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

If contracted, 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.

Doctors Without Borders/Médecins Sans Frontières (MSF) has treated hundreds of people with the disease and helped to contain numerous life-threatening epidemics.

Ebola: Latest MSF Updates

Click Here to Read the latest report: "Pushed to the Limit and Beyond"

MSF Ebola activities in West Africa, January 14, 2016

 

WHO Figures (Updated January 14, 2016)

  Date of Info Cases Deaths
Guinea Outbreak over 3,804 2,536
Liberia Outbreak 1 over 10,666 4,806
  Outbreak 2 over 9 3
Sierra Leone Outbreak over 14,122 3,955
Nigeria Outbreak over 20 8
Senegal Outbreak over 1 0
USA Outbreak over 4 1
Spain Outbreak over 1 0
Mali Outbreak over 8 6
UK Outbreak over 1 0
TOTAL   28,636 11,315

MSF Staff on the Ground (as of January 14, 2016)

At its peak, MSF employed nearly 4,000 national staff and over 325 expat staff to combat the epidemic across the three countries.

MSF’s Ebola response started in March 2014 and included activities in the three most-affected countries (Guinea, Liberia, and Sierra Leone) as well as Nigeria, Mali, and DRC. Since the beginning of the epidemic, 10,288 patients were been admitted to MSF Ebola management centers, 5,226 of whom were confirmed to have the disease. Of those, 2,478 patients recovered.

With the declaration of the end of the Ebola epidemic in West Africa, January 14, 2016, should be a day of celebration and relief. But lessons must be learned from the outbreak and the response.

Lessons learned must be used to improve responses to future epidemics and to neglected diseases. This Ebola response was not limited by a lack of international resources, but by a lack of political will to rapidly deploy assistance to help communities. The needs of patients and affected communities must remain at the heart of any response and outweigh political interests.

This devastating epidemic hit nearly 40 years after the first discovery of Ebola in 1976, yet the lack of research and development on Ebola meant that even today, after the medical trials and at the end of the epidemic, there is no effective treatment.

This has been an unprecedented epidemic with an unprecedented response.

From the very beginning of the epidemic, MSF responded in the worst-affected countries—Guinea, Liberia and Sierra Leone—by setting up Ebola treatment centers and providing services such as psychological support, health promotion, surveillance, and contact tracing. At its peak, MSF employed nearly 4,000 national staff and over 325 international staff to combat the epidemic across these three countries. MSF admitted a total of 10,376 patients to its Ebola treatment centers, of which 5,226 turned out to be confirmed Ebola cases. In total, the organization has spent over 96 million euros on tackling the epidemic.

But there is still a lot of room for progress. Most importantly, there still is no treatment for this deadly disease, and much about the virus remains unknown.

Steps must be taken to better prepare the world for a future outbreak.

A lot of data has been gathered during this outbreak, and a lot of it remains to be analyzed. This analysis will be of vital importance to learn as much as possible about the disease before another outbreak occurs.

We now have a promising vaccine for Ebola, but it is yet to be approved for regular administration. In order for it to be useful during a new outbreak, we must ensure that it will be accessible to those in need.

There’s no treatment for Ebola yet, but there are a few promising developments in the pipeline. In order to test these products, preparations of clinical studies of the most promising treatment products should be prepared before the next outbreak, in order to lose as little time as possible.

A sustained and well-functioning surveillance and rapid response system is essential in order to maintain zero cases of Ebola across West Africa and also to respond to cases of other diseases with epidemic potential, including measles and cholera, which have previously broken out in the region.

Finally, already weak public health systems were seriously damaged by the epidemic and their recovery must be sufficiently funded and resourced.

MSF will continue its work on Ebola.

Even though the epidemic is over, MSF’s work on Ebola is not. Ebola survivors are a particularly vulnerable group, facing continuing health challenges such as joint pain, chronic fatigue, and hearing and vision problems. They also suffer from stigmatization in their communities and need specific and tailored care. MSF has invested in setting up five Ebola survivor clinics in Liberia, Sierra Leone, and Guinea, providing a comprehensive care package, including medical and psychosocial care and protection against stigma.

Re-emergence of cases is very rare.

Evidence gathered during the epidemic shows that the virus can stay in some parts of survivors’ bodies for as long as nine months (or longer). In Sierra Leone and Liberia, there have been some cases of transmission of the disease by survivors, as well as what seems to be relapse of the disease. But these episodes are extremely rare. Only ten cases of re-emergence have been identified out of a total of 15,000 survivors. However, it is important to maintain adequate surveillance systems in order to identify and treat such cases and avoid further transmission.

Sierra Leone

Update: January 14, 2016

The outbreak was declared over on November 7, 2015. MSF is now focusing activities on survivor health care and surveillance in Western Area (Freetown) and Tonkolili (Magburaka). There are also plans to begin non-Ebola health activities in several districts of the country, as many components of the health system need to be strengthened.

Magburaka (Survivor Clinic)

MSF is running a survivor health clinic in Magburaka town as well as a mobile clinic in the surrounding villages in Tonkolili and Bombali districts. By the end of December the team had provided support to 146 survivors for medical and mental health needs. The team also ran a two-week mobile clinic in Kailahun facilitating eye exams and providing medical screenings; 153 survivors were seen.  

Freetown (Survivor Clinic)

MSF has run a survivor clinic in Freetown since February 2015, providing care to about 150 patients, mostly primary health care and mental health support.

Koinadugu and Tonkolili Districts (Maternal and Child Health)

MSF is currently working to incorporate survivor health care in the national facilities in Tonkolili District. Since January 4, 2016, the team has started clinical care in the maternity and pediatric wards of Magburaka Government Hospital. The program will expand to provide basic emergency obstetrics and newborn care to primary level of care. 

In Kabala Hospital, in Koinadugu District, MSF is preparing to open a new project with the aim to increase access to free secondary level maternal, neonatal, and pediatric care while ensuring free health care to Ebola survivors in the district and effective response to outbreaks and emergencies in the area.

Liberia

Update: November 2, 2015

After first being declared Ebola-free on May 9, a 17-year-old boy died on June 29, followed by five further cases of the virus. The outbreak was declared over again on September 3, and the country is now observing a period of heightened vigilance.

With the national health system decimated by the outbreak—and nearly 200 Liberian health care workers killed by the disease, according to official statistics—MSF is focusing activities on supporting the recovery of health facilities, hoping to encourage Liberian people to feel confident they can go to hospital to have their health care needs looked after.

Monrovia

In Monrovia, MSF is running a 74-bed pediatric hospital, including a neonatal intensive care unit, aiming to contribute to restoring the provision of secondary health care in the aftermath of the Ebola outbreak. In September, 374 children were cared for at the hospital. Twenty-five percent of the cases admitted in the emergency room suffered from malaria.

MSF also runs a clinic for Ebola survivors in the premises of the hospital. Former patients have to face stigma and discrimination while accessing care, as well as social and economic problems (loss of work, loss of housing, etc.). MSF provides general outpatient consultations and addresses mental health needs for a group of more than 500 identified former Ebola patients, estimated to be one-third of all survivors in Liberia. Common complaints are joint pains and ophthalmic issues, for which MSF guarantees referral to external specialists.

Guinea

Update: November 2, 2015

There were three new confirmed cases of Ebola in Guinea during the week ending October 25. All three new cases are from the same household in the sub-prefecture of Kaliah, Forecariah, and are registered high-risk contacts linked to a case from the same area last week.

The country also reported three cases the previous week. There are currently 364 contacts under follow-up in Guinea (an increase from 246 the previous week), 141 of whom are high-risk. An additional 233 contacts identified during the past 42 days remain untraced.

Nigeria

Update: October 23, 2014

WHO declared October 20 as the official end of the epidemic after 42 days without a case. The MSF intervention has been closed.

Senegal

Update: October 23, 2014

WHO declared October 17 as the official end of the epidemic after 42 days without a case. The MSF intervention has been closed. MSF’s West African Unit (Dakar) will keep in contact with the government for follow-up as part of their routine activities.

Democratic Republic of Congo (DRC)

Update: November 20, 2014

The outbreak in DRC’s Equateur province, which was unrelated to the one in West Africa, was declared over this week. Around 60 MSF staff worked on this outbreak and two case management centers were established. The MSF teams have activated an exit plan.

Uganda

Update: November 20, 2014

On September 29, a case of Marburg fever was declared in Uganda. MSF has helped reinforce local capacities for treating confirmed cases and for infection control. No new cases of the disease have been declared since. 

Mali

Update: November 20, 2014

Mali confirmed its first case of Ebola on October 23. So far there have been seven reported deaths in the country (including the first case): five confirmed with Ebola and two suspected cases. To date, 360 contacts have been identified and nearly all have been placed under surveillance.

In Bamako, MSF is running a CMC in collaboration with CNAM, Mali’s national disease center. The only confirmed Ebola patient admitted to this facility recently died. The case was detected on November 11 and the patient was immediately admitted to the facility. There is one more suspected case currently at the CMC.

MSF has reinforced its team and expanded its activities to help stop the disease spreading further. MSF is training Malian staff from CNAM to manage Ebola cases, and is overseeing the organization of an ambulance system and safe burials.

No specific treatment or vaccine is yet available for Ebola.

Video

Symptoms of Ebola

Early on, symptoms are nonspecific, making it difficult to diagnose.

The disease is often characterized by the sudden onset of fever, feeling weak, muscle pain, headaches, and a sore throat. This is followed by vomiting, diarrhea, 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 while caring for patients,” said Henry Gray, MSF’s emergency coordinator, during an outbreak of Ebola in Uganda in 2012.

“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 him or her 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.

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

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

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Risk of Ebola Spreading

The risk of Ebola spreading to the US is minimal, but to minimize 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.

"I was collecting blood samples from patients. We did not have enough protective equipment to use [and] I developed the same symptoms,” says Kiiza Isaac, a nurse from Uganda.

On November 19, 2007, I received laboratory confirmation—I had contracted Ebola.

"MSF came to Bundibugyo and they ran a treatment center. Many patients were cared for. Thank God, I survived. After my recovery, I joined MSF."

It is estimated there have been over 1,800 cases of Ebola, with nearly 1,300 deaths.

The Ebola virus was first associated with an outbreak of 318 cases of a hemorrhagic 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.

The Ebola virus is made up of five species: 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.

MSF has treated hundreds of people affected by Ebola in UgandaRepublic of Congo, the Democratic Republic of Congo (DRC), Sudan, Gabon, and Guinea. In 2014, MSF admitted 7,400 people into Ebola management centers.

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