Ebola derives its name from the Ebola river situated near Yambuku in the Democratic Republic of Congo where the first documented Ebola cases were reported back in 1976 along with Sudan and Nzara.
As of 2014, the resurgence of Ebola has caused widespread fatalities in the sub-Saharan continent with Liberia, Sierra Leone and Guinea being the worst affected of all. Steep increase in cases continue to be reported from Sierra Leone with virtually all districts being affected. Genetic analysis has shown that the outbreak in Congo that started in August this year is unrelated to the main epidemic. Incidentally, Congo also declared its 3 month Ebola outbreak officially over on 15th November with no new cases being reported since October 4.
According to the latest update by WHO, there have been 15,935 reported cases and 5,689 reported deaths up to the end of November 23rd (true figures assumed to be almost three times higher, owing to the fact only those people who have taken medical help have been accounted for) and it has been the worst epidemic of Ebola in the history of the world.
The WHO’s Response
The WHO formally designated the outbreak as a Public Health Emergency of International Concern. This legal designation has been used only twice before (for the 2009 H1N1 pandemic and in early 2014 for the resurgence of polio) which calls for legal measures on disease prevention, surveillance, control, and response, by 194 signatory countries.
In August, a roadmap was devised by the WHO with the aim of stopping the Ebola outbreak in 6 to 9 months. The roadmap contains a review of the epidemiological situation based on official information provided by ministries of health. Following the roadmap structure, country reports fall into 3 categories:
- Those that have widespread and furious transmission (Guinea, Liberia and Sierra Leone)
- Those that have had initial cases or with localized transmission (Mali, Nigeria, Senegal, Spain and the United States of America)
- Those that have strong trade ties with areas of active transmission.
In a 26 September statement, the WHO said, “Never before in recorded history has a bio-safety level four pathogen infected so many people so quickly, over such a broad geographical area, for so long.”
For governments and health ministries, the WHO has developed the Consolidated Ebola Virus Disease Preparedness Checklist that identifies 10 key components and tasks to be completed between 30, 60 and 90 days from the issuing of the list.
The UN Mission for Ebola Emergency Response has been established to attend to the uncontrolled outbreak, and is the first ever mission designed by UN for public emergencies.
How to identify an Ebola patient
The Ebola virus is comprises of 5 species named on their places of origin with ‘Zaire’ being the most potent (responsible for the current outbreak as well) and ‘Reston’ the least. The virus has an equal predilection for both sexes and usually affects people between 15 and 45 years of age. Statistics from the current epidemic reveal that it has been fatal for those beyond 45 years of age consistent with findings from past outbreaks as well. Incubation period for the virus ranges from 2 to 21 days. An Ebola outbreak is considered to be officially over at the end of 42 days (double the incubation period) if no new case is reported.
Ebola cases are classified as suspected, probable, or confirmed depending on following criteria laid by WHO.
- Suspected: Any person, alive or dead, who has (or had) sudden onset of high fever and had contact with a suspected, probable or confirmed Ebola case, or a dead or sick animal OR any person with sudden onset of high fever and at least three of the following symptoms: headache, vomiting, anorexia/ loss of appetite, diarrhea, lethargy, stomach pain, aching muscles or joints, difficulty swallowing, breathing difficulties, or hiccup; or any person with unexplained bleeding OR any sudden, unexplained death.
- Probable: Any suspected case evaluated by a clinician OR any person who died from ‘suspected’ Ebola and had an epidemiological link to a confirmed case but was not tested and did not have laboratory confirmation of the disease.
- Confirmed: A probable or suspected case is classified as confirmed when a sample from that person tests positive for Ebola virus in the laboratory.
We suggest you download and print the WHO’s guide for dealing with suspected or confirmed Ebola patients.
Is there any cure?
Till date, no new vaccine or drug has shown promising results in curing ebola. Supportive therapy has been the standard treatment. As it is transmitted through close contact with body fluids, blood or secretions, using personal protective equipment and ensuring safe burials are the safest bet for health care workers considering that the virus remains active even in dead bodies.
We earlier reported in our October medical news roundup that the National Institutes of Health were conducting trials for an experimental Ebola vaccine. US President Barack Obama recently praised the progress made in the vaccine trials and appealed for an additional $6 billion in emergency funding to finish development of the vaccine.
Also in October, WHO and UNMEER announced a comprehensive 90-day plan to tackle the Ebola outbreak. The immediate objective is to isolate at least 70% of Ebola cases and safely bury at least 70% of patients who die from Ebola by 1 December 2014 (the 60-day target) – this has become known as the 70:70:60 program. The ultimate goal is isolation of 100% of Ebola cases and the safe burial of 100% of casualties by 1 January 2015 (the 90-day target).
All in all the situation still remains grim owing to inadequate funding, critical gap in trained manpower coupled with the highly infectious strain of the disease.
- The WHO’s Ebola Response Roadmap – Situation Report (http://www.who.int/csr/disease/ebola/situation-reports/en/)
- Doctors Without Borders (http://www.doctorswithoutborders.org/our-work/medical-issues/ebola)
- WHO Statement of the IHR Emergency Committee (http://www.who.int/mediacentre/news/statements/2014/ebola-20140808/en/)
Disclaimer: This website is not intended to provide any medical advice. By engaging in a general discussion about medical topics, we hope to raise awareness and provide visibility to issues of medical interest. Doctors must conduct further research for a more informed opinion and should not rely solely on any advice or information provided on this website.