Out of control: Ebola in West Africa

Neither vaccination nor remedies: the end of the hitherto most severe Ebola epidemic is not in sight

Quarantine Station in Kinshasa, DR Congo (then Zaire) during the Ebola epidemic of 1976. The patient was the third known case of haemorrhagic Ebola fever and died a few days after the photo was taken. © CDC / Public domain
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Deadly virus: Ebola is one of the greatest horrors of our time. The virus is highly contagious, fatal in up to 90 percent of cases, and there is no cure for the hemorrhagic fever caused. The current epidemic in West Africa is the worst outbreak of Ebola fever yet, and there is no end in sight to the epidemic. What makes the virus and this epidemic so treacherous?

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Since the end of February 2014, the worst Ebola epidemic since the discovery of the deadly virus has been raging in the West African countries of Guinea, Liberia and Sierra Leone. After the outbreak in Guinea, Ebola fever first spread to neighboring Liberia in April and eventually to Sierra Leone in May.

Again and again deadly Ebola epidemics

More than 670 deaths have occurred since the beginning of the epidemic - almost three times as many as the first and most severe Ebola outbreak in 1976. At that time, the disease broke out on the eponymous Ebola River in the Democratic Republic of the Congo, claiming 280 lives. Since then, epidemics of fatal Ebola fever have been recurring in Africa.

The disease caused by the Ebola virus is a so-called hemorrhagic fever: The symptoms are initially similar to those of the flu: fever, muscle pain, hoarseness, chills and nausea. The nervous system is also affected, which can lead to seizures and temporary paralysis. Soon, however, follow the frightening and typical signs of the disease: Permeable blood vessels lead to internal bleeding especially on the mucous membranes. Blood from the nose and eyes as well as bloody diarrhea are the result. But the cause of death is not blood loss. Instead, vital organs are failing under the onslaught of the virus. display

Death rate up to 90 percent

The first symptoms of Ebola fever occur between two and 21 days after infection. From that point on, it often takes only a few days to die. In the current epidemic in West Africa, less than half of the more than 1, 200 sufferers have survived. Earlier epidemics had death rates of at worst up to 90 percent. Even with the lowest mortality outbreaks, at least one in four died.

The origin of the virus is so-called bushmeat: In Africa it is not uncommon to eat the meat of animals such as antelopes, but also monkeys or bats. The bats in particular are regarded as hosts and transmitters of the Ebola virus, but without being affected by the disease themselves. As one of the first measures in the fight against the current epidemic, the health authorities in Guinea therefore advised against the consumption of bushmeat. Meanwhile, trade in and consumption of bat meat is prohibited there.

The only possibility: prevent spreading

From person to person, the virus is transmitted through contact with infected body fluids. Even before the first symptoms, the virus can already be passed on this incubation period lasts up to three weeks. Tracing and controlling the contacts of an infected person during this time is one of the greatest difficulties of the helpers in West Africa. Especially infected travelers carry the virus on. The government of Liberia has now sealed off its borders and is trying to put the whole country under quarantine.

When the hemorrhagic fever first sets in, the risk of infection from the numerous haemorrhages increases sharply. In the care of patients or the burial of the dead, however, close contact can hardly be avoided. This is especially true in African society, where often many people live together in a confined space. Afraid to infect themselves with the Ebola fever, many medical employees of the hospitals in the major cities have already refused their service. The fact that this fear is not unjustified, the cases of several doctors show: A leading doctor from Sierra Leone infected despite all safety precautions with the virus. Two employees of a US aid organization are also ill.

Doctors against mistrust and superstition

Effective drugs or vaccinations against the fever, there is not yet. The only treatment option is to keep the infected as well as possible and hope for their own resilience. The reasons why some people have better chances of survival than others are not yet known. However, survivors are subsequently immune to the respective strain of the virus. For this reason, doctors are urgently searching for these causes in search of a possible remedy.

However, the survivors of the West African epidemic have another important role to play: they become, to a certain extent, "Ebola ambassadors" who, in their hometowns, are helping to clear up the contagiousness of the virus and the virus Work of the doctors help. Many local people find the employees of international aid organizations on the ground suspicious or even hostile. They do not trust the foreign doctors and insist on their own treatment methods. A sick woman was literally kidnapped from her family by her family members.

Red Cross workers disinfect a body bag during an Ebola epidemic in 1995 in Kikwit, DR Congo. CDC / public domain

In extreme cases, the helpers are even blamed for the epidemic. The organization "Doctors Without Borders" even decided in the meantime to withdraw its employees from West Africa because of such hostility. Meanwhile, however, their doctors have resumed work.

Completely out of control

In American and European hospitals such as the University Hospital Hamburg-Eppendorf there are specially equipped isolation stations for patients with such highly contagious diseases. For this reason, experts believe it unlikely that Ebola fever could spread as epidemically in our country as it is presently in West Africa, even if infected people come here by plane from the epidemic area.

In Africa, however, the situation is different: with hundreds of infected people and in much worse conditions, it is a tough fight for local aid organizations to curb the spread of the Ebola virus. With the recent outbreak of Ebola fever, for the first time the virus reaches densely populated areas like the capitals Conakry and Monrovia. Previous epidemics had limited to remote villages where the widespread spread of the virus was relatively easy to prevent. Now, on the other hand, the doctors of aid organizations are almost powerless. The "Doctors Without Borders" described the situation in June 2014 as "completely out of control".

(MSF / WHO, 29.07.2014 - AKR)