EBOLA OUTBREAK

INTRODUCTION
An epidemic of Ebola virus disease (EVD) is ongoing in West Africa. The outbreak began
in Guinea in December 2013, but was not detected until March 2014, after which it spread
to Liberia, Sierra Leone, Nigeria and Senegal. The outbreak is caused by the Zaire ebola virus,
known simply as the Ebola virus (EBOV). It is the most severe outbreak of Ebola in terms of the
number of human cases and deaths since the discovery of the virus in 1976, with the number of
cases from the current outbreak now outnumbering the combined cases from all known previous
outbreaks. Another outbreak in the Democratic Republic of Congo, which has killed 13 people as of
26 August 2014, is believed to be unrelated to the West African outbreak.

COMPLICATIONS IN CONTAINMENT EFFORTS

Difficulties faced in attempting to contain the outbreak include the outbreak's multiple locations
across country borders, inadequate equipment provided for medical personnel, and lack of soap and
water for hand-washing and disinfection. Containment efforts are further hindered because there is
reluctance among country people to recognize the danger of infection related to person-to-person
spread of disease, such as burial practices which include washing of the body of one that has died.

A condition of dire poverty exists in many of the areas that have experienced a high incidence of
infections. According to the director of an NGO in Guinea, "The poor living conditions and lack
of water and sanitation in most districts of Conakry pose a serious risk that the epidemic escalates
into a crisis. People do not think to wash their hands when they do not have enough water to drink."

Denial in some affected countries has often made containment efforts difficult. Language barriers
and the appearance of medical teams in protective suits has sometimes exaggerated fears of the
virus. There are reports that some people believe that the disease is caused by sorcery and that
doctors are killing patients. In late July, the former Liberian health minister, Peter Coleman, stated
that "people don't seem to believe anything the government now says." Acting on a rumor that the
virus was invented to conceal "cannibalistic rituals", demonstrations were staged outside of the main
hospital treating Ebola patients in Kenema, Sierra Leone. The demonstrations were broken up by
the police and resulted in the need to use armed guards at the hospital. In Liberia, a mob attacked
an Ebola isolation centre stealing equipment and "freeing" patients while shouting "There's no
Ebola".Red Cross staff was forced to suspend operations in southeast Guinea after they were
threatened by a group of men armed with knives.

SIGNS AND SYMPTOMS

There are various symptoms that are connected to the Ebola virus. Whereas some symptoms are
common during the first phase of the infection, there are others that become severe, over time.
During the first five days of infection, there are some early signs and symptoms that include; muscle
and joint aches, body becomes weak, fever and severe headaches. But over time, time the
symptoms change levels.
The common ones are vomiting, and nausea accompanied by diarrhea with blood. Also, the infected
people have raised rush and red eyes. Chest pains are also rampant especially during coughs. There
is also uncontrollable bleeding from body orifices such as; the nose, ears, eyes and the rectum.
Apart from the openings, Ebola virus results to stomach aches and internal bleeding. There are risk
factors that are associated with Ebola virus. The risk factors are the activities that increase the risks
of becoming infected. Since Ebola is prevalent in Africa, in some African countries, visiting or working
in such countries exposes a person to the risks of getting infected.
Treatment is primarily supportive in nature and includes minimizing invasive procedures, balancing
fluids and electrolytes to counter dehydration, administration of anticoagulants early in infection to
prevent or control disseminated intravascular coagulation, administration of procoagulants late in
infection to control bleeding, maintaining oxygen levels, pain management, and the use of
medications to treat bacterial or fungal secondary infections. Early treatment may increase the
chance of survival.
ETHICAL THEORIES

Utilitarianism is a theory that believes an action is right, and only right if it produces the greatest
balance of pleasure over pain for everyone. An individual taking this approach would take the stance
on if the majority would benefit, then that is the ethical thing to do. An example of Utilitarianism would
be the choice to kill one person to save millions. The average person would agree that killing one to
save millions would be the ethical thing to do; however if the person to be killed was yourself, another
love one, the thought on whether this is the ethical thing to do would more than likely change. There
are four distinctive theses of Utilitarianism. The first is consequentialism. This is the rightness of
actions is determined solely by their consequences. The second is hedonism. Hedonism is utility is
the degree to which an act produces pleasure. This particular thesis is pleasure or happiness is the
good that we seek. Maximalism is that the right action produces the greatest good consequences
and the least bad. The last thesis is Universalism. This thesis states that the consequences to be
considered are those of everyone affected, and everyone equally.
Kantian ethics is opposite of Utilitarianism, and is a branch of deontological ethics. Kantian ethics
was derived from a philosopher Immanuel Kent, a strong opponent of Utilitarianism, whose theory
was based on the idea of a moral duty. Kantianism asserts that a good will is the only intrinsically
good thing and that an action is only good if performed out of duty, rather than out of practical need
or desire. Even though Kantianism is opposite of Utilitarianism they both address the question “What
actions are right”. Kantianism acts under the assumption that all rational beings would seek to do
good and these types of decisions can be applied in every culture, in any part of the world. Examples
of universal laws that would fall under Kantianism are; do not lie, do not steal, and do not murder.
Kantian ethics thrives off of good will. It is believed that goodwill is better than the idea of being a
good person.

Considering the theories for ethical considerations, in either theories, the aim remains the help and
subsidence of infirmity. It is felt that ebola scare in africa should be dealt from a humanitarian point
of view and maximum help , aid in terms of economic and medical assistance should be provided by
the world over and no discrimination should be made based on race , status and creed. This being
a global threat, the spread should be curtailed with a unified effort on part of developed and
developing countries together with an aim to tide over the crisis keeping a humanitarian purview over
and above any self interests, though personal safety should also be a bench mark to be kept aloft
for if self care falters then assistance to others shall undoubtedly suffer. Hence healthcare workers
should be protected and their personal safety and protection should be prime.

CONCLUSION

The American Nurses Association (ANA) opposes the mandatory quarantine of health care
professionals who return to the United States from West African nations where Ebola is widespread.
ANA supports registered nurse Kaci Hickox, who recently returned to the United States after treating
Ebola patients in Sierra Leone, in her challenge of a 21-day quarantine imposed by state officials in
Maine, her home state. Hickox arrived at Newark airport on Oct. 24 and was immediately
quarantined in a hospital tent by New Jersey state officials, who eventually allowed her to travel to
Maine via private transport on Oct. 27. After testing negative twice for Ebola, nurse Hickox, who
continues to be symptom free, poses no public threat yet is restricted to her home.
ANA, along with the American Hospital Association and American Medical Association, supports the
Centers for Disease Control and Prevention’s (CDC) guidance based on the best available scientific
evidence. The CDC guidance would not require a mandatory 21-day quarantine of Hickox given risk
levels outlined by the CDC in her particular case. ANA urges authorities to refrain from imposing
more restrictive conditions than indicated in the CDC guidelines, which will only raise the level of
fear and misinformation that currently exists.
ANA supports a policy of appropriate monitoring for health care workers who have cared for or been
in contact with patients with Ebola. Those who are not exhibiting symptoms of illness consistent with
Ebola do not require quarantine. Monitoring should follow recommendations outlined by the CDC
based on risk levels and the presence or absence of symptoms, including regular monitoring of body
temperature and oversight by a public health agency. If symptoms do occur, the appropriate next
step is isolation and transport to a medical facility for further evaluation. ANA seeks to balance
protection of public health and safety with individual liberties. Policies to protect the public from the
transmission of Ebola must be based on evidence and science, not fear.
Mandatory quarantine for individuals who do not have symptoms or risk factors is not backed by
science. Such actions undermine efforts to recruit sufficient numbers of volunteer nurses and other
health care professionals, who are essential to help contain the spread of the disease in West Africa.

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