There is no effective antiviral treatment. Instead, treatment is supportive, and is directed at maintaining renal function and electrolyte balance and combating haemorrhage and shock.
Transfusion of convalescent serum may be beneficial.
Post-exposure treatment with a nematode-derived anticoagulation protein and a recombinant vesicular stomatitis virus vaccine expressing the Zaire Ebola virus glycoprotein have been shown to have 33% and 50% efficacy, respectively, in humans.
Recent studies have shown that small interfering RNAs (siRNAs) can be potentially effective in silencing Zaire Ebola virus RNA polymerase L, and treatments in rhesus macaque monkeys have resulted in 100% efficacy when administered everyday for 6 days; however, delivery of the nucleic acid still remains an obstacle.
IMMUNIZATION: None.
PROPHYLAXIS: None. Management of the Ebola virus is solely based on isolation and barrier-nursing with symptomatic and supportive treatments.
Based on the stark facts of Ebola, people are understandably very concerned. When another case arises, the press rush the news to print, making the spread seem wider than it is.
But what can we do to safeguard ourselves? What lessons can we learn from this recent outbreak, that may afford us better protection in the future?
Firstly, the mechanism of spread must be evaluated. Coming into contact with contaminated hosts, both dead and alive clearly is a major player in all of this. Isolation of those contaminated can help reduce the spread, but as we are seeing, with the 21st Century routine migration of travellers, suspected cases can arrive anywhere in the world, at any time.
A closed borders for entry policy is not economically viable, but, is plausible in a major outbreak to which containment is not possible.
In the mean time, local level migration control in countries worst effected (Such as Sierra Leone) is utilised to try and gain control.
We are left to trust decision makers that our best interests are catered for - but, systems fail, non symptomatic travellers, within the incubation period, can travel freely to home countries, residing with their families, before potentially infecting others nearby.
As citizens, it is our duty to do everything we can to protect our living environments around us, not just for neighbours, but also for ourselves, and our families.
Good levels of hygiene are critically important, washing of hands for example, using sanitising gel regularly, and particularly after making contact with another person.
Sanitising the entire work environment, phone systems, keyboards, light switches, door handles, and in our case, we maintain a staff toilet, and a customer toilet. Both are kept incredibly clean - but one is controlled over who uses it - all these things help cut down cross contamination.
Food eaten is prepared by the consumer only - no outside food is consumed wherever possible, all food prepared is cooked properly, or is within its own natural packaging (i.e. Banana's), the exterior of which is cleansed before unwrapping.
This is the daily routine, and although it sounds extreme, it falls into good practice, and prevents to the greater part, picking up lots of other bugs.
But, we cannot avoid all human contact in day to day life. We should not become recluse. It is important to engage with other people, and to do so in a familiar way without an eye of suspicion that could otherwise damage a relationship, be it professional or personal.
The game changer comes when cases become prevalent within our community.
A whole range of respiratory protective aids are available, from basic face masks through to CBRN respirators, which cost more, and are less available than the paper counterparts. Full CBRN suits are used by professionals, in conjunction with decontamination units and full assistive backup.
But without these resources, the lay responder, the worker, the citizen is most vulnerable to contamination, so more austere measures are required.
All the above sanitisation regimes should be used, as well as protecting from outside contact.
This extreme measure requires some forethought in preparation - without shopping for food, and supplies, we would soon become unstuck, without going to work, we would soon become financially void.
Good preparedness in home storage is needed, with a backup food supply of canned goods, and water, as well as toiletries, means the need to enter society for trivial means can be avoided.
All avoidance is impossible, and socially problematic, so keeping distance is appropriate instead. Avoiding physical contact, and sharing of food is an aide to preventing cross contamination.
Managing the dead - ensuring disposal of the body is prompt, and complying with local authority guidance is all important in preventing the spread too, and of course managing your own form of decontamination is vital.
Good resources to keep at home include:
Strong Surgical Gloves - Many pairs of Marigolds
Bin Bags
Face masks
Alcohol Gel
Camping toilets
Bottled Water
Tinned food of all varieties
Camping cookers
All of this seems extreme, but, up until quite recently, it formed part of the British education in preparedness for Nuclear Attack. After the dissolution of the communist government in Russia, it was felt the risk had been removed, however, although the risk may have changed, there is still the need for protection of one form or another.
Society has a Pronoia well established in its minds eye, always expecting the best outcome from the powers that be. This post in contrast may seem like Paranoia, but, the very same thing that may have attracted the reader, also encouraged the poster.
It takes one major event to change the thinking of others, but that major event may be one step too far for the survivability of many.
Further information is encouraged by visiting:
http://www.redcross.org.uk/en/What-we-do/Preparing-for-disasters/How-to-prepare-for-emergencies
https://www.gov.uk/government/publications/emergency-preparedness
https://www.gov.uk/browse/citizenship/government/emergencies-preparation-response-and-recovery
www.centricuk.com
https://www.facebook.com/First.Aid.Training.Centric
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