Ebola: Shades of Gray

Posted: October 28, 2014 in Africa, America, health, One World, privilege
Tags: , , , , , , , , ,

Hello, hello, my internet fellows!

Apologies for the short delay. This has been an eventful week for me to say the least, which I will.

There are larger issues at play this week than my shenanigans. As most of you may already know, Mali had a big spot in the news this week. As of this week Mali is officially the newest country to have reported a case of Ebola. A two year old girl was diagnosed with the disease after entering the country through Guinea with some family who have since been quarantined. She has since passed. Unfortunately at least one of the girl’s parents had already died from the virus when she left Guinea, which shares it’s largest border with Mali. The girl was noted to have had a nosebleed for the duration of their bus ride, which stopped in multiple cities along its route. No other travelers have been found with symptoms so far, but the government is still trying to track down everyone who she may have come into contact with along her trip to be sure. The Guinean-Malian border is fairly open, which is a large concern for Malians, but thankfully Ebola isn’t the most contagious of diseases.

According to the World Health Organization Fact Sheet on Ebola, the Ebola Virus Disease is only contagious when people are showing symptoms of sickness. Symptoms begin 2 to 21 days after contracting the virus. Transmission happens through direct contact with the fluids of someone exhibiting symptoms. According to the WHO, “first symptoms are the sudden onset of fever fatigue, muscle pain, headache and sore throat. This is followed by vomiting, diarrhoea, rash, symptoms of impaired kidney and liver function, and in some cases, both internal and external bleeding (e.g. oozing from the gums, blood in the stools). Laboratory findings include low white blood cell and platelet counts and elevated liver enzymes.” In early stages transmission through fluids could mean the sweat of someone fevering, however generally it is not easily transmissible unless fluids come into contact with “broken skin or mucous membranes,” like armpits or tear ducts, though hang nails and small cuts on the hands are something to watch out for and maintain. So shaking an infected person’s sweaty hand does not automatically condemn you; it is still a good idea, and definitely worth it to wash your hands if you think you might have.

The major issue with how this outbreak has been handled is brought to light in Mali’s particular situation. Most people who have been paying attention to the outbreak know not to touch people who are showing severe symptoms like bleeding from the eyes or vomiting in the street, but one question of real importance seems to be consistently overlooked; what counts as the beginning? Unfortunately the truth of the matter is that even the first signs of sweat from someone feeling feverish, or the saliva from a cough could contain traces of Ebola. This is why the virus is confused with one that could be transmissible through the air. The Ebola virus cannot be transmitted through the air, but it can be transmitted through droplets of mucus or saliva traveling through the air, making a bus ride with an infected person potentially dangerous if they are coughing or sneezing into the open. This method of transmission has only been found between pigs and monkeys so far, and in experimental conditions however, so needless to say it is not the easiest route for the disease to take. So the verdict stands; carriers are infections from the moment they begin excreting fluids as a result of the virus. This issue poses an unfortunate and controversial problem for people when you throw another element into the mix: children.

We want to comfort and take care of our children when they are sick, but in cases where Ebola may be the reality of the situation, such care may have to be given from a distance. No one wants to think about, let alone discuss the possibility of separating oneself from their sick child. Most parents are commendably committed to staying as close as possible to make themselves available for whatever reason their child may need them, but with Ebola, children create a special highway on which to travel. This, the first and only reported case in Mali so far, as well as Patient Zero in Guinea were children. However in Senegal, one and only one case was reported because their Patient Zero was a 21 year old man whom did not spend his time in the constant care of others. Unfortunately this is such a barbaric virus that it turns our compassion into our fatal undoing.

Mali, as well as the rest of the world, might need to start clarifying a bit more about how Ebola can be transmitted outside of the health centers. Unfortunately Mali also has to deal with the issue of ensuring procedure is correctly followed within those centers, but thankfully Mali’s health services in major cities are generally pretty competent. Once confirming this case was in fact Ebola there was swift action taken to track down and disinfect the bus, as well as find any who may have made contact with the child. It is the culture of the populous that concerns me most at the moment. Health officials have suspected the virus existed in Mali for some time, but the overwhelming desire to hide infection and simply ride it out at home poses some of the greatest risks for transmission. Cases can’t be reported when people don’t come forward. That being said, Mali needs to get it’s story straight and try to send out a more consistent set of information to its citizens. They’ve been giving it a good effort; I’ve seen the PSA’s on TV. The dissemination of information here needs to be wider-reaching and more comprehensive though, especially if they really want to cut this virus off in its path and hope to contain it along the towns and villages bordering Guinea.

In addition, not much information has been circulating concerning post-recovery procedures for those who are lucky enough to survive infection. Once again, as the WHO has so eloquently put it, “People remain infectious as long as their blood and body fluids, including semen and breast milk, contain the virus. Men who have recovered from the disease can still transmit the virus through their semen for up to 7 weeks after recovery from illness.” Bummer, man.

At the end of the day, what can the average person do? The answer is obvious and not isolated to this Ebola outbreak. Wash your hands whenever you get a chance. Cover your mouth when you sneeze and don’t touch other peoples’ dirty clothes, especially if they’ve been BLEEDING FROM THEIR EYES. No, but seriously. If you do find yourself in a vulnerable position in relation to this outbreak, practicing basic, common-sense hygiene may be your best defence against contracting the virus. If not, wash your hands anyway. Remember, even soap is a privilege many do not enjoy.

I hope this clarified some things. Until next time, be safe people. Onward and upward.

-Z

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