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ePaper created 2014-09-11, 14:51:02 | version 1.30.01
Science & Practice Thursday, 11 September 2014 10 www.fdiworldental.org is a perfect storm created by a lethal combinationofthesefactors,including rampant deforestation, poverty and the war-stricken situation in many Africancountries. So how does Ebola spread? Accor- ding to World Health Organization reports, Ebola virus disease (EVD) is introducedintothehumanpopulation through close contact with the blood, secretions, organs or other bodily fluids of infected animals. Human-to- human transmission is through direct contact(throughbrokenskinormucous membranes) with the blood, secre- tions, organs or other bodily fluids, suchassaliva,ofinfectedpeople,and indirect contact with environments contaminated with such fluids. Trans- mission through the air has not been documented in the natural environ- ment, nor have there been any case reportsoftransmissionthroughsaliva contamination. Infection in health care settings has been due to health care workers treating patients with suspected or confirmed EVD, espe- cially when infection control precau- tions were not strictly practised. Reports indicate that those who re- covered from the disease could trans- mit the virus through their semen for uptotwomonthsafterrecovery. EVD is a severe acute illness characterised by the sudden onset of fever,intenseweakness,musclepain, headache and sore throat. This is followedbyvomiting,diarrhoea,rash, impaired kidney and liver function, and both internal and external bleed- inginsomecases.Oralmanifestations, such as acute gingival bleeding, have been reported. The mortality rate of EVD is very high and 50 to 90 per cent of patients die owing to the profound systemic haemorrhage or its compli- cations.The incubation period of EVD is2to21days. Up to now, there have been no reportedcasesoftransmissionofEVD in any dental settings. However, the fact that it is transmitted through human secretions, which includes saliva, and that the incubation period could last up to 21 days implies that dental care workers in the endemic areas of the virus, such asWest Africa and sub-Saharan Africa, may run the risk of acquiring the disease if strict standard infection control measures arenotroutinelyfollowed. In dentistry, we are constantly exposed to these emerging and re-emerginginfectiousthreatsandwe cannot afford to let our guard down. Vigilance, awareness and good clini- cal practice with standard infection controlatalltimesarefundamentalto prevention, as yet-unimagined new diseases surely lie in wait. Although we have made spectacular technical and scientific advances since the release of the original IOM report sometwodecadesago,itappearsthat humans are still defenceless in the face of the relentless march of our microbefoes. Prof. Lakshman Samaranayake is head and Professor of Oral Microbio- mics and Infection at the University of Queensland School of Dentistry in BrisbaneinAustralia.Intheupcoming days, he will presenting a lecture as well as a seminar discussing infection control in dentistry as part of the FDI 2014scientificprogramme. “…we cannot afford to let our guard down.” AD