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Largest Ebola Outbreak in History Continues to Spread

by Albert Fuchs, M.D.

July 25, 2014 | 5:45 pm

Doctors without Borders staff carry body of a patient killed by Ebola in Guinea.
AFP/Getty Images

Given the myriad horrors happening around the world this week you could be excused if West Africa has fallen off of your radar, but from a health perspective, it deserves some attention.

I wrote in April about an Ebola outbreak in southeastern Guinea that had spread to Liberia and Sierra Leone. (Browse that first post for a history of Ebola, its symptoms, and how it’s transmitted.) By April the outbreak had already become the most geographically widespread Ebola outbreak in history, and the first in West Africa. By that time it had reached the capital of Guinea and had infected over 130 people and killed 88.

As of now, the outbreak remains to be contained, and by any measure is now the worst outbreak ever. Over 1,000 have been infected, causing over 600 deaths. The outbreak has also reached the capital of Sierra Leone. Most worrisome is that new cases are still developing, with 67 new cases reported from July 15 to 17.

Emblematic of the struggles that local health officials have faced in containing this infection is the news that the lead physician treating Ebola patients in Sierra Leone has himself become infected. At least eight nurses in the same hospital have also contracted Ebola. This large number of infected healthcare workers hints at poor adherence to infection prevention guidelines or perhaps a simple lack of isolation supplies such as gloves and masks.

Officials are also battling public mistrust and false rumors about the cause and transmission of Ebola. Many locals also adhere to traditional funeral rites that involve contact with the deceased, increasing the likelihood of infection. A patient in the capital of Sierra Leone was forcibly removed from the hospital by her family and remains unaccounted for. Most recently, a possible Ebola case surfaced in Nigeria. If confirmed this would add a fourth country to this outbreak’s toll.

The World Health Organization’s recent update on the outbreak was quite frank about the shortcomings of the current efforts. It criticized

"low coverage of contact tracing; persisting denial and resistance in the community; weak data management; inadequate infection prevention and control practices, especially in peripheral health facilities; and weak leadership and coordination at sub-national levels."

My last post worried about an Ebola patient getting off a plane in a large European or American city. I no longer have that concern. I think a country with an advanced healthcare system and an informed and cooperative public would quickly extinguish an Ebola outbreak. But the ensuing panic in which every fever is a potential Ebola case would cause much disruption.

I know you share my hope that the health workers toiling in West Africa gain the upper hand and contain this outbreak soon. Then we could go back to only worrying about all the other horrors in the world.

Learn more:

Worst Ebola outbreak ever gets worse: top Ebola doctor now infected (Vox)
A Doctor Leading The Fight Against Ebola Has Caught The Virus (NPR)
Ebola virus disease, West Africa – update (World Health Organization Global Alert and Response)
First Ebola victim in Sierra Leone capital on the run (Chicago Tribune)
Ebola Outbreak in West Africa Worries Health Officials (My post in April about the current outbreak)

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Important legal mumbo jumbo:
Anything you read on the web should be used to supplement, not replace, your doctor’s advice.  Anything that I write is no exception.  I’m a doctor, but I’m not your doctor.

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ABOUT THE AUTHOR

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Practicing internal medicine in Beverly Hills since 2000, Dr. Fuchs brags that his practice is “tiny and meant to stay that way.” He has blogged for the past three years...

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