Merchant Mariner concerns travelling to West Africa

angus63

Captain
Joined
May 20, 2002
Messages
3,726
Since West African trade is ever ongoing, many colleagues and students of mine are making port in West African countries and we all have concerns for their well-being with the recent outbreak of Ebola. I was not up on Ebola and the news never seemed to answer the concerns I had. I did some searching and found what I consider excellent info on Ebola and would like to share what I found. Hopefully you find it informative:
Ebola
National Center for Emerging and Zoonotic Infectious Diseases
Division of High-Consequence Pathogens and Pathology (DHCPP)
Ebola, previously known as Ebola hemorrhagic fever, is a severe, often fatal disease in humans and nonhuman primates (such as monkeys, gorillas, and chimpanzees).
Ebola is a rare and deadly disease caused by infection with a virus of the family

Filoviridae, genus Ebolavirus. There are five identified Ebolavirus species, four of which have caused disease in humans: Zaire ebolavirus; Sudan ebolavirus; Taï Forest ebolavirus, formerly Côte d’Ivoire ebolavirus; and Bundibugyo ebolavirus. The fifth, Reston ebolavirus, has caused disease in nonhuman primates but not in humans.
Ebola is found in several African countries. The first Ebola species was discovered in 1976 near the Ebola River in what is now the Democratic Republic of the Congo. Since then, outbreaks have appeared sporadically in Africa.
The natural reservoir host of Ebola remains unknown. However, on the basis of available evidence and the nature of similar viruses, researchers believe that the virus is animal-borne with bats being the most likely reservoir. Four of the five subtypes occur in an animal host native to Africa.
Transmission
Because the natural reservoir host of Ebola has not yet been identified, the manner by which the virus first appears in a human at the start of an outbreak is unknown. However, researchers believe that the first patient becomes infected through contact with an infected animal.
When an infection does occur in humans, there are several ways the virus can be spread to others. These include:


direct contact with the blood or body fluids (including but not limited to feces, saliva, urine, vomit and semen)
of a person who is sick with Ebola


contact with objects (like needles and syringes) that have been contaminated with the blood or body fluids of an infected person or with infected animals
The virus in the blood and body fluids can enter another person’s body through broken skin or unprotected mucous membranes in, for example, the eyes, nose, or mouth. The viruses that cause Ebola are often spread among families and friends, because they come in close contact with blood or body fluids when caring for ill persons.
During outbreaks of Ebola, the disease can spread quickly within healthcare settings, such as clinics or hospitals. Exposure to Ebola can occur in healthcare settings where hospital staff are not wearing appropriate protective clothing including masks, gowns, gloves, and eye protection.
Dedicated medical equipment (preferably disposable, when possible) should be used by healthcare personnel providing care for someone sick with Ebola. Proper cleaning and disposal of instruments, such as needles and syringes, is also important. If instruments are not disposable, they must be sterilized before being used again. Without adequate instrument sterilization, virus transmission can continue and amplify an outbreak.
Signs and Symptoms
A person infected with Ebola is not contagious until symptoms appear.
Signs and Symptoms of Ebola typically include:


Fever (greater than 38.6°C or 101.5°F)


Severe headache


Muscle pain


Vomiting


Diarrhea


Stomach pain


Unexplained bleeding or bruising
Symptoms may appear anywhere from 2 to 21 days after exposure to Ebola but the average is 8 to 10 days. Recovery from Ebola depends on the patient’s immune response. People who recover from Ebola infection develop
antibodies that last for at least 10 years

.
 
Risk of Exposure
Ebola is found in several African countries. Since 1976, Ebola outbreaks have occurred in the following countries:
 


Democratic Republic of the Congo (DRC)


Gabon


South Sudan


Ivory Coast


Uganda


Republic of the Congo (ROC)
 


South Africa (imported)


Guinea


Liberia


Sierra Leone


Senegal


Nigeria
 
Because the natural reservoir host of Ebola, and the manner in which transmission of the virus to humans remain unknown, risk assessment in endemic areas is difficult.
During outbreaks of Ebola, those at highest risk include healthcare workers and the family and friends of a person infected with Ebola. Healthcare workers in Africa should consult the

Infection Control for Viral Hemorrhagic Fevers In the African Health Care Setting to learn how to prevent and control infections in these settings. Medical professionals in the United States should consult the Infection Prevention and Control Recommendations for Hospitalized Patients with Known or Suspected Ebola Hemorrhagic Fever in U.S. Hospitals.
Diagnosis
Diagnosing Ebola in a person who has been infected for only a few days is difficult because the early symptoms, such as fever, are not specific to Ebola infection and are seen often in patients with more commonly occurring diseases, such as malaria and typhoid fever.
However, if a person has symptoms of Ebola and had contact with blood or body fluids of a person sick with Ebola, contact with objects that have been contaminated with blood or body fluids of a person sick with Ebola or contact with infected animals, the patient should be isolated and public health professionals notified. Samples from the patient can then be collected and tested to confirm infection.
Laboratory tests used in diagnosis include
Timeline of Infection
Diagnostic tests available
Within a few days after symptoms begin


- Antigen-capture enzyme-linked immunosorbent assay
(ELISA) testing
- IgM ELISA
- Polymerase chain reaction (PCR)
- Virus isolation


Later in disease course or after recovery


- IgM and IgG antibodies


Retrospectively in deceased patients


- Immunohistochemistry testing
- PCR
- Virus isolation


Treatment
Currently there are no specific vaccines or medicines (such as antiviral drug) that have been proven to be effective against Ebola.
Symptoms of Ebola are treated as they appear. The following basic interventions, when used early, can significantly improve the chances of survival:


Providing intravenous(IV) fluids and balancing electrolytes (body salts)


Maintaining oxygen status and blood pressure


Treating other infections if they occur
Timely treatment of Ebola is important but challenging since the disease is difficult to diagnose clinically in the early stages of infection. Because early symptoms such as headache and fever are not specific to

Ebolaviruses, cases of Ebola may be initially misdiagnosed.
However, if a person has symptoms of Ebola and had contact with blood or body fluids of a person sick with Ebola, contact with objects that have been contaminated with blood or body fluids of a person sick with Ebola, or contact with an infected animal, the patient should be isolated and public health professionals notified. Supportive therapy can continue with proper protective clothing until samples from the patient are tested to confirm infection.
Experimental treatment has been tested and proven effective in some animals but has not yet been evaluated in humans.
Prevention
When cases of the disease do appear, there is increased risk of transmission within healthcare settings. Therefore, healthcare workers must be able to recognize a case of Ebola and be ready to use appropriate infection control measures. The aim of these techniques is to avoid contact with the blood or body fluids of an infected patient.
Appropriate procedures include:


isolation of patients with Ebola from contact with unprotected persons


wearing of protective clothing (including masks, gloves, impermeable gowns, and goggles or face shields) by persons caring for Ebola patients


the use of other infection-control measures (such as complete equipment sterilization and routine use of disinfectant)


Avoid touching the bodies of patients who have died from Ebola
Healthcare workers should also have the capability to request diagnostic tests or prepare samples for shipping and testing elsewhere.
CDC, in conjunction with the World Health Organization, has developed a set of guidelines to help prevent and control the spread of Ebola. Entitled

Infection Control for Viral Hemorrhagic Fevers In the African Health Care Setting, the manual describes how to:


recognize cases of viral hemorrhagic fever


prevent further transmission in health care setting by using locally available materials and minimal financial
resources
 

Bob_VT

Moderator & Unofficial iBoats Historian
Staff member
Joined
May 19, 2001
Messages
26,019
Yes, I have done ALLOT of reading too. AND...... there are still questions to be answered such as the "true" incubation period which has been said to be normally less then 21 days but recently extended to 42 days............ and the other main threat which even the US Army has addressed is the mutation into an "airborne" infection.

This is a scary event.

I actually have considered "Prepping" with PPE stuff for my home and family.
 

phillyg

Petty Officer 1st Class
Joined
Jul 26, 2007
Messages
209
Any mariner making port calls in any of those West African countries should not go ashore there, and should be aware that any products or stores bought locally have likely been handled by or subjected to bodily fluids by someone who already has Ebola or who has touched someone who has Ebola, IMHO.
 

RGrew176

Commander
Joined
Mar 20, 2002
Messages
2,088
Any mariner making port calls in any of those West African countries should not go ashore there, and should be aware that any products or stores bought locally have likely been handled by or subjected to bodily fluids by someone who already has Ebola or who has touched someone who has Ebola, IMHO.


I agree with your assessment but we need to do more here. We should not allow any person(s) from the affected areas into this country until the epidemic has been brought under control if indeed there are the tools to do that.
 

achris

More fish than mountain goat
Joined
May 19, 2004
Messages
27,468
The best place for the best, most up-to-date information is the W.H.O. website. (http://www.who.int/csr/don/archive/disease/ebola/en/)

I was working in Gabon (very close to the outbreak region) during July and August and returned home through the country. All of us on the vessel were interested in what was happening, we all did a LOT of research and all came up with the same website...

Not sure disallowing citizens to return to their own country after being in any area, Ebola affected or not, is legal. Or the best way to prevent the spread of the disease...

That's one of the things I have been banging on about over the last few years.... How many diseases have we (human race) cured in the last 30 years? None. The big drug companies have realised that to cure a disease they get to sell one tablet/series of tablets/injection/series of injections, but to 'manage' the symptoms they get to sell a raft of drugs for the REST OF THE VICTIMS LIFE!!! At a purely accounting level, which one is more profitable? And if you think that a drug company wouldn't act like that, wake up and smell the flowers Alice, we're not in Kansas any more....

So, Ebola. The only way to control the symptoms is to kill the virus, and that's the same as a cure... Not in Big Pharma's interests, so don't expect a 'cure' any time soon.

Chris......
 
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