3.The Ebola Virus Time Line
II.The Ebola Crisis of The 2014
III.The Ebola Crisis of The 2014 Actors,Policy and administrative address
1.Liberia,Guinea,and Sierra Leone Policy and administrative address
2.The UN and WHO Addressing the Ebola Crisis
The Univeristy of Baltimore
Abstract: This research paper explains what the Ebola Virus Diseases (EVD) is meant about and accounts of history centering on policy and administrative measures to tackle the EVD. In elucidating details of the EVD the research paper narrates aspects of when the virus was incepted in history and the origins of the virus. It also assesses controversies behind the origin of the virus and gives a conclusion that wild animals of unspecified type are the origin. Its origin is unspecified given the fact that various wild animals are considered to be the root causes either as a contact or as food resources. Added, the paper details how the Ebola Virus Diseases of 2014 expanded beyond geographical barriers and affected huge numbers of people breaking the overall records in history and surpassing the overall past occurrences together in magnitude and scope. The plague with such magnitude has shattered the capacity of Western African countries to contain it and put into question the ability of the world health organization (WHO) and the global community. Be that as it may, the collective participation of the global community has brought the plague into a defeat. The plague has been contained with the diverse role played by the international community, INGOs, WHO, the UN and the host West African countries of Guinea, Liberia and Sierra Leone. Guinea, Liberia and Sierra Leone have used different administrative and policy mechanisms to contain the Ebola Virus Disease of the 2014. The 2014 Ebola Crisis could not have been contained without those administrative and policy addressees that the host countries have designed and implemented. The UN, WHO, and INGOs have also collaborated in containing the plagues with diverse administrative and policy issues besides providing resources to avert the farther expansion of the plague and its huge impact on security in its border term among which failure of investing on health facilities in West Africa was unprecedented. The research has finally drawn a recommendation and a conclusion. Key Terms: Ebola Virus Disease, UN, WHO, INGOs, Guinea, Liberia, Sierra Leone, Security
This research paper has three sections. The first section details a historical back ground of the Ebola virus disease. In detailing accounts of history, it articulates that the virus was first found in Germany in 1967 according to Peters &Peters (1999). It also points that the virus had come into contact with humans in 1967 as a filo virus family as depicted by Peters &Peters (1999) in the Journal of Infectious Diseases. In depicting this, it does not counter the notion that the Ebola virus was first identified in 1976. Yes, the virus was first identified as Ebola virus in 1976 and recorded as coming into contact with humans as Ebola virus in the same year.
The research paper also addresses diverse origins of the virus and gives its own conclusion of where the virus originated. Are bats or monkeys or chimpanzees the sources of the virus? While there is no specifically established conclusion over the source, the paper generally concludes that wild animals of unspecified types are the sources of the disease.
The second section of the paper explains details of the timelines in Ebola virus disease. It takes peoples understanding of the 1976 Ebola virus disease as 1st identification of the virus and the founding of the virus in 1967 as a filo virus family. It also explains if there was an Ebola outbreak in 1972. In narrating the timelines, the paper distinguishes five types of Ebola virus named after the place they were found.
Finally, the paper’s third section explains what policy and administrative addresses were made to curtail the disease which is the central research question this paper answers. In digging out the different policy and administrative addresses, it studies details of what decisions the governments of Guinea, Liberia and Sierra Leone took to contain the pandemic. It also elucidates the role of the UN, WHO and at last the INGOs. How did they play roles in combating the disease and what addresses they do to contain the Ebola crisis? A brief conclusion and recommendation is also given to this paper.
The Ebola Crisis
I. Historical Back ground
Historical accounts relatively differ over the founding and the identification of the Ebola virus. Most accounts for example as observed by Alexander, Sanderson, Marthe, and et al (2015) date the identification and the first outbreak of the virus to 1976. This notion is reinforced by diverse authors such as Garret in the council on Foreign Relations (2015), and the UNDP African Policy Note (2014). There are other researchers who note that the Ebola virus was first identified in 1972 as explained by Alexander, Sanderson, Marthe, et al (2015). Doctors without borders reinforce this notion in one of its report (March 2016) pointing that the virus was 1st discovered in 1970s without specifying the exact year.
According to Peters &Peters (1999) in the Journal of Infectious Diseases, the virus was found in 1967 in Germany as a filo virus family. Peters & Peters (1999) elucidated that the virus was found in Germany after exported with a monkey from Africa and resulted in a case rate of 31 and 23% mortality rate and a transmission to health care workers. The virus according to Peters &Peters (1999) created fear and panic at that time and was identified as Ebola virus in 1976. This fear and panic continues to this date and impeded the international effort to control the outbreak of the 2014 according to Shah (2016, p.203).
Despite all these minor differences in historical accounts, huge consensus is available that the virus was identified in 1976, a date that marked a human contact with Ebola as noted by Alexander, Sanderson, Marthe, et al (2015) in Neglected Tropical Diseases contrasting that of Peters & Peters (1999). While this notion looks like contradictory to each other in terms of date and in terms of the human contact of the Ebola virus, it is also a notion that supports each other in terms of the “founding and the identification” date of the virus.
The virus was found in 1967 as a Filo virus family and not yet identified as the Ebola virus. Thus, even if its contact with humans was observed in 1967 for the first time, it was not recorded as the Ebola virus but a historical record as Ebola virus and identification came out a decade later. David Quammen (2014, P. 72) also notes that 1976 was the 1st occurrence of the virus as the Ebola virus. Garret (2014, p.4) also affirms that Ebola was discovered in 1976 taking its name from the Congolese river called Ebola in the DRC, former Zaire. The Ebola virus has multiple species which are five in number all of which are named according to the geographical locations of where they were found. According to Kilgore, Grabensteine, Salim &Rybak (2015) the viruses are all part of the filoviruses (family filoviridae) and categorized into five subspecies which are the Zaire, the Sudan, Tai Forest, Bundisbugyo and Reston Ebola virus species. All these viruses except the Reston virus discovered in the US were evolved in the African continent from Zaire to the Sudan and from theCote d'Ivoire with the specific Tai Forest virus and the Budisbugayo in Uganda. What makes all these viruses the same is that all have the potential to cause deadly diseases except the Reston family Ebola virus according to the Iowa State University center for Food Security and Public Health (2014). Other than causing diseases as observed by Kilgore, Grabensteine, Salim &Rybak (2015) all the viruses are uniform in causing widespread viral replication and dissemination in the Varity of organ with sever immune suppression leading to organ failure and death. The 2014 Ebola outbreak that led to global crisis is the result of the Zairian filo family according to Goeijenbier, Kampen, Reusken, Koopmans & Gorp (2014) in the Journal of Medicine.
Accounts of the origin of the virus is commonly the same that some researchers point to monkeys as the source as noted by Peters & Peters (1999). This finding is supported by many scholars such as Quammen, (2014, p 2-3) who observed that nonhuman animals like monkeys are the source. Quammen (2014, p 2-3) also associates the origin of the Ebola virus to other wild animals.
Chimpanzees are considered to be the origin of the Ebola virus too partly because of similar “physiology between the chimpanzees and humans, “as explained by Alexander, Sanderson and Marthe, et al (2014). According to Alexander, Sanderson and Marthe et, al (2014) Ebola virus has killed 90%-95% of Chimpanzees that contracted the virus between 2000- 2003 in Congo which links to the Ebola outbreak in Cote d'Ivoire where the hunting and sharing of the meat was associated as the source of the outbreak.
The notion that Chimpanzees are the source of the Ebola virus is also noted by Goeijenbier, Kampen, and Reusken, Koopmans & Gorp (2014) in the Journal of Medicine who also addressed that gorillas and duikers are the sources. These all show how complicated the sources are. Further complicating the origin is that it is associated to fruit bats. Odutayo quoting Dr. Eric Leory in the council on Foreign Relations (2015) narrated that bats are the likely source where Alexander, Sanderson and Marthe et, al (2014) reinforced the notion that bats are the likely source but divided the bats into multiple types as the hammer-headed fruit bats, the strawcolored fruit bats and the little collard fruit bats.
In distinguishing the bats from one another Alexander, Sanderson and Marthe et al (2014) noted that the straw-colored fruits bats have the ability to migrate long distance and were immense in Central Africa from which they possibly migrated to the West African region causing spill over.
Alexander, Sanderson and Marthe et al also (2014) noted that bush meat is the likely source without distinguishing what this bush meat is. Yet, this understanding underlines what the WHO noted in its January 2016 report saying that the source of the virus is wild animals without distinguishing what these wild animals are. This note of WHO details that exact specific clues to the origin of the Ebola virus is not yet established. The lacking of exact specific origin of the virus is supported by Younde (2014) who elucidates that the “exact animal reservoir for the disease is not known.” This notion is also stressed by Matuaa, Mostert, Walb, Rozzano C. Locsinc (2015, p.310) in the Brazilian journal of infectious diseases. Yet, while the exact source of the Ebola virus is argumentative to trace at this moment, it is quite understandable that wild animals are the source of the Ebola virus. This notion is squarely supported by the death of the two-year-old boy in Guinea after direct contact with wild animals as traced by the WHO (January 2015) report which eventually grew into the 2014 Ebola outbreak. The way one contracts them from wild animals is either through bush meat feeding or through contact to the animals’ secretions while these secretions contact is still unclear. The bush meat consumption as noted in the Journal of Medicine by Goeijenbier, Kampen, Reusken, Koopmans & Gorp (2014) is also commercialized where it has the high possibility of creating spill over to those who consume and to the nearest that care for the diseased.
The Ebola virus disease is the deadliest disease with the fatality rate of 90% according to Youde (2014) among those contracted by the disease. This percentage is countered with WHO’s January 2016 update that put the percentage fatality into 50%. Shah (2014, p. 206) supports this percentage depicting that the virus takes half of its victims on average. Kadanali & Karagoz (2015) noted that the disease’s morbidity rate exceeded 80% but modern medicine and public health measures have brought down the fatality rate.
The symptoms of the virus are diverse once it contracts humans. Goeijenbier, Kampen, Reusken, Koopmans & Gorp (2014) in the Journal of Medicine put the diverse symptoms as follows:
“Symptoms in EVD patients normally occur after an incubation period of 4-10 days, with a range of 2-21 days. After a sudden onset of ‘flu-like’ symptoms (fever, myalgia, chills) and vomiting and diarrhea, the disease can rapidly evolve into a severe state with a rapid clinical decline. This disease phase is characterized by potential hemorrhagic complications and multiple organ failure. EVD patients may present with gastrointestinal symptoms (nausea, stomach ache, vomiting and diarrhea), neurological symptoms (headache, profound weakness and coma), respiratory symptoms (coughing, dyspnoea and rhinorrhoea), and generalized symptoms related to failure of the cardiovascular system resulting in shock and oedema. The most commonly described symptoms are fever in combination with anorexia, asthenia and a maculopapular rash between day 5 and 7 after the onset of the disease...”
The CDC supports this notion (CDC, 2014) noting that the disease reflects diverse symptoms at the same time fever, severe headache, muscle pain, weakness, fatigue, diarrhea, vomiting, abdominal (stomach) pain, unexplained hemorrhage (bleeding or bruising). This means the virus causes internal and external bleeding damaging the immunity system of the victim leading to death.
The virus, as noted above is transmitted from nonhuman animals to humans through coming in contact with them. It is also transmitted through feeding on the meets of wild animals or merchandizing the meats of wild animals that are contracted with Ebola virus where Alexander, Sanderson, Marthe et al (2014) noted that bush meat has become a commercial commodity trafficked beyond borders illegally. When trafficked these bush meats are dried and Alexander, Sanderson, Marthe et al (2014) noted that Ebola virus survives for 50 days if kept at the temperature of 4 degrees centigrade. In this case the possibility for Ebola virus to cross borders and victimize non-Africans is the possibility.
The other means of contracting the disease is through human to human contact which may be direct or indirect according to Doctors without borders support research on Ebola (2016). Doctors without borders explained in this research (2016) that the indirect way of contracting Ebola is through contacting the contaminated secretions such as vomit or during traditional burials of patients who had died from Ebola. This means even after death victims have the capability of infecting others which Shah (2016) observes as the continuity of social contact after death resulting in the infection of the living. It is also through carless touch or being exposed to sharp needles used by any Ebola victim.
The virus is also transmitted through sexual contact making the semen a potential source of infection as presented by the MSF in Ebola 2014-2015 facts &figures (2015). In this report titled 2014-2015 Facts & Figures (2015) the MSF noted that Ebola virus can stay in semen’s of an Ebola survivor for 82 days since the onset of the symptoms making sexual abstinence or a protective sex a necessity. Added, as observed by Alexander, Sanderson, Marthe, and et al (2014) the lack of vaccine and the wide range of geographical space the outbreak encompasses creates problem to counter the disease.
Given the highest transmissibility rate of the Ebola virus, ending the Ebola virus outbreak is tantamount important. Isolation of Ebola victims, having advanced medical infrastructure and aggressive communication and teaching of the community about the virus and cultural practices is uniquely important. These all involved multiple policy and administrative addresses to be discussed.
3. The Ebola Virus Time Line
According to Peters & Peters (19991), as depicted above, the 1st Ebola virus disease although not identified as the Ebola virus was found in Germany after a monkey was transported from Africa. The second was identified in DRC in Tandala as Alexander, Sanderson and Marthe et al (2014) elucidated quoting Weisfled, Webb, and Johnson& Carins in Neglected Tropical diseases. The last outbreak was quite in our memory and it is remembered in history as the greatest Ebola outbreak of the 2014 although the exact year of the outbreak was December 2013. The CDC (CDC, 2016) details the chronology as shown in the table below except the 1967 and 1972 additions. The table elucidates details of the Ebola outbreaks in history from 1967 to 2014. It explains all about the diverse Ebola virus subfamilies, their respective occurrence places and how many people they contracted and how many were deceased as a result.