Ebola Heads-up

"Perhaps someone eats bush meat, or comes into contact with bats. But then the virus makes it into a human body, and that human is pretty unlucky."
"After about a week, you get a huge frontal headache, a high temperature, maybe a rash. Then a few days later you get nausea, vomiting, diarrhoea -- and then bleeding, from the eyes, from the mouth, from the backside."
"It doesn't spread very easily -- it's not an airborne virus. You need to get close to fluids, such as blood or vomit."
"We know it as a filovirus -- not a typical virus, which looks [at a microscopic level] like a kind of tiny football, but this extraordinary-looking thread, like a piece of cotton."
"[Unfortunately], if you present at a hospital in west Africa with vomiting, you'll probably be diagnosed as having cholera. So nurses and doctors won't take appropriate precautions and will become infected."
"If you touch the person's face or something, and then touch your eyes or mouth without first having washed your hands, you could be infected."
Professor John Oxford, virologist, University of London

Benjamin Black, 32, a volunteer with the charity Médecins Sans Frontières in Sierra Leone

"The early symptoms are generic, so your judgement on whether the case in front of you is something dangerous depends on what's going on in the region -- if there's been an outbreak of typhus, for instance."
"A lot of hospital staff abscond when the diagnosis is made. And lots of people who were on the plane with the first man who died in Nigeria have absconded, because they don't want to be quarantined."
"When I was in east Africa, all sorts of rumours were flying around when we tried to get blood samples -- it's a Western plot to give us HIV/AIDS, that sort of thing."
Professor Paul Hunter, specialist in health protection, University of East Anglia

"The 'hospital' is a group of tents in a clearing in the jungle, away from the population to reduce the risk. It's a low-resource setting, just doing basic medicine: hydration, nutrition, fever control, promoting hygiene."
"There is a sense of -- not fear, but precaution. If you don't pay attention, you do put yourself at risk."
"What we're doing is gaining trust, dispelling rumours -- showing that we're not here to steal organs or take blood, we're providing food, providing medicine."
"They go away knowing to wash their hands, and they tell their families"
Dr. Tim Jagatic, Canadian doctor with Medecins Sans Frontieres

^{Dr Benjamin Black, who is treating Ebola patients in Sierra Leone}

Dr. Jagatic has just returned  to Europe after a stint with Medicins Sans Frontieres in Sierra Leone. Even with the limited medical tools at the disposal of health workers his experience was with, they succeeded  in bringing down the death rate from around 90% to below 60%. With the knowledge while they were working with infected patients, some near death, that they were themselves at risk, as has been the experience with some doctors who have succumbed to the virus; one who died thus far.

Not a minuscule bit of flesh can be unprotected; health workers must be properly geared. The disease is capable of killing nine of every ten people it infects, a painful and horrible death; it kills its victims who bleed to death internally. In Liberia, Sierra Leone and Nigeria more than 700 people have died. There is as yet no cure or vaccine for Ebola virus. This is the most severe of the outbreaks that have resulted from a crossover from bats harbouring Ebola to human beings who come in contact with them. 

The virus is capable of surviving for several days outside the body. Custom in much of west Africa is to touch the skin of the dead, at funerals. And the problem here is that in a hemorrhagic fever victim, the skin will remain covered with the still-infectious agent that killed them. And that agent-virus is highly communicable through touch. People must be informed that this is a custom that must cease. For their own protection and that of those around them.

Ebola first came to the notice of the medical-health community in 1975 in Zaire and Sudan. The nature of the disease, and that it survives in bat colonies sporadically moving to the human community, makes this a disease that is difficult to wrestle with; the usual response was what the people in those countries spoke of as "shut you away and bury you nicely." Vaccines and cures have been elusive, but on the other hand, since the disease is specific to sub-Saharan Africa there has been no impetus in the West to find a cure.

The affected countries' governments have begun the process of control; quarantining, improved hygiene, altered funeral practices that is hoped will be effective in stopping the chain of infection. And in those African countries the one specific piece of advice that has long circulated in the West, repeated ad infinitum by government authorities, health agencies and the medical community prevails there as well, as one of the most effective preventives: people must vigorously, repeatedly as required, wash their hands.