One of the most significant health-related events which emerged during 2014 was the emergence of the ebola virus disease (EVD) epidemic in several parts of Africa. Given the mobility of the global population in general, including healthcare workers (HCWs), has given rise to concerns of a global epidemic. The purpose of this paper is to examine the event based on a recent article on the topic which will help present the relationship among causal agents, susceptible persons, and environmental factors, as well as the role of the BSN nurse in addressing the outbreak; it will also examine possible health promotion/health protection strategies that could be implemented to mitigate the outbreak.
Article Summary
The article being used to obtain much of the information for this paper comes from “Ebola: Where Did It Come From and Where Might It Go?” by J. Boulton from 2014. Boulton (2014) provides in the introduction to the article a concise overview of the identification and the subsequent spread of EVD across the African continent. The article also describes challenges to containing, treating, and mitigating the epidemic, as well as concerns regarding the potential for EVD to spread to other continents and begin further epidemics. In terms of identifying the source of the epidemic, Boulton (2014) indicates that it is not clear where the virus originally began, though the current epidemic appears to have begun in Guinea, a fact echoed by Lupton (2015), though both authors indicate a dramatic impact in Sierra Leone. Though the origin of the disease may not be understood, the source of the current outbreak seems clearer. Three of the five known species which affect humans reveal the zoonotic element of EVD – that is to say, it is communicable between humans and animals (Boulton, 2014). This reveals the causal agents in the disease dynamic, as well as some environmental factors. Boulton (2014) indicates that the current outbreak is connected to EBOV (that is, from Zaire) and is believed to come from fruit bats and can affect the bats, humans, and several other animals. The disease can be transmitted through the dead tissue of any of these populations. Here, the primary route of transmission emerges: the preparation and consumption of ‘bush meat’ which is undercooked (Boulton, 2014).
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Additionally, EVD is communicable between people, so the disease can be spread via direct contact with the bodily fluids like blood and secretions such as blood, sweat, and semen (Boulton, 2014; Lupton, 2015). EVD can survive outside the body (Boulton, 2014). Therefore, the causal agents appear to be infected animals and individuals; animals can be agents in terms of carrying and communicating the disease both through contact and the consumption of their meat. Contact between people can also facilitate transmission of the virus. This means that the disease can ‘travel’ wherever people can travel.
Susceptible persons include individuals who consume the meat of infected animals (Boulton, 2014). Individuals who regularly work with patients – namely HCWs – infected with EVD are also at risk (Boutlon, 2014; Kilmarx, Clarke, Dietz, Hamel, Husain, McFadden, Park, Sugerman, Bresee, Mermin, McAuley, & Jambai, 2014; Lupton, 2015). There is currently “no licensed vaccine or treatment” for EVD, though mortality can be mitigated, and an experimental drug known as ZMapp – which has been used and shown significant success – is currently still be testing (Boulton, 2014, p. 990).
Boulton (2014) concludes the article with two sections. One section explores the impact of EVD on nurses in the United Kingdom and how they ought to respond to the outbreak. The conclusion explores the current plans to address the outbreak and how both the UK and the rest of the world are responding. The facts that the disease can travel and survive outside of the human body, as well as the desire of many HCWs to provide aid and assistance to affected areas, highlights the significance of this issue to global epidemiology. Furthermore, the fact that the mortality rate for the disease is so high, and no licensed vaccine or treatment currently exist, also make it a significant issue.
Impact on Nursing Practice
The most immediate and obvious impact on nursing is that nurses, being HCWs, belong to the group of highly susceptible persons (Boulton, 2014; Kilmarx et al., 2014; Lupton, 2015). HCWs should definitely consider themselves to be high risk because of the potential of contact with infected patients and their bodily fluids. Therefore, it is critical that nurses make themselves familiar with the symptoms of EVD and notify appropriate authorities. Furthermore, the risks involved in treating and managing EVD should directly affect nurses’ decisions regarding traveling to affected areas to offer assistance (Boulton, 2014; Lupton, 2015).
Possible health promotion/health protection strategies include using personal protective equipment (PPE) by HCWs (Lupton, 2015). This can prevent or reduce the likelihood of contact with bodily fluids. PPE is almost universally used by HCWs traveling to work in affected areas (Lupton, 2015). Another strategy is to teach the native populations affected by the epidemics to properly prepare and cook bush meat, or to avoid it altogether (Boulton, 2014). Both of these strategies have been employed with success in affected areas.
Conclusion
Currently, no licensed vaccine or standard treatment protocol exists for EVD. The virulence of the disease as well as its ability to travel and its ability to survive outside the body mean that it is particularly capable to spread farther and potentially faster than can be conceived. This makes it extremely significant to global epidemiology. Likewise, its impact on nursing and how nurses can facilitate health education and strategies make a critical issue to nursing.
