Infectious Diseases

Updated 08 August 2014

How prepared is South Africa for an Ebola outbreak?

There is no cure and no vaccine for the deadly Ebola virus. As an epidemic grips West Africa, Health24 finds out how well prepared South Africa is for a possible outbreak.

Ebola epidemics are limited, but they create panic every time because Ebola is fatal in up to 90% of cases, according to Doctors Without Borders.

In the last three months, three people have been tested for Ebola in South Africa, the National Institute for Communicable Diseases (NICD) told News24. All tests proved to be negative.

The World Health Organisation (WHO) has alerted health officials and workers across the globe that the Ebola epidemic trend in Sierra Leone, Liberia, and Guinea “remains precarious,” - because transmissions of infections within communities and health facilities are still taking place.

Read: The extent to which Ebola is causing havoc in Africa

How is the world reacting?

In West Africa, Sierra Leone’s president has declared a public health emergency, putting epicentres into quarantine and introducing airport screenings.

Liberia has shut its borders, banned public meetings and closed schools. While the regional air carrier Asky and the Nigerian carrier Arik Air have suspended flights to and from Liberia and Sierra Leone.

In the US, ‘quarantine officers’ have been stationed at 20 airports. The Centre for Disease Control (CDC) has issued a “Level 2” alert for travelers, which urges people travelling in Africa to take extra precautions to avoid coming into contact with infected people.

Read: Could Ebola hit SA?

A CDC spokesman told the New York Post it could raise the alert to Level 3, which would discourage Americans from any non-essential travel to countries in West Africa.

In the UK, the government has held an emergency meeting and is expected to put the Royal Air Force’s Infection Prevention Control Team on standby to collect UK citizens and return them to Britain in quarantine conditions if they are infected with Ebola.

British airports and airlines have been put on high alert - anyone suspected of carrying the virus is to be detained, isolated and diagnosed within 24 hours, health officials have said.

Read: SA woman fleeing Sierra Leone talks to Health24

How well equipped is South Africa?

Professor Lucille Blumberg, a Deputy Director at the NICD, pointed out that unlike the US or the UK, South Africa deals with different viral haemorrhagic fevers (VHF) on a daily basis - regularly testing for Congo Fever or Rift Valley Fever for example..

“We have lots of experience here, with a high index of suspected cases - so lots of screening happens,” she said.

At the moment, the WHO is not recommending the routine screening of passengers arriving in South Africa.

Routine screening is not possible anyway, as testing for all VHF viruses, including Ebola, is only available at the NICD’s laboratory in Johannesburg.

Read: Ebola Frequently Asked Questions

What’s more, Blumberg said testing for Ebola - which contains a series of tests - costs hundreds or thousands of Rand per person, while the virus can often be ruled out by simply interviewing the person and testing for other illnesses.

The “very expensive, high tech” laboratory in Johannesburg is manned by highly skilled individuals, said Blumberg.

“You couldn’t just set it up anywhere, and the last thing you’d want is (untrained) people getting infected or making a mistake,” she added.

Read: The Liberian health system collapses

What is South Africa doing to prepare for the worst?

WHO has advised the government that given the frequency of travel between South Africa and western Africa, there is a risk of Ebola being imported into South Africa. “But overall this risk is thought to be low,” it said.

It has warned South Africa to treat healthcare or international agency workers with “a high index of suspicion”, advising that a detailed history of travel and contact with suspected cases is “extremely important”.

The Department of Health claims that it “has taken the necessary steps to detect and treat cases if they arrive in the country”.

The Department told News24 it has put private and public health care workers, outbreak response teams, hospitals and Port Health services “on the alert” for any ill people who have travelled to risk areas.

Blumberg said South Africa is taking the threat “very seriously”, with NICD working on responses since March when the outbreak was declared. However, she admitted that “Ebola would challenge any country’s health system”.

Read: Hospitalised woman dies of Ebola after being taken to traditional healer

Though the Department said it did not envisage any strain on the country’s resources, Blumberg said that overall, the country’s facilities are “limited”.

Within South Africa’s health system, the Department of Health said that only the central hospitals contain the state of the art infection control equipment and specialists required, including isolation wards and screening facilities.

A spokesman told News24: “Should there be any case of ebola both public and private health facilities are required to transfer such patient to these central hospitals.”

In the Western Cape, for example, suspected VHF cases will be managed and treated in consultation with the Infectious Disease Specialist/VHF consultant at Tygerberg Hospital.

The department has Infectious Disease Specialists at Tygerberg and Groote Schuur Hospitals that are equipped to manage and treat suspected viral haemorrhagic fever cases.

Read more:

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