Ebola - A Race Against Time | MSF

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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. MSF has 300 staff on the ground and we have brought in more than 40 tonnes of equipment and supplies to help fight the epidemic.

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Ebola treatment centre: interactive guide

Hover over the image below for an interactive guide to Ebola

Ebola Guide

"I was collecting blood samples from patients. We did not have enough protective equipment to use [and] I developed the same symptoms,” says Kiiza Isaac, a nurse from Uganda.

"On 19th November 2007, I received laboratory confirmation - I had contracted Ebola.

Facts

Ebola first appeared in 1976 in simultaneous outbreaks in Nzara, Sudan, and in Yambuku, DRC
The latter was in a village situated near the Ebola River, from which the disease takes its name
Fruit bats are considered to be the natural host of the Ebola virus
The case-fatality rate varies from 25 to 90 percent, depending on the strain

"MSF came to Bundibugyo and they ran a treatment centre. Many patients were cared for. Thank God, I survived. After my recovery, I joined MSF."

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.

The Ebola virus is made up of five species: 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.

MSF has treated hundreds of people affected by Ebola in UgandaRepublic 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.

No specific treatment or vaccine is yet available for Ebola

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 nurse Lucie Perardel checks her goggles, an essential part of the protective gear that must be worn when treating patients during an Ebola outbreak. Guinea, 2014

Diagnosing Ebola

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.

“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.”

Treating 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.

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.

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Ebola: latest updates from the frontline

Update 24th July 2014

As the Ebola outbreak continues to spread, with 1,093 cases and 660 deaths now reported across West Africa, MSF is stepping up its response in the most affected areas.

While the number of cases in Guinea has declined significantly, in neighbouring Sierra Leone and Liberia, more and more people are being infected with the virus.

Sierra Leone

In Sierra Leone – now the epicentre of the epidemic, with 454 cases recorded so far – our teams are rapidly scaling up its response, with 22 international and 250 Sierra Leonean staff.

In Kailahun, in the east of the country, the team is running a 64-bed Ebola treatment centre.

Since the facility opened on 25th June, 131 suspected, probable and confirmed patients have been admitted for treatment. So far, 12 patients have recovered and returned home to their families.

An MSF psychologist is providing support and counselling to patients and their families, as well as to our staff.

We are also supporting the Ministry of Health and Sanitation at two referral sites in the Kailahun district.

In the past three weeks, MSF has trained more than 200 community health workers to deliver essential health messages to people in their villages about how to protect themselves against Ebola and what action to take if someone shows any signs or symptoms of the disease.

We will now focus on halting the spread of the disease in the border area between Sierra Leone, Guinea and Liberia, where the population is very mobile and people continue to transmit the disease to different villages.

Liberia

In Liberia, the situation is deteriorating rapidly, with cases now confirmed in seven counties, including in the capital Monrovia.

There are critical gaps in all aspects of the response, and urgent efforts are needed to scale up.

Already stretched beyond capacity in Guinea and Sierra Leone, MSF is able to provide only limited technical support to the Liberian Ministry of Health (MoH).

Our team has set up an Ebola treatment centre in northern Liberia, where cases have been increasing since the end of May.

After the initial set up, we handed over the centre to Samaritan’s Purse on 8th July. There are currently six patients and MSF experts continue to provide technical support and training.

The team will now shift its efforts to Voinjama, also in Lofa county, where there are reports of people dying of Ebola in their villages.

Our  team will set up a referral unit so suspected Ebola patients can be isolated and transferred to the treatment centre.

In Monrovia, an MSF emergency team is building a new tented treatment centre with capacity for 40-60 beds. It is scheduled to open on 27th July and will also be run by Samaritan’s Purse.

A 15 bed MSF treatment unit set up at Monrovia’s JFK hospital was handed over to the MoH in April.  However, the unit has since been closed and all patients are currently cared for at ELWA hospital in Paynesville until the new centre is open at the same site.

Currently there are 14 patients admitted to this centre.

Our team is also supporting the MoH in the overall coordination of the Ebola response and providing technical and medical advice.

Guinea

In Guinea, the situation has stabilised in some areas and MSF has closed its Ebola treatment centre in Telimélé, in the west of the country, after no new cases were reported for 21 days.

During seven weeks, 21 people with the disease were admitted to the centre, with an astonishing 75 percent of patients making a recovery.

Without medical care, as few as ten percent of patients could be expected to survive.

In the capital Conakry, MSF is reducing its activities as far fewer cases are appearing.

Of the 59 confirmed Ebola patients admitted to the Donka centre since 25 March, 63 percent recovered and were able to return home.

In Guéckédou, in the south east – the original epicentre of the epidemic – the number of patients in MSF’s centre has declined significantly, with currently just two patients admitted.

It is very unlikely however, that this reflects an end to the outbreak; instead it suggests that infected people may be hiding in their communities rather than coming for treatment.

There continues to be significant fear surrounding Ebola amongst local communities and MSF teams have been prevented from visiting four villages due to hostility.

Weare working with local authorities and elders to try to ensure safe access to these areas to obtain a clearer picture of whether people are still being infected and dying of the virus.

Since the beginning of the outbreak, MSF has treated 150 patients in its centre in Guéckédou.

Back to Ebola Emergency hub

Kailahun. Sierra Leone: A nurse receives a suspected Ebola patient

It is the financial support of individuals like you that enables us to fight Ebola. Thank you.

Donate to MSF's Ebola Emergency Appeal

Update: 7th July 2014

MSF is currently working to treat patients and contain the Ebola outbreak that is currently gripping Guinea, Sierra Leone and Liberia in West Africa.

According to the World Health Organization (WHO), there have been 779 cases and 481 deaths since the beginning of the outbreak in these three countries.

Guinea

In Guinea, MSF is running three medical projects to respond to the Ebola emergency: one in Donka Hosptal in Conakry, one in Telimele in Basse-Guinée, and another in Guéckédou, in Guinée forestière, the epicentre of the outbreak.

On each project our teams offers medical and psychosocial care in specialised Ebola treatment centres, ambulance services, disinfection of bodies and safe burials.

We are also carrying out activities to clean areas contaminated by the virus such as treatment centres, homes, and public places, and is offering support in contact tracing and epidemiological analysis.

  • In Conakry, we have treated 59 patients with Ebola, 33 of whom have recovered.
  • In Gueckedou, the team has treated 130 patients, and 31 have recovered.
  • In Telimele, the team has treated 21 confirmed cases, 16 of whom have recovered. They are in the process of closing the project as there were no cases for 21 days.
  • We have also closed the treatment centre in Macenta, Guinée forestière, as there were no new cases for 21 days.
  • In Macenta, teams treated seven people – five died, and two recovered.

Anja Wolz, Emergency coordinator in Sierra Leone Kailahun Ebola project.

Sierra Leone

In Sierra Leone, MSF is operating in Kailahun, Kenema, Koindu and Daru, in the east of the country. We set up the 50-bed treatment centre in Kailahun, which has been operating since the beginning of July.

MSF has already treated 45 suspected, probable and confirmed cases of Ebola in Kailahun project. Twelve of those patients have died.

In collaboration with the Ministry of Health (MoH), teams also seeing patients at pre-screening facilities in Koindu and Daru.

While doing their outreach activities, our teams are hearing that there are 10 to 15 suspected cases of Ebola in some villages. MSF and the MoH identified one village with more than 40 suspected cases.

Liberia

MSF is supporting the MoH in their efforts to stop the spread of Ebola in Monrovia with a team of four.

In Foya, we are handing over the project it set up to another NGO.

Update: 25th June 2014

With Ebola continuing to spread in Guinea, Sierra Leone and Liberia, bringing the epidemic under control will require a massive deployment of resources. Ebola patients have been identified in more than 60 separate locations across the three countries, complicating efforts to treat patients and curb the outbreak.

MSF is currently the only aid organisation treating people affected by the virus, which can kill up to 90 percent of those infected.

Since the outbreak began in March, MSF has treated some 470 patients, 215 of them confirmed cases, in specialised centres set up in the region.

“The epidemic is out of control,”  says Dr Bart Janssens, MSF director of operations. Read the full Ebola update

Update: 5th June 2014

New cases of Ebola have been reported in Guinea and Sierra Leone.

Our teams are setting up a treatment centre in Koindu, the epicentre of the epidemic in Sierra Leone, in collaboration with the Ministry of Health.

A team of specialists will join the people already present on the ground. We will also send medical and logistical supplies such as protective clothing kits and medicines with a view to protecting health staff and to setting up facilities where patients can be treated.

Read more about Ebola in West Africa

Update: 29th May 2014

Ebola is said to have spread to Sierra Leone after the Ministry of Health (MoH) confirmed four deaths from the disease in the last few days.

MSF is working closely with the MoH in order to assess the situation. A team composed of two nurses, two logisticians and a water and sanitation expert are on the way to Kenema, Kailahun and Koindu in Sierra Leone. They will prepare the arrival of a permanent team with all the needed equipment.

While this assessment is ongoing, our coordination team is working closely at national level with the MoH to support the national response.

In Guinea, there are still new cases and the teams continue to support the Guinean Ministry of Health in Macenta, Guéckédou, Telimele and Conakry.

MSF ebola treatment

It is the financial support of individuals like you that enables us to fight Ebola. Thank you.

Donate to MSF's Ebola Emergency Appeal

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It is the financial support of individuals like you that enables us to fight Ebola. Thank you.

Donate to MSF's Ebola Emergency Appeal

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This page was last updated on 21st July 2014

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