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  Table of Contents  
GUEST EDITORIAL
Year : 2014  |  Volume : 32  |  Issue : 4  |  Page : 363
 

Ebola virus re-emergence: Is it really knocking at our door?


Department of Microbiology (LD, AC), All India Institute of Medical Sciences, New Delhi, India

Date of Submission15-Sep-2014
Date of Acceptance16-Sep-2014
Date of Web Publication4-Oct-2014

Correspondence Address:
L Dar
Department of Microbiology (LD, AC), All India Institute of Medical Sciences, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0255-0857.142229

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How to cite this article:
Dar L, Choudhary A. Ebola virus re-emergence: Is it really knocking at our door?. Indian J Med Microbiol 2014;32:363

How to cite this URL:
Dar L, Choudhary A. Ebola virus re-emergence: Is it really knocking at our door?. Indian J Med Microbiol [serial online] 2014 [cited 2019 Nov 18];32:363. Available from: http://www.ijmm.org/text.asp?2014/32/4/363/142229


The re-emergence of Ebola in 2013 leading to an epidemic which is still going strong in 2014, is a typically unpredictable event, in keeping with the chequered history of this viral illness. Named after the Ebola river valley where the first reported outbreak occurred, the virus has shown endemic activity with intermittent outbreaks since 1976. The virus was relatively quiescent in the 1980s and returned with a vengeance in the mid-1990s. The story of the current outbreak began in Gueckedouin (Guinea) where, on 6 December 2013, a 2-year-old boy was affected. Nobody would have imagined that this index case would be the start of the largest outbreak of Ebola, resulting (till the present date) in over 2,500 clinical cases and more than 1,300 deaths.

What differentiates this outbreak from the previous ones is not just its magnitude (past outbreaks resulted in a maximum of a few hundred cases), but its first ever appearance in west African countries (Guinea, Liberia, Sierra Leone and Nigeria). The 'Guinea strain' is a variant of the Zaire Ebola virus (ZEV), but haemorrhagic manifestations are not as apparent this time around, leading to the use of the term Ebola virus disease (EVD) instead of Ebola haemorrhagic fever. The mortality also seems to be lower than usual, at (a still very high) 50-55%. No indigenous cases have been reported outside West Africa and cases diagnosed in other continents are due to importation of the virus through travel.

International collective action to control this Ebola outbreak was a bit slow during the initial months, until the WHO appropriately drew attention to it by declaring an international health emergency, seeing that it was raging unabated. Global surveillance and screening is now in place at all concerned ports, both at exit from West Africa, as well as at entry, on return from the affected countries. However, from current trends, this outbreak is expected to be slow to contain. Therefore, it is important for us in India to understand the disease and implement a preventive plan.

The Ebola virus is transmitted only through close and direct contact with the blood or body fluids of human cases or affected animals. Also, transmission can occur only from symptomatic cases and not during the incubation period, which lasts for 2-21 days. Aerosol transmission has not been reported. All these factors restrict its spread and it is unlikely that even a traveller to affected areas would be exposed to such situations, unless he visits a hospital or attends a funeral. Nevertheless, the Indian government is taking all due precautions by screening travellers, returning from affected countries, by asking them to fill a form related to their travels, which is also in their own interest. Those who have fever at the time of entry are being admitted to special facilities and tested. Follow-up after return to the community ensures that the period of incubation is covered. The isolation and testing facilities are in keeping with the precautions advised for this biosafety level 4 (BSL-4) pathogen. Testing is currently restricted to the National Institute of Virology (NIV), Pune and the National Centre for Disease Control (NCDC), Delhi. In addition, efforts are being made to spread awareness and reduce panic. India has not seen any case of Ebola so far. It is expected that the preventive measures will ensure the safety of our population as effectively as during the SARS epidemic and the localized outbreaks of Crimean Congo haemorrhagic fever and avian influenza. As microbiologists, we have an important role to play in providing correct and sensible information. As health care personnel are at a higher risk of exposure to Ebola, this situation should also serve as another opportunity to re-emphasize the importance of standard precautions, including proper hand washing, in the prevention of spread of all infections, including this dreaded disease.




 

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