Ebola is so infectious that patients need to be treated in isolation by staff wearing protective clothing.
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Since the Ebola outbreak in West Africa was officially declared on 22 March in Guinea, it has claimed more than 10,000 lives in the region.
The outbreak is the largest ever, and is currently affecting two countries in West Africa: Guinea and Sierra Leone. Liberia is waiting to be declared Ebola free. Outbreaks in Mali, Nigeria and Senegal have been declared over. A separate outbreak in Democratic Republic of Congo has also ended.
Update: 10 April 2015
Though the number of Ebola patients has dropped to 30 in the West Africa region in the past week, the main challenge to get to zero is continued vigilance until all three countries reach 42 days with no new cases.
We currently have 14 confirmed and suspected patients admitted in our MSF centres, but with just one case, the outbreak continues. Unsafe burials continue and the contact tracing indicators for Guinea (48 percent) and Sierra Leone (56 percent) remain unacceptably low and indicate possible hidden chains of transmission.
This means we still don’t know where half the cases are coming from and the outbreak cannot be considered under control.
It remains vital for all the countries to keep a strong surveillance system in place, and all available resources must be deployed to investigate suspected cases and to respond quickly, ensuring that transmission is broken as early on as possible
In Guinea there is ongoing reticence of some communities. People continue to deny that Ebola is real, while others believe an Ebola management centre is a place to be avoided at all costs. Improved awareness-raising activities must continue and be reinforced.
Though Liberia is currently on the countdown to 42 days with no news cases, the country remains at risk while the virus lives on in neighbouring Guinea and Sierra Leone.
It remains vital for all the countries to keep a strong surveillance system in place, and all available resources must be deployed to investigate suspected cases and to respond quickly, ensuring that transmission is broken as early on as possible. The fall in cases is encouraging but it is equally true that the numbers continue to fluctuate, particularly in Guinea. The emergency is not over and it is not yet time to declare victory.
Additionally, the upcoming rainy season means that access to healthcare and surveillance will be hampered by bad roads and inaccessible parts of the countries. There is the chance of water-borne diseases to emerge, such as cholera which would be extremely difficult to manage in the midst of an Ebola outbreak. Increased malnutrition is also a concern as the hunger gap occurs during the rainy season.
MSF's Ebola response
Since the response began, 27 MSF staff members have fallen ill with Ebola, 14 of whom have recovered and 13 have died.
The vast majority of these infections were found to have occurred in the community.
Since the beginning of our Ebola response, we have sent more than 1,400 tonnes of cargo to West Africa.
Read an extensive interview with an MSF Ebola specialist about how we care for our Ebola patients.
MSF case numbers since the outbreak began (as of 3rd March)
- Admitted* 8,449 patients
- 5,074 were confirmed as having Ebola
- More than 2,390 patients have survived
* Admissions include all suspected, probable and confirmed cases.
Hover over the image below for an interactive guide to an MSF Ebola treatment centre
Hover over the image below for an interactive guide to the high risk zone inside an MSF Ebola treatment centre
Hover over the image below for an interactive guide to our Ebola protective kit
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 are five 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.
Risk of Ebola spreading
The risk of Ebola spreading to the UK is minimal, but to minimise it even further we need more resources to bring the outbreak under control in West Africa.
Before this outbreak, MSF has 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 is transmitted 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 from two to 21 days after exposure. Some patients may go on to experience rashes, red eyes, hiccups, chest pains, difficulty breathing and swallowing.
MSF UK doctor Javid Abdulmoneim reflects on his time battling Ebola in Sierra Leone in this powerful and painful TEDxAthens talk
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 is also working on the current 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 vaccine is 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.
Read an extensive interview with an MSF Ebola specialist about how we care for our Ebola patients.
Update 23 March
MSF publishes its 'Pushed to the limits and beyond' report, taking a critical look back one year into the Ebola outbreak.
“The Ebola outbreak has often been described as a perfect storm: a cross-border epidemic in countries with weak public health systems that had never seen Ebola before,” says Christopher Stokes, MSF general director. “Yet this is too convenient an explanation. For the Ebola outbreak to spiral this far out of control required many institutions to fail. And they did, with tragic and avoidable consequences.”
Update 24 February 2015
French research institute INSERM have released the initial results of a clinical trial of the experimental drug favipiravir, stating that it reduces mortality among patients with low levels of infection, but is ineffective for those with high viral loads.
Update 4 February 2015
A trial of the experimental Ebola drug brincidofovir in Liberia has been halted due to a significant drop in the number of new Ebola cases, coupled with the 30th January announcement by the drug’s manufacturer that it would no longer participate in the trial.
Update 28 January 2015
A new maternity unit for pregnant women with Ebola – or those suspected of having Ebola – has been opened within an Ebola treatment centre in Sierra Leone by MSF.
Update 26 January 2015
A downward trend of new cases is reported in MSF Ebola management centres across West Africa with just over 50 patients currently under our care. While this is a promising development, we caution that a loss of vigilance now would jeopardise the progress made in stemming the epidemic.
Update 8 January 2015
We have begun to admit our first patients to a new Ebola Treatment Centre in Kissy, an Ebola hotspot on the outskirts of Freetown, Sierra Leone.
Update 1 January 2015
A clinical trial for an anti-viral drug has started to test whether it can be used as a possible treatment for Ebola. The trial is led by Oxford University and is being held at the MSF treatment centre in Monrovia, Liberia.
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