Category Archives: WHO

The Five Days of December 1952 When the Killer Smog Blanketed London.


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Myself 

By T.V. Antony Raj

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Smokestack belching dense dark smoke.
Smokestack belching dense dark smoke.

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The modern fight against environmental pollution around the world owes much to the tragedy that befell Greater London, about 63 years ago. The haphazard use of coal brought the country to the brink of a frightening black disaster on December 5, 1952.

During the Industrial Revolution, from about 1760 to around 1840, there was a transition to new manufacturing processes. The main factor in this transition was the change from wood and other biofuels to coal.

Indiscriminate use of coal drove Britain, the most powerful empire in the world. Tall smokestacks became the symbols of the industrial age in Britain. The appalling use of coal in industries, for generating electricity, heating homes, for cooking, etc., was frightening. Trains, boats, iron, steel, everyday items used coal. In London, it was like millions of micro-volcanoes erupting all at once. It was as if London was eating coal to survive.

People were burning large quantities of poor quality coal and emitting pollution at low elevations. The pollution from home chimneys was double the amount of the industries.

In the Victorian era, London was well known for its romantic fog that covered the city for 90 days each year for decades. But as the years passed by, this romantic fog and the smoke and fog turned into a poisonous cloud of smog (smoky fog) during each winter. In his book “Reminiscences of Sherlock Holmes” Sir Arthur Conan Doyle (18591930) wrote:

In the third week of November, in the year 1895, a dense yellow fog settled down upon London. From the Monday to the Thursday I doubt whether it was ever possible from our windows in Baker Street to see the loom of the opposite houses. … But when, for the fourth time, after pushing back our chairs from breakfast we saw the greasy, heavy brown swirl still drifting past us and condensing in oily drops upon the windowpanes, my comrade’s impatient and active nature could endure this drab existence no longer. He paced restlessly about our sitting- room in a fever of suppressed energy, biting his nails, tapping the furniture, and chafing against inaction.

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A view of Battersea Power Station in 2012 from River Thames.
A view of Battersea Power Station in 2012 from River Thames.

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Construction of the first phase, the A Station of the Battersea Power Station, began in March 1929. It first generated electricity in 1933, but was not completed until 1935. The total cost of its construction was £2,141,550. It burned approximately 10,000 tons of coal each week to supply one fifth of the electricity for the entire city of London.

Washing off the accumulated soot in London.
Washing off the accumulated soot in London.

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Slowly, with time, London became completely covered in soot.

In late 1952 an unusual cold cinch had gripped London for weeks. On December 5, 1952, the day the disaster began, Londoners awoke to find a clear sky, but coal fireplaces worked overtime to fight the chill in the air. As the day progressed, a light veil of fog began to blanket the city. In the afternoon, the fog mixed with the thousands of tons of soot being pumped into the skies of London by million or more coal stoves, home chimneys, from local factories and industrial smokestacks began to turn a sickly shade of yellow and settled in the London basin.

Smog was nothing new for Londoners, but on that day, this thick sulfurous yellow “pea souper” quickly thickened into a poisonous brew, unlike anything the city had ever experienced before. A high-pressure system parked over London caused a temperature inversion. The air about a thousand feet above the surface, warmer than that at ground level kept the smog under the clouds and prevented it from rising. And, there was no breeze to disperse and dissipate the soot-laden soup.

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The Killer Smog That Blanketed London, 63 Years Ago (Source: history.com)
The Killer Smog That Blanketed London, 63 Years Ago (Source: history.com)

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For five days from Friday, December 5 to Tuesday, December 9, 1952, the Great Smog paralyzed life in London. Poisonous smog closed down all establishments.  Day became as dark as night.

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People found it difficult to breathe the murky air.
People found it difficult to breathe the murky air.

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People found it difficult to breathe the murky air. The smog was so dense that residents of the Isle of Dogs section of the city reported they were unable to see their feet as they walked. It was as if they needed a blind person to lead them home.

The dense smog crippled all transportation. Boat traffic on the Thames came to a halt. Bus conductors holding flashlights and torches walked in front of the double-deckers to guide drivers. Flights were grounded, and trains canceled. Only the Underground was in service.

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The ambulance drivers had to rely on the police and people holding live burning torches s to show them the way.
The ambulance drivers had to rely on the police and people holding live burning torches s to show them the way.

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London was completely silent. Only sirens of ambulances which brought those whose lives were in danger to the hospitals was heard. The ambulance drivers had to rely on the police and people holding live burning torches to show them the way.

Even at mid-noon, automobile drivers and motorcyclists turned on their headlights. They hung their heads out the windows in a futile attempt to inch ahead through the yellow gloom. Many abandoned their vehicles.

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Traffic police used large lamps to light themselves up to avoid getting hit by vehicles.
Traffic police used large lamps to light themselves up to avoid getting hit by vehicles.

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Traffic police used large lamps to light themselves up to avoid getting hit by vehicles.

A greasy grime covered exposed surfaces. Pedestrians with their faces and noses blackened by the smog tried not to slip on the greasy black ooze that coated the sidewalks.

People wore face masks to go to shopping, to walk their dogs. Students wore face masks to go to school.

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People wore face masks even to kiss.
People wore face masks even to kiss.

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People wore face masks even to kiss.

Fearing the children might get lost in the smog, authorities advised parents not to send their children to school.

Fearing the children might get lost in the smog, authorities advised parents not to send their children to school.

Criminals emboldened by the thick dark smog resorted to purse snatching and burglaries and then vanished into the cloaking darkness.

Birds lost in the fog crashed into buildings.

Breeders fashioned improvised gas masks for their cattle by soaking grain sacks in whiskey. Eleven prize heifers brought to Earls Court for the famed Smithfield Show choked to death.

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All weekend soccer matches were canceled.
All weekend soccer matches were canceled.

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All weekend soccer matches were canceled. However, Oxford and Cambridge carried on with their annual cross-country competition at Wimbledon Common. As runners materialized out of the thick haze, the track marshals shouted continually, “This way, this way, Oxford and Cambridge.”

Since the smog seeped even inside closed buildings, movie theaters closed down as the yellow haze made it impossible for the audience to see the screen. The opera houses too put up their shutters as the audience could no longer see the performers on the stage due to the acrid smog.

The unparalleled admissions to hospitals and the great number of pneumonia reports overwhelmed the medical authorities.

Sadly, the Great Smog was not only a nuisance, it was also lethal for those with respiratory and cardiovascular problems, the elderly, the babies and the infants. Amidst coughing and the wheezing, death came silently to London. The smog literally choked thousands to death. Deaths from bronchitis and pneumonia increased more than seven-fold and the death rate in the East End increased ninefold.

Eventually, the siege abated on December 9, 1952, when cold winds from the west swept the toxic smog away from London and carried out to the North Sea. Yet, the detrimental effects lingered on, and death rates remained above normal into the summer.

Initial reports estimated that upwards of 4,000 died prematurely in the first week of the Great Smog. The mortality rate remained high for a couple of months after the Great Smog. People realized the impact of the deadly Smog when the undertakers ran out of caskets and the florists out of flowers and bouquets.

There were 12,000 unexplained deaths and additional deaths during the episode and in the two months after the abatement of the peak smog.

A preliminary report not finalized yet attributed these later deaths to an influenza epidemic. New evidence shows that only a fraction of the deaths could be from influenza.

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The lungs of the dead confirmed that they died due to prolonged exposure to black carbon.
The lungs of the dead confirmed that they died due to prolonged exposure to black carbon.

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Thorough examinations of the lungs of the dead confirmed that they died due to prolonged exposure to black carbon, a byproduct of burning coal and a short-term overexposure to a high concentration of fine particulate matter containing heavy metals.

Initially, the British government was reluctant to act in the wake of the Great Smog.

The Coalition for Clean Air calculated the concentration of pollution in London at the time. They concluded that it might have surpassed the current pollution in China by a large margin even though PM2.5 was not measured at the time. During the Great Smog, the concentration of sulfur dioxide was 190 times higher than the WHO standard.

Following the investigation, the British Parliament passed the Clean Air Act of 1956, which restricted the burning of coal in urban areas. The Act authorized local councils to set up smoke-free zones.

The public received grants to convert from coal stoves to alternative heating systems.

It took years, for London to transit from its primary source of heating coal to gas, oil, and electricity. During the transition period, deadly smogs occurred periodically, such as one that killed 750 people in 1962. But none of them reached the scale of the Great Smog that descended upon London on December 5, 1952.

In the 1960s, after the Great Smog in London, other countries began to reduce and control their use of coal.

Now, India, a country suffering from severe air pollution is also on a similar footing. Soon, India will become the world’s second largest consumer of coal. Yet, as of today, India has not yet set standards for emissions of important pollutants in its industries.

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Ebola Virus Disease (EVD) in the United States


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Myself . By T.V. Antony Raj

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Great Seal of the United States

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Today, Ebola virus disease (EVD) represents a major public health issue, not only in sub-Saharan Africa, where it originated, but also to the whole world.

Researchers believe that the index case of the current EVD epidemic was the death of a 2-year-old boy in the village of Meliandou, Guéckédou Prefecture, in the West African nation of Guinea.

Guinea’s local health officials reported the first cases of fever in February 2014. They diagnosed the early cases as other diseases more common to the area and not as Ebola.

On March 19, 2014, Reuters reported an outbreak of an undetermined haemorrhagic fever in Guinea.

On March 22, 2014, Guinea confirmed that the viral hemorrhagic fever that killed more than 50 people is Ebola. On the same day, Liberia reported two EVD cases.

On March 30, 2014, Sierra Leone reported suspected cases.

On April 4, 2014, a mob attacked the Ebola treatment center in Guinea. In Sierra Leone and Liberia healthcare workers faced hostility from fearful, suspicious people.

On June 17, 2014, Liberia’s capital Monrovia reported the first case of Ebola.

On July 27, 2014, Liberia closed its borders with neighbouring countries. Three days later, Liberia shut down all schools. It quarantined worse-affected communities using troops.

On August 2, 2014, a U.S. missionary physician infected with Ebola in Liberia was flown to Atlanta in the United States for treatment.

On August 5, 2014, a second U.S. missionary infected with Ebola was flown from Liberia to Atlanta for treatment.

On August 8, 2014, World Health Organization (WHO) declared Ebola as “international public health emergency.”

On August 15, 2014, Médecins Sans Frontières (MSF) or Doctors Without Borders said it would take about six months to control the epidemic.

On August 19, 2014, one of the two U.S. missionaries treated in Atlanta declared free of the virus was released from the hospital.

On August 21, 2014, the second U.S. missionary treated in Atlanta declared free of the virus was released from the hospital.

By September the epidemic accelerated in sub-Saharan Africa.

On September 3, 2014, a third U.S. missionary doctor infected with Ebola was flown from Liberia for treatment in Omaha, Nebraska.

On September 7, 2014, President Barack Obama said the United States needs to do more to help prevent Ebola from becoming a global crisis.

On September 8, 2014, a fourth Ebola patient was flown to Atlanta.

On September 9, 2014, WHO said at least 2,296 died out of 4,293 cases recorded in five countries.

On September 13, 2014, Liberia appealed to Obama for help fight Ebola.

On September 16, 2014, President Obama promised to send 3,000 military engineers and medical personnel to West Africa to build clinics and train healthcare workers.

Thomas Eric Duncan (Source: abcnews.go.com)
Thomas Eric Duncan (Source: abcnews.go.com)

On September 20, 2014, Thomas Eric Duncan, a Liberian, flew to the United States after trying to help a woman with Ebola in his home county. He flew from Liberia to Dallas in the United States via Brussels and Washington.

On September 25, 2014, Duncan went to the Texas Health Presbyterian Hospital Dallas with fever and abdominal pain. Despite telling a nurse that he travelled from West Africa, the hospital sent him back to the apartment where he was staying with antibiotics.

On September 28, 2014, Duncan returned to Dallas hospital by ambulance.

On September 30, 2014, U.S. Centers for Disease Control and Prevention (CDC) confirmed Duncan afflicted with Ebola. This was the first case diagnosed in the United States.

On October 2, 2014, NBC News said that Ashoka Mukpo, the American freelance cameraman in its employ, afflicted with Ebola will be flown to the United States for treatment.

On October 8, 2014, Duncan, the first person diagnosed with Ebola in the United States, died in Texas Health Presbyterian Hospital Dallas.

The United States government ordered five major airports to screen passengers from West Africa for fever.

On October 9, 2014, WHO said there is no evidence of the epidemic being brought under control in West Africa. Some lawmakers in the United States called for the ban of travelers from the West African countries hit hardest by Ebola.

On October 10, 2014, WHO raised the death toll to 4,033 out of 8,399 cases in seven countries. Most fatalities were in Liberia, Sierra Leone and Guinea.

On October 11, 2014, Medical teams at New York’s John F. Kennedy International airport began screening travelers for Ebola symptoms from three West African countries.

Ebola survivor Nina Pham appears at a press conference after she was discharged from the hospital on ct. 24, 2014. (Source: abcnews.go.com)
Ebola survivor Nina Pham appears at a press conference after she was discharged from the hospital on October 24, 2014. (Source: abcnews.go.com)

On October 12, 2014, Nina Pham the nurse who took care of Liberian, Thomas Eric Duncan, at Texas Health Presbyterian Hospital Dallas tested positive for Ebola. She became the first person to contract the virus in the United States. U.S. National Institutes of Health said nurse Pham will be moved from Dallas to a National Institutes of Health (NIH) isolation unit in Bethesda, Maryland.

Nurse Amber Vinson (Source: nbcnews.com)
Nurse Amber Vinson (Source: nbcnews.com)

On October 15, 2014, officials said that Amber Vinson, a second Texas nurse who treated Duncan had contracted Ebola. She was treated at Emory University Hospital in Atlanta. Authorities said Vinson took a flight from Cleveland to Dallas/Fort Worth International Airport while running a slight fever.

On October 16, 2014, a U.S. congressional subcommittee sharply questioned health officials about the response to Ebola in the United States.

Dr. Craig Spencer (Source - nbcnews.com)
Dr. Craig Spencer (Source – nbcnews.com)

On October 17, 2014, The 33-year-old Dr. Craig Spencer, a New York doctor returned from Ebola-hit Guinea. Spencer, treated Ebola patients while working for MSF. After completing his work on October 12, 2014, he left Guinea two days later via Brussels, Belgium. He arrived at John F. Kennedy International Airport in New York City, on October 17, 2014. On his arrival, he did not exhibit any symptoms of the virus. The physician, who worked at Columbia Presbyterian Hospital, was checking his temperature twice a day. He had not seen any patients since his return.

On October 20, 2014, Emory University Hospital in Atlanta released an unidentified American who had contracted Ebola in Sierra Leone.

In Texas, 43 people were taken off Ebola watch lists. About 260 people were still being monitored in Texas and Ohio. United States issued stricter guidelines for health workers treating Ebola victims. Not to expose skin or hair.

On Tuesday, October 21, 2014, Dr. Spencer started feeling fatigued and sluggish though without a fever. That day, he visited a coffee stand and a meatball restaurant in Manhattan. The next day, he ran for three miles in his neighborhood, and took the subway to a bowling alley in Brooklyn. He was not symptomatic then.

On October 23, 2014, Spencer developed a fever, nausea, pain and fatigue in the morning. His fever spiked to 100.3 degrees Fahrenheit (about 38 Celsius). He tested positive for Ebola. He is the first case of the deadly virus in New York City and the fourth diagnosed in the United States.

Health officials cleared both the coffee stand and the bowling alley after assessing them. After closing the bowling alley on Thursday, they had the bar cleaned and sanitized as a precaution.

Spencer’s Manhattan apartment has been isolated and locked.

Spencer was in contact with a few people after he started exhibiting symptoms. Ebola is not contagious until someone has symptoms. Health officials said that three people – his fiancée and two friends – are on quarantine and monitored,

“They are all well at this time; none of them is sick,” said Dr. Mary Travis Bassett, New York City’s health commissioner.

Spencer also travelled on three subway lines. “At the time that the doctor was on the subway, he did not have fever… He was not symptomatic,” Bassett said. The chances of anyone contracting the virus from contact him are “close to nil,” she said.

Ebola spreads by direct contact with the body fluids of an infected person. The time between exposure to the virus and the development of symptoms of the disease is usually two to 21 days. Estimates based on mathematical models predict around 5% of cases might take greater than 21 days to develop the symptoms.

Dr. Craig Spencer is now lodged at New York’s Bellevue Hospital Center. He has been in isolation since emergency personnel took him there. It is one of the eight hospitals statewide designated by New York Governor Andrew Cuomo as part of an Ebola preparedness plan.

“We are as ready as one could be,” Cuomo said. New York state will be different from Texas he said.

“We had the advantage of learning from the Dallas experience,” he said, recalling the death of Liberian Thomas Eric Duncan on October 8, 2014, diagnosed with Ebola.

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Fatu Kekula: the Brave Ebola Lifesaver


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Myself . By T.V. Antony Raj

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The rampant spreading of the Ebola Virus Disease (EVD) in Liberia, has created a chaos in that country. As on October 18, 2014, out of the 4,665 patients diagnosed for Ebola in Liberia, 2,705 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 county has yet to report an EVD case.

Even before the outbreak of the Ebola virus, Liberia faced a health crisis. It had only 50 physicians in the entire country – one for every 70,000 citizens. In September 2014, the US Centers for Disease Control and Prevention (CDC) reported that some hospitals in Liberia had been abandoned, and the hospitals which were still functioning lacked basic facilities. They did not have running water, rubber gloves, and sanitizing supplies.

At the end of August 2014, the World Health Organization (WHO) stated that Liberia fell short of 1,550 beds to treat EVD patients. In September, a new 150-bed treatment clinic opened in the capital, 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.

The treatment of EVD in other parts of the country is more pathetic. To add to the woes, on October 12, 2014, Liberian nurses threatened a strike over wages.

Fatu Kekula, 22-year-old Liberian student nurse (Source: edition.cnn.com)
Fatu Kekula, 22-year-old Liberian student nurse (Source: edition.cnn.com)

Amidst this chaos comes the story of Fatu Kekula, a brave 22-year-old Liberian nursing student.  She took care of four relatives affected by the Ebola virus by herself. She managed to save three out of the four patients, she cared for. That is a whopping 25% death rate, far better than the estimated average Ebola death rate of 58% in Liberia. Now, her unique methods for survival are being taught all over West Africa.

In July 2014, Fatu’s father, Moses Kekula, experienced high blood pressure. She took him to the local hospital in Kakata. After admitting Moses, the crowded hospital provided a bed that had become free. At that time, none of Fatu’s family members knew that the previous occupant of the bed had died from EVD. Soon after, Moses showed symptoms of EVD. He developed a fever. He started vomiting and had diarrhoea. A few days later the authorities shut down the hospital because nurses started dying of EVD.

Fatu then took her father to Monrovia. Three hospitals turned him away because they were already filled over capacity. So, Fatu took her father back to Kakata and got him admitted in another hospital. There they said he had typhoid fever and did little for him. Frustrated, Fatu returned home with her father.

At home Moses infected three other family members: his wife Victoria (57), elder daughter Vivian (28), and nephew Alfred Winnie (14). Fatu was the only unaffected family member.

Fatu contacted their family doctor. But he refused to come to their home, fearing the possibility of getting infected. Taking the next best option, Fatu requested the doctor to for directions. She got the medicines and fluids prescribed by the doctor from a local clinic. Her training at the nursing school helped her create her own intravenous lines.

Fatu Kekula, 22-year-old Liberian student nurse  saved her father's life in this makeshift isolation ward in a spare unfinished room at home. - MCT
Fatu Kekula, 22-year-old Liberian student nurse saved her father’s life in this makeshift isolation ward in a spare unfinished room at home. – MCT

Fatu then began to take care of her father, mother, sister, and cousin, all by herself. She put her three patients – father, mother and cousin in makeshift isolation ward in a spare unfinished room at home.

Fatu Kekula, 22-year-old Liberian student nurse. She took all the precautions for avoiding contact by using layers of trash bags on her feet and hair. She wore rubber boots, four pairs of gloves, and a face mask. (Source: edition.cnn.com)
Fatu Kekula, 22-year-old Liberian student nurse. She took all the precautions for avoiding contact by using layers of trash bags on her feet and hair. She wore rubber boots, four pairs of gloves, and a face mask. (Source: edition.cnn.com)

She did not have personal protection equipment such as those white space suits and goggles used in Ebola treatment units. She invented her own protective gear. She came up with the trash bag method. She took all the precautions for avoiding contact by using layers of trash bags on her feet and hair. She wore rubber boots, four pairs of gloves, and a face mask.

She fed her patients, gave them medicines, and cleaned them, all by herself day in and day out. It is a miracle that Fatu herself was not infected in the two weeks she was taking care of her family though she was in close contact with them.

On August 17, 2014, space became available at John F. Kennedy Medical Center, the national medical center of Liberia, located in the Sinkor district of Monrovia. Fatu’s father, mother, and sister recovered, but her cousin Alfred Winnie succumbed to the disease at the hospital the following day.

Fatu Kekula’s father is trying to find a scholarship for her that so she can finish her final year of nursing school. He has no doubt his daughter will go on to save more lives in the future.

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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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