20 October 2014
Working with communities in Gueckedou for better understanding of Ebola. (Photo: T. Jasarevic, <ahref=”http://www.who.int/en/”target=”_blank”>WHO)
Since the outbreak of the disease in March 2014, South Africa and its neighbours have no confirmed cases of Ebola Virus Disease (EVD), according to the South African Department of Health.
Up until 12 October, there have been 8 997 confirmed, probable, and suspected cases of Ebola in Guinea, Liberia, Nigeria, Senegal, Sierra Leone, Spain and the United States. A total of 4493 people have died from the disease.
The last confirmed cases in Senegal and Nigeria were reported on 29 August and 8 September respectively. Both Spain and the United States continue to monitor potential contacts.
Ebola cases continue to grow
The Health Department says the Ebola outbreak continues to accelerate, with half of the nearly 5 000 cases having occurred in the last three weeks alone. There are fears that 20 000 people could become infected before the disease is curtailed.
“However, most cases are concentrated in only a few localities,’ said the department.
Health Minister Aaron Motsoaledi said in August the department would continue to give the South African public regular updates on the EVD outbreak in the West of Africa.
A travel advisory issued by Cabinet in August is still being strictly enforced. South Africa took the decision to impose a total travel ban for all non-citizens traveling from identified high risk countries to limit the spread of Ebola to the country, unless the travel is considered absolutely essential.
The first-ever United Nations emergency health mission, the UN Mission for Ebola Emergency Response (UNMEER), has been set up to stop the spread of the disease, treat infected patients, ensure essential services, preserve stability and prevent the spread to countries currently unaffected by EVD.
The Word Health Organisation (WHO) continues to be responsible for overall health strategy and advice within the Mission. It has now moved its base of operations from Conakry, Guinea, to the UNMEER Mission headquarters in Accra, Ghana.
90-day plan to contain Ebola
A comprehensive 90-day plan to control and reverse the epidemic of EVD in West Africa has been put into action. On 17 October, WHO reported that Senegal has managed to end the transmission of Ebola after the first case in the country was confirmed on 29 August in a young man who had travelled by road to Dakar from Guinea, where he had had direct contact with an Ebola patient.
Senegal’s response plan after the reported case was swift and included identifying and monitoring 74 close contacts of the patient, prompt testing of all suspected cases, stepped-up surveillance at the country’s many entry points and nationwide public awareness campaigns.
Working together with a team of epidemiologists from WHO, staff from Senegal’s Ministry of Health, Medecins sans Frontieres and the United States Centers for Disease Control and Prevention (CDC) were able to contain the spread of the disease. On 5 September, the young man tested negative, indicating that he had recovered from the disease.
Background on Ebola
The Ebola virus causes an acute, serious illness which is often fatal if untreated. According to WHO, Ebola virus disease (EVD) first appeared in 1976 in two simultaneous outbreaks, one in Nzara, Sudan, and the other in Yambuku, Democratic Republic of Congo. The latter occurred in a village near the Ebola River, from which the disease takes its name.
The current outbreak in West Africa is the largest and most complex Ebola outbreak since the Ebola virus was first discovered in 1976. There have been more cases and deaths in this outbreak than all others combined. It has also spread between countries starting in Guinea then spreading across land borders to Sierra Leone and Liberia, by air (1 traveller only) to Nigeria, and by land (1 traveller) to Senegal.
The most severely affected countries are Guinea, Sierra Leone and Liberia. On 8 August, the WHO Director-General declared this outbreak a Public Health Emergency of International Concern.
The Ebola virus family Filoviridae includes three genera: Cuevavirus, Marburgvirus, and Ebolavirus. There are five species that have been identified: Zaire, Bundibugyo, Sudan, Reston and Tai Forest. The first three, Bundibugyo ebolavirus, Zaire ebolavirus, and Sudan ebolavirus have been associated with large outbreaks in Africa. The virus causing the 2014 West African outbreak belongs to the Zaire species.
Ebola key facts
Ebola virus disease, formerly known as Ebola haemorrhagic fever, is a severe, often fatal illness in humans. The following are key facts from WHO about the disease:
- The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission
- The average EVD case fatality rate is around 50%. Case fatality rates have varied from 25% to 90% in past outbreaks
- The first EVD outbreaks occurred in remote villages in Central Africa, near tropical rainforests, but the most recent outbreak in west Africa has involved major urban as well as rural areas.
- Community engagement is key to successfully controlling outbreaks. Good outbreak control relies on applying a package of interventions, namely case management, surveillance and contact tracing, a good laboratory service, safe burials and social mobilisation
- Early supportive care with rehydration, symptomatic treatment improves survival. There is as yet no licensed treatment proven to neutralise the virus but a range of blood, immunological and drug therapies are under development
- There are currently no licensed Ebola vaccines but two potential candidates are undergoing evaluation