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 Updates

Read MSF's Response to the World Health Organization's Ebola Road Map

MSF Activities (Updated August 27, 2014)

WHO figures (as of August 20, 2014)

 

Cases

Deaths

Guinea

607

406

Liberia

1,082

624

Nigeria

16

5

Sierra Leone

910

392

Total

2,615

1,427

According to WHO, from August 19 to 20, 142 new cases and 77 deaths were reported.

Since the Ebola outbreak began in March in Guinea, it has claimed 1,427 lives. The outbreak has spread far beyond Guinea, and is now raging unabated. A total of four countries are now affected: Guinea, Liberia, Nigeria, and Sierra Leone.

The World Health Organization has declared the largest-recorded Ebola epidemic an “international public health emergency,” yet the international effort to stem the outbreak is dangerously inadequate. MSF teams on the ground are seeing critical gaps in all aspects of the response: medical care, training of health staff, infection control, contact tracing, epidemiological surveillance, alert and referral systems, community education, and mobilization. All countries require an immediate and massive mobilization of resources.

MSF has been responding to the outbreak since March, and now has 1,327 staff working in Guinea, Liberia, Nigeria, and Sierra Leone, treating a rapidly increasing number of patients. 

MSF Medical Data
  Info Date Admissions (since start of activities*) Confirmed Recovered
GUINEA        
Conakry 8/25/2014 307 107 52
Guéckédou 8/24/2014 496 237 54
SIERRA LEONE        
Kailahun 8/21/2014 348 226 64
LIBERIA        
Foya 8/25/2014 540 315 63
Monrovia (ELWA 3) 8/24/2014 194 22 11
TOTAL   1,885 907 170

*Admissions include all suspected, probable, and confirmed cases. Anyone who is admitted is lab tested, which can take 12 days for results. If they are negative, they are discharged. Total admissions includes people who are currently waiting for lab confirmation and people who have never had Ebola but had symptoms and were therefore admitted to the suspected ward.

PBS NewsHour: Ebola Efforts Need More People in the Field

As the Ebola outbreak continues to spread, with 1,093 cases and 660 deaths now reported across west Africa, Doctors Without Borders/Médecins Sans Frontières (MSF) is stepping up its response in the most affected areas. Read more.

Sierra Leone

Update: August 8, 2014

In Sierra Leone, MSF’s Ebola case management center in Kailahun, near the border with Guinea, has been expanded to 80 beds, to cope with spiralling patient numbers. Between five and ten new patients are being admitted each day. Currently there are 60 patients in the center. Nine patients were discharged on August 4 after recovering from the disease.

Meanwhile, 200 community health workers are running health promotion activities in the region to increase knowledge about Ebola and educate people on how to protect themselves from infection.

Figures

  • MSF currently has 26 international staff and 300 Sierra Leonean staff working in the country.
  • In total, MSF case management centers have admitted 260 patients174 were confirmed to have Ebola. 36 patients have recovered and returned home.

In Sierra Leone—now the epicenter of the epidemic, with 454 cases recorded so far—MSF teams are rapidly scaling up the response, with 22 international and 250 Sierra Leonean staff.

In Kailahun, in the east of the country, the team is running a 64-bed Ebola treatment center.

Since the facility opened on June 25, 2014, 131 suspected, probable, and confirmed patients have been admitted for treatment. So far, 12 patients have recovered and returned home to their families.

An MSF psychologist is providing support and counseling to patients and their families, as well as to our staff.

MSF is also supporting the Ministry of Health and Sanitation at two referral sites in the Kailahun district.

In the past three weeks, MSF has trained more than 200 community health workers to deliver essential health messages to people in their villages about how to protect themselves against Ebola and what action to take if someone shows any signs or symptoms of the disease.

MSF is now focusing on halting the spread of the disease in the border area between Sierra Leone, Guinea, and Liberia, where the population is very mobile and people continue to transmit the disease to different villages.

Liberia

Update: August 18, 2014

Doctors Without Borders/Médecins Sans Frontières (MSF) admitted nine patients today into its newly constructed ELWA 3 Ebola Management Center in Monrovia, Liberia, beginning a process of scaling up operations at the 120-bed facility.

An Ebola outbreak continues to rage virtually unchecked in this city of approximately one million people, far exceeding the capacity of the few medical facilities accepting Ebola patients. Much of the city’s health system has shut down over fears of Ebola among staff members and patients, leaving many people without treatment for other conditions.

The first nine patients at ELWA 3 were among those seeking treatment at another Ebola center, ELWA 2, which is currently run by the Ministry of Health. MSF will increase the number of patients at ELWA 3 in the coming days, as newly trained staff members gain experience with the safety procedures. MSF currently has 19 international and 250 national staff members in Monrovia.

Update: August 8, 2014

The situation in the Liberian capital, Monrovia, is “catastrophic,” according to Lindis Hurum, MSF emergency coordinator in Liberia. There are reports of at least 40 health workers being infected with Ebola over recent weeks. Most of the city’s hospitals are closed, and there are reports of dead bodies lying in streets and houses.

MSF teams are providing technical support for an Ebola case management center in Monrovia in conjunction with the Ministry of Health, and has started construction of a new case management center.

An MSF team based in Guékédou, Guinea, has recently launched a response in Liberia’s Lofa region, alongside the Guinean border, which has been badly affected by Ebola.

MSF is reinforcing its current team of nine international staff and 10 Liberian staff, but the organization is reaching the limits of its capacity, and there is a dire need for the WHO, Ministry of Health, and other organizations to rapidly and massively scale up the response in Liberia.

In Liberia, the situation is deteriorating rapidly, with cases now confirmed in seven counties, including in the capital Monrovia.

There are critical gaps in all aspects of the response, and urgent efforts are needed to scale up.

Already stretched beyond capacity in Guinea and Sierra Leone, MSF is able to provide only limited technical support to the Liberian Ministry of Health (MoH).

The MSF team has set up an Ebola treatment center in northern Liberia, where cases have been increasing since the end of May.

After the initial set up, the center was handed over to Samaritan’s Purse on July 8. There are currently six patients and MSF experts continue to provide technical support and training.

The team will now shift its efforts to Voinjama, in Lofa county, where there are reports of people dying of Ebola in their villages.

The team will set up a referral unit so suspected Ebola patients can be isolated and transferred to the treatment center.

In Monrovia, an MSF emergency team is building a new tented treatment center with capacity for 4060 beds. It is scheduled to open on July 27 and will also be run by Samaritan’s Purse.

15 bed MSF treatment unit set up at Monrovia’s JFK hospital was handed over to the MoH in April. However, the unit has since been closed and all patients are currently cared for at ELWA hospital in Paynesville until the new center is open at the same site.

Currently there are 14 patients admitted to this center.

MSF is also supporting the MoH in the overall coordination of the Ebola response and providing technical and medical advice.

Guinea

Update: August 8, 2014

In Guinea, MSF is running two Ebola case management centers—one in the capital, Conakry, and one in Guéckédou, in the southwest of the country, where the outbreak began. After a lull in new cases in Guinea, recent weeks have seen an increase in new infections and deaths from Ebola. Currently there are 17 patients in Conakry and nine in Guéckédou.

In Macenta transit center in southwest Guinea, near the Liberian border, MSF is supporting the Ministry of Health by transferring Ebola patients by ambulance for case management in either Conakry or Guékédou. Patients are arriving from a wide area, including the region around Nzerekore.

Figures

  • MSF currently has 31 international staff and 300 Guinean staff working in the country.
  • In Conakry, to date MSF case management centers have admitted 232 patients; 124 were confirmed to have Ebola. 64 patients have recovered and returned home.
  • In Guékédou, to date MSF case management centers have admitted 366 patients; 169 were confirmed to have Ebola. 46 patients have recovered and returned home.

In Guinea, the situation has stabilized in some areas and MSF has closed its Ebola treatment center in Telimélé, in the west of the country, after no new cases were reported for 21 days.

Over seven weeks, 21 people with the disease were admitted to the center, with an astonishing 75 percent of patients making a recovery.

Without medical care, as few as ten percent of patients could be expected to survive.

In the capital Conakry, MSF is reducing its activities as far fewer cases are appearing.

Of the 59 confirmed Ebola patients admitted to the Donka center since March 25, 63 percent recovered and were able to return home.

In Guéckédou, in the southeast—the original epicenter of the epidemic—the number of patients in MSF’s center has declined significantly, with currently just two patients admitted.

It is very unlikely, however, that this reflects an end to the outbreak; instead it suggests that infected people may be hiding in their communities rather than coming for treatment.

There continues to be significant fear surrounding Ebola amongst local communities and MSF teams have been prevented from visiting four villages due to hostility.

We are working with local authorities and elders to try to ensure safe access to these areas to obtain a clearer picture of whether people are still being infected and dying of the virus.

Since the beginning of the outbreak, MSF has treated 150 patients in its center in Guéckédou.

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.

Health care 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 nonspecific, 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, 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.

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 2007, MSF entirely contained an epidemic of Ebola in Uganda.

 

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