The Ebola outbreak has killed about 11,312 people in west Africa, and affected the US and Spain, where people returning from the region have died and transmitted the infection to several nurses. We examine the background to the disease, its spread and its impact
West Africa experienced the biggest outbreak of the Ebola virus ever known, causing thousands of deaths, devastating fragile healthcare systems and damaging the economies of countries, some of which were still recovering from civil war. At the peak of the epidemic, in autumn 2014, infections were doubling every few weeks. The World Health Organisation said there had been 28,457 officially recorded cases by 4 October 2015, almost all in Sierra Leone, Liberia and Guinea, with about 11,312 deaths, but many go unrecorded and the true figure is thought to be two to three times higher. However the forecast by the US Centres for Disease Control (CDC) in September 2014 that if nothing changed there could be 1.4 million cases by late January proved to be unduly pessimistic. For the first time since the outbreak began, there were no new cases officially recorded in the week to 7 October. Serious concerns about the spread of the virus to countries bordering the epidemic region intensified when a child died of Ebola in Mali, having travelled while sick for hundreds of miles by bus, but Mali, just like Nigeria, managed to close down the outbreak. Outside Africa, two nurses were infected while caring for a patient in Texas, who flew from Liberia before exhibiting symptoms, as was a nurse who treated a missionary repatriated to Madrid. In both cases, the patients died but the nurses recovered. A doctor returning to New York from Liberia fell sick and British nurse Pauline Cafferkey, who had volunteered in Sierra Leone, was also diagnosed, but both survived. Cafferkey fell ill again last week and is being treated at the Royal Free Hospital, in London, where she is “critically ill”.