Oral Rehydration Therapy and the Ebola outbreak

Diarrhea and the accompanying dehydration is the second leading cause of death in children under five worldwide. Since the early 1980s, the WHO and UNICEF have recommended oral rehydration therapy (ORT) to reduce mortality from number of diseases with diarrheal symptoms. The therapy is widely credited with preventing millions of deaths; it was adopted and utilized across Asia and Sub-Saharan Africa in the 1980s and 1990s, resulting in a decrease of 3.1 million deaths by 1999. ORT’s simplicity – it is a mix of clean water, salt and sugar – and its low cost appeared as an efficient, high-impact solution to the diarrhea issue.

The Ebola virus falls into the category of diarrheal disease and I wondered whether ORT was a part of the care for patients during the recent West African Ebola outbreak. Vaccines and targeted drugs for the disease are not fully developed yet, so the best medical advice right now is aggressive fluid replacement. Through a study of Ebola survivors, researchers learned that drinking 4 liters of rehydration solution daily is crucial.

However, it is really difficult for an Ebola patient to drink the fluids due to nausea, a common symptom of the disease. I can understand why it’s hard for Ebola patients to stay hydrated; one is simultaneously fighting to avoid vomiting and forcing a salty liquid down one’s throat. Flavoring the liquid may help. Orange-flavored granules are available and patients have said they are much more pleasant than the flavorless kind. This observation might be helpful intreating children who dislike the taste of ORS.

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Dr. Igonoh drinking her orange-flavored oral rehydration solution.

“As I took the ORS and treated dehydration, it provided me with energy, and my immune system was able to battle the virus,” said Ada Igonoh, a doctor who contracted Ebola while working in Lagos, Nigeria. Nigeria has rid itself of Ebola and has suffered fewer deaths compared to other countries in West Africa. The WHO’s interviews of several of the Nigerian survivors indicated that hydration was a factor in Nigeria’s lower fatality ratio. The WHO promotes Nigeria’s approach as the blueprint for other developing countries at risk of Ebola.

[1] Diarrhoeal disease. (2013, April 1). Retrieved December 5, 2014, from http://www.who.int/mediacentre/factsheets/fs330/en/

[2] Gale, J. (2014, November 17). Beating Ebola Means Drinking,  Last Thing Patient Wants to Do. Retrieved December 5, 2014, from http://www.bloomberg.com/news/2014-11-16/beating-ebola-hinged-on-sipping-a-gallon-of-liquid-a-day.html

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