NR 503 Discussion Current Event

Sample Answer for NR 503 Discussion Current Event Included After Question

This week we will explore current events related to epidemiology. You will present a scientific article to the class. Please focus on interpreting the research question, methodology, results, and conclusions from a sample of peer-reviewed scientific literature. Please be sure the article is related to epidemiology, summarizing its contents for the class, and providing a succinct written summary. Current events must have been published within the last six months. Written summaries should include:

  • State the objectives of the study
  • Summarize the study design and findings
  • Provide a reference of the article
  • Provide your opinion on how the “average” reader will respond to the article. Will the article influence decision making or thinking? Does the article leave out any important information?

A Sample Answer For the Assignment: NR 503 Discussion Current Event

Title: NR 503 Discussion Current Event

Zaire ebolavirus is a filovirus with five subspecies (Bundibugyo, Zaire, Restone, Tai Forest, and Sudan) with a case fatality ratio of 25-90% (Barry et al, 2018). It is transmitted through contact with the body fluids of infected patients (CDC, 2018). The way of stopping the transmission is by patient isolation and care, early diagnosis, infection control, rigorous tracking of contacts, and the use of targeted vaccination.

On May 3, 2018, the Ministry of Health of the Democratic Republic of the Congo was notified from the Health Division of Equateur Providence that 40 cases of fever (95%) with gastrointestinal symptoms, general fatigue (37 [90%] cases), loss of appetite (37 [90%]), and hemorrhagic signs (14 [33%] people) were occurred including 17 deaths due to possible Ebola virus (Barry et al, 2018). These data were collected by health professionals attending to cases and field investigators. On May 8, 2018, the Democratic Republic of the Congo reported 50 cases (13 probable, 37 confirmed) of Ebola virus disease in Equateur Province where is connected to the capital city (Barry et al, 2018). In order to confirm the cases, detection of Ebola virus RNA in body fluids or blood by reverse transcription PCR was required and used.

Since the affected area is concentrated with high population, this outbreak is the highest and complex risk ever experienced by the Democratic Republic of the Congo. On May 20, 2018, 25 deaths from Ebola virus disease had been reported (Barry et al, 2018). In addition, they also reported that 1,458 contacts had been reported and addition 78 cases were confirmed, assuming heterogeneous transmissibility (Barry et al, 2018). The median age of people with probable or confirmed infection was 40 years and usually male (30 [60%]) (Barry et al, 2018).

The design of the study is an epidemiological study with the case-controlled group since it studied people that have already contracted the disease. This study also reviewed published epidemiological evidence about clinical characteristics of Ebola virus disease and contrasted the results of past outbreaks. The aim of this study was to investigate and control the current Ebola virus disease outbreak in the Democratic Republic of the Congo. The results showed that the epidemiological characteristics and features of this outbreak in the Democratic Republic of the Congo, such as signs and symptoms of cases were consistent with previous outbreaks of Ebola virus disease in West Africa(Barry et al, 2018).

It also reported that the most common exposures were caused by contact with infected people and participation in traditional burial rites for those who have died from this disease. The source of this outbreak is unknown; however, it’s possible that a new chain of transmission could occur after sexual contact with a male survivor (CDC, 2018). In addition, the case fatality ratio was higher than when this outbreak occurred in West Africa from 2014 to 2016 (Barry et al, 2018). Since West Africa has greater access to Ebola treatment, the case fatality ratio was decreased. The article concluded the study with the importance of safe and dignified burials, community engagement, early detection, and implementation of Ebola treatment along with vaccination for outbreak control (Barry et al, 2018).

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As the reader, I believe that this article was informative and written thoroughly with analytical data and literature reviews. The average reader would find this information useful since it’s easy to understand and follow without a lot of medical terminologies. The article is also reliable and credible by showing the author’s information on the article. The writer also believes that the article didn’t leave out any important information. The article will influence when the Ministry of Health of the Democratic Republic of the Congo reinforces the implementation of Ebola treatment and vaccination at community clinics, local hospitals, and public health centers since the study results show high mortality and fatality rate of Ebola virus disease.

Barry, Ahmadou et al. (2018). Outbreak of Ebola virus disease in the Democratic Republic of the Congo, April–May 2018: An epidemiological study. The Lancet, 392 (2) 213-221, doi.org/10.1016/S0140-6736(18)31387-4

The Centers for Disease Control and Prevention (CDC). (2018). 2018 Democratic Republic of the Congo, Bikoro. Retrieved from https://www.cdc.gov/vhf/ebola/outbreaks/drc/2018-may.html

A Sample Answer 2 For the Assignment: NR 503 Discussion Current Event

Title: NR 503 Discussion Current Event

A 2005 study published in Nature and directed by Eric Leroy tested more than 1,000 small vertebrates in central Africa and found evidence of asymptomatic Ebola infection in three species of frugivorous bats, which led him to believe that perhaps these animals that sometimes they hunt to consume their meat, were the reservoir of the virus (Kupferschmidt, 2017). Humans can become infected by hunting and eating infected meat or by direct contact with bats. Once infected, the human can transmit the virus to others. Moreover, Ebola has an incredible ability to take over the body fluids of men who have survived the disease long after they have healed. In fact, one study found that more than half of men who survived the West African epidemic tested positive for Ebola in semen a year or more after recovery (CDC, 2016).

In one case, the analysis yielded a positive result no less than 565 days after the cure (CDC, 2016). Because of the risk of the disease spreading, survivors are advised to avoid having unprotected sex until their semen has twice tested negative for the presence of the virus. It is estimated that each infected person infects an average of two other people (Doucleff, 2014). The bodies of deceased people remain highly infectious for about seven days. Although Ebola has often been classified as a hemorrhagic fever, WHO and other experts begin to avoid the term as not all individuals present with visible hemorrhages (WHO, 2014).

In fact, the evolution is as follows: the first symptoms (tiredness, nausea, fever, headache) are similar to those of diseases such as influenza and malaria, which makes early diagnosis difficult. As the infection progresses, muscle aches, fever and headache become more pronounced and diarrhea and vomiting appear. Often, there is bleeding from the nose or gums. Death occurs within two weeks after the onset of the first symptoms (WHO, 2014). 

The rVSV-ZEBOV vaccine, specific for the Zaire strain and not yet approved, was developed by the National Microbiology Laboratory of Canada, tested in Guinea and Sierra Leone during the 2014-2016 epidemic and then purchased by the company. Pharmaceutical Merck, which holds the rights. 100% of the people vaccinated did not develop the disease. However, it was the end of the outbreak and the actual efficacy of this compound must still be proven (Medaglini & Siegrist, 2017). The first trials with the candidate vaccines show that they are safe and that they induce an immune response.

What is not yet known is the level of protection and the duration of it. Even if the vaccines do not confer lasting protection, they can be used in future outbreaks to protect the most exposed populations (health workers, among others). Moreover, there is currently no approve vaccine or specific treatments for Ebola. For now, the most effective way to limit in part the mortality caused by the virus is to provide intensive support care, which consists in restoring liquids and electrolytes lost by diarrhea and vomiting. 

CDC (2016). Virus Linger Longer than Expected in Semen. Retrieved on July 8, 2018 from https://www.cdc.gov/media/releases/2016/p0830-ebola-virus-semen.html 

Doucleff, M. (2014). No, Seriously, How Contagious Is Ebola?. Public Health. Retrieved on July 12, 2018 from https://www.npr.org/sections/health-shots/2014/10/02/352983774/no-seriously-how-contagious-is-ebola 

Kupferschmidt, K. (2017).Hunting for Ebola among the bats of the Congo. Since AAAS.  (361)6398. doi:10.1126/science. Aan6907  WHO (2014). Ebola Response Team. Ebola virus disease in West Africa — the first 9 months of the epidemic and forward projections. N Engl J Med.371:1481-1495 

A Sample Answer 3 For the Assignment: NR 503 Discussion Current Event

Title: NR 503 Discussion Current Event

The Center for Disease Control and Prevention (CDC) lists current outbreaks in the US and Internationally.  Contamination of food during processing is prevalent in the US currently where Ebola continues to be a problem in Africa and Measles and Yellow Fever Continue to affect some areas around the world (CDC, 2018).  One issue also currently being monitored is Zika virus. 

A study from the Morbidity and Mortality Weekly Report (MMWR) seeks to properly attribute birth defects to Zika.  In the real world, birth defects exist. They can be for a variety of reasons, not all are clear. Cragan et al (2017) examined 774 pregnancies with evidence of birth defects at various stages of gestation to determine if they are attributed to Zika.  Cragan et al (2017) examines the severity of fetal defects based on stage and mode of Zika exposure to mother. Although Zika is transmitted by mosquitoes, the effects can vary determining on gestational stage, if father is infected at the time of conception(CDC, 2018).

The study frequently references the CDC for information regarding parameters for testing. The live virus is only in the system 2-7 days, but its effects can last for weeks.  Antibody and RNA testing is not indicated unless there is birth defect evidence and there is high risk potential in exposure of other or father which almost always refers to travel (Cragan et al, 2017).  The average reader would understand that there is no cure for Zika and that travel advisories are most crucial.

Cragan, J. D., Mai, C. T., Petersen, E. E., Liberman, R. F., Forestieri, N. E., Stevens, A. C., & … Meaney-Delman, D. M. (2017). Baseline Prevalence of Birth Defects Associated with Congenital Zika Virus Infection – Massachusetts, North Carolina, and Atlanta, Georgia, 2013-2014. MMWR: Morbidity & Mortality Weekly Report66(8), 219-222. doi:10.15585/mmwr.mm6608a4

Centers for Disease Control and Prevention. (July 5, 2018). Zika Virus. Retrieved from https://www.cdc.gov/zika/index.htmlLinks to an external site.

A Sample Answer For 4 the Assignment: NR 503 Discussion Current Event

Title: NR 503 Discussion Current Event

Thank you for all the great feedback and additional information regarding Zika.  The study I reviewed was a surveillance study to understand severity of malformations attributed to Zika.  The study began with weeding out malformations consistent with Zika from other malformations.  According to CDC(2018) microcephaly is the most common finding in ultrasound for Zika. However, this can be consistent with other syndromes such as Downs Syndrome and congenital dwarfism.  What Cragan et al(2017) foud was that 747 abnormalities consistent with Zika were classified as to severity.   The study classified severity of the abnormalities into 4 categories.  Brain malformations/microcephaly, Neural tube deficits and other early brain malformations, eye abnormalities, and other CNS dysfunctions. 

Of the 747 pregnancies followed, the most severe cases were most prevalent and 55% of all cases were deemed as likely attributed to Zika(Cragan et al, 2017).  There are not specific hard numbers because the literature seeks to make note that these types of abnormalities, even in Zika infected mothers(or fathers), can be attributed to a number of factors especially when malformations occur at such an early stage in fetal development. However, it is clear that the incidence of fetal brain and neural tube abnormalities is 33 times higher than in pre Zika years(Cragan, 2017). 

The article does concern me greatly in terms of public health as we have many immigrants from tropical and subtropical sreas as well as many American travelers visiting these high risk areas.  I also worry about the migration of the carrier mosquitoes coming north and creating Zika prone areas in the US as is already beginning in South Florida.  The CDC(2018) keeps an up to date travel advisory map on their website that is very helpful to travelers. 

Cragan, J. D., Mai, C. T., Petersen, E. E., Liberman, R. F., Forestieri, N. E., Stevens, A. C., & … Meaney-Delman, D. M. (2017). Baseline Prevalence of Birth Defects Associated with Congenital Zika Virus Infection – Massachusetts, North Carolina, and Atlanta, Georgia, 2013-2014. MMWR: Morbidity & Mortality Weekly Report66(8), 219-222. doi:10.15585/mmwr.mm6608a4

Centers for Disease Control and Prevention. (July 5, 2018). Zika Virus. Retrieved from https://www.cdc.gov/zika/index.htmlLinks to an external site.