Edit: 2/6/16 Zika discussion begins on page 44
We've all been talking about this everywhere else so I figured I should get together a centralized thread for it.
What is Ebola?
Ebola hemorrhagic fever is caused by a virus that infects primates. It is spread through contact with fluids from another infected individual, such as blood, sweat, feces, and semen. The incubation period can be between 2-21 days, but is usually a little over a week from infection to the appearance of symptoms. Symptoms start rapidly and often appear flulike - high fever, headaches, fatigue, muscle pains. Vomiting and diarrhea are also common, as are rashes and also bleeding, internal and from mucus membranes; it's called a hemorrhagic
fever for a reason. Vomit and stools can often become bloody as well. This is not a pleasant disease. Fatality rates have been as high as 90% in some outbreaks. In the current outbreak, it appears to be approximately 50-60%, but accurate overall statistics are hard to come by. I'll get into this later.
EDIT: From reports as of 23 September, Case Fatality Rates
is approximately 71% in this epidemic.
Fruit bats are believed to be the reservoir for the virus, as they can be infected without showing symptoms, unlike great apes like chimpanzees and gorillas
, who also have extremely high fatality rates upon infection. It apparently jumps from bats to humans when people eat the bats. More on this later as well.
A brief history of Ebola
The very first case/first outbreak of Ebola was in 1976 in a village in what's now the Democratic Republic of the Congo. Of 318 people infected, 280 died. The virus was named after the nearby Ebola River, That same year, there was another outbreak in Sudan - 284 infected, 151 dead. Three years later, at the same site in Sudan there was another tiny outbreak, and then aside from some laboratory exposure the virus didn't bother anybody until 1994, after which outbreaks occurred every year or two
. Until now, all the outbreaks have either occurred in central Africa or were connected to an outbreak in central Africa.
The current epidemic and where it's striking
The current epidemic of Ebola is the largest outbreak and first real epidemic in history. It's striking in three countries currently:
Population 11.5 million. The outbreak began here in December 2013, with the first known cases being a 2 year old boy who died, followed soon by the deaths of his sister, mother, and grandmother. By May it had spread to the capital Conakry, the country's largest city (population of 2 million) and center of its economy.
Population 6 million. Its capital and largest city Freetown has 1.2 million people; it was founded as a colony for freed slaves by the British. A civil war was fought here between 1991 and 2002; anywhere between 50,000-300,000 were killed and 2.5 million people (almost half the population) became refugees.
Population 4 million. Liberia was founded by freed slaves from the United States; its capital and largest city Monrovia (current population 1 million or so) was named after James Monroe. It suffered not just one but two successive civil wars, from 1989 to 1997, and then 1999-2003. Somewhere between 250-500,000 died in these wars.
All three countries are rich in natural resources and desperately, terribly impoverished. Illiteracy, malnutrition, lack of clean water and medical facilities, overcrowded slums, etc etc, if it's terrible they have it. Now they also have Ebola. By March 2014 it had spread to Liberia, and by May it was in Sierra Leone. It was first reported in Freetown in July.
There was also a small outbreak in fatalities in Nigeria due to an official who flew from Liberia to Lagos (most populous city of Nigeria and Africa, at 21 million) and died soon after arrival at the airport. The doctor and nurse who treated him died, but due to rapid and effective quarantining of all the people he had come in contact with it is believed to be contained.
UPDATE 4 SEPT: Or maybe not anymore.
UPDATE: 20 OCT Actually, that did get stopped, so yay.
As of August 22nd:
The World Health Organization, in partnership with the Ministries of Health in Guinea, Sierra Leone, Liberia, and Nigeria reported 2615 suspect and confirmed cases of EVD [Ebola Virus Disease], including 1528 laboratory-confirmed cases, and 1427 deaths
As of September 23rd: 6,574 reported cases and 3,043 reported deaths.
Mind you, this is not an accurate count at all. This is the best we have but it's known to be underreported. The World Health Organization has uncovered widespread evidence of people hiding relatives who have symptoms of Ebola and secret funerals. There is a great distrust of authority (see: three civil wars) so for instance, President Ellen Johnson Sirleaf of Liberia making it a crime to hide people suspected of having Ebola just made more people hide it all the more.
Previous outbreaks typically struck small isolated villages, quickly went through the limited population, and then burned out from lack of new victims. While the same factors (poverty, funerary practices, distrust of authority including attacking health care workers) were in play, the isolation of these areas acted as a kind of effective quarantine, preventing it from spreading outwards. Ebola's rapid progression to death ironically kept it from getting any worse. Unlike, say HIV, where someone can be asymptomatic but infectious for upwards of ten years, Ebola patients are only infectious when symptoms are showing and if they don't make it, for a period of time after they die. However now for the first time, the virus has spread to major cities, cities crammed with slums, slums crammed with people who lack any facilities for basic hygiene. For these reasons, Doctors Without Borders/Médecins Sans Frontières has stated that the current outbreak is "totally out of control."
What's the deal with the funeral practices? I always hear about this.
Funeral practices in many of these areas consist of a LOT of handling of the bodies. Hand-washing and hair-braiding or whatever by the relatives to prepare the body for the funeral, and then often handling of the body including touching and kissing during the funeral. Big families mean lots of people going to the funerals, so one funeral can lead to 20 or more new infections.
Because bodies can stay infectious for days, standard practices for a patient who dies is to dispose of the corpse as rapidly as possible, cremation or bagging followed by rapid burial. Since this flies in the face of all the cultural/religious practices of people there it tends to cause a lot of anger and resentment, and has on several occasions in the past lead to crowds murdering doctors and nurses who were only trying to keep everybody else from dying.
It seems to be getting pretty crazy.
Remember that the biggest dumbass on the internet, one who's been educated on TV and barely literate comment sections and has a brain full of lies and deceptions, still has learned more about Ebola than a good portion of the people who are being affected right now. “OH GOD EBOLA BLOOD DEATH GET AWAY FROM THE BODY TOUCH AND YOU DIE AAAAAH!” is more knowledge about it than an illiterate slum dweller whose family fled from their home village years ago. What do they see? Someone gets sick, goes to the hospital, and the hospital isolates them until they die. More and more people go in, and more often than not they don't come back out, and then they're not even allowed to bury their loved ones properly. They don't know what's happening or why, there are often language barriers, there's no trustworthy news so people fall back on rumors. Evil government people killing folks, or magic, or who knows what else the rumor mill comes up with.
Even if people do have knowledge about it, though, there's often not much that can be done. During Liberia's civil wars, 95% of the health care facilities were destroyed. Hospitals, clinics, pretty much everything. Many of the known cases and fatalities of Ebola are from doctors and nurses who were treating other Ebola patients and became infected themselves. They often lack such basic medical equipment as gloves
. At some hospitals, nurses have gone on strike until they can get something, anything to protect themselves, because otherwise treating Ebola patients is a death sentence. This is leading to secondary medical issues such as people dying from other, more common and treatable diseases like malaria because no one remains to treat them or the incredibly limited medical facilities are already swamped.
I'm going to be that hipster jerk who comes in the thread and berates people all smugly about being upset about this disease when others kill way more people every year.
Screw you too buddy, and there's a reason why this disease causes more fear than others that kill more: one of the deepest and most primeval human fears is fear of the unknown, and Ebola is a disease that we don't know much about. We're pretty sure now that fruit bats are the reservoir, but we're not entirely sure and we only got this hypothesis in the last few years. We don't have a known good treatment or cure. “Keep them hydrated and they kinda seem to have a slightly better chance of survival” and “we whipped this serum thingy together and think it probably should work; at least we really hope so” don't exactly inspire confidence.
Yes, childhood diarrhea kills 800,000 children a year and this is an absolute travesty
but we know damn well how to treat it – oral rehydration therapy
is a fairly simple mixture of clean water, sugar, and salt that you feed to someone to keep them from dying of dehydration and replace electrolytes. There's a formula to it. Any of us could whip it together in a few minutes. That there are still 800,000 deaths a year is due to other crappier elements of the human condition like apathy and laziness, but these don't inspire fear (though should inspire some righteous indignation and action). A disease that strikes suddenly, hits everybody, kills over half of them within a week, and oh god some of them look like they're bleeding out their eyes, and there's jack all we can do – that scares people.
So please keep the self-righteous crap out and instead go donate to Doctors Without Borders and be smug about that instead. Or just donate anyway.
Wait...wait...are you saying we should be panicking about this?
No of course not. Unless you're living in West Africa right now or you hunt and eat fruit bats in Bangladesh (fruit bats have been found with Ebola antibodies in Bangladesh, so seriously, if you do you should stop), you'll be fine. If you don't make direct physical contact with someone showing symptoms of Ebola or body fluids from them, you won't get infected. It's not spread through the water or the air or non-bush-meat food. The virus's mutation rate is about 100 times less than that of flu, so it's not going to rapidly evolve into some even deadlier ultra-hyper-virulent teleporting disease. Quarantines are highly effective because it prevents further physical contact. Even the likes of Nigeria, which isn't exactly considered a pinnacle of first world nations, was able to contain two outbreaks before it really was able to happen.
I think this OP is long enough now. Discuss.
Edit 28 Sept: updated some information.
Edit 6 Nov: Eh, let's go ahead and talk whatever other infectious diseases too.