Ebola is one of the world’s most deadly diseases.
It is a highly infectious virus that can kill up to 90 percent of the people who catch it, causing terror among infected communities.
Ebola is so infectious that patients need to be treated in isolation by staff wearing protective clothing.
After more than 11,000 deaths over the course of nearly two years, the West Africa Ebola outbreak was finally delcared over on 14 January 2016.
West Africa Ebola Outbreak, 2014-16
The Ebola outbreak in West Africa killed 11,315 people after being officially declared on 22 March 2014 in Guinea.
The emergency was declared over on 14 January 2016 after Liberia celebrated 42 days without any new Ebola infections.
During the Ebola emergency, 28 of our staff members caught Ebola. Fourteen recovered but 14 died.
The vast majority of these infections were found to have occurred in the community.
On 22 December 2016, the results of an experimental Ebola vaccine trial were released by the Lancet. The trial found the vaccine to be highly effective in protecting people against the Zaire strain of Ebola.
“This vaccine will be a powerful tool to help prevent the spread of the Zaire strain of Ebola and to protect health workers,” said MSF President Dr Bertrand Draguez.
“MSF will try to make use of it in any future outbreak of the disease. More research is still needed to determine the length of protection that it offers to people and into vaccines for other strains of Ebola. Progress also still needs to be made in improving the treatment of patients once they are infected with Ebola, to make sure more lives can be saved.”
It is estimated there had been over 1,800 cases of Ebola, with nearly 1,300 deaths, before this latest outbreak in 2014.
The Ebola virus was first associated with an outbreak of 318 cases of a haemorrhagic disease in Zaire (now the Democratic Republic of Congo) in 1976. Of the 318 cases, 280 died — and died quickly.
That same year, 284 people in Sudan also became infected with the virus, killing 156.
There arefive different strains of the Ebola virus: Bundibugyo, Ivory Coast, Reston, Sudan and Zaire, named after their places of origin.
Four of these five have caused disease in humans. While the Reston virus can infect humans, no illnesses or deaths have been reported.
Before the 2014 outbreak, MSF had treated hundreds of people affected by Ebola in Uganda, Republic of Congo, the Democratic Republic of Congo (DRC), Sudan, Gabon and Guinea.
In 2007, MSF entirely contained an epidemic of Ebola in Uganda.
What causes Ebola?
Ebola can be caught from both humans and animals. It istransmitted through close contact with blood, secretions, or other bodily fluids.
Healthcare workers have frequently been infected while treating Ebola patients. This has occurred through close contact without the use of gloves, masks or protective goggles.
In areas of Africa, infection has been documented through the handling of infected chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found dead or ill in the rainforest.
Burials where mourners have direct contact with the deceased can also transmit the virus, whereas transmission through infected semen can occur up to seven weeks after clinical recovery.
Symptoms of Ebola
Early on, symptoms are non-specific, making it difficult to diagnose.
The disease is often characterised by the sudden onset of fever, feeling weak, muscle pain, headaches and a sore throat. This is followed by vomiting, diarrhoea, rash, impaired kidney and liver function and, in some cases, internal and external bleeding.
Symptoms can appear fromtwo to 21 days after exposure. Some patients may go on to experience rashes, red eyes, hiccups, chest pains, difficulty breathing and swallowing.
Diagnosing Ebola is difficult because the early symptoms, such as red eyes and rashes, are common.
Ebola infections can only be diagnosed definitively in the laboratory by five different tests.
Such tests are an extreme biohazard risk and should be conducted under maximum biological containment conditions. A number of human-to-human transmissions have occurred due to a lack of protective clothing.
“Health workers are particularly susceptible to catching it so, along with treating patients, one of our main priorities is training health staff to reduce the risk of them catching the disease whilst caring for patients,” said Henry Gray, MSF’s emergency coordinator, during an outbreak of Ebola in Uganda in 2012. Henry also worked on the 2014 outbreak.
“We have to put in place extremely rigorous safety procedures to ensure that no health workers are exposed to the virus – through contaminated material from patients or medical waste infected with Ebola.”
No specific treatment or vaccineis yet available for Ebola.
Standard treatment for Ebola is limited to supportive therapy. This consists of hydrating the patient, maintaining their oxygen status and blood pressure and treating them for any complicating infections.
Despite the difficulty of diagnosing Ebola in its early stages, those who display its symptoms should be isolated and public health professionals notified.
Supportive therapy can continue with proper protective clothing until samples from the patient are tested to confirm infection.
Once a patient recovers from Ebola, they are immune to the strain of the virus they contracted.
MSF contained an outbreak of Ebola in Uganda in 2012 by placing a control area around the treatment centre.
An Ebola outbreak is officially considered at an end once 42 days have elapsed without any new confirmed cases.