ebola what you should know

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Ebola – What You Should Know

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MSF Staff are fighting to save the lives of hundreds of patients and contain the outbreak of Ebola in West Africa. What is Ebola and what should you know?

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Page 1: Ebola What You Should Know

Ebola – What You Should Know

Page 2: Ebola What You Should Know

Ebola – What You Should KnowAs of 14 August 2014 the governments of Guinea, Liberia, Nigeria and Sierra Leone are in the midst of the Ebola crisis. The Ebola outbreak is an extraordinary epidemic and it requires an extraordinary response. Lives are being lost because only a small fraction of the necessary response is currently happening.

In Sierra Leone and Liberia, the epidemic is causing an additional public health crisis due to the fear of Ebola in local health workers, fear of infections within the health system and the strain on resources necessary to treat existing health crises like malaria and maternity mortality.

MSF, whilst responding and being at the forefront of the treatment of Ebola cases in the region has reached its limits in terms of resopurces.

There needs to be a much greater mobilisation of resources on the ground to fill critical gaps in all aspects of the response in Sierra Leone and Liberia.

Safe treatment centres need to be set up along with the implementation of basic hygiene measures in all public places where people have contact.

Additional crucial measures to bring the epidemic under control include:

– Effective alert system and referral service– Health promotion in the community– Infection control reinforcement in local health facilities– Epidemiological investigation to understand the chain of transmission

Page 3: Ebola What You Should Know

Other measures which require sensitive thought and careful management include closing borders, setting up a cordonne sanitaire.

MSF has recently announced the opening of a new facility in Monrovia, Liberia with some 125 beds and the potential to treat up to 700 potential Ebola patients.

Whilst MSF welcomes the steps the WHO is taking to adopt exceptional regulatory procedures in order to assess new experimental drug treatments for Ebola, MSF believes the priority right now is to save lives of the people effected today.

For further information and updates on MSF’s response to the Ebola epidemic please visit – http://msf.org.uk/ebola

Photographs and video B-roll of MSF’s Ebola treatment operations are available to download for publication and broadcast our media library.

Login or Register here: http://media.msf.org

MSF KEY FIGURES (in isolation centres) Patients Admitted Confirmed Ebola Patients Recovered

Guinea 606 250 95Liberia (Early data) 134 Sierra Leone 294 191 47……………………………………………………………………………………………………TOTAL 1,034 441 142

Page 4: Ebola What You Should Know

What is Ebola?

Ebola is one of the world’s most deadly diseases. It is a highly infectious virus that can kill up to 90 percent of the people who catch it, causing terror among infected communities

Page 5: Ebola What You Should Know

Kailahun. Sierra Leone. Médecins Sans Frontières (MSF) Ebola Treatment Centre. Two medical staff bring a weak patient who has been in contact with people infected with Ebola to the admission centre. Photo: Sylvain Cherkaoui/Cosmos/MSF

Page 6: Ebola What You Should Know

How probable is death from Ebola?

The case-fatality rate varies from 25 to 90 percent, depending on the strain. There are five different strains of the Ebola virus: Bundibugyo, Ivory Coast, Reston, Sudan and Zaire, named after their places of origin.

Four of these five strains have caused disease in humans. While the Reston virus can infect humans, no illnesses or deaths have been reported.

Page 7: Ebola What You Should Know

Kailahun. Sierra Leone. In the forest, a few meters from the MSF Treatment Centre, a World Health Organization team buries patients who died from Ebola, the patients’ families did not attend.Photo: Sylvain Cherkaoui/Cosmos/MSF

Page 8: Ebola What You Should Know

When was Ebola first seen?

Ebola first appeared in 1976 in simultaneous outbreaks in Nzara, Sudan, and in Yambuku, Democratic Republic of Congo. The latter was in a village situated near the Ebola River, from which the disease takes its name.

Page 9: Ebola What You Should Know

Kailahun. Sierra Leone. Médecins Sans Frontières (MSF) Ebola Treatment Centre. Two patients wait in a Red Cross ambulance to be admitted at the Treatment Centre.Photo: Sylvain Cherkaoui/Cosmos/MSF

Page 10: Ebola What You Should Know

How is Ebola transmitted?

In areas of Africa, infection has been documented through the handling of infected chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found dead or ill in the rainforest.

Ebola can be caught from both humans and animals. It is not an air-borne disease.

Page 11: Ebola What You Should Know

Kailahun. Sierra Leone. Médecins Sans Frontières (MSF) Ebola Treatment Centre. An MSF doctor helps a young patient, most likely infected with the Ebola virus, to get out of a vehicle driven to the Treatment Centre.Photo: Sylvain Cherkaoui/Cosmos/MSF

Page 12: Ebola What You Should Know

How is Ebola transmitted?

Human to human transmission occurs through close contact with blood, secretions, or other bodily fluids of an Ebola-infected person.

Page 13: Ebola What You Should Know

Ebola Treatment Centre, Gueckedou, Conakray Guinea. Despite their protective gear, the medical team tries to maintain personal contact with patients by talking with them at length and getting close enough to be able to look into their eyes.Photo: Sylvain Cherkaoui/Cosmos/MSF

Page 14: Ebola What You Should Know

Ebola and Caring for the Dead

Direct contact with dead bodies, such as at funerals, is one of the main ways the disease is transmitted.

Funerals are a significant practice in the communities affected by this outbreak and involve people washing and touching the body, expressing their love for the deceased.

Page 15: Ebola What You Should Know

Kailahun. Sierra Leone. Médecins Sans Frontières (MSF) Ebola Treatment Centre. In the forest, a few meters from the MSF Treatment Centre, a World Health Organization (WHO) team is burying the deceased patients whose families did not attend. As part of the funerals, the gravediggers offer a Muslim and a Christian prayer to the deceased.Photo: Sylvain Cherkaoui/Cosmos/MSF

Page 16: Ebola What You Should Know

In the last hours before death, the virus becomes extremely virulent and therefore the risk of transmission from the dead body is much higher. Ensuring safe burials is a crucial part of managing the outbreak.

Unprotected healthcare workers have frequently been infected while treating Ebola patients.

Increased Risk of Transmission

Page 17: Ebola What You Should Know

Ebola Treatment Centre, Gueckedou, Conakray Guinea. Two days after testing positive for Ebola, this patient dies. The sanitary team dresses the deceased to present her to her family so that they can confirm her identity before the body bag is sealed for burial.Photo: Sylvain Cherkaoui/Cosmos/MSF

Page 18: Ebola What You Should Know

Early on, symptoms are non-specific, making it difficult to diagnose.

The disease is often characterised by the sudden onset of fever, feeling weak, muscle pain, headaches and a sore throat.

What are the symptoms?

Page 19: Ebola What You Should Know

Kailahun. Sierra Leone. Médecins Sans Frontières (MSF) Ebola Treatment Centre. MSF staff accompany a young patient suspected of being infected by the Ebola virus.Photo: Sylvain Cherkaoui/Cosmos/MSF

Page 20: Ebola What You Should Know

Early symptoms of Ebola may be followed by vomiting, diarrhoea, rash, impaired kidney and liver function and, in some cases, haemorrhagic symptoms including nosebleeds, bloody vomit, bloody diarrhoea, internal bleeding and conjunctivitis.

However, these haemorrhagic symptoms are seen in less than 50 percent of cases.

Haemorrhagic Symptoms

Page 21: Ebola What You Should Know

Kailahun. Sierra Leone. Médecins Sans Frontières (MSF) Ebola Treatment Centre. A nurse receives a suspected Ebola patient inside the high-risk area.Photo: Sylvain Cherkaoui/Cosmos/MSF

Page 22: Ebola What You Should Know

How long after exposure do the symptoms occur?

Symptoms can appear from two to 21 days after exposure.

Page 23: Ebola What You Should Know

Ebola Treatment Centre, Gueckedou, Conakray Guinea. A hygienist approaches patients classified as suspects. They are awaiting results of a blood test that will determine whether or not they have the Ebola virus.Photo: Sylvain Cherkaoui/Cosmos/MSF

Page 24: Ebola What You Should Know

Diagnosing Ebola in an individual who has been infected for only a few days is difficult, because the early symptoms, such as red eyes, muscle pain and onset of fever are nonspecific to Ebola infection and are seen often in patients with more commonly occurring diseases.

How is Ebola diagnosed?

Page 25: Ebola What You Should Know

Ebola Treatment Centre, Gueckedou, Conakray Guinea. Following a phone call, an MSF team goes to the home of a woman who reported extreme weakness, vomiting, and dysentery. These symptoms, along with fever and nosebleeds, are typical of those caused by the Ebola virus. Photo: Sylvain Cherkaoui/Cosmos/MSF

Page 26: Ebola What You Should Know

If a person has the early symptoms of Ebola and there is reason to believe that it should be considered, the patient should be isolated and public health professionals notified. Samples from the patient can then be collected and tested to confirm infection.

Suspected Cases of Ebola

T

Page 27: Ebola What You Should Know

Ebola Treatment Centre, Gueckedou, Conakray Guinea. The logistics team erects an incinerator in the isolation ward.Photo: Sylvain Cherkaoui/Cosmos/MSF

Page 28: Ebola What You Should Know

There is no specific treatment or vaccine available that has proven efficacy in humans and is registered for use in patients.

Experimental drugs and vaccines are now being considered for use in the frame of accelerated clinical trials.

How is Ebola treated?

Page 29: Ebola What You Should Know

A Médecins Sans Frontières nurse working in the Gueckedou Ebola Treatment Centre, in Conakray, Guinea, removes her protective clothing after a shift treating patients.Photo: Sylvain Cherkaoui/Cosmos/MSF

Page 30: Ebola What You Should Know

Standard treatment for Ebola consists of hydrating the patient, maintaining their oxygen status and blood pressure, providing high quality nutrition and treating them with antibiotics for any complicating infections.

Supportive treatment can help the patient survive longer, and the extra time may just be what the patient’s own immune system needs to start fighting the virus.

Supportive therapy

Page 31: Ebola What You Should Know

Conakray, Guinea. An MSF team disinfects the home of a woman confirmed of being infected by the Ebola virus. The mattress and every item that cannot be disinfected with bleach is burned.Photo: Sylvain Cherkaoui/Cosmos/MSF

Page 32: Ebola What You Should Know

Surviving Ebola

Once a patient recovers from Ebola, they are immune to the strain of the virus they contracted.

Page 33: Ebola What You Should Know

Guekedou treatment centre, Conakray, Guinea. An Ebola patient signals her pleasure to nurses through the airlock between the isolation ward and the rest of the structure set up by MSF. The patient’s lab results have been negative twice in a row and she can now return home.Photo: Sylvain Cherkaoui/Cosmos/MSF

Page 34: Ebola What You Should Know

An Ebola outbreak is officially considered at an end once 42 days have elapsed without any new confirmed cases.

When is an Ebola outbreak officially over?

Page 35: Ebola What You Should Know

Médecins Sans Frontières ELWA 3 Ebola Management Centre, Monrovia, Liberia. A view inside one of the wards under construction at this new treatment centre which will have 125 beds for patients. The first patients arrived 17 August. At full capacity the centre will be able to care for over 700 Ebola related cases.Photo: Tim Shenk/MSF

Page 36: Ebola What You Should Know

Ebola patients need to be treated in isolation by staff wearing protective clothing. One of MSF’s main priorities in an Ebola outbreak is to train health staff to reduce the risk of transmission while caring for patients.

MSF puts in place extremely rigorous safety procedures to ensure that no health workers have unprotected exposure to the virus.

How do health workers protect themselves from infection?

Page 37: Ebola What You Should Know

Kailahun. Sierra Leone.MSF Ebola Treatment Centre. A hygienist wearing protective clothing enters the high-risk area of the centre.Photo: Sylvain Cherkaoui/Cosmos/MSF

Page 38: Ebola What You Should Know

MSF treatment centres are designed to ensure the safest possible working environment for our staff: Sufficient space in between patients; clear separation between high-risk and low-risk areas; sufficient lighting; secure waste management and regular cleaning and disinfection of the wards.

MSF Treatment Centres

Page 39: Ebola What You Should Know

Kailahun. Sierra Leone. MSF Ebola Treatment Center. Staff follow a strict regime of hygene and disinfect their boots on entering and exiting the centre.Photo: Sylvain Cherkaoui/Cosmos/MSF

Page 40: Ebola What You Should Know

Our international staff members are rotated every 4-6 weeks to ensure they are not too tired, which helps reduce risk. Our staff always work in pairs in a buddy system. They look out for each other to make sure the other is not making any mistakes or is too tired.

We try wherever possible to administer oral therapy rather than injections, which reduces the risk of needle stick injuries, and also limit the number of blood tests.

MSF Staff and Ebola

Page 41: Ebola What You Should Know

Kailahun. Sierra Leone. Médecins Sans Frontières Ebola Treatment Centre. Theresa Jones, 19, is a hygienist working at the MSF centre .Theres, a business studies student, lives in Freetown with her sister. Her school closed after the Ebola alert and when a friend told her that MSF had a treatment centre and was looking for workers she applied and took the role of hygenist.Photo: Sylvain Cherkaoui/Cosmos/MSF

Page 42: Ebola What You Should Know

Ebola Treatment, Monrovia, Liberia:http://media.msf.org/Folder/24BHRGVLNJT

Ebola Treatment Kailahun, Sierra Leone:http://media.msf.org/Package/24BHRG7JOT4

Ebola Treatment, Conakray, Guinea:http://media.msf.org/Package/24BHRGUWPK4

Ebola photo and video resources for media download:

Browse and download photography and video B-roll about MSF’s Ebola response in West Africa as well as of all our projects globally.

Login or Register here:http://media.msf.org

Page 43: Ebola What You Should Know

Gueckedou treatment centre, Conakray, Guinea. Each time a patient is discharged, staff and patients are extremely happy. While there is no specific treatment for Ebola, staff attempt to strengthen the patientís body by treating the symptoms. Photo: Sylvain Cherkaoui/Cosmos/MSF