Ebola Outbreak

Ebola virus disease (EVD) also known as Ebola hemorrhagic fever is a severe illness, with a fatality rate of up to 90%. The infection is due to one of the five viruses in the family Filoviridaeis that are transmitted by direct contact with the blood, body fluids and tissues of infected animals or people.  In 1976, Peter Piot, a Belgian doctor travelled to the Congolese rainforest to find out why many people were dying from an unknown and terrifying disease.  Before departing he had observed a large worm like virus under an electron microscope, in a blood sample from a nun, who had died from a mysterious illness. It was the epidemiologic analysis in the field and the electron microscope finding that he and his associates made brought them to the conclusion they were dealing with a new virus they named after the nearby Ebola River.

When EVD outbreak occurs those at higher risk of infection are health workers, family members and others in close contact with sick people and deceased patients. 

Ebola virus disease outbreaks can devastate families and communities, but the infection can be controlled through the use of recommended protective measures in clinics and hospitals, at community gatherings, or at home.  The Ministries of Health of the affected countries and the World Health Organization (WHO) have reported an outbreak of Ebola in several Guinean, Liberian and Sierra Leone districts.  As of today 1,323 people have been infected and 729 have died, 339 in Guinea, 233 in Sierra Leone and 156 in Liberia, and 1 in Nigeria this is the largest outbreak of EVD in history. In Sierra Leone, Dr. Umar Khan, 39, the doctor who led the fight against Ebola, died from the disease.  His death follows that of prominent Liberian doctor Samuel Brisbane.  The transmission is usually thru close contact and not thru the air as in flu or measles. Because the EVD is spreading rapidly in Africa, and the world is inter-connected by air, public health officials are issuing warnings to health care workers to consider the Ebola virus when encountering travelers with flu-like symptoms from the affected countries in West Africa.  One such patient with Ebola boarded a flight in Liberia, had stopovers in Ghana, and Togo, and arrived in Nigeria, where he died days later. While experts say, it is unlikely he infected others, there are questions whether Ebola could become an epidemic to be spread by international air travel.  The fact that an infected person who may have been obviously ill managed to board a plane has stoked fears that other travelers could carry the disease to still more countries.  As a result, health officials in the affected countries are monitoring people for signs of infection before allowing them to board departing flights.  Also, travellers at airports in the affected countries will have to wash their hands with disinfectant and have their temperatures checked.  As EVD is one world’s most virulent diseases West African governments sought to control the spread of the virus, with Liberia recently closing its borders, while keeping the airport in Monrovia open with all travelers coming in and out tested for the virus.  On July 31, 2014 Sierra Leone declared a public health emergency and had security forces quarantine the epicenters of the outbreak in the east of the country.  Two airlines, Asky and Arik Air, have ceased flying to Liberia and Sierra Leone.

While the Center for Disease Control (CDC) said that “the risk of Ebola spreading to the United States was low,” it “nevertheless issued a Level 2 health alert, advising U.S. doctors and healthcare workers to check patients’ travel histories to identify those who might have recently traveled to West Africa.” In addition, the CDC “urged physicians to learn the symptoms of Ebola.”  EVD symptoms may appear anywhere from 2 to 21 days after exposure though 8-10 days is most common.  They typically include, fever, headache, joint and muscle aches, weakness, stomach pain, vomiting, diarrhea, lack of appetite, rash, red eyes, chest pain, cough, difficulty breathing and swallowing and bleeding inside or outside the body.  Severely ill patients require intensive hospital care, isolation and protective measures for those coming in contact with them.

Update:  On September 18, 2014 the United Nations Security Council issued the following statement: Determining that the “unprecedented extent” of the Ebola outbreak in Africa constituted a threat to international peace and security, the Security Council this afternoon called on Member States to respond urgently to the crisis and to refrain from isolating the affected countries.

Update:  On September 30, 2014 the CDC announced a patient with suspicious symptoms just back from West Africa was diagnosed with Ebola.  He was hospitalized at Texas Health Presbyterian Hospital in Dallas.  He is the first confirmed case with the disease in the U.S.

Update: On October 12, a nurse in Dallas, in the team that treated Thomas Duncan the Liberian man who died of Ebola on October 8, tested positive for the disease, officials in the Centers for Disease Control said.  It is not clear how she became infected despite wearing protective gear.  The news of her infection stoked fears among health care workers across the country.