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Sherry Ayittey, middle, Dr. Tia Sugri Alfred, Deputy Minster for Health (Left), Mahama Ayariga, Minister of Information and Media Relations togerther with other health officials at the press briefing

Worries over the presence of Ebola in Ghana are increasing, but officials point to vague initial reports to assure the people that there is no cause for alarm.

On April 5, a 12-year-old girl died of ?undetermined causes? at the Komfo Anokye Teaching Hospital (KATH) in Kumasi after having exhibited symptoms similar to the known description of the Ebola virus attack which is spreading rapidly throughout West Africa. The World Health Organisation has described the outbreak as ?unprecedented?.

The victim experienced symptoms of fever and bleeding before her death.

The death of the girl whose identity has been kept secret by health officials sparked widespread fears among Ghanaians who are certain the Ebola virus has crossed into Ghanaian territory from neighbouring Guinea, Sierra Leone, Liberia and Mali.

Health officials have been quick to quell the questions raised regarding the plausibility of a threat within Ghanaian borders.

The Minister of Health, Sherry Ayittey, stepped up to allay public fears last week saying, ??the samples of the blood analyzed are negative for the Ebola virus and also negative of any common viral fever. In this case, we would like to allay the fears of Ghanaians that any Ebola case has been detected in Ghana.?

According to the Health minister, the blood sample of the girl was sent to the Noguchi Memorial Institute of Medical Research for a test for the Ebola virus to be conducted. However, the test results showed negative for the disease.

They hold to the position that the girl?s death was not confirmed to be Ebola by lab results and thus there is no reason for concern, yet the public is almost unconvinced about the appeal for calm by health officials.

A Negative Report

A bat being examined A bat being examined

Up to now, the Ministry of Health (MoH) and Noguchi Memorial Medical Research Center, where the girl?s blood was sent for testing, have not given details on the queer disease that claimed the life of the young girl.  All the health officials keep saying is that the test results for the Ebola virus was negative.

However, according to the World Health Organization (WHO), Ebola virus can only be ruled out if a variety of other diseases are also tested for and one is discovered to be the cause of the symptoms. Some of these diseases that exhibit similar symptoms as the Ebola virus include malaria, typhoid fever, cholera, meningitis, hepatitis and plague, amongst many others, including other varieties of haemorrhagic fever.

This essentially means that if the girl did have Ebola the test could have shown a negative result, and in this case each suspected disease would need to be tested for. The length of this list of diseases with common attributes may be partly to blame for the Ministry of Health?s delay in updating on the determined cause of death of the 12-year-old girl.

Similarly, the WHO fact sheet on Ebola virus states that ?it is not always possible to identify patients with EBV [Ebola virus] early because initial symptoms may be nonspecific.?

Regardless of the possibilities, the unnamed girl who died at the Komfo Anokye Teaching Hospital was handled with the due care and preventative measures necessary should the disease turn out to be Ebola, Head of Public Health Department of the Ghana Health Service, Dr. Joseph Amankwa said.

Such measures included patient isolation and protective clothing for the medical staff to ensure no one came into contact with contaminated bodily fluids, indicating that the need for caution still exists.

An Ebola Virus Victim Being treated An Ebola Virus Victim Being treated

Whilst unable to confirm that the girl?s case was not Ebola, Dr. Amankwa did confirm that the epidemic in Guinea is caused by the Zaire strain, also known as ZEBOV (Zaire Ebola virus).

This strain is known as the ?most deadly? strain because of its high fatality rate, ranging from 53-90% deaths of all individuals infected, as WHO statistics indicate.

Despite the gravity of this disclosure, this allays the fears of a rumoured new strain, a very real concern after the outbreak that hit Uganda in 2008 of a previously un-encountered strain of Ebola virus.

The Initial Response

The World Health Organization (WHO) defines the Ebola virus as a ?severe acute viral illness often characterized by the sudden onset of fever, intense weakness, muscle pain, headache and sore throat; followed by vomiting, diarrhoea, rash, impaired kidney and liver function, and in some cases both internal and external bleeding [?] low white blood cell and platelet counts and elevated liver enzymes.?

It is a type of haemorrhagic fever characterized by acute febrile illness (sudden fever accompanied by malarial symptoms) which often results in severe dehydration and blood loss, and for which there is no known cure.

Prevention is the only possible means of containing the disease, so stopping the infection before it starts is the only way to curb an epidemic.

Ms. Ayittey explained that Ghanaian authorities were working fervently with WHO to address the threat, focusing on preventing human to human or animal to human transmission of the virus by concentrating on surveying potential carriers such as wildlife (specifically, fruit bats, monkeys and pigs) and travellers coming into the country.

She reiterated this over the course of the week, citing orientations which had been held soon after the first outbreaks in Guinea for officials working at all points of entry, including seaports and airports, educating them on how to detect potential carriers of the virus.

However, Ebola virus has an incubation period of 2-21 days in a carrier, meaning that a person may be infected with the disease and spreading it to others via direct contact while they feel none of the symptoms for a period of up to 21 days, making detection impossible in such cases regardless of surveillance measures.

The most pertinent threat, however, is the transmission from animals to humans, particularly through livestock such as pigs as well as bush meat, WHO said. In response to this, Ms. Ayittey reported that 56 quarantine stations are being set up across the country to detect the virus in local wildlife as it crosses borders into Ghana and to contain such cases in order to prevent the virus from transferring to humans.

She did not state whether or not any animals have been detected carrying the infection ? which would be adequate reason to set up a quarantine zone in such places. However, Public Relations Officer of the Ministry of Health Tony Goodman says that the Ministry of Agriculture is screening livestock and wildlife for signs of the disease.

Similarly, WHO Representative Dr. Magda Robalo stressed that trade and travel should not be restricted in any way, not even with Guinea, where the epidemic originated.

The reason is that people might use other means to cross the already proliferated boarders into the country, a situation that might elude boarder authorities and increase the risk of the country.

This advice came a week after the announcement that Senegal closed the border it shares with Guinea on Saturday, March 29 in order to decrease the chance of an outbreak within its own borders.

It follows a month after the visit of Guinea President Alpha Cond? for the express purpose of ?connecting Ghanaian business owners in the agriculture, tourism, energy and mining sectors with Guinea government officials and business executives,? as reported in the media.

For now, there has been no response on how the outbreak has affected trade relations between the countries, or on the likelihood of the disease passing into Ghanaian borders through import of Guinean agriculture or tourists coming from that country.

Prevention

The 2014 West African Ebola virus outbreak has claimed a total of 117 lives in Guinea, Liberia, Sierra Leone and Mali as of Wednesday 9 April, according to the Centres for Disease Control and Prevention. This makes the death rate 62.5% out of the 187 confirmed cases.

Ibrahima Tour?, Country Director of Plan Guinea NGO blames the poor living conditions and lack of sanitation for the advent of the outbreak. He said that people do not wash their hands ?when they do not have enough to drink.?

Accordingly, the World Health Organization gives the following advice in order to prevent the spread of infection: do not eat raw meat, thoroughly cook any meat intended for consumption, and avoid bush meat and pig in general (as they are the most likely to be infected by fruit bats carrying the virus); avoid contact with the bodily fluids of anyone infected, and nurses and other care physicians should wear gloves and protective clothing when treating such patients; bury the dead immediately, especially those known to have died from Ebola, and do not hold or attend funerals where the body is expected to be touched before burial.

There have been reports that the outbreak in Guinea has been exacerbated by the fact that many still attend such funerals, thus exposing themselves to infection via direct contact with infected bodies.

Liberia?s Health Minister, Walter Gwenigale, even suggests that people stop kissing, shaking hands and having sex, as an infected person can still pass on the disease up to seven weeks after recovery according to WHO.

Growing Concern

In the meantime, Dr. Robalo maintains that the ?scare? was a ?good thing? for Ghana, reiterating the need to take speedy preventative measures and sustain constant vigilance, especially at the borders and points of entry.

Regardless, the need for concern is not over; until another cause of death is determined for the girl in Kumasi, the Ebola virus cannot be ruled out, and the status of wildlife infection has still not been determined. In the meantime, the situation in Guinea and its surrounding countries is still grim.

?This is one of the most challenging Ebola outbreaks we have ever faced,? said Keiji Fukuda, assistant director-general of the World Health Organization. ?We fully expect to be engaged in this outbreak the next two to four months before we are comfortable that we are through it.?

By Stephanie F. Miles and Jamila A. Okertchiri

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