Emergence of ebola virus disease and its devastating impact in poor-resourced areas of sub-Saharan Africa

Abstract

Ebola virus disease (EVD) is an unusual infection, and one of the most virulent emerging viral diseases known causing severe morbidity and significant mortality. In recent epidemic outbreak of EVD in West African countries of Guinea, Sierra Leone and Liberia (the 3 nations epi-centre of the epidemic), the disease has affected over 25,000 people resulting in more than 10,000 deaths, (Case Fatality Rate, CFR>40%; i.e. from December, 2013-March, 2015). Following the first outbreak of EVD in Sudan and Democratic Republic of Congo (DRC) in 1976, several epidemics (>20 outbreaks) of the disease have been recorded particularly in poor-resourced areas of the East, Central and West-Africa resulting in significant mortality. CFR of EVD is 25-90 percent. Ebola virus is transmitted to humans by wild animals (mainly non-human primates) and spreads in human population via close contact with blood, body fluids and secretions of infected patients. EVD can also be acquired through direct contact with infected corpses. It is characterized (at initial stage) by non-specific flu-like symptoms including headache, fever, myalgia and malaise following incubation period of 2-21 days. This may terminate into severe systemic manifestations including diffuse internal and external bleeding, shock and death if untreated early. Non recognition of the specific natural host of Ebola virus and rapid progression of infection including slow mounting of acquired immunity against EVD by infected host complicate control measures. The socio-economic cost of EVD epidemic outbreak is colossal. Despite notable advances in healthcare-related technology enhancing the diagnosis, treatment / management and prevention / control of infectious or viral diseases, the response of the stakeholders over the years geared toward controlling the spread of the disease left much to be desired. No clinically certified drugs or vaccines against EVD are yet available. There is the urgent need by stakeholders to device appropriate preventive / control measures including development of effective drugs and vaccines to checkmate the spread of EVD and associated severe morbidity, high mortality and devastating socio-economic impact.

Key Words: Ebola virus disease, severe morbidity, mortality, socio-economic impact, checkmate.