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1 [1] (November 24, 2014)

handle is hein.crs/govcbzx0001 and id is 1 raw text is: FF. ' iE ,E .$r . i , Ebola: 2014 Outbreak in West Africa - mmm, go mppm qq\ , q I aS 11LIANJILiN, November 24, 2014 In March 2014, an outbreak of Ebola Virus Disease (EVD) began in Guinea. It spread to Liberia in the same month and to Sierra Leone a month later. An EVD outbreak that began in Nigeria in July was contained in August. In that same month, a case was detected and contained in Senegal. Health officials are working to contain an outbreak that began in Mali in October. As of November 20, Mali has reported six cases, including five deaths. The current EVD outbreak is the largest, most persistent one ever documented, and is the first in West Africa. As of November 21, more than 15,000 people had contracted EVD and nearly 5,500 had died (Figure 1). Infection rates are declining in Liberia, are stable or rising in various parts of Guinea, and are accelerating in Sierra Leone. Figure I. Global Ebola Outbreaks: 1976-2014 Source: Created by Tiaji Salaam-Blyther based on WHO data. There have been 20 medical evacuations of international medical workers to developed countries infected in Guinea, Liberia, or Sierra Leone (the affected countries), seven to the United States and 13 to Europe. Until October, all EVD cases outside of West Africa were among medical evacuees. In that month, the United States and Spain experienced their first secondary cases, which occurred in health workers who had cared for EVD patients. Prior human EVD outbreaks occurred primarily in rural and forested areas of Central and East Africa. The current outbreak is occurring in both urban and rural areas. Its current size and rate of growth is widely viewed as a potential threat to other African countries and the world. Due to weak surveillance systems, there is uncertainty about the actual number of EVD cases in West Africa. The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) both assert that EVD cases are underreported. Actual cases could be two to four times larger than reported, according to WHO. Transmission. Fruit bats are the suspected natural reservoir of EVD in West Africa, where some people consume bats and other potentially infected forest animals. Humans can contract EVD when exposed to bodily fluids of infected animals and persons, or through contact with contaminated surfaces or items (e.g., needles). Inter-human transmission is the primary source of infection in West Africa. During outbreaks, close associates of infected persons face a high risk of infection, as do health care and funeral workers. Asymptomatic patients are not contagious. Disease. Symptoms typically include fever; weakness; head, joint, muscle, throat, and stomach aches; vomiting; diarrhea; and bleeding. Kidney and liver function may be impaired; white blood cell and platelet counts may drop; and shock and death may occur. The incubation period (the time between infection and the onset of symptoms) ranges between two and 21 days, but is usually 8 to 10 days. There is no cure for EVD, but EVD treatments and vaccines are being developed. Palliative care focuses on balancing fluids and electrolytes; maintaining blood pressure and access to oxygen; and treating complicating infections. Prompt treatment can extend survival prospects, but those in early EVD onset stages may delay seeking health care, since symptoms are akin to those of many common illnesses. Prevention. In clinical settings, suspected EVD cases are isolated, health care workers (HCWs) wear personal protective equipment (PPE), and contaminated objects are sterilized. In communities, HCWs are working with community leaders to develop alternatives to cultural practices (e.g., funeral rites) that might spread EVD, as well as training safe burial teams. The Ebola outbreak has overwhelmed the governments of the affected countries, where it is exacerbating preexisting social, economic, development, and security challenges and creating new ones. Schools and many health facilities have been closed. Trade and other economic activity have been disrupted by road and border closures and domestic controls on population movements. These closures have interrupted access to food, income, and social and health services. Public skepticism about political leadership and state capacity is growing. International pledges of financial and medical support are increasing, but critics allege that the international response to date has been inadequate. International Response. In September, the United Nations (U.N.) established the U.N. Mission for Ebola Emergency Response (UNMEER) to coordinate the international response to the outbreak. That month, the U.N. Security Council and General Assemblies held special meetings on Ebola at which member states were urged to expedite support for the affected countries and a U.N. integrated Ebola response plan. Implementing U.N. agencies include the WHO, which leads the U.N. health response. The six-month, $988 million U.N. plan is designed to halt the outbreak and mitigate related health and social impacts. .O 'T

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