Below is a poster being distributed by UNICEF, bearing information and illustrations on the symptoms of Ebola virus disease (EVD) and best practices to help prevent its spread in this 2014 UNICEF handout photo. As of July 27, 2014, a total of 1,323 cases, including 729 deaths, had been attributed to EVD in the four West African countries of Guinea, Liberia, Nigeria and Sierra Leone. Liberia has borne 329 of these cases, including 156 deaths. [Via source: China Daily]

UNICEF infographic

UNICEF infographic

 

The US and China have issued advisories and alerts for Ebola (CDC guidelines for the US), Japanese authorities are strangely complacent by comparison.

Universities in the UK, have also put out an alert in case of Ebola cases surfacing among students.

 

See …
Will a summer vacationer bring back Ebola to Japan?
KUCHIKOMI AUG. 12, 2014 – Japantoday.com

TOKYO —
As of Aug 2, the number of known fatalities from Ebola hemorrhagic fever—a disease with a mortality rate ranging from 50 to 90%—was 729. That figure has since increased by several hundred.

In the United States, the Atlanta, Georgia-based Centers for Disease Control and Prevention (CDC) announced on Aug 6 that it had raised its alert level to 1, the highest of six levels, and issued an advisory that Americans refrain from travel to Guinea, Liberia and Sierra Leone.

“Ebola HF is contracted through direct contact with the excretions, saliva, blood and other bodily fluids of an infected person,” Dr Kiichi Inoue, director of the Setagaya Inoue Hospital, tells Shukan Jitsuwa (Aug 21-28). “Its incubation period can range from three days to three weeks, and for that reason it’s difficult to grasp where the patient was infected. Also, at the initial stage, many symptoms of Ebola—such as fever, diarrhea, headache and so on—resemble those of influenza, making diagnosis difficult.”

In a July 31 telebriefing, Dr Tom Frieden, director of the CDC, was quoted as saying the reason for issuing the advisory against nonessential travel to Guinea, Liberia and Sierra Leone was “… because the ongoing Ebola outbreak in these countries poses a potential risk to travelers particularly if you are traveling and happen to fall ill or be injured in a car crash and needed to go to a medical facility which might have recognized or unrecognized spread of Ebola.”

“People living in the infected countries are known to eat the meat of monkeys, gorillas and other wild game, and this is believed to be how the infection initially spread to humans,” an unnamed science writer tells the magazine. “The first cases in the current outbreak were traced to an area of jungle proximate to Conakry, the capital of Guinea. It’s likely that infected individuals then traveled from there to neighboring Liberia and Sierra Leone.”

Since then, the media has reported that a man from Liberia flew to Nigeria, where he was diagnosed with Ebola. He has since expired from the disease.

“Fundamentally Ebola is not spread via airborne infection, but that doesn’t necessarily mean that passengers who were on the same plane won’t become infected,” the science writer explains. “In Africa, medical workers have been contracting the disease one after another, and over 100 have reportedly been infected, despite the protective gear they were wearing, with half of them dying. That alone shows how easily it can spread.”

The aforementioned Dr Inoue concurs.

“The possibility of Ebola reaching Japan is not zero,” he remarks gravely, adding, “Once a single case makes its way into the country, it’s feared that it will spread like wildfire.”

With the summer season for overseas travel set to peak just a few days from now, Shukan Jitsuwa concludes, an extra level of vigilance is called for.

Meanwhile, Yukan Fuji (Aug 9) worries that given the disease’s incubation period of up to three weeks, it may not be practical to spot an infected person upon arrival at an airport.

What will happen if a carrier of the virus enters Japan? A staff member at the Ministry of Health, Labor and Welfare tells the newspaper, “Considering that Ebola HF is only transmitted through direct contact with the affected person’s bodily fluids, it’s unlikely that it would spread.” So while it appears there’s no need for excess worry, Japan still cannot let down its guard.” End of excerpt, read more here.

………

How strange that in the JT report above, the Ministry of Health official should have been so complacent and overly confident in his assessment that Ebola was unlikely to spread in Japan. The Ebola virus is highly contagious and spreads through contact with bodily fluids, it should remind us of the very similar way in which the Noro virus spreads in Japan. The latter is a debilitating and wearying disease for children that many of us parents in Japan have had some experience with.

Viruses like these are horrifying for the primary carer, anyone who has to care for an infected family member, especially children. Containing the bodily fluids, urine, vomit and cleaning up, while trying not get infected yourself, is a nightmare. You have to stockpile tonnes of kitchen towel paper, bottles of bleach, detergent, you have to not only clean, but contain and decontaminate everything within the radius of the infected, you scrub and wash every surface, toilet, toilet floor, sink or wash basin. You have to wash separately and decontaminate (or burn) every single piece of clothing, bedding, towel, hanky, and eating utensil, cup and dish…and then do the same with your own (which had been exposed to the patient’s germs). All your gloves and washcloths and brushes need to be disposed of.

When you care for sick children, they will hug or hang onto you, spill their tears, snot and vomit projectiles over you. CDC advises eye-goggles because your eyes can become infected too. So you need to constantly shower and wash your hair, scrub every bit of your exposed skin. The garbage has to be tied securely and disposed of without infecting the garbageworkers. When you clean, you need to put on a double layered mask the whole time. You can prevent yourself from being ill – and it is imperative that you successfully quarantine your patient, and keep yourself free of infection to prevent the infection from spreading to yet another member of the family, and continuing the terrible cycle and if you are the only person your family depends on or who knows how to care for the family. The infected individual needs to be confined or quarantined to a single room, and his or her footprint trail reduced to as little as possible. See the CDC guidelines to see the level of care required for healthcare people.

The kind of care required is thus very onerous for at least a week from the onset of the infection, and at least a week after recovery during which time the patient remains infectious, and at the same time, you have to also run out and get the groceries, medical supplies, so the burden is very great if you have no family or community support. But when a disease like Ebola strikes, it is exactly when you need the most support, that everyone around you will disappear and avoid your house like the plague, pun intended. Who will care for the singles, homeless and destitute or elderly living alone, when they get infected. You can also see that good healthcare requires a certain level of financial resource as well, which is probably the key reason why Ebola is losing the battle in Africa. You also require a well-educated and compliant population (like the Japanese) who will follow all of the quarantine and care instructions to a T. Even after recovery, the patient remains infectious for a time, typically, infectious flu’s and viruses spread in Japan through public nurseries and elementary schools, because parents aren’t conscientious, considerate or knowledgeable enough to keep their kids at home till the danger period has passed.

In Japan, when you bring the infected individual such as a norovirus or other flu-of-season sufferer to the clinic or hospital, most clinics have a separate waiting area, and that helps limit the spread of the disease within medical facilities. But you may notice that even the UNICEF poster fails to suggest precautions to preempt the likelihood of turning the hospital into a hotbed for contracting the virus.

Even for diseases like rotavirus and the more notorious noro virus, it typically takes the second year after a new disease has made its rounds, and lots of public information dissemination and TV programming campaigns before Japanese people learn how to cope with the disease.

The disease can be contained and prevented from spreading, but how many people (even for the compliant Japanese) will actually do all it takes to contain it? Once Ebola gets a toehold into just about any country, it is hard to see how the disease cannot help but spread quickly. Either the health official mentioned above deliberately wished to prevent a public panic or else he was certainly greatly lacking in imagination in saying the Ebola disease was unlikely to spread in Japan…

This will not be Japan’s first brush with the Ebola threat. In 1992, members of Japan’s Aum Shinrikyo cult considered using Ebola as a terror weapon. Their leader, Shoko Asahara, led about forty members to Zaire under the guise of offering medical aid to Ebola victims in a presumed attempt to acquire a virus sample. Because of the virus’s high morbidity, it is a potential agent for biological warfare.

Japan would probably survive an outbreak of Ebola, for with first-world care, Ebola might not even take any lives, see the case of the British victim in Ebola outbreak. But that is no excuse to be complacent. …

See Japan Times’s Prompt treatment can stop Ebola

Further news and other article links on Ebola:

Africa’s Ebola outbreak is officially “spiraling out of control” Mic.com

U.S. and international health authorities admitted Tuesday that the West African Ebola virus epidemic may soon outpace the ability of medical teams to contain it. “It’s spiraling out of control. The situation is bad, and it looks like it’s going to get worse quickly,” Centers for Disease Control and Prevention director Tom Frieden told NBC News. “This is different than every other Ebola situation we’ve ever had. It’s spreading widely, throughout entire countries, through multiple countries, in cities and very fast.”

Ebola in Nigeria: Japan to soon deliver experimental Ebola drug
– Zmapp After, U.S., Japan becomes the next country to offer an experimental Ebola drug for containing the on-going Ebola outbreak in West …

Japanese researchers develop 30-minute Ebola test- Nikkei Asian Review, Sep 1, 2014

TOKYO — Researchers at Japan’s Nagasaki University, in collaboration with Eiken Chemical, have developed a method that can detect the presence of the Ebola virus in just 30 minutes. The new method is simpler than the current one and can be used in places where expensive dedicated testing equipment is unavailable, said professor Jiro Yasuda.

He and his team of researchers hope to tie up with companies to make the method available in countries hit by the virus. Ebola hemorrhagic fever has a high fatality rate and is now seriously affecting West Africa, where more than 1,500 people have died in the current outbreak.

Yasuda’s team developed a substance called a primer that amplifies, or increases, only those genes specific to the Ebola virus. There are five types of the virus, which differ in the base sequences of their genes. The team selected the six sections of these genes with the fewest differences in sequence among the virus types and made primers that combine with them. “The method can probably be used on new types of the Ebola virus,” Yasuda said….

What is Ebola?

Symptoms

The incubation period can range from 2 to 21 days but is generally 5–10 days. Symptoms are varied and often appear suddenly. Initial symptoms include high fever (at least 38.8°C; 101.8°F), severe headache, muscle, joint, or abdominal pain, severe weakness, exhaustion, sore throat, nausea, dizziness, internal and external bleeding. Before an outbreak is suspected, these early symptoms are easily mistaken for malaria, typhoid fever, dysentery, influenza, or various bacterial infections, which are all far more common and reliably less fatal.

Ebola may progress to cause more serious symptoms, such as diarrhea, dark or bloody feces, vomiting blood, red eyes due to distension and hemorrhage of sclerotic arterioles, petechia, maculopapular rash, and purpura. Other, secondary symptoms include hypotension (low blood pressure), hypovolemia, and tachycardia. The interior bleeding is caused by a reaction between the virus and the platelets that produces a chemical that will cut cell-size holes into the capillary walls.

On occasion, internal and external hemorrhage from orifices, such as the nose and mouth, may also occur, as well as from incompletely-healed injuries such as needle-puncture sites. Ebola virus can affect the levels of white blood cells and platelets, disrupting clotting. More than 50% of patients will develop some degree of hemorrhaging.

Diagnosis
Methods of diagnosis of Ebola include testing saliva and urine samples. Ebola is diagnosed with an Enzyme-Linked ImmunoSorbent Assay (ELISA) test. This diagnosis method has produced potentially ambiguous results during non-outbreak situations. Following Reston, and in an effort to evaluate the original test, Dr. Karl Johnson of the CDC tested San Blas Indians from Central America, who have no history of Ebola infection, and observed a 2% positive result. Other researchers later tested sera from Native Americans in Alaska and found a similar percentage of positive results. To combat the false positives, a more complex test based on the ELISA system was developed by Tom Kzaisek at USAMRIID, which was later improved with Immunofluorescent antibody analysis (IFA). It was however not used during the serosurvey following Reston. These tests are not commercially available.

Treatment
There is no standard treatment for Ebola hemorrhagic fever. Treatment is primarily supportive and includes minimizing invasive procedures, balancing electrolytes, and, since patients are frequently dehydrated, replacing lost coagulation factors to help stop bleeding, maintaining oxygen and blood levels, and treating any complicating infections. Convalescent plasma (factors from those that have survived Ebola infection) shows promise as a treatment for the disease. Ribavirin is ineffective. Interferon is also thought to be ineffective. In monkeys, administration of an inhibitor of coagulation (rNAPc2) has shown some benefit, protecting 33% of infected animals from a usually 100% (for monkeys) lethal infection (however, this inoculation does not work on humans). In early 2006, scientists at USAMRIID announced a 75% recovery rate after infecting four rhesus monkeys with ”Ebolavirus” and administering Morpholino antisense drugs. Development of improved Morpholino antisense conjugated with cell penetrating peptides is ongoing.

More on Ebola:

Here’s are some interesting facts about the Ebola virus that make it so deadly.

It can kill within seven days: Unlike other viruses (like HIV) that can remain dormant in a person for years without causing the disease, Ebola violently multiplies until the viral particles are amplified to about 100 million viral particles in a droplet of blood. Further, without resting in a dormant stage the virus kills the host to find a new one. The fatality rate of the disease is 60 percent.

There is no vaccine or treatment available: What makes this virus deadly is the fact that researchers have not been able to find an effective treatment or preventive technique to combat the virus and the spread of the disease. The experimental drug Zmapp has shown promising results but the safety and efficacy of the drug are to be evaluated. So, as of now, neither do we have an effective form of therapy nor do we have a vaccine to prevent the disease.

Attacks every part of the human body: Ebola only needs a host cell that can help it produce multiple copies of itself. What worsens the condition is the fact that the virus does not need a specific type of cell to multiply (unlike other deadly diseases). According to studies, except for skeletal muscles and bones, the virus is known to infect every part of the human body. Connective tissues, the ones that hold your internal organs in place, are primary targets of the virus.

Disrupts your immune system: Viral proteins present on the outer surface of the Ebola virus are what destroy the immune system. VP35, one of those proteins, interferes with the production of some important components of the human immune system, like interferons. Another protein traps the white blood cells inside the circulatory system by limiting their movement. As a response to the virus, whatever molecules the immune cells release are used by the virus to devastate the vascular system and activate blood clot formation. Here are 10 reasons that make the Ebola virus deadly for humans. – The Health Site