Ebola Virus Disease (EVD) in Liberia


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Myself . By T.V. Antony Raj

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Coat of arms of Liberia

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On December 6, 2013, a 2-year-old boy died in the village of Meliandou, Guéckédou Prefecture, Guinea. Researchers believe the boy’s death was the index case of the current Ebola virus disease epidemic.

Hammer-headed bat (Hypsignathus monstrosus), also known as the big-lipped bat, is a megabat widely distributed in equatorial Africa. (Credit - Shyamal - Wikipedia)
Hammer-headed bat (Hypsignathus monstrosus), also known as the big-lipped bat, is a megabat widely distributed in equatorial Africa. (Credit – Shyamal – Wikipedia)

Bushmeat refers to meat from non-domesticated mammals, reptiles, amphibians, and birds hunted for food in tropical forests. The dead boy’s family were hunters of bats for bushmeat. They hunted the Ebola-harbouring species Hypsignathus monstrous and Epomops franqueti. This may have been the original source of the infection. The dead boy’s mother, sister, and grandmother fell ill with similar symptoms and died. People infected by those victims spread the disease to other villages.

Now, Ebola represents a major public health issue in sub-Saharan Africa. But in early 2014, West Africa did not report any no cases of Ebola. The early cases of Ebola were diagnosed as other diseases more common to the area. Thus, the disease had several months to spread before it was recognized as Ebola.

On Wednesday, March 19, 2014,  Reuters reported an outbreak of an undetermined viral haemorrhagic fever in the West African nation of Guinea. According to Guinea’s local health officials, the first case of the fever was reported in February 2014 that sickened at least 35 people and killed 23.

Dr. Sakoba Keita, the doctor in charge of the prevention of epidemics in Guinea’s Health Ministry said:

“Symptoms appear as diarrhoea and vomiting, with a very high fever. Some cases showed relatively heavy bleeding… We thought it was Lassa fever or another form of cholera, but this disease seems to strike like lightning. We are looking at all possibilities, including Ebola, because bushmeat is consumed in that region and Guinea is in the Ebola belt.”

Keita also said that most of the victims had been in contact with the deceased or had handled the dead bodies. He said those infected had been isolated, and they had sent samples to Senegal and France for further tests.

By March 24, 2014, Médecins Sans Frontières (MSF) or Doctors Without Borders had set up an isolation facility in Guéckédou.

By late May 2014, the outbreak had spread to Guinea’s capital, Conakry, a city of about two million inhabitants. On May 28, 2014, the total number of cases reported had reached 281 with 186 deaths.

In late March 2014, Liberia, reported the spread of Ebola in Lofa and Nimba counties. In mid-April 2014, the Liberia’s Ministry of Health and Social Welfare recorded possible cases of Ebola in Margibi and Montserrado counties. In mid-June 2014, Liberia’s capital Monrovia reported the first cases of Ebola. On July 27, 2014, Ellen Johnson Sirleaf, the Liberian president, announced that Liberia would close its borders with neighbouring countries. In August, he declared a national state of emergency, with the “suspensions of certain rights and privileges”.

Liberia faced a health crisis even before the outbreak of the Ebola virus. It had only 50 physicians in the entire country — one for every 70,000 Liberians. In September 2014, the US Centers for Disease Control and Prevention (CDC) reported that some hospitals in Liberia had been abandoned. The report also said the hospitals which were still functioning lacked basic facilities such as running water, rubber gloves, and sanitizing supplies.

At the end of August, the World Health Organization (WHO) stated that Liberia’s capacity to treat Ebola Virus Disease (EVD) cases fell short of 1,550 beds. In September, a new 150-bed treatment clinic was opened in Monrovia. At the time of the opening ceremony six ambulances were already waiting with potential Ebola patients. More patients were waiting by the clinic after making their way on foot with the help of relatives.

2014 ebola virus epidemic in West Africa (Author: Mikael Häggström)
2014 Ebola virus epidemic in West Africa (Author: Mikael Häggström)

As on October 19, 2014, out of the 4,665 patients diagnosed for Ebola in Liberia, 2,705 had died. In the past week alone Monrovia reported 305 new EVD cases. Out of the 15 counties in Liberia 14 have reported cases of Ebola. Only Grand Gedeh has yet to report an EVD case.

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