Ebola is one of the world’s 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.

Ebola is so infectious that patients need to be treated in isolation by staff wearing protective clothing.

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Crisis Info: January 2015

Since the Ebola outbreak in West Africa was officially declared on 22nd March in Guinea, it has claimed more than 8,200 lives in the region.

The outbreak is the largest ever, and is currently affecting four countries in West Africa: Guinea, Liberia, Sierra Leone and Mali. Outbreaks in Nigeria and Senegal have been declared over. A separate outbreak in DRC has also ended.

Disaster response

In September, 2014, MSF called for states with biological-disaster response capacity to urgently dispatch human and material resources to West Africa, all three of the worst-hit countries have received some assistance from the international community.

But foreign governments have focused primarily on financing or building Ebola case management structures, leaving staffing them up to national authorities, local healthcare staff and NGOs.

Across the region, there are still not adequate facilities for isolating and diagnosing patients where they are needed.

Other elements that are essential to an Ebola response – such as awareness-raising and community acceptance, safe burials, contact tracing, alert and surveillance, access to health care for non-Ebola patients – are still lacking in parts of West Africa.

Clinical trials

Two of the three clinical trials for different treatments led by MSF and three research institutions have started, while the third should start soon at MSF sites in West Africa.

The French National Institute of Health and Medical Research (INSERM) is leading a trial for antiviral drug favipiravir at MSF’s facility in Guéckédou, Guinea.

The inclusion of patients at this site has started mid-December. The University of Oxford leads, on behalf of the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC), a Wellcome Trust-funded trial of the antiviral drug brincidofovir at Elwa3 in Monrovia. The inclusion of patients started on January, 1st.

The Antwerp Institute of Tropical Medicine (ITM) will lead a trial of convalescent plasma therapy at MSF’s Donka Ebola centre in Conakry, Guinea. This trial is expected to start in the coming weeks.

MSF’s Ebola response

MSF has been responding to the outbreak since March. On 30th December, there were almost 3,900 staff working in Guinea, Liberia, Sierra Leone and Mali.

Since the response began, 27 MSF staff members have fallen ill with Ebola, 14 of whom have recovered and 13 have died.

The vast majority of these infections were found to have occurred in the community.

Since the beginning of our Ebola response, we have sent more than 1,400 tonnes of cargo to West Africa.

MSF case numbers since the outbreak began (as of 8th January)

Guinea: Admissions* - 3,175 | Confirmed - 1,715 | Recovered - 774

Sierra Leone: Admissions - 1,929 | Confirmed - 1,415 | Recovered - 761

Liberia: Admissions - 2,538 | Confirmed - 1,625 | Recovered - 660

Total: Admissions - 7,642 | Confirmed - 4,755 | Recovered - 2,195

* Admissions include all suspected, probable and confirmed cases.

Ebola treatment: interactive guides

Hover over the image below for an interactive guide to an MSF Ebola treatment centre

Hover over the image below for an interactive guide to the high risk zone inside an MSF Ebola treatment centre

Hover over the image below for an interactive guide to our Ebola protective kit

Ebola Guide

It is estimated there had been over 1,800 cases of Ebola, with nearly 1,300 deaths, before this latest outbreak in 2014.

Ebola history

The Ebola virus was first associated with an outbreak of 318 cases of a haemorrhagic disease in Zaire (now the Democratic Republic of Congo) in 1976. Of the 318 cases, 280 died — and died quickly.

That same year, 284 people in Sudan also became infected with the virus, killing 156.

Facts

Ebola first appeared in 1976 in simultaneous outbreaks in Nzara, Sudan, and in Yambuku, DRC
The latter was in a village situated near the Ebola River, from which the disease takes its name
Fruit bats are considered to be the natural host of the Ebola virus
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 have caused disease in humans. While the Reston virus can infect humans, no illnesses or deaths have been reported.

Risk of Ebola spreading

The risk of Ebola spreading to the UK is minimal, but to minimise it even further we need more resources to bring the outbreak under control in West Africa.

Before this outbreak, MSF has treated hundreds of people affected by Ebola in Uganda, Republic of Congo, the Democratic Republic of Congo (DRC), Sudan, Gabon and Guinea. In 2007, MSF entirely contained an epidemic of Ebola in Uganda.

What causes Ebola?

Ebola can be caught from both humans and animals. It is transmitted through close contact with blood, secretions, or other bodily fluids.

Healthcare workers have frequently been infected while treating Ebola patients. This has occurred through close contact without the use of gloves, masks or protective goggles.

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.

Burials where mourners have direct contact with the deceased can also transmit the virus, whereas transmission through infected semen can occur up to seven weeks after clinical recovery.

No specific treatment or vaccine is yet available for Ebola

Symptoms of Ebola

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. This is followed by vomiting, diarrhoea, rash, impaired kidney and liver function and, in some cases, internal and external bleeding.

Symptoms can appear from two to 21 days after exposure. Some patients may go on to experience rashes, red eyes, hiccups, chest pains, difficulty breathing and swallowing.

Diagnosing Ebola

Diagnosing Ebola is difficult because the early symptoms, such as red eyes and rashes, are common.

Ebola infections can only be diagnosed definitively in the laboratory by five different tests.

Such tests are an extreme biohazard risk and should be conducted under maximum biological containment conditions. A number of human-to-human transmissions have occurred due to a lack of protective clothing.

“Health workers are particularly susceptible to catching it so, along with treating patients, one of our main priorities is training health staff to reduce the risk of them catching the disease whilst caring for patients,” said Henry Gray, MSF’s emergency coordinator, during an outbreak of Ebola in Uganda in 2012.Henry is also working on the current outbreak.

“We have to put in place extremely rigorous safety procedures to ensure that no health workers are exposed to the virus – through contaminated material from patients or medical waste infected with Ebola.”

Treating Ebola

No specific treatment or vaccine is yet available for Ebola.

Standard treatment for Ebola is limited to supportive therapy. This consists of hydrating the patient, maintaining their oxygen status and blood pressure and treating them for any complicating infections.

Despite the difficulty of diagnosing Ebola in its early stages, those who display its symptoms should be isolated and public health professionals notified.

Supportive therapy can continue with proper protective clothing until samples from the patient are tested to confirm infection.

Once a patient recovers from Ebola, they are immune to the strain of the virus they contracted.

MSF contained an outbreak of Ebola in Uganda in 2012 by placing a control area around the treatment centre.

An Ebola outbreak is officially considered at an end once 42 days have elapsed without any new confirmed cases.

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Meet Lumatu Samura, 16, one of the few pregnant women to survive Ebola at an MSF treatment centre.

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