Why Ebola is so dangerous

According to the World Health Organisation, evidence suggests the death toll from the Ebola outbreak in West Africa is vastly underestimated. The UN agency said it was prepared for the crisis to continue for months. The numbers of reported Ebola virus cases and deaths “vastly underestimate the magnitude of the outbreak,” the UN agency said last week. The death toll from the worst ever outbreak of Ebola has risen to 1,145, WHO said as 76 new deaths were reported in the two days of August 12 and 13 in the four West African nations affected by the epidemic. The UN health agency said a total of 152 confirmed, probable and suspected new cases of the deadly hemorrhagic fever were reported in the two day period in Guinea, Liberia, Nigeria and Sierra Leone, bringing the total cases for the outbreak to 2,127.

Monday, August 18, 2014
Ebola is a viral illness whose initial symptoms can include a sudden fever, intense weakness, muscle pain and a sore throat, according to the World Health Organisation. Net photo.

According to the World Health Organisation, evidence suggests the death toll from the Ebola outbreak in West Africa is vastly underestimated. The UN agency said it was prepared for the crisis to continue for months.

The numbers of reported Ebola virus cases and deaths "vastly underestimate the magnitude of the outbreak,” the UN agency said last week.

The death toll from the worst ever outbreak of Ebola has risen to 1,145, WHO said as 76 new deaths were reported in the two days of August 12 and 13 in the four West African nations affected by the epidemic.

The UN health agency said a total of 152 confirmed, probable and suspected new cases of the deadly hemorrhagic fever were reported in the two day period in Guinea, Liberia, Nigeria and Sierra Leone, bringing the total cases for the outbreak to 2,127.

The vast majority were in Guinea, Sierra Leone and Liberia while there have also been several deaths in Nigeria.

Several airlines have suspended flights to infected countries, however WHO has emphasised that "air travel, even from Ebola-affected countries, is low risk for Ebola transmission” because the virus is not airborne.

Meanwhile, health officials in Liberia have received doses of an experimental Ebola treatment drug approved by the US Federal Drug Authority called ZMapp. The drug has already been administered to two infected American aid workers. 

A Spanish priest who had also begun taking the experimental drug became the first European to succumb to the virus this year.

The highly contagious virus is a form of hemorrhagic fever that can cause severe fever, unstoppable bleeding and organ failure. There is no Ebola vaccine.

The feeling of having Ebola

Elizabeth Brou, an Ivorian councillor who was in Seirra Leon during the outbreak, says the disease is one of the worst diseases that have attacked Africa but shouldn’t be seen as a reason to see West Africa as an outcast. 

"I left Seirra Leon and went to Burkina Faso then later back home but even then, I hadn’t gotten in contact with someone diagnosed with the disease. Later, I started having some headaches and a rash. It was then that I thought time for me to leave the earth had come,” she narrated. 

She read everything she could get online about Ebola and tried to compare her symptoms with those online. She spent three nights without sleeping just because she was waiting for morning to look in the mirror and see if she had red eyes. 

"Everything I could feel that wasn’t right in my body felt like it was an Ebola sign or symptom. The part that made me weaker was the fact that it could take 21 days before all signs show. I felt like I was still in those 21 days. I literally fell sick because of the scenario my head created,” she said in a relieving tone. 

Brou then went to the hospital and got tested and found negative. She was so relieved. 

"It was a hard time for me in my mind. I have no children but I take care of my two sisters. I didn’t know how the news would be broken to them if I couldn’t heal against Ebola.” She said with her voice slowing toning down and continued, "It’s a tough time for anyone, but the worst part of it is that we already get weak in our minds before anything else kills us.” 

Ebola can cause a high fever, bleeding and vomiting and has killed about half of those infected in this outbreak.

"There is no cure and no licensed treatment for Ebola virus disease but rumours are circulating, especially in affected areas, that certain products or practices can help prevent or cure it,” WHO said in a statement.

An Ebola survivor

On Thursday, August 7, Jo Dunlop, a Unicef consultant based in Sierra Leone, shared her experience of encountering Ebola survivors at the Ebola Treatment Centre in Kenema, Sierra Leone. In her heartfelt blog, Dunlop describes the joy of seeing survivors leave the centre with their clearance certificates.

Vandy Jawad, 7, is a reminder of hope and survival in an otherwise deeply tragic situation. He was in the treatment centre at Kenema for more than one month after contracting the virus in Daru village about 40 kilometres out of Kenema town, and one of the worst affected communities in Sierra Leone.

According to nurses, he displayed some very serious symptoms when first admitted, "That small boy was very, very sick. We did not think he would survive as so many haven’t,” said Sister Nancy Yoko, the nurse in charge of the Ebola Treatment Centre in Kenema.

Vandy started showing signs of recovery a couple of weeks ago slowly gathering his strength. When he finally achieved a negative test result, which revealed there was no more Ebola virus in his system, it was time for him to go home.

"Little Vandy provided laughter at the most unlikely moments inside that ward, I’m so happy for his recovery, " commented a British volunteer nurse who treated him inside the centre.

Before patients leave the ward, they are presented with transport money to get home (about US$10), a clean set of clothes, and a certificate declaring that they are healthy and no longer have Ebola. They are photographed and congratulated by staff, and in humble way, celebrated for their resilience.

Vandy was also given a small plastic truck and showed it off to all the nurses before he left the restricted compound area with an enormous grin on his face. "It’s nice for the children to have a toy before they go, it makes them happy, look at Vandy,” said Sister Nancy.

Without a cure, how do some people survive?

Doctors don’t know for certain who will survive Ebola, and there is no specific treatment or cute for the disease. But studies suggest there are some biological markers linked with a higher chance of surviving Ebola.

When a person becomes infected with Ebola, the virus depletes the body’s immune cells, which defend against infection, said Derek Gatherer, a bioinformatics researcher at Lancaster University in the UK, who studies viral genetics and evolution. In particular, the Ebola virus depletes immune cells called CD4 and CD8 T lymphocytes, which are crucial to the function of the immune system, Gatherer said.

But if a person’s immune system can stand up to this initial attack — meaning their immune cells are not as depleted in the first stages of infection — then studies suggest they are more likely to survive the disease.

"The patients that survive it best are the ones who don’t get such a bad immune deficiency,” Gatherer told Live Science.

But if the body is not able to fend off this attack, then the immune system becomes less able to regulate itself, Gatherer said. This means the immune system is more likely to run out of control and release a "storm” of inflammatory molecules, which cause tiny blood vessels to burst, leading in turn to a drop in blood pressure, multi-organ failure and eventually death.

Is Rwanda at risk of Ebola? 
The Minister for Health, Dr Agnes Binagwaho, says Rwanda has taken measures against Ebola that are far beyond what the international regulations require and citizens should remain calm.
The minister said they have put together a national committee in the Ministry of Health to fight Ebola coming into Rwanda and isolation units have been set up in all hospitals. Rwanda remains open to foreign visitors but surveillance and emergency management systems have been established.
Health workers have been trained across the country and are vigilant. This will enable timely detection, notification and appropriate management of any suspected cases.