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What is South Africa’s defence against the Ebola outbreak?

Coagulopathy, bleeding from mucous membranes, seizures, severe headaches. These could quite possibly be the ingredients to any Sam Raimi or Eli Roth film: but it’s actually the real, life threatening symptoms of the deadly Ebola virus that has been spreading through West Africa at an alarming rate.

Last week the number of deaths from the virus stood at 672 people, and the latest casualty was a Liberian doctor who treated Ebola patients in the country – he collapsed in Lagos, Nigeria on his way home to Minnesota in the US.

The outbreak has been called the deadliest Ebola outburst in history, with the first reported deaths taking place in the Democratic Republic of Congo in 1976. Almost 300 people died from that outbreak, but history saw another violent flare-up in 1995, when over 250 people died in – again in the DRC.

The latest round of panic originates from the West African nations of Guinea, Liberia, and Sierra Leone where 814 laboratory confirmed cases have been reported.

With hundreds of flights across the continent that inevitably stop in South Africa, how safe are we and what kind of technology is being used to combat the virus?

Well, it not really that simple but the short answer is that there isn’t a lot that can be done.

Geographic distribution of Ebola virus disease in West Africa as at 16 June 2014

But before panic starts to spread around the nation, South Africa’s National Institute for Communicable Diseases says that the chance of infection in South Africa is really low.

The virus is spread by coming in close contact with an infected person’s bodily fluid – which is the medium for virus transmission. It’s not airborne, but can be carried by infected animals and passed on to humans.

But even if there is a low chance of the virus spreading to South Africa, we luckily do have some measures in place to detect it early.

“As per the recent announcement by the National Institute for Communicable Diseases (NICD), the National Department of Health is monitoring the situation at all ports of entry in South Africa and not just airports. As Airports Company South Africa we are assured that the Port Health officials based at our airports are on high alert and are monitoring current processes in place,” Unathi Batyashe-Fillis, Airports Company South Africa (ACSA) spokesperson told htxt.africa.

At the arrivals terminal at Johannesburg’s OR Tambo airport, passengers have to walk underneath an Infrared Fever Screening System. The system uses passive Infrared Imaging technology that thermographs of anyone wanting to enter the country. If a passenger’s temperature is too high (which might indicate a fever), they will be quarantined. A fever is one of the early-onset symptoms of Ebola.

“Airports Company South Africa’s OR Tambo International Airport has body temperature sensors at its immigration queuing points to detect any changes in body temperature of passengers. This process as indicated is managed by the Department of Health through its Port Health Division.”

In the event that a passenger does trip the alert, there are also processes in place to deal with potentially infected passengers.

“The airport has a quarantine facility in an event passengers are required to be held in isolation prior to being transferred for further treatment,” Batyashe-Fillis explained.

But the problem with that is the Ebola virus doesn’t necessarily present itself until three weeks after being infected. So it is quite possible that an infected passenger could enter South Africa without being detected.

On the risk of importing Ebola virus disease (EVD) cases to South Africa, the NICD stressed again that it’s fairly low for average people, as the people at most risk are healthcare or international agency workers.

“The risk of infection for travellers is generally low since most human infections result from direct contact with the body fluids or secretions of infected patients, particularly in hospitals (nosocomial transmission) and as a result of unsafe procedures, use of contaminated medical devices (including needles and syringes) and unprotected exposure to contaminated body fluids.”

But even with the technology employed at airports and at harbours, which is actually the only way of preventing the disease from entering the country, NICD urges local doctors to be on the lookout for symptoms.

“While the risk of introduction of Ebola virus into South Africa is considered low, we strongly recommend that surveillance for viral haemorrhagic fevers (and at present, particularly EVD), be strengthened.

“This should be done primarily through Port Health services, but it is also extremely important that public and private practitioners are on the alert for any ill persons that have travelled to viral haemorrhagic fever risk areas. There needs to be a high index of suspicion for EVD in health workers from the affected region with unexplained fever.”

[Image – World Health Organisation (map), CC by 2.0/National Institute of Allergy and Infectious Diseases ]

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