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Explainer

Ebola: What is it? How do people become infected?

Ebola first appeared in 1976. The current outbreak has killed more than 1,300 people, with experts warning it could take six months to bring under control.

AS THE HSE confirms it is carrying out tests on the body of a man found in Donegal to determine whether he died of Ebola, authorities in the west African nation of Liberia said today they were struggling to deal with their dead.

More than 1,350 people have died since March in Guinea, Liberia, Nigeria and Sierra Leone as a result of the disease — the worst outbreak since Ebola’s discovery almost 40 years ago.

So what is Ebola? How is it spread? And how are doctors treating it?

Here’s our brief guide…

Origins…

Ebola first appeared in 1976 in two simultaneous outbreaks, one in a village near the Ebola River in the Democratic Republic of Congo, and another in Sudan.

It’s precise origins are unknown but fruit bats are considered the most likely hosts, according to research.

Here’s how the World Health Organisation describes it:

Ebola virus disease (EVD) is a severe, often fatal illness, with a case fatality rate of up to 90 per cent. It is one of the world’s most virulent diseases. The infection is transmitted by direct contact with the blood, body fluids and tissues of infected animals or people. Severely ill patients require intensive supportive care. During an outbreak, those at higher risk of infection are health workers, family members and others in close contact with sick people and deceased patients.

AP / Press Association Images AP / Press Association Images / Press Association Images

File photo: Jan 1997… Government veterinarians line up dead monkeys after administering lethal injections at a farm near Manila. More than 600 monkeys in the farm were ordered killed following the discovery of an Ebola virus strain from two of them which were shipped to the US for scientific research. 

What does it do?

The typical signs are a sudden onset of fever, intense weakness, muscle pain, headache and sore throat.

This is followed by diarrhoea, vomiting, impaired liver function — and in some cases internal and external bleeding.

As the disease progresses, the body goes into shock, coma and death…

AFP news agency / YouTube

How do people become infected?

In the current outbreak, the majority of cases have occurred as a result of human-to-human transmission.

The disease is spread via direct contact through broken skin or mucous membranes, with the blood or other bodily fluids of infected people.

It can also be spread through objects that have become infected with a victim’s bodily fluids — like soiled clothing, bed linen or used needles. Transmission has also occurred during funerals and burial rituals.

Generally, for an outbreak to start, a person must come into contact with an animal that has Ebola — and it can then spread within the community from person to person.

AP / Press Association Images AP / Press Association Images / Press Association Images

File photo: December 2001… Workers wearing protective clothing bury five-year old Adamou, next to the graves of other Ebola victims in a cemetry in Mekambo, north eastern Gabon, following an outbreak.

What’s the incubation period?

The time interval from infection to onset of symptoms is from 2 to 21 days.

Patients become contagious when they develop symptoms but are not contagious during the incubation period. 

People remain infectious as long as their blood and bodily fluids contain the virus. Infected patients are closely monitored by medics, and regular lab tests are carried out before they can be cleared and allowed home.

Men who recover from Ebola can still spread it for up to seven weeks after their recovery through their semen.

Who is most at risk?

Again according to the WHO, those at higher risk of infection are…

  • Healthcare workers. 
  • Family members of victims.
  • Mourners who have direct contact with the bodies of victims at funerals. 

More than 100 health workers have been exposed to the virus while caring for Ebola patients, including two American aid workers who were discharged from hospital this week after being treated with an experimental drug.

AP / Press Association Images AP / Press Association Images / Press Association Images

Ebola victim Dr. Kent Brantly during a news conference after being released from Emory University Hospital in Atlanta today.

The treatment…

No known vaccine or drug treatment has been proven to fight Ebola.

Treatment of the virus involves providing the patient with intravenous fluids and balancing electrolytes — as well as providing oxygen, if needed, and treating other infections as they occur.

Although the two American patients, and a number of other Liberian doctors, were treated with a drug which had never been used before on humans, it’s unclear as yet whether that drug aided in their recovery.

The experimental ‘ZMapp’ treatment was also administered to a Spanish priest who contracted the disease, but he died in Spain last week, the BBC reports.

The survival rate for the current outbreak is around 47 per cent.

How has the latest outbreak spread?

Scientists in France confirmed back in March that a highly contagious epidemic raging through the southern forests of Guinea was, in fact, Ebola, as 59 deaths were confirmed.

Liberia confirmed its first cases before the end of that month.

In May, Sierra Leone confirmed its first fatality, and the WHO warned that the rapid spread had occurred in part because containment efforts had been too relaxed.

In July, the virus spread to Africa’s most populous country, Nigeria, as a Liberian national died in quarantine in Lagos. Doctors Without Borders warned that Ebola was out of control and that there was a risk of it spreading to other countries.

A number of countries, including Nigeria, have declared national emergencies in the weeks since. Guinea, Liberia and Sierra Leone have set up a a cross-border isolation zone around the epicentre of the outbreak.

Some airlines have suspended flights to affected countries as a result of Ebola fears.

However, the WHO says that the risk of transmission of the disease during air travel remains low…

Travel advice….

The Department of Foreign Affairs has been regularly updating its travel advice for affected countries since the start of the outbreak. The advice for Liberia, Guinea and Siera Leone was updated today.

It will come as no surprise that Irish citizens are being warned against all non essential travel to the region.

[DFA/screengrab]

Here’s the DFA’s advice for anyone returning

“If you develop fever, unexplained fatigue, diarrhoea or any other severe symptoms in the few weeks following a departure from a tropical area, you should: seek rapid medical attention mentioning your travel history, since it may result from an infection like malaria that requires immediate investigation and treatment.

“If you have been directly exposed to any bodily fluids from a dead or living infected person or animal, including unprotected sexual contact with patients that have recovered, you should: Seek rapid medical attention mentioning your travel history.

Contact the medical care facility by phone before your visit, in order to enable medical personnel to use appropriate protection at the time of admission.

What’s being done about the outbreak?

Authorities have been hampered in their fight against Ebola by the death of several top health officials and numerous frontline doctors.

But despite the rising death toll, WHO spokeswoman Fadela Chaib this week noted “encouraging signs” in Nigeria and Guinea, where prevention measures and work to trace lines of infection are starting to take effect.

The Nigerian outbreak has been traced to the first patient, who died in Lagos. All subsequent Nigerian victims had direct contact with him.

Ebola virus: AFP

In Sierra Leone, where 374 people have died, the outbreak has also been traced back to one person: a herbalist in the remote eastern border village of Sokoma.

Further use of experimental treatments has been authorised by the WHO, given the extent of the crisis — including ZMapp and the Canadian-made VSV-EBOV vaccine.

However, Doctors Without Borders says that the outbreak could take up to six months to control.

Includes reporting from AFP.

Read The HSE is investigating whether a man died from Ebola in Donegal 

Read US doctor who contracted Ebola in Liberia to be released from hospital

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