Ebola, Anthrax, and Smallpox

Running head: EBOLA, ANTHRAX, AND SMALLPOX 1

Lindsay Ashley, Sunny Crawford, Kelsey Ellenburg,

Annsley Greeson, Kaylee Johnson, Carter Logan

Dalton State College, Nursing 2012

Gail Dove Ward, EdD, RN, MN

March 30, 2017

EBOLA, ANTHRAX, AND SMALLPOX 2

Ebola, Anthrax, and Smallpox

Ebola, anthrax, and smallpox are devastating diseases that possess the potential to be

used as a means of bioterrorism. Throughout history, these destructive illnesses have claimed the

lives of millions of helpless individuals. The current conflict among nations and the threat of

bioterrorism has elevated the priority of education among healthcare personnel. Knowledge

allows prevention measures, isolation protocols, and effective intervention to be promptly

initiated. Only through understanding of the disease processes can a mass epidemic be avoided

and optimum patient outcomes be achieved. This paper will provide a description including the

means of transmission, prevention, management, as well as the nursing responsibilities of Ebola,

anthrax, and smallpox. It will then go on to discuss how these illnesses are related to the threat of

bioterrorism.

Ebola

Ebola hemorrhagic fever is a highly contagious, life-threatening disease caused by the

species Ebolavirus (“Ebola”, 2015). Five species of the ebolavirus exist including the Sudan

ebolavirus, Zaire ebolavirus, Baundibugyo ebolavirus, Reston ebolavirus, and Tai Forest

ebolavirus (Mangila et al., 2015). All species are a threat to humans excluding the Reston

ebolavirus (Mangila et al., 2015). Transmission of the virus from animal to human and from

human to human consists of direct contact between non-intact tissue and contaminated blood or

bodily fluids (“Ebola”, 2015). Animals that have been associated with Ebola virus include

primates and fruit bats (Ignatavicius, Workman., Blair, Rebar, & Winkelman, 2016). There is no

evidence Ebola is transmitted through air, water, food, or vector bites (“Ebola”, 2015).

The incubation period for Ebola is less than three weeks. Symptoms typically start eight

to ten days after exposure, and last a total of fourteen to twenty-one (Mangila et al., 2015).

EBOLA, ANTHRAX, AND SMALLPOX 3

Manifestations include pyrexia, chest pain, severe headache, myalgia, abdominal pain, diarrhea,

vomiting, and unexplained hemorrhage (Ignatavicius et al., 2016, p. 412). Progression of the

illness leads to multiple organ failure and eventual death (Mangila et al., 2015).

Suspected diagnosis of Ebola hemorrhagic fever is validated through detection of viral

antigens within bodily secretions (Endom, 2013). However, such tests are restricted to Biohazard

Safety Level four laboratories including the Center for Disease Control and the United States

Army Research Institute of Infectious Diseases (Endom, 2013). Currently, there are no

vaccinations to prevent contracting of the Ebola virus (Thèves et al., 2014). Likewise, there is no

definitive cure once the virus is transmitted. Disease management goals of healthcare providers

are primarily focused on prevention, early detection, and containment.

Prevention and management

As a result of the recent Ebola pandemic, health care providers are taking action to avert

possible reoccurrence. This includes education in disease prevention and management. Such

steps by all healthcare personnel are vital if an epidemic is to be avoided.

The primary means of prevention include avoiding contact with infected individuals and

secretions to prevent transmission of infection. This necessitates avoiding travel to countries

experiencing an Ebola outbreak, as well as, facilities where Ebola patients are being hospitalized

(“Ebola”, 2015). During such times, it is important for a person to practice careful hand hygiene

using soap and water or an alcohol based hand sanitizer. Individuals should avoid contact with

blood or bodily fluids such as, feces, urine, breast milk, saliva, sweat, semen, and vaginal fluid of

a client with a suspected diagnosis of Ebola (Adongo et al., 2016). Healthcare workers, family

members of Ebola patients, and morticians who have physical contact with the patient have a

greater risk of infection through direct mode of transmission. During times of contact, these

individuals should utilize current droplet precautions in addition to Tyvek suits and powered air

EBOLA, ANTHRAX, AND SMALLPOX 4

purifying respiratory hoods (Baird, 2016). Transmission of Ebola can also occur through indirect

means such as handling contaminated clothes, materials, bedding, needles, and medical

equipment (Adongo et al., 2016). Biohazard workers should separately bag and autoclave or

incinerate such items (Baird, 2016). In previous circumstance, high-risk practices including

washing and handling of the corpse were prohibited during an outbreak (Adongo et al., 2016).

Early identification of risk factors and symptoms is the key to containment. If Ebola is

suspected, strict droplet precautions set forth by the Center for Disease Control should be

instituted immediately. Health care personnel should isolate the patient, as well as anyone in

contact with the patient as soon as possible (“Ebola”, 2015). Prevention of further transmission is

a primary defense against this devastating, life-threatening disease.

Nursing Responsibilities