Dr Khan, 39, described by the authorities of Sierra Leone as a national hero, is being treated at a centre run by the medical charity Médècins Sans Frontières (MSF), as the governments of Sierra Leone, Liberia and Guinea struggle to contain the rapidly expanding outbreak.
There is not known cure for Ebola, which causes vomiting, diarrhoea and internal and external bleeding. The disease, which develops within 21 days of contagion with symptoms including fever and muscular pain, has a 50-90 per cent mortality rate. According to the World Health Organisation, several vaccines are being tested, but none are available for clinical use.
The World Health Organisation has put the death toll so far at 660 people since the outbreak started in Guinea’s remote Forest Region in February. This surpasses the previous record of 425 in Uganda in 2000 and the 280 victims of the first known outbreak in 1976, in a remote village near the Ebola river in what is today the Democratic Republic of Congo.
Dr Khan’s personal fight with the virus highlights the challenge for west African governments in one of the world’s poorest areas. International health officials say that without more resources, the death toll will climb further.
“We need to step up the response and we need to do it fast”, says Zabulon Yoti, a team leader with the WHO in Sierra Leone.
But health workers working in remote areas face daunting challenges. This is the first big outbreak in west Africa and the region has no experience in dealing with the disease and is ill equipped to combat it. Anja Wolz, emergency co-ordinator with MSF who is running the Ebola treatment centre in Kailahun – where Dr Khan is interned – said doctors were “running behind Ebola”.
West African officials also worry about the potential for the outbreak to spread to the region’s larger countries such as Ivory Coast, Ghana and, particularly, Nigeria. In the latter case, the authorities are already testing a potential case in the country’s commercial capital Lagos.
Previous scares in west Africa of other haemorrhagic viruses, including Lassa fever virus and the dengue virus, have turned out to be false alarms and so far the Ebola outbreak has had little or no economic impact. But foreign investors with millions of dollars invested in the area’s mines and other business travellers are starting to be worried.
International SOS, one of the world’s top medical and travel security risk services, said it had received “hundreds of requests for advice on the outbreak” from foreign companies operating in the region in the past few weeks.
Mining companies in the area, including London Mining and African Minerals, have imposed travel restrictions on their workers, while some non-essential staff have left the region. The share price of both miners have fallen roughly 60 per cent since January. However, the companies say their operations are far away from the outbreak areas and production continues.
Nonetheless, the International Monetary Fund said economic activity in Guinea was subdued in the first half of the year, reflecting “the impact of the Ebola epidemic”, while analysts fear the virus is forcing people to flee farming areas in the affected zones, potentially affecting both economic output and food supply.
Health workers from the WHO and MSF have been working with local authorities to quarantine people with the infection and to educate communities about basic hygiene measures that can restrict its spread. Fewer than one in five people in the three countries affected by the outbreak have a flushable toilet or even a pit latrine.
Public health infrastructure in Sierra Leone, Liberia and Guinea varies from weak to non-existent. Average annual per capita spending on healthcare ranges from $32 in Guinea to $96 in Liberia, according to the World Bank. This compares with $8,895 in the US.
Justine Greening, the UK’s top development official, on Friday announced a £2m package to combat the outbreak, saying that Ebola was posing “a serious public health risk to west Africa”.
Funerals of Ebola victims have been identified as a particular problem because bodies are traditionally washed by hand, putting mourners at risk of infection. And not everyone has confidence in the aid workers’ ability to help: on Friday a female victim was taken from hospital in Freetown, capital of Sierra Leone, by her family and is now being sought by health officials and the police.
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