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The East African : Nov 3rd 2014
The EastAfrican 38 EBOLA SPREAD Govts going about Ebola control the wrong way; try humane measures US P≥esident Obama said the qua≥antine of health wo≥ke≥s ‘a≥en’t based on science and best p≥actices’ By JULIET NABWIRE The EastAfrican G overnments have come under intense criticism over measures taken to control the spread of the deadly Ebola virus, the latest being Australia, which has issued a blanket ban on visas to travellers and immigrants from Ebola-hit West African countries. The announcement by Immi- gration Minister Scott Morrison caught the Australian Medical Association by surprise. “It’s not necessarily a very well-focused decision. The bigger picture needs to be on our preparedness at home but more importantly our involvement in West Africa itself, putting doctors and nurses and other logistical elements in place and trying to combat the crisis there,” said the president of the association, Dr Brian Owler. Many airlines, including Kenya Airways, have suspended direct flights to the Ebola-hit countries in West Africa while health workers (especially from the US) who are helping save lives are facing discrimination when they return home in what has been termed a “disincentive” to health workers. A recent case involved nurse Ka- ci Hickox, who was quarantined in New Jersey upon her return from West Africa. She has since been released. CNN reported that Doctors Without Borders (Medecins Sans Frontieres) as saying, “Forced quarantine of asymptomatic health workers returning from fighting the Ebola outbreak in West Africa is not grounded in scientific evidence and could undermine efforts to curb the epidemic at its source.” On Tuesday, President Barack Obama in a live broadcast, castigated the quarantines, saying they “aren’t based on science and best practices” and called them “another barrier on somebody who’s already doing really important work on our behalf.” New York, New Jersey and Il- linois states said anyone returning from having direct contact with Ebola patients in West Africa would have to be quarantined for 21 days. Appearing on the popular CNN talk show Quest Means Business, former UN secretary general Kofi Annan castigated the quarantines as detrimental to containing Ebola. Mr Annan called Ebola “a poor man’s disease,” saying, “We have known Ebola for 40 years. It is a poor man’s disease because companies feel that if they do research and come up with a medication the poor man cannot afford it.” Also unhappy with the quaran- tine was Dr Ambrose Talisuna, of Kemri-Wellcome Trust Research Programme. Dr Talisuna, who previously headed the Epidemiology and Surveillance Working Group of the Ebola Task Force in Uganda, advocates that people be allowed to Registered nurses protest inadequate Ebola preparedness in California, US on October 28, while right, a woman is led to an observation area on arrival at JKIA, Nairobi. Pic: File go home. “Unless there is a reasonable ground to suspect that there was exposure to the Ebola virus, people should be allowed to have voluntary isolation at their homes and should be counselled to limit contact with family members for the mandatory 21 days. During this period, health workers who have adequate protective equipment should assess them daily for any symptom onset,” said Dr Talisuna Dr Talisuna emphasises screen- ing at ports of entry where people should fill in forms with information on where they have been in the past 21 days, where they are going, and if there is any risk of exposure. This, he said, will help the country 21 By JEFF OTIENO The EastAfrican UGANDA, TANZANIA and Burundi have the highest number of people at risk of zoonotic transmission of the Ebola virus disease in the East African Community. The three countries have been identified as having strong environmental suitability for the four African species of Ebola virus along with 16 other countries. A study conducted by scientists from top research institutions in Europe puts Uganda as the country with the biggest population at risk followed by Tanzania and Burundi. The 19 countries were identified after an in-depth examination of past Ebola outbreaks, distribution of species suspected to OUTLOOK NOVEMBER 1-7,2014 surveillance team follow up on any cases and stop any outbreak in its tracks. “The bedrock of an efficient Eb- ola outbreak investigation and response is universal infection control procedures and a quick and robust surveillance system to track cases should they occur and their contacts”, said Dr Talisuna. He also said Entebbe Airport in Recommended days in quarantine for Ebola-suspected people. Uganda seems to have put robust measures in place. There, passengers disembarking fill in forms at the health desk with information that can help the surveillance team to monitor them. This, he says is not foolproof but it is better than only taking the temperatures of passengers. Dr Talisuna added his voice to those of other health experts who criticised the suspension of flights and travel restrictions to West Africa, saying this would hamper efforts to manage the outbreak. “How do you expect logistics to be flown into the affected areas for Uganda, Tanzania and Bu≥undi most at ≥isk in EA of zoonotic be carriers of the virus and the land surface temperatures in different parts of the continent. “The relationship between the Ebola virus Disease niche and the environmental covariates, underscore that there are clear environmental limits to transmission of the virus from animals to humans, and that ecoregions dominated by rainforest are the primary home of such zoonotic cycles,” the scientists said in their study entitled “Mapping the Zoonotic Niche of Ebola Virus Disease in Africa.” This means if only environmental suitabil- ity is considered as the dominant factor for transmission, then the three countries have the highest chance of experiencing an Ebola outbreak in future compared with their other neighbours. However, Ebola can be easily spread by cross-border movement of infected travellers be it by air, road or sea, meaning other EAC member states are also not safe. This mode of transmission (human-to-human) is the main cause of the high rate of spread in West Africa after the first case was reported in a remote village in Guinea. In all countries at risk, since the discovthe disease in 1976, the scientists said, ery of urban and rural populations have increased and become more interconnected both within and across national borders. The scientists identified the 19 countries using the latest niche modelling techniques to predict geographical distribution of potential zoonotic transmission of the disease. Using the results, the researchers then esti- mated the number of people at risk from Ebola both in countries where cases have been reported and those with strong environmental suitability for outbreaks. The world is currently experiencing the worst Ebola outbreak in the disease’s history, which has so far killed almost 5,000 people. The US-based Centres for Disease Control and Prevention projects up to 1.4 million people could be infected by January next year, if the cases continue to increase exponentially. The World Bank predicts the epidemic could inflict a devastating blow, amounting to $359 million, to the fragile economies of the worst affected countries in West Africa this year. However, the financial institution adds, in the worst-case scenario, the losses could rise to $809 million by the end of 2015.
Oct 27th 2014
Nov 10th 2014