It has been among the world’s most feared infectious diseases since its discovery in the jungles of central Africa in 1976. But never, until last month, had the Ebola virus been detected as far west on the continent as Guinea.
The outbreak – it has so far caused 66 deaths out of 103 suspected cases, with further possible infections in neighbouring Sierra Leone and Liberia – has left authorities trying to prevent a regional epidemic for which they are woefully ill-prepared.
Concern has mounted this week as the outbreak, initially concentrated in Guinea’s remote southeast Forest Region, has spread to the capital, Conakry, a port city of 2m people on the Atlantic coast. On Thursday, the government confirmed at least four cases in Conakry, rattling nerves and straining resources in one of the world’s poorest nations.
Help is arriving from aid agencies, such as Médecins Sans Frontières, and the World Health Organisation as medics rush to isolate suspected victims and educate communities about the basic hygiene measures that can prevent infection.
Meanwhile, epidemiologists are hunting for clues to explain how the virus got to Guinea. One theory is that it was brought by bats, which are thought to be the most likely natural host of the disease. Consumption of bat soup, a regional delicacy, and other forms of “bushmeat”, such as monkeys and cane rats, has been banned by the Guinea government.
The outbreak has focused attention on how little progress has been made towards tackling Ebola since it was first identified in an Antwerp laboratory 38 years ago by Belgian scientists analysing a blood sample from a person struck down by a mysterious virus in Zaire, now the Democratic Republic of Congo.
Since then the haemorrhagic fever has become notorious for its gruesome symptoms, including vomiting, diarrhoea and both internal and external bleeding, its high fatality rate of up to 90 per cent, and the lack of a cure.
Experts say there are two main obstacles to a treatment. First is the difficulty of working with such a deadly virus. Research is strictly controlled in high-security government laboratories in the US and Europe.
Tests on animals have opened several promising paths to a potential vaccine or cure but the human trials that would usually follow such a breakthrough are almost impossible to carry out given the speed and unpredictability of Ebola outbreaks.
The second obstacle is the lack of economic incentive for drug companies to invest in a virus that flares up only sporadically in some of the poorest and remotest parts of Africa.
“There is no real market for such a product; it would have to be a stockpile arrangement in which a government agency or the WHO would buy the product and wait to use it when an outbreak occurs,” says Charles Arntzen, a life sciences professor at Arizona State University who has worked with the US government on a potential Ebola vaccine.
The US government stepped up research into Ebola after the 2001 attacks on New York and Washington amid fears the virus could be used for bioterrorism or could spread to the country through international travel.
Diane Berry, head of government affairs at Sarepta Therapeutics, a Massachusetts biotech company that specialises in infectious diseases, recalls how the company was contacted by the US defence department in 2004 after a scientist accidentally penetrated her protective clothing with an Ebola-contaminated needle at an army laboratory.
Officials wanted to know if the company could produce an emergency treatment if the woman turned out to have been infected. She was given the all-clear after a spell in quarantine but the scare marked the start of a government partnership with Sarepta to develop a cure.
Michael Wong, medical director of Sarepta, says good progress was made until federal budget cuts in 2012 led to the programme being scrapped. Work is continuing, however, on a treatment for the Marburg virus, another haemorrhagic fever, which Mr Wong says could in future be developed for use against Ebola.
Barbara Knust, an Ebola expert at the US Centers for Disease Control and Prevention, says that while further work must be done on potential cures, there are more basic steps that can be taken to help African countries fight the virus.
“It is important to recognise that Ebola outbreaks become so widespread because of the hospital conditions and poor resources,” she says. “Health workers might not even have access to gloves and family members of infected people might not have running water to wash their hands.”