EBOLA VIRUS
INTRODUCTION
The Ebola virus disease, formerly called the
Ebola hemorrhagic fever, was first identified in rural Zaire (now the
Democratic Republic of Congo) in 1976. The disease had mostly been confined to
relatively small outbreaks in rural settings until its 2014 outbreak, which hit
urban areas in Guinea, Liberia, and Sierra Leone, infecting more than 28,600
people and killing more than 11,300 by the end of 2015. The World Health
Organization (WHO), which was criticized for its slow response to the epidemic,
called the outbreak "the most severe, acute health emergency seen in
modern times." In January 2016, West Africa was declared free of the
disease, although officials warned that small flare-ups were likely. As the
outbreak waned, health officials looked to learn from the uneven international
response and prepare for future pandemics.
What is Ebola?
Ebola is a severe and often fatal illness that
attacks the immune system and causes extreme fluid loss in its victims. The
disease disrupts the blood-clotting system, which can lead to internal and
external bleeding. Early symptoms include fever, muscle pain, headache, and
sore throat, and are followed by vomiting, diarrhea, rash, and bleeding. Most
fatalities are caused by severe dehydration or low blood pressure related to
fluid loss. The virus is named after the Ebola River in the Congolese region
where it was first identified. The largest outbreak prior to 2014 was in Uganda
in 2000, in which 425 people were infected and 224 died.
How is it transmitted?
Ebola is transmitted through bodily fluids from
an infected person with apparent symptoms or by handling a victim's corpse.
Unlike the common flu and the measles, Ebola is relatively difficult to
contract. In October 2014 the New England Journal of Medicine estimated the
infection rate (denoted as R0) in this outbreak was between R1.7and R2 in
Liberia, Sierra Leone, and Guinea; on average, each sick person infected
between 1.7 ana 2 other people. An outbreak is considered "out of
control" once it passes R2.
Vaccinations and treatments for Ebola have
undergone clinical trials, and health workers have used ring
vaccination—vaccinating primary and secondary contacts of infected persons—to
contain the disease. The U.S. Food and Drug Administration (FDA) in September
2015 awarded fast-track status to ZMapp, an experimental drug used to treat
some cases of Ebola. Treatments also include rehydration and plasma infusions
from Ebola survivors, who are believed to possess antibodies to the disease
Why did the outbreak occur in West Africa?
The outbreak is believed to have started in
December 2013 in a Guinean village in the prefecture of Gueckedou, near the
Liberian and Sierra Leonean borders. The New England Journal of Medicine traced
the disease to a two-year-old boy who died on December 6; he and his family
were never tested for the disease, although their symptoms were consistent with
those of Ebola (his mother, sister, and grandmother subsequently became sick
and died). Researchers do not know how the family caught the virus, which can
be contracted from contact with primates, bats, or contaminated food.