Chemical agents that will kill the virus include bleach, detergents, solvents, alcohols, ammonia, aldehydes, halogens, peracetic acid, peroxides, phenolics, and quaternary ammonium compounds. Ebola virus can be killed with hospital-grade disinfectants such as household bleach when used according to the label instructions. Environmental Protection Agency-registered hospital disinfectant with a label claim for a nonenveloped virus norovirus, rotavirus, adenovirus, poliovirus can be used to disinfect environmental surfaces in rooms of PUIs or patients with confirmed EVD.
There is limited evidence of Ebola virus transmission through the environment or an inanimate object that may be contaminated during patient care with infectious organisms and serve in their transmission bed rails, doorknobs, laundry. In addition, spills of biological fluids should be immediately cleaned and disinfected. Disinfectants should also be added to bagged waste. Inactivation of Lassa, Marburg, and Ebola viruses by gamma irradiation.
J Clin Microbiol. Physicochemical inactivation of Lassa, Ebola, and Marburg viruses and effect on clinical laboratory analyses. J Clin Microbiol ; 20 3 Microbiologic evaluation of a large volume air incinerator pdf icon [PDF -6 pages]. Appl Microbiol ; Inactivation of Ebola virus with a surfactant nanoemulssion. Acta Tropica ; Assessment of the risk of Ebola virus transmission from bodily fluids and fomites.
J Infect Dis ; S—7. Ribner BS. Treating patients with Ebola virus infections in the US: lessons learned. Africa is no stranger to epidemics. The Ebola virus disease EVD outbreaks in West Africa and the Democratic Republic of Congo DRC are examples of many disease outbreaks in recent times that have had devastating socioeconomic effects and high fatality rates. This is followed by West Africa with 36, cases and deaths, East Africa with 18, cases and deaths, and Central Africa with 17, cases and deaths.
It was estimated that there would be 1. This was nearly three months after the first confirmed case was reported in December , in Wuhan, China. The EVD outbreaks showed that the surveillance capacity in many countries in SSA was weak, with serious implications for case finding and contact tracing, and mass community testing. This resulted in delay in identifying the outbreaks and slowing down timely reporting of the outbreaks to WHO, which in turn contributed to a delay in galvanizing international support to put a public health response in place.
International support was also needed to institute social interventions to curtail myths and misconceptions, address concerns about cultural aberrations resulting from changes in burial rites, and bridge the mistrust between citizens and government. The delay in instituting public health and social measures increased the number of EVD infections exponentially, and increased the risk to lives and deaths of many health care workers and volunteers.
The response has been led by governments of the affected countries. Countries mostly adopt measures such as promotion of regular hand washing, use of hand sanitizers, and social distancing which can be challenging to practise on a continent where significant large numbers of the population reside in urban slums, informal settlements and townships with poor access to water, sanitation and hygiene infrastructure.
In addition, by 30 March , 46 countries have imposed partial or full closures of their borders airports, ports and in some cases land borders , 44 have closed schools, banned public gatherings, or put in place other social distancing measures; and 11 have declared a state of emergency. Stigma causes a delay in seeking formal health care. Myths and misconceptions also promote poor compliance with public education messages.
Many religious gatherings promulgate spiritual protection messages. The EVD epidemic also witnessed myths and misconceptions, limiting effective public response and disrupting research. Access to facility and ambulatory care was a challenge during the EVD epidemic. In addition, the capacity to test due to poor access to laboratory reagents, have implications for case identification. Poor access to Personal Protective Equipment PPE led to the death of a large number of health care workers, further undermining the weak health system.
As of 02 June , 1, clinical trials have been registered with clinicaltrials. The high fatality associated with EVD also prompted debate about compassionate access to experimental therapeutics. Rapid data sharing during outbreaks enhances understanding of disease transmission, facilitates prompt evaluation of the public health response, and helps predict future outbreaks.
During the EVD outbreak in West Africa, failure to collect, store, curate and disseminate data, poor political will, and low priority for rapid data sharing contributed to a delayed response. Unfortunately, there is little investment in biorepository and biobank infrastructure for ongoing and future research in SSA. This causes an ethical quagmire, as the inequitable distribution of resources, and poor country capacity to build technical expertise for planning and preparing for outbreak, epidemic and pandemic responses may be exaggerated by the inefficient use of the limited financial resources by the countries.
Probably because infection preventive measures such as total lockdown are not economically sustainable, some African countries are gradually lifting this control strategy. If that is done, governments can rely on the system to deliver the care and community participation that is needed during pandemics. Community engagement in the design and implementation of these trials should not be excluded.
During the EVD outbreak, the WHO recommended the establishment of a special committee that could rapidly review research protocols and promoted associated community engagements. Community engagement also needs to facilitate effective communications with communities through education and information dissemination by trusted community leaders.
Local and digital channels such as town criers, radio programmes, social media and other platforms used by people in the communities will serve as effective communication channels. Also, engagement activities can be implemented with civil societies, religious and opinion leaders, youth organizations, networks, influencers and volunteer programmes by designing social and behavioural change communication interventions, with consideration for the need to tailor interventions and age appropriate messaging to different communities and groups.
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