MALONGZA’S PRINCIPLE OF DISSOCIATION TO STOP EBOLA HEMORRHAGIC FEVER EPIDEMIC

AARJMD VOLUME 1 ISSUE 29 (JANUARY 2015) ISSN : 2319 - 2801

Asian Academic Research Journal of Multidisciplinary

www.asianacademicresearch.org

465

A Peer Reviewed International Journal of Asian

Academic Research Associates

AARJMD

ASIAN ACADEMIC RESEARCH

JOURNAL OF MULTIDISCIPLINARY

MALONGZA’S PRINCIPLE OF DISSOCIATION TO STOP EBOLA HEMORRHAGIC

FEVER EPIDEMIC

FRANCIS ISSAHAKU MALONGZA BUKARI1; NYAABIIRE NSOBILLA

ATINDAANA2; GLORIA TWUMASI

3; ADWOA NYANTAKYIWAA

4

1Department of Environment and Resource Studies, Faculty of Integrated Development

Studies, University for Development Studies, P. O. Box 520,Wa, Upper West Region, Ghana. 2Ghana Health Service, Achimota Hospital,

P. O. Box AH 15, Greater Accra Region, Accra,Ghana. 3Department of Biomedical and Forensic Sciences, School of Biological Sciences, University of

Cape Coast, University Post Office, Cape Coast, Ghana. 4Institute for Educational Planning and Administration, University of Cape Coast, University

Post Office, Cape Coast, Ghana.

Abstract

Despite numerous efforts to control the Ebola Virus Disease in West Africa since the beginning of the

2014 epidemic, there is still no hope that the disease could be stopped within the shortest possible time.

Hence, the main objective of this study is to present a global plan of action to stop the Ebola epidemic.

The disease, which reached the status of an epidemic in March 2014, has caused several socio-economic

mishaps, including loss of lives, crippling local economies, discouraging international movement of

goods and persons, and increasing dependency. The major challenge is the lack of approved drugs and

vaccines to deal with the disease. Being the outcome of a basic research, and identifying its niche from

content analysis of available data, this study proposes an alternative way of stopping the strive and spread

of the disease by a principle known as the Malongza’s Principle of Dissociation. This hypothesizes that

the incidence of the Ebola Virus Disease could be discontinued if the elements in the mediums that

support its occurrence are identified and eliminated. It also paves the way for applied research into the

practical relevance of the proposed principle to the control of hemorrhagic fever related diseases.

Key Descriptors: Ebola Virus Disease, epidemic, Malongza’s Principle of Dissociation, West Africa, the

World.

file:///F:/Kathir/Asian_2/WebLayout/3/index.html




466

Introduction:

The Ebola virus disease (EVD), formerly known as the Ebola hemorrhagic fever is a severe and

very fatal disease which is transmitted to people from infected wild animals, such as fruit bats. It

then spreads in human populations through human-to-human transmission. The case-fatality rate

of the disease has varied between 25% and 90% in past outbreaks (WHO, 2014). It is fatal

because at its advanced stage, it is symptomatically associated with excessive dehydration

through vomiting, diarrhea, and internal and external bleeding. Others include rash and malaria-

like symptoms such as fever, headache, muscle pain and nausea. Once it attains the status of an

epidemic, the EVD becomes an issue of global concern because it causes high case-fatality rate,

crippling of local economies, risk of transmission across international boundaries,

discouragement of international movement of goods and persons and heavy expenditure on the

management of the disease, as some of the negative socio-economic problems (Dixon & Schafer,

2014; World Bank, 2014).

Historically, the EVD is said to have originated from villages around the rainforests of

Central Africa, and was first detected in Nzara of South Sudan and Yambuku of the Democratic

Republic of Congo by a microbiologist called Peter Piot, in 1976. Spickler (2014), however

reports that earlier in 1967 hemorrhagic fever outbreak occurred among laboratory workers in

the Marburg city of Germany, due to contact with infected vervets. The virus responsible for the

disease was accordingly called the ‘Marburgvirus’. This is a virus of the same family with the

Ebola virus (Filoviridae). The virus responsible for the EVD was also named Ebola, because

Yambuku is located near the Ebola River in the Democratic Republic of Congo.

The recent EVD epidemic is better described as being disease relocation diffusion. This is

because some countries of origin, such as South Sudan are no longer involved (Haggett, 2000).

The EVD diffused to West Africa for the first time at Guinea in December 2013. After a

contagious diffusion in this country, it was reported as attaining an epidemic of international

significance in March 2014, as it spread by expansion diffusion to neighboring Liberia and Sierra

Leone. The EVD claimed 4,033 lives out of a total of 8,399 cases with a case-fatality rate of

about 48% reported from these three hardest hit West African countries by October 8, 2014. By

16 November 2014, 14,409 cases and 5,174 deaths with a case-fatality rate of about 37% (To the

nearest percentage figure) had occurred in the world, as the EVD spread further to Nigeria,

Senegal, USA, Spain and Mali, according to the World Health Organisation and the Center for

Disease Control (CDC) (2014).

The authors of this article argue that, the present situation has arisen because the initial

attempts to control the disease either did not foresee the possibility of its present rates of

transmission and fatality, or efforts made to manage the outbreak within the affected countries

and across international borders by the associated governments and the international community

have not been effective enough. The approaches used so far, focused on the identification of

infected persons and contact tracing and quarantining of suspects, restricted movements,

treatment of patients with experimental drugs, management of infected dead bodies, the safety of




467

health personnel, foreign support in terms of skilled personnel, experimental vaccines and

protective gear, and public sensitization.

Despite the adoption of all the possible means of controlling and preventing the incidence

of the EVD at various locations in response to the situations in situ, there has been no uniformity

in the processes. In other words, the ongoing approaches lack the deliberate adoption of a theory

that organizes all the ongoing control and preventive practices in a coherent manner, to protect

the unaffected populations of the Ebola endemic countries and the world at large from the risk of

infection. This explains the persistence and continuing spread of the disease. This has led to a

situation where heavy financial and material resources are being injected into the affected

countries to the extent that the United Nations (UN), reports that aid pledges to fight Ebola have

fallen short of $1billion (800 million Euros) (Parry & Bazinet, 2014).

In view of the above, this study presents the Malongza‟s Principle of Dissociation (MPD)

to explain how the Ebola virus disease could be stopped from spreading both within the affected

countries and across international boundaries. It seeks to present a more uniform and effective

way to stop the epidemic within a specified period of seven weeks. The characteristic of the

EVD to be transmitted in human populations, presents the idea that the incidence of the disease

is dependent on contacts between people. This inspires the authors of this study that such human

contacts are made possible by the prevalence of the mediums of human associations. These refer

to all the possible means by which an infected individual relates to others. These include

households, friendships, schools, workplaces, markets, play grounds, hospitals/clinics,

passengers in a transport, congregational worships, festivals, outdoor inter-group sports, among

other forms of social gatherings. The risk of transmission starts once an initial contact with

infected wild animals by an individual, belonging to any of these mediums has occurred. The

principle presented in this piece of work therefore poses the dictum that once an infected case is

recorded, further infections would continue in human populations as long as the contacts

between individuals and the mediums that facilitate the contacts remain unaltered.

From the above, it is apparent that any action to eliminate the direct effects of human

contacts and the level of human associations would discontinue further occurrences and spread

of the EVD. This is so for any hemorrhagic fever related disease that has a known incubation

period for symptoms to be identified and treated, or creates little chances of survival of victims

such that the possibilities of further transmissions as carriers are eliminated. This is the premise

of the Malongza‟s Principle of Dissociation, postulated by Bukari Francis Issahaku Malongza, a

lecturer at the Department of Environment and Resource Studies, University for Development

Studies, Ghana, and a doctoral student at the Institute for Development Studies, University of

Cape Coast, Ghana in October 2014.

The article employs a simple mathematical approach to explain how dissociation could be

used to control the disease. The study derives its arguments from the theory of disease diffusion,

and identifies the Ebola epidemic as the dependent factor and the influence of infected wildlife in

the environment, human contacts and the mediums of human associations as the independent




468

factors. These influence the momentum of the disease incidence as the premise of the disease

diffusion theory. The study argues that any effort to control the independent factors could

positively impact on the control of the epidemic. It goes further to present suggested activity

schedules for remedy in the affected countries and all others at risk of infection, based on an

adopted ranking criterion. Its scope does not emphasise the practical aspects of medication and

vaccination. It is the result of a basic research, with the main objective to explain how to stop the

continuing spread of the disease and its negative effects within a minimum period of seven

weeks.

Theoretical basis of the study

The theory that gives direction to this study is the disease diffusion theory. Central to the

Malongza’s Principle of Dissociation are the tenets of contagion, expansion and relocation of the

diffusion theory.

Theory of disease diffusion

Leo Frobenius is the earliest scholar to conceptualize diffusion as a social phenomenon in his

1897/98 publication. It was however, related to the spread of elements of culture, such as belief

systems, technology, food and language (Frobenius, 1897/97). It has since been applied in other

social sciences to explain the spread of social phenomena, such as disease. Thus, health

geographers see disease diffusion as the occurrence and expansion of the incidence of a disease

within a location, and its spread to other locations from the original source. The expansionary,

relocation and contagious aspects of disease diffusion are central to the scientific method

adopted by this study.

Contagious diffusion occurs when the disease spreads through person-to-person contact

at a given destination.

Expansionary diffusion concerns the development and intensification of the incidence of

a disease at an original location and includes the possibility of spread to new locations.

Relocation diffusion is concerned with the trans-boundary or spatial spread of a disease,

as its original source becomes free of the disease (See Haggett, 2000).

Empirically, WHO (2014) and Dixon and Schafer (2014) explain the initial spread of the EVD

by contagious diffusion from the Districts of Gueckedou, Macenta, and Kissidougou in the

recent outbreak in Guinea. This was due to spatial interaction between the districts. The accounts

reveal that on March 21, 2014, there were only 49 reported cases with a case-fatality rate of 59%.

This reached 1,919 cases, with a case-fatality rate of about 41% by November 16, 2014.

Expansionary diffusion of the EVD began when on March 30, 2014, cases were reported in the

Foya District of neighboring Liberia. By May 2014, Sierra Leone also recorded its first case and

as of June 18, the total number of Ebola cases had increased to 528. It was however, disclosed

that the earlier victims of the disease in both Liberia and Sierra Leone had travelled to Guinea

(Ng & Cowling, 2014).




469

In terms of the relocation diffusion of the EVD, since it started from the DR. Congo and

Sudan in 1976, Uganda is remembered for recording the highest number of 425 cases with a

case-fatality rate of 53% between 2000 and 2001 (Dixon & Schafer, 2014). Despite the breaking

of this Ugandan EVD record by June 2014, it is interesting to note that some of the countries

previously affected by the disease are no longer involved in the recent epidemic. This implies

disease relocation diffusion, as it moves from Central Africa to West Africa.

The contextual relevance of the theory of disease diffusion is that, from the contagious to

the relocation stages, certain conditions provide the mediums of spread. The continued spread of

the diseases within and across countries generates an enquiry into the efforts made so far, why

they failed and what could be done to stop the incidence and spread of the Ebola virus disease.

Ebola as a Hemorrhagic Fever Related Disease

According to WHO (2014), hemorrhagic fever related diseases refer to severe illnesses caused by

a number of viruses, and are sometimes characterised by bleeding. Some viral families

associated with such diseases include Arenaviridae (Lassa fever, Junin and Machupo),

Bunyaviridae (Crimean-Congo hemorrhagic fever, Rift Valley Fever, Hantaan hemorrhagic

fevers) and Flaviviridae (yellow fever, dengue, Omsk hemorrhagic fever, Kyasanur forest

disease). The Ebolaviruses and Marburgviruses belong to the Filoviridae family, which are

responsible for the Ebola virus disease (EVD) and Marburg virus disease (MVD) respectively

(Spickler, 2014). Specifically, WHO, reports that the dominant species of the 2014 EVD

outbreak is the Zaire ebolavirus.

Disease vectors

The viruses responsible for the EVD and other hemorrhagic diseases are believed to be carried in

fruit bats, which have antibodies to the viruses and so remain asymptomatic or unaffected by the

EVD or MVD. These Filoviridae have been found in ill or dead antelopes and chimpanzees

among other wild animals (Ng & Cowling, 2014; Spickler, 2014).

Mode of transmission

Ebola and other hemorrhagic fever related diseases are zoonotic. This means they are transmitted

to persons by contact with ill or dead infected animals identified above, either accidentally or

during wildlife care services. Hunting or contact with infected game meat could be a major

source of animal-to-human transmission from carrier asymptomatic animals such as fruit bats.

Human-to-human transmission then follows once an infected person begins to show symptoms,

through direct contact with the body fluids of that person, such as tears, blood, sweat, saliva,

urine, semen, vaginal fluids, excreta, vomit. Men who have recovered from the disease can also

still infect their sexual partners within 7 weeks after recovery by their semen (Spickler, 2014).




470

Incubation period

The incubation period for the Filoviridae is between 3 to 16 days for nonhuman primates

(Spickler, 2014) and about 2 to 21 days for humans, and until signs of the disease appear, carriers

are not infectious within the incubation period (WHO, 2014).

Symptoms

According to the World Health Organization (2014), the symptoms or signs of EVD include

sudden onset of fever, intense weakness, muscle pain, headache and sore throat. This is followed

by vomiting, diarrhea, rash, impaired kidney and liver function, and in some cases, both internal

and external bleeding, which could result into death within a few days.

Persons most at risk of infection

The EVD affects all persons irrespective of sex, age or race. However, persons at higher risk of

infection include health workers, family members or others in close contact with infected people,

and mourners who have close contact with bodies of the diseased as part of burial ceremonies,

hunters and farmers working in forest areas believed to be hosting the disease vectors.

Treatment

There is no cure or vaccine for the EVD at the moment except experimental drugs such as

ZMapp, which is being developed by Leaf Biopharmaceutical Inc, of San Diego in USA.

However, according to WHO (2014) and the Center for Disease Control and Prevention (CDC)

(2014), in view of the fact that affected patients are frequently dehydrated, they need intensive

and supportive care, intravenous fluids or oral rehydration with solutions that contain

electrolytes.

From the literature above, it is obvious that Ebola is a hemorrhagic fever disease which is

Transmitted from wild animals within the environment of a human population;

Infection is by contact with infected animals and humans; and

In human-to-human transmission, the risk of infection increases with the level of

association or relationships with infected people.

These are the independent variables that this study seeks to examine in a mathematical

relationship, identify the gaps in the existing practices in efforts to control the disease in the

context of the variables, and design schedules of activities as policy recommendations to address

the challenge

Ebola Virus Disease as an Epidemic

According to Tsai and Koerner (2009) an epidemic occurs when a country considers the

incidence of a disease as causing a state of public emergency in terms of the number of people

being infected and dying from the disease. The writers state further that the Center for Disease

Control classifies a disease as being epidemic, when the number of deaths exceeds 7.7% of the

total number of reported cases.

Tsai and Koerner (2009), however opined that the CDC’s definition of an epidemic, as

―The occurrence of more cases of disease than expected in a given area or among a specific

group of people over a particular period of time" (CDC, cited in Tsai & Koerner, 2009, in State




471

27/04/2009 ed.) does not stand the test of time since the prevalence rates of various diseases are

not the same. Furthermore, the 7.7% fatality rate is not static for all periods within a year. They

accordingly urge the CDC to come out with statistical figures on what it describes as being ‘more

than expected’ with reference to the various diseases.

In view of the above, this article adopts a numerical stratification format based on past

statistics, for the ranking of Ebola countries in the 2014 epidemic. This is to aid the explanation

of how the MPD is to be implemented based on the ranks of countries. Table 1 presents the

stratification adopted by the authors of this article. The general assumption in the context of

epidemic in Table 1 is that it is based on reports that all cases were due to spread of the disease.

In this, e-low stands for low cases of Ebola epidemic and is taken for 1-9 confirmed infected

persons; e-medium stands for medium cases of Ebola and is taken for 10-399 confirmed infected

persons; and e-high stands for high cases of Ebola epidemic and is taken for 400+ confirmed

infected persons. Additionally, ‘ex‟ denotes a previous record of Ebola epidemic for a country

that was later declared Ebola-free after successful treatment and control measures for low,

medium and high cases, while e-free stands for countries that have never experienced the Ebola

virus disease.

Table 1: Stratification of Ebola cases under the Malongza’s Principle of Dissociation (MPD).

MPD Stratification Interpretation Basis

0-9= e-low Countries with low Ebola cases WHO and CDC consider records of

Ebola incidences below 10 cases of

minor global epidemic significance. (e.g.

South Africa and Russia in 1996)

10-399= e-medium Countries with medium Ebola cases The WHO and CDC consider Ebola

cases above 10 as being massive.

However, the case of Uganda in 2000-

2001 was considered the most serious

Ebola epidemic until the 2014 outbreak,

because the number of cases was 400

and above. Therefore cases between 10

and below 400 are considered medium

(e.g. Nigeria in 2014; DR Congo in

2014)

400+ = e-high Countries with high Ebola cases Cases of up to 400 and above were

historically considered as very serious

epidemics (e.g. Uganda in 2000-2001;

Guinea, Liberia and Sierra Leone in

2014)

ex-e low Countries declared free of Ebola after

previously low cases

Based on WHO declaration that a

country with low Ebola record has all

patients treated, no further reported cases

or deaths and no new infections after six

weeks since the last successful treatment

or death (e.g. Senegal in October 2014)

ex-e medium Countries declared free of Ebola after

previously medium cases


country with medium Ebola record has

all patients treated, no further reported

cases or deaths and no new infections




472

after six weeks since the last successful

treatment or death (e.g. Nigeria in

October 2014)

ex-e high Countries declared free of Ebola after

previously high cases


country with high Ebola record has all

patients treated, no further reported cases

or deaths and no new infections after six

weeks since the last successful treatment

or death (e.g. Uganda in 2001).

e-free Countries with no record Ebola All countries with no history of Ebola

virus disease.

Source: Authors’ modification of data from the National Center for Infectious Diseases & Centers for Disease

Control and Prevention (2014)

Distribution of the Recent Ebola Virus Disease Outbreak (2014)

Table 2, presents a summary of the distribution of reported cases, deaths and calculated case-

fatality rates for the EVD, based on a summation of published data (From March 21, 2014) up to

November 16, 2014, by the Centers for Disease Control and Prevention and the World Health

Organisation.

Table 2: Distribution of the recent Ebola virus disease outbreak as of November 16, 2014

Country Number of

reported cases

Number of deaths Case-fatality rate MPD ranking

Guinea 1,919 1,166 70% e-high

Liberia 6,878 2812 41% e-high

Sierra Leone 5,586 1,187 21.25% e-high

Nigeria 20 8 40% ex-e medium

Senegal 1 0 0% ex-e low

United States 4 1 25% e-low

Spain 1 0 0% e-low

Mali 4 3 75% e-low

Sources: CDC (2014); WHO (2014)

The data in Table 2 shows that apart from the diffusion of the disease from the Guinea, Liberia

and Sierra Leone as the initial sources of the 2014 Ebola epidemic, all other affected countries

except Spain, has met the CDC’s condition for the declaration of an epidemic. In other words,

they have case-fatality rates of more than 7.7%. Even though countries such as Senegal and

Nigeria managed to control the spread of the EVD after recording ex-e low and ex-e medium

cases on the MPD ranking, the prevailing incidences in the e-high countries is a warning that no

country is free forever until the EVD is all over (BBC, 2014).

As of November 16, 2014, there were a total world record of 14, 409 cases and 5,174

deaths (CDC, 2014; WHO, 2014). The associated world case-fatality rate was about 36%, which

also signifies that a global epidemic exists, since it exceeds the 7.7% limit. These rankings are

considered in the dissociation schedules of the MPD in the results and discussions section of this

article.




473

The Socio-economic Effects of the Ebola Virus Disease Epidemic

Since the recent out-break of the Ebola virus disease in December 2013 in Guinea, and its

subsequent spread to other West African countries and beyond, some negative and positive

socio-economic effects have been realised. One of the negative effects includes increasing loss of

lives. About 4,033 persons died by October 8, 2014 and by November 16, 2014, the figure

increased to 5,174 on world record. Guinea, Liberia and Sierra Leone were the most affected

countries. The increasing level of mortality further has the effects of increasing the number of

orphaned children, widows and the aged as bread winners of households die. This increases the

vulnerability of the orphans to poor human development, while dependent widows and the aged

are also exposed to poverty, stigmatization and marginalisation, including the children as well

(World Bank, 2014).

The increasing risk of transmission of the EVD across international border has compelled

other countries to institute preventive measures such as bans on flights to, and from the Ebola

affected countries. This discourages international movement of goods and persons, while some

citizens of the affected countries who travelled to other countries temporally become exiled, as

they remain stranded in foreign lands. Furthermore, apart from the effects of restricted cross-

border movements, as the energetic labour force of the affected countries fall sick of the EVD

and internal movements are restricted due to scare and preventive measures, agricultural and

local business activities are also negatively impacted, which cripple the local economies. Such

economies become exposed to problems of food insecurity, reduced sources of income to

governments, businesses and households.

The situation becomes exacerbated as the already constrained governments have to spend

their limited financial resources on the management of the disease. This affects other aspects of

state responsibilities, such as the provision of basic infrastructure and the payment of salaries of

public sector workers, including health staff with additional overtime and risk allowances. In

Liberia for instance, President Ellen Johnson Sirleaf’s administration threatened to lay off

government employees who failed to report to work on the excuse of attending to sick family

members due to Ebola (The Analyst, October 2014). In Nigeria, President Goodluck Jonathan

sacked 16,000 resident doctors in August 2014, for striking during the outbreak of EVD in that

country (Kover, 2014).

One major positive effect of the EVD outbreak is that it has influenced some level of

international cooperation between countries that were initially in conflict. For instance, despite

the antagonism between USA and Russia over the latter’s interference in the political affairs of

Ukraine, the two countries collaborated in the production of an experimental vaccine called

Triazoverin. The scientists of the two countries produced the drug in Russia, and tested in USA.

This collaborative process is seen as an element of peace building (Specia, 2014). Furthermore, it

could be said that the widespread nature of the 2014 Ebola outbreak contributed to more serious

international alertness and innovation, which made it possible for the discovery of the EVD

vaccine, since the disease started in 1976. Another aspect of international solidarity, include




474

financial assistance. For instance European countries have contributed about 500m euros for the

control of the EVD in Africa in October 2014 (BBC, 2014).

It has also led to the training and acquisition of skills for Ebola treatment and control by

health and military personnel of countries that are experiencing the EVD for the first time, as

well as those that have never even experienced it, as they prepare against a future outbreak.

Additionally, the management of the EVD provides additional income in the form of allowances

to health personal, as well as increased employment and market opportunities to industries

engaged in the production of the drugs, vaccines and protective gear for the epidemic. For

example Weiqun (2014), reports that the Weifang Lakeland Safety Products factory in China,

with only 100 employees was producing up to 6,000 protective plastic suits in October 2014, and

planned to increase its capacity in terms of employees and output in January 2015.

The high levels of morbidity and mortality associated with the EVD 2014 epidemic, as

well as the increasing levels of vulnerability of the masses to socio-economic mishaps, makes the

negative effects to out-weigh the positive effects of the disease. This therefore calls for the need

to explore more stringent methods of stopping the incidence of the disease in order to save

human lives.

Methodology

Typically the study has a basic research orientation, since it seeks to provide the knowledge base

and understanding in the explanation of how the Ebola virus disease epidemic could be

controlled in a systematic manner, through the postulation of the Malongza’s Principle of

Dissociation. The applicability of the principle also means that the study lays a foundation for

applied research if its principle becomes of practical relevance (See Kumar, 1999). In other

words, it is directed towards the use of knowledge gained by basic research to explain the

necessary conditions and situations that serve as a practical or utilitarian purpose for the control

of the Ebola epidemic in the affected countries in West Africa and the world at large (See Parker,

1984).

Philosophically its presents a positivistic argument expressed by mathematical models,

and then employs basic information from available research findings to identify the knowledge

gaps and establish the alternatives approaches for addressing the problem of controlling the

Ebola virus disease epidemic. This is by analysing the acquired information based on the

relationships between the variables of the mathematical basis of the principle. It is therefore a

combination of both objective and subjective realities for establishing the truth about the

management of the disease. This is achieved by a content study of existing information on

current practices on the subject to support and shape the focus of the idea behind what is

described as the Malongza’s Principle of Dissociation (MPD) to stop the Ebola virus disease.

Results and Discussions

From the contexts of the background information, the theories and empirical data on the Ebola

virus disease epidemic presented earlier, we now focus attention on the proposed principle and

the schedule of activities to stop the EVD.




475

The Malongza’s Principle of Dissociation

The Malongza’s Principle of Dissociation (MPD) states that a phenomenon strives and spreads

as long as the conditions that support its medium remain unaltered. Therefore, the elimination of

the conditions that constitute its medium discontinues the phenomenon.

From our definition of the MPD above, we assume that

1. The dependent phenomenon (E) = Incidence of Ebola virus disease

2. Independent conditions (C) = {C1=Environmental factors (infected animals); &

C2=human contacts (hand shaking, hugging, etc.)} and

3. Independent mediums (M)= Presence of structural arrangements that promote human

contacts through association e.g. markets, schools, homes/ households, workplaces,

hospitals, commercial passenger transport, places of worship and all forms of social

or public gatherings.

Deriving from points 1-3 above, E = C+M

But C= C1 + C2

∴ E= C1 + C2 + M

In other words Ebola virus disease (E) is dependent on the presence of infected

animals in the environment (C1); human contacts (C2); and the mediums that

promote human contacts (M).

Let’s assume C1 cannot be changed within the shortest possible time with the best

available technology and medical practices.

⇒ E= C2 + M……………………………………………. (1)

The law of the MPD is that any action to eliminate C2 or M would reduce the

incidence of Ebola virus disease by the magnitude of the independent factor that is

removed. E.g. let’s remove human contact (C2),

Then we obtain E - C2 = C2 – C2 + M

⇒ E - C2= M………………..………………………… (2)

What this means is that the level of prevalence of Ebola virus disease is now determined by the

level of mediums (M) of human associations but with minimal level of contacts. In other words,

households, schools, workplaces, churches and mosques will continue to operate but with

controlled levels of human contacts, such as all people wearing protective clothing and gloves.

If we take away M also, then have

E - C2 - M= M – M

Such that the incidence of the Ebola virus disease is now reduced to

E - C2 - M= 0……………………………………… (3)

This does not mean Ebola ends completely, but the incidence of Ebola would be weakened by

dissociation. That is by reducing both human contacts and the mediums that promote human

associations. This does not also mean that society ceases to exist before Ebola is controlled. In

other words, the dissociation process is completed by equation 3, such that the strive and spread




476

of the EVD through all possible means of human contacts and association are discontinued.

Whether the Ebola epidemic would continue or not, in a given society where the MPD is

implemented depends on how effective and efficient the stages of dissociation are carried out.

Duration and Dissociation Procedures According to MPD Ranking of Countries

This section discusses the duration and schedule of activities marking the procedures for the

implementation of the proposed MPD.

Duration of the implementation of the MPD

In the individual country cases, the World Health Organization and the Centers for Disease

Control and Prevention, adopt a standard period of 46 days or six weeks, for determination of

whether a country should be declared Ebola free. This depends on whether or not new cases are

reported since the last case of Ebola confirmed. The principle behind the duration is by doubling

the incubation period of 21 days for the Ebola virus. Being proposed for a global exercise, the

MPD suggests an additional one week to be distributed over the preparatory, effective

coordination, collation and communication activities. Seven weeks are therefore proposed for the

execution of the MPD schedules.

Scheduling for Dissociation Procedure by MPD Ranks of Countries

We now present activity schedules for the execution of what the MPD describes as

‘dissociation’. This involves the policy implications of ‘eliminating’ C2 (human contacts) and M

(Mediums of human associations) in the MPD equations 2 and 3 based on the ranking methods

described in Tables 1 and 2. Once approved for implementation, a commencement date is

declared by the World Health Organisation for all participating countries. This implies that the

legal consent of countries, especially e-free countries should be sought by the signing of an

agreement to stop the Ebola virus disease epidemic universally.

Table 3: Schedule of activities for dissociation by the elimination of C2 (Human contacts)

e-high countries

Activity Target persons Responsibility Monitoring &

Evaluation

Remarks

International

agreement and

declaration of

intention to

implement the MPD

and the purpose

Governments and

peoples of all e-

high countries

WHO, health

departments and

social media of e-

high countries

WHO and health

ministries of e-high

Countries

Screening of all

citizens for Ebola

symptoms

Members of all

households in e-high

countries

Health departments

of e-high countries,

trained military

personal, Red Cross

Society and

volunteers

Health ministries of

e-high countries and

WHO

representatives

Immediate

quarantine of

Members of all


Health departments

of e-high countries






477

confirmed and

suspected persons

for treatment in

previously designed

isolated wards. All

persons sick of any

other disease other

than Ebola, shall

also be under

compulsory custody

of the health

department within

the MPD period.

countries WHO

representatives

Scheduled

temporary and

regulated stay off

from residential

homes while mass

disinfection takes

place in the homes

Members of all


countries

Trained military

personal, , Red

Cross Society and

volunteers



WHO

representatives

Provision of plastic

protective clothing,

gloves and foot

wears and enforcing

their use

Members of all


countries

WHO, through

globally mobilized

funds from Ebola

special levy on all

able adults in the

MPD participating

countries.

Health ministries

and social welfare

departments of e-

high countries,

military personnel,

volunteers and

WHO

representatives

Education of citizens

on how Ebola virus

spreads from person-

to-person contacts,

how they should use

the protective plastic

clothing, symptoms

of the disease, self

examination for

symptoms and

where to report in

the event of illness.

Members of all


countries

Departments of

education, health,

social welfare,

information and

social media of the

e-high countries

WHO, Ministries of

health, education

and communication

of all e-high

countries.

Self quarantine of all

households in their

disinfected homes

without individual

household member

interactions, except

persons under five

Members of all


countries

Health ministries

and social welfare

departments of e-

high countries,

military personnel,

Red Cross Society

and volunteers.

WHO, health

ministries, social

welfare departments

of e-high countries,

traditional

authorities




478

with mothers. This is

after provisions for

food and water have

been considered.

Domestic animals

and pets should also

be quarantined

separately, and

examined for

infection, treatment

or euthanasia. The

duration should be

21 days (3 weeks)

e-medium

countries

International

agreement and

declaration of

intention to

implement the MPD

and the purpose

Governments and

peoples of all e-

medium

countries

WHO, health

departments and

social media of e-

medium

countries

WHO and health

ministries of e-

medium

Screening of al1

residents of towns

and villages that

have records of

EVD.

All households in

towns and villages

of e-medium

countries.

Health departments

of e-medium

countries, trained

military personal, ,

Red Cross Society

and volunteers


e-medium countries

and WHO

representatives

Immediate

quarantine of

confirmed and

suspected persons

for treatment in

previously designed

isolated wards. This

is followed by

contact tracing for

all persons that had

contact with the

infected persons

outside the enlisted

towns and villages in

the country. The

locations of

identified persons

are included in the

screening process.

All households in

towns and villages

of e-medium

countries

Health departments

of e-medium


e-medium countries

Scheduled Members of all Trained military Health ministries of




479

temporary and

regulated stay off

from residential

homes of the

enlisted locations

while mass

disinfection takes

place in the homes

households of

enlisted locations in

e-medium countries

personal, , Red

Cross Society and

volunteers

e-medium countries

and WHO

representatives



gloves and foot

wears and enforcing

their use

Members of all

households of

enlisted locations in

e-medium countries

WHO, through

globally mobilized

funds from Ebola

special levy on all

able adults in the

MPD participating

countries.

Health ministries

and social welfare

departments of e-

medium countries,

military personnel,

volunteers and

WHO

representatives

Education of all

citizens on Ebola

transmission, how

the protective gear

should be used by

those in enlisted

areas, and self

examination for

symptoms and

where to report in


Members of

households in the

enlisted areas of e-

medium countries

Departments of

education, health,

social welfare,

information and

social media of the

e-medium countries

WHO, Ministries of

health, education

and communication

of e-medium

countries.

Self quarantine of

households of the

enlisted areas in

their disinfected

homes without

individual household

member interactions,

except persons under

five with mothers.

There should be

considerations for

food and water.

Domestic animal

management should

also be considered,

to prevent re-

infection of persons

after the MPD

period by the

animals.

Members of

households in the

enlisted areas of the

e-medium countries

Health ministries

and social welfare

departments of e-

medium countries,

military personnel ,

Red Cross Society

and volunteers.

WHO, health

ministries, social

welfare departments

of e-medium

countries and

traditional

authorities




480

The duration should

be 21 days (3

weeks)

For towns and

villages without

Ebola cases in the e-

medium, countries,

there should

adequate public

education about

Ebola, conscious

change of culture

within the MPD

period. E.g. all

persons should

acquire and use

impermeable long-

sleeve clothing and

the use of plastic

hand gloves at

subsidised cost.

Men and boys

should were trousers

and women and girls

should wear long

skirts. The use of

open foot wears and

direct contacts with

other persons

outside their homes

should be avoided.

Members of

households in the

Ebola free areas of

the e-medium

countries

Military personnel ,

Red Cross Society

and volunteer groups

Ministries of health

and defense and

traditional

authorities.

e-low countries

International

agreement and

declaration of

intention to

implement the MPD

and the purpose

Governments and

peoples of e-low

countries

WHO, health

departments and

social media of e-

low countries

WHO and health

ministries of e-low

countries

Screening of al1

residents of the

particular residential

areas in the towns

and villages that

have records of

EVD. This should

include the locations

of persons identified

All households in

residential areas of

towns and villages

with Ebola cases in

the e-low countries.

Health departments

of e-low countries,

trained military

personal, , Red

Cross Society and

volunteers


e-low countries and

WHO

representatives




481

by outcomes of

contact tracing.

Immediate

quarantine of

confirmed and

suspected persons

for treatment in

previously designed

isolated wards.

All households in


towns and villages

with Ebola cases in

the e-low countries

Health departments

of e-low


e-low countries

Scheduled

temporary and

regulated stay off

from residential

homes of the

enlisted locations

while mass

disinfection takes

place in the homes

All households in


towns and villages

with Ebola cases in

the e-low countries

Trained military

personal, Red Cross

Society and

volunteers


e-low countries



gloves and foot

wears and enforcing

their use

All households in


towns and villages

with Ebola cases in

the e-low countries

WHO, through

globally mobilized

funds from Ebola

special levy on all

able adults in the

MPD participating

countries.

Health ministries

and social welfare

departments of e-low

countries, military

personnel and

volunteers

Education of all

citizens on Ebola

transmission, how

the protective gear

should be used by

those in enlisted

areas, and self

examination for

symptoms and

where to report in


All households in


towns and villages

with Ebola cases in

the e-low countries

Departments of

education, health,

social welfare,

information and

social media of the

e-low countries

WHO, Ministries of

health, education

and communication

of e-low countries.

Self quarantine of

households of the

enlisted areas in

their disinfected

homes without

individual household

member interactions,

except persons under

five with mothers.

There should be

considerations for

All households in


towns and villages

with Ebola cases in

the e-low countries

Health ministries

and social welfare

departments of e-low

countries, military

personnel and

volunteers.

WHO, health

ministries, social

welfare departments

and traditional

authorities of e-low

countries.




482

food and water.

Domestic animal

management should

also be considered,

to prevent re-

infection of persons

after the MPD

period by the

animals.

The duration should

be 21 days (3

weeks)

For towns and

villages without

Ebola cases in the e-

low, countries, there

should be adequate

public education

about Ebola,

conscious change of

culture within the

MPD period, as in

the case of e-

medium countries

above.

All households in


towns and villages

with Ebola cases in

the e-low countries

Military personnel

and volunteer groups

Ministries of health

and defense and

traditional

authorities.

e-free, ex-e high,

ex-e medium,

and ex-e low

countries

International

agreement and

declaration of

intention to

implement the MPD

and the purpose

Governments and

peoples of countries

with previous or no

record of Ebola virus

disease

WHO, health

departments and

social media of

countries with

previous or no

record of Ebola virus

disease

WHO and health

ministries of Ebola

free countries

Intensification of

education on the

causes, symptoms,

treatment, effects,

and prevention of

Ebola virus disease.

Citizens of all

countries with

previous or no Ebola

cases

WHO, health and

education

departments and

social media of

countries with


cases

WHO and health

ministries of Ebola

free countries

Conscious change of

culture within the

MPD period. E.g. all

Citizens of all

countries with


WHO, health and

education

departments and

WHO and health

ministries of Ebola

free countries




483

persons should

acquire and use

impermeable long-

sleeve clothing and

the use of plastic

hand gloves at

subsidised cost.

Men and boys

should were trousers

and women and girls

should wear long

skirts. The use of

open foot wears and

direct contacts with

other persons

outside their homes

should be avoided.

cases social media of

countries with


cases

Interpretations of the MPD ranks of countries: e-low =1-9 Ebola cases; e-medium =10-399 Ebola cases; e-high= 400+ Ebola cases; ex- (high,

medium & low) = previously e-high, e-medium and e-low; e-free= Never had Ebola.

Source: Authors’ own construct

Table 4: Schedule of activities for dissociation by the elimination of M (Mediums of human

contacts)

e-high countries

Activity Target persons Responsibility Monitoring &

Evaluation

Remarks

Obtaining and

distribution of all

basic necessities to

cater for the needs of

the populations of at

least, three e-high

countries during a 21

day lockdown..

Members of all


countries

WHO/UN,

Governments and

peoples of Ebola and

non-Ebola countries

in the world.

WHO, Disaster

Management

Organisations of the

e-high countries

Total lockdown of

all mediums of

social gathering and

human interactions,

e.g. schools,

workplaces, markets,

congregational

worship, local and

international

transport, all forms

of rites of initiation,

meetings and

celebrations for 21

days.

Governments and

peoples of all e-

high countries

The military, Red

Cross Society,

Volunteers

WHO, health

ministries and

Disaster

Management

Organisations of e-

high,




484

Ebola Preventive

training and

certification

exercises for

management and

employees of all

public and private

social service

institutions, e.g.

hospitals, beauty

salons, barber shops,

driver associations,

financial institutions,

, hotels and

restaurants, markets,

local food vendors,

hawkers, etc. (This

could be before or

immediately after

the 21 day

lockdown)

Management and

employees of social

service providing

institutions in e-high

countries

Health departments,

Red Cross Society

and Disaster

Management

Organisations of e-

high countries.

WHO, Health

ministries and

Disaster

Management

Organisations of

e-high countries

During the

lockdown, there

should be

disinfection of the

mediums of social

contacts. These

include the

structures involved

in the preventive and

certification

exercises specified

above.

All mediums of

social contacts in e-

high countries

Health departments,

Disaster

Management

Organisations,

trained military

personnel, Red

Cross Society and

volunteers of e-high

countries

WHO and Health

ministries of

e-high countries

Data collection and

analysis on EVD

based on cases of

human contacts in

the social mediums

after 21 days

All mediums of


high countries

Recommended

national laboratories

for the diagnosis of

Ebola virus in the e-

high countries

WHO and health

ministries of e-high

countries

e-medium

countries

Obtaining and

distribution of all



the populations of

enlisted areas of

Members of

households in the


medium countries

WHO/UN,

Governments and


non-Ebola countries

in the world.

WHO, Disaster

Management


e-medium countries




485


day lockdown..

Total lockdown of

all mediums of


human interactions,

e.g. schools,


congregational

worship, local and

international



meetings and

celebrations for 21

days.

All mediums of

social contacts in the


medium countries

The military, Red

Cross Society,

Volunteers

WHO, health

ministries and

Disaster

Management

Organisations of e-

medium

Ebola Preventive

training and

certification

exercises for

management and

employees of all

public and private

social service

institutions, e.g.

hospitals, beauty




, hotels and


local food vendors,

hawkers, etc. (This

could be before or

immediately after

the 21 day

lockdown)

Management and

employees of social

service providing

institutions in the


medium countries

Health departments,

Red Cross Society

and Disaster

Management

Organisations of e-

medium countries.

WHO, Health

ministries and

Disaster

Management

Organisations of

e-medium countries

During the

lockdown, there

should be

disinfection of the

mediums of social

contacts. These

include the

structures involved


certification

All mediums of



medium countries

Health departments,

Disaster

Management

Organisations,

trained military

personnel, Red

Cross Society and

volunteers of e-

medium countries

WHO and Health

ministries of

e-medium countries




486

exercises specified

above.

Data collection and

analysis on EVD

based on cases of

human contacts in

the social mediums

after 21 days

All mediums of


medium countries

Recommended




medium countries

WHO and health

ministries of e-

medium countries

e-low countries

Obtaining and

distribution of all



the populations of

enlisted areas of


day lockdown..

All households in


towns and villages

with Ebola cases in

the e-low countries

WHO/UN,

Governments and


non-Ebola countries

in the world.

WHO, Disaster

Management


e-low countries

Total lockdown of

all mediums of


human interactions,

e.g. schools,


congregational

worship, local and

international



meetings and

celebrations for 21

days.

All mediums of



towns and villages

with Ebola cases in

the e-low countries

The military, Red

Cross Society,

Volunteers

WHO, health

ministries and

Disaster

Management

Organisations of e-

low

Ebola Preventive

training and

certification

exercises for

management and

employees of all

public and private

social service

institutions, e.g.

hospitals, beauty




, hotels and


local food vendors,

All mediums of



towns and villages

with Ebola cases in

the e-low countries

Health departments,

Red Cross Society

and Disaster

Management

Organisations of e-

low countries.

WHO, Health

ministries and

Disaster

Management

Organisations of

e-low countries




487

hawkers, etc. (This

could be before or

immediately after

the 21 day

lockdown)

During the

lockdown, there

should be

disinfection of the

mediums of social

contacts. These

include the

structures involved


certification

exercises specified

above.

All mediums of



towns and villages

with Ebola cases in

the e-low countries

Health departments,

Disaster

Management

Organisations,

trained military

personnel, Red

Cross Society and

volunteers of e-low

countries

WHO and Health

ministries of

e-low countries

Data collection and

analysis on EVD

based on cases of

human contacts in

the social mediums

after 21 days

All mediums of


low countries

Recommended




low countries

WHO and health

ministries of e-low

countries

e-free, ex-e high,

ex-e medium,

and ex-e low

countries

Ebola Preventive

training and

certification

exercises for

management and

employees of all

public and private

social service

institutions, e.g.

hospitals, beauty




, hotels and


local food vendors,

hawkers, etc. This

could be before or

immediately after

All mediums of


non-Ebola countries

Health departments,

Red Cross Society

and Disaster

Management

Organisations of

non-Ebola countries.

WHO, health

ministries and

Disaster

Management

Organisations of

non-Ebola countries




488

the 21 day lockdown

in the e-high, e-

medium and e-low

countries. NB: No

lockdown in Non-

Ebola countries

Selected non-Ebola

countries to serve as

points of reception

and conveyance of

international aids to

the e-high, e-

medium and e-low

countries. Apart

from the points for

Ebola aids only,

there should be a

ban on movement of

goods and persons to

and from the Ebola

affected countries

within the 21 day

lockdown period.

Selected countries

for Ebola aids and

Ebola affected

countries

Customs and Excise

Service,

immigration,

aviation, naval and

road transport units

of both Ebola and

non-Ebola affected

countries.

Ministries of

transport, defense

and foreign affairs of

Ebola and non-Ebola

affected countries of

all MPD

participating

countries.

Ebola screening at

border points and

regular health

checks of new

immigrants

irrespective of

countries of origin,

by recommended

health facilities up to

21 days from the

commencement of

the MPD

implementation

(Frequency of

check-ups to be

determined by the

health ministry)

All new immigrants

into non-Ebola

affected countries

within the period of

the MPD

implementation.

Customs, national

immigration units

and the

recommended health

facilities of the non-

Ebola countries

WHO, foreign

affairs and health

ministries of non-

Ebola affected

countries.

Data collection and

analysis on EVD

based on cases of

human contacts in

the social mediums

after 21 days

All mediums of


non-Ebola countries

Recommended



Ebola virus in the

non-Ebola countries

WHO and health

ministries of non-

Ebola countries

Interpretations of the MPD ranks of countries: e-low =1-9 Ebola cases; e-medium =10-399 Ebola cases; e-high= 400+ Ebola cases; ex- (high,

medium & low) = previously e-high, e-medium and e-low; e-free= Never had Ebola.




489

Source: Authors’ own construct.

The activities marking the elimination of the variables C2 and M in Tables 3 and 4 are supported

by some relevant empirical applications. For instance when Thomas Eric Duncan of Liberia

became the first man to contract EVD in Dallas city of USA, apart from himself as an EVD

patient, his family and over 100 others who had contact with him, identified by contact tracing

were also quarantined for 21 days. At the same time, Duncan’s home was power-washed or

disinfected (Stone, 2014). The news of Ebola outbreak in Dallas, following the infection of the

nurses who treated Duncan, prompted Ebola alertness on the part of the ordinary citizens, as they

changed their dressing style by wearing long-sleeve jackets, hand gloves and boots. Airline

flights to Ebola affected countries were also cancelled in the US and other parts of the World.

The Ebola control process also had to do with waste management. Thus, everything that

Thomas Eric Duncan used was packed and sealed in plastics and safely disposed. Stableford

(2014), also reports a similar situation for a female Spanish nurse who contracted Ebola in Spain.

Besides, a Spanish court ordered the euthanizing of the nurse’s dog, to prevent further zoonotic

(Animal-to-human) transmission of the EVD. Faul (2014), presents a case on the issue of total

lockdown, when she reports that following the death of 25 persons in 5 days, the authorities of

Sierra Leone ordered a two weeks lockdown of the eastern Kono District of the country. This

was to control further transmission of the EVD.

Despite the relevance of these strategies, the lack of global uniformity in their

applications has negatively impacted on the progress to control the disease. It is therefore argued

that a uniform adoption of theory such as the MPD for concurrent application all over the world

could stop the spread of the EVD and other hemorrhagic fever diseases. Thus, 21 days or three

weeks are required for the execution of the schedules in Tables 3 and 4 concurrently all over the

world. The expected outcomes are that within that period

There would be no chances of disease diffusion;

New cases occurring within a given household due to earlier contacts before the

MPD would have no chances of infecting other household members; and

All infected persons would have been identified and quarantined for treatment or

would have been dead.

An additional 21 days after the implementation of the MPD schedules are required to assess

whether new cases would, or would not occur. At the end, based on the distribution of the extra 7




490

days or one week, analysed data on country-by-country bases are compiled, and the new MPD

rankings of countries declared by the World Health Organisation. This serves as feed-back for

policy review or project exit due to successful implementation.

Conclusion

The discussions have shown that it is possible to bring the Ebola virus disease under global

control. It simply requires the harmonization of the on-going but separate strategies at various

locations in the world to be implemented uniformly. Thus, a stratification of countries on the

basis of the prevalence of the disease, and identifying which existing practice is best suitable for

addressing the situation of each country in the interest of the whole world, is what is needed. The

Malongza’s Principle of Dissociation makes this simple by contributing to the stratification

criterion and identifying the independent variables as human contacts (C2) and the mediums that

promote human contacts (M). The comprehensive schedule of activities in the tabular form

serves as a global master plan on how the variables could be regulated through dissociation to

stop the spread of the disease.

It is however, expected that zoonotic researchers would be inspired by the mathematical

basis of the principle of this study, to determine how the influence of the vector of the disease

(bats and other animals or the C1 factor) could be controlled for a more permanent solution.

Already, practices such as euthanizing infected animals and the avoidance of contact with, or the

eating of meat of wild animals are ongoing. But a lot more need to be covered by zoonotic

researchers. Also, the challenge of overcoming the influence of socio-cultural factors as such the

performance of funeral rights and adaptation to the appropriate dressing styles within the limited

period of 21 days in typical traditional African societies stands to be dealt with, through intensive

education and the enforcement of associate regulations.

Although efforts have been made to indicate the sources and rational use of funding, the

cost implications of the MPD could also be considered with alternative options based on

situational analysis. It is however, far cheaper than the total cost of treating infected persons and

vaccinating the whole world, since the MPD has the potential to stop the Ebola virus disease

within seven weeks without emphasis on medications.




491

References

BBC (2014). Ebola crisis: Nigeria declared free of virus. BBC news, October 20, 2014.

Bonnett, A. (2008) What is geography? London: SAGE.

Centers for Disease Control and Prevention (CDC) (2001). Outbreak of Ebola hemorrhagic

fever ---Uganda, August 2000--January 2001. Weekly, 50(05); 73-7

Centers for Disease Control and Prevention (2014). 2014 Ebola Outbreak. New York: CDC.

Centers for Disease Control and Prevention (CDC) (2014). Ebola in West Africa: impact on

health. New York Times, September 22, 2014.

Centers for Disease Control and Prevention (CDC) (2014). Ebola outbreaks

2000-2014. Accessed December 28, 2014.

http://www.cdc.gov/vhf/ebola/outbreaks/history/summaries.html.

Dixon, M.G. & Schafer, I.J. (2014). Ebola viral disease outbreak — West Africa, 2014.

Weekly, 63(25): 548-551.

Faul, M. (2014). Sierra Leone area to hold 2-week Ebola 'lockdown'. Associate Press,

December 10, 2014.

http://news.yahoo.com/sierra-leone-area-hold-2-week-ebola-lockdown-140920923.html.

Frobenius, L. (1897/98). Der westafrikanische Kulturkreis. Petermanns Mitteilungen, P. 43-44.

Haggett P. (2000). The geographical structure of epidemics. Clarendon; Oxford

Isaac, B. (2004). The invention of racism in classical antiquity. Princeton: Princeton University

Press.

Kover, C. (2014). Nigerian president sacks doctors on strike during the Ebola outbreak. Vice

News, August 15, 2014.

National Center for Infectious Diseases & Centers for Disease Control and Prevention (2014).

Known cases and outbreaks of Ebola hemorrhagic fever, in reverse chronological order.

New York: CDC.

Ng, S. &Cowling, B.J. (2014). Association between temperature, humidity and ebolavirus

disease outbreaks in Africa, 1976 to 2014. Euro Surveill, 19(35): ii. Accessed November

26, 2014. http://www.eurosurveillance.org/ViewArticle.aspx?

http://news.yahoo.com/sierra-leone-area-hold-2-week-ebola-lockdown-140920923.html

http://www.eurosurveillance.org/ViewArticle.aspx




492

Muanya, M. (2014). Hoe Nigeria contained Ebola virus disease. The Guardian, October 8, 2015.

Parker, S. (ed.) (1984). McGraw-Hill dictionary of science and technical terms. New York:

McGraw-Hall Book Company.

Parry, R.L & Bazinet, I. (2014). Ebola toll passes 4,000 as fears grow worldwide. Yahoo News,

October 10, 2014.

Specia, M. (2014). Russia claims to have ebola vaccine. Mashable, October 13, 2014

Spickler, A.R. (2014). Ebolavirus and Marburgvirus infections. Iowa: The Center for Food

Security & Public Health.

Stableford, D. (2014). Excalibur, Ebola nurse's dog, is euthanized in Spain.

Yahoo News, October 8, 2014.

http://news.yahoo.com/excalibur-spanish-ebola-nurse-dog-dead-175117255.html.

Stone, M. (2014). Four who hosted Dallas Ebola patient quarantined.

Al Jazeera America, October 2, 2014.

http://america.aljazeera.com/articles/2014/10/2/ebola-texas-fourquarantined.html

The Analyst (2014). No threat to „non-essential‟ civil servants-MICAT reacts. Liberian News

Agency, October 16, 2014.

Tsai, M. & Koerner, B. (2009). Outbreaks vs. epidemics. Sate, April 27, 2009.

http://www.slate.com/articles/news_and_politics/recycled/2009/04/outbreaks_vs_epidemi

cs.html.

Weiqun, Z. (2014). China factory whirs overtime to make Ebola suits. Accessed October 30,

2014. http://news.yahoo.com/china-factory-whirs-overtime-ebola-suits-070204145.html

World Bank (2014). Ebola: economic impact could be “catastrophic”- World Bank.

Washington DC: World Bank.

World Health Organisation (WHO) (2014). Ebola disease. Geneva: WHO.

World Health Organisation (WHO) (2014). Global alert and response: Frequently asked

questions on Ebola virus disease. Geneva: WHO.

World Health Organisation (WHO) (2014). Global alert and response: Ebola virus disease

outbreak news, November 16, 2014.

http://news.yahoo.com/excalibur-spanish-ebola-nurse-dog-dead-175117255.html

http://america.aljazeera.com/articles/2014/10/2/ebola-texas-fourquarantined.html

http://www.slate.com/articles/news_and_politics/recycled/2009/04/outbreaks_vs_epidemi

MALONGZA’S PRINCIPLE OF DISSOCIATION TO STOP EBOLA HEMORRHAGIC FEVER EPIDEMIC

Documents

Transcript of MALONGZA’S PRINCIPLE OF DISSOCIATION TO STOP EBOLA HEMORRHAGIC FEVER EPIDEMIC