Jane Apunyo, head nurse at an Ebola treatment center in Mubende, Uganda, last week. Badru Katumba/Agence France-Presse — Getty Images

The first major Ebola outbreak in Uganda happened when I was a medical student at Makerere University in Kampala. A professor of virology explained to us the dangers of filoviruses, the virus family Ebola belongs to, and why they should be avoided at all costs.

Seven years later, in 2007, I was a newly minted military officer, detailed to respond to a new Ebola outbreak near the border of Uganda and the Democratic Republic of Congo, where I saw this danger firsthand.

It’s one thing to learn about the virus in medical school, but it’s another to travel deep into a remote area to face a deadly scourge.…  Seguir leyendo »

Durante los últimos diez años, la ayuda externa en materia de salud para países de África del oeste se ha visto incrementada en el contexto de los Objetivos de Desarrollo Sostenible, sin embargo la mayor parte de esta ayuda se ha destinado a combatir el VIH-SIDA, la malaria y la tuberculosis, y una parte de lo que quedaba ha ido a la salud materno infantil. Por tanto, la ayuda destinada para apoyar el desarrollo general de los sistemas de salud ha sido escasa. Esta falta de inversión fue determinante en el control del brote de ébola de 2014. Un sistema sólido disminuye la vulnerabilidad de un país y asegura un alto nivel de preparación para mitigar el impacto de cualquier crisis.…  Seguir leyendo »

“We are monitoring everybody that comes in and out of our community, and if we don’t know them we track them carefully and take their temperature,” said Kou Gbaintor-Johnson, a local activist in the Liberian capital of Monrovia, as she showed me a clipboard with the names and telephone numbers of people who had entered her neighborhood. She explained that she and other volunteers worked “day and night” to keep up their monitoring efforts.

That was in the fall of 2014, weeks after the peak of the Ebola epidemic that ultimately claimed almost 5,000 lives in the country. Yet by the end of the crisis, Kou’s township, population 17,000, had registered just two cases and a single death.…  Seguir leyendo »

A nurse prepares a vaccine against Ebola in Goma in August 2019. Photo: Getty Images.

The world’s second-largest Ebola outbreak is ongoing in the Democratic Republic of the Congo (DRC) and experts from around the world have been parachuted in to support the country’s operation to stamp out the outbreak. The signs are encouraging, but we need to remain cautious.

In such emergencies, little thought is usually given to what happens to the body-fluid samples taken during the course of the outbreak after the crisis is over. What gets left behind has considerable implications for global biosecurity.

Having unsecured samples poses the obvious risk of accidental exposures to people who might come into contact with them, but what of the risk of malicious use?…  Seguir leyendo »

Ha pasado un año desde que el ministerio de salud de la República Democrática del Congo declarara un nuevo brote de ébola en el noreste del país. Sin embargo, lejos de haber sido contenido, este brote se ha convertido en el segundo en cinco años en la RDC en ser clasificado por la Organización Mundial de la Salud como una Emergencia de Salud Pública de Importancia Internacional, la designación más grave (usada solo cuatro veces en el pasado) que la OMS puede hacer. Es el segundo mayor brote de ébola jamás registrado.

Hay disponible una vacuna experimental muy eficaz contra el ébola, y los equipos desplegados en terreno se están esforzando por controlar el virus.…  Seguir leyendo »

Workers wearing protective clothing bury Agnes Mbambu, who died of Ebola. The 50-year-old grandmother of a 5-year-old boy who became Ebola's first cross-border victim, lived in the village of Karambi, near the border with Congo, in western Uganda. (Ronald Kabuubi/AP)

Public health authorities have recorded more than 2,000 cases in the ongoing Ebola outbreak in eastern Congo. Last week, a 5-year-old boy died of Ebola in neighboring Uganda, signifying the outbreak has spread across the border. The latest update published by the World Health Organization (WHO) suggests the Congolese outbreak is not close to ending — the number of new cases is actually on the rise.

This is the second-deadliest Ebola outbreak on record. In the 2014-2016 Ebola epidemic in West Africa, health authorities recorded more than 28,000 cases, and more than 11,000 people died.

Why has the current Congolese outbreak been so challenging for the government and other stakeholders to contain?…  Seguir leyendo »

Why Couldn’t My Ebola Treatment Center Save This Baby?

A young mother stepped out of the ambulance into the triage area of our Ebola Transit Center, here in the northeast of the country. She moved slowly, careful not to wake the sick baby, swathed in layers of linens, that she carried in her arms. They had been brought here for testing because health workers suspected the baby might have Ebola.

We are six months into this latest Ebola outbreak. It is the worst on record for the Democratic Republic of Congo, and the second largest ever, after the 2014-2016 epidemic in West Africa. We’ve come a long way since then.…  Seguir leyendo »

What to Know About the Ebola Outbreak in the Democratic Republic of Congo

On 9 May, a cluster of undiagnosed illness and deaths in a remote location in the north of the Democratic Republic of Congo (DRC) was reported to the World Health Organization (WHO). Several individuals tested positive for Ebola (Zaire subtype) a few days later. As of 19 May, 29 confirmed and suspected cases, including three deaths, had been reported. With the wounds of the West African Ebola outbreak that killed more than 11,000 between 2014 and 2016 still fresh, the rapidly evolving situation in northern DRC is likely to cause unease locally, nationally and internationally.

Here are six things to understand about this new outbreak:

  1. The potential for international spread is limited.
…  Seguir leyendo »
President Ellen Johnson Sirleaf of Liberia, center, surrounded by heavy security visiting to quarantined neighborhood in Monrovia, Liberia, in 2014. Credit Daniel Berehulak for The New York Times

One of the saddest stories of this year has been the death of Salome Karwah, a Liberian health worker who was featured on the cover of Time magazine as a fighter in the 2014 Ebola epidemic.

She lost most of her family to the disease. She was also infected, but she recovered to return to the clinical front lines to care for hundreds of other patients. Earlier this year in Monrovia, the capital of Liberia, she died from complications of childbirth.

Her death draws new attention to the governing structure in Liberia. The scope of the dysfunction that Ebola revealed is beyond what can be chalked up simply to being a weak state in West Africa.…  Seguir leyendo »

A man walks past a billboard to educate Liberians about the treatment of Ebola in Monrovia on July 10, 2015. (Ahmed Jallanzo/European Pressphoto Agency)

Liberia was finally declared Ebola-free a year ago this month. The 2013-2015 outbreak wreaked havoc on the lives of thousands of Liberians, infecting at least 10,675 and killing 4,809. Many more were affected: 4 in 10 Liberians reported having a relative or close friend die during the outbreak.

During Liberia’s epidemic, analysts pointed to multiple obstacles blocking effective response: inadequate health facilities and resources, citizens’ mistrust of government, and the slow international response. There were questions about whether the Ebola outbreak would have severe consequences for Liberia’s already embattled government, leaving citizens even more distrustful of government and its ability to protect and provide for them.…  Seguir leyendo »

The Red Queen has to keep running just to stay where she is. Wikimedia Commons

Scientists know that Ebola can cause anything from severe hemorrhagic fever to no symptoms at all (asymptomatic infections). What wasn’t known, until now, is the number of people who experienced asymptomatic infections during the 2013-2016 outbreak of Ebola in West Africa.

This is not the first report of potential asymptomatic cases of Ebola. About one in five people who came into contact with individuals infected during the 1976 outbreak in Sudan had detectable antibodies against Ebola but had not been ill. A 2005-2008 survey of the public in Gabon, which had its first outbreak of Ebola in 1994, suggested 15% had been infected with Ebola but did not show symptoms.…  Seguir leyendo »

Ebola was a brutal wake-up call not only for people across West Africa, but also for the global health community whose job it is to prevent such disastrous outcomes. The United Nations, nonprofit organizations and foreign governments all promised to do better next time.

The first good sign came on February 1, when the World Health Organization declared Zika a public health emergency of international concern, rather than waiting many more months as it had during the Ebola epidemic.

But global health experts have forgotten an even more important lesson in the fight against Ebola: Don't just act, listen.

During the Ebola outbreak, millions were spent to develop and deliver simple, generic messages about the disease and how to mitigate infection rates.…  Seguir leyendo »

A Scottish nurse infected with Ebola in Sierra Leone last year is now back “in a serious condition” nine months after doctors said she had made a full recovery. Although the exact nature of the condition has not been reported, Pauline Cafferkey’s doctors have detected the Ebola virus and moved her to a specialist isolation unit in London.

The virus is thought to be a re-emergence of her original infection as it is extremely unlikely she was infected again while at home in the UK. Her move to containment is being treated as a cautionary procedure, she is not thought to be contagious and the risk to the public is very low.…  Seguir leyendo »

Yo era un joven médico asignado a la Unidad de Emergencias del Hospital de Niños Ola During, en Sierra Leona, cuando tuve que aconsejar a la madre de una niña gravemente enferma de malaria que dijera una mentira flagrante. Su hija Mariama, de cuatro años, necesitaba una transfusión de sangre para no morir, pero la madre no tenía dinero para pagar las pruebas de detección de infecciones y compensar al donante. Yo había visto a muchos niños morirse mientras sus padres buscaban desesperadamente los fondos necesarios.

Decidido a salvar la vida de Mariama, dije a la madre que volviera a casa y anunciara que su hija había muerto.…  Seguir leyendo »

As Sierra Leone waits for Ebola all-clear, its emotional scars will take longer to heal

Sierra Leone has just reported one week of zero confirmed Ebola infections – the first time since the deadly virus reached its border in May 2014. If there are no more infections for 42 days after the country’s last Ebola patient was discharged, the outbreak will be declared over. But the race to end West Africa’s Ebola epidemic is not just about getting to zero infections. It’s also about how the three countries most affected can deal with the broad humanitarian crisis the virus has left, which impacted livelihoods and led to food shortages, loss of education, widespread fear and mistrust in communities.…  Seguir leyendo »

Recent news from West Africa that the number of new Ebola cases continues to fall and that an Ebola vaccine appears to provide protection against infection is heartening. But focusing only on these positive developments overlooks the huge challenges that remain.

The West African epidemic, which has caused at least 11,298 deaths since it was first reported in Guinea in March 2014, is incredibly stubborn and has proved hard to control. With a grave shortage of health professionals in the region, the international community needs to remain committed to rebuilding health care systems in the wake of Ebola’s destruction.

So much of what I hear about Ebola in West Africa is wrong.…  Seguir leyendo »

One year ago West Africa was descending into chaos. As the Ebola death toll approached 1,000 for the first time ever and Liberia closed its borders, the World Health Organization declared the situation an international health emergency. Experimental drugs were cautiously put to use to try to treat those infected, but what was urgently needed to stop the spread was a vaccine. Now, 12 months on, it looks very much like we have one.

Interim results published Friday in the medical journal the Lancet provide clear evidence that the rVSV-ZEBOV candidate vaccine currently undergoing phase 3 trials – the final phase before vaccines can be licensed – is not only safe in the short-term, but also highly effective at protecting people from the Ebola virus circulating in Guinea.…  Seguir leyendo »

For more than a year and a half, three of the world’s poorest countries have struggled against the most devastating Ebola epidemic in human history. Containing this unprecedented outbreak would have been a huge challenge for Guinea, Liberia and Sierra Leone under any conditions. But the scale of the task was far greater because of the absence of the most effective possible defence: a vaccine.

That may all be about to change. I normally like to avoid superlatives when describing the interim results of a medical trial, but it is difficult to talk about the report of the experimental Ebola vaccine in the Lancet as being anything less than spectacular.…  Seguir leyendo »

A billboard aimed at educating Liberians about the treatment of Ebola, in Monrovia, Liberia, on July 10. (Ahmed Jallanzo/European Pressphoto Agency)

Crisis often generates a tension between fear and compassion. Much of the reaction to Ebola in the United States last year was evidence of fear trumping compassion. We saw public health policy being guided by fear rather than by the best available science. We observed sufferers of Ebola — and even healthy individuals who simply volunteered to fight the virus — being treated not like victims or heroes but criminals and threats to the public. These attitudes broke my heart, not just for the casualties of this public attitude but also for the public itself.

When we discriminate against those for whom we ought to have compassion, we lose our sense of empathy.…  Seguir leyendo »

When President Obama and his fellow Group of Seven leaders meet in Germany beginning today, Ebola will be on the agenda. The leaders will talk about the need to wipe out the relatively small number of remaining cases in West Africa, as well as the need for aid to rebuild the ravaged nations of the region. Both steps are critical.

But neither will address what should be our No. 1 lesson from the Ebola crisis: the need for substantial measures to keep us safe from the pandemic on the horizon, a catastrophic event that is inevitable if we don’t move quickly to prevent it.…  Seguir leyendo »