What will it take to stop the deadliest Ebola outbreak in history?

Health officials across three countries are scrambling to contain the outbreak

Published July 29, 2014 7:35PM (EDT)

Scanning electron microscopic image of Ebola virions                                                         (Public Library of Science)
Scanning electron microscopic image of Ebola virions (Public Library of Science)

Five months after it first emerged in Guinea, West Africa's Ebola outbreak has grown to become the largest and deadliest of its kind -- ever -- and it shows no signs of stopping. Spreading to Sierra Leone and Liberia, the disease has infected 1,201 people across the region and killed at least 672, according to the World Health Organization's most recent numbers. After a case was reported in Nigeria, some have raised fears of the potential for a global epidemic, while the infection of two American aid workers raised still more alarms: as one CDC official acknowledged, "anyone with an illness is just one plane ride away from coming to the U.S."

But here's the thing about Ebola: Even if it did reach the U.S., we'd be unlikely to see a sequence of events like the one currently unfolding in West Africa. That's because the disease, while highly transmissible and highly fatal, can be relatively easy to contain -- in the right conditions. Yet the current outbreak is characterized by "intense transmission" in communities and healthcare settings.

"We're working with a determination to bring this outbreak under control, and to end this outbreak, but it's going to take a lot of work, coordination and support from all kinds of actors on the ground," said WHO spokesperson Paul Garwood. According to WHO, there are five main components that need to come into place: social mobilization and communication -- educating people about what Ebola is and how they can protect themselves; tracing all of the patients, along with everyone they've had close contact with; infection control, which entails the proper handling of both patients and bodies; enough treatment facilities staffed with trained healthcare workers to ensure early access to treatment; and lab facilities set up to quickly identify cases.

All of those come with unique challenges: The three affected countries are among the world's poorest, and lack basic healthcare resources. The disease is new to many affected communities, meaning healthcare workers need to be taught how to protect both themselves and potential patients. That newness is also creating a climate of fear and mistrust, leading some to resist treatment. According to Leticia Linn, a communications officer with the Pan American Health Organization currently working in Liberia, many people still refuse to believe that it exists, or that it's possible for them to contract it.

And yet all are equally necessary if the outbreak is to be contained. "If you don't have one of those elements, you can't control the outbreak," said WHO's Tarik Jasarevic, speaking with Salon from Sierra Leone. Not only do they all need to be implemented in parallel, Jasarevic emphasized, they also need to be coordinated across the three affected countries.

Health officials don't know how long the outbreak will last, but the conditions for declaring it officially over are steep: According to Garwood, a period of about three to four weeks needs to pass without any new cases before we can say that the outbreak is under control. "Up until that period passes," he added, "the need to remain ever-vigilant persists."

By Lindsay Abrams

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Cdc Ebola Epidemic Guinea Liberia Public Health Sierra Leone West Africa Who