divided into 3 category.

Category A

• These high-priority agents pose a risk to national security, can be easily transmitted and disseminated, result in high mortality, have potential major public health impact, may cause public panic, or require special action for public health preparedness.

• Ebola virus falls under this category.• Other agents like Small pox virus, Botulinum toxin and Lassa

virus.

• Ebola's exponential spread has rekindled fears that terrorists may seek to turn the virus into a powerful weapon of mass destruction.

• Such talk has occurred on Capitol Hill and in national security circles. But the financial and logistical challenges of transforming Ebola into a tool of bioterror makes the concern seem overblown—at least as far as widespread devastation is concerned.

References•Ebola virus disease. http://www.who.int/csr/disease/ebola/en/.•Bioterrorism.http://www.wikipedia.com•Biosafety level.http://www.wikipedia.com