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.

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

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.

http://dailypost.ng/2014/09/21/ebola-two-nigerian-lecturers-recount-montenegro-airport-officials-quarantined-hour/

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.

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

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.

http://dailypost.ng/2014/09/21/ebola-two-nigerian-lecturers-recount-montenegro-airport-officials-quarantined-hour/

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

Eskalacija epidemije Ebole / Escalation of Ebola outbrake

Kuba / Cuba

Kuba šalje 165 medicinskih radnika (doktora i medicinskih sestara) u zapadnu Afriku da pomognu kontroli ove epidemije. Ovo je do sada najveći kontigent medicinskih radnika poslat od jedne države. Kuba je poznata po tome da ima jak obrazovni sistem za medicinsko osoblje i uvijek su bili u prvim linijama tokom velikih nestreća po svijetu, šaljući svoje doktore gdje god je to bilo potrebno.

Cuba sends 165 medical workers to help combat the Ebola outbreak. This is to date largest contingent of medical professionals sent by one Country. Cuba is known for theirs state of the art medical schools and for their commitment to send and help in all disaster areas around the world.

SAD / USA

Tokom konferencije za štampu Bjele Kuće, američki presjednik Barak Obama je najavio slanje 3000 pripadnika njihovih oružanih snaga u Liberiju na čelu sa general majorom Darryl A. Williams-om. Mandat će se sastojati u stvaranju i održavanju zračnog mosta za dopremanje materijala i osoblja, obezbjeđenju istog te pomaganju okolnom području u borbi protiv ove epidemije, gradnjom poljskih bolnica (planirano je oko 1000 kreveta za početak) opremljenih jedinicama za izolaciju bolesnika.

During press conference in White House, American president Barack Obama has announced sending 3000 members of armed forces in to Liberia to combat the outbreak of Ebola. Commanding officer of this contingent will be Major General Darryl A. Williams and the mandate will be establishing an securing a air bridge to bring medical, logistics and personnel help in affected areas. The plan initially is to build new field hospitals with adequate isolation units for patients and helping the local government with theirs expertise in organizing and logistics.

Trenutno stanje / Current condition

Prema riječima WHO funkcionera, stanje u zapadnoj Africi se otima kontroli zbog nedostatka materijala i stručnog osoblja. Ponovo šalju poruku svim svijetskim vladama da pomognu u borbi protiv ove bolesti. Traže se osoblje i medicinski materijal. Procijene govore o tome da bi do kraja godine broj bolesnika mogao narasti i do 20000.

As announced by WHO officials the conditions in West Africa are spinning out of control because of severe lack of materials and especially of medical personal. They are sending a message to all countries of the world for help to combat this outbreak. The estimates are projecting that disease will infect more than 20000 people till the end of the year.

Ebola

Već više od 7 mjeseci u mnogim afričkim zemljama hara epidemija Ebole, opasne i smrtonosne bolesti izazivajući paniku, nerede i nepovijerenje. Radi se o najsmrtonosnijoj epidemiji ove bolesti u od otkrića iste 1976 godine. Trenutno zahvaćene države su (podaci do 31 Avgusta): Guinea (771 slučaj / 494 smrtna slučaja), Liberija (1698/871), Nigerija (21/7), Senegal (1/0), Siera Leone (1216/476), podaci su od Centra za Prevenciju i Kontrolu Bolesti (američki CDC). Zabilježeni slučajevi izvan Afrike su uglavnom inficirani medicinski radnici koji su pomagali u zaraženim oblastima, 2 slučaja u SAD, 1 u Španiji (koji je na žalost završio fatalno) i jedan u Saudijakoj Arabiji. Postoji i nekoliko lažnih alarma koji su prodrmali evropske medije, vidi link.

Seven months has passed since many African countries have been hit with a severe outbreak of Ebola virus hemorrhagic fever, dangerous and deadly disease, causing wide spread panic, death and mistrust. It is the deadliest outbreak of this disease since it's discovery in 1976. At the moment affected countries are Guinea (771 case / 494 deaths), Liberia (1698/871), Nigeria (21/7), Senegal (1/0), Sierra Leone (1216/476), data are from 31st August 2014 according CDC. The cases reported outside Africa are mostly medical and assistance workers helping the relief of outbreak regions, 2 cases in USA, 1 case in Spain (unfortunately fatal) and one in Saudi Arabia also fatal. There are few false alarms around mentioned in the media, see link. 

Ova mapa je od Jula sadrži nešto starije podatke ali daje dobar uvid u raširenost epidemije
This map is a bit old, from July, but it is suited to show the extent of the outbreak

Što je Ebola / What is Ebola

Ebola je virusna bolest koja izaziva izuzetno jaku hemoralgičnu groznicu (groznicu koja je popraćena gubitkom tečnosti kroz sluznice pa bolesnik izgleda kao da krvari iz svakog otvora na tjelu). Bolest je strahovito smrtonosna od 40% do 90%. Trenutna epidemija u Africi pokazuje smrtnost od oko 60% do 65%.

Ebola is a virus infection which causes a severe hemorrhagic fever (fever accompanied with significant loss of bloody fluids through mucous and body orifices). The infection is deadly with mortality rate from 40% to 90%. Observed mortality of this outbreak is 60% to 65%.

Inkubacija traje prosječno od 8 do 10 dana ali zabilježeni su slučaji i od 2 do 21. Simptomi počinju kao kod većine virusnih oboljenja (poput gripe), povišenom temperaturom, glavoboljom, bolovima u zglobovima i mišićima, proliv i povraćanje. Zatim ubrzo simptomi se pogoršavaju, moguća je pojava osipa ali najvažniji simptom je krvarenje. Bolesnik počinje krvariti kroz tkivo, sluznice, unutarnje organe. Stvaraju se podlivi na koži, ima krvavu stolicu i urin. Bolest u ovoj (krvavoj) fazi je najopasnija, većinom smrtonosna i najlakše se prenosi. Smrt nastaje zbog zatajenja svih važnih organa poput bubrega, jetre, pluća.

Incubation of this disease generally lasts from 8 to 10 days but there are known cases with ranges from 2 to 21 days. Symptoms initially are similar to any viral infection, sore throat, pain in muscles and joints, headache, high temperature, diarrhea, vomiting. Sometimes the patient develops rush and than stars bleeding through all possible openings and surfaces and organs. Hematoma develops under the skin, urine and stools are tainted with blood. The patient dies due to systemic organ failure.

Virus Ebole
Ebola Virus

Bolest izaziva virus, iz takozvane taksonomske grupe Ebolavirus, od kojih većina izaziva neki oblik hemoralgične groznice. Zanimljivo je i to da se radi o RNK virusu odnosno virusu koji koristi RNA kao svoj genetski materijal a ne DNK. (poznati primjeri takvih virusa su i svima poznati virusi gripe, prehlade, SARS, hepatitis C, polio ili boginje).

The infection is caused by a virus from ebolavirus family from which most of them can cause this type of fever. Interesting to note this virus is RNA type of virus and not a DNA based one. Many other notable infectious diseases have a RNA based pathogen like: SARS, influenza, hepatitis C, West Nile fever, common cold, polio and measles.

Virus je porijeklom životinjski i smatra se da potiče sa biljojednih sljepih miševa. Takođe je zarazan i za majmune i neke vrste antilopa. Ljudi se početno zaraze jedući nedovoljno kuhano meso ovih životinja. Zatim se bolest se prenosi sa čovijeka na čovijeka. Kako se to događa objašnjeno je u donjem pasusu.

The virus is of animal origin, prime suspects are fruit bats (but it is not deadly to them just a small malady). The infection is also severe and deadly to many types of apes and monkeys (some scientists think that this illness is partially to blame for endangerment of gorilla spices). Humans eat the infected meat, or come in contact in another way and get infected. Than it spreads from human to human in a pattern I´ll describe later.

Za ovu bolest nema lijeka niti vakcine. Međutim posljednjih mjeseci se ubrzano radi na razvoju vakcine i testovi obećavaju, smatra se da će testiranje eksperimentalne vakcine početi upravo u Septembru. Takođe postoji i eksperimentalni metodi lječenja upotrebom nekih antiviralnih supstanci te antitjela, međutim ovo je tek veoma eksperimentalna metoda lječenja koja još nije počela da se testira u ljudi. Detalji se mogu naći na ovom linku.

For this disease there is no cure and no vaccine. But recently few treatments are in development and in experimental phase, also a experimental vaccine is ready to start human trials as soon as this September. See details in this link.

Za sada jedini način da se olakša bolesnicima od ebole jeste simptomatska medicina, odnosno ublažavanje simptoma postojećim metodama, rehidracija (oralno ili infuzijom), nadomiještanje izgubljenih elektrolita i ublažavane simptoma groznice.

For now the only treatment is symptomatic, reducing the discomfort and consequences of symptoms, reducing dehydration and keeping the electrolyte balance in the body.

Takođe šire, koristi se i strogi karantin za spriječavanje širenja bolesti, ovo obuhvata strogu izolaciju dok medicinski radnici moraju biti u potpunosti zaštićeni hazmat odjelima.

Also for all outbreaks a strict quarantine is kept which consist of full isolation of the patient and people whom he came in contact with and wearing full bio hazmat suit, as seen in the picture.

Kako se bolest prenosi / How it is transmitted

Bolest se prenosi kroz sluznice ili otvorene ranice koje dolaze u dodir sa zaraženim tjelesnim fluidima, otpadom (poput fekalija) ili zaraženim medicinskim instrumentima. Važno je napomenuti da se bolest ne prenosi zrakom ili direktnim dodirom kože na kožu, ali je moguće da se prenese kroz kapljice sline koje nastaju kihanjem i kašnjem ako ove kapljice dođu u kontakt sa sluznicama (zdrava koža bi trebala biti u stanju zaštititi tijelo od prenošenja ove bolesti). Esencijalno ova bolest ima jako sličan metod prenošenja kao recimo SIDA.

The infection is transmitted through bodily fluids such as blood, urine, feces, plasma, semen and similar. Humans contract this disease if those infected fluids come in contact with exposes mucous or through injures on the skin. It can not pass through healthy skin but it is theoretically possible to transmit it if those fluids become aerosol through inhalation. But it was never confirmed and virus would probably be killed during process of aerosolization due to desiccation. Essentially this virus is transmitted in somewhat similar way as AIDS.

Ciklus bolesti sa životinja na ljude
Cycle of the disease from animals to humans

Zašto se onda ova bolest tako lako prenosi po Africi? / Why is than this disease so easily transmitted in affected African countries?

Serija idućih slika govori dosta o tome zašto se to događa:

The series of following photos show why:

Na žalost u većem djelu Afrike ne postoji adekvatna medicinska zaštita, najveći dio stanovništva živi u dubokom siromaštvu. Mnogi bolnički smještaji su uglavnom ovakvi, oronuli ili sklepani na brzinu, bez mogućnosti da se vrši zadovoljavajuća sterilizacija opreme, bez napajanja strujom ili čak i bez čiste vode. U ovakvim uslovima same bolnice su smrtonosna zamka za mnoge požrtvovane medicinske radnike i dosta njih podlježe ovoj bolesti. Ovaj gubitak medicinskog osoblja se dalje odražava na ozbiljnost epidemije, smanjujući broj obučenog osblja koji se mogu zadovoljavajuće boriti protiv ove bolesti.

Unfortunately in most parts of Africa, adequate medical service does not exist, most of the population lives in deep poverty. Many hospitals are mostly like this, makeshift, decrepit facilities without possibility to do adequate medical care or sterilization, without running clean water or electrical power. In this condition hospitals became a death trap for many dedicated and needed medical workers and many of those (real heroes) have succumbed to the disease. This loss of medical personnel has terrible effect to the fight to stop the infection.

Osim toga afrička kultura vrvi od raznih praznovijerja koje običan i neobrazovan Afrikanac i te kako shvata ozbiljnima. Ovo stvara dodatne teškoće zbog stvaranja nepovijerenja među ljudima, bolest se pripisuje nadnaravnim uzrocima i u mnogim slučajevima se čak i sami medicinski radnici optužuju da namjerno šire bolest. Afrika je takođe jako pobožno mjesto i otpraćaj mrtvih je veoma složen obred, zavisno od etničkih i religijskih običaja u svakom slučaju mu se veoma predano prilazi. Kako je preminuli i dalje jak izvor zaraze događa se da se bolest prenese sa preminulog na ukućane zbog čestih dodira, kupanja ili oblačenja tjela. Pokušaj vlasti da limitiraju ili čak spriječe takve obrede samo rezultira produbljavanjem nepovijerenja i kontrola epidemije postaje sve teža.

Also the African culture if full of superstition which is taken seriously by mostly uneducated people living there. This causes even more problems as the outbreak is attributed to supernatural and even to medical personnel them selves whom are accused to spread it intentionally (which is not true). This deepens the mistrust and poses a full new sometimes insurmountable problem. Africa is also a devout land of many religions. The death and subsequent funerals are taken extremely seriously. This poses a big problem because, a deceased from this infection is still highly contagious and due to many rituals the corpse is touched, washed, dressed, making contact with many people who subsequently contract the disease. The attempts of governments to limit the rites or even to ban them were met to increased hostility which caused even more mistrust among the people.

Da ne govorim o tome da su i onako oronuli medicinski smještaji iznad svih mogućih kapaciteta i da mnogi bolesnici i kada se jave u te ustanove bivaju jednostavno odbijeni jer nema više mjesta. Ovaj idući video govori o jednom takvom bolnom primjeru. Ova reportaža New York Times-a prikazuje bolnu istinu ove Afričke tragedije, u njoj se sve vidi, oronulost, nepovjerenje i očaj kome su ovi ljudi izloženi. Gledateljima upozorenje da se radi o veoma emocionalno nabijenom videu.

It is also a sore fact that existing decrepit medical facilities are overwhelmed with this outbreak, all facilities are full many times over limit and personnel worked out to exhaustion. Many patients are turned down to their own devices. The next video, made by New York Times, shows full extent of this crisis. It is heart wrenching reality so viewers are advised for very emotional content.

Koliko je ostatak svijeta u opasnosti? / Is World at large in danger?

Opasnost postoji, u slučaju ovakvih događaja uvijek postoji vjerovatnost da se bolest šire otrgne kontroli. Ali moram napomenuti da mjesta za neki veću brigu u stvari nema. Zbog specifičnog načina prenošenja ova bolest se realno, dosta teško prenosi na mjestima gdje je higijena na visokom nivou a medicinska pomoć adekvatno razvijena. Razvijene zemlje sa zadovoljavajućom infrastrukturom (kanalizacijom, čistom vodom, bolnicama koje si se mogu priuštiti bilo kakav sanitarni standard i sa građanstvom koje ima razvijene sanitarne navike) nisu u direktnoj opasnosti te čak i da dođe do pojave bolesti ona bi bila ograničena tek na nekoliko slučajeva koji bi ubrzo bili izolirani i u karantinu. Široka epidemija kao u Africi bi vijerovatno bila nemoguća.

The danger always exist, there is always some probability that this outbreak could spread without control outside of Africa, through air travel or some other method. But I must stress that there is no any serious threat at this moment. The specific way this illness is transmitted is such that is easily prevented in countries with higher living standards. The authorities of those countries are always alert and existing facilities are more than enough to stop any outbreak if such happens to happen. The wide spread of this illness in technologically advanced countries is highly unlikely. 

S druge strane postoje mnoga mjesta na svijetu gdje sanitarni uslovi nisu mnogo bolji nego u Africi. Takva područja su u realnoj opasnosti od širenja ove zaraze, međutim da bi se to dogodilo zaražena osoba bi morala otputovati tamo, (skoro namjerno) jer su te oblasti obično izvan glavnih tokova prometa i transporta. Stoga širenje ove bolesti u tim područjima je takođe vrlo malo vjerovatno.

On the other hand many places on earth are not prepared in case of outbreak and have similar sanitary conditions like in Africa. In such places the infection would spread easily. But that to happen the infected would need to travel there (almost intentionally). Most of those places are remote and far outside of normal busy travel and commercial routes so Ebola appearing there is highly unlikely.

Na kraju postoji hipotetočka opasnost da ovaj virus mutira u neki agresivniji oblik, na primjer da se počne prenositi zrakom. Međutim ovakva promjena zahtjeva veoma kompleksne mutacije genoma ovog virusa koje bi uticale i na samu funkcionalnost istog. Takva promjena bi rezultirala posve novim virusom koji bi imao veoma drugačije karakteristike i malo zajedničkog sa originalnim. Tako obimna mutacija se može dogoditi ali vjerovatnoća da se to desi je zasnemariva. U biti ne postoji neka realna briga da bi se to moglo desiti iako su sve službe na oprezu.

There is always a remote hypothetical possibility that this virus can mutate in a more aggressive form, to become airborne for example. But that to happen the virus needs to pass through several fundamental mutations which would make it essentially a new spices with new set of abilities and even changing its epidemiology little in common with original strain. This extensive set of mutations could happen but probability of it is so small that nobody except some fear-mongering  conspiracy theorists take it seriously. In all seriousness there is no real fear that this will ever happen.

Teorije zavijere / Conspiracy theories

Internetom kruži gomila različitih teorija zavjere o ovoj bolesti i porijeklu epidmije. Od toga da je virus vještački i proizveden u nekoj tajnoj laboratoriji za proizvodnju biološkog oružja pa do neizbježnih vanzemaljaca. Naravno niti jedna od tih priča nije tačna. Takođe postoji čitav niz dezinformacija o ovoj bolesti, na primjer da se krije tačan broj žrtava, da se proširila svugdje po svijetu pa da se to krije, da je mutirala u oblik koji se prenosi zrakom itd. Sve to su gluposti i ništa od toga nije tačno. Kada se dođe do takvih bombastičnih vijesi, najbolje ih je uzeti sa zrncem soli i potražiti izvor takvih priča, najbolje kroz internet. Obično je izvor neki od mnogih siteova ili blogova koji šire ideje o teorijama zavijere poput toga da ljudi nikada se nisu spustili na Mjesec, da se HAARP koristi za kontrolu vremena, da CIA kontroliše naše mozgove preko radio valova (zato služe kape o aliminijske folije, da uzemlje tu naprednu CIA-inu tehnologiju), da su vanzemlajci među nama, da su X-Files u stvari dokumentarac, da reptili vladaju svjetom itd.

Internet and gossip press are full of conspiracy talks about this infection. From stories that this disease is man made biological weapon up to a wide alien plot to overtake our planet. None of those stories is true or even remotely serious. Also many disinformation's are afloat around, like story that the real amount of deaths is hidden, or that the disease have already spread across the world or that there is an eminent threat that this virus will mutate in to airborne pathogen. Also none of those are true, just a shameless fear-mongering of unscrupulous attention craving individuals or disreputable media. The reader of such stories is advised to seek the source of those news, in many cases he will find a source connected to other similar conspiracy bull**** like humans never visited the Moon or HAARP is used to control weather and our minds, or that reptiles rule the world or X-Files are a documentary disguised as a TV show.

Zakjučak / Conclusion

Ovo je jedna od najvećih tragedija modernog doba, pošast kojoj se na žalost ne nadzire kraj. Mnoge humanitarne organizacije poput Doktora Bez Granica neumorno rade na zaustavljanju i kontroli ove bolesti. Mnogi dobrovoljci iz cijelog svijeta rizikuju svoje živote da bi spriječili ovu bolest i pomogli tamošnjem stanovništvu. Međutim proći će još dosta mjeseci dok se njihov trud ne isplati, moraju se suočiti sa teškim uslovima rada, nepovijerenjem lokalnog stanovništva i sveobuhvatnim nedostatkom obrazovanja većine tamošnjih žitelja.

This one is one of the major disasters in modern era and for which there is no end in sight. Many charity organisations like Doctors Without Borders are tirelessly working to combat and stop this outbrake. Many private people bravely and under personal risk to life go there to help the population in need. But many months will pass until their effort will show any progress because they face a harsh climate, lack of basic equipment and growing mistrust of local people.

Ljudi koji žive izvan Afrike su relativno zaštićeni visokom standardom života ili zabačenošću, međutim nemojmo dozvoliti da nas ta činjenica uljuljka u potpunu sigurnost. Postoji uvijek rizik da nešto pođe po zlu i da se ova bolest povampiri na najgori mogući način i krene u haranje po svijetu. Zato uvijek treba pratiti razvoj situacije na terenu, kroz vijesti ili internet, međutim biti oprezan da se ne zaglavi na kakvo mijesto koje sadrži lažne informacije koje samo šire teorije zavijere i rekla kazala priče. Valjane su samo provijerene informacije koje nedvosmisleno upućuju na transparentni, poštovani i stručni izvor.

People living outside Africa are protected with higher standard of living or with remoteness, but we must not let our guard down. There is always a small risk that this illness could transform in to even more terrible monster. Because of that it is advised to follow this story until it´s (hopefully) positive ending, culminating in to the full defeat of this illness and development of a good working vaccine to prevent it to reappear ever again. Also be wary of all those unscrupulous fear-mongering individuals whom are so happy to serve you lies and untrue news just to promote them selves. Always search a good and reputable source for your news.

Afrika je domovina svih ljudi na svjetu i kao takva morali bi smo se više truditi da pomognemo tamošnjem narodu koji je u neku ruku ostao kod kuće. Ne samo u borbi protiv ove bolesti već i na druge načine. Najvažnije je širiti obrazovanje, graditi škole i učiti nove mlade generacije Afrikanaca o tome kako pomoći svom kontinentu, kroz nauku i kako odbraniti svoj bogati kulturni indentitet i biti ponosan na njega.

Africa is homeland of all the people on Earth and we should take care of it together. We need to help the nations whom stayed at home, from which all of us have departed to conquer the world so long time ago. Not only we need to stop the outbreak but we need to help in all other ways. Most important is to bring education to all and everyone there so the new generation of Africans can rise and change their continent for the better through science and their own unique culture.

Linkovi / Links:

http://www.cdc.gov/vhf/ebola/index.html?s_cid=cdc_homepage_feature_001

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

http://www.who.int/mediacentre/factsheets/fs103/en/

http://www.doctorswithoutborders.org/

http://www.sciencedaily.com/articles/e/ebola.htm

http://www.webmd.com/a-to-z-guides/ebola-fever-virus-infection

http://en.wikipedia.org/wiki/Ebola_virus_disease