Ebola What You Should Know
Ebola What You Should KnowAs of 14 August 2014 the governments of Guinea, Liberia, Nigeria and Sierra Leone are in the midst of the Ebola crisis. The Ebola outbreak is an extraordinary epidemic and it requires an extraordinary response. Lives are being lost because only a small fraction of the necessary response is currently happening.
In Sierra Leone and Liberia, the epidemic is causing an additional public health crisis due to the fear of Ebola in local health workers, fear of infections within the health system and the strain on resources necessary to treat existing health crises like malaria and maternity mortality.
MSF, whilst responding and being at the forefront of the treatment of Ebola cases in the region has reached its limits in terms of resopurces.
There needs to be a much greater mobilisation of resources on the ground to fill critical gaps in all aspects of the response in Sierra Leone and Liberia.
Safe treatment centres need to be set up along with the implementation of basic hygiene measures in all public places where people have contact.
Additional crucial measures to bring the epidemic under control include:
Effective alert system and referral service Health promotion in the community Infection control reinforcement in local health facilities Epidemiological investigation to understand the chain of transmission
Other measures which require sensitive thought and careful management include closing borders, setting up a cordonne sanitaire.
MSF has recently announced the opening of a new facility in Monrovia, Liberia with some 125 beds and the potential to treat up to 700 potential Ebola patients.
Whilst MSF welcomes the steps the WHO is taking to adopt exceptional regulatory procedures in order to assess new experimental drug treatments for Ebola, MSF believes the priority right now is to save lives of the people effected today.
For further information and updates on MSFs response to the Ebola epidemic please visit http://msf.org.uk/ebola
Photographs and video B-roll of MSFs Ebola treatment operations are available to download for publication and broadcast our media library.
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MSF KEY FIGURES (in isolation centres) Patients Admitted Confirmed Ebola Patients Recovered
Guinea 606 250 95Liberia (Early data) 134 Sierra Leone 294 191 47TOTAL 1,034 441 142
What is Ebola?
Ebola is one of the worlds 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
Kailahun. Sierra Leone. Mdecins Sans Frontires (MSF) Ebola Treatment Centre. Two medical staff bring a weak patient who has been in contact with people infected with Ebola to the admission centre. Photo: Sylvain Cherkaoui/Cosmos/MSF
How probable is death from Ebola?
The case-fatality rate varies from 25 to 90 percent, depending on the strain. 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 strains have caused disease in humans. While the Reston virus can infect humans, no illnesses or deaths have been reported.
Kailahun. Sierra Leone. In the forest, a few meters from the MSF Treatment Centre, a World Health Organization team buries patients who died from Ebola, the patients families did not attend.Photo: Sylvain Cherkaoui/Cosmos/MSF
When was Ebola first seen?
Ebola first appeared in 1976 in simultaneous outbreaks in Nzara, Sudan, and in Yambuku, Democratic Republic of Congo. The latter was in a village situated near the Ebola River, from which the disease takes its name.
Kailahun. Sierra Leone. Mdecins Sans Frontires (MSF) Ebola Treatment Centre. Two patients wait in a Red Cross ambulance to be admitted at the Treatment Centre.Photo: Sylvain Cherkaoui/Cosmos/MSF
How is Ebola transmitted?
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.
Ebola can be caught from both humans and animals. It is not an air-borne disease.
Kailahun. Sierra Leone. Mdecins Sans Frontires (MSF) Ebola Treatment Centre. An MSF doctor helps a young patient, most likely infected with the Ebola virus, to get out of a vehicle driven to the Treatment Centre.Photo: Sylvain Cherkaoui/Cosmos/MSF
How is Ebola transmitted?
Human to human transmission occurs through close contact with blood, secretions, or other bodily fluids of an Ebola-infected person.
Ebola Treatment Centre, Gueckedou, Conakray Guinea. Despite their protective gear, the medical team tries to maintain personal contact with patients by talking with them at length and getting close enough to be able to look into their eyes.Photo: Sylvain Cherkaoui/Cosmos/MSF
Ebola and Caring for the Dead
Direct contact with dead bodies, such as at funerals, is one of the main ways the disease is transmitted.
Funerals are a significant practice in the communities affected by this outbreak and involve people washing and touching the body, expressing their love for the deceased.
Kailahun. Sierra Leone. Mdecins Sans Frontires (MSF) Ebola Treatment Centre. In the forest, a few meters from the MSF Treatment Centre, a World Health Organization (WHO) team is burying the deceased patients whose families did not attend. As part of the funerals, the gravediggers offer a Muslim and a Christian prayer to the deceased.Photo: Sylvain Cherkaoui/Cosmos/MSF
In the last hours before death, the virus becomes extremely virulent and therefore the risk of transmission from the dead body is much higher. Ensuring safe burials is a crucial part of managing the outbreak.
Unprotected healthcare workers have frequently been infected while treating Ebola patients.
Increased Risk of Transmission
Ebola Treatment Centre, Gueckedou, Conakray Guinea. Two days after testing positive for Ebola, this patient dies. The sanitary team dresses the deceased to present her to her family so that they can confirm her identity before the body bag is sealed for burial.Photo: Sylvain Cherkaoui/Cosmos/MSF
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.
What are the symptoms?
Kailahun. Sierra Leone. Mdecins Sans Frontires (MSF) Ebola Treatment Centre. MSF staff accompany a young patient suspected of being infected by the Ebola virus.Photo: Sylvain Cherkaoui/Cosmos/MSF
Early symptoms of Ebola may be followed by vomiting, diarrhoea, rash, impaired kidney and liver function and, in some cases, haemorrhagic symptoms including nosebleeds, bloody vomit, bloody diarrhoea, internal bleeding and conjunctivitis.
However, these haemorrhagic symptoms are seen in less than 50 percent of cases.
Kailahun. Sierra Leone. Mdecins Sans Frontires (MSF) Ebola Treatment Centre. A nurse receives a suspected Ebola patient inside the high-risk area.Photo: Sylvain Cherkaoui/Cosmos/MSF
How long after exposure do the symptoms occur?
Symptoms can appear from two to 21 days after exposure.
Ebola Treatment Centre, Gueckedou, Conakray Guinea. A hygienist approaches patients classified as suspects. They are awaiting results of a blood test that will determine whether or not they have the Ebola virus.Photo: Sylvain Cherkaoui/Cosmos/MSF
Diagnosing Ebola in an individual who has been infected for only a few days is difficult, because the early symptoms, such as red eyes, muscle pain and onset of fever are nonspecific to Ebola infection and are seen often in patients with more commonly occurring diseases.
How is Ebola diagnosed?
Ebola Treatment Centre, Gueckedou, Conakray Guinea. Following a phone call, an MSF team goes to the home of a woman who reported extreme weakness, vomiting, and dysentery. These symptoms, along with fever and nosebleeds, are typical of those caused by the Ebola virus. Photo: Sylvain Cherkaoui/Cosmos/MSF
If a person has the early symptoms of Ebola and there is reason to believe that it should be considered, the patient should be isolated and public health professionals notified. Samples from the patient can then be collected and tested to confirm infection.
Suspected Cases of Ebola
Ebola Treatment Centre, Gueckedou, Conakray Guinea. The logistics team erects an incinerator in the isolation ward.Photo: Sylvain Cherkaoui/Cosmos/MSF
There is no specific treatment or vaccine available that has proven efficacy in humans and is registered for use in patients.
Experimental drugs and vaccines are now being considered for use in the frame of accelerated clinical trials.
How is Ebola treated?
A Mdecins Sans Frontires nurse working in the Gueckedou Ebola Treatment Centre, in Conakray, Guinea, removes her protective clothing after a shift treating patients.Photo: Sylvain Cherkaoui/Cosmos/MSF
Standard treatment for Ebola consists of hydrating the patient, maintaining their oxygen st