Why Is This Ebola Outbreak Different From All The Other Ones?


Gwynn Guilford looks into it:

[A]s viral public health menaces go, Ebola should be easy to contain. Unlike airborne viruses like, say, swine flu, it’s not exactly sneaky. Ebola is spread only when infected bodily fluids come into contact with someone’s mucus membranes or open cuts. And it tends to broadcast the risk of infection pretty clearly; the symptoms include vomiting, diarrhea and, in some cases, hemorrhaging of mucus membranes. That made Ebola relatively easy to contain when it flared up in remote forests of central and eastern Africa, which are sparsely populated. But this new pandemic is a totally different story …

Why is that?

For one, Sierra Leone, Guinea and Liberia all have dreadful medical infrastructure. Sierra Leone has a single laboratory capable of Ebola testing. Earlier this week, Monrovia, Liberia’s capital, ran out of hospital space to quarantine Ebola patients. And that’s in its biggest city, where infrastructure is most robust. In other parts of Liberia, as well and in Guinea and Sierra Leone, hospitals simply aren’t available, according to data from Afrobarometer, a survey group.

Furthermore, Julia Belluz adds, a shortage of medical workers means many patients are not identified:

Ebola specialists believe one of the key reasons this outbreak has spread so far is because of the shortage of health-care personnel to deal with it: if you don’t have enough people on the ground doing the labor-intensive job of tracing the contacts of positive patients and ensuring they are identified before becoming ill too, each missed case is the new beginning of more human-to-human spread. Those missed cases are what worries Tarik Jasarevic, a World Health Organization worker on the ground in Guinea. He says that because of the geographic dispersal of the current outbreak—the demand for so many specialists in a relatively rare disease over several countries—mobilizing people and getting systems in place to care for everyone is problematic.

The doctors caring for ebola patients are also getting sick and dying:

Since the disease is transmitted through direct exposure to bodily fluids—from vomit to blood and sweat—health-care workers are advised to wear face masks, goggles, gowns and gloves while caring for patients. The trouble is, health workers in the developing-country context—especially those working in some of the poorest countries on earth, where the disease emerged this time—don’t always have access to this protective gear.

It’s important to note that they are also the ones who have died in this outbreak. Of the 60 deaths so far, none involved foreign workers (though two Americans are currently battling the virus, and one is a doctor). Foreign aid agencies such as Doctors Without Borders—which apply stringent precautions for all their health personnel—have never lost members of their teams to Ebola. So the problem this time is as much about size of the outbreak as it is about resources.