Ebola virus: UK 'not ready' to deal with outbreak

A member of Doctors Without Borders

After Foreign Secretary chairs Cobra meeting, UK Border staff say they are unprepared for Ebola

LAST UPDATED AT 10:04 ON Thu 31 Jul 2014

The Ebola outbreak in West Africa, described yesterday by the Foreign Secretary as a threat to the UK, could catch UK Border staff unprepared, a union official has said.

Lucy Moreton, general secretary of the Immigration Service Union, said border, immigration and customs staff are "very concerned" about the risk of Ebola reaching the UK.

She said her members told her they felt unprepared to deal with people entering the UK with suspected cases of the deadly virus, and that staff who are serving on the "front line" need further training and guidance to deal with the threat.

"There is no health facility at the border, there is no containment facility, and until extremely recently there has been no guidance issued to staff at all as to what they should do," She told the BBC Radio 4's The World Tonight. "They are phoning us up and asking 'what are we supposed to do, how do we spot this, how do we protect ourselves?', and we can't answer that for them just now."

Yesterday Philip Hammond, the Foreign Secretary chaired an emergency meeting of the Cobra committee to discuss ways of managing the risk. He had earlier said that Ebola posed a threat to the UK.

The deadliest Ebola outbreak on record has so far killed more than 670 people in Sierra Leone, Guinea, Liberia and Nigeria and there are fears of a global epidemic.

However, Hammond said that he was "fairly confident" that no Britons had been infected so far and added that the disease had not been detected in the UK. He said the government was "absolutely focused" on dealing with the risk and was planning to look at "whether there are precautions we need to take either in the UK or to protect our nationals".

An alert has been issued by Public Health England for doctors across the UK to be aware of symptoms of the disease. One man in Birmingham was tested for the disease but results came back negative, the BBC reports.

Several airlines have followed the lead of Nigerian carrier Arik Air, which has suspended flights to the affected areas of West Africa in order to contain the disease.

The government's chief scientific adviser Sir Mark Walport told the Daily Telegraph that by living in such an interconnected world "disruptions in countries far away will have major impacts" across the globe.

"We were lucky with Sars. But we have to do the best horizon scanning", he said. "We have to think about risk and managing risk appropriately."

Ebola virus factfile 

What is the Ebola virus and what are the symptoms? 

The World Health Organization describes Ebola as "a severe acute viral illness". Early symptoms are similar to malaria and include the sudden onset of fever, intense weakness, muscle pain, diarrhoea, vomiting and both internal and external bleeding.

Is there a cure? 

There is no known cure or vaccine for the virus and the disease kills between 25 and 90 per cent of its victims. The only treatment doctors can offer is "supportive intensive care" such as rehydration of infected patients under strict quarantine.

Where did it come from? 

Scientists believe it was initially present in wild animals such as fruit bats living in tropical rainforests in equatorial Africa. The disease spread to humans when they came into contact with the organs, blood or other bodily fluids from infected animals through hunting.

How is it spread? 

Ebola is highly infectious. It can be transmitted through contact with the blood, bodily fluids and organs, including skin, of sufferers or through indirect contact with environments contaminated by the disease. The disease can also have a long incubation period, up to three weeks, which allows it to spread rapidly before diagnosis and quarantine can take place.


Ebola: flights suspended as virus spreads to Nigeria

29 July

Extraordinary measures are being taken across West Africa to contain the deadliest ever outbreak of Ebola, which has killed at least 672 people in the past seven months.

Flights across the region have been cancelled, a Nigerian hospital has been shut down and armed police are patrolling hospitals in Sierra Leone, The Guardian reports. The new measures follow Liberia's decision to shut most of its borders yesterday in an attempt to contain the highly infectious disease.

Last week, a Liberian man died of the disease after flying into Lagos despite feeling unwell. Before then, there had been no reported cases of the disease in Nigeria. Liberian president Ellen Johnson Sirleaf criticised the man for not following medical advice, saying the victim put others at serious risk due to "disrespect for the advice which had been given by health workers".

Anyone who was seated near the infected man could be in "serious danger", Derek Gatherer, a virologist at the University of Lancaster told The Guardian. The hospital where he died has been closed and quarantined, and the World Health Organisation is working to trace all the passengers on board the flight. 

One of the largest airlines in the region, Arik Air has suspended flights between Nigeria, Liberia and Sierra Leone, Reuters reports.

As public fear continues to grow, armed police have been called in to guard a hospital in Sierra Leone, which houses several confirmed cases of the disease. Local residents had threatened to burn the centre down because of popular misconceptions surrounding the disease, according to Reuters.

Ebola outbreak forces Liberia to close most of its borders

28 July

The Liberian government has closed its borders in a bid to stop the deadly Ebola virus from spreading further across the continent.

More than 670 people have died from Ebola across West Africa, including one of Liberia's most high-profile doctors, Dr Samuel Brisbane.

An American physician, Dr Kent Brantly, is currently being treated for the deadly virus, as well as a US missionary, Nancy Writebol, who was working in the capital city, Monrovia.

Brantly, who had been wearing protective coveralls from head to toe while treating patients, was lucky to notice the signs early but he is "not out of the woods yet", said aid workers.

Yesterday, Liberia's president, Ellen Johnson Sirleaf, said: "All borders of Liberia will be closed with the exception of major entry points. At these entry points, preventive and testing centres will be established, and stringent preventive measures to be announced will be scrupulously adhered to."

Public gatherings such as marches and demonstrations have also been restricted.

The virus, which is highly contagious, is transmitted by direct contact with the blood, body fluids and tissues of infected animals or people. It also has no known cure, making it one of the deadliest in the world. It begins with symptoms such as a fever and sore throat and escalates to vomiting, diarrhoea and internal and external bleeding.

At least 1,201 people have been infected in Liberia, Sierra Leone and Guinea, according to the World Health Organisation. Ebola can kill up to 90 per cent of those who catch it, although the fatality rate of the current outbreak is around 60 per cent.

On Friday, Nigerian officials said that a Liberian man had died of Ebola in Lagos. "An outbreak in Lagos, a megacity where many live in cramped conditions, could be a major public health disaster," says the Washington Post.

Experts believe the outbreak in Africa might have begun in January in south-east Guinea, though the first cases were not confirmed until March.

Ebola: chief doctor fighting outbreak infected with virus

24 July

The head doctor fighting an outbreak of Ebola in Sierra Leone has himself been infected with the disease, the president’s office has announced.

Sheik Umar Khan, a 39-year-old virologist who has treated more than 100 people infected with the deadly Ebola virus, has now been admitted to a treatment ward in Kailahun, the epicentre of the latest outbreak.

More than 630 people have died in Sierra Leone, Liberia and Guinea since the outbreak began in February, according to the latest data from the World Health Organisation.

The outbreak in the three West African states is the deadliest to date. There is no known vaccination, cure or treatment for Ebola, beyond the relief of symptoms. The disease kills 90 per cent of those it infects.

Health minister Miatta Kargbo said the news about Dr Khan reduced her to tears. She described him as a "national hero" and said she would do "anything and everything in my power to ensure he survives," The Independent reports.

Medical charity Medecins Sans Frontieres described the latest outbreak as "out of control".

Nurses in the government hospital in Kenema town in Sierra Leone went on strike on Monday following the death of three of their colleagues of suspected Ebola, the BBC reports. The strike was suspended after the government promised to investigate their demands, which included the relocation of the Ebola ward from the hospital to a separate facility administered by Medecins Sans Frontieres.

It is not known how Dr Khan contracted the illness. Ebola is spread through bodily fluids such as sweat and saliva – but according to Reuters, the doctor was "always meticulous with protection, wearing overalls, mask, gloves and special footwear".

Nevertheless, Khan said he feared Ebola. "I am afraid for my life, I must say, because I cherish my life," he said. "Health workers are prone to the disease because we are the first port of call for somebody who is sickened by disease. Even with the full protective clothing you put on, you are at risk."

Ebola outbreak: why the disease is 'out of control'

11 July

The Ebola virus is "out of control" and continuing its rapid spread across Guinea, Liberia and Sierra Leone, with the World Health Organisation recording 44 new infections and 21 deaths in just two days, Al Jazeera reports.

This comes despite agreement between West African nations about how to tackle the deadly disease at crisis talks held in Ghana.

We examine why governments and health workers are having such difficulty controlling the spread of the disease, and how humans are making it worse.

Where did the virus originate?

The Ebola virus was first identified in the Democratic Republic of Congo in 1976. It gets its name from the Ebola River, which is situated near the village where it was discovered.

Ebola is a "zoonotic" disease, meaning that the virus can spread easily between animals and humans, according to the WHO. Scientists believe it was initially present in wild animals living in tropical rainforests in equatorial Africa. Fruit bats have been identified as one of the main hosts as they can transmit the disease while remaining unaffected by it.

The disease spread to humans when they came into contact with blood or other bodily fluids from infected animals through hunting. 

Why is it so difficult to control? 

Ebola is highly infectious. It can be transmitted through bodily fluids, skin and other organs or through indirect contact with environments contaminated by the disease.

The disease can also have a long incubation period, lasting up to three weeks, which allows it to spread rapidly before diagnosis and quarantine can take place. Men who have been infected with the disease and recovered can still pass it on through sexual contact for up to seven weeks.

High population densities in the affected West African cities and the difficulty in regulating the movement of people across the region further compounds the problem.

How are humans making it worse? 

The consumption of bush meat is a significant contributing factor in West Africa, Mother Jones reports. Bush meat is often sold from roadside grills, and despite being banned in the Ivory Coast in an attempt to stop the spread of the disease, people continue to sell and consume it.

Traditional burial rituals, such as embalming, commonly practised in West African countries, involves direct contact with the body. Even where such customs have been banned or discouraged, relatives have risked transmitting the disease further by insisting on traditional burials.

Human activity in the region, particularly deforestation, mining and conflict all contribute to the destruction of rainforest and animal habitats and causes "people and animals to have more contact" than usual", says epidemiologist and Ebola expert Dr Jonathan Epstein.

In this way, "human activity is driving [infected] bats to find new habitats amongst human populations".

West Africa faces deadliest Ebola outbreak in history

3 July

Health ministers from across West Africa are meeting in Ghana to form a regional response to the Ebola outbreak that has killed almost 500 people.

The World Health Organisation has confirmed that this outbreak, which affects Sierra Leone, Liberia and Guinea, is the deadliest and most aggressive in history.

The organisation says "drastic" action is needed to contain the spread of the virus.

"We’re hoping to take decisions about how to enhance collaboration and responses [of these countries] so we can get a grip and halt this outbreak," WHO spokesman Daniel Epstein told the BBC.

The disease is described as "a severe acute viral illness". It kills up to 90 per cent of those infected and is highly contagious, with no known vaccine or cure.

There are various challenges facing the containment of the disease. "In Liberia, our biggest challenge is denial, fear and panic. Our people are very much afraid of the disease," Bernice Dahn, Liberia’s deputy health minister, told Reuters at the meeting in Ghana.

Sierra Leone’s health minister says more money is needed to pay for drugs, medical staff, protective clothing and isolation centres to halt the spread of the disease.

The WHO sites three main reasons it has been so difficult to contain the spread of the disease: high population densities in the major cities affected, the difficulty in regulating the movement of people across the region and families insisting on traditional burials of victims which risk spreading the disease.

Medical charities in the region are also reporting attacks on foreigner aid workers, who some blame for the disease. "We are seeing an increasing level of hostility borne out of fear in some communities," said Dr Bart Janssens, director of operations for Médecins Sans Frontières.

Ebola outbreak: London Mining staff leave Sierra Leone

3 June

A number of staff from a British mining firm have left Sierra Leone following an outbreak of the deadly Ebola virus.

London Mining said it was not aware of any incidences of the disease among its own workforce, but said it was monitoring the health of all of its employees and has imposed restrictions on travel in the region – which prompted "non-essential" staff to return home.

The BBC says London Mining is the first company to go public on an "evacuation" since 50 suspected cases of the incurable and highly contagious disease emerged in the west African country. Five people have died in Sierra Leone, while more than 100 people have died in neighbouring Guinea where the outbreak started. Cases have also been reported in Liberia.

Symptoms of Ebola, which first emerged in central Africa 20 years ago, include internal and external bleeding, diarrhoea and vomiting. The disease kills between 25 and 90 per cent of its victims.

It emerged last month that relatives of Ebola patients in Sierra Leone had been removing their loved ones from community health centres despite protests from medical staff.

The family of one woman said they had removed her from a clinic because they did not trust the medical system and feared she would die if a planned transfer to a general hospital went ahead.

BBC international development correspondent Mark Doyle said some families apparently wanted to have their loved ones treated by traditional African healers.

Amara Jambai, the Health Ministry's director of disease prevention and control, warned that those patients now risk infecting their family members and others in the community.

London Mining said in a statement: "A number of non-essential personnel have left the country due to voluntary restrictions on non-essential travel."

It said it has established "proactive health monitoring" of the workforce, including screening all staff and visitors entering its sites and ensuring its facility has the appropriate medication and equipment to manage any potential occurrences of the disease. It added that production at its Marampa mine is "not currently affected".

Ebola death toll passes 100 as disease spreads from Guinea

9 April

THE DEADLY Ebola outbreak in West Africa is one of the "most challenging" seen since the virus emerged four decades ago, the UN World Health Organisation (WHO) says.

More than 100 people have now died from the disease in Guinea, Liberia and Mali, and experts say that it may take up to four months to contain.

Guinea now has 157 suspected and confirmed cases of Ebola and 101 deaths. The virus has also spread across the border to Liberia where there are another 21 suspected and confirmed cases and 10 deaths.

So why is this outbreak so challenging? The BBC's global health reporter Tulip Mazumdar says that the virus's broad geographical spread is to blame.

Previously, much smaller areas have been affected. The last significant outbreaks in the Democratic Republic of Congo and Uganda in 2012 led to 60 deaths in total. Health officials were able to contain the spread of the virus in both cases because the outbreaks occurred in remote locations.

By comparison, the recent outbreak in Guinea has now spread to the capital of Conakry, which has a population of two million people, and across the border to Mali and Liberia.

"We fully expect to be engaged in this outbreak the next two to three to four months before we are comfortable that we are through it," Keiji Fukuda, assistant director-general of the World Health Organisation, said at a briefing in Geneva.

Saudi Arabia has suspended visas for Muslim pilgrims from Guinea and Liberia hoping to take part in the Hajj in October. Mali has also promised to tighten border controls.

The WHO describes Ebola as "a severe acute viral illness". Early symptoms include the sudden onset of fever, intense weakness, muscle pain, headache and sore throat, it adds. There is no known cure or vaccine for the virus. Medecins Sans Frontiers said that the current Zaire strain of Ebola was the most aggressive and most deadly it had ever seen, killing nine out of ten patients. 

Ebola virus: 'unprecedented' outbreak kills 78 in Guinea

1 April

SEVENTY-EIGHT people have died in an outbreak of the Ebola virus across Guinea that a medical charity describes as "unprecedented".

Medecins Sans Frontiers (MSF) said that the Zaire strain of the Ebola virus was the most aggressive and most deadly it had ever seen, killing nine out of ten patients, Al Jazeera reports.

"We are facing an epidemic of a magnitude never before seen in terms of the distribution of cases in the country: Gueckedou, Macenta Kissidougou, Nzerekore, and now Conakry," said Mariano Lugli, who is coordinating MSF's project in Conakry, the capital of Guinea.

Guinean health authorities report that to date there have been 78 deaths and 122 suspected patients. The virus is also believed to have spread to Liberia and Sierra Leone, but so far no cases have been confirmed in either country.

On Saturday, Senegal announced that its border crossings to Guinea would be closed "until further notice".

Liberia's Health Minister Walter Gwenigale advised people to stop having sex, as the virus can be spread through bodily fluids, the BBC reports. People have also been recommended to stop kissing and shaking hands.

The WHO describes Ebola as "a severe acute viral illness". Early symptoms include the sudden onset of fever, intense weakness, muscle pain, headache and sore throat, it adds.

"This is followed by vomiting, diarrhoea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding. Laboratory findings include low white blood cell and platelet counts and elevated liver enzymes." The virus is said to have a fatality rate of up to 90 per cent.

Senegalese singer Youssou N'Dour cancelled his concert in Guinea over concerns that bringing large groups of people together could help the virus spread.

This is the first outbreak of Ebola in west Africa in two decades. Since it was discovered in Zaire, now the Democratic Republic of Congo, in 1976, the virus has killed an estimated 1,500 people.  · 

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