EBOLA

Updates & Lesson Learned

07/17/2020 1
 Table of Contents
• Introduction
• The Statistics
• EVD ‘Milestone’
• Cost of EVD Outbreak
• Lessons Learned
• Conclusion

07/17/2020 2
 Introduction
• The virus under electron microscope

www.bbc.com
07/17/2020 3
 Introduction …overview

07/17/2020 4
 Introduction (3)
• First case - Guinea on Dec 20131 (2 year old Emille Ouamou)
followed by his sister and mother
• Outbreak declared 23 March 2014 by WHO
• Liberia’s outbreak - late March
• First case in Sierra Leone 24th May 2014 – one of attendees
of a funeral of traditional healer that attempted to treat
many Ebola victims in Guinea
• Nigeria’s first – 25th July
• Difficulty in diagnosing early
– looking into initial symptoms – by the time the symptoms is more
convincing, the condition is already too late

07/17/2020 5
07/17/2020 6
 The Statistics

07/17/2020 7
The statistics…..just how infectious is Ebola?

07/17/2020 8
 Statistics (3)…The Trend

07/17/2020 9
 Statistics (3)…Mortality

07/17/2020 Source: WHO 2015 10

 EVD ‘Milestone’
• PHEIC declared on 8 Aug 2014
• Outbreaks in Nigeria and Senegal officially
over (nil since 5 Sept 2014)
• Moved to second phase (slowing transmission
to ending epidemic)

07/17/2020 11
 Cost of EVD outbreak

07/17/2020 12
 Lessons Learned
• Strengthen surveillance
• Increase public awareness and cooperation
• Strengthen coordination among neighbouring
countries
• Improve outbreak management
– Gaps in risk communication, infection prevention
and control (IPC), lab infrastructure, case
management and point of entry
• Strengthen preparedness
07/17/2020 13
 Strengthen Surveillance

07/17/2020 14
Increase Public Awareness and Cooperation
The villagers were skeptical of the outsiders and their medicines, which
included malaria pills. Go away, one man said, “and take your poison with
you.” Chilcott tried to reassure them by swallowing pills as they watched.
But the mood became increasingly hostile. Alarmed, Chilcott sent an
emergency satellite signal for the helicopter to return. It arrived in 21
minutes and swooped everyone away before they had even buckled their
seat belts.
Source: Washington Post 2014

07/17/2020 15
Source: BBC News Africa 2014
 Increase Public Awareness and Cooperation
(2)

07/17/2020 16
 Increase Public Awareness and Cooperation
(3)
• Colour of body bags for burial help increasing
public cooperation – they prefer white body
bag instead of black
• Design of tailored Ebola clinics – replace walls
of clinic with fences and windows
– Patient more willing to get treatment

07/17/2020 17
 Health workers carry the body of an Ebola victim for burial at a
cemetery in Freetown on Dec. 17, 2014
07/17/2020 18
 Workers wearing personal protective equipment inside the
contaminated area at the Elwa Hospital in Monrovia, Liberia
07/17/2020 19
 Increase Public Awareness and Cooperation
(4)

Wrong information on Ebola Prevention

07/17/2020 20
 Strengthen coordination among neighbouring countries

07/17/2020 21
 Improve Outbreak Management

• Police in Conakry, Guinea, secure the area around a man who collapsed in a puddle of water
on the street on Wednesday. People would not approach him out of fear he may have been
suffering from the Ebola virus. The man lay in the street for several hours

07/17/2020 22
 Improve Outbreak Management (2)

A health worker sprays a man suspected

of dying from Ebola with disinfectant
chemicals in Monrovia, Liberia, on Sept.
4.

07/17/2020 23
 Improve Outbreak Management (3)

• Get the local leadership involvement in risk

communication
• Allay excessive fear and increase cautious
attitude (get the information right)
• Inform what the public should do
• Get cooperation with stakeholder

07/17/2020 24
 Strengthen Preparedness

• Recent Ebola outbreak had shown how

difficult it was to get resources for vulnerable
people at the frontline
• Speed of action and prompt informed decision
making is crucial

07/17/2020 25
 Strengthen preparedness….Model To Predict
Spread of Ebola

07/17/2020
Source: MOBS Lab and Northeastern University 26
Strengthen Preparedness…..Reservoir Factor

07/17/2020 27
 Ebola Preparedness – Sarawak Context

• Possible sources
– Logging industries workers come back from EVD
affected countries’
– Students, travellers from EVD affected areas
• Scenario
– EVD inflicted patients from rural, late in seeking
medical attention, low index of suspicion by rural
clinic staff, seek medical attention at private hosp

07/17/2020 28
EVD Prevention and Control for Sarawak

• Public health
– Prevent entry (entry screening, isolation)
– Prevent spreads (early detection)
– Prevent becoming the focus for further spread
(containment)
• Hospital
– Prevent death
– Prevent nosocomial spread (staff, family, other
patients)
Datu Andrew Kiyu
07/17/2020 29
 Treatment
• Symptomatic (hydration, electrolyte repletion,
hemodynamic support, treatment for organ
failure)
• Drugs and vaccine for EVD still under trial
– TKM-Ebola (interfering RNAs that targeting Zaire
Ebola virus RNA polymerase L protein
– Zmapp (3 monoclonal antibodies that attack Ebola
virus; used on the 2 US health workers)
– VSV-EBOV vaccine (Canada)
07/17/2020 30
 Conclusion
• Stopping EVD in West Africa is still a long way
to go
• Pave the way for preparation of future
outbreak
• To win the game, we must be one step ahead
of the outbreak

07/17/2020 31
 Reference
• WHO (2015) Ebola situation reports. Retrieved from
http://apps.who.int/ebola/en/current-situation/ebola-
situation-report on February 6, 2015
• Sun et. al. (2014) Ebola’s lessons, painfully learned at great cost
in dollars and human lives, Washington Post. Retrieved from
http://www.washingtonpost.com/national/health-
science/ebolas-lessons-painfully-learned-at-great-cost-in-
dollars-and-human-lives on February 6, 2015
• Stylianou, N. (2014) How world’s worst Ebola outbreak began
with one boy’s death, BBC Africa News. Retrieved from :
http://www.bbc.com/news/world-africa-30199004 on February
6, 2015
07/17/2020 32
 Thank you

07/17/2020 33