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Opinions of Tuesday, 29 July 2014

Columnist: Anim-Mensah, Alexander

Ebola Could be Knocking on Ghana’s Doors

.....Sooner than Anticipated

- Government to Push for Increased Awareness, Education and Preparedness.
Gone are the days when news about Ebola in Central Africa seemed somehow far away from West Africa because of the ease of containment which curbed spreading. Today Ebola is knocking on doors in West Africa and has the potential to spread even more compared to Central Africa given West Africa’s improved transportation network and systems, increased mobility and less confinement by war. Infested people will want to go back home for medical treatment in situations when one contracts the virus whiles in a foreign country. The blessings of ECOWAS includes allowing people to travel easily among West African countries as well as joints efforts. Moreover, most Ghanaian culture will want deceased members on another land to be brought home for burial if possible and so as Ebola deceased victims. In addition, victims of Ebola who are affluent will like travel to other developed West African countries for treatment. A first case of Ebola in Nigerian was in “The Guardian” on July 25, 2014 where a 40 year Liberian Ebola victim currently deceased collapsed at Nigerian main airport on arrival ( Some of the above instances support the fact that Ebola could spread and not far from Ghana’s door.

The current cases on Ebola was in Guinea which quickly spread to Sierra Leone and Liberia where hundreds have been reported deceased by the virus. Guinea boundaries with Guinea-Bissau, Senegal, Mali, Sierra Leone, Liberia and Ivory Coast. Guinea-Bissau is to the west of Guinea, Senegal and Mali are to the northwest and northeast of Guinea, respectively; Sierra Leone to the south, Liberia to the southeast and Ivory Coast to the east of Guinea. Ivory Coast is Ghana’s only buffer on the west and Ivory Coast boundaries with both Guinea and Liberia which have increased Ebola cases. Currently, Ivory Coast claims to have no cases and has secured the border with Liberia from allowing returning home refugees who fled to Liberia during the war from entering the country because of fear of spreading the disease. Ghana reported a case of a US man who visited Sierra Leone, however, test on victim confirmed negative. The question is; how prepared is Ghana to handle such cases in the event of out breaks? How well are we drawing awareness and educating Ghanaians about this scary disease? In my view, the action is now which the subsequent paragraphs present some information on this deadly and scary Ebola and what one can do in a small way to recognize a carrier, symptoms, prevent contracting this virus and/or use precautionary measures.

This epidemic could spread faster and wider than anticipated because of the improved transportation networks in West Africa. Ebola was first recognized in 1976 during an outbreak around the Ebola River Valley in the Democratic Republic of the Congo (formerly Zaire). Four (4) of the five (5) known species of Ebola are associated with the Ebola Virus Disease (EVD). The ''Zaire Ebola virus'' is the type which was first discovered and also the most deadly. Ebola is transmitted by direct contact and through bodily fluids. Skin and conjunctiva exposure may also lead to transmission, but to a lesser extent. Conjunctiva is the mucous membrane that covers the front of the eye and lines the inside of the eyelids. The Ebola in Guinea, Sierra Leone and Liberia since it has taken several lives is a deadly type of the virus.
While Ebola is very dangerous, however, the danger of contracting the disease could be dimmed low if one knows the basic precautionary measures. Ebola is not spread by casual contact like the flu or cold; it requires direct contact with the body fluids of deceased and/or living victim, or by eating contaminated bush meat, especially bats, monkeys, gorillas, porcupines, agoutis, antelopes, grasscutters, and others. For this reason, deceased Ebola victims either human or animals are still infectious, and require necessary proper and safe disposal medical measures to be taken despite local traditional burial rites.
The rapid onset of the Ebola symptoms from the time the disease turn out to be infectious in an individual makes it easy to identify victims and it may limits an individual's ability to spread the disease by traveling. The development period of Ebola ranges from 2 - 21 days but generally about 5-10 days. Symptoms are wide-ranging and generally appears unexpectedly. Early symptoms include severe headache, sore throat, fever, high fever with associated body minimum temperatures of at least 38.8°C; abdominal, muscle, or joint pains, severe weakness, exhaustion, nausea, dizziness, internal and external bleeding. These initial symptoms may easily be mistaken for malaria, typhoid dysentry, influenza, or various bacterial infections, which are all far more common and reliably less fatal.
Ebola disease may evolve into a more severe symptoms including diarrhea, vomiting blood, dark or bloody feces, red eyes due to distension (i.e. swelling) and hemorrhage (i.e. blood escape from a raptured vessel especially when profuse) of sclerotic arterioles, petechiae (i.e. appearance of round spots on the skin as results of bleeding under the skin), maculopapular rash (i.e. skin disorder that is identified by excessive redness of the affected skin, accompanied by the formation of tiny bumps ), and purpura (i.e purplish discoloration of the skin produced by small bleeding vessels near the surface). Secondary symptoms include; tachycardia (i.e a situation leading to disruption of the normal electrical impulses that control the rate of one’s heart pumping action), hypotension (i.e. low blood pressure), and hypovolemia (i.e. reduction in one’s body blood volume which could be due to loss of blood or body fluids). The loss of blood from interior bleeding is caused by a reaction between the virus and the platelets that produces a chemical that will cut cell-size holes into the capillary walls. Occasionally, internal and external flow of blood from the nose and mouth may occur, as well as needle-puncture sites from not fully healed injuries. Additionally, the Ebola virus can affect the levels of white blood cells and platelets, disrupting clotting. Over 50% of Ebola victims develops some degree of bleeding.
Diagnosing of Ebola includes testing of saliva and urine samples. There is no standard for treating Ebola victims, however, some treatment methods has led to some survivals. Early detection and treatment improves survival. Generally, Ebola victims lose body fluids and blood among others which treatment is primarily supportive and involves minimizing invasive procedures, balancing electrolytes, and replacing lost coagulation factors to help stop bleeding, maintaining oxygen and blood levels. Additionally, treating of any complicating infections will be necessary. Convalescent plasma therapy which involves using plasma from patients who have survived the particular infection, in this case Ebola has shown promising as a treatment method.
With the knowledge on Ebola from the above what can one do in a small way not to contract the disease? What education on Ebola is going on in Ghana given the various media - Radio, TV, newspapers, etc.? What plans are in place to prevent this scary virus appearance in Ghana? What plans are in place in Ghana in the event of outbreaks? In my view, education, identification and reporting in this situation are part of the solution. Is something in the Ghanaian culture and/or lifestyles which will fuel the spread of the virus incase this disease find its way into Ghana? There is no standard treatment method however some methods has led to survival. Early detection and treatment improves survival. Mode of spreading or contracting the virus is mostly by contacts and includes contacts with body fluids, sweats, blood, etc. of a person with the disease. For this reason we need to examine our ways to minimize possible contacts to dim contracting the disease in any advent. I will be critical here in my suggestions since people have different susceptible levels and effects to every disease.
In accessing our local way of life common possible contact includes hand-shaking which is the order of the day in Ghana when people meet casually or formally; people share the same drinking cups, plates and cutlery at chop bars, restaurants and/or home without proper sanitization; nature of passengers’ bodily contact in our transporting systems such as trotro, taxis, and buses, need to be examine critically. I will not be surprised if exchanging money from a sweated pocket during buying and selling could transmitted this disease from a victim. Bats known to carry the disease interacts in the wild as well as domestically or in our homes. Some of our trees in our homes bear fruits which attracts millions of bats from the wild to our homes at night. Droppings from these bats could be all over the place in that event including partial ate fruits which human, domestic animals like the goat, sheep, cat, dog, etc. could contact. In the wild, bats and monkeys could drop partially ate fruits which serves as food sources for other wild animals (our bush meat), hence, spreading the disease. Animals deceased from Ebola are food sources to other animals and human which could be a source of spreading the disease.
From the above, in my view, it will be better for one to possess his/her own cup, plates and cutlery, and avoided group eating from the same bowl to dim contracting any virus. Restaurants and/or chop bar owners should properly sanitize their wares after every use. Consult the health department for proper sanitization procedures. It is important not to touch any suspected partially ate fruits on the ground which one did not do. To clean any suspected bat dropping and partially ate fruits in one’s home, in case, care should be taken to wear appropriate protective device such as gloves, aprons, nose mask or better safe sanitize with chlorine before cleaning. Dispose of the gloves, aprons and nose mask quickly to the rubbish damp or burn. Do not reuse. In addition, it will be advisable not to touch already dead animal found in the wild since the cause of the death is unknown or touch any suspected partially eaten fruit which could have been dropped by a bat, monkey, etc. I will not be surprised if a hunter could sell an already dead bush meat nicely smoked. Ivory Coast has placed a ban on bush meat to curb possible spreading of the disease. Care should be taken when touching in trotro and taxis which one could sweat on the sun waiting for transport. One can limit unnecessary hand shaking or quickly wash hands after hand shaking. People with the disease show some similar initial characteristics as the common cold which one should be aware of and take necessary precautions. Take a bath if you are unsure of any contact after an event as well as take your bath each day after a hard day’s work. Businessmen in Ghana who ply Guinea, Sierra Leone and Liberia should take utmost precautions and also limit the travels to these Ebola prone areas.

Given the current hardship, everything should be done not to welcome Ebola to Ghana, however, this is inevitable. Suspected victims and family should be encouraged to report any symptoms, use proper procedure and safety methods to send victims to hospitals as soon as possible for treatment while quarantined. Note - early diagnosis and treatment improves survival chances. The various spiritual organizations should be educated to send suspected victims to the hospital as soon as possible rather than delaying to pray for any suspected victims. I will ask the numerous media - radios, TVs and newspapers to provide education on Ebola and precautionary measures while the government make available the necessary equipment such as disposable gloves, rubber aprons, and all required for handling anything associated Ebola. There should be nationwide tip lines to report suspected cases which any case need to be treated with utmost serious. A trained task force should rather move suspected victims from homes and render sanitization in any event. Heaven helps those who help themselves. Let’s be wise as the serpent and as bold as the lion in our executions in situations like this, for it will pay-off and safeguarding citizens in the event of the unexpected.
God bless
Alexander Anim-Mensah, PhD
Dayton Ohio

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