HEALTH

The 2014 crisis is the largest Ebola outbreak in history and the first in West Africa. Learn more about the deadly disease and responses to the crisis. (Centers for Disease Control and Prevention)

Use our resources to learn more about the last major outbreak of Ebola.

Discussion Ideas

• What is ebola?
  • Ebola is an infectious disease caused by a virus. In fact, most doctors and researchers call it Ebola virus disease (EVD). There are actually five ebola viruses, four of which cause diseases in humans. (The fifth virus has only caused disease to non-human primates, such as chimpanzees.)

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• When was Ebola discovered?
  • Ebola virus disease (EVD) first appeared in 1976 in two simultaneous outbreaks—in Nzara, Sudan, and Yambuku, Zaire (now Democratic Republic of Congo).

 

• Is Ebola related to any other diseases?
  • Yes. Ebola is classified as a hemorrhagic fever. Other hemorrhagic fevers include the Hantavirus, yellow fever, dengue fever, and encephalitis. Read more about hemorrhagic fevers here.

 

• Why is Ebola uppercase? Other hemorrhagic fevers are lowercase.
  • The first outbreak in Democratic Republic of Congo occurred in a village near the Ebola River, from which the disease takes its name. Click here to see a map of the Ebola River.

 

• What does hemorrhagic mean?
  • “Hemorrhagic” refers to blood, and some Ebola patients have uncontrolled bleeding—usually nosebleeds or oozing from their gums or in their stools (poop). The bleeding doesn’t always happen and is usually quite light; it does not cause damage in and of itself.

 

• What are some common symptoms of Ebola?
  • Although some ebola patients suffer uncontrolled bleeding, most symptoms are not radically different from other flu-like diseases. This makes Ebola difficult to diagnose.
  • Symptoms include fever (as high as 38° Celsius/101° Fahrenheit), headaches, vomiting, diarrhea, and general fatigue.

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• How soon can someone be infected?
  • Most ebola patients display symptoms of the disease within two weeks of contracting it. Some patients, however, don’t display symptoms for almost a month.

 

• I live in the United States. Can I catch Ebola?
  • It’s very, very unlikely. Only three cases affecting humans have ever developed outside Africa—one in England and two in Russia. All three of these cases were incidents of laboratory contamination, not natural infections.
  • Every single natural case of Ebola has appeared in sub-Saharan Africa. Here is a map of the distribution of the disease.

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• What is the fatality rate?
  • Ebola is a very serious disease. Once diagnosed, it has about a 50% fatality rate—that means only half of the people who get the disease survive it. In some areas, the survival rate is as low as 10%.
  • Victims of Ebola who do not recover suffer multiple organ failure and usually die within a week.
  • Someone who has survived ebola can no longer transmit it.

 

• Is there a cure for Ebola? Is there a vaccine?
  • There is no cure for Ebola. A cure is a remedy for an illness that has already been contracted.
  • There is no vaccine for Ebola. A vaccine prevents an illness from developing in the first place.

 

 

• What is the treatment for Ebola?
  • Ebola symptoms are treated as they develop—pain-reliever for fever, anti-diarrhea medicine, etc.
  • Health-care workers generally make sure patients have plenty of fluids, usually delivered intravenously (IV drip) with high concentrations of electrolytes (salts).
  • Many Ebola patients need supplemental oxygen, because they have trouble breathing.
  • There are some promising experimental drug treatments for Ebola, but they are not widely available and have not been rigorously tested.

 

• Where does Ebola come from?
  • Scientists aren’t sure what the “reservoir” of Ebola viruses are. Disease reservoirs are defined as “sources which normally harbor disease-causing organisms and thus serve as potential sources of disease outbreaks. Reservoirs are distinguished from vectors and carriers, which are agents of disease transmission rather than continuing sources of potential disease outbreaks.”
  • Most researchers think the reservoir for Ebola virus may be fruit bats.

 

 

• How does an Ebola outbreak get started?
  • Ebola can infect animals as well as humans, and most researchers think “patient zero” in an Ebola outbreak is someone who has had the bad luck to come into contact with an infected animal—through livestock farming, cooking, or hunting, for example.
  • Almost all Ebola patients catch the disease from someone who has already been infected.

 

 

• Most Ebola patients catch the disease from contact with someone who has already been infected. Can you get it from touching an infected person? Is it airborne?
  • No and no. Ebola is not airborne or waterborne. You cannot catch the disease by simply being around (breathing air in the same space as) an infected person.

 

 

• How do you catch Ebola? If you can’t catch it by breathing it in, why do health-care workers wear hazmat suits?
  • You catch Ebola by getting the virus into your own bloodstream. You do this by absorbing a tiny amount of an infected person’s bodily fluid—contact with an open wound, sexual contact, even being around an infected person with a cough can transmit fluids such as mucus. Simply touching the fluids, such as blood or breast milk, will not get you infected—the fluid (even a minute amount) needs to get into your bloodstream.
  • Having an open wound (such as a cut or scratch) or not wearing protective goggles and masks when you’re around an infected patient can increase your chances of contracting Ebola.
  • Changing diapers or treating injuries can be high-risk activities.
  • Kissing (the virus can live in saliva) or having sex with an infected person puts you at very high risk.
  • People are at risk by coming into contact with objects that have been contaminated by the virus. These includes hypodermic needles and syringes often used in health care facilities. They can also include contaminated bedding and clothing.
  • Farmers, hunters, and people working in the food-service industry may be at risk by coming into contact with infected animals or meat.
  • Health-care workers wear protective clothing to avoid coming into contact with the bodily fluids of an infected person.

 

• The current outbreak of Ebola is the worst in the history of the disease. Why do you think this outbreak of Ebola is so devastating to West Africa?
  • All previous outbreaks have occurred in isolated, rural communities. The current outbreak has spread through densely populated urban areas, including the capital cities of Monrovia, Liberia; Freetown, Sierra Leone; and Conakry, Guinea.
  • Almost all the nations affected by the current outbreaks have open or porous borders, meaning people in the region travel easily. This increases the risk of spreading the disease. Here is a map of the impacted region in West Africa.

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• I’ve heard there are two Ebola outbreaks in Africa. Is this true?
  • Yes. Researchers think the current outbreak in West Africa is not related to the current outbreak in Democratic Republic of Congo.

 

• How are local communities dealing with outbreaks?
  • All groups are working together to make sure people living in at-risk regions are educated about the disease and how to prevent it. Encouraging people to not hide infected patients and alter traditional burial practices, such as washing the body of the deceased, are among the goals of the programs.
  • Sometimes, education this includes teaching communities how not to prevent it. Some communities think that folk remedies, spirituality, or homeopathic treatments may prevent or cure Ebola. Read more about one herbal “remedy” here.

 

• How are West African and nearby nations dealing with outbreaks?
  • The most drastic measure taken by nations impacted by the Ebola outbreak is quarantine. Sierra Leone, for example, enforced a 3-day quarantine on its entire population earlier this month. During this time, people stayed in their homes, while health-care workers went house-to-house. The health-care workers were diagnosing possible cases of Ebola, mapping sites of potential outbreaks, and educating individual families about the disease. Read more about Sierra Leone’s aggressive tactics here.
  • Liberia has enacted a different type of quarantine—the government has refused all “shore passes” to members of its navy, preventing sailors from entering any of its ports and risking infection.
  • Many nations in West Africa and beyond have imposed strict border control. Chad, South Africa, and Sri Lanka, for example, are all withholding visas for visitors from affected countries.
  • Other nations, such as Morocco and Ivory Coast, have canceled flights and increased airport security to prevent people from affected countries from entering.
  • Still other nations, such as Qatar, have banned the importation of agricultural goods from the affected area.

 

• How are nations outside West Africa dealing with outbreaks?
  • Many nations have provided funding to the affected regions, through direct aid to government health-care efforts, or the work of agencies such as the Red Cross or Doctors Without Borders. Australia, Germany, the United Kingdom, and Japan have all provided millions of dollars to help combat the disease.
  • Some nations, such as China, Cuba, and Malaysia, have provided much-needed health-care personnel and equipment.
  • The United States has provided funding, equipment, health-care expertise, and military troops to West Africa. The troops are there to help set up testing facilities, field hospitals, and transport equipment and personnel.

 

• How are regional organizations dealing with outbreaks?
  • The African Union has launched a campaign to recruit African health-care workers to address the crisis.
  • The Economic Community of West African States has worked with local and national governments to prevent the spread of the disease by discouraging travel between affected regions.

 

• How are international organizations dealing with outbreaks?
  • The World Health Organization is working tirelessly to address the issue through personnel, equipment, facilities, political outreach, and education campaigns. Read more about all WHO is doing to contain the Ebola outbreak here.
  • The Centers for Disease Control is working with other U.S. agencies and WHO to provide technology, medical assistance, and facilitation between parter agencies. Read more about all the CDC is doing to contain the Ebola outbreak here.
  • The United Nations Security Council passed a resolution calling the current Ebola outbreak a “threat to international peace and security” and formed the United Nations Mission for Ebola Emergency Response (UNMEER) to coordinate logistical and financial cooperation between the UN’s wide array of agencies.
  • The European Union has established a “mobile lab” to help diagnose and treat Ebola more quickly in Guinea.
  • A wide variety of nonprofit organizations, such as Doctors Without Borders and Samaritan’s Purse, have responded to the crisis. Foundations established by both founders of Microsoft have also provided significant funding—the Bill and Melinda Gates Foundation and the Paul Allen Foundation.

 

• What are some social challenges involved in containing the current outbreak of Ebola?
  • Poverty. West Africa includes some of the most poverty-stricken areas in the world, with limited access to running water and health-care facilities. Click to look this map, which shows the amount of health-care spending per person in Africa.
  • Mistrust of authority. West African communities have a long, horrible history of being victimized by those in power. Local communities are wary of government or foreign health-care workers telling them how to live their lives. Read more about how family members “freed” infected patients from a hospital here.
  • Political instability. Sierra Leone’s civil war ended in 2002. The Liberian civil war ended in 2003. The Democratic Republic of Congo is still enduring insurgencies, most notably from the powerful rebel group the Lord’s Resistance Army. These conflicts delay progress in social, political, economic, and health-care infrastructure.
  • Economic impact. Quarantines have shut down markets and food-distribution networks. This has devastated local economies and increased levels of food insecurity in West Africa. Read more about undernourishment and food insecurity here.

 

• Weren’t some American aid workers infected? Why did they recover but thousands of Africans have not?
  • American Ebola patients have been flown back to the U.S. to receive treatment at well-funded, top-notch American hospitals.
  • Two American patients received an experimental drug, ZMapp. Although both patients recovered, the company that is developing the drug has not tested it on human beings in a rigorous setting, and has not manufactured enough of the drug to distribute it. Read more about how the American patients were treated here.
  • Politically, this was a difficult situation. The American government did not provide the treatment, and the aid workers were working for a private organization (Samaritan’s Purse). Still, many critics were upset that Western patients received the most sophisticated treatment, while thousands of poor Africans do not. Others rebut this opinion by recognizing that it would have been just as politically and ethically dodgy for a big Western pharmaceutical company to supply untested drugs to poor African patients.

 

• How have previous Ebola outbreaks ended?
  • Ebola outbreaks have ended only when the spread of the virus has been contained—a combination of quarantine, strict preventative measures, and improved health-care and hygiene. See a table on the history of Ebola outbreaks here.