“Our health units are not enough to handle the Ebola virus”

Dr Gladys Fosah Tayong, Regional Delegation of Public Health, North West spoke to this paper on the Ebola virus.

What is Ebola virus and how is it transmitted?

It is actually called Ebola virus disease. It is caused by a virus that is transmitted from animals to humans and it is through close contacts either with blood or infectious fluids or secretions from infected animals such as monkeys, chimpanzees, porcupines, pigs and fruit bats. When a human being gets in contact with an infected animal, the virus gets into his system. When the virus gets into a human it has an incubation period of 21 days. The range of manifestation of the symptoms is between two to twenty one days and it depends on the individual’s specificities.

What are the symptoms?

It causes an acute disease condition. That means when it starts within two days of contact, it means it is quite acute. You have a sudden onset of fever, headache, and sour throat. After a few days, you will have some digestive problems like vomiting and it can also cause bleeding both internal and external. You can be bleeding in your intestines and do not even know and it can damage your liver and your kidney. It causes liver and kidney failure.

What do you do in such a situation?

You have to be taken to the hospital but there is no specific treatment and there is no vaccine. The hospital will only give supportive care. This means if there is fever, we try to bring down your temperature, if there is vomiting and diarrhea we try to stop the vomiting and give you enough fluids to replace the fluid you have been losing. If you have bled too much we will do a blood transfusion. When somebody is infected, he spreads it in his community through human to human transmission. This is through close contact with blood, secretion, semen fluid or virginal fluid of someone who is infected. You can get the infection through broken skin, in your blood when you share sharp things with someone who is infected or even through the mucus membrane in the eyes, the nostril and the mouth.

How can the spread be contained if there is an infection in Cameroon?

The way it is transmitted it would not only be the health services to do something. It must involve everybody from the household through the community level to the level of the ministries including wildlife. We have to start at the level of the animals. Most often, when animals are infected, they do not present symptoms of the disease. So we need to use detergents to disinfect the farms. The farmers should clean their pig farms as often as possible because they can be a source of infection. You can indirectly be infected by the farms in which these animals are just by holding the fence with a wound in your hand. Farmers must wear thick protective clothing, boots, sucks and gloves as they handle animals. They should wear goggles to prevent their eyes from any fluids getting to them. If animals are detected to be infected there will be supervised killing and burial. As concerns human beings, if there is an outbreak somewhere, there should be restricted movements in and out of that area. There will be supervised movements making sure that all those who are infected are receiving supportive care. Cameroon has to restrict the entry of people from countries where there is an outbreak and no Cameroonian should go to those countries with outbreaks.

What measures are being put in place to fight the virus if there is an outbreak?

At the level of the Ministry of public health a lot is being done. Since January, the Minister has been sending out circular letters informing the regions that this is the situation we have at hand. These letters have been sent to all district health centres informing all district medical officers that there is an outbreak of Ebola virus in West Africa. Please watch out for what is happening in your region. The health districts at the borders like Ako and others have to watch out for any movements in and out. Unfortunately, the Ministry of public Health cannot restrict movements at the border. So there is sensitization going on in all health districts. There was training of Regional Chiefs in Charge of Managing Epidemics in Yaounde and the management and prevention of Ebola was top on the agenda. There is another meeting in Yaounde looking at strategies for the prevention of Ebola virus.

Are the hospitals equipped enough to handle this Ebola virus?

Good question (hesitation) Are we equipped enough? You have a case walking into the hospital that I have this acute fever, headache and nose bleeding. Could it be Ebola? The health worker who receives the patient should have adequate working conditions to receive the patient. We have heard how transmission occurs, close contact and you cannot receive a patient without having close contact. You have to touch the patient and ask questions. Yes our health units are equipped but not to an extent to handle the Ebola virus. When a patient comes in you want to provide care in maximum biological containment conditions.

If you are receiving the patient in a room where there is a filter, no air goes in and no air goes out. There is a filter filtering every air around this patient. I bet you in the regional hospital, there maybe a filter in the reference TB lab. Imagine that if such a case is received in the regional hospital, you will not have the biological containment condition. When you want to collect specimen from this patient, the specimen that you want to test is a biological hazard because a drop of that blood on the floor exposes people.

I want to think the conditions are very critical and it is time we started equipping our health units to be able to handle situations like that. It is true that in Cameroon, we have not had a case but it is better we arm ourselves early before something comes and meets us when we are not prepared.