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| Sierra Leone is one of the countries affected by the current epidemic. Downtown Freetown still bustles despite the outbreak. Tommy Trenchard for NPR |
NPR:
Back in early December, a little boy in southern Guinea caught a mysterious disease. He had a fever, was vomiting and had blood in his stool.
The boy died a few days later. Before he did, he passed the disease to his 3-year-old sister, his mother, his grandmother and a midwife. The latter was eventually hospitalized in Gueckedou, a nearby city of 200,000 people.
By March, the disease spread to four cities. And international health officials realized they had an Ebola outbreak on their hands. The virus quickly spilled over into Sierra Leone, Liberia and Nigeria. Now more 1,400 have died in the outbreak, the World Health Organization says.
The disease is named for the river near the town of Yambuku in Zaire (now the Democratic Republic of Congo), where some of the first documented cases of the disease were identified in 1976.
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| Body collectors come to the home of four children in Monrovia who lost both parents to Ebola. Tommy Trenchard for NPR hide caption itoggle caption Tommy Trenchard for NPR |
The entire outbreak in West Africa likely started with only one person, who caught the virus from a sick animal. Maybe a bat. Or another animal that had been infected by a bat.
Pierre Rollin, an infectious disease doctor with the Centers for Disease Control and Prevention. says. "We think that there was only one introduction [from animals] and then from that it went from human to human to human to human,"
Scientists figured this out in two ways. First, every person they know who has been infected with Ebola, so far, has had contact with somebody else with the disease.
"We always find a link with someone else who had been sick," Rollin says. "You always find this chain," he added. So the virus isn't just popping up seemingly randomly.
Joseph Fair, an infectious disease doctor who works in Sierra Leone, says. "What was interesting is we did find two individuals — and that was up to five years ago — with recent exposure to Ebola Zaire,"
That's the type of Ebola causing the outbreak right now. The team found only two patients with signs of a previous Ebola Zaire infection. But with the recent outbreak in region, that finding likely means that Ebola has been hiding out in animals in West Africa for years now.
And it was waiting for just the right moment — and the right person — to launch an outbreak.
There is no evidence that the disease can spread through the air, nor do mosquitoes carry it. But blood and indeed any bodily fluid can transmit it from person to person. According to the Centers for Disease Control and Prevention, the individual will be contagious only after symptoms appear.
The only way others could be infected is by direct contact with the bodily fluids of the infected person. And the virus would need to enter the other person via a cut on the skin or by contact with eyes, nose, mouth or ears.
Dead bodies are highly contagious because of the high levels of virus in body fluids.
Traces of the virus linger in semen and breast milk; a patient who survives Ebola is released but told to use condoms or wean her children upon returning home, for a period of several weeks.
In 1989, the Reston species of the virus was discovered in a blood sample from crab-eating macaques from the Philippines that had been brought to Hazleton Laboratories in Reston, Va. A year later, there were four reported cases in the U.S. of humans infected with Ebola Reston, but all were asymptomatic. Monkeys and humans can be infected by this species but CDC notes that compared with other Ebola viruses, this one appears to be "less capable, and possibly incapable" of causing disease in humans.
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| Street vendors sell water on a street of Gueckedou — the city in Guinea where the Ebola outbreak began. Bordering Sierra Leone and Liberia, Gueckedou is a bustling city of more than 200,000 people. SEYLLOU/AFP/Getty Images |
After 10 days in Liberia, NPR producer Nicole Beemsterboer has just landed in London. "You don't realize how much has been hanging over your head until you're out," she says.
She's talking about Ebola, the virus raging in Liberia as well as Sierra Leone and Guinea. "It was silent and invisible," she says. "So you're always on edge, always careful."
How did you protect yourself?
I got used to not touching anyone, no handshakes. And there are buckets of chlorine solution everywhere — outside every office building, police station, government office, hotel, store. Everywhere. I washed my hands dozens of times a day, and was careful never to touch my face.
At government buildings, officials watch you wash your hands and then take your temperature with an ear-gun thermometer. They write your temperature on a piece of paper and actually staple it to your lapel so it's visible to everyone inside. You can't get in the building if you have a temperature, and it sends a message: We're being vigilant; you need to be vigilant, too. Hold yourself and others accountable.
And you were careful right down to the soles of your boots?
We were concerned that if anything was contaminated, it was the bottom of our boots, so we were constantly rinsing them in the chlorine solution.
I don't know that we started a trend, but on the last day we were there, our hotel added a shoe wash — a box with a big foam pad inside, soaked in chlorine so you didn't have to soak your shoes but were getting enough chlorine on [the soles] to decontaminate them. We started seeing this more and more, at Redemption Hospital and other places around the city.
Headlines emphasize how hard it is to keep up with the outbreak.
For people in Monrovia, if they do show symptoms, there are still limited options for where they can go. The MSF (Doctors Without Borders) facility is expanding, but as soon as they have more beds, they are immediately filled. There simply isn't enough room for all the people who are sick, and until there are, people who get sick will stay home, get sicker and put those around them at risk.
When we landed in Casablanca, instead of someone taking your temperature with the ear gun, they had us stand about 20 feet away from a staff person in nurses scrubs in front of an infrared camera. If anyone does have a fever, the airport staff doesn't have to be anywhere near you.