Ebola outbreak: what to expect

A Pan-African airline has suspended all flights to and from the capitals of Liberia and Sierra Leone, as fears grow of the spread of the Ebola virus

Professor Tom Solomon, Head of the Institute of Infection and Global Health and Director of the National Institute for Health Research’s (NIHR) Health Protection Unit in Emerging and Zoonotic Infections, discusses here what to expect from this outbreak.

1. Why is Ebola a cause for concern?

“Ebola is worrying because it is not completely clear how humans become infected in the first place at the start of an outbreak.  It can spread from human to human and the death rate depends on the subtype of Ebola virus, but it can be up to 90%, making it one of the most severe infections of humans.”

2. How does it spread?

“Research suggests the virus exists naturally in some fruit bats, and that humans can become infected directly from the bats, perhaps through exposure to bat blood, or other bodily fluids excreta – faeces and urine.

“Humans may also become infected by contact with blood or bodily fluids of monkeys, or by consuming ‘bush meat’, that may have become infected through contact with bats.

“Once the first person has become infected, then others are at risk, because the virus is excreted in a patient’s blood and other bodily fluids. Family members and health care workers looking after patients are especially at risk.

“In the early outbreaks the lack of precautionary and protective measures and the reuse of non-sterilised needles contributed to the rapid spread.  Some traditional burial customs, whereby all mourners touch the body, also causes the virus to spread, because the virus may be on the skin.”

3.  What can we do to treat it?

“There is no antivirus drug to treat Ebola. If we can keep people alive through replacing lost fluids, however, by oral or intravenous rehydration, then this gives their body the best chance of fighting the infection itself. There is currently no vaccine to protect people.”

4.  Is this outbreak different to others and if so, how?

“This outbreak is different to others in several respects. Firstly it is larger than previous outbreaks.  More than 670 people have died. Secondly it appears to be spreading between different geographical places more easily than other outbreaks.  So far it has spread from Guinea to Sierra Leone, Liberia, and now Nigeria.”

5.  How likely is it that Ebola will mutate into something that can spread more easily?

“There is nothing to suggest this so far. The current outbreak is caused by Ebola Zaire strain, which is the most dangerous strain of the virus.”

6. What are researchers in the UK doing to protect us?

“The NIHR Health Protection Research Unit in Emerging and Zoonotic Infections was established by the UK Government in April 2014 to help protect us from infections like Ebola. It is a collaboration between researchers from the University of Liverpool’s Institute of Infection and Global Health, the Liverpool School of Tropical Medicine, and Public Health England.

“Members of the Health Protection Research Unit are currently helping to fight the Ebola outbreak in Africa, as well as doing research to try and better understand why this outbreak is especially bad.

“The Health Protection Research Unit’s virologists are doing research to understand what makes particular strains of Ebola more severe. The Unit’s epidemiologists and modelers are working together to understand the factors involved in its spread, and the risks to the UK.”