EBOLA IN CHIANG MAI
The Thai Government in conjunction with the Thai Public Health Department hosted a meeting last week with Health Professionals, Schools and those working within the tourism industry to discuss the Thai response to the threat of Ebola. The CDC and World Health Organisation have recognised the potential for Ebola Virus to spread and cause more cases globally outside of the current infectious areas of West Africa. The Public Health Department policy on Ebola includes assessment of those entering Thailand through Chiang Mai International Airport with scanning of people who have traveled from West Africa over the past weeks or months. Those showing any signs of Ebola will be quarantined on arrival and monitored in isolation at specialist units set up in Chiang Mai Hospitals. Those at risk of infection, who are currently free from any signs of Ebola, will be monitored over a period of 21 days and taken into isolation if any symptoms arise. They are currently monitoring 12 people, coming from infected areas, through Chiang Mai International Airport. The Public Health Department have set up mobile assessment and decontamination units that will be employed if they get notice of an at risk person with symptoms of Ebola. The Thai Government are asking those working in Schools, Hospitals and with tourists to notify the Public Health Department of any suspected cases.
Ebola Virus Disease
Ebola Virus Disease (EVD) is a severe often fatal illness in humans. It is initially spread from wild animals to the humans and spreads in the human population through human-human transmission. The disease is fatal in up to 90% of those infected. Ebola is passed through direct contact (through broken skin or mucus membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e.g bedding and clothing) contaminated with these fluids.
Incubation (the time interval from infection to onset of symptoms) is 2 to 21 days. Humans are not infectious until they develop symptoms. First symptoms are the sudden onset of fever, fatigue, muscle pain, headache and sore throat. This is followed by vomiting, diarrhea, rash, symptoms of impaired kidney and liver function, and in some cases, both internal and external bleeding (e.g oozing from the gums, blood in the stools)
Prevention and Control
Good outbreak control relies on applying a package of interventions, namely case management and contact tracing, a good laboratory service and safe burials. Community engagement is key to successfully controlling outbreaks. Raising awareness of risk factors for Ebola infection and protective measures that individuals can take is an effective way to reduce human transmission. Reducing the risk of human-human transmission from direct or close contact with people with Ebola symptoms, particularly with their body fluids. Gloves and appropriate personal protective equipment should be worn when taking care of ill patients at home. Regular hand washing is required are visiting patients in hospital, as well as after taking care of patients at home.
Treatment
Supportive care- re-hydration with oral or intravenous fluids- and treatment of specific symptoms improves survival. There is yet no proven treatment available for EVD. However, a range of potential treatments including blood products, immune therapies and drug therapies are currently being evaluated. No licensed vaccines are available yet, but 2 potential vaccines are undergoing human safety testing.
HEALTH UPDATE
MERS IN CHIANG MAI
Middle East Respiratory Syndrome (MERS)
MERS is a viral respiratory illness first reported in Saudi Arabia in 2012. It is caused by a coronavirus called MERS-CoV. Most people who have been confirmed to have MERS-CoV infection developed severe acute respiratory illness. They had fever, cough, and shortness of breath. Abut 30% of people confirmed to have MERS-CoV infection have died.
So far, all the cases have been linked to countries in and near the Arabian Peninsula. This virus has spread from ill people to others through close contact, such as caring for or living with an infected person. However, there is no evidence of sustained spreading in community settings.
CDC continues to closely monitor the MERS situation globally and work with partners to better understand the risks of this virus, including the source, how it spreads, and how infections might be prevented.
Precautions- Travelers from the Arabian Peninsula
If you develop a fever and symptoms of respiratory illness, such as cough or shortness of breath, within 14 days after traveling from countries in or near the Arabian Peninsula, such as Saudi Arabia, UAE, Qatar or Oman, you should call ahead to a healthcare provider and mention your recent travel. While sick, stay home from work or school and delay future travel to reduce the possibility of spreading the illness to others.
CDC routinely advises that people help protect themselves from respiratory illnesses by taking everyday preventive actions:
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Wash your hands often with soap and water for 20 seconds, and help young children do the same. If soap and water are not available, use an alcohol-based hand sanitizer.
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Cover your nose and mouth with a tissue when you cough or sneeze, then throw the tissue in the trash.
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Avoid touching your eyes, nose and mouth with unwashed hands.
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Avoid personal contact, such as kissing, or sharing cups or eating utensils, with sick people.
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Clean and disinfect frequently touched surfaces such as toys and doorknobs.
There is no specific antiviral treatment recommended for MERS-CoV infection. Individuals with MERS can seek medical care to help relieve symptoms. For severe cases, current treatment includes care to support vital organ functions.