At least 759 people in Guinea, Sierra Leone and Liberia have been infected by Ebola since its symptoms were first observed four months ago, according to the World Health Organization. 467 of them have died. That’s a 61.5 percent mortality rate. The WHO says “drastic action is needed” to contain the virus, which has spread from rural areas to cities in West Africa. It has dispatched teams of experts to the region and is holding talks with the health ministers from 11 countries about what to do next. The Ebola virus causes viral hemorrhagic fever (VHF), which according to the U.S. Centers for Disease Control and Prevention (CDC), refers to a group of viruses that affect multiple organ systems in the body and are often accompanied by bleeding. The virus is named after the Ebola River in the Democratic Republic of Congo (formerly Zaire), where one of the first outbreaks occurred in 1976. The same year there was another outbreak in Sudan.
The WHO says there are five different strains of the virus — named after the areas they originated in. Three of these have been associated with large outbreaks of hemorrhagic fever in Africa. Ebola virus disease (EVD), formerly known as Ebola hemorrhagic fever, is a severe, often fatal illness in humans.
- EVD outbreaks have a case fatality rate of up to 90%.
- EVD outbreaks occur primarily in remote villages in Central and West Africa, near tropical rainforests.
- The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission.
- Fruit bats of the Pteropodidae family are considered to be the natural host of the Ebola virus.
- Severely ill patients require intensive supportive care. No licensed specific treatment or vaccine is available for use in people or animals
Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals. In Africa, infection has been documented through the handling of infected chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest. Ebola then spreads in the community through human-to-human transmission, with infection resulting from direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and indirect contact with environments contaminated with such fluids. Burial ceremonies in which mourners have direct contact with the body of the deceased person can also play a role in the transmission of Ebola. Men who have recovered from the disease can still transmit the virus through their semen for up to 7 weeks after recovery from illness. There have been more than 3,140 reported cases and more than 2,000 deaths since the discovery of Ebola.
Timeline:
Includes outbreaks resulting in more than 100 deaths or special cases.
1976 – First recognition of the EBOV disease is in Zaire (now Democratic Republic of the Congo). The outbreak has 318 reported human cases, leading to 280 deaths. An SUDV outbreak also occurs in Sudan (now South Sudan), which incurs 284 cases and 151 deaths.
1989 – In Reston, Virginia, macaque monkeys imported from the Philippines are found to be infected with the Ebola virus (later named the Ebola-Reston virus).
1990 – In Texas and Virginia quarantine facilities, four humans develop Ebola antibodies after contact with monkeys imported from the Philippines. None of the humans has symptoms.
1995 – An outbreak in Democratic Republic of the Congo (formerly Zaire) leads to 315 reported cases and at least 250 deaths.
2000-2001 – A Ugandan outbreak (SUDV) results in 425 human cases and 224 deaths.
2001-2002 – An EBOV outbreak occurs on the border of Gabon and Republic of the Congo (ROC), which results in 53 deaths on the Gabon side and at least 43 deaths on the Republic of the Congo side.
December 2002-April 2003 – An EBOV outbreak in Republic of the Congo results in 143 reported cases and 128 deaths.
2007 – An EBOV outbreak occurs in the Democratic Republic of the Congo (DRC), 187 of the 264 cases reported result in death. In late 2007, an outbreak in Uganda leads to 37 deaths. 149 cases were reported.
November 2008 – The Ebola-Reston virus (RESTV) is detected in five humans in the Philippines. They are workers on a pig farm and slaughterhouse and suffer no symptoms. This is the first known occurrence of the Reston virus in pigs.
March 2014-present – Outbreak in Guinea, Sierra Leone and Liberia. According to the World Health Organization, there are at least 410 confirmed or suspected cases of EVD in Guinea, resulting in 310 deaths there. In Liberia, there are 196 suspected or confirmed cases, resulting in 116 deaths. In Sierra Leone, there have been 442 suspected or confirmed cases with 206 deaths.
Signs and symptoms
EVD is a severe acute viral illness often characterized by the 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. Laboratory findings include low white blood cell and platelet counts and elevated liver enzymes.
Diagnosis
Other diseases that should be ruled out before a diagnosis of EVD can be made include: malaria, typhoid fever, shigellosis, cholera, leptospirosis, plague, rickettsiosis, relapsing fever, meningitis, hepatitis and other viral hemorrhagic fevers.
Ebola virus infections can be diagnosed definitively in a laboratory through several types of tests:
- antibody-capture enzyme-linked immunosorbent assay (ELISA)
- antigen detection tests
- serum neutralization test
- reverse transcriptase polymerase chain reaction (RT-PCR) assay
- electron microscopy
- Virus isolation by cell culture.
Samples from patients are an extreme biohazard risk; testing should be conducted under maximum biological containment conditions.
Vaccine and treatment
No licensed vaccine for EVD is available. Several vaccines are being tested, but none are available for clinical use. Severely ill patients require intensive supportive care. Patients are frequently dehydrated and require oral rehydration with solutions containing electrolytes or intravenous fluids. No specific treatment is available. New drug therapies are being evaluated.
Health ministers from across West Africa met in Ghana to form a regional response to the Ebola outbreak that has killed almost 500 people. The World Health Organization has confirmed that this outbreak, which affects Sierra Leone, Liberia and Guinea, is the deadliest and most aggressive in history. The organization says “drastic” action is needed to contain the spread of the virus. “We’re hoping to take decisions about how to enhance collaboration and responses [of these countries] so we can get a grip and halt this outbreak,” WHO spokesman Daniel Epstein told the BBC. The disease is described as “a severe acute viral illness”. It kills up to 90 per cent of those infected and is highly contagious, with no known vaccine or cure. There are various challenges facing the containment of the disease. “In Liberia, our biggest challenge is denial, fear and panic. Our people are very much afraid of the disease,” Bernice Dahn, Liberia’s deputy health minister, told Reuters at the meeting in Ghana. Sierra Leone’s health minister says more money is needed to pay for drugs, medical staff; protective clothing and isolation center’s to halt the spread of the disease.
The WHO sites three main reasons it has been so difficult to contain the spread of the disease: high population densities in the major cities affected, the difficulty in regulating the movement of people across the region and families insisting on traditional burials of victims which risk spreading the disease. Medical charities in the region are also reporting attacks on foreigner aid workers, who some blame for the disease. “We are seeing an increasing level of hostility borne out of fear in some communities,” said Dr Bart Janssens, director of operations for Médecins Sans Frontières.
Alusine Melvin Moseray Kanu DA
