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Table of Contents   
LETTER TO THE EDITOR  
Year : 2016  |  Volume : 9  |  Issue : 6  |  Page : 425-426
An indispensable need to offer comprehensive clinical care to the Ebola survivors


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Kancheepuram, Tamil Nadu, India

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Date of Web Publication14-Nov-2016
 

How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. An indispensable need to offer comprehensive clinical care to the Ebola survivors. Ann Trop Med Public Health 2016;9:425-6

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. An indispensable need to offer comprehensive clinical care to the Ebola survivors. Ann Trop Med Public Health [serial online] 2016 [cited 2017 Sep 23];9:425-6. Available from: http://www.atmph.org/text.asp?2016/9/6/425/193960
Dear Sir,

The 2013 outbreak of Ebola virus disease (EVD) in West Africa that has continued for more than 2 years had accounted for more than 28,630 cases and deaths of 11,316 people till the middle of February 2016.[1] It is quite an alarming concern that thousands of people, including hundreds of health professionals, lost their lives to a disease which could have been easily controlled before it reached the magnitude to be termed as a public health emergency of international concern.[1],[2]

However, the estimates about the disease, the associated mortality, and the resulting health consequences represent just one aspect of the Ebola outbreak.[1] The current challenge is that more than 10,000 survivors of EVD are living in the affected nations, and all of them are in the need of both clinical and convalescent care.[3] In fact, a wide range of acute and chronic consequences has been reported among EVD survivors, family members, and even the community.[1] Further, owing to the persistence of the virus even after recovering from the disease, especially in the semen of males, there is always a high potential risk of re-introduction of the virus in the regions from which they have been eliminated.[1],[3]

All these attributes provide a clear background and the necessity to extend a comprehensive package of support services to not only respond to the medical and psychosocial needs, but even to encourage the survivors to ensure safe sexual practices till the semen has tested negative twice.[4] Ideally, the medical services should be merged with the existing primary health care, nevertheless in settings with a weak public health care delivery system, there is an immense need to establish EVD survivor-specific services.[3],[5]

The comprehensive package of services for the EVD survivors comprises the preparation of a plan to ensure desired follow-up (viz., first follow-up within 2 weeks, then monthly for 6 months, then every quarter for 1 year, and as and when needed); counseling services for the do's and don'ts during convalescence and for safe sex education for both males and females; ensuring systematic evaluation of different body organs/system for the common sequelae of the disease, and offering appropriate clinical management, including referral services; extending special care to the vulnerable population groups such as pregnant females; providing mental support to overcome the emotional injuries; monitoring survivors (male – semen, female – vaginal fluids or breast milk) for persistent Ebola virus infection; motivating health professionals to adhere to standardized infection prevention and control guidelines while collecting laboratory samples; encouraging survivors for safe disposal of infectious wastes; and strengthening the dimension of risk communication between the health professionals and the survivors to not only clear their myths, but even enable them to adhere to all the recommended measures.[1],[2],[3],[4],[5]

To conclude, the phase of extending appropriate clinical and convalescent care to the EVD survivors is as important as providing prompt medical care. Thus, the need of the hour is to not neglect any dimension which can further deteriorate the existing public health emergency in future.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
World Health Organization. Ebola Situation Report – 14 February, 2016; 2016. Available from: http://www.apps.who.int/ebola/current-situation/ebola-situation-report-14-february-2016. [Last accessed on 2016 Feb 25].  Back to cited text no. 1
    
2.
World Health Organization. Ebola Virus Disease – Fact Sheet No. 103; 2016. Available from: http://www.who.int/mediacentre/factsheets/fs103/en/. [Last accessed on 2016 Feb 26].  Back to cited text no. 2
    
3.
World Health Organization. Clinical care for survivors of Ebola virus disease. Geneva: WHO Press; 2016. p. 1-22.  Back to cited text no. 3
    
4.
Schieffelin JS, Jacob ST. Raising the standard for clinical care of patients with Ebola virus disease. Lancet Infect Dis 2015;15:1247-8.  Back to cited text no. 4
    
5.
Olu O, Cormican M, Kamara KB, Butt W. Community Care Centre (CCC) as adjunct in the management of Ebola Virus Disease (EVD) cases during outbreaks: Experience from Sierra Leone. Pan Afr Med J 2015;22 Suppl 1:14.  Back to cited text no. 5
    

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Correspondence Address:
Saurabh RamBihariLal Shrivastava
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, 3rd Floor, Ammapettai Village, Thiruporur - Guduvancherry Main Road, Sembakkam Post, Kancheepuram - 603 108, Tamil Nadud
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.193960

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