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virus diseases, which was refers to as “ hemorrhagic fever”in the past is a serious and deadly viral illness that affectsprimates, especially humans. The virus is spread from one humanto another through contact, but can also be transmitted by wildanimals. Although the illness is a very severe fatal disease, thesymptom starts between two days and three weeks after infection andare mild. As the virus attacks fatal organs in the body (such asliver and kidney), the symptoms become worse. This results into bothinternal and external bleeding. The disease has a very high risk ofdeath since up to 90 percent of those affected by the disease do notsurvive. is a highly infectious disease, making treatment andmanagement a critical aspect of public health. The virus ismainly spread through direct or indirect contact with body fluidsfrom an infected person (Sunit 2014). Thus, medical workers andfamily members taking care of patient are at a high risk ofinfection. This is because the virus can also be transmitted throughitems that have been recently contaminated with the virus but havenot been effectively sterilized. Although there have been concernsthat virus can be spread through air, there are no scientificevidence that has verified this hypothesis. However, the World HealthOrganization maintains that breast milk, semen and other body fluidscontains virus up to several months after the patient hasrecovered for the disease (Feldmann &amp Geisbert 849).

as a global public health problem

can infect anybody who comes into contact with the virus. However,outbreaks have mainly been reported in tropical regions mainly in thesub-Saharan Africa. However, secondary infections have been reportedin other parts of the world. The most important outbreak inhistory is currently going on in West Africa, mostly affectingLiberia, although the epidemic has officially ended. The disease hasbeen a major public concern in West Africa region causing massivedeath, among other social and economic impacts in countries such asSenegal, Mali, Guinea, Liberia, Sierra Leone, and Nigeria. Althoughthe disease has been contained in most parts of the region, it hasnot been contained in Liberia. However, the disease was firstreported in 1976 when outbreaks in the modern day South Sudan and DRCwere reported simultaneously. Since then, several outbreaks have beenreported in the region. The current outbreak is the most serious, andthe first to be reported in West Africa. The World HealthOrganization reports that over twenty eight thousand infections andover eleven thousand death have been reported in the currentoutbreak. However, it has been argued that the figures may not beaccurate and have significantly resulted into understating themagnitude and seriousness of the outbreak. Additionally, there areseveral cases that have been reported outside the West Africanregion, although they were contained before they reached criticallevels. This includes secondary infection of health care workers inthe United States, United Kingdom, Spain and Italy (Chertow et al2054).

Controlof the outbreak is a complicated undertaking that require theinput of all stakeholders in the health care sector, including healthcare workers, political leaders, the community and internationalcommunity. The international community plays a critical role,especially in ensuring that the outbreak does not spread to otherregions or continents. A coordinated effort between the healthdepartments and medical services and community engagement is verycritical. The current outbreak in the West Africa is the mostimportant outbreak and a critical global health issue because ofseveral factors (Gatherer, 2014). While the previous outbreaks werecontained within weeks, the current outbreak has reached epidemiclevels. An important factor that has contributed to the currentoutbreak running out of control is the inability of the nationsaffected to respond effectively to the epidemic. Most importantly,the regions affected by the outbreak have very high levels ofpoverty. This limits the accessibility of health care serviceshindering early detection and control of the spread of the disease.The situation was aggravated by dysfunctional health care systems inthe affected countries. This is due to lack of enough adequatelytrained medical personal as well as adequate medical facilities todeal with the outbreak (Chertow et al 2057).

Itis also important to note that some of the countries affected by theoutbreak have had political instability in the recent past. Themistrust in the political leadership and government officialsnegatively affected the ability of the government to respond to theoutbreak. For example, the impact of the political tensions thatresulted into military coup and military rule in the 1980s are stillevident in Liberia. The effects of the civil wars that resulted intodeaths and displacements of populations resulted into destruction ofsocial and economic systems in Liberia. Although the intervention ofthe international community led to a peace agreement in the early2000s, over 85 percent of people in the country live below thepoverty line, while the government is struggling to provide essentialservices such as medical care. Sierra Leone on the other hand hasstruggled with massive corruption and mismanagement of governmentresources which led to more than a decade of civil war (Kabia, 2009).The social and economic impacts of the conflict had a huge impact onthe ability of the nation to respond to the outbreak. Due to thesefactors, Liberia and Sierra Leone delayed in their respond to theoutbreak resulting into an epidemic. The situation was different inother countries in West Africa, mainly Mali and Nigeria where quickresponse ensured that the outbreak was handled more effectively(Ansumana et al. 587-588).

Inaugust 2014, the epidemic in West Africa was declared a “publichealth emergency of international concern” by the World HealthOrganization. This was due to failed attempt to contain the epidemic.However, the World Health Organization was condemned by somecommentators for delay in responding to the health crisis resultingfrom the epidemic. It has been argued that the World HealthOrganization should have called the attention of the global societythe emergency situation in the region before the epidemic went out ofcontrol. The limited access to health care services, inadequatesupply of medical workers, and shortage of medical suppliers in majorhospitals contributed to the crisis. At some point, some medicalfacilities were overwhelmed by the number of patients, forcing themto shut down (Gatherer 1622). The main challenge in dealing with theoutbreak was the mode in which the disease is transmitted. The highlycontiguous disease put medical workers at the greatest risk ofinfection. The venerability of hospital workers and the inadequatelyequipped facilities made the situation worse. At the type the WorldHealth Organization was declaring the epidemic a global public healthemergency at last ten percent of the people who had died from thedisease were medical workers. As a result, the capacity of the localhealth care systems to deal with the epidemic declined rapidlycalling for international intervention. International interventionswere mainly through nongovernmental organization, mainly “Doctorswithout Borders” which has high presence in underprivilegedcommunities in Africa. However, the organization was the first tocriticize the international community through the World HealthOrganization and United Nations for their slow response in dealingwith the health crisis (Gatherer 1624).

Economicand social impacts of outbreak

Anyepidemic has far reaching social and economic impacts on the affectedcountries and societies. Thus, the recent epidemic has numerouseconomic impacts on the affected nations. Due to the panic associatedwith the highly contagious disease, the epidemic resulted intoa massive decline in economic activities. Attempts to control thespread of the disease through emergency restrictions led to closureof businesses, markets and a decline in business transactions.Additionally, international companies evacuated their workers andreduced their operations in the countries. This led to a decline ineconomic growth and gross domestic product as the epidemicprogressed. The decline in economic activities also decreasedgovernment revenue while the health care spending increased. As aresult, resources that were used in the provision of other essentialservices were diverted to health care departments. This led topostponement or abandonment of major government investment. As aresult, private consumption, government investment and foreign directinvestment declined threatening the economies with collapse (UnitedNations 2015). Other immediate economic impacts of the epidemicinclude depreciation of the local current and unhealthy levels ofinflations. While the domestic economies were slowing down and thelevel of government revenue was falling, government spending was onthe increase. The government was faced with an immense financialobligation of containing the epidemic and dealing with social impactsof the epidemic such as increased number of orphans and poor as wellas food security. Due to the challenges that had faced the affectedcountries about a decade before the onset of the epidemic, they didnot have adequate resources to deal with inverse trend of governmentspending and revenues. This resulted into huge and rapidly expandingfiscal deficit. At the time the international community intervened,the fiscal deficits in Liberia and Sierra Leone had expanded tocrisis levels. Additionally, some of the financial assistance offeredby the international community to finance the gaps was inform ofloans. Other short term and long term impacts of the epidemic includedecrease supply of labor, decreased human capital productivity,increased poverty and economic inequality (United Nations 2015).

Themost important social impact of the epidemic in sub-SaharanAfrican was restriction of cross border movement of people. Due tothe magnitude of the epidemic and the contagious nature of thedisease, major airlines canceled their flights to the affectednations. This negatively affected interaction and communicated withother societies around the world. Additionally, neighboring countriesclosed their borders with the affected nations. This had a hugeimpact on regional and international integration. Due to therestricted movements in the affected or suspected countries, thesocieties in the affected countries lived in isolation. Thisisolation further limited the identification of the problem as aglobal emergency thus delaying international response. Since thebeginning of the 21stcentury, the two countries which were worst affected by the epidemicfaced a wide range of social problems due to extended periods ofpolitical instability. The epidemic shifted the focus of theinternational community resulting into worsening of other socialissues that are not directly related to epidemic (African Union2015). This resulted into increased morbidity and mortality ratesresulting from other medical conditions such as malaria and yellowfever. Additionally, the accessibility to basic health care servicessuch as prenatal care, child health care and basic vaccinationdeclined as the health care systems focused on containing theepidemic. Although the impact on the education system has not beenquantified, there is no doubt that the education sector was adverselyaffected by the epidemic. This is due to the reduction in budgetaryallocations and extended disruption of educational activities. Otherimportant social impacts of the epidemic includesstigmatization of people from the affected countries, increasedlevels of unemployment due to economic slowdown and reducedinvestment, and increased number of orphans and vulnerablecommunities (African Union 2015).

Publichealth principles to counter outbreak

Preventionand management of involves taking immediate action upon theconfirmation of an infection case. Due to the high contagious natureof the disease, even a single confirmed case is considered a seriouspublic health issue. The basic public health principles that can beused to control and prevent an epidemic include infectioncontrol, contact trading and isolation of infected individuals.Contact tracing is critical for the control of an outbreak. Itinvolves tracing all individuals who have had contact with aconfirmed case and screening to determine whether they are infected.This is also important in determining the source of the infection(Vidal 2015). Isolation involves separating the infected and infectedindividuals in the community to prevent new infections. Quarantineswhere individuals exposed to the disease or suspected are separateduntil confirmed to be safe is one of the most effective method ofcontrolling international spread of . Nonetheless, infectioncontrol is the basic public health principle that can effectivelymanage and control outbreak. Infection control involves properhandling of infected individuals and objects, disinfection ofservices and equipments, use of protective equipments and gears,proper handling of dead bodies, and early response to incidences ofinfections (CDC 2016). In my opinion, there were major reasons ofwhat happened during the recent outbreak and mainly is the failure ofpreparedness and emergency responses plans. Since is a highlycontagious disease, it needs to be controlled with variety of aspectssuch as providing quick and strong surveillance, building campaignsto educate the communities, collaborative organizations efforts allover the world especially in coordination with regional centers ofexcellent detections and responses, strengthen a systemiccommunication between them and collecting data to detect casesearlier before it spreads, provide investigations where needed, andat the end immediate isolation of suspected cases will make a bigdifference in such an outbreak.

Significanceto the United States health care system

Duringthe West African epidemic, there were some confirmed cases ofsecondary infection in the United States. Although the health caresystems in the United States have the capacity to deal with outbreak and prevent an epidemic, uncontrolled epidemic on otherparts of the world is a risk to the United States public health. Thisis because has no cure or vaccine. The only option available isstopping the disease by doing the right thing at the right time. TheUnited States health care system has the resources and manpower tomonitor, educate and prevent the spread of the disease (Johnson et al2015). However, the countries affected by the disease do not havethese resources and manpower. Their health care systems aredysfunctional. Due to the inevitable mobility of people in and out ofthe United States, uncontrolled in West Africa is a publichealth risk in the United States and the rest of the world. Thus,addressing this problem would be beneficial to the United States.


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