Monday, October 13, 2014

Ebola izvan Afrike / Ebola outside Afrika

Ono čega se WHO najviše bojao se upravo događa. Naime ebola je izašla iz Afrike i krenula u svijet. Na svu sreću svi slučajevi su na vrijeme locirani i stavljeni pod karantin i data im je lječnička pomoć. 

The worst WHO fears have come to pass. Ebola have stepped out of Africa via uncontrolled means. Fortunately all cases were located and isolated and under medical care. All people who came in contact with them have been quarantined.

Potvrđeni slučajevi / Confirmed cases

USA

Do sada su zabilježena dva slučaja Ebole, obadva u Dallasu, Teksas. Prvi slučaj je na žalost završio fatalno i radilo se o putniku iz Zapadne Afrike koji nije pokazivao znake bolesti tokom putovanja već se razbolio nekoliko dana po dolasku u USA. Sve osobe koje su došle u kontakt sa njim su stavljene pod karantin. Na žalost bolesnik je preminuo nekoliko dana poslje. Drugi slučaj je medicinski radnik koji je radio oko ovog bolesnika. Međutim važno je napomenuti da je on preliminarno testiran i taj test je bio pozitivan, kako napominju zvaničnici iz CDC, potrebno je ponoviti testove da bi se sa sigurnošću znalo. Osoba je takođe stavljena u karantin.

Up to now two cases of Ebola have been found in US. First case is a man whom traveled from West Africa to US for family visit. He wasn't sick during the travel but developed the illness after he arrived in US. Unfortunately he died few days later. All people who came in to contact with him have been quarantined. Second case is still unclear. A health worker working on this patient have been tested positive to virus. Still, this is a preliminary result and more testing is needed, in the mean time the person is under quarantine and observation.

Takođe u SAD zabilježeno je i nekoliko lažnih uzbuna. S druge strane SAD je postrožio svoje mjere na graničnim prelazima, pogotovu na aerodromima prema putnicima koji dolaze iz Afrike. Ispitivanja i mjerenje temperature su sada obavezni za te putnike.

http://www.bostonglobe.com/metro/2014/10/12/ebola/z3DybKoXBg0XjPO6m5yVgK/story.html

Also worth to note is that there were few false alarms around US which have been dismissed later. Also the US authorities have stepped up the border control especially on airports targeting mostly travelers from Africa. The temperature measurements and questioning are now part of the routine checking of those passengers.

 http://www.bostonglobe.com/metro/2014/10/12/ebola/z3DybKoXBg0XjPO6m5yVgK/story.html

Španija / Spain

Medicinska sestra, koja je pomagala misionaru koji je obolio u Africi i prebačen u Španiju na liječenje i koji je na žalost preminuo, je takođe postala zaražena, prema njenim riječima svojom pogreškom tokom manipulacije zaraženom opremom. Njeno stanje se prema riječima tamošnjih dužnosnika popravlja. Takođe sve osobe koje su došle u kontakt sa njom su stavljene u karantin i prismotru. Jedina žrtva za sada u vezi sa ovom medicinskom sestrom je njen pas kojeg su vlasti eutanizirale na protest okolnih društava za zaštitu životinja. S druge strane eutanaziranje je možda bilo preuranjeno, vlasti su možda trebale zadržati ovog psa kao vrijedan izvor informacija o tome kako se Ebola ponaša kod drugih životinja pogotovu kućnih ljubimaca (psi i mačke), s obzirom da o tome vrlo malo znamo.
A nurse fell ill in Spain after she contracted the disease during her work caring for a missionary whom contracted Ebola in Africa during his work helping people there. The missionary unfortunately died in Spain after he was transferred from Africa for medical care. The nurse contracted the disease because she made an error during manipulation with infected equipment. All persons who came in contact with here were put under observation and quarantine. As Spanish official announced the nurses health is improving at the moment. Her dog on the other hand was euthanized by authorities under protest from many animal rights organisations (PETA and such). On the other hand this euthanization might be a mistake as we know very little about how this disease is spread among other animals, especially pets. This dog could have brought some knowledge about this.

 http://news.yahoo.com/first-outside-africa-nurse-spain-hospital-contracts-ebola-174043185.html

Potvrđeni slučajevi koji su kontrolirano prebačeni iz Afrike u svoje matične zemlje zbog liječenja / Confirmed cases of Ebola outside Africa whom have been transported in their countries for medical attention under controlled environment. 

Nju Jork Times iznosi podatak da za sada takvih kontroliranih slučajeva ima 13 od kojih je dvoje umrlo, 6 ih je još pod medicinskom brigom a 6 ih se oporavilo. U ovo nisu uračunati gore pomenuti slučajevi.

http://www.nytimes.com/interactive/2014/07/31/world/africa/ebola-virus-outbreak-qa.html?_r=0

New York Times gives this set of data for controlled cases of Ebola: total of 13 cases of transported infected, mostly medical workers from Africa, two of which died, 6 are still in treatment and 6 have recovered. In this numbers above, wild cases were not included.

 http://www.nytimes.com/interactive/2014/07/31/world/africa/ebola-virus-outbreak-qa.html?_r=0

Lažne uzbune i pojačane mjere opreza / False alarms and increased control measures

Posljednjih dana je bilo dosta lažnih uzbuna po ovom pitanju pa ću samo pomenuti nama najbliže i one najveće u svjetu.

Makedonia: Jedna osoba, engleski državljanjin je naglo oboljela u svojoj hotelskoj sobi, prebačen je u bolnicu gdje je preminuo od unutarnjeg krvarenja. Kasniji nalazi su potvrdili da osoba nije bolovala od ebole niti od drugih vrsta hemoralgičnih groznca.

http://www.independent.co.uk/news/uk/home-news/ebola-briton-who-died-in-macedonia-did-not-have-deadly-virus-officials-say-9789075.html

Crna Gora: Dvije osobe, putnici iz Nigerije su zadržane na areodromu Podgorica u trajanju oko 1 sat (zbog ispitivanja ali na žalost sa malo uspijeha jer ispitivači nisu znali Engleski) i kasnije pušteni uz obavezne kontrole svaki dan dok su se nalazili u Crnoj Gori.
Hrvatska i Srbija: U obije države su pojačane mjere kontrole putnika koji dolaze iz zaraženih zona. U Hrvatskoj se trenutno nalazi 18 osoba pod medicinskom prismotrom koje su došle iz Nigerije i Liberije. U Srbiji se nalazi trenutno oko 720 ljudi pod sličnom prismotrom.

http://www.balkaninsight.com/en/article/croatia-monitors-africa-returnees-for-ebola
http://inserbia.info/today/2014/10/no-ebola-in-serbia-health-care-system-ready/

Albanija: Postoje neke vrlo nepotvrđene informacije da su u Albaniji zaustavili emigrante od kojih su neki pokazivali simptome bolesti. Međutim ove informacije su čini se samo izmišljotina. Sve ovo se navodno desilo još negdje u Avgustu.

Last days were full of false alarms in many places, because there are a lot of them i will just cover the closest ones to my country.

Macedonia: An Englishman died in a hospital after he fell ill in his hotel room. The death was caused from massive internal bleeding which made medical personal there suspect the Ebola virus. Fortunately later was confirmed that it was not a case.
Montenegro: Two persons traveling from Nigeria were stopped in Podgorica airport and placed in quarantine zone for one hour for questioning (which proved difficult as none of interrogators knew English). Later the travelers were set free under condition to report every day to the medical authorities during their stay in Montenegro.
Croatia and Serbia: Both countries have tighten their control over borders toward travelers from Africa. In Croatia 18 persons are under medical surveillance and in Serbia more than 720 all of which were travelers from Africa.

 http://www.balkaninsight.com/en/article/croatia-monitors-africa-returnees-for-ebola
http://inserbia.info/today/2014/10/no-ebola-in-serbia-health-care-system-ready/

Albania: A rumor surfaced that Albanian police have stopped 40 immigrants from Africa some of which showed symptoms of Ebola. Those rumors were almost certainly not true. Anyways this alleged event had taken place in August.

Nije za uzgred ponoviti! kako se prenosi Ebola. / Lets go over it again! How Ebola is transmitted.



Ebola se prenosi direktnim kontaktom sa inficiranim tjelesnim tečnostima (krv, mokraća, slina, plazma, mljeko, sperma, izmet, gnjoj) preko sluznica ili kroz otvorene povrede. Bolest ne može proći kroz kožu i mora doći u dodir sa sluznicama (kroz usta ili seksualnim kontaktom) ili ranicama. Takođe prenosi se i preko zaraženih predmeta poput nesteriliziranih medicinskih pomagala, ćebadi, odjeće i sličnog, opet samo kroz sluznice ili otvorene ranice. Postoji sumlja i da se može prenjeti preko aerosola sline kroz kihanje i kašljanje ali takvi slučajevi nikada nisu dokumentirani i najvjerovatnije su malo su vjerovatni.

Ebola is transmitted through direct contact with infected bodily fluids (blood, sperm, plasma, milk, urine, feces, pus, saliva) through mucous and open wounds. The virus can not pas through healthy skin and must came in contact with open wound and mucous (through mouth or during sexual contact). Also it can be transmitted through infected items such unclean medical equipment, blankets or clothing. There is a concern that it can be transmitted through aerosol of infected saliva but it was never observed and it is a very low chance if even possible.

Inkubacija traje do 22 dana ali se može javiti i poslje samo nekoliko dana od zaraze.

Incubation lasts up to 22 days but the onset could happen only few days after infection.

Bolesnik je zarazan tek kada se bolest pojavi simptomima, dok je bolest u inkubaciji bolesnik nije zarazan, barem ne u normalnim uslovima življenja i kontakata. Leš umrle osobe od ove bolesti je jako zarazan i veoma opasan za manipuliranje. Osoba koja je preležala bolest nije zarazna u normalnim uslovima življenja i kontakata, međutim virus se može zadržati u spermi muškarca više mjeseci tako da se preporučuje seksualna apstinencija u trajanju od bar 90 dana uz obavezne kontrole da bi se odredila preostala količina virusa do potpunog nestanka istog.

The patient is contagious only during symptoms phase, during the illness onset and duration. During the incubation patient is not contagious during normal circumstances of life and contacts. The corpse of a person whom died from this illness is highly contagious and very dangerous and should be handled with utmost care and preferably by expert professionals. The person whom survived the illness and does not present any symptoms any more is not contagious under normal circumstances of life. But it was found that the virus can be present in sperm of male survivors for months. It is advised to restrain from sexual contacts for at least 90 days after the infection end, and to control the level of virus via medical exams until person is declared virus free.

Osoba koja je preležala Ebolu je imuna iako se ne zna koliko ta imunost traje. Do sada nisu zabilježeni slučajevi da je preležala osoba bila ponovo zaražena.

Person whom survived the outbreak is immune but it is unknown for how long. Up untill now there were no reported cases of person getting reinfected with the disease.

 Prevencija / Prevention

Održavati ličnu higijenu na visokom nivou, obavezno pranje ruku i cijelog tijela ukoliko se dođe u kontakt sa oboljelom osobom, svaki put kad do toga dođe. Pregledati svoje tijelo dali postoje otvorene ranice ili oštećenja i propisno ih dezinficirati i zaštititi hanzaplastom ili nekim drugim nepropusnim materijalom. Održavati čistoću u kući i na radnom mjestu upotrebom dezinficirajućih sredstava poput tečnosti za pranje prozora, varikinom i slično. Ovo je pogotovu važno ukoliko se došlo u kontakt sa zaraženom osobom i tada je dezinfekcija obavezna. 

Maintaining personal hygiene all the time, washing hands and whole body especially if you come in contact with infected person. Check your body for any open wounds or damage and disinfect those places on skin and cover them with bandaid or some other waterproof aid. Maintain cleanliness in the household and in work place using disinfectant liquids and detergents.   

Ukoliko se radi oko osobe koja je zaražena (pomaganje ili asistencija u lječenju bolesnika), a nema se propisna hazmat oprema, propisno zaštititi usta i disajne puteve maskom, oči nekim zaštitnim plastičnim radnim naočarima, upotrebljavati gumene rukavice i obući dugi vodonepropusni mantil čiji su otvori zatvoreni nekim nepropusnim selotejpom, Odjeću i posteljinu za koju se sumlja da je zaražena treba spaliti, naravno oprezno da se ne bi izazvao požar.

In case you need to take care of unfortunate victim of infection and you don't have appropriate hazmat suit, use any means to protect your mouth and nose (using makeshift mask soaked in disinfectant), protect hands with rubber gloves, protect eyes with protective eye-gear and ware a long raincoat fastened with belt and sealed off with adhesive tape. All clothing and bedding suspected to be infected just burn in controlled manner to avoid uncontrolled fire.

Vakcine i lijek / Vaccines and cure

Trenutno ne postoji lijek protiv ove bolesti, međutim postoji nekoliko modela liječenja koji daju rezultate koji obećavaju i koji obuhvataju neke novo razvijene antiviralne ljekove i simptomatsku medicinu.

At the moment there is no cure for this illness. Some promising treatments exist involving newly developed antiviral drugs and via symptomatic medicine, but all of those are highly experimental.

Vakcina se ubrzano razvija i već su počeli testovi na ljudima u pogođenim djelovima svijeta. Međutim očekuje se masovna primjena iste tek za oko 6 mjeseci kada testiranje na ljudima donese rezultate i ukoliko se pokaže efikasnom.

Vaccine is under fast development and already is been tested in the field in affected areas of the World. In any case the vaccine should be available for mass production in about 6 months if those tests in field come back positive.

Linkovi / Links

http://www.cdc.gov/vhf/ebola/

http://www.who.int/csr/disease/ebola/en/

http://www.theverge.com/2014/10/11/6962039/ebola-vaccine-is-now-being-tested-in-west-africa

http://www.cbsnews.com/news/ebola-vaccine-being-tested-in-rapid-fashion-say-researchers/

http://www.english.rfi.fr/africa/20141011-suspected-french-ebola-case-tests-negative-minister

http://news.yahoo.com/first-outside-africa-nurse-spain-hospital-contracts-ebola-174043185.html
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