Globalization Emerging Infectious Diseases

Globalization Emerging Infectious Diseases

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Globalization Emerging Infectious Diseases

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Globalization Emerging Infectious Diseases

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The current assignment focuses on globalization and its impact upon the health of people. Globalization has resulted in effective collaboration between countries. The collaboration has often been established in terms of exchange of services and products. Additionally, there has been exchange of human labour between different countries as a result of globalization. The free pass between countries is also a gateway to a huge number of pathogens and viruses. Some of these viruses could be life threatening and lead to lethal consequences. The assignment particularly discusses the transmission and the impact of the Ebola virus.
The epidemic of the Ebola virus in the year 2014-2015 raised global concerns.  It soon became pandemic and had lethal consequences claiming a huge number of lives. The outbreak of the Zaire ebolavirus (EBOV) began in guinea by the end of 2013. The disease soon spread to the neighbouring regions of Liberia and Sierra Leone. By April 2016, there have been 28,652 cases of Ebola virus disease (EVD) in West Africa alone. Of these almost 40% of the case were found to be fatal (Gee & Skovdal, 2018).
Source and transmission of Ebola
The Ebola virus disease (EVD) is caused by Ebola virus which is a member of the filovirus family and occurs in humans and other primates. The disease first occurred in the year 1976 in the Democratic Republic of the Congo and the Sudan. There are five species of the ebola virus such as – Zaire ebolavirus, Sudan ebolavirus, Tia forest (also formerly known as ebola ivory coast) and Bundibugyo ebolavirus, the fifth one is the Reston ebolavirus. The investigations caused the first outbreak to be caused by RESTV in one export facility in the Philippines. Though there were no clear indications regarding the manner in which the facility got contaminated. There have been several outbreaks of Ebola in Africa in between 1976 and 2014. Some of these were primarily restricted to the remote areas, whereas most confined cases were reported from the Democratic Republic of the Congo.  In 2014, 74% of the EVD outbreaks were caused by the Zaire ebolavirus (Nyarko, Goldfrank, Ogedegbe, Soghoian & Aikins, 2015). The transmission was found to occur on contact with blood and body fluids such as semen, sputum etc. The Ebola was first reported in individuals who handled infected gorillas, chimpanzees and the first antelope in the republic of Congo (Evans, Goldstein & Popova, 2015). The first case in West Africa likely occurred due to exposure to bats. The infection was carried forward with direct contact with body fluids of infected individuals or through contaminated or soiled articles. As reported by McDermott (2016), acquisition of the disease on sexual contact with a survivor has also been reported. It has been seen that the virus remains in the semen of the infected individual even months after recovery. The hospital workers have severely contacted the Ebola virus on contact with infected individuals. As mentioned by Evans, Goldstein & Popova (2015), lack of timely detection of the disease contraction in the healthcare professionals further enhanced the spread of the disease.
The incubation period of the Ebola virus ranges from 2-21 days. The illness is suddenly expressed with the onset of fever, headache, joint and muscle pain, intense weakness etc. The situation could worsen within the patients in the form of expression such as rash, red eyes, hiccups, impaired function of the liver and kidney along with internal and external haemorrhage. Ebola can lead to fatal consequences in 40-90% of the cases. As mentioned by McInnes (2016), diagnosis of Ebola in the early stages is difficult as there are little or no symptoms. The exposure to Ebola has been seen to double in the lack of healthcare professionals using effective personal protective equipments (Bradbury-Jones & Clark, 2017). Additionally, the lack of vaccines has made the treatment of Ebola difficult. Therefore, Ebola has reached the stage of epidemic where once contracted could not be easily cured. More importance has been placed upon the isolation and barrier techniques.  Therefore, the healthcare professionals have laid much importance upon the use of personal protective equipments such as masks, gloves and gown.
Comparison of Ebola with other conditions which do have vaccines
Ebola has been compare with a number of other pathogen and viruses based upon the treatment and the therapies.  Ebola is an RNA virus and is single stranded which means that its genome is more prone to mutation. As reported by Evans, Goldstein & Popova (2015), most of the mutations could be attributed to single nucleotide polymorphisms (SNPs). The drastic mutation rates have made medicines and vaccinations ineffective.  Therefore, no sufficient amount of vaccinations has been effective in reducing the rates of occurrence of EVD (“Ebola data and statistics”, 2018). The medications have only been able to provide temporary relief to the patients. In this respect, none of the vaccines for Ebola virus have been found to be sage enough for testing within the human population. As mentioned by McInnes (2016), there has been licensing issues which has restricted the use of the virus within the population at large. Some of the vaccines, which have been in the developmental stage are- ChAd3-ZEBOV and VSV-EBOV. Both the vaccines have been developed by GlaxoSmithKline in collaboration with Us National Institute of Allergy and infectious diseases (NIAID). However, a number of ethical considerations have to be passed for the effective trial and use of vaccine within the population. Some of the ethical implications laid down by the WHO were that there should be a strong scientific hypothesis behind the trial of a particular scientific formula (Ayeni, Iyiola, Ogunnaike & Ibidunni, 2016). The intervention methods should have been tested and trialled in animal models and non-human primates.
The availability of vaccination of Ebola has been compared with some of the other diseases such as measles, pertusis, HIV and seasonal influenza. Measles and pertusis have been seen to possess no treatment or cure whereas both have been preventable with the use of vaccination.  As argued by Bradbury-Jones & Clark (2017), no vaccine is 100% effective and the length of the response produced depends upon the immunity of the patient. For example, vaccination against varicella zoster has not been found to be 100% effective in treating chicken pox. Therefore, the immunity of the patient against the chicken pox virus depends upon the amount of immunoglobulin (IgA, IgG) generated in the body of the patient (Mate et al., 2015). Therefore, the vaccines if cannot totally eliminate the chances for the contraction of a disease can reduce the length of the recovery period along with producing. Sufficient research and evidences have focused upon the timely intake of vaccine before and after leaving the country as certain disease are endemic to a country. WHO has prescribed those vaccines for hepatitis, Japanese encephalitis, polio, typhoid and yellow fever should be taken before visiting a list of counties as some of them have been found to be endemic to the region (“Ebola data and statistics”, 2018). As argued by Alirol  et al. (2017), some of the countries have implemented a weekly epidemiological record as there are huge number of pilgrims visiting Arab during the hajj. WHO has recently placed sufficient importance on the pre-travel consultation for people visiting the west and east African countries as Africa is still not 100% free of the Ebola virus (Osterholm et al., 2015). This is because even after recovery the virus could remain in the semen of the survivors.  However, the huge number of ethical challenges made the success of Ebola vaccine questionable.  As mentioned by Nyenswah  et al. (2015), a huge number of ethical challenge were faced in the recruitment of healthcare workers for Ebola vaccine. For example, vaccination programs for healthcare professionals who were looking after the care concerns of Ebola affected patients within home care settings were not prioritized. This was a clear breach of the ethical standards and programs.  As mentioned by Coltart, Johnson & Whitty (2015), the success rate of the experimental vaccine needs to be reviewed as part of the ethics process. In the lack of clarity a greater part of the population might be prone to infection and diseases. Additionally, the study products need to be reviewed as per the Trade related prospects of intellectual property rights (TRIPS) agreement (Henao-Restrepo et al., 2017). Though, in December 23rd 2016 a highly effective vaccine against the Ebola virus have been developed in Geneva. The vaccine has been found to be highly protective. However, little had been discovered and diagnosed regrading the side effects of administration of the vaccine. Additionally the patent rights further made free distribution   of the drug outside of Geneva difficult (Shoman, Karafillakis & Rawaf, 2017).
Public health management and prevention of Ebola
There are number of public health management strategies for Ebola. Some of these measures have been implemented for prevention of the healthcare workers returning from the ebola affected area. For example, maintaining a register for healthcare workers enrolled in EVD protection and care (“Ebola virus disease”, 2018). As mentioned by Gee & Skovdal (2018), providing effective training sessions to the healthcare workers deployed in the care of the Ebola patients. The healthcare workers deployed were made educate regarding the different aspects of incubation, clinical presentation and transmission. They were further instructed on maintaining effective protective measures such as wearing face masks and hand gloves while dealing with the patients. This needs to be followed by individual exposure assessment which will help in evaluating the level of exposure an individual had to particular pathogens. This is because implementing quarantine at the level of the healthcare professionals can help in providing greater amount of safety to the population at large (“Department of Health | Ebola”, 2018). As prescribed by WHO the healthcare professionals who has retuned from the infected areas were kept under strict monitoring for 21 days (“Ebola virus disease”, 2018). Some of the vital signs were monitored for the healthcare workers such as body temperature. It should be ensured that no-attendance of the healthcare workers are maintained during the assessment period.
Additionally, the patient needs to be kept in quarantine during the disease period. Every article used by the patient should be properly disinfected and disposed safely rightly after use. The clinical set up should be prepared rightly for receiving an infected patient using Infection prevention and control measures (IPC) (“Department of Health | Ebola”, 2018) . The travel or contact history of the patient should be taken in full detail. This will further help in understanding the level or the degree of exposure of the patients. The case investigation includes identification of close contacts which could further help in extending the quarantine measures.  As mentioned by Bradbury-Jones & Clark (2017), the patients should be provided counselling on the transmission risks. This can further reduce the chances of infection as by knowing regarding the consequences one would not eventually risk the life of their near and dear ones. The monitory of health (MOH) has advised effective testing strategies to ensure that the body fluids of the patients are free of viruses (“Ebola Virus – Ministry of Health”, 2018).  It is only after passing such criteria that the patients are released from the acute care setup. The items use by the patient in different wards should be kept separate and properly sterilised before separation from the patients. OnGlobalization Emerging Infectious Diseasese of the most important aspect which had been focused upon the by the healthcare team is   providing effective health education to the population. As mentioned by Coltart, Johnson & Whitty (2015), awareness regarding the modes of transmission can help in reducing the rates of contraction of the disease.
The current assignment focuses on the aspect of globalisation and its effect upon the health of the community. The assignment discusses the evil effects of globalisation with reference to the contraction and management of Ebola.  Ebola had become a health hazard in the 2014-15 quarter when a large mass of people who had travelled to West Africa with regards to work had been exposed to the deadly virus. The disease was carried through the immigrants in different countries and spread through body fluids. The assignment had further discussed the affectivity of vaccination with regards to controlling the rate of epidemic. However, there have been biopolitical disputes with regards to sharing the vaccination rights with different countries which have made the people more exposed to disease and pathogen.
Alirol, E., Kuesel, A. C., Guraiib, M. M., de la Fuente-Núñez, V., Saxena, A., & Gomes, M. F. (2017). Ethics review of studies during public health emergencies-the experience of the WHO ethics review committee during the Ebola virus disease epidemic. BMC medical ethics, 18(1), 43.
Ayeni, A. W., Iyiola, O. O., Ogunnaike, O. O., & Ibidunni, A. S. (2016). Globalisation and Ebola disease: Implications for business activities in Nigeria, 54-65.
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McInnes, C. (2016). Crisis! What crisis? Global health and the 2014–15 West African Ebola outbreak. Third World Quarterly, 37(3), 380-400.
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Nyarko, Y., Goldfrank, L., Ogedegbe, G., Soghoian, S., & Aikins, A. D. G. (2015). Preparing for Ebola Virus Disease in West African countries not yet affected: perspectives from Ghanaian health professionals. Globalization and health, 11(1), 7.
Nyenswah, T., Massaquoi, M., Gbanya, M. Z., Fallah, M., Amegashie, F., Kenta, A., … & Pessoa-Silva, C. L. (2015). Initiation of a ring approach to infection prevention and control at non-Ebola health care facilities-Liberia, January-February 2015. MMWR. Morbidity and mortality weekly report, 64(18), 505-508.
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