As a terrifying outbreak of Ebola virus spreads across west Africa, the world is beginning to wake up to the threat of a public health disaster in the region – and possibly more widely – but efforts to contain the epidemic require much more local co-ordination and global support. With more than 1,100 cases and 660 deaths reported so far, this is not only the largest Ebola epidemic to date but also the first to threaten urban west Africa, where populations are larger and more mobile than in the relatively isolated central parts of the continent affected previously.
Ebola’s scary reputation is based on its lethality – the virus kills about 60 per cent of those it infects – and the lack of any effective treatment beyond making sure that patients are kept fully hydrated. But it is not as contagious as some other germs such as influenza that can spread considerable distances through the air. People catch Ebola by physical contact with an infected person or animal; scientists believe fruit bats, often eaten as bushmeat in Africa, are a reservoir of infection.
Sophisticated healthcare, with quick diagnosis of suspected cases followed by barrier nursing and medical care, could halt the epidemic. The challenge is to provide that – or something closer to it than exists in much of west Africa today – in a region where the public health infrastructure is generally poor.