Sunday, October 26, 2014

How prepared is India against Ebola

The ministry has designated Ram Manohar Lohia Hospital, Delhi, as the management centre for the disease in Delhi with a separate 10 bedded ward for suspected Ebola patients.
A CRPF personnel returning home after a UN peacekeeping mission in Ebola-hit Liberia on Saturday became the latest to be confined in an isolation ward for the mandatory quarantine period of 21 days or three weeks for being suspected of carrying the killer virus.

The woman peacekeeper, attached to the central law enforcement agency, now joins the several "high risk" Indian Ebola suspects who have already been quarantined for further monitoring, in recent months.

Liberia, the West African country from where the personnel is coming is the hardest hit in the current outbreak, which began in Guinea in December 2013, with number of Ebola cases and fatalities there estimated at 4,693 and 2,704, respectively, as of October 19.

The World Health Organisation (WHO) terms the epidemic "the most severe acute public-health emergency in modern times" with fears of up to 10,000 new victims a week by December, 70 per cent of whom, perhaps, will die.

Though India is yet to report a case, the authorities are leaving no stones unturned in tackling the invisible menace. Officials fighting the disease are relying on thermal scanners, a virus tracking equipment that has helped Nigeria in its fight against the disease before being declared "Ebola free" by WHO. The scanners are already in use in almost all the 15 major airports across the country, with more slated to be installed in the coming days at the behest of the health ministry.

The ministry has designated Ram Manohar Lohia Hospital (RML), Delhi, as the management centre for the disease in the Capital with a separate 10 bedded ward for suspected Ebola patients. The government has also asked Safdarjung Hospital and Lady Hardinge Medical College to keep aside beds for Ebola patients. A helpline for people who want to know more about the disease has also been set up.
"We have set up isolation units and ICUs to examine and treat Ebola patients," said a senior doctor at RML hospital who did not want to be named. "If it is observed that the chances of infection in a person are high, he/she will be quarantined. We have also taken several measures to ensure the protection of healthcare workers, as per the guidelines issued by WHO," the doctor said.

Yet, experts also acknowledge the daunting nature of Ebola virus that can prompt even the most intrepid healthcare workers to flee in panic. The challenge is much higher than tackling any other virus-borne diseases such as swine flu or Crimean Congo Haemorrhagic Fever (CCHF), said Dr Baijayantimala Mishra, Department of Microbiology, All India Institute of Medical Sciences (AIIMS).

"There is a need for countrywide preparedness in dealing with Ebola since an outbreak can occur simultaneously at multiple sites," said Mishra. Perhaps, the biggest challenge then would be logistical.

Ebola is a disease that can stretch resources thin, as its containment is based on forming protective rings around a patient. For instance, once a patient diagnosed with Ebola is isolated in a hospital, healthcare workers have to locate all the people who came into contact with the infected patient and monitor them for 21 days. They then have to spend the next three weeks conducting routine checkups on the patient's contacts. If someone in the contact list develops symptoms, the whole process of tracing the contacts of the newly infected person, begins. Treating an Ebola victim too requires a constantly rotating roster of doctors, nurses, disinfectant teams and janitors, with an average of four highly trained staff members per patient, according to international guidelines.

However, Mishra believes the country is capable of handling the situation. "We have shown our capability in prompt and effective containment of similarly fatal viral diseases such as hemorrhagic fever and CCHF in the past," said Mishra. "The health ministry has also issued several guidelines for effective management of the situation in case the virus enters the country," she said.

A meeting in this regard was held recently by the Union Health Minister, Dr. Harsh Vardhan, with the representatives of the ministries of Defence, External Affairs, Civil Aviation, Home, Shipping, Shipping, and National Disaster Management Authority.

Measures have also been initiated to make in-flight announcements about the virus and collect information from passengers arriving from affected countries, as the disease can be contained to a great extent by responding honestly to the queries sought by the airline and airport staff.

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