GUYANA is moving towards establishing an action plan to deal with the Ebola Virus, and in this regard a wide cross section of stakeholders from various organisations met yesterday to establish the measures to be undertaken in order to put the plan into operation.

Participants were drawn from the Ministry of Health, various hospitals, the Cheddi Jagan International Airport, Civil Defence Commission, Ministry of Foreign Trade and International Co-operation, Guyana Revenue Authority, Veterinary Public Health, Ministry of Agriculture and the Civil Aviation Department, among others.

Minister of Health Dr. Bheri Ramsaran expressed appreciation at the number of agencies which had representatives at the meeting. He noted that they would be helping the Ministry of Health to focus on the public health approach to the disease.

The Minister pointed out that Chief Medical Officer (CMO) Dr. Shamdeo Persaud had been having discussions with smaller groups which were supported by the Pan American Health Organisation/World Health Organisation (PAHO/WHO). The movement to address Ebola, he noted, follows similar moves to address Chikungunya and SARs.

Minister Ramsaran pointed out that even before yesterday’s meeting, work had been ongoing regarding students in Guyana who came from Africa. However, he noted that checks on them have proved them safe.

“I am happy that you have joined us in this multi-stakeholder approach, and I hope that you will create for us a barrier against the disease penetrating (Guyana), and if we do have cases, we will quickly identify and isolate them, and the good work that you will do today, will allow us to triumph quickly,” the Minister stated.

The Health Minister observed that a lot of work has been done in relation to identifying isolation areas. He noted that there is the intellectual capacity and the infrastructure along with the ‘political will’ to address the issue.

Spearheading the meeting, Dr. Persaud gave an overview of the disease which he said was 90% fatal. He said that the issue was to spearhead the plans and programmes which are mainly couched under International Health Regulations, and pointed to the need to identify the symptoms.

Meanwhile, Dr. Mariano Bonet, Epidemiologist, PAHO/WHO, gave the participants a background of the Ebola virus, pointing out that the virus is not new but is approximately 40 years old. He lamented the fact that there is still no vaccine or treatment for it. Noting that the response is weak, he stated that it is growing in West Africa and expanding. With an incubation period of 20 days it is a rapid infection which can kill in about two days. Dr. Bonet pointed out that the United Nations has allocated US$500M to stop the virus in West Africa in nine months.

Dr. William Adu-Krow, Representative of PAHO/WHO in Guyana urged that all should be on the alert. He also insisted that rapid detection is necessary to capture the symptoms of the disease. Dr. Adu-Krow added that risk reduction was just as important through the involvement of Customs, Immigration, Police and Travel Agents. He stressed that the travel agents would be able to link travellers to their susceptibility to the disease through their line of travel. The PAHO/WHO representative underscored that the process which would be put in place would be able to be adapted in other situations.

DRAFT PLAN
The draft plan addresses five areas. The first for co-ordination and control will see the activation of the national health emergency committee which will hold regular meetings. This committee will develop and approve the action plan and work on the constitution of the national rapid response team. It will also establish communication systems and develop targeted communication materials. This material will include an airport advisory in the form of a poster; traveler’s information in pamphlet form; public information; health care provider information.

The committee will also be responsible for the implementation of WHO’s International Health Regulations (IHR) plan including a Situation Room.
The second area of Point Of Entry (POE) will identify all points of entry into Guyana with the possibility of introducing the Ebola Virus Disease (EVD) into the country. The POEs will concentrate on the CJIA and Ogle airports; the Lethem and Moleson Creek crossings and the various sea ports such as Georgetown, New Amsterdam, Bartica, Charity etc. The points of entry will also seek to have personnel ensure that all arrival procedures are in place. This will include aircraft and ship sanitation, general flight declaration including the health sections and the training of flight attendants among other issues.

The POE personnel will also ensure the examination of flight manifests to identify any possible traveller from infected areas and maintain a register of such travellers. They will also meet with persons from the Guyana Civil Aviation Authority and the Airport Authority for establishing control points. Posters for arrival areas at the CJIA and Ogle Airports will also be organised. In addition, they will provide outgoing travellers with information and identify port quarantine facilities at both airports and provide all basic equipment and supplies. POE personnel will also identify and equip ambulances for special transfer of suspected EVD cases.

The third area is clinical preparedness. This will ensure that personnel follow the standard precautions guidelines and implement the infection control plan. They will also meet with hospitals to identify isolation units and train health workers on infection control. Workers will also be trained on clinical management of Ebola.

The fourth area regards laboratory work and will ensure testing to ensure that all differential diagnosis diagnostic testing takes place with feedback transferred to physicians. There will also be moves to identify a reference laboratory and establish protocol whilst establishing guidelines for EVD.

The fifth area deals with epidemiology, public health and prevention. This will strengthen the surveillance for febrile illness accompanied by analysis and reports which includes a case definition. Personnel will also define the target audience and conduct briefings for all health workers.

EBOLA VIRUS DISEASE
Ebola is a severe febrile illness that affects humans and nonhuman primates and is often fatal. EVD outbreaks mainly occur primarily in Central and West Africa.

Ebola is transmitted to the human population through close contact with the blood, secretions, organs or other bodily fluids of infected wild animals such as infected fruit bats, chimpanzees, gorillas, monkeys, etc.

The virus is spread through humans by direct person to person contact through broken skin or mucous membranes (eyes, nose, mouth, etc.) with the blood, secretions, organs or other body fluids of infected persons with Ebola signs and symptoms. This virus can also be spread through indirect contact with environments contaminated with such body fluids.

The initial symptoms are sudden fever, headache, sore throat, muscle pain and intense weakness. These symptoms advance to vomiting, diarrhoea, skin rash and bleeding (internal and external).

The virus attacks the body quickly, and causes the infected individual to be sick in as little as two days but can take up to 21 days for the symptoms to show up.

Protection against the disease can be done by washing hands regularly with soap and water. Hands carry lots of germs that cause diseases. Avoiding direct contact with body fluids (urine, tears, saliva, sweat, semen, vaginal fluid, blood, etc). Using protective clothing such as gloves, etc, when handling urine, stool or attending to wounds. Semen and vaginal fluids also contain virus that can cause Ebola and other diseases.

Avoid sexual intercourse with a sick person or a person recovering from EVD for at least three months. Avoid contact with or handling of wild animals, alive or dead or their raw or undercooked meat. Avoid unprotected handling of contaminated corpses.

If you have fever, seek medical attention – fever is one of the early indications of viral infections.

There is no specific treatment and there is no vaccine currently available for humans. It is just supportive care. Pain relievers and fever medicines are recommended.

(GINA)