Ebola, previously known as Ebola hemorrhagic fever, is a rare and deadly disease caused by infection with one of the Ebola virus strains. Ebola can cause disease in humans and nonhuman primates (monkeys, gorillas, and chimpanzees). In past outbreaks the death percentage was 88% now it has been reduced to 53.8%, either by medical care or due to mutation. It is unclear.
The recent outbreak isn't just the worst single Ebola outbreak in history, it has now killed more than all the others combined.
Healthcare workers are visibly struggling, the response to the outbreak has been damned as "lethally inadequate" and the situation is showing signs of getting considerably worse.
The outbreak has been running all year, but the latest in a stream of worrying statistics shows 40% of all the deaths have been in just the past three weeks.
So what can we expect in the months, and possibly years, to come? The stories of healthcare workers being stretched beyond breaking point are countless. A lack of basic protective gear such as gloves has been widely reported.The charity "Médecins Sans Frontières" has an isolation facility with 160 beds in Monrovia. But it says the queues are growing and they need another 800 beds to deal with the number of people who are already sick.This is not a scenario for containing an epidemic, but fuelling one.
Dr Dye's tentative forecasts are grim: "At the moment we're seeing about 500 new cases each week. Those numbers appear to be increasing. "I've just projected about five weeks into the future and if current trends persist we would be seeing not hundreds of cases per week, but thousands of cases per week and that is terribly disturbing.
"The situation is bad and we have to prepare for it getting worse."
The World Health Organisation is using an educated guess of 20,000 cases before the end, in order to plan the scale of the response. It is also unclear when this outbreak will be over. Officially the World Health Organisation is saying the outbreak can be contained in six to nine months. But that is based on getting the resources to tackle the outbreak, which are currently stretched too thinly to contain Ebola as it stands.
There have been nearly 4,000 cases so far, cases are increasing exponentially and there is a potentially vulnerable population in Sierra Leone, Liberia and Guinea in excess of 20 million.
there are is also a fear being raised by some virologists that Ebola may never be contained. Prof Jonathan Ball, a virologist at the University of Nottingham, describes the situation as "desperate". His concern is that the virus is being given its first major opportunity to adapt to thrive in people, due to the large number of human-to-human transmissions of the virus during this outbreak of unprecedented scale like HIV and influenza, Ebola's genetic code is a strand of RNA. Think of RNA as the less stable cousin of DNA, which is where we keep our genetic information.
It means Ebola virus has a high rate of mutation and with mutation comes the possibility of adapting. Prof Ball argues: "It is increasing exponentially and the fatality rate seems to be decreasing, but why?
"Is it better medical care, earlier intervention or is the virus adapting to humans and becoming less pathogenic? As a virologist that's what I think is happening."
There is a relationship between how deadly a virus is and how easily it spreads. Generally speaking if a virus is less likely to kill you, then you are more likely to spread it - although smallpox was a notable exception.
Prof Ball said "it really wouldn't surprise me" if Ebola adapted, the death rate fell to around 5% and the outbreak never really ended.
"It is like HIV, which has been knocking away at human-to-human transmission for hundreds of years before eventually finding the right combo of beneficial mutations to spread through human populations."
Ebola is caused by infection with a virus of the family Filoviridae, genus Ebolavirus. There are five identified Ebola virus species, four of which are known to cause disease in humans: Ebola virus (Zaire ebolavirus); Sudan virus (Sudan ebolavirus); Taï Forest virus (Taï Forest ebolavirus, formerly Côte d’Ivoire ebolavirus); and Bundibugyo virus (Bundibugyo ebolavirus). The fifth, Reston virus (Reston ebolavirus), has caused disease in nonhuman primates, but not in humans.
Ebola viruses are found in several African countries. Ebola was first discovered in 1976 near the Ebola River in what is now the Democratic Republic of the Congo. Since then, outbreaks have appeared sporadically in Africa.
The natural reservoir host of Ebola virus remains unknown. However, on the basis of evidence and the nature of similar viruses, researchers believe that the virus is animal-borne and that bats are the most likely reservoir. Four of the five virus strains occur in an animal host native to Africa.
Up until now all cases of human illness or death from Ebola had occurred in Africa (with the exception of several laboratory contamination cases: one in England and two in Russia). On 9/30/2014, CDC confirmed, the first travel-associated case of Ebola to be diagnosed in the United States and now the recent contamination case in Madrid is the first non-travel associated contamination case on record.
Healthcare providers caring for Ebola patients and the family and friends in close contact with Ebola patients are at the highest risk of getting sick because they may come in contact with the blood or body fluids of sick patients. People also can become sick with Ebola after coming in contact with infected wildlife. For example, in Africa, Ebola may spread as a result of handling bushmeat (wild animals hunted for food) and contact with infected bats. The virus also can be spread through contact with objects (like clothes, bedding, needles, syringes/sharps or medical equipment) that have been contaminated with the virus or with infected animals.
No FDA-approved vaccine or medicine (e.g., antiviral drug) is available for Ebola.
Symptoms of Ebola are treated as they appear. The following basic interventions, when used early, can significantly improve the chances of survival:
• Providing intravenous fluids (IV)and balancing electrolytes (body salts)
• Maintaining oxygen status and blood pressure
• Treating other infections if they occur
Experimental vaccines and treatments for Ebola are under development, but they have not yet been fully tested for safety or effectiveness.
Recovery from Ebola depends on good supportive care and the patient’s immune response. People who recover from Ebola infection develop antibodies that last for at least 10 years, possibly longer. It isn't known if people who recover are immune for life or if they can become infected with a different species of Ebola. Some people who have recovered from Ebola have developed long-term complications, such as joint and vision problems.
Symptoms of Ebola include
• Fever (greater than 38.6°C or 101.5°F)
• Severe headache
• Muscle pain
• Abdominal (stomach) pain
• Unexplained haemorrhage (bleeding or bruising)
Symptoms may appear anywhere from 2 to 21 days after exposure to Ebola, but the average is 8 to 10 days.
Recovery from Ebola depends on good supportive clinical care and the patient’s immune response. People who recover from Ebola infection develop antibodies that last for at least 10 years.
In a statement published on August 8 the WHO said: “States should be prepared to facilitate the evacuation and repatriation of nationals (e.g. health workers) who have been exposed to Ebola.” Both Manuel García Viejo, the 69-year-old priest who was infected in Sierra Leone, and Miguel Pajares, the other missionary who was infected in Liberia, were moved and admitted to the Carlos III hospital in Madrid, which is theoretically prepared to receive this type of patient. Nevertheless, staff have complained that the protective suits given to health workers did not comply with regulations, something the hospital itself denies.