2 Jul 2014

West Africa battles deadliest ever ebola outbreak

An ongoing outbreak of ebola, one of the world’s deadliest diseases, has already cost 467 lives and is being described by some experts as “out of control”. But why is it so lethal?

Doctors in protective gear move the body of an Ebola victim (Getty)

The highly infectious disease, which causes fever, vomiting, bleeding and diarrhoea, can kill between 50 and 90 per cent of patients.

In the current outbreak 759 people are known to have been infected across Guinea, Liberia and Sierra Leone, and the death toll of 467 is by far the deadliest in one separate outbreak.

On Wednesday the World Health Authority (WHO) hosted an emergency meeting in Ghana for 11 West African states to discuss the escalating crisis, and separately, the director of the Welcome Trust charity said the spread of the disease was “out of control”.

Not a single individual has been offered anything beyond tepid sponging and ‘we’ll bury you nicely’. It’s just unacceptable Jeremy Farrar, Welcome Trust

Jeremy Farrar, who is also a professor of tropical medicine, said: “We have more than 450 deaths so far – and not a single individual has been offered anything beyond tepid sponging and ‘we’ll bury you nicely’. It’s just unacceptable.”

He added that those at risk of dying should be offered experimental treatments during an outbreak, because the normal course of developing drugs, with testing being carried out on animals, then healthy volunteers, takes too long.

“It’s ridiculous that we haven’t got these (experimental) products out of labs and animal trials and into human testing, and at least offered to people,” said Mr Farrar.

Photo: Nurse Babu Washington Stanley wears protective clothing in the ebola isolation ward of St Mary’s Hospital in Lacor, Uganda. She contracted the disease, bu managed to surviva.

Why is Ebola so dangerous?

Outbreaks of Ebola have a staggering fatality rate of up to 90 per cent, mainly because it can spread through human-to-human contact – either through broken skin or mucous – with blood, secretions or other bodily fluids, according to WHO.

While traditional funeral practices, where mourners touch the body of the deceased, are blamed for passing on the virus, health workers can also be infected while treating patients. They need to wear rubber gloves, masks and plastic suits to try and protect themselves, and there is a strict cleaning regime for their uniforms and equipment.

To make matters worse, men who have recovered from the disease can still pass it on through semen for up to seven weeks after their recovery.

The WHO has called on other states in the region to prepare for the disease, which is headed in their direction, and is trying to coordinate a stronger response from the states affected.

The recent warning also echoes comments made by Medecins Sans Frontieres (MSF) at the end of June, when the charity said it had reached the limits of what it could do. At that stage, ebola patients had been identified in 60 different locations in three countries, and Dr Bart Janssens, the MSF’s director of operations said: “the epidemic is out of control.”

Photo: gloves and boots used by medical staff dry in the sun at a centre for ebola victims in Guekodou, Guinea

Fear and distrust in local communities

Ebola is a relatively rare disease, but regular outbreaks have been reported since the virus was identified around 40 years. However the scale of the current outbreak is “unprecedented”, says MSF, in terms of geographical distribution, the number of people infected, and the number of deaths so far.

Coupled with the lack of treatments available, a lack of understanding of the disease is not helping: local communities remain suspicious of some health facilities, and local communities are still fearful of the virus itself. MSF said that people were continuing to attend funerals that did not have infection-controlled measures in place.

In Gueckedou, Guinea, around 650kms south east of the capital, the Red Cross said they had been forced to suspend operations aimed at tackling the disease after staff were threatened by a group of men armed with knives. It is thought that the attack was motivated by the belief that doctors were actually bringing the disease to the country, rather than helping to manage the symptoms.

The WHO has flagged three main factors driving the spread of ebola: the burial of victims in accordance with cultural practices and traditional beliefs in rural communities; dense population around the capital cities of Guinea and Liberia; and the bustling cross-border trade across the region.