Volunteering to help with the Ebola virus disease crisis

It is the nature of healthcare professionals to want to volunteer in a crisis or emergency; it’s part of their DNA. The Ebola crisis in West Africa, and the lack of health professionals on the ground to address this crisis, prompts that volunteer spirit. Before committing to the work, you should consider these suggestions from experts at the Centers for Disease Control and Prevention and others. More detailed information for humanitarian volunteers is available at http://wwwnc.cdc.gov/travel/page/humanitarian-workers-ebola.

1. See your primary care provider for a physical and assessment of your ability to endure extreme working conditions; individuals with asthma may be less able to tolerate the environmental stressors.
2. Make certain all vaccinations are up to date and that you have malaria prophylaxis available. If possible, consult a physician who specializes in international travel. He or she can tell you which vaccinations are appropriate for West Africa.
3. Understand that the use of personal protective equipment, including masks, water-repellent gowns, eye shields, gloves, etc., may result in heat stress. Doctors Without Borders limits time in this garb to 45 minutes, but other organizations may not set these important limits to prevent heat and cardiopulmonary stress.
4. Be aware that the abundant use of bleach and other decontaminating agents may trigger or exacerbate asthma symptoms.
5. Anticipate that health services may not be readily available or sufficient for your specific needs should problems arise.
6. Consider the absolutely vital importance of working with organizations that have the resources, support and logistics to care for or evacuate you should the need arise.

Treating Ebola

Prevention is the most efficacious approach to Ebola. Public health experts are treating the EVD epidemic with standard measures for those who become infected, such as identifying, isolating and caring for patients who are ill, making sure healthcare workers have access to personal protective equipment and are properly trained in infection control measures, and tracing patients’ contacts to detect any secondary infections as soon as possible. Current treatment includes:

• Balancing fluids and electrolytes;
• Maintaining oxygen levels;
• Maintaining blood pressure; and
• Treating secondary infections.

No specific treatment for either prevention or cure is currently available for Ebola virus disease, but work is underway on several investigational approaches. Most have heard of an experimental therapy known as ZMapp, a treatment developed by Mapp Biopharmaceutical Inc.; this is the same therapy given to two health professionals airlifted to the U.S. after being diagnosed and stabilized. Because the therapy has not been tested for safety and effectiveness in humans, it is not broadly available. However, work on this and other treatments is ongoing and receiving attention and support from federal government agencies. According to the CDC website:

• The Department of Health and Human Services has contracted with Mapp Biopharmaceutical Inc. to develop and manufacture ZMapp.
• The National Institutes of Health (NIH) is working on two approaches: prevention and treatment. NIH will begin initial human testing of an investigational vaccine to prevent EVD and is working with a company to develop an antiviral drug to treat Ebola.
• The Department of Defense has funded two companies that are developing drug therapies for Ebola and is working with another company to develop an Ebola vaccine.