Ebola Virus Disease: A Review and Analysis

This assignment provides an in-depth examination of Ebola virus disease, covering its epidemiology, symptoms, treatment options, and pathogenesis. The study guide includes a collection of research papers and articles from reputable sources, offering a holistic approach to understanding the disease. Topics covered include the 2014 epidemic, management and prevention strategies, and the moral challenges associated with the disease. This comprehensive review is suitable for students, researchers, and professionals seeking to understand Ebola virus disease in detail.

Running Head: Globalization and its Impact on Health
Globalization and its Impact on Health
Ebola Virus Disease (EVD)

Globalization and its Impact on Health: Ebola 1
Introduction
Ebola (or Ebola Haemorrhagic fever) is a life threatening viral fever caused by the Ebola
virus. It is responsible for blood clotting problems which often lead to internal bleeding from
small blood vessels (Goeijenbier, Kampen, Reusken, Koopmans, & Gorp, 2014). It also leads
to tissue damage and inflammation. It is highly contagious and often fatal in humans and
nonhuman primates. It results in fever and severe internal bleeding. The virus belongs to the
Filoviridae family (genus Ebolavirus) and affects humans as well as nonhuman primates
(monkeys, chimpanzees). Ebola can be spread via infection from one of the following
viruses:
 Ebola Virus
 Taï Forest Virus
 Sudan Virus
 Bundibugyo Virus
 Reston Virus (Centers for Disease Control and Prevention, 2017)
The first four infect the humans while the last virus targets pigs and nonhuman primates only.
It can be easily transmitted via direct contact with the blood, body fluids and the tissues of the
infected person or animal (Wambani, Ogola, Arika, Rachuonyo, & Burugu, 2016). Common
symptoms may include fever, muscle pain, intense weakness, sore throat and headache. Ebola
is considered to be a zoonotic virus since it originated in animals first and was later spread to
humans.
Ebola ça suffit vaccine was tried on 4,000 people in Guinea and was found to be effective
100%.
Ebola is likely to spread quickly through friends and families as they are exposed to the
secretions that are infectious while caring for the sick individual. The time interval of Ebola
infection to the onset of its symptoms has a range of 2-21 days (Roca, Afolabi, Saidu, &
Kampmann, 2015). Globalisation can contribute immensely towards the spread of an
epidemic.

Globalization and its Impact on Health: Ebola 2
Source of Origin
Ebola Virus Disease (EVD) was first reported in 1976 outbreak of Ebola in Sudan and
Democratic Republic of Congo (Zaire). It is titled after the river, near which it was found,
Ebola (Moghadam, Omidi, Bayrami, Moghadam, & Alinaghi, 2015). Since then, many
people have been infected in many African countries from time to time. Ever since the
discovery, many organisms had been tested as expected Ebola reservoir. Bats were found to
efficiently replicate and survive the virus simultaneously (Kaner & Schaack, 2016). The
origin of the virus is unknown but the scientists speculate it to be animal-borne especially
fruit bats. Bats can transmit it to humans, monkeys, apes and others.
The recent Ebola epidemic is speculated to have originated in a boy in a small village in
Guinea (West Africa) in December 2013. It killed many people in the village and spread to
the neighbouring villages as well (Quammen, 2015). It then spread to Sierra Leone and
Liberia (Kimur, et al., 2015). Decline in the apes can also be linked to the Ebola virus
outbreaks in human.
According to the Centre for Disease Control and Prevention (CDC), 28,639 cases of EVD
and 11,316 cases of deaths have been reported worldwide as of March 13, 2016. Major Ebola
outbreak initiated in March 2014. A new outburst occurred in Guinea (in the early 2016) with
800 cases of confirmed Ebola as of Mach 22, 22016 (Bradford, 2016).
Mode of Transmission
It spreads through contact with an infected person’s bodily fluids like saliva, sweat, faeces,
mucous, tears, urine, breast milk and semen. It could be from infected patient or the one who
died due to Ebola. The virus can infect from cuts and mucous membranes of mouth, eyes and
nose. It spreads from sexual contact. Also, direct contact with bodily fluids, blood and tissues
of infected primates and infected bats (Muyembe-Tamfum, et al., 2012). Medical equipment
and needles also help spread the virus. Being in contact with infected animals or eating their
meat is also plausible causes. Post recovery, the virus may be carried in the infected person
for weeks or months and may be transmitted through semen or breast milk (Mustafa, et al.,
2016). The after recovery side effects include fatigue, vision issues, muscle pain and stomach

Globalization and its Impact on Health: Ebola 3
ache. Stigma is often experienced by the survivors. Infected people and the survivors remain
contagious from about 21 to 42 after the symptoms abate.
Due to the globalisation and inter country trade, the spread of Ebola magnified as the
travellers may infect people from other countries. Tourism is increasing day by day and
increases the risk of infection. Traders and businessmen travel on a frequent basis and are
have a high probability of being infected. Globalisation has increased the consumption by
imports goods from other countries. The products may be infected with blood, fluids and
mucous of the infected person. The virus can survive without host for a very long time.
These products when used by the consumers of other countries may infect the people.
Globalisation can thus contribute in the spread of an epidemic. Imported monkeys from the
Philippines and Africa need to go through animal research to prevent Ebola from entering
other countries. Dead bodies also have to be examined and prepared before burial rituals to
avoid the contamination. The suspected cases must be given proper medical care.
Reasons for Delay in Vaccine Development
It is important to develop a vaccine without compromising its effectiveness and safety. They
are expensive, time consuming and difficult to develop especially amidst a global health
crisis. Despite the urge from global health officials to accelerate the development of the
vaccine, the countries and companies could not develop one because of many reasons.
i. The medicines that were previously tested on patients did not offer easy solutions to
all. Ebola has multiple mutating strains which makes the vaccine development even
more difficult. A drug that suited all was difficult to develop (CNBC News, 2014). It
is very important to develop a suitable one because its side effects could be more
devastating.
ii. There was technology available but the incentive for the big companies was missing.
Ebola largely surfaced sporadically in the lower economic countries of Africa which
were far away from the researchers. There existed the problem to economics of
development of drug. Instead of large pay-offs there existed the possibility of losses.
The other vaccines had economics of development. There had been incentives for the big
pharmaceutical companies and the countries to develop them. Ebola virus is a comparatively
complex one and the development was all the more difficult.

Globalization and its Impact on Health: Ebola 4
A range blood products, drugs and immune therapies are being evaluated. WHO licenced two
vaccines after testing which were cAd3-ZEBOV and rVSV-ZEBOV (Nichols, 2017).
Vaccine VSV-ZEBOV was initially tested on 11,847 people in 2015. There was no sign of
illness for 10 days or even more in 5,837 people out of 11,847 who received the vaccine.
There were 23 cases of Ebola in 10 days or more in people who did not get vaccinated. World
Health Organisation (WHO) took the trial along with Guinea’s Ministry of Health and a few
other international associates. For trial, ring vaccination protocol was adopted where some
rings were vaccinated soon after detection. On the other hand, rest were vaccinated after 3
weeks (World Health Organisation, 2018).
Health Management and Prevention
The misery and deaths from Ebola have accelerated in poor nations because of poor and
inadequate levels of public health systems and health care. There is negligence on the part of
governments and their approach towards the epidemic. There exists a moral challenge in both
rich and poor nations affected by Ebola for both the individuals and the authorities.
Expenditure on healthcare must be spent judiciously in case of epidemics and steps must be
taken to prevent future outbreaks.
Poor countries neither had the capacity nor the infrastructure to manage the Ebola outburst.
They lacked trained professionals as well as institutions to cater to the large scale of infected
people. This not only accelerated the spread of Ebola but also contributed to large scale of
people suffering and their deaths. People were not provided proper knowledge and education
to deal with the wide spread disease. This leads to spread of infection because of its
contagious nature.
Rich and poor economies are affected by the epidemics alike but the countries’ economic
status influences the survival rate. Rich countries spend a major portion of their GDP on
public healthcare. This leads to healthier citizens and reduced risk of vulnerability to
diseases. While on the other hand, poor countries are o a higher risk in case of an epidemic
outburst. The poor are the most affected ones with unfair treatments. Principle of social
justice must be followed and resources must be allocated in fair quantities to the sufferers,
irrespective of the income level and social worth. The public services in this case require

Globalization and its Impact on Health: Ebola 5
special attention to the weaker sections of the society especially pregnant women, young
children and mentally or physically disabled.
In the poor country of Liberia, there was an area-wide quarantine imposed on the poorest
section of West Point in the capital city of Monrovia. 60,000- 120,000 people were asked to
live in unsanitary, deplorable and slum-like conditions which can further worsen the situation
of Ebola and increased scope for further infection. There were no or very little healthcare
facilities available for them. The streets were piled with dead bodies in the quarantine.
Liberia was highly affected by Ebola. It was left devastated by a civil war right before the
outburst. It had a population of 4.4 million and one doctor per 100,000 people before Ebola.
Due to the deficiency of personal protective equipment, even after frequent deaths of many
healthcare workers, the others refused to work (Senga, et al., 2016). Eventually, only 18% of
the patients are able to have access to hospital facilities. Major portion of patients had to be
taken care of at homes by relatives and friends. It further increased the cases due to lack of
knowledge and training.
On the contrary, Nigeria (a rich neighbour of Liberia) was able to control the epidemic by
responding effectively and efficiently to the initial cases. It was important to take steps since
the country has the largest population in Africa. It appointed health educators to acknowledge
the general public. Contact training was done by the health workers who were trained in
epidemiology. Patients were provided isolated rooms in the hospitals and air conditioning.
Workers were provided with protective equipment and were asked to work in longer shifts.
Testing labs were efficient and could deliver the Ebola results in hours (Rothstein, 2015).
Unlike Nigeria, Liberia, Guinea and Sierra Leone were not able to control the epidemic and
hence contributed to the international scourge of Ebola. Investment in the public health
infrastructure by the government is an indispensible part of economic development.
Conclusion
Ebola is highly contagious and there is a need for prevention. It is a deadly disease which
needed extra care because of lack of vaccines then. The big pharmaceutical firms lacked
motivation to develop the vaccine because of low economies of scale. The vaccines needed to
be provided at a low rate so that everyone could afford it. This could lead to losses for the
firms and hence the vaccines took so long to develop. The economies affected were very poor

Globalization and its Impact on Health: Ebola 6
with low level of healthcare infrastructure. It heightened the issue and took larger population
under it ambit.
There is a moral challenge on individual as well as collective level. It is important to abate
the political rancour and personal interests at the time of emergencies. There is a need for
greater investment in the healthcare facilities as well as education to deal on the individual
levels. People should be encouraged to help each other at the time of emergencies and set
aside personal benefits. Also, the pharmaceutical firms should be given an incentive so that
the process of vaccine development can be accelerated. Basic hygiene and sanitation must be
encouraged.
It is impossible to isolate a nation in an interconnected and globalised world. This increases
the risk of spread of epidemics. The only step could be to strengthen the healthcare system
and promote innovation in the field of medicine. Healthier lifestyles must be encouraged.
Ebola can be eradicated only when the poor countries of Africa, that is the place of EVD
origin, are controlled and targeted.
References
Bradford, A. (2016, March 28). Ebola: Causes, Symptoms & Treatment. Retrieved March 27,
2018, from Live Science: https://www.livescience.com/48311-ebola-causes-
symptoms-treatment.html
Centers for Disease Control and Prevention. (2017). About Ebola Virus Disease. Retrieved
March 26, 2018, from Centers for Disease Control and Prevention:
https://www.cdc.gov/vhf/ebola/about.html
CNBC News. (2014, October 02). Ebola Vaccine: Why It's Taking So Long To Make One.
Retrieved March 27, 2018, from CNBC News:
https://www.nbcnews.com/business/business-news/ebola-vaccine-why-its-taking-so-
long-make-one-n216586

Globalization and its Impact on Health: Ebola 7
Goeijenbier, M., Kampen, J. v., Reusken, C., Koopmans, M., & Gorp, E. v. (2014,
November). Ebola virus disease: a review on epidemiology, symptoms, treatment and
pathogenesis. The Journal of Medicine, 72(09), 442-448.
Kaner, J., & Schaack, S. (2016, September 13). Understanding Ebola: the 2014 epidemic.
Globalization and Health 2016, 12(53).
Kimur, H., Tsukagoshi, H., Ryo, A., Oda, Y., Kawabata, T., Majima, T., . . . Shimojima, M.
(2015, February). Ebola virus disease: a literature review. Journal of Coastal Life
Medicine, 03(02), 85-90.
Moghadam, S. R., Omidi, N., Bayrami, S., Moghadam, S. J., & Alinaghi, S. A. (2015, March
16). Ebola viral disease: a review literature. Asian Pacific Journal of Tropical
Biomedicine, 05(04), 260-267.
Mustafa, M., Yusof, I., Kassim, M., Jeffree, M., Illzam, E., & Sharifa, A. (2016, April). Ebola
Virus Disease, Management, and Prevention. IOSR Journal of Dental and Medical
Sciences (IOSR-JDMS), 15(04), 142-148.
Muyembe-Tamfum, J., Mulangu, S., Masumu, J., Kayembe, J., Kemp, A., & Paweska, J. T.
(2012). Ebola virus outbreaks in Africa: Past and present. Onderstepoort Journal of
Veterinary Research, 79(02), 451-458.
Nichols, H. (2017, May 23). Ebola: What you need to know. Retrieved March 28, 2018, from
Medical News Today: https://www.medicalnewstoday.com/articles/280598.php
Quammen, D. (2015, July). Seeking the Source of Ebola. Retrieved March 26, 2018, from
National Geographic: http://ngm.nationalgeographic.com/2015/07/ebola/quammen-
text
Roca, A., Afolabi, M. O., Saidu, Y., & Kampmann, B. (2015, April). Ebola: A holistic
approach is required to achieve effective management and control. The Journal of
Allergy and Clinical Immunology, 135(04), 856-867.
Rothstein, M. A. (2015, January). The Moral Challenge of Ebola. American Journal of Public
Health, 105(01), 6-8.
Senga, M., Pringle, K., Ramsay, A., Brett-Major, D. M., Fowler, R. A., French, I., . . . Sellu,
J. (2016, May 18). Factors Underlying Ebola Virus Infection Among Health Workers,

Globalization and its Impact on Health: Ebola 8
Kenema, Sierra Leone, 2014–2015. Clinical Infectious Diseases, 63(04), 454-459.
Wambani, R., Ogola, P., Arika, W., Rachuonyo, H., & Burugu, M. (2016). Ebola Virus
Disease: A Biological and Epidemiological Perspective of a Virulent Virus. Journal
of Infectious Diseases and Diagnosis, 01(01).
World Health Organisation. (2018, January). Ebola virus disease. Retrieved March 27, 2018,
from World Health Organisation:
http://www.who.int/mediacentre/factsheets/fs103/en/