Death toll soars in Africa as Ebola outbreak spreads

Fear, suspicion of foreign doctors has helped virus spread

The latest data from the World Health Organization (WHO) show that 467 people in Guinea, Liberia, and Sierra Leone have succumbed to what experts are calling the deadliest outbreak of Ebola in history.

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The outbreak, which began in Guinea, has infected 759 people, according to WHO. The data show a significant spike in cases: Just one week ago, the death toll was 367.

By comparison, the previous most deadly outbreak of Ebola killed 254 residents of Congo 1995, WHO says. The incurable disease kills about two-thirds of the people it infects by causing untreatable bleeding that can claim victims in a matter of days or weeks.

The outbreak somewhat subsided in March, leading the president of Guinea to declare the situation "well in hand." But the complacency led to a second, more aggressive surge, health experts say. Now, the outbreak is "out of control," according to a recent report from Doctors Without Borders.

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Suspicion, fear impeding health workers' efforts

Foreign health care workers' efforts have been met with suspicion and sometimes violence. In April, an angry crowd attacked a Doctors Without Borders clinic in Guinea, accusing the health workers of bringing Ebola to their village. Reports also indicated that mobs have thrown rocks at health workers.  

When health workers do get the chance to treat Ebola victims, they have to deal with the growing problem of runaway patients who distrust the workers in full-body suits and masks. Amara Jambai, Sierra Leone's director of disease prevention, estimates at least 57 infected patients have gone "missing." He says, "When you lose cases that way, you will not know where the next case will appear."

Moreover, rumors have impeded containment efforts. For example, one rumor suggests that doctors will remove victims' limbs before burying them, prompting some victims' relatives to attempt to retrieve the bodies to give them a proper burial, according to Mohamed Vandi, the chief medical officer in one district of Sierra Leone. One death can lead to a dozen more infections when family and friends prepare a victim's body for burial, experts say. In June, local police had to fire tear gas at a hospital to prevent locals from retrieving bodies.

On top of all the rumors and distrust, stigmas associated with the deadly disease have driven some families to hide Ebola victims.

"My biggest problem, as it stands, is getting people to accept the disease," says Sheik Umar Khan, a doctor who works with Vandi in Sierra Leone. He adds, "These escapes, emanating from fear and misunderstanding, make our work even more difficult."

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Working towards a solution

Experts say Ebola has spread more easily because the governments of the three countries were unprepared and the infrastructures of their health ministries were weak. With no public health response system, residents relied on traditional healers' recommendations.

Sierra Leone's first Ebola case was found in a traditional healer, called a "sowei," who was treating sick people crossing from the Guinea border, Vandi says. At border checkpoints like these, locals are putting their faith in herbal rope bracelets that police and soldiers are handing out. Meanwhile, masked health workers are trying to take the temperature of all border crossing travelers to monitor anyone carrying a fever.

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This week, WHO is convening an 11-country meeting this week to coordinate more aggressive regional responses (Fox, NBC News, 7/1; AP/Boston Globe, 7/1; Washington Post, 6/29; Fofana, Reuters, 6/30).

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