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Could there be an Ebola outbreak in Coffs Harbour – Are we really at risk?

An epidemic has been reported in Africa, and in an age of global travel, what does this mean for Australians living in Coffs Harbour?

What is Ebola?

Ebola is a virus.  A virus is an incredibly tiny infectious disease that infects and grows inside host organisms, often causing illness.  Influenza, which is endemic to the world, is also a virus. Ebola originates from Sub-Saharan Africa, and is named after an initial outbreak near the Ebola River in Congo in 1976.

What are the symptoms?

Once contracted, Ebola lies symptomless in the body for a period of 1-7 days.  After this ”latent” period severe fevers are experienced. Severe fevers are not “I’m running a bit of a temperature today and have a case of the snuffles”, they consist of full body sweats and chills, caused from the body’s inability to regulate temperature, which the immune system is placed in overdrive attempting to combat the virus.  Full body aches and pains accompanied by severe lethargy and drowsiness may also be experienced here as well.  Imagine the worst case of the flu, and then times that by 10.  At this stage most people are bedridden.

If the severe fevers are not enough, after 7-21 days Ebola often causes a breakdown of internal bodily tissue. This can lead to progressive organ failure (namely kidneys and liver).  Your organs are rather important, so this is when things can get very serious.  In an attempt to shed the virus from the body, you begin to start virulently discharging from every orifice, this means severe vomiting, diarrhoea, sweating, all whilst on top of the worst fever you have ever had.  Not particularly pleasant for anyone involved.  It is only at the point where the body is experiencing severe virulent discharge that virus has the opportunity to be transmitted.

How is it transmitted?  Is it contagious?

The Ebola virus can be transmitted from one person to another transmitted by touch, inhalation, or ingestion, either directly from person to person or through contaminated clothing.  This can only occur once a person reaches days 7-21 where their body is experiencing severe virulent discharge.  Up until this point, despite the severe fevers, the virus is not able to spread from person to person.  The important message here: if you see someone with a raging fever experiencing vomiting, diarrhoea and associated discharge, do not make physical contact unless you have appropriate medical protection (such as gloves, face mask, etc)! Aid workers are particularly at risk here.

 How do we treat it?

Unfortunately there exists no treatment or vaccination for Ebola.  Antibiotics target bacteria, although they are totally ineffective against Ebola, which is a virus.  The best we can do is support the body in the fight against the virus with fluids and nutrition and limit the spread to other people.

 Are we at risk in Coffs Harbour from an Ebola outbreak?

Short answer: Not really.  Fortunately Australia has very strict quarantine guidelines enforced for any travelers entering the country with a confirmed Ebola outbreak.  Any person entering the county from these areas are tested for a fever and then placed in solitary isolation for 21 days. (Remember that Ebola can only be transmitted only when an infected person has had severe fevers 7-21 days after contracting the disease and showing signs of virulent discharge; vomiting, diarrhoea, etc).  Anyone with suspected symptoms of Ebola are flagged well before the virus becomes contagious, meaning that the spread of the virus can be easily controlled.

 If the spread of the Ebola virus can be easily controlled, why is there such an epidemic Africa?

There are a number of potential reasons here.  Primarily because that is where the disease originates from. Another reason is the lack of ability to identify and isolate cases of Ebola, meaning that infected persons are placed in medical care in situations where they can infect others.  Another may be the lack of health literacy and medical supplies of the population in the infected areas when it comes to handling patients who are experiencing virulent discharge (which requires surgical gloves, face masks, etc).  The third reason is that in many African cultures it is sometimes customary to physically touch the body of a deceased person as part of the funeral ceremony.  A recently deceased person may still harbor massive amounts of infectious Ebola virus on their skin or on their clothing. 

 Take home messages:

  1. If you have visited Sub-Saharan Africa or West Africa within the last 21 days and are experiencing a fever, you MUST seek immediate medical attention.  This means go and visit your GP.  If you don’t have a regular GP book an appointment online here at www.chcmedical.com.au
  2. If you are in contact with someone who is showing signs of severe fever, vomiting and diarrhea, refer them to a doctor and ensure that no physical contact is made.
  3. If you are considering travelling anywhere overseas, please check out www.smarttraveller.gov for up to date information about the spread of this disease abroad.

I hope that you have found this article helpful and informative, please note that this is not a tool for diagnosis and nor an exhaustive source of information on this rapidly changing disease.  For more information please visit the World Health Organisation (WHO) (http://www.who.int/mediacentre/factsheets/fs103/en/)

Samuel Ledger - BPharm MPS AACPA (Clincial Pharmacist)

CHC Pharmacy – “Where you always speak to a pharmacist”

 


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