Flickr: European Commission DG ECHO
Updated 6/8/14
The World Health Organization has put the current death count to 887, but cases may not have been reported. Two Americans who had recently traveled to countries in West Africa contracted the disease and are now in US quarantine. A third case was suspected in New York City, but the hospital reports that he most likely does not have Ebola. International health efforts in Liberia, Guinea, and Sierra Leone are still unable to contain the outbreak. Health care workers are concerned that the virus will spread to neighboring West African nations, while the risk of the outbreak spreading to developed nations remains low.
---------
I’m lucky that my personal experiences with diseases are limited to the common cold and the flu. In fact, before the most recent outbreak of Ebola virus in West Africa, I wouldn’t have been able to tell you what the disease looks like, or why it is such a major concern for the worldwide health community. However, with West Africa currently in the midst of the deadliest outbreak of what many consider one of the world's deadliest diseases, it’s time to get the facts. Here is everything you need to know about the Ebola virus and the hurdles that are preventing health workers from reigning in the current surge:
The virus in focus
The Ebola virus is considered to be extremely deadly because of its incredibly low survival rate: 68% of cases are fatal, with some strains pushing that number up to 90%. Currently there is no cure- instead treatments focus on the symptoms to keep the body strong enough to fight off the virus. While some symptoms are external and easy to spot (think fever, aches, and extreme weakness) others, like internal bleeding, are more difficult to catch and can lead to deadly shock or organ failure. Making matters more confusing, the fact that these symptoms are similar to other, more common diseases causes people to dismiss their symptoms. When people don’t realize the severity of the situation, they forgo the treatment they need and spread the virus to others. This confusion and lack of education about the disease is largely responsible for the current outbreak.
What makes this outbreak different
As of July 2nd, the current outbreak in West Africa has claimed 467 lives, making it the deadliest Ebola virus outbreak thus far (previously, the hightest toll from an Ebola virus outbreak was 254 deaths). Here's why: because there is no vaccine or cure for Ebola virus, the first priority of any response is to quarantine the patients to prevent the virus from spreading (the virus can only be spread by direct contact with the infected, so tracking and limiting movement of people with the disease is the best way to contain it). In the past this strategy has proved to be largely successful, but this time the virus has spread internationally.
This iteration was first recognized in Guinea in March and it has since spread to Sierra Leone and Liberia. In addition to making its way through rural villages, the virus has also spread to several major cities including to Conakry, the capital of Guinea.
What’s happening on the ground
Despite their best efforts, health care workers, local and international, have had to contend with resistance from many communities. Additionally, while there have been many attempts to educate the population on how to recognize and avoid the Ebola virus, many areas have not been reached. Furthermore, traditional medicine is still practiced and traditional burial rites include the handling of the body by members of the community.
To effectively communicate, health care workers need to work with local leaders, but there is a history of mistrust due to corruption in many areas. The recent civil war in Sierra Leone, for instance, contributes to the general suspicion of government officials. Because the first response to Ebola virus is quarantine, rumors spread about what is actually happening to those being kept behind hospital walls. People frightened of being taken away flee to other areas often bringing the virus with them, and I understand why- I would be terrified to be separated from my family and put my well-being in the hands of strangers. Border checks have been put in place to combat this, but the governments have been unable to prevent everyone from getting through.
When these hurdles are combined with the weakness of the healthcare system in general (Sierra Leone has the highest maternal and infant mortality rates in the world), health care workers have their work cut out for them. Wrap your mind around this horrific scenario- in some cases, there has been a shortage of basic supplies such as gloves. Knowing that human-to-human contact is the most frequent method of transmission, healthcare workers without gloves and face masks are being asked to put themselves in extreme danger.
The future of the outbreak
Predictions for the future of the outbreak are mixed. The spread has not been contained, but leaders in the health departments of the affected countries claim that the outbreak will soon be in hand. For us in the developed world, rest easy- there is relatively little risk of the virus having a similar dissemination where we live even if an infected person traveled there. While I am grateful that my loved ones are safe, this heartbreaking inequity highlights that every nation without an effective health care system is vulnerable to this kind of nightmare. I think you'll agree that cultural differences aside, only a worldwide effort to increase access to education and healthcare can prevent the advancement of any contagious disease in developing nations.
-----
Michelle Kennedy