Ebola Q+A: Why is this outbreak so severe?

by Alex Whiting | @AlexWhi | Thomson Reuters Foundation
Tuesday, 12 August 2014 14:29 GMT

Liberian soldiers check people travelling in Bomi County August 11, 2014. Liberian troops set up Ebola roadblocks and stopped public access to some of the worst-hit towns after the country declared a state of emergency to tackle the worst outbreak of the disease on record. REUTERS/Stringer

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How easy is it to catch Ebola, and why has this outbreak affected so many more people than previous ones?

LONDON (Thomson Reuters Foundation) – The largest ever outbreak of Ebola shows no sign of abating, and attempts to contain it have so far met with little success.

People are avoiding medical centres for fear of catching Ebola, and dying of treatable diseases like malaria and diarrhoea as a result.

But how easy is it to catch Ebola? And why has this outbreak affected so many more people than previous outbreaks of the disease?

Thomson Reuters Foundation asked Medecins Sans Frontieres (MSF) and the World Health Organization (WHO). Here’s a quick summary of what they said:

How easy is it to catch Ebola?

Ebola is one of the deadliest diseases known to humanity with a fatality rate of up to 90 percent and no known cure.

To catch it, infected blood, saliva, urine or other secretions have to enter your eyes, nose, mouth or broken skin.

It can also be spread through infected needles.

Men who have fully recovered can spread the disease through their semen for weeks afterwards.  

All those caring for a patient are vulnerable to infection, as are relatives handling the body of someone who has died of the disease.

Most Ebola outbreaks are very small. Why is this one so different?

Since Ebola was first discovered in 1976 in Congo and Sudan, there have been more than 20 outbreaks, most of them affecting only a handful of people.

The latest outbreak, which was first identified in Guinea in March, had killed 1,013 people across West Africa by Aug. 9.

So why is this one different?

Most outbreaks start when a hunter from a remote jungle village catches Ebola from an animal. In that situation the disease can be contained within the village, and doctors can go house to house to explain how people can protect themselves.

By contrast, this one began in a village in Guinea near the border with Sierra Leone and Liberia, and quickly spread to nearby towns with good transport links.

Why do medical staff dress like they’re in a chemical warfare zone?

Agencies and hospitals that can afford protective suits want to ensure their staff run no risk of infection as the disease has no cure.

But the clothing is tiring to wear, and causes some people to faint.

Relatives have to suit up to visit patients in specialist units, and are decontaminated when they leave. Because visitors cannot stay in the units, patients often die alone.

Is the Ebola outbreak more deadly than other diseases in countries like Liberia and Sierra Leone?

Guinea, Sierra Leone and Liberia have very limited healthcare so even treatable diseases are deadly, including cholera, malaria, tuberculosis and AIDS.

Sierra Leone has experienced the largest number of Ebola cases so far - 730 cases and 315 deaths. By contrast, malaria alone killed 3,611 people, and diarrhoea 5,460 children in the West African country in 2012. 

Sierra Leone has only a few hundred medical staff to serve a population of nearly 6 million, according to WHO figures.

What’s being done to stop its spread?

Countries and health agencies are educating people about Ebola and the importance of hygiene.

But there are many false rumours about the disease, including that Ebola clinics are being used to harvest organs. A few days ago, a bishop in Liberia said on local radio that Ebola didn’t exist.

Governments are also trying to impose travel blockades and close borders to try to contain it.

The most effective way to control the outbreak is to trace each patient and then trace everyone they’ve been in contact with. But as yet there isn’t enough accurate data to do this.

West Africa has never experienced Ebola before, and there are few medical staff in the worst-affected countries. Aid agencies have deployed international experts to help treat and contain the disease.

Is the outbreak likely to last much longer?

The outbreak seems to be easing in Guinea, but is growing in Sierra Leone and Liberia, especially the latter. It has also spread to Nigeria, Africa’s most populous nation, where there have been 13 confirmed cases.

It’s likely to continue for a few months yet, and spread to more African countries.

It’s unlikely to spread to the West because of the quality of health care there.

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