(CNN) -- Hundreds of people are dead as the worst Ebola
virus outbreak in history sweeps through West Africa. It began as a handful of cases in Guinea in March
but quickly spread to neighboring Sierra Leone and Liberia. Here are nine things to know about what the World Health
Organization calls "one of the world's most virulent diseases."
Why does Ebola generate such fear?
Medecins Sans Frontieres (MSF) describes Ebola as "one of the
world's most deadly diseases."
"It is a highly infectious virus that can kill
up to 90% of the people who catch it, causing terror among infected
communities," it says.
There is also no vaccination against it.
Of Ebola's five subtypes, the Zaire strain -- the
first to be identified -- is considered the most deadly.
The WHO said preliminary tests on the Ebola virus in Guinea in March
suggested that the outbreak there was this strain, though that has not been
confirmed.
What is Ebola, and what are its symptoms?
The Ebola virus causes viral hemorrhagic fever,
which according to the U.S. Centers for Disease Control and
Prevention (CDC), refers to a group of viruses that affect multiple organ
systems in the body and are often accompanied by bleeding.
The virus is named after the Ebola River in the
Democratic Republic of Congo (formerly Zaire), where one of the first outbreaks
occurred in 1976. The same year there was another outbreak in Sudan.
The WHO says there are five different strains of the
virus -- named after the areas they originated in. Three of these have been
associated with large outbreaks of hemorrhagic fever in Africa.
These are the Bundibugyo -- an area of Uganda where
the virus was discovered in 2007 -- Sudan and Zaire sub-types.
There has been a solitary case of Ivory Coast Ebola.
This subtype was discovered when a researcher studying wild
chimpanzees became ill in 1994 after an autopsy on one of the animals. The
researcher recovered.
Finally, Reston Ebola is named after
Reston in the U.S. state of Virginia, where this fifth strain of the Ebola
virus was identified in monkeys imported from the Philippines. The CDC says
while humans have been infected with Ebola Reston, there have been no cases of
human illness or death from this sub-type.
What are Ebola's symptoms?
Early symptoms include sudden onset of fever,
weakness, muscle pain, headaches and a sore throat. These symptoms can appear
two to 21 days after infection.
The WHO says these nonspecific early symptoms can be
mistaken for signs of diseases such as malaria, typhoid fever, meningitis or
even the plague.
MSF says some patients may also develop a rash, red
eyes, hiccups, chest pains and difficulty breathing and swallowing.
The early symptoms progress to vomiting, diarrhea,
impaired kidney and liver function and sometimes internal and external
bleeding.
Ebola can only be definitively confirmed by five
different laboratory tests.
How is it treated?
There are no specific treatments for Ebola. MSF says
patients are isolated and then supported by health care workers.
"This consists of hydrating the patient,
maintaining their oxygen status and blood pressure and treating them for any
complicating infections," it says.
There have been cases of healthcare workers contracting the virus
from patients, and the WHO has issued guidance for dealing with confirmed or suspected cases of the
virus.
Carers are advised to wear impermeable gowns and
gloves and to wear facial protection such as goggles or a medical mask to
prevent splashes to the nose, mouth and eyes.
MSF says it contained a 2012 outbreak in Uganda by
placing a control area around its treatment center. An outbreak is considered
over once 42 days -- double the incubation period of the disease -- have passed
without any new cases.
What drugs exist to combat the drug?
Two American missionary workers infected with Ebola
were given an experimental drug called ZMapp which seems to have saved their lives. The drug, developed by a
San Diego firm, had never been tried before on humans, but it showed promise in
small experiments on monkeys.
But rolling out an untested drug during a massive
outbreak would also be very difficult, according to MSF. Experimental drugs are
typically not mass-produced, and tracking the success of such a drug if used
would require extra medical staff where resources are already scarce. ZMapp's
maker says it has very few doses ready for patient use.
There are other experimental drugs out there.Tekmira, a
Vancouver-based company that has a $140
million contract with the U.S. Department of Defense to develop an Ebola
drug, began Phase 1 trials with its drug in January. But the FDA recently
halted the trial, asking for more information.
At least one potential Ebola vaccine has been tested
in healthy human volunteers, according to Thomas Geisbert, a leading researcher
at the University of Texas Medical Branch. And last week, the NIH
announced that a safety trial of another Ebola vaccine will start as early
as September.
And in March, the U.S. National Institute of Health awarded a five-year, $28 million grant to establish a
collaboration between researchers from 15 institutions who were working to
fight Ebola.
"A whole menu of antibodies have been
identified as potentially therapeutic, and researchers are eager to figure out
which combinations are most effective and why," a news release about the
grant said.
How does Ebola virus spread?
The WHO says it is believed that fruit bats may be
the natural host of the Ebola virus in Africa, passing on the virus to other
animals.
Humans contract Ebola through contact with the
bodily fluids of infected animals or the bodily fluids of infected humans.
MSF says that while the virus is believed to be able
to survive for some days in liquid outside an infected organism, chlorine
disinfection, heat, direct sunlight, soaps and detergents can kill it.
MSF epidemiologist Kamiliny Kalahne said outbreaks
usually spread in areas where hospitals have poor infection control and limited
access to resources such as running water.
"People who become sick with it almost always
know how they got sick: because they looked after someone in their family who
was very sick -- who had diarrhea, vomiting and bleeding -- or because they
were health staff who had a lot of contact with a sick patient," she said.
Can plane passengers become infected?
While the CDC acknowledges it's possible a person
infected with Ebola in West Africa could get on a plane and arrive in another
country, the chances of the virus spreading during the journey are low.
"It's very unlikely that they would be able to
spread the disease to fellow passengers," said
Stephen Monroe, deputy director of CDC's National Center for Emerging Zoonotic
and Infectious Diseases.
"The Ebola virus spreads through direct contact
with the blood, secretions, or other body fluids of ill people, and indirect
contact -- for example with needles and other things that may be contaminated
with these fluids."
He added that most people who have become infected
with Ebola lived with or cared for an ill patient.
"This is not an airborne transmission,"
said Dr. Marty Cetron, director of CDC's Division of Global Migration and
Quarantine. "There needs to be direct contact frequently with body fluids
or blood."
Travelers should take precautions by avoiding areas
experiencing outbreaks and avoid contact with Ebola patients.
"It is highly unlikely that someone suffering
such symptoms would feel well enough to travel," IATA
said in a statement.
"In the rare event that a person infected with
the Ebola virus was unknowingly transported by air, WHO advises that the risks
to other passengers are low. Nonetheless, WHO does advise
public health authorities to carry out contact tracing in such
instances."
This means determining who had contact with the
affected person.
What should flight crew do if Ebola
infection is suspected?
The CDC has issued guidance for airline crews on Ebola virus infections.
"As with many other global infectious disease
outbreaks, airline carriers, crew members, airports can be very important
partners in that front line," said Cetron. "Being educated, knowing
the symptoms, recognizing what to do, having a response protocol, knowing who
to call, those are really, really important parts of the global containment
strategy to deal with threats like this."
The CDC advises that when flight crew members
encounter a passenger with symptoms that they suspect could be Ebola, such as
fever and bleeding, that they keep the sick person away from other passengers.
They've been instructed to wear disposable gloves and to provide the sickened
person with a surgical mask to prevent fluids from spreading through talking,
sneezing or coughing.
The airline cleaning crew are also instructed to
wear disposable gloves, wipe down surfaces including armrests, seat backs,
trays and light switches. The CDC says that packages and cargo should not pose
a risk, unless the items have been soiled with blood or bodily fluids.
When someone becomes ill on a flight, the captain is
required by aviation regulations to report the suspected case to air traffic control,
according to IATA.
How many cases have there been ?
The CDC estimates there have been more than 3,000 cases of
Ebola and more than 2,000 deaths since 1976.
The last recorded outbreaks before the current one
in Guinea were in 2012 -- in Uganda and Democratic Republic of Congo.
The Uganda outbreak involved a total of 24 probable
and confirmed cases, and 17 deaths, according to
the WHO, which declared it had ended in October 2012.
MSF said the Uganda outbreak had been the Sudan strain,
while the virus found in DRC was the Bundibugyo sub-type.
Before 2014, the most deadly outbreak was the 1976
outbreak in then Zaire, when 280 of 318 infected people died, according to the
CDC. In 2000, there were 425 cases of Ebola Sudan in Uganda, which resulted in
224 fatalities.
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