Ebola epidemic increases susceptibility to measles

Ebola cycle

Experts from John Hopkins have found the Ebola epidemic has increased susceptibility to measles, with the rate of increase seen to potentially double in the wake of the problems related to the virus that continues to spread in parts of Africa.

The principal problem related to the Ebola virus is the disruption in the health care system, according to the experts.  Much of the public health focus in areas of Africa is on Ebola, so that fewer people are being vaccinated against measles.  This problem may increase the rate of measles as a consequence of resources having been diverted to the greater problem faced by Ebola.  But measles also has the potential to disable and to cause death, so health authorities are particularly concerned about the problem.

Anti-science, anti-government tactics seen at heart of health emergencies

Food defense information from Department of Homeland Security

Are you against vaccinations?  Do you believe the government is hiding facts about disease and related issues or exaggerating claims about it?  Do you deny climate change is in part caused by man's behaviors?  If so, you are among those seen as part of the growth in health emergencies.

It is a world problem, experts say. The growth of skepticism and those who foster beliefs that are contrary to science can hurt many people.

How might health care workers respond in the event of a disease pandemic?

Nurse, a key caregiver in health care emergencies

One of the tragedies of Hurricane Katrina had to do with the lack of responders in the emergency. This same sort of situation could well happen in the possibility of a pandemic of Ebola.  The same problem might occur in the event that Ebola becomes widespread in the United States, which most experts agree is at most a remote possibility.  What has research indicated might occur with health workers and what might be the overall response?

Approximately 1 in 6 public health workers completed a survey put out by the Centers for Disease Control in 2009, maintaining they would not report to work in the event of an emergency.  In that case the question was related to the potential of an H1N1 pandemic flu. Researchers at the time of the report declared that was a problem but also observed it was an improvement over a similar study made in 2005 where 40% of health care workers maintained they wouldn't respond to a pandemic emergency.

This is relevant as the world prepares for what the Centers for Disease Control and the World Health Organization maintain could be a major problem in adequately preparing health care workers and supporting them in responding to any disease emergency  For the individual hospital there may be a wait-and-see stance for some elements of preparation. The new study suggests ways of improving the response of the workforce in general that are essential in the preparation.of health care workers in the United States if there is a significant increase in the numbers identified with Ebola.

Daniel Barnett, MD, MPH, leading author of 2009 study, that took place under the aegis of the Department of Environmental Health Sciences at Bloomberg School of Public Health, underlined how important it is to understand the underlying factors involved in whether or not an employee will respond appropriately to an emergency." He goes on to say, "Overall, 16 percent of the workers surveyed said they would not report regardless of the severity of the outbreak."

1,835 public health workers participated in the online survey in Minnesota, Ohio and West Virginia during the period. What the survey found was those public health workers who were particularly concerned about what might happen in a pandemic threat and were confident they could fulfill their obligations were 31 times more likely to respond in an emergency then those
who perceived a threat was low or who didn't have confidence in their abilities to respond appropriately.

"We found belief in the importance of one's work was strongly associated with a willingness to report to work in an emergency. Our results could help preparedness planners to identify workforce needs and develop strategies for improving worker response," said Ran Balicer, MD, PhD, MPH, who is the senior lecturer in the Epidemiology Department at the Ben-Gurion University of the Negev in Israel, and Joint Editor of the Israeli Ministry of Health Pandemic Preparedness Plan.

According to OSHA the preparation of health care workers for a pandemic is especially difficult given travel restrictions and multiple emergency procedures that might need to be taken during a major catastrophe. It can increase the need for beds in hospitals, staffing, transportation and a host of other problems. The training across geographic locations, cultures, with communication issues makes the job of health care especially complex during emergencies. Add to this the pressures of time, the potential for health problems among those assigned to help others and personal needs, including families; and those who serve during emergencies will be under definite strain, according to experts.

On the other hand, many of the Ebola experts recommend regional centers for the treatment of Ebola patients as opposed to every individual hospital.  That being the case, the response could be different.  But again those involved in the study highlighted that attitude of health care workers is tied to how they perceive the disease, their training to deal with it and whether or not they believe they are well equipped to handle the emergencies that might occur.

The CDC has acknowledged it could have done better in its own initial responses to the Ebola health care personnel in Texas. The agency is underlining the importance of a more adequate and faster response in the future to any incident where a patient is identified with Ebola.  It is training that will help increase the potential for a good response from health care workers in the (remote) event of a major increase in Ebola cases in the United States.  Comprehensive training for those who care for others during a serious crisis can make a difference also in not just how health care workers respond but how the public responds in general, as avoiding a panic is also key to the management of the disease throughout any widespread geographic area.

Ebola experts advise public to travel, not panic, and for world cooperation, W. Africa aid

Market in Lagos, Nigeria, country where Ebola spread being interrupted

"My wife and I were just talking this morning and wondering if we should take our scheduled trip to Disneyland next month.  She is concerned about Ebola."  In wondering this, the account executive at a major company joins many others in expressing concern about airplane travel, as Ebola fears mount.  But what do the experts say?

Fears expressed like this are exacerbated by some of the remarks made by politicians, some considering a run for the Presidency, like Bobby Jindal, who has advised people not to travel into countries affected by Ebola and those in the media who fan the flames of panic.  That's because statements like those of Jindal are being reiterated as fact by some of the bloggers who are passing along the advice as key to community and individual protection from Ebola.

News media around the world present the news about the recent cases of Ebola in the West as if they mirrored those in Africa.  However, experts in global health maintain that the focus should be on building the infrastructure in West Africa to support stopping the chain of transmission at the source.  At the same time experts maintain that all the countries throughout the globe should be connected in a communication and support network, again to build and solidify the appropriate response to a virus that is seen by some to be potentially like a modern plague if not managed appropriately.  They also say that restricting travel to West Africa could cause a panic of people, that might cause more to leave.

"Not only would (banning flights) not be effective, I think it could be detrimental to the overall efforts," is Dr. Eden Wells' response to politicians and some in the media recommending that people not travel within their own country borders or to West Africa.

Dr. Wells is the Associate Director for the Preventive Medicine Residency at the University of Michigan School of Public Health.  He further tells us, "We need to be able to get resources in and out of these countries to break the chain of transmission."

In assessing the potential of panic and concern about people crossing the borders of various countries who may have the virus, Dr. Well concludes, "We might feel good by trying to close down borders, but in fact I think it would be a very false sense of security." He explains internal evaluator support within communities and atracking the disease at its source in each case, to be the most valuable way to prevent the further spread of the virus.  He uses as evidence the successful way that Nigeria has responded to the outbreak that is largely contained there.  The country of Nigeria was able to halt much of the chain of transmsision with what Dr. Wells calls "Good contact tracing."

While the headlines offer dramatic statements about the virus, global health experts have explained consistently how important is to go to the source of the problem in West Africa and help personnel to build and solidify the infrastructure there.  President Obama has responded by getting military personnel into West Africa to help those countries, just as the experts have recommended.

Aaron Buseh is an associate professor in the University of Wisconsin-Milwaukee College of Nursing and an expert on global public health.  He comes from Liberia, where he grew up, and where Ebola has been most rampant.  He is one of those who advocates decision-making that is based on scientific evidence and understanding the culture as important steps in working in West Africa.  He says it is important to build relationships that are based on scientific evidence and cultural understanding and to help the medical community in West Africa.

Countries need to work together in the effort to stop the spread of Ebola, says Buseh, "The fight over containment of the Ebola disease is really a fight against time, and it is no longer on the side of the affected countries and their vulnerable public health systems.  He sees the Ebola outbreak as a global health issue, with the need to strengthen resources where the disease is most rampant.  This is being done as President Obama has sent in 3000 troops into West Africa to help in the fight against Ebola.

Buseh quotes President Obama as he told the U.N. Gneral Assembly, "It's easy to see this as a distant problem---until it is not,"as a reminder that by working hard to stop the disease in West Africa the rest of the world helps to secure its own safety.

And even as these experts encourage people not to panic, nevertheless there are others that ask individuals and nations to be vigilant, those in the healthcare field to be properly trained to deal with Ebola and for those who have been in contact with Ebola patients not to travel using public transportation.  But for others who might want to go to Disneyland, experts maintain the potential for widespread Ebola cases in the United States, and other developed countries, remains low, even as everyone in government and special healthcare agencies need to build cooperation and connections to ensure the safety and security of everyone.