2014 has seen the worst outbreak of Ebola Virus Disease (EVD) in history, with WHO reporting more than 1,700 cases worldwide (as of August this year). In this infographic we take an in-depth look at the virus (formally known as Ebola Haemorrhagic Fever) and its history, origin, genus, transmission, symptoms, fatality rate, and treatment.
All information is correct as of mid-August 2014. Data sources include the World Health Organisation (WHO), the Center for Disease Control (CDC), Medecins Sans Frontieres (MSF), the BBC, The Guardian, and other high profile news outlets.
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The disease first appeared in 1976 in Africa, with two simultaneous outbreaks.
- Nzar – South Sudan
Sudan saw the first outbreak of Ebola (Ebola-Sudan) infecting more than 284 people.
Mortality Rate: 53%
- Yambuku – People’s Democratic Republic of Congo
A few months later, the second Ebola virus (EBOZ) emerged from Yambuku infecting 318 people.
Mortality Rate: 88%
* The later outbreak was in a village situated near the Ebola river, from which the disease takes its name.
History of Ebola Outbreaks
* 2014 data correct as of 8th August 2014. The figures for 2014 will no doubt continue to rise.
* On 8th August 2014, WHO declared an international emergency in relation to the Ebola outbreak, with officials saying a co-ordinated response was essential to stop and reverse the spread of the virus.
The number of cases and deaths has been listed for the biggest outbreaks.
- 1976: 602 cases 432 deaths
- 1995: 315 cases 254 deaths
- 2000: 425 cases 224 deaths
- 2007: 413 cases 224 deaths
- 2014: 1,779 cases 960+ deaths
The 2014 Ebola Crisis
Four countries in West Africa have confirmed cases of the Ebola virus.
Guinea, Sierra Leone, Liberia, and Nigeria are the four main countries involved in the 2014 outbreak.
- GuineaSuspected and confirmed case count: 495 (08/08/2014)
Suspected and confirmed case deaths: 367Mortality Rate: 74%
- Sierra LeoneSuspected and confirmed case count: 717 (08/08/2014)
Suspected and confirmed case deaths: 298Mortality Rate: 74%
- LiberiaSuspected and confirmed case count: 554 (08/08/2014)
Suspected and confirmed case deaths: 294Mortality Rate: 53%
- NigeriaSuspected and confirmed case count: 13
Suspected and confirmed case deaths: 2Mortality Rate: 15%
The majority of cases are from Guinea, Sierra Leone, and Liberia, but concerns are growing about the spread of the virus in Nigeria.
There has been a sharp rise in cases in the first half of August. Here is the increase over time of cases and deaths during the 2014 outbreak.
The outbreak began in March, with the first case reported in Guinea. Since then the number of cases and deaths have risen at an alarming rate.
Ebola is introduced into the human population through close contact with the blood, secretions, organs, or other bodily fluid of infected animals.
In Africa, infection has been documented through the handling of the following infected animals found ill or dead in the rainforest:
- Fruit Bats
- Forest Antelope
Ebola then spreads in the community through human-to-human transmission, with infection resulting from direct contact (through broken skin or mucous membrane) with the blood, secretions, organs, or other bodily fluid of infected people, and indirect contact with environments contaminated with such fluids.
The following are the most common methods of EVD transmission between people:
- Contact with infected saliva/sweat
- Contact with infected stool or urine
- Contact with infected blood
- Contact with an infected dead body
- Contact with infected medical items
- Unprotected sex with an infected person
Symptoms of Infection
EVD is a secure acute viral illness often characterised by the sudden onset of fever, intense weakness, joint and muscle pain, sore throat, and headache. This is then followed by more severe complications.
- Red eyes
- Sore throat
- Difficulty swallowing
- Difficulty breathing
- Chest pain
- Joint and muscle pain
- Skin rash
- Stomach pain
- Lack of appetite
- Internal and external bleeding
- Feeling of weakness
Symptoms present in most patients
Early stages of infections
Symptom may appear in some patients
Later stages of infections
Diagnosis and Treatment
EVD diagnosis requires ruling out other diseases, these may include: malaria, typhoid fever, shigellosis, cholera, leptospirosis, plague, rickettsiosis, relapsing fever, meningitis, hepatitus, and other viral heamororrhagic fevers.
Once these have been ruled out, Ebola virus infections can be diagnosed definitively in a laboratory through several types of tests.
- Antibody-capture enzyme – linked immunosorbent assay (ELISA)
- Antigen detection tests
- Serum neutralisation test
- Reverse transcriptase polymerase chain reaction (RT-PCR) assay
- Electron microscopy
- Virus isolation by cell culture
To confirm the diagnosis blood test samples are tested for viral antibodies, viral RNA, or the virus itself.
There is no licensed vaccine or specific treatment available for Ebola. Several vaccines are currently being tested, but none are available for clinical use. New drug therapies are also being evaluated.
The lack of vaccines or specific treatments is part of what makes the mortality rate so high, with the death rate from Ebola ranging from 20% to 90% depending on the strain.
The course of treatment for infected patients is, generally speaking, as follows:
Hospitalisation of patient, likely in intensive care. Supportive measures for shock will be used to treat patient.
There will be an attempt to correct bleeding abnormalities, which may include platelet transfusion.
Isolation of infected patients, destruction of infected tissues and extreme care in handling contaminated materials/equipment.
Potential of Spreading Internationally
There are major concerns that the EVD outbreak could spread – particularly to Europe and the United States. But how likely is this? What are the chances of a major global pandemic?
The main concern centres around air travel, which is thought to the primary potential route for the virus to spread across international and continental borders. Here are the final destinations of airline travellers departing from Guinea, Liberia, and Sierra Leone in the month of August (by WHO region)
- Americas 4.5%
- Europe 29.6%
- W. Pacific 3.1%
- S.E. Asia 1.1%
- E. Med 6.5%
- Africa 55.2%
The figures show that travel from Sierra Leone, Guinea, and Liberia within the continent of Africa is much more prevalent than travel elsewhere.
This coupled with the fact that outbreaks persist in countries with poor sanitation and a shortage of resources to contain them (rather than resource-rich places like the US and the UK) leaves public health officials relatively unconcerned about Ebola becoming a big problem in the developed world.
Far more concerning is the potential of the disease spreading within Africa, which is what public health officials are really worried about.