Ebola outbreak spreads in West Africa

By John Rowe
9 July 2014

In an ongoing outbreak that has been characterized as unprecedented in size, geographic distribution and location, the Zaire Ebola virus is currently infecting people throughout the countries of West Africa. Doctors Without Borders (MSF) has said the epidemic is currently out of control in Guinea, Sierra Leone and Liberia, where laboratory analysis has confirmed 759 cases with 467 deaths.

Ebola is a hemorrhagic fever whose first symptoms resemble those of the flu, making it hard to differentiate from other common infections. As it progresses, the disease causes internal and external bleeding, as well as multiple organ failure, often leading to death. The virus is spread through exposure to the bodily fluids of the infected and the ingestion of infected animal products, such as bush meat. There is currently no vaccine against the virus or treatment beyond that designed to alleviate the symptoms.

The fatality rate for the current Ebola epidemic is over 60 percent in lab-confirmed cases. In actuality it could be much higher due of underreporting, the hiding of cases by communities, and lack of surveillance in the beginning of the epidemic. According to MSF, Ebola death rates can be as high as 90 percent.

As of June 24, there were over 60 separate areas in West Africa with known Ebola outbreaks. This constitutes the largest and deadliest outbreak since the disease first appeared in Sudan and Zaire in 1976, according to the World Health Organization (WHO). The outbreak was first confirmed in Guinea on the western coast of Africa last February, though it may have been ongoing since December. It appears to have spread to Sierra Leone and Liberia mostly due to people trying to flee the infection out of fear.

The risk of the virus spreading to areas outside of Africa is the most significant it has ever been. In the past, Ebola has been isolated to rural areas and only a few locations. The current outbreak has affected multiple urban centers and border areas that are ill-defined and see a constant flow of people.

The WHO and representatives from the affected countries held emergency talks in Ghana last week to coordinate local, national and international responses to the epidemic. Primary concerns are isolating the infected from the general population and educating the populace about the nature of the epidemic. According to the Guardian, in Liberia those hiding family or friends with suspected cases of Ebola could face prosecution by the state.

The inability of West Africa’s governments to contain the epidemic is a product of the terrible poverty in the affected area. Ebola, though hard to contract under normal circumstances, spreads easily in the inadequate medical infrastructure found throughout most of Sub-Saharan Africa, where needles and other medical equipment that contain bodily fluids are often reused.

A recent report by CBS revealed the inadequate conditions of the quarantine facilities where patients are isolated, which are often nothing more than plywood and tarps with a makeshift decontamination area. Doctors, nurses and other caregivers, who are more likely to contract the virus due to their close proximity to the infected, often work in clinics outside the larger cities that lack proper barrier protection and become ill as a result. Some clinics that had been set up to deal with treating and isolating the infected were later identified as sources of the infection and had to be destroyed.

The region does not have enough trained medical professionals or proper equipment. Local populations thus must rely on traditional healers, who cannot treat the disease and then become a new source of transmission. Burial practices in West Africa often bring victims’ families into contact with the deceased’s bodily fluids, further spreading the infection.

Doctors Without Borders has stated that it is currently stretched beyond its limit and cannot help people in all the affected areas, which requires a massive international mobilization of resources. Regardless of whether or not international agencies are able to contain the present Ebola outbreak, the miserable social and economic conditions that prevail in West Africa ensure that thousands more will die as a result of diseases that could otherwise be contained.