Panic in West Africa after Ebola outbreak in Guinea

Fear is spreading all over West Africa after the health ministry in Guinea confirmed the first Ebola outbreak in this part of Africa. According to official numbers, at least 86 are infected and 59 are dead as a result of this very contagious disease.

Today also the World Health Organisation (WHO) issued a risk warning to neighbour countries, where several cases of suspected Ebola infections are being investigated. I areas just across the border in Liberia and Sierra Leone, six possible cases are being looked into, out of which five already have ended lethally.

Ebola is not normally known to occur in West Africa, so the outbreak already has created some panic tendencies in the region. Health authorities in The Gambia, Senegal, Côte d’Ivoire and Mali have already launched actions to isolate possible cases of Ebola virus to prevent further spread of the outbreak.

The fear is far from baseless. The so-called “zaire strain” of the deadly virus is found to be behind the surprise Guinean outbreak, according to test results from Institut Pasteur in Lyon (France). This strain has a mortality rate of 90 percent among the infected victims.

But authorities are nonetheless faithful they will manage to limit the spread of the outbreak, despite the extremely poorly developed health care system in Guinea. The Ebola epidemic so far only has been confirmed in three districts in the south of Guinea: Guéckédou, Nzérékoré and Kissidougou. It does not look to have spread northwards, towards the capital Conakry.

The WHO today confirms that this is the first time ever that an outbreak of the Ebola virus in Guinea and West Africa. The disease is more common in Central Africa, in particular in countries such as Uganda and Congo Kinshasa – where there have been nine outbreaks since 2001 – in addition to Gabon and South Sudan.

Aid operations have started
Not only local authorities, which are poorly prepared for an Ebola epidemic, are trying to limit the sudden outbreak. In cooperation with Guinea health authorities, the organisation Médecins Sans Frontières (MSF) has sent several aid workers to Guinea to start isolating the affected areas, so as to reduce the contagion risk.

The health organisation already has started an isolation facility for suspected Ebola cases in Guéckédou, a city located very close to the border against Liberia and Sierra Leone, with around 250,000 inhabitants. Within few days, a similar facility will be set up in the town Macenta in the Nzérékoré region. Macenta, close to the Liberian border, has around 100,000 inhabitants.

“These isolation units are essential to prevent the spread of the disease, which is highly contagious,” explains Dr Esther Sterk, MSF tropical medicine advisor. “Specialised staff are providing care to patients showing signs of infection,” she added.

MSF now also considering the situation in Nzérékoré (300,000 inhabitants) and Kissidougou (125,000), two other important cities in southern Guinea. Nzérékoré is located close to the border to Liberia and Côte d’Ivoire. Further, the organisation is examining the situation in neighbouring countries, in particular Sierra Leone and Liberia, where suspected cases already have been reported.

There organisation has sent some 33 tons of supplies to Guinea on two charter planes leaving from Belgium and France, containing medicines, medical equipment and the supplies necessary for isolating patients, putting sanitation measures in place and protecting its teams, according to MSF.

A very lethal virus
Ebola haemorrhagic fever is among the most feared virus diseases existing, with the highest mortality rates and the quickest course of disease. The virus is known to have its natural reservoir among apes, and it is mainly transferred to people when apes are hunted for human food consumption. Wherever there is an outbreak, panic follows in its footsteps.

The name Ebola stems from the Ebola River in Congo Kinshasa, where the virus was first identified in 1976, and there have since then been registered several outbreaks in exactly that area. Most reported occurrences of Ebola are from Congo Kinshasa and South Sudan. I December 2000 there was registered a major outbreak in Uganda, while there was an outbreak in Congo Brazzaville and Gabon in 2003.

The symptoms of the feared and acute disease are characterised by the sudden onset of fever, intense weakness, muscle pain, headache and sore throat. This is followed by vomiting, diarrhoea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding from nose, mouth and intestines.

The incubation period – the interval from infection to onset of symptoms – varies from only two to 21 days. The virus is extremely contagious and therefore also puts health workers at risk of infection. Ebola spreads through close contact with the blood, secretions, organs or other bodily fluids of infected people. Burial ceremonies where mourners have direct contact with the body of the deceased person also play a role.

There is no effective treatment or vaccine against the disease. Mortality rates are between 50 and 90 percent, depending on which strain of the virus has caused the outbreak. The Zaire strain, which now is causing an epidemic in Guinea, is the most lethal.

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