This document provides information about Ebola virus disease (EVD) including its transmission, symptoms, prevention, and the 2014 West Africa outbreak. It details how a Liberian diplomat, Patrick Sawyer, unknowingly spread the disease to Nigeria by traveling there while infected and in denial about his infection. Sawyer came into contact with 59 people in Nigeria and exhibited disruptive behavior at hospitals in both Nigeria and Liberia before succumbing to the disease, highlighting the risks of disregarding medical advice during an outbreak. The document outlines key facts about EVD transmission, symptoms, treatment and prevention measures to raise awareness about the disease.

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EBOLA VIRUS DISEASE (EVD):
BASIC INFORMATION AND AWARENESS ON THE TRANSMISSION, SYMPTON AND PREVENTION.
VICTOR DARLINGTON OMEJE
A SEMINAR PRESENTATION MADE IN THE SANCTUARY OF JESUS PRAYER GROUP OF THE CATHOLIC CHARISMATIC RENEWAL MINISTRY, ST. JOHNBOSCO’S CATHOLIC CHURCH, ASABA, DELTA STATE, IN A PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE CREATION OF AWARENESS ON THE OUTBREAK OF EBOLA VIRUS DISEASE (EVD).
AUGUST, 2014.

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Table of Contents
Chapter One: Pages
1.1 Introduction 3
1.2 Chronology of previous Ebola virus disease outbreaks 4
A. 1976 outbreak 4
B. 1995 to 2013 outbreaks 4
C. 2014 West Africa Ebola virus outbreak 5
1.3 Use of unproven experimental drugs 5
Chapter Two:
2.1 How Ebola virus disease (EVD) entered Nigeria 6
Chapter Three:
3.0 Some key facts to know about Ebola virus disease (EVD) 8
3.1 What is Ebola virus disease (EVD)? 8
3.2 Is EVD a new disease? 8
3.3 How does EVD spread in human communities? 9
3.4 Who is most at risk? 10
3.5 What are typical signs and symptoms of EVD? How can I suspect someone has EVD? 10
3.6 When should someone seek medical care? 11
3.7 What is the treatment of EVD? 11
3.8 What can I do? Can it be prevented? 11
3.9 What are the ways to prevent infection and transmission? 11
3.10 Some Dos and Don’ts to contacting and preventing infection and transmission of EVD.12
3.11 What about health workers? How do they protect themselves from the high risk of caring for sick patients? 13
3.12 Awareness for travelers 13
Questions and discussion with participants 15

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CHAPTER ONE
1.1 INTRODUCTION
Ebola virus disease (EVD) or Ebola hemorrhagic fever (EHF) is a disease of humans and other primates caused by an Ebola virus. EVD is caused by four of five viruses classified in the genus Ebolavirus, family Filoviridae, order Mononegavirales. The four disease-causing viruses are Bundibugyo virus (BDBV), Sudan virus (SUDV), Taï Forest virus (TAFV), and one simply called Ebola virus (EBOV, formerly Zaire Ebola virus)). Ebola virus is the sole member of the Zaire ebolavirus species, and the most dangerous of the known Ebola disease causing viruses, as well as being responsible for the largest number of outbreaks. The fifth virus, Reston virus (RESTV), is found in China and the Philippines, and while it can infect humans, has not killed one to date – instead causing the death of scores of monkeys and pigs. Reston is not thought to be disease-causing in humans. The five Ebola viruses are closely related to the Marburg viruses.
The 5 distinct species of Genus Ebolavirus are:
• Bundibugyo ebolavirus (BDBV)
• Sudan ebolavirus (SUDV)
• Zaire ebolavirus (EBOV)
• Taï Forest ebolavirus (TAFV).
• Reston ebolavirus (RESTV)
BDBV, EBOV, and SUDV have been associated with large EVD outbreaks in Africa, whereas RESTV and TAFV have not. The RESTV species, found in Philippines and the People’s Republic of China, can infect humans, but no illness or death in humans from this species has been reported to date. More studies of RESTV are needed before definitive conclusions can be drawn about the pathogenicity and virulence of this virus in humans.
Bats are considered the most likely natural reservoir of the Ebola virus (EBOV). In a 2002–2003 survey of 1,030 animals including 679 bats from Gabon and the Republic of the Congo, 13 fruit bats were found to contain EBOV RNA fragments. As of 2005, three types of fruit bats (Hypsignathus monstrosus, Epomops franqueti, and Myonycteris torquata) have been identified as being possible natural hosts for Ebola virus. They are now suspected to represent the EBOV reservoir hosts. Although non-human primates have been a source of infection for humans, they are not thought to be the reservoir but rather an accidental host like human beings. Bats drop partially eaten fruits, then land mammals such as gorillas, monkeys, and even humans feed on these fallen fruits. This chain of events forms a possible indirect means of transmission from the natural host to animal populations.
The average time between contracting the infection and the start of symptoms is 8 to 10 days, but it can vary between 2 and 21 days. Early symptoms of EVD may be similar to those of malaria, dengue fever, or other tropical fevers, before the disease progresses to the bleeding phase. In the bleeding phase, which typically starts 5 to 7 days after first symptoms internal and subcutaneous bleeding may present itself through reddening of the eyes and bloody vomit. Types of bleeding

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known to occur with Ebola virus disease include vomiting blood, coughing it up or blood in the stool. If the infected person does not recover, death due to multiple organ dysfunction syndrome occurs within 7 to 16 days (usually between days 8 and 9) after first symptoms.
1.2 CHRONOLOGY OF PREVIOUS EBOLA VIRUS DISEASE OUTBREAKS
A. 1976 outbreak
The first identified case of Ebola was on 26th August, 1976, in Yambuku, a small rural village in Mongala District in northern Democratic Republic of the Congo (DRC, then known as Zaire). The first victim, and the index case for the disease, was village school headmaster Mabalo Lokela, who had toured an area near the Central African Republic border along the Ebola river between 12th – 22nd August, 1976. On 8th September, 1976, he died of what would become known as the Ebola virus. Subsequently a number of other cases were reported, almost all centered on the Yambuku mission hospital or having close contact with another case. The virus responsible for the initial outbreak, first thought to be Marburg virus was later identified as a new type of virus related to Marburg, and named after the nearby Ebola River. With 318 reported cases, it resulted in an 88% death rate (280 people). Another Ebola virus, the Sudan virus species, was also identified that same year when an outbreak occurred in Sudan, affecting 284 people and killing 151.
B. 1995 to 2013 outbreaks
The second major outbreak occurred in 1995 in the Democratic Republic of Congo, affecting 315 and killing 254. The next major outbreak occurred in Uganda in 2000, affecting 425 and killing 224; in this case the Sudan virus was found to be the Ebola virus species responsible for the outbreak. In 2003 there was an outbreak in the Republic of Congo that affected 143 and killed 128, a death rate of 90%, the largest to date.
In August 2007, 103 people were infected by a suspected hemorrhagic fever outbreak in the village of Kampungu, Democratic Republic of Congo. The outbreak started after the funerals of two village chiefs, and 217 people in four villages fell ill. The 2007 outbreak eventually affected 264 individuals and resulted in the deaths of 187.
On 30th November 2007, the Uganda Ministry of Health confirmed an outbreak of Ebola in the Bundibugyo District in Western Uganda. After confirmation of samples tested by the United States National Reference Laboratories and the Centers for Disease Control, the World Health Organization confirmed the presence of a new species of Ebola virus, which was tentatively named Bundibugyo. The WHO reported 149 cases of this new strain and 37 of those led to deaths.
The WHO confirmed two small outbreaks in Uganda in 2012. The first outbreak affected 7 people and resulted in the death of 4 and the second affected 24, resulting in the death of 17. The Sudan variant was responsible for both outbreaks.

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On 17 August 2012, the Ministry of Health of the Democratic Republic of the Congo reported an outbreak of the Ebola-Bundibugyo variant in the eastern region. Other than its discovery in 2007, this was the only time that this variant has been identified as the Ebola virus responsible for an outbreak. The WHO revealed that the virus had sickened 57 people and claimed 29 lives. The probable cause of the outbreak was tainted bush meat hunted by local villagers around the towns of Isiro and Viadana.
C. 2014 West Africa Ebola virus outbreak:
In March 2014, the World Health Organization (WHO) reported a major Ebola outbreak in Guinea, a western African nation; it is the largest ever documented, and the first recorded in the region. Researchers traced the outbreak to a two-year old child who died on 6 December, 2013. As of 10th April, 2014, WHO reported 157 suspected and confirmed cases in Guinea, 22 suspected cases in Liberia, and 8 suspected cases in Sierra Leone. By 31 July 2014, they reported that the death toll had reached 826 people from 1440 cases. On 8 August, the WHO declared the epidemic to be an international public health emergency. Urging the world to offer aid to the affected regions, the Director-General said, "Countries affected to date simply do not have the capacity to manage an outbreak of this size and complexity on their own. I urge the international community to provide this support on the most urgent basis possible."
Emory University Hospital was the first US hospital to care for people exposed to Ebola. In July 2014, two American medical providers were exposed while treating infected patients in Liberia. In August, arrangements were made for them to be transported to Emory via specialty aircraft. Emory Hospital has a specially built isolation unit set up in collaboration with the Centers for Disease Control and Prevention (CDC) to treat people exposed to certain serious infectious diseases.
1.3 USE OF UNPROVEN EXPERIMENTAL DRUGS
Efforts are ongoing to develop a vaccine; however, none yet exists. On 31 July 2014, an experimental drug, ZMapp, was first tested on humans. It was administered to two Americans (Dr. Kent Brantly’s and Nancy Writebol) who had been infected with Ebola. Both people appeared to have had positive results. Their conditions have significantly improved after receiving a medication of the experimental drug, ZMapp at the Emory University Hospital in Atlanta. Soon thereafter, ZMapp was administered to a third Ebola patient, a 75 year old Spanish priest, who nonetheless died. This made Zmapp not to be completely approved vaccine.
The Minister of Health, Prof. Onyebuchi Chukwu, said that the Anti-Ebola drug Nano-Silver produced by a Nigerian scientist in the diaspora which was made available to the Emergency Operations Centre in Lagos on August 14, 2014, did not meet basic research requirements of the National Health Research Ethics Code. Nano-Silver is being considered a pesticide by the U.S. Environmental Protection Agency. Danish researchers claim it can penetrate and damage cells.

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CHAPTER TWO
2.1 HOW EBOLA VIRUS DISEASE (EVD) ENTERED NIGERIA
A Liberian Diplomat, Patrick Sawyer, is the man credited with ‘importing’ Ebola Virus Disease (EVD) to Nigeria. He knew that he was sick with the virus before entry to Nigeria. He was also advised by the Liberian Health Ministry not to travel out of the country but he ignored the instruction, flew to Nigeria and died here transmitting the virus to Nigerian medical personnel who offered medical services to him.
AllAfrica.com (http://allafrica.com/stories/201407310920.html) gives a very detailed tale of how the Liberian American Patrick Sawyer acted before and after he was diagnosed with Ebola. The website narrated the story as follows:
Barely 24 hours before his death, Patrick Sawyer had a rather strange – and in the words of medical and diplomatic sources, “Indiscipline” encounter with nurses and health workers at First Consultants Hospital in Obalende, one of the most crowded parts of Lagos, a population of some 21 million inhabitants, Front Page Africa has learned.
Looking to get to the bottom of Sawyer’s strange ailment on the Asky Airline flight, which Sawyer transferred in, hospital officials say, he was tested for both malaria and HIV AIDS. However, when both tests came back negative, he was then asked whether he had made contact with any person with the Ebola Virus, to which Sawyer denied. Sawyer’s sister, Princess had died of the deadly virus on Monday, July 7, 2014 at the Catholic Hospital in Monrovia, Liberia.
Back in Lagos, authorities at the First Consultants Hospital in Obalende decided that despite Sawyer’s denial, they would test him for Ebola, due to the fact that he had just arrived from Liberia, where there has been an outbreak of the disease with more than 100 deaths. The hospital issued a statement stating that Sawyer was quarantined immediately after he was discovered to have been infected with the deadly virus. In addition, a barrier nursing was implemented around him and the Lagos State Ministry of Health was immediately notified. Hospital authorities also requested the Federal Ministry of Health for additional laboratory test based on its suspicion of Ebola.
FrontPageAfrica learned that upon being told he had Ebola, Mr. Sawyer went into a rage, denying and objecting to the opinion of the medical experts. He was so adamant and difficult that he took the tubes from his body and took off his pants and urinated on the health workers, forcing them to flee.
The hospital reported that it resisted immense pressure to let out Sawyer from its hospital against the insistence from some higher-ups and conference organizers that he had a key role to play at the ECOWAS convention in Calabar, the Cross River State capital. In fact, FrontPageAfrica was informed that officials in Monrovia were in negotiations with ECOWAS to have Sawyer flown back to Liberia.

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LUTH Positive Laboratory Test on Ebola
First Consultants said that it then went further to reach senior officials in the Office of the Secretary of Health of the USA who assisted it with contacts at the Centre for Disease Control and W.H.O Regional Laboratory Centre in Senegal. According to the hospital, the initial results from LUTH laboratory showed a signal of possible Ebola virus, but required confirmation.
The First Consultants statement noted that it was able to obtain confirmation of Ebola virus disease, (Zaire strain) after working with the state, federal and international agencies. Sawyer was pronounced dead at 6:50 AM Nigeria time, on July 25 and all agencies were properly notified. On Friday, July 25, 2014, 18 days later, Sawyer died in Lagos.
Once the case was officially confirmed, the hospital was temporarily shut down and in-house patients immediately evacuated. Sawyer’s body was subsequently cremated under W.H.O guidelines and witnessed by all appropriate agencies, according to the hospital statement. “In keeping with W.H.O guidelines, the hospital is shut down briefly as full decontamination exercise is currently in progress. The re-opening of the hospital will also be in accordance with its guidelines”, the hospital said. The patient has been cremated and the ash will be transferred to the Liberian government whenever the need arises.
In total, Sawyer reportedly came in direct contact with 59 persons, 44 of whom were at the hospital he was taken to when he fell ill, according to the Lagos State government. However, it has been reported that Sawyer came in contact with three ECOWAS officials – a driver, a liaison officer and a protocol officer. Also in the list are two nursing staff and five airport handlers.
In the aftermath of Sawyer’s death, diplomatic, ECOWAS and medical authorities here are baffled over Sawyer’s deception, especially armed with new information that his sister, Princess had died of the deadly virus and his denial. Federal and state authorities have instituted measures to curb the spread of the disease and quarantining all those who came in contact with Sawyer.
FrontPageAfrica has learnt that Sawyer exhibited similar indiscipline behavior during his sister’s stay at the Catholic Hospital in Monrovia where she was taken because he noticed she was bleeding profusely and was later found to be a victim of Ebola. Sawyer was seen with blood on his clothing after his sister’s death and had earlier demanded that she be placed in a private room. President Ellen Johnson-Sirleaf cited indiscipline and disrespect as a key reason why Sawyer contracted the Ebola virus. She said his failure to heed medical advice put the lives of other residents across the nation’s border at risk.
For Sawyer, questions are lingering over his behavior, both at the Catholic Hospital in Monrovia and the First Consultants in Lagos and what led him to behave the way he did. More importantly diplomatic observers here are puzzled over his demise, the timing and behavior. A few persons who spoke to Sawyer, including FrontPageAfrica reported that he sounded fine hours before his death. It is unclear what pushed him to the wall and why?

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CHAPTER THREE
3.0 SOME KEY FACTS TO KNOW ABOUT EBOLA VIRUS DISEASE (EVD)
3.1 What is Ebola virus disease (EVD)?
Ebola virus disease is a severe viral disease that can lead to death in over half of people who get infected with the virus. The good news is that it can be prevented by some simple techniques and, even those who are infected may survive if they can get good hospital treatment as soon as possible. The origin of the virus is unknown but fruit bats (Pteropodidae) are considered the likely host of the Ebola virus, based on available evidence. Ebola is what scientists call haemorrhagic fever. Haemorrhage is a medical condition in which there is severe loss of blood from inside a person’s body. Ebola operates by making its victims bleed from almost anywhere in their body. Usually, victims bleed to death from Ebola. About 90% of people that catch EVD will die from it. It's one of the deadliest diseases in the world, killing in a few weeks. The sad part is that Ebola has no known treatment or cure but people can be taken care of and might recover if they report to the authorities EARLY! Victims are usually treated for symptoms with the faint hope that they recover.
3.2 Is EVD a new disease?
No, Ebola virus disease (EVD) is not a new disease. It has been around since 1976, when it first appeared in two simultaneous outbreaks, – one in a village near the Ebola River in the Democratic Republic of Congo (after which the disease was named), and the other in a remote area of Sudan. From 1976 (when it was first identified) through 2013, fewer than 1,000 people per year have been infected. The largest outbreak to date is the ongoing 2014 West Africa Ebola outbreak, which is affecting Guinea, Sierra Leone, Liberia, and Nigeria. As at 13th August, 2,127 cases have been identified, with 1,145 deaths. EVD affects both human beings and primates like monkeys, gorilla, chimpanzee, but no one knows exactly where the virus comes from as at this presentation. Fruit bats (a delicacy in some parts of West Africa) are considered the most likely hosts (that is, they can carry it without being affected). Ebola virus is transmitted from infected animals to people who come into close contact with the blood, secretions, organs or other bodily fluids of those animals. Here in Africa (Nigeria), such infected animals include chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines which are found ill or dead or in forests (in other words, usually considered as "bush meat"). It is important to reduce contact with high-risk animals (such as fruit bats or apes) this includes picking up dead animals found lying in the forest (anything could have killed them) or handling their raw meat.
EVD is highly contagious; being transmitted via contact with body fluids such as blood, saliva, semen or body discharges. Airborne transmission has not been documented during previous EVD outbreaks. Spread through the air has not been recorded in the natural environment. Ebola virus disease (EVD) is NOT AIRBORNE!

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3.3 How does EVD spread in human communities?
The potential for widespread EVD infections is considered low as the disease is only spread by direct contact with the secretions from someone who is showing signs of infection. The quick onset of symptoms makes it easier to identify sick individuals and limits a person's ability to spread the disease by traveling.
Once a human being comes into contact with an animal that has Ebola virus, it can spread within the community from person to person. Infection occurs from direct contact (through injured skin or mucous membranes like the mouth, anus and vagina) with either
 blood, or other bodily fluids or secretions ( such as stool, urine, saliva, semen) of infected people.
 environments that have been contaminated with the infectious fluids of someone with Ebola virus, such as soiled clothing, bed linen, or used needles.
People can transmit Ebola as long as their blood and secretions contain the virus. Anyone who is infected should therefore be closely monitored by medical professionals and tested to ensure the virus is no longer in their systems before they can return home. When a patient is discharged to return home, they are no longer infectious and cannot infect anyone else.
Men who have recovered from the illness can still spread the virus to their partner through their semen for up to 7 weeks after recovery. Men treated for Ebola should therefore avoid having sex (or wear condoms if they do) for at least 7 weeks after recovery.
Health workers have frequently been exposed to the virus when caring for Ebola patients. A clear example is the case of medical practitioners that attended to the late Liberian Ebola victim (Mr. Patrick Sawyer) and from that contact the spread has been moving in Nigeria. The infection of our medical practitioners happens when they don't wear personal protection equipment, such as gloves, and other coverings, when caring for the patients. All health care providers everywhere should know about the nature of the disease and how it is transmitted, and strictly follow the recommended infection control precautions, especially frequent hand washing using disinfectants.
Mourners in burial ceremonies who come into direct contact with the body of the deceased person can also easily be infected by Ebola and transmit it to others. Persons who have died of EVD (or any unknown causes) must be carefully handled, using strong protective clothing and gloves, and buried immediately. We should be very careful with various cultural practices found in our localities during burials such as washing of dead body, dressing of dead body, touching of dead body especially while crying and even lying-in-state. Kindly note that, i am not discouraging the attendance needed to be given to our dead relatives, friends, colleagues, etc but what i am advocating is that we should be very careful while handling persons who have died of

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EVD (or any unknown causes). Most of the spread in this recent outbreak has been through human-to-human transmission.
3.4 Who is most at risk?
During an outbreak, those at higher risk of infection are: health workers, family members or others in close contact with infected people, mourners who have direct contact with the bodies of the deceased as part of burial ceremonies, and hunters in the rain forest who come into contact with dead animals found lying in the forest. More research is needed to understand if some groups, such as those with compromised immune systems (like people with HIV) or with other underlying health conditions, are more likely than others to contract the virus. Exposure to the virus can be controlled through the use of protective measures in clinics and hospitals, at community gatherings, or at home.
3.5 What are typical signs and symptoms of EVD? How can I suspect someone has EVD?
 Sudden fever (increased body temperature).
 Intense weakness and muscle pain.
 Severe Headache.
 Sore throat.
 This is followed by vomiting and diarrhoea, skin rash, impaired kidney and liver function, and in some cases, both internal and external bleeding.
Laboratory tests might find that the person has low white blood cell and platelet counts, and elevated liver enzymes. Ebola virus disease (EVD) infections can only be confirmed through laboratory testing and not mere suspicion.
Note: You can't get Ebola from someone during the incubation period. You can only get it when they start to show symptoms. That is when they are contagious. The time between being infected to when symptoms start (i.e. the incubation period), is from 2 to 21 days. The symptoms generally take 2 - 21 days to become apparent. The symptoms are generally deceptive – tending to look a lot like malaria or flu, so be very careful.
Some of the symptoms are:
 Fever
 Diarrhoea
 Weakness
 Stomach Pain
 Headache
 Vomiting
 Joint & Muscle Ache
 Lack of Appetite

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Once more, people aren't contagious until they display symptoms.
3.6 When should someone seek medical care?
If a person has been in an area known to have Ebola virus disease or in contact with a person known or suspected to have EVD and they begin to have the above symptoms, they should seek medical care immediately. You should report any case of persons you suspect to have EVD to nearest health unit without delay. It's for their own good as well as yours and the entire community – prompt medical care is essential to whether they will survive, and to reducing its spread to other people.
3.7 What is the treatment of EVD?
So far, there is no specific treatment, but people who are severely ill with Ebola can be helped by intensive supportive care - this means care to support their bodies in fighting the infection. This includes intravenous fluids ("drip") or oral rehydration with solutions that contain electrolytes ("ORT") to prevent dehydration which is common. If started early enough, supportive treatment in a good hospital can make a big difference. To help control the spread of the virus, anyone suspected or confirmed to have EVD should be isolated from other patients and treated by health workers using strict infection control precautions.
3.8 What can I do? Can it be prevented?
There isn't yet any licensed vaccine for Ebola virus disease. Several are being tested, but none is available right now.
The good news is that you can help reduce illness and deaths by raising awareness of both risk factors and protective measures.
3.9 What are the ways to prevent infection and transmission?
In the absence of effective treatment and a human vaccine, raising awareness of the risk factors for Ebola infection and the protective measures individuals can take is the only way to reduce human infection and death. You should understand the nature of the disease, how it is transmitted, and how to prevent it from spreading further. These answers are intended to help you with that:
 Listen to and follow instructions from the Ministry of Health, WHO, NGO and other health organizations.
 If you suspect someone close to you or in your community of having Ebola virus disease (EVD), encourage and support them in seeking appropriate medical treatment in a healthcare facility.
 If you choose to care for an ill person in your home, notify public health officials of your intentions so they can train you and provide appropriate gloves and personal protective

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equipment (PPE), as well as instructions as a reminder on how to properly care for the patient, protect yourself and your family, and properly dispose of the PPE after use.
 When visiting patients in the hospital or caring for someone at home, wash your hand with soap and water after touching a patient, coming in contact with their bodily fluids, or touching the surroundings.
 Don’t handle anyone who has Ebola without appropriate protective equipment. Be sure to bury them immediately they are dead. Additionally, minimize contact with high-risk animals (i.e. fruit bats, monkeys, or apes). If you suspect an animal is infected, do not even touch it. Cook animal products (blood and meat) thoroughly before eating.
 Pig farms in Africa can play a role in the amplification of infection because of the presence of fruit bats on these farms. Appropriate bio-security measures should be in place to limit transmission. For Reston virus (RESTV), educational public health messages should focus on reducing the risk of pig-to-human transmission as a result of unsafe animal husbandry and slaughtering practices, and unsafe consumption of fresh blood, raw milk or animal tissue. Gloves and other appropriate protective clothing should be worn when handling sick animals or their tissues and when slaughtering animals. In regions where RESTV has been reported in pigs, all animal products (blood, meat and milk) should be thoroughly cooked before eating.
3.10 Some Dos and Don’ts to contacting and preventing infection and transmission of EVD.
There are a few things to do to protect yourself and your family from contacting or transmitting EVD. They are:
1. Wash Your Hands thoroughly with Soap.
Do this a lot. You can also use a good hand sanitizer. Avoid unnecessary contact!
2. Curtail or avoid Bush Meat & Suya.
Bush meat may be carrying the virus. Also curtail or avoid suya. It is better to restrict yourself to food you prepared yourself.
3. Disinfect Your Surroundings.
The virus cannot survive disinfectants, heat, direct sunlight, detergents and soaps. Try and Clean up!
4. Fumigate If you Have Pests.
Fumigate your environment & dispose of the carcasses properly! Better a clean environment for you!
5. Don't Touch Carcasses.
Infected dead bodies can still transmit Ebola. Don't touch them without protective gear or avoid them altogether.
6. Protect Yourself.
Use protective gear if you must care or go near someone you suspect has Ebola.
7. Practice good hygiene.
It does not cost a fortune to maintain or practice a good hygiene. Lets brace up with the need to keep healthy through hygienic practices.

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8. Report case of any suspicion.
Report any suspicious symptoms in yourself or anyone else IMMEDIATELY you notice them. Don't delay!!
9. Educate Everyone.
Tell your neighbours, colleagues, church members and domestic staff about Ebola virus disease (EVD). You're safer when everyone is educated about Ebola. One of such education is what we are doing today.
Please don't ignore nor mess around with this advice, remember, Ebola has no cure!
3.11 What about health workers? How do they protect themselves from the high risk of caring for sick patients?
Health workers treating patients with suspected or confirmed illness are at higher risk of infection than other groups. They should observe the following:
 In addition to standard health-care precautions, strictly apply recommended infection control measures to avoid exposure to infected blood, fluids, or contaminated environments or objects - such as a patient's soiled linen or used needles.
 Use personal protection equipment such as your own gowns, gloves, masks and goggles or face shields.
 DO NOT reuse protective equipment or clothing unless they have been properly disinfected.
 Change gloves between caring for each patient suspected of having Ebola.
 Invasive procedures that can expose medical doctors, nurses and others to infection should be carried out under strict and safe conditions.
 Keep infected patients separate from other patients and healthy people, as much as possible.
3.1 Awareness for travelers
Travelers leaving for or arriving in an area where EVD is occurring should be provided at points of entry (e.g. in airports or ports on boarding or arrival areas or at ground crossing points) with information on the potential risk of EVD. Information should also be spread among communities that may include cross-border travelers and near all relevant international borders.
The information provided should emphasize that travelers or residents in the affected areas of countries can minimize any risk of getting infected if they avoid:
 Contact with blood or bodily fluids of a person or corpse infected with the Ebola virus.
 Contact with or handling of wild animals, alive or dead or their raw or undercooked meat.

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 Having sexual intercourse with a sick person or a person recovering from EVD for at least 7 weeks.
 Having contact with any object, such as needles, that has been contaminated with blood or bodily fluids.
Travellers should be informed where to obtain medical assistance at the destination and who to inform (e.g. through hotline telephone numbers).
Returning visitors from the affected areas should be alerted that if they develop infectious disease symptoms (such as fever, weakness, muscle pain, headache, sore throat, vomiting, diarrhoea, rash, or bleeding) within three weeks after return or if they suspect that they have been exposed to Ebola virus (e.g. volunteers who worked in healthcare settings) in the affected areas, they should seek rapid medical attention and mention their recent travel to the attending physician.
Note that Ebola virus disease (EVD) is Deadly but Preventable! Let’s work together to save lives! If you see anything suspicious - or anyone displaying the symptoms of Ebola, call these numbers immediately. You will save lives!
• 0803 308 6660
• 0805 532 9229
• 0802 316 9485
• 0805 528 1442
• 0803 306 5303
For more information, please go to www.ebolafacts.com
Spread the Word Not the Virus!!!!!!!!!

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Questions and discussion with participants
1) Given the recent outbreak of EVD, many persons have attributed this epidemic to an “end-time” crisis which can only be eradicated through prayers rather than scientific and medical approach. What is your opinion to this assertion?
2) In a recent broadcast by radio and television stations, religious leaders have been fervently advised to curtail or even avoid certain religious practices such as handshake, hugging, and other religious body contacts during religious services. In your opinion, do you think that such advice is necessary? Or should the advice be ignored because it is undermining the strength of the presence of God in those religious services? Please explain your opinion.
3) Bush meat is a very nice delicacy. Our forefathers ate it, and we have been enjoying it without being infected with any disease. Some of us have even enjoyed fruit bats in the past either fried or roasted with all the oily body without being infected with any disease. Given the recent advice to curtail or rather avoid eating bush meat and fruit bats, in your opinion; do you think that this advice is deceptive? Explain.
4) Hygienic practice is a feature of the rich people only. It is either difficult or even impossible for the poor to maintain a hygienic practice, live in a clean environment, ensure edible intake and appear neat in all ramification. Do think this opinion is correct? Please explain.
5) Because we so much love our friends and relatives, we can’t afford to allow them be in the care of certified healthcare givers alone when they are sick (especially with EVD) without showing them some love like cleaning up their excretion, washing their clothes, bathing them, cleaning their nostrils and other attendants that will make them feel our contacts and concern. Do you have any advice for this belief?
6) Intercessory prayer is a great weapon for Christians and believers. Laying of hands on patients while praying is a common feature. It is quite understandable that prayers can correct any ill situation. Will it be necessary to refer patients to appropriate health care centre or keep them at prayer houses (healing homes/centre) while intensifying prayers for recovery. In this, what is your advice for intercessors?