Ebola virus disease first appeared in 1976, and although its origins are unknown, bats are considered the likely host. One of the world’s most deadly diseases, Ebola has a mortality rate of between 25 and 90 per cent. While Ebola is a fragile virus that can be easily killed with heat, bleach, chlorine and even soap, it is easily transmitted through close contact – leading to rapidly growing outbreaks that are difficult to contain.
The largest outbreak of Ebola in history was officially declared on 22 March 2014 in Guinea. It claimed more than 11,300 lives in six affected countries in West Africa (Guinea, Liberia, Mali, Nigeria, Senegal and Sierra Leone), including over 500 healthcare staff – more than all previous outbreaks combined. Earlier outbreaks of Ebola occurred in remote villages in Central Africa, but the outbreak that began in 2014 included major urban areas as well, making contact tracing and control of transmission more difficult. The outbreak and its impact were exacerbated by high mobility of the population, weak health systems and lack of infrastructure and human resources in Guinea, Liberia and Sierra Leone, the three worst-affected countries.
The outbreak officially ended in June 2016 after the last flare up in Liberia.
For more information: WHO Ebola fact sheet
- Transmission: The Ebola virus is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals; human-to-human transmission occurs through direct contact with blood, bodily secretions, organs and sick people.
- Signs and symptoms: Sudden onset of fever, fatigue, muscle pain, headache and sore throat is followed by vomiting, diarrhoea, rash, symptoms of impaired kidney and liver function, and in some cases both internal and external bleeding.
- Diagnosis: On clinical basis, Ebola can be difficult to distinguish from a number of other infectious diseases; confirmation can be made using a number of different laboratory tests.
- Treatment: There are no proven treatments or licensed vaccines for Ebola; however two vaccines are undergoing human safety studies.
- Prevention and control: Outbreak control requires a package of interventions, including case management, surveillance and contact tracing, laboratory services, safe burials and social mobilisation.
MSF has intervened in almost all reported Ebola outbreaks in recent years, but until 2014 these were usually geographically contained and involved more remote locations. From the very beginning of the recent Ebola epidemic, MSF responded in the worst affected countries – Guinea, Liberia and Sierra Leone – by setting up Ebola management centres 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 the three countries. MSF admitted a total of 10,376 patients to its Ebola management centres, of which 5,226 were confirmed Ebola cases. In total, the organisation spent over 96 million euros on tackling the epidemic.
Those who survived Ebola often found the battle was not over. Many faced significant medical and mental health problems such as joint pain, chronic fatigue, and hearing and vision problems. They also suffered from stigmatisation in their communities and required specific and tailored care. MSF set up dedicated survivors’ clinics in the three worst-affected countries. At the end of 2016, once most acute medical conditions affecting survivors had been treated, MSF began closing its medical and mental health programmes for survivors and arranged for those who need ongoing mental health support to receive continuing care from their national health systems or other organisations.
MSF learned a lot from the last outbreak, and this should allow us to provide an improved response during any future outbreak. There is now a new, promising vaccine that can help slow and control an epidemic, and also protect medical staff working with Ebola patients. However, the vaccine has yet to be approved for regular administration and, in order for it to be useful during the next outbreak, it must be made available at an affordable price to ensure access in low-income countries.
Hover over the image below for an interactive guide to an MSF Ebola care centre.