West Africa Ebola Outbreak 1 West Africa Ebola Outbreak Joseph Toole Principles of Epidemiology PHE 5015 S01 12 Jun 2016 Introduction Around two years ago, there was worldwide uproar concerning Ebola. The outbreak had occurred in West Africa with individuals nations’ health departments stretched to the limit while trying to cope with the situation. Well wishing nations had to volunteer in terms of health practitioners and funds among other ways in order to assist the nations. Ebola is an infectious disease that is deadly discovered in Zaire in 1976. It is caused by Ebola virus which can be spread via contact with an infected person. Its spread it’s fast since contact with an infected person’s blood or body fluids. This paper will cover an overview of outbreak in 2014 in West Africa, observations, recommendations and conclusion. Overview, Investigative methodology and rationale for the topic The first outbreak of the epidemic was discovered in early 2014. It was reported in countries of West Africa namely: Sierra Lone, Guinea and Liberia. The three countries were the huge victims of the epidemic. Most of the victims of the outbreak died with a few survivors (CDC, 2016 n.d. - a). The reported symptoms among the victims were fatigue, fever, severe headaches, diarrhea, vomiting, abdominal pain and unexplained bleeding (CDC, 2016 n.d.-b). The symptoms are discovered roughly between 2 -21 days after infection. The methodology employed in order to determine the magnitude the outbreak encompassed different aspects. There was laboratory tests, study design and patients, data analysis and ethical considerations played a vital role. Study was carried out around the suspected victims. Lab tests were done via use of victim’s blood or oral swap. Ethical considerations were employed to determine the response of public health to the outbreak and contain it. Data analysis was vital in order to relate each case to a certain geographical location. Data from center for disease, World health Organization, European center for Disease prevention and control, National Institute of health will play a critical role in this paper since it will back up the facts presented. The rationale behind choosing the topic is to assist in comprehending the methods employed by epidemiologists in order to understand diseases in populations determine what disease is affecting the population and finally employ measures to treat as well as prevent its future occurrence. Ebola in West Africa Outbreaks in Africa have been reported as early as 2007. The ailment was previously known as Ebola hemorrhagic fever which is capable of affecting both humans and primates. It has a couple of species which include the Sudan virus, Reston virus, Bundibugyo virus, Tae Forest virus and Ebola virus. Reston is common in the monkey species. Few cases have been reported regarding the outbreak since it was discovered ranging from around 1-400 annually. For instance, in Gulu villag.

1. West Africa Ebola Outbreak
1
West Africa Ebola Outbreak
Joseph Toole
Principles of Epidemiology PHE 5015 S01
12 Jun 2016
Introduction
Around two years ago, there was worldwide uproar concerning
Ebola. The outbreak had occurred in West Africa with
individuals nations’ health departments stretched to the limit
while trying to cope with the situation. Well wishing nations
had to volunteer in terms of health practitioners and funds
among other ways in order to assist the nations. Ebola is an
infectious disease that is deadly discovered in Zaire in 1976. It
is caused by Ebola virus which can be spread via contact with
an infected person. Its spread it’s fast since contact with an
infected person’s blood or body fluids. This paper will cover an
overview of outbreak in 2014 in West Africa, observations,

2. recommendations and conclusion.
Overview, Investigative methodology and rationale for the topic
The first outbreak of the epidemic was discovered in early 2014.
It was reported in countries of West Africa namely: Sierra Lone,
Guinea and Liberia. The three countries were the huge victims
of the epidemic. Most of the victims of the outbreak died with a
few survivors (CDC, 2016 n.d. - a). The reported symptoms
among the victims were fatigue, fever, severe headaches,
diarrhea, vomiting, abdominal pain and unexplained bleeding
(CDC, 2016 n.d.-b). The symptoms are discovered roughly
between 2 -21 days after infection. The methodology employed
in order to determine the magnitude the outbreak encompassed
different aspects. There was laboratory tests, study design and
patients, data analysis and ethical considerations played a vital
role. Study was carried out around the suspected victims. Lab
tests were done via use of victim’s blood or oral swap. Ethical
considerations were employed to determine the response of
public health to the outbreak and contain it. Data analysis was
vital in order to relate each case to a certain geographical
location. Data from center for disease, World health
Organization, European center for Disease prevention and
control, National Institute of health will play a critical role in
this paper since it will back up the facts presented. The
rationale behind choosing the topic is to assist in
comprehending the methods employed by epidemiologists in
order to understand diseases in populations determine what
disease is affecting the population and finally employ measures
to treat as well as prevent its future occurrence.
Ebola in West Africa
Outbreaks in Africa have been reported as early as 2007. The
ailment was previously known as Ebola hemorrhagic fever
which is capable of affecting both humans and primates. It has a
couple of species which include the Sudan virus, Reston virus,
Bundibugyo virus, Tae Forest virus and Ebola virus. Reston is
common in the monkey species. Few cases have been reported
regarding the outbreak since it was discovered ranging from

3. around 1-400 annually. For instance, in Gulu village in Uganda,
there were 425 deaths following a small outbreak. In 2014
however, the course changed with 28,652 cases being reported
by March 2014. As many people as 11, 325 succumbed to death
according to reports in April 2016. There is no standard vaccine
that can be used to combat the virus hence treating the virus
depending on symptoms displayed in each case. Some treatment
methods such as treating symptoms, intravenous fluids,
maintenance of blood pressure and oxygen status are the
common (CDC, 2016 n.d.-a).
Epidemiological methods used were an Ebola Response team
which encompassed Incident Management System to control
outbreak as well as coordinate with other committees in the
outbreak control. The team included management teams, social
mobilization teams, contact tracing teams, security,
communication teams, case investigators and surveillance
teams. The Ebola Response team was thus a taskforce which
aimed at early identification of infection and control (PLOS,
2015). The World Health Organization had carried out a
research in order to make certain that the outbreak and does not
reach the rest of the world according to United States House of
Representatives (2015). The concept of rapid spread from
contact was what led to the research in order to come up with
measures to control the spread. Mathematical methodology was
employed to control the spread. Calculations were done of the
areas in high risk of infection in order to employ early
preventive measures. There were other methods used in order to
understand Ebola, cure and control its spread. Studies done
classified the virus in genus Ebola Virus and Filovirida and its
control was termed as hard as only a short duration is required
for the infection to react. An infected person can spread the
virus to a population living around within 24 hours such as in a
public gathering. Movement of infected population thus a good
measure in order to curb the spread
In West Africa, the incubation period observed was between 9-
12 days. In the past EVD as noted in the earlier part of the

4. paper was around three weeks after coming into contact with the
virus. An episode of the disease is reported after no new cases
are recognized within 42 days after the last EVD case. By
looking at each type of virus, the Ebola Zaire infection resulted
to 69 to 88% infection rate. The Ebola Sudan, CFR of outbreaks
extended from 53% to 69%. The Ebola Bundibugyo, the CFR
episodes scaled from 34% to 42%. Roughly 70% of the affirmed
cases wren due to Ebola Zaire with variations observed amongst
the three most infected nations that is, Guinea, Sierra Leone and
Liberia. In the Equatorial regions of West Africa, 69 affirmed
cases were reported between the months July to October 2014 in
Democratic Republic of Congo with CFR of 74% (WHO, 2016).
Pre-Ebola Performance
Prior to Ebola, the nations that were to later become victims
were making progress in terms of economy. The countries
exhibited rapid economic development as the countries were
recuperating from the civil wars that were rampant in the
countries. Liberia and Sierra Leone were some of the countries
faced with the worst form of civil wars which caused the
nation’s economy. Most of the citizens back then were living in
poverty due to wars that destroy property and hindered
recovery. The countries were thus faced with issues hence it
was a time when they were recovering and building their
economy while trying to catch up the lost time during the civil
war. Liberia and Sierra Leone had previously been among the
top ten in terms of GDP growth in the world. Such a move
shows that the country was already putting effort towards the
economy growth agenda. Guinea was not growing at the same
rate but it was promising owing to the projects that it had
undertaken. For example, the Simandou iron ore project was set
to benefit the country where it would draw investors in iron
mining to the country. Ebola outbreak thus created distraction
from the development as resources were redirected towards
containing the outbreak. According to IMF, the prospected GDP
growth from Sierra Leone, Liberia and Guinea was 11.3%,
5.9%, 4.5% respectively which was fairly good for the economy

5. of the countries. The outbreak led to revision in the rates where
the percentages given was 8.0%, 2.5% and 2.4% respectively
which is quite low from the previous projections (WHO, 2016).
The projections depicted a slow down in the economy due to the
outbreak.
Apart from the wide suffering and deaths of victims, the
economy of the nations was greatly affected. The outbreak came
during the planting season in countries which have agricultural
output as the backbone of the economy. That means planting
never happened as it should have or none happened at all. The
yields from the agricultural fields were low such as yields in
crops such as rice and maize. The economy was thus incurring a
lot handling recurrent expenditure without any income from the
expected areas. In response, the agricultural products rose in
price to around 150% in line with the law of demand depicting a
potential economic disaster. Less mining activities were carried
given that mining played a critical role in the economy. Aspects
such as travel restrictions slowed down the economic activities.
There was massive decline revenues both in households and
nationwide. Individuals could hardly engage in income
generating activities as usual due hindrances brought about by
the outbreak. For instance, less labor supplies, movement
restrictions among others. At the national level, taxes, duties as
well as tariffs reduced thus the government hardly had the
income as it relied to such sources of revenue (Sy, 2014). Fiscal
imbalances were evident due to need to fund health initiatives.
At the international level, countries had already started banning
travel to and from the areas. That means among others that
tourism was greatly affected given the countries rely on tourism
as a source of income.
Recommendations
To reduce the spread, it’s vital to have a few considerations.
It’s vital to have knowledge of the symptoms and easy it is to
control. The health practitioners involved should thus be well
informed on the above information. Signs and symptoms such as
vomiting, fatigue, and muscle pain, headaches, and fever are

6. what the practitioners should be cautious about. Monitoring the
virus is vital to take intone consideration. Individual immune
system is a determiner given that persons with strong system
may sustain the virus for a while before displaying the
symptoms. It is thus vital to take ach case study differently. It is
preferable for infected persons to stay away from the rest in
order to eliminate the chances of spreading the virus. In
addition to that, research should be done in order to define the
pattern of the infected persons. Pattern such as location where
such a person interacted with others is vital as it’s a possible
point of infection. It is thus possible to know the areas to be
potentially infected and take measures to control (Bah Marc, et
al 2015).
Ebola is infectious especially after one comes into contact with
the virus especially from interaction with an infected person.
For instance, a family member can get it as a result of taking
care of a sick person. Similarly, a doctor can get infected if the
doctor fails to take the measures that are required in handling
the patients. It is thus advisable for health care personnel to
take measures before getting into contact. In terms of patient
placement in a hospital facility, its advisable to have each
patient housed in private room which has the entire patient
requires such as bathrooms and such a room properly closed. A
log should be maintained of all persons that are going into the
room in order to make it easier to detect the infection at the
early stages. In terms of equipment, Proper medical equipment
should be employed in the health care provision. The most
preferred equipment is the disposable ones since they reduce the
risk of infection. In a situation where non-disposable equipment
are used, it’s vital to properly disinfect and clean according to
health facility policy or the description outlined by the
manufacturer. The move will prevent infection from contact via
equipment. When it comes to patient care considerations, use of
sharp objects should be limited such as needles in order to avoid
the contact with blood. In case the objects are supposed to be
produced, the objects should be handled with care and disposed

7. in a sealed container which can’t leak. In an EVD case, Aerosol
Generating Procedures are highly not recommended and if used,
measures to reduce exposure are advisable in order to curb the
spread. Environmental surface cleaning is also required for
proper infection control. Hand hygiene is required and should
be frequent before and after contact with patient and infected
material (Dramowski, 2015). A health care facility should
ensure supplies to ensure hand hygiene are readily available.
Each case of infection should be handled differently. Potentially
infected personnel should be monitored. Persons who have come
into contact with infected body fluid or blood should wash the
exposed areas with water and contact health care personnel
immediately. The move will assist in employing post-exposure
measure such as testing and evaluation. Such a person should
comply with required measures until declared free of infection.
Follow up of the 21 days in required in order monitoring the
health of the person. Visits to infected person should be avoided
unless with permission from health care personnel which differ
on case to case basis.
Conclusion
In conclusion, Ebola is one of the most deadly outbreaks that
have led to widespread suffering in Africa and particularly West
Africa. Countries such as Liberia, Sierra Leone, and Guinea
among others have counted huge negative impacts. The three
were the most affected nations. There are various species of
Ebola namely: Ebola Zaire, Ebola Sudan, Ebola Bundibugyo and
Tae Forest Ebola and Reston Ebola. In West Africa, the most
notable species was Ebola Zaire which accounted for around
70%. Fatalities cases were around 11,000 with infection cases
of around 28,000 persons reported (WHO, 2016). The effect of
the virus was also felt in other areas such as economy with
economic slow down in the affected areas due to hindrances of
the outbreak. The outbreak led to creation of Ebola Response
team which had the mandate to identify, treat, control and
prevent possible infection. Some of the recommendations are
advisable both at health care facility level and individual level.

8. Health care personnel should be well versed with its symptoms
and control prevention strategies. Hygiene is key with proper
cleaning of contact surfaces and disinfection advised. Disposal
of infected material should be following the policies and
minimal contact with infected persons should be followed. With
such measures followed, it’s possible to control the spread of
the virus and eliminate it completely.
References
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the Challenge of Stability and Security in West Africa.
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west-africa/index.html
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