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Unprecedented Ebola outbreak crosses borders in West Africa

April 8, 2014 at 6:24 PM EDT
More than 100 people have died so far in the worst outbreak of the Ebola virus in years, which began in Guinea before spreading to Liberia. Now health officials are investigating possible cases in Mali and Ghana. Jeffrey Brown talks to Laurie Garrett from the Council on Foreign Relations about past outbreaks and the current challenges for containment.
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JUDY WOODRUFF: Several countries in West Africa are now coping with the worst outbreak of the Ebola virus in years. The World Health Organization describes it as one of the most challenging episodes of the disease it’s ever faced. More than 100 people have died so far.

Ebola, which is spread by a virus initially transmitted from wild animals, has a high fatality rate.

Jeffrey Brown has more on the struggle to contain it.

JEFFREY BROWN: One of the concerns is that Ebola has crossed borders. Guinea is where the outbreak began and was first made public in March. More than 100 deaths and 150 cases have been reported there.

Another troubling aspect: The disease has turned up in a wide area, from tropical forests to the capital of Conakry to the Liberian border. In Liberia, investigators believe there are at least 10 deaths. Health officials are now investigating possible cases in both in Mali and Ghana.

And more than 60 percent of infected people so far have died.

Laurie Garrett of the Council on Foreign Relations has tracked outbreaks in the past as a journalist and author of several books on global health and disease. She joins us now.

Laurie, welcome back to the program.

First, remind us a bit about what Ebola is and exactly how it’s transmitted.

LAURIE GARRETT, Council on Foreign Relations: Thank you.

Yes, Ebola is an RNA virus, a very small virus that attacks the endothelial linings that maintain the integrity of your blood vessels, blood veins, capillaries, first little microscopic holes through which bits of blood and fluids will leak, but eventually larger and larger holes, until the individual begins to hemorrhage internally, and hemorrhaging blood through tears, from the mouth, from the nose, all over the body, so that they become quite frightening to see.

And individuals will get a high fever. They may get blood in the brain, which will lead to even more insane behavior, a kind of deranged look in their eyes, all of which contributes to a great deal of fear.

On top of it all, the fluids contain virus, so they’re highly, highly contagious to the touch.

JEFFREY BROWN: So, in — so, in the current situation, as we mentioned, we’re seeing it spreading into several countries. That’s — that’s unusual, right?

LAURIE GARRETT: We have never seen this before.

This — as NSF put it correctly, this is unprecedented. We have had outbreaks before, but they have always stayed within a country and even within a pretty confined part of the country. The outbreak I was in, in Kikwit, Zaire, in 1995, only got to a few peripheral villages, a large distance, but walking distance.

There were no ways to get around other than walking and Land Rovers, no streets, no roads, no real airports, and so on. This is different because Conakry is a real city. It has a real, serious airport. Senegal is next door, and Dakar is one of the biggest airports in all of West Africa.

It has indeed crossed borders, involved multiple governments, multiple sets of policies. It’s in all different kinds of religious communities, cultural communities, different languages, all of which makes conquering it much more difficult, because your number one obstacle with Ebola is fear and how the public responds.

JEFFREY BROWN: But, at the same time, health officials have said — they’re reporting that they have traced the sources of transmission for everyone who’s sick. Now, that sounds like a good sign for trying to contain this.

LAURIE GARRETT: Could be. Could be.

But there are some — fundamental mystery here. Something’s going on in the rain forest, because what these countries share is a special ecology, a special rain forest region, in which are the fruit bats that normally carry the Ebola virus harmlessly to the bat population, but can pass it on to other primates, which can be eaten by the humans, or to people, hunters that may be in the rain forests.

And it’s possible that we’re getting multiple introductions, or at least more than one, across the region. So if something is going on in the rain forest that is why the bats are stressed and passing the virus, then we will see multiple rounds of reintroduction.

But the bottom line here is to extract individuals from their homes, put them in quarantine, give them safe and, you know, humane care, and make sure that all the caregivers have proper protective gear.

JEFFREY BROWN: And all that hasn’t really changed all that much since Ebola was first found in 1976, right, I mean, in terms of what can be done once an outbreak begins?

LAURIE GARRETT: We understand it a little better, but we don’t have any different technology today than we have had all along since we have known of the Ebola virus in 1976.

It’s all about hand-washing, latex gloves, protective gear masks, and a kind of infection control.

JEFFREY BROWN: So, on the one hand, the WHO is saying they’re getting a handle on this, but they’re also saying that it may take months to deal with. What does that tell you?

LAURIE GARRETT: Well, it tells me that we have a real problem because it’s so dispersed.

It’s across a broad, broad territory, multiple different ecologies, different cultures. And let’s not forget, this is a region that has recently been through civil wars, Sierra Leone’s civil war, Liberia’s civil war, Mali ongoing conflict.

This means that the infrastructure is in terrible shape, that the nerves of the people are raw. There’s a lot of suspicion and countersuspicion between populations and for or against government. So trying to conquer a problem like this means overcoming a lot of larger political issues that have been rife in the region for a long time.

JEFFREY BROWN: Laurie Garrett, thanks so much.

LAURIE GARRETT: Thank you.