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The Ebola outbreak in West Africa is the world's deadliest to date and the
World Health Organization has declared an international health emergency
as more than 3,850 people have died of the virus in Guinea, Liberia, Sierra
Leone and Nigeria this year.
What is Ebola?
Ebola is a viral illness of which the initial symptoms can include a sudden fever,
intense weakness, muscle pain and a sore throat, according to the World
Health Organization (WHO). And that is just the beginning: subsequent stages
are vomiting, diarrhoea and - in some cases - both internal and external bleeding.
The current outbreak is the deadliest since Ebola was discovered in 1976
The disease infects humans through close contact with infected animals,
including chimpanzees, fruit bats and forest antelope.
It then spreads between humans by direct contact with infected blood, bodily
fluids or organs, or indirectly through contact with contaminated environments.
Even funerals of Ebola victims can be a risk, if mourners have direct contact with
the body of the deceased.
The incubation period can last from two days to three weeks, and diagnosis is
difficult. The human disease has so far been mostly limited to Africa, although
one strain has cropped up in the Philippines.
Healthcare workers are at risk if they treat patients without taking the right
precautions to avoid infection. People are infectious as long as their blood and
secretions contain the virus - in some cases, up to seven weeks after they
recover.
World Health Organization guidance on Ebola
Bushmeat - from animals such as bats, antelopes, porcupines and monkeys - is a prized delicacy in much
of West Africa but can also be a source of Ebola
It was first discovered in the Democratic Republic of Congo in 1976 since when it
has mostly affected countries further east, such as Uganda and Sudan.
This year's outbreak is unusual because it started in Guinea, which has never
before been affected, and it quickly spread to urban areas.
Figures accurate from 4-6 October, depending on country. Death toll in Liberia includes probable, suspect
and confirmed cases, while in Sierra Leone and Guinea only confirmed cases are shown
From Nzerekore, a remote area of south-eastern Guinea, the virus spread to the
capital, Conakry, and neighbouring Liberia and Sierra Leone.
There have been 20 cases of Ebola being imported by someone travelling from a
country of widespread transmission to Nigeria, with eight confirmed deaths. The
US and Senegal have both confirmed one case each. The US Centers for
Disease Control and Prevention (CDC) said in September that the virus might
have been successfully contained in Nigeria and Senegal.
In October, a nurse in Spain became the first person to contract the deadly virus
outside of West Africa, after treating two Spanish missionaries who had
eventually died of Ebola in Madrid.
Continue reading the main story
4,951
Deaths - probable, confirmed and suspected
(Includes one death in US and one in Mali)
2,413 Liberia
1,510 Sierra Leone
1,018 Guinea
8 Nigeria
Source: WHO
Getty
The medical charity Medecins Sans Frontieres (MSF) says the outbreak is
"unprecedented" in the way the cases were scattered in multiple locations
across Guinea, hundreds of kilometres apart, and says it is a "race against
time" to check people who come into contact with sick people in
neighbouring Sierra Leone.
Ebola: Mapping the outbreak
Ebola: Why is it this disease we fear?
Ebola: How bad can it get?
Strict precautions must be observed when burying those who have died of Ebola
If a person has died from Ebola, their body will have a very high viral load.
Bleeding is a usual symptom of the disease prior to death. Those who handle the
body and come into contact with the blood or other body fluids are at greatest
risk of catching the disease.
MSF has been trying to make people aware of how their treatment of dead
relatives might pose a risk to themselves. It is a very difficult message to get
across.
All previous outbreaks were much smaller and occurred in places where Ebola
was already known - in Uganda and the DR Congo for example. In those places
the education message about avoiding contact has had years to enter the
collective consciousness. In West Africa, there simply has not been the time for
the necessary cultural shift.
The virus detective who discovered Ebola
Ebola drains weak health systems
Washing hands and improving hygiene is one of the best ways to fight the virus
Carers should wear gloves and protective equipment, such as masks, and wash
their hands regularly.
The WHO also warns against consuming raw bushmeat and any contact with
infected bats or monkeys and apes. Fruit bats in particular are considered a
delicacy in the area of Guinea where the outbreak started.
In March, Liberia's health minister advised people to stop having sex, in addition
to existing advice not to shake hands or kiss. The WHO says men can still
transmit the virus through their semen for up to seven weeks after recovering
from Ebola.
Surgical cap
Goggles
Medical mask
Scrubs
Overalls
Apron
Double gloves
Boots
Respirator
Surgical cap
The cap forms part of a protective hood covering the head and neck. It offers medical
workers an added layer of protection, ensuring that they cannot touch any part of their
face whilst in the treatment centre.
Goggles
Goggles, or eye visors, are used to provide cover to the eyes, protecting them from
splashes. The goggles are sprayed with an anti-fogging solution before being worn. On
October 21, the US Centers for Disease Control and Prevention (CDC) announced
stringent new guidelines for healthcare personnel who may be dealing with Ebola
patients. In the new guidelines, health workers are advised to use a single use
disposable full face shield as goggles may not provide complete skin coverage.
Medical mask
Covers the mouth to protect from sprays of blood or body fluids from patients. When
wearing a respirator, the medical worker must tear this outer mask to allow the
respirator through.
Respirator
Medical Scrubs
A surgical scrub suit, durable hospital clothing that absorbs liquid and is easily cleaned,
is worn as a baselayer underneath the overalls. It is normally tucked into rubber boots to
ensure no skin is exposed.
Overalls
The overalls are placed on top of the scrubs. These suits are similar to hazardous
material (hazmat) suits worn in toxic environments. The team member supervising the
process should check that the equipment is not damaged.
Double gloves
A minimum two sets of gloves are required, covering the suit cuff. When putting on the
gloves, care must be taken to ensure that no skin is exposed and that they are worn in
such a way that any fluid on the sleeve will run off the suit and glove. Medical workers
must change gloves between patients, performing thorough hand hygiene before
donning a new pair. Heavy duty gloves are used whenever workers need to handle
infectious waste.
Apron
A waterproof apron is placed on top of the overalls as a final layer of protective clothing.
Boots
Ebola health workers typically wear rubber boots, with the scrubs tucked into the
footwear. If boots are unavailable, workers must wear closed, puncture and fluidresistant shoes.
Fighting the fear and stigmatisation surrounding Ebola is one of the greatest
challenges health workers face.
But health workers themselves are becoming scared of treating patients, and are
demanding better protective clothing when exposed to patients.
Ebola has already claimed the lives of dozens of doctors and nurses in the
Ebola-hit region, including Sierra Leone's only virologist and Ebola expert, Sheik
Umar Khan.
This has put a further strain on the health services of these West African states,
which have long faced a shortage of doctors and hospitals.
The current outbreak is killing between 50% and 60% of people infected
There are no vaccines, though some are being tested, along with new drug
therapies. The WHO ruled in August that untested drugs can be used to treat
patients in light of the scale of the current outbreak.
The experimental drug ZMapp has been used to treat several people who
contracted Ebola: Two US aid workers and a Briton have recovered after taking it
but a Liberian doctor and a Spanish priest have died.
But the US pharmaceutical company that makes it says it has for now run out of
it.
Patients with Ebola frequently become dehydrated so they should drink solutions
containing electrolytes or receive intravenous fluids.
MSF says this outbreak comes from the deadliest and most aggressive strain of
the virus.
The current outbreak is killing between 50% and 60% of people infected.
It is not known which factors allow some people to recover while most succumb.
Ebola: Experimental treatments
Ethics: Resolving the Ebola dilemma