The head of the Department of Communicable Diseases and Health Analysis of the Pan American Health Organization / World Health Organization (PAHO / WHO), Marcos Espinal, stated that “prevent local transmission” Ebola is the main objective to be achieved before the possible arrival of a case of disease in Latin America and the Caribbean.
According to the specialist, in charge of providing support to countries in the region for their preparation and response to the possible arrival of imported cases of the disease, the local transmission of the disease can be prevented or cut if detected and isolated cases and identify and track people who had contact with them. (See the interview here: https://www.youtube.com/watch?v=nOb6EdyuUWI)
Question: Can you get Ebola Latin America and the Caribbean?
Answer: You cannot rule out a case of Ebola reaches our beaches or our country.The risk is, and we should prepare for that possibility. What defines a good preparation is anticipated. We cannot say it will be perfect, we can not rule out that it will get a case, but if we minimize the risk of local transmission, we are doing our job.
Question: What should be done before the arrival of a case of Ebola?
Answer: When we have such cases, it is important rapidly isolate and identify contacts, people who had contact with that person, because that is what is going to cut the transmission. It is proved, and in particular outbreaks that have occurred in Africa since 1976: isolation and identification of contacts. And watch for 21 days outlet temperature to determine if it has passed the virus or not. If we do not identify the contacts that’s growing source for them from spreading the disease and the virus to spread in any of our countries.
Question: What are you doing PAHO to help countries prepare to respond to Ebola?
Answer: The PAHO Director, Dr. Carissa Etienne, has put an extraordinary emphasis on support to countries. It has created a task force, has given a message to the entire organization that this is a corporate response and has given all facilities. The working group meets weekly to discuss strategies, new ideas, innovate and review the progress of the response of the preparation of the country. This group is composed of directors of technical, administrative and key facilitators of PAHO. Also, the organization has created a website specifically devoted to Ebola. We have a whole series of documents that countries can use in preparing their preparedness strategies in the preparation of plans and risk communication in the preparation of contingency plans for Ebola, which must be based on the basic skills IHR. We are also taking the initiative to offer quests to get in touch with the ministries, authorities, provide training and try to tie it all together so that we are prepared countries.
Question: What is the main recommendation to the eventual arrival of a case of Ebola?
Answer: The main recommendation is the national leadership. From the Head of State to the Minister of Health, but also the ministers of other sectors such as finance, education, tourism. Must have a corporate, multi-sectoral approach to the disease. The education of the population is something whole, not for only the Ministries of Health. There should be a task force in each country, a task force meeting every week, analyze the gaps for where we need to improve: whether to identify areas of isolation, whether to purchase protective equipment or whether to adjust the risk communication campaign to inform the population.
Question: ¿ Why put so much emphasis on communication?
Answer: We recommend good risk communication campaigns to be transparently report the population. Do not be afraid to say “we have a potentially imported case, we have isolated, we investigated and as soon as we have more information we will inform the public” because the people when they see this part of the authorities gain confidence.
Question: What can you learn from the experience Americas Ebola control of Senegal and Nigeria?
Answer: Senegal and Nigeria nicely handled these cases, the contacts identified immediately and were able to cut the chain of transmission and the WHO declared Ebola free Senegal and Nigeria. It is important that developed countries because these massive campaigns to identify those contacts, they were isolated, they were found and today have Ebola. They did not use very sophisticated, experimental drugs, cut the chain of transmission in outbreak management, epidemiologically, is the main reference: prevent local transmission. And that is the main goal in our America: isolate cases to prevent transmission or local expansion to other people, to other towns within our region.
Question: What are the advantages of health systems in the Americas with regard to West Africa to deal with the arrival of Ebola?
Answer: Our countries are stronger than those of African health systems. They have physical infrastructure. In Africa many people have to walk miles to travel far distances to access the nearest health post. We are human, so there is need to train, but do not train at all, but a team that is prepared to handle and treat such cases.
Question: Should all hospitals in a country prepared to handle cases of Ebola?
Answer: Not all hospitals should and can handle a case of Ebola. Therefore the recommendation is to have a dedicated center where the case is isolated and has a team of trained specialists. It is important that each country assigns its isolation area. If they are federal countries, will decide whether one, two or three, but the important thing is to have an area where cases are isolated, are rapidly transported.If you are very large countries have a team when a suspect in a province is identified, the equipment is moved quickly to the province to give first aid and travel (the patient) by air or fast ambulance to the isolation zone. Hospitals must give first aid where the person (suspect) comes, and be prepared to make that call to an emergency number for an ambulance or by helicopter, or whatever needs to be prepared, that person is transferred, is you take the sample and the sample was sent for confirmation to the approved laboratories.
Question: Should I train all health workers from one country to handle cases of Ebola?
Answer: There is no need to train all doctors to handle Ebola. The information is important and educate the public and health professionals is vital, but we can not expect to train 10,000 people for handling these cases. The important thing is to train a group that is current and qualified to handle such cases. Not a massive training is to have equipment for the handling of the case, and have rapid response teams to the internal of the country to give first aid, make sure the person is isolated. Also, having personal protective equipment, for that team in the isolation zone, teams that PAHO is facilitating the purchase to countries that wish to purchase through OPS is protected.
Question: What should be done if a suspected case of Ebola was present in a health service?
Answer: What you should do immediately is, if there is a good medical history, asking the questions: “Have you had contact with the countries that are affected by Ebola? Have you had contact with patients with Ebola? Were is Liberia, Sierra Leone. Whether or not there is going to depend. If symptoms and signs are quite compatible with Ebola, then notify the authorities and that team national rapid response to be put into action and make the evaluation as quickly as possible, the patient is isolated while in a room while I moved to the isolation unit, as was the case of Brazil, it immediately transferred by plane from one state to another, the isolation unit in Rio de Janeiro. At the end the person had not Ebola, Ebola because it can be confused with malaria, yellow fever, typhoid … It is important to remain calm and use prevention and infection control. If you arrive at a rural clinic handwashing, use of gloves is important, and so we have it in the rural clinic until the person can be moved.
Question: Who would be at greater risk of infection if a case is detected?
Answer: The groups most at risk are health care workers, so in Africa have seen that there are over 400 health workers affected. Hence the recommendation of PAHO purchase or acquisition of personal protective equipment for healthcare workers, it is vital. That country must act fast, place your orders through PAHO, make sure they have computers, because protective equipment greatly reduces the risk.
Question: How can minimized the risk of infection to health care workers who care for patients with Ebola?
Answer: The important thing is training how to take off and how personal protective equipment. On our website dedicated to Ebola OPS have information with photographs, infographics on how to handle protective equipment. We are also virtual and physical training.
Question: What is the treatment?
Answer: Treatment is supportive, is isolation, is to maintain the vital signs of patients, and maintain adequate hydration and monitoring. We have seen in the outbreak in Africa that there is a survival of 50%. Treatments that have been used are experimental, none is proven, there will be treatment, but it will take time. There are two vaccines that are already in testing phase, there are five more coming in the experimental stage and the idea is that the former are ready for some time in 2015.
Question: There is concern about ebola What should the public know about Ebola?
Response: The concern is natural and human to a disease that has not yet approved drug that has no vaccine, people are very concerned. But Ebola is not airborne, by mosquitoes is not transmitted, but by contact with body fluids or fluids of an infected person who is ill. In the incubation period no transfer, then the person has to be in contact with sweat, fluids, urine, blood from a person with symptoms, and that the healthy person also has gaps in its skin.
Question: Are international flights to the most affected countries in West Africa should be banned?
Answer: The position is not to prohibit flights, posture is a departure screening is done in the most affected countries such as Sierra Leone, Guinea and Liberia, the temperature is taken to people leaving. Other countries have taken steps, each country is sovereign and decides the best you see fit and PAHO accompanies, but PAHO recommends that the recommendations of the Emergency Committee of the International Health Regulations which was convened by WHO are implemented. (WHO news)
