70-70-60 Plan: Tackling the Ebola Crisis

Louise Clancy considers the world’s fight against the deadly Ebola virus

One of the biggest epidemics of the decade has recently been causing widespread concern with health professionals, government organisations and the general public alike. The Ebola virus has become a major problem in Western Africa, particularly in Guinea, Sierra Leone and Liberia. Researchers have discovered that the index case of the virus was from a 2 year old boy in Guinea who died in December 2013, after his family hunted bats for bush meat, which was the source of the virus. By March 25th 2014, the World Health Organisation (WHO) released its first report concerning the Ebola outbreak in West Africa. On August 8th, the World Health Organisation declared the Ebola epidemic as an international public health emergency.

In early October, 44 year old Spanish nurse Teresa Romero contracted Ebola after treating a priest who was repatriated from West Africa. This was the first transmission of the virus outside Africa. On September 30th, 42 year old Liberian national Thomas Eric Duncan was diagnosed with Ebola in Dallas, Texas after travelling to the United States to visit his family. He died on October 8th. On October 12th, a nurse in Texas, who treated Duncan was found positive for the Ebola virus. This was the first transmission of Ebola in the United States. On October 15th, another Texas healthcare worker was confirmed to have the virus. By October 15th there had been seventeen cases of the Ebola virus outside Africa, resulting in four deaths.
As of October 22nd, the Ebola virus has been contracted in seven countries; five in Africa, one in Europe and one in North America. There has been over 9,991 reported cases of Ebola globally. Out of these cases there has been over 4,868 deaths as a result.

“It is predicted by WHO that by December 2014 there will be between 5,000 to 10,000 new cases of Ebola per week”

Ebola is a virus found in humans, primates and bats. Ebola can be divided into five subtypes that are named after the location they were identified. These include: Zaire, Sudan, Reston, Bundibugyo, and Tai Forest (formerly Ivory Coast). The Zaire strain has the highest mortality rate and is the current strain in the 2014 epidemic. The symptoms of Ebola are fever, severe headache, muscle pain, weakness, diarrhoea, vomiting, stomach pain, and unexplained bleeding and bruising. Symptoms can appear in the infected between two days to three weeks after exposure to the virus. Diagnosis of an Ebola patient in the early stages can be difficult because the early symptoms are not exclusive to Ebola and are seen in more common diseases such as malaria and typhoid.

"There is no vaccination for the Ebola virus. However there are efforts being made in developing a safe and effective Ebola vaccine."
“There is no vaccination for the Ebola virus. However there are efforts being made in developing a safe and effective Ebola vaccine.”

Ebola is not air-borne or water-borne, so it cannot be spread as easily as influenza. However, it can be transferred through blood and other body fluids, syringes containing the virus and coming into contact with infected fruit bats and primates. Healthcare workers are at the highest risk of being infected as they are most likely to come into contact with the blood and body fluids of the patients.

There is no vaccination for the Ebola virus. However there are efforts being made in developing a safe and effective Ebola vaccine. There are simple measures in preventing the Ebola virus from spreading. These measures include practising careful hygiene and not handling items that may have come into contact with an infected person’s blood and body fluids.

There is also no definitive cure for the Ebola virus. Treatment only consists of minimizing dehydration, and balancing fluids and while treating secondary infections. It is true that early treatment increases chances of survival rates, however, the disease carries a mortality rate of 90%. With proper diagnosis and treatment, along with medical advances in the past few decades, WHO estimates the rate of survival is between 60%-65%. In the current Ebola outbreak, the survival rates differ in geographical location. In the United States the survival rate is over 80%, while the survival rate in West Africa is approximately 30%. This contrast is due to a lack of proper infrastructure and affordable healthcare in West Africa.

The first outbreak of Ebola was in 1976 in the Democratic Republic of Congo (then known as Zaire). The epicentre of the epidemic came from the village Yambuku, 96 kilometres south of the Ebola River. The index case of the first Ebola epidemic was the local school headmaster Mabalo Lokela on August 26th 1976. Shortly before, Lokela toured with the Yambuku mission along the Ebola River, which is where he most likely contracted the disease. On September 8th 1976, Mabalo Lokela was the first confirmed person to die of the Ebola virus in history. Within a week of Lokela falling ill, similar cases were presented at the hospital. As was the local custom, several of Lokela’s female relatives helped prepare Lokela’s body for burial. Within days most of them were seriously ill and many died. The reuse of unsterilized needles in the local hospital also spread the infection. From the first outbreak there were 318 identified cases and 280 people died out of those cases.

The current 2014 Ebola epidemic is the most severe outbreak regarding the number of cases, the number of deaths and the number of countries affected. The future is uncertain of how many more people will be infected, how fast it will spread and when this current outbreak will end. It is predicted by WHO that by December 2014 there will be between 5,000 to 10,000 new cases of Ebola per week. The UN Mission for Ebola Emergency Response launched a strategy to contain the disease known as the “70-70-60 Plan.” This plan ensures that 70 percent of burials are done safely and 70 percent of suspected cases isolated, within 60 days. There are also screenings for Ebola symptoms in 5 American airports and in Gatwick and Heathrow airports in the UK, from affected countries. Although the current strain of Ebola is the most serious recorded outbreak since 1976, the likeliness of the Ebola virus spreading into a wide population, particularly in developed countries is considered small. Once there are preventative measures put into effect and containment of the disease becomes manageable, the Ebola outbreak will most likely wind down.