Ebola victims include pharmacy professionals
Community pharmacy professionals are among the Ebola fatalities of health care workers in Sierra Leone, although reported numbers vary.
A pharmacist source on the ground earlier this week told FIP that one pharmacist and four pharmacy technicians have died, all five from the community pharmacy sector. However, another report from the Pharmaceutical Society of Sierra Leone is that there has been one pharmacy Ebola death – a pharmacy technician who was practising in a community pharmacy in Kenema, one of the disease epicentres.
The outbreak of the virus in West Africa was declared an “extraordinary” public health emergency by the World Health Organization last week (7 August 2014), requiring a coordinated international response to stop its spread.
Pharmacies in Liberia have been inundated with people wanting to buy essential medicines after a second outbreak of the virus. Many are reluctant to go to hospitals and clinics because several health workers have become infected. Pharmacists in affected and neighbouring countries have been preparing for the spread of the virus. The Liberia Medicine and Health Regulatory Authority is now directing an ongoing awareness campaign at pharmacists and dispensers across the country. The Pharmaceutical Society of Ghana has warned pharmacists to be alert for Ebola symptoms and Sierra Leone’s Ministry of Health held a pharmacy “sensitisation meeting” in collaboration with the country’s pharmacy board and the pharmaceutical society. Training programmes based on WHO guidelines have been conducted in Sierra Leone. However, it has also been reported to FIP that some pharmaceutical outlets where the outbreak is seriously affecting health care workers have closed.
A spokesman from the Pharmaceutical Society of Sierra Leone said that activities to educate both pharmacy professionals on basic preventive measures, identification and prompt referral of suspected cases are being undertaken. Public campaigns are also being run on the proper use of disinfectants and hand sanitisers. “We currently have a lot of chlorine and chlorine-containing products . . . being used by the general public as a means of antisepsis. We realised that the general public was wrongly mixing the chlorine and thereby exposing themselves to the toxic effects of the chlorine or having too little of the chlorine in the mixture, which mitigates against its proper antiseptic functions. So we engaged all pharmacy professionals and pharmacy business owners on how to properly use the chlorine-containing preparations and other disinfectants against the virus. . . . Currently we have teams going around towns and teaching the general public on how to properly mix the chlorine for public hand washing,” he said.
“Pharmacists, as the first point of care for many people, have an important role to play in such emergencies, not only in terms of vigilance but also on a wider scale such as raising awareness and knowledge and providing advice to travellers,” says Luc Besançon, CEO and general secretary of the International Pharmaceutical Federation.
WHO resources on Ebola include a fact sheet containing essential information on the disease, transmission and prevention, frequently asked questions and advice for travellers. Salient points include:
• The incubation period of Ebola virus disease (EBV) varies between 2 and 21 days.
• Direct contact with infected persons or their body fluids/secretions (considered the principal mode of transmission) should be avoided. There is no risk of transmission during the incubation period and low risk in the early phase of symptoms.
• Risk of tourists and businessmen/women returning from affected areas in a country becoming infected with Ebola virus is “extremely low”. The WHO also describes risks for other groups including those visiting friends and relatives and health care workers.
• Returning visitors from affected areas should be alert to symptoms such sudden onset of fever, weakness, muscle pain, headache and sore throat (early stage) within three weeks of leaving the area. Later stage symptoms include vomiting, diarrhoea, rash, impaired liver and kidney function and internal and external bleeding.
• Effective disinfectant is a dilution of sodium hypochlorite at 0.05% or 500ppm available chlorine with a recommended contact time of 30 minutes.
• When within 1 metre of patients with EBV, health care workers should wear face protection (face shield or mask plus goggles), a long-sleeved gown and gloves.
FIP is also drawing attention to WHO guidance specifically for healthcare professionals. “All pharmacists, not only those in affected areas, could potentially play a part in the coordinated international response to stop the spread of this virus,” Mr Besançon says.
More information is available at www.who.int/csr/disease/ebola/en/
The use of the experimental drug ZMapp to treat two American aid workers and a Spanish priest, its delivery to Liberia and its subsequent exhaustion of supply has been widely reported in the media, highlighting debates over ethics, responsible use of medicines and access. This week (11 August 2014) the WHO convened a panel of experts to consider and assess the ethical implications for clinical decision-making of the potential use of unregistered interventions. A report of the meeting proceedings is expected to be available by 17 August 2014.