It hits suddenly with a fever, headache and a sore throat. Patients’ muscles ache but they feel to weak, too tired to move them much. Soon those symptoms are joined by vomiting and diarrhea with impaired kidney and liver function.
Less commonly, blood will appear next — in places like their eyes, nose, rectum, vomit or IV puncture marks — as the haemorrhagic part of the disease causes bleeding both internally and externally.
That blood, along with the rest of the patient’s bodily fluids, are thick with the virus and ripe for transmission if contact occurs. Most patients who contract Ebola will die and the disease has a historic case-fatality risk of up to 90 per cent. With no cure or vaccine, medical workers can only treat the symptoms.
The current outbreak in Guinea, Liberia and Sierra Leone has killed about 70 per cent of patients so far, with more than 670 people now dead out of over 1,200 reported cases.
For doctors on the ground, such as those from Médecins Sans Frontières/Doctors Without Borders (MSF), stopping the spread of the disease is paramount.
Patients are contagious once they start showing symptoms, which can take anywhere from two to 21 days from when they made contact with the virus. Ebola doesn’t spread easily the way flu does, through the air. It takes direct contact with bodily fluids which is why medical workers and family members of patients are most at risk.
Organizations like MSF have set up specialized Ebola clinics in places like Conakry, the capital of Guinea. These are set up to both treat patients and keep workers and the surrounding community safe.
A diagram showing how Médecins Sans Frontières set up an Ebola clinic in Guinea’s capital, Conakry.
Clinics are high-risk, isolated zones with strict entry and exit protocol that limits how many workers can be inside at once and how long they can stay for.
Staff entering the clinic must wear full protective gear, including boots, medical gowns, aprons, hoods, masks and two layers of gloves. They and their equipment are chemically disinfected when they leave the isolation area and anything that can’t be disinfected is incinerated.
A picture taken on July 24, 2014 shows protective gear including boots, gloves, masks and suits, drying after being used in a treatment room in the ELWA hospital in the Liberian capital Monrovia. (ZOOM DOSSO/AFP/Getty Images)
Within the wards, MSF uses a buddy system for staff so they monitor one another for fatigue and mistakes. Staff are rotated every four to six weeks so prevent burnout.
Needles present a risk because they can poke through the protective gear, so oral medication is used when possible. In 2009, a researcher in Germany who was injected mice with Ebola accidentally pricked herself with a needle. She was administered an experimental vaccine produced by Canada’s National Microbiology Lab in Winnipeg. The virus never manifested itself in the researcher, though it’s still unclear whether the vaccine worked or she simply hadn’t contracted the disease.
Despite the precautions, a Liberian doctor named Dr. Samuel Brisbane has died after treating patients at the John F. Kennedy Memorial Medical Center in Monrovia. Two Americans have also contracted the disease, a missionary worker and Dr. Kent Brantly, who had also been treating patients in Liberia. His condition has been reported as “grave” by the Associated Press.
Even once health workers arrive back home with no symptoms, MSF asks staff so stay within a short driving distance of a hospital that’s equipped to test and isolate an Ebola patient — just in case.
A file photo taken on June 25, 2014 shows the isolation ward at the Donka Hospital in Conakry where people infected with the Ebola virus are being treated. (CELLOU BINANI/AFP/Getty Images)
Outside of the controlled environments of the clinic, there are greater challenges to containing the virus, many stemming from a distrust among some locals of Western doctors and medicine. As the New York Times reported earlier this week, villagers armed with machetes and slingshots have prevented health workers from entering.
Another source of transmission is from the bodies of the deceased, which can still transmit the virus. Burial traditions, such as washing the body, create a high risk of infection, the Washington Post reports. The bodies of those who die in clinics cannot be returned to loved ones for traditional burial, increasing the brewing distrust with health workers and leading some to the sick, putting yet more people at risk.
Because Ebola’s initial symptoms — fever, headache, sore throat and the like — are common to numerous less-lethal illnesses, like the common flu, those who are infected may not know they’re harbouring such a deadly infection until it’s too late.
A man reads a newspaper with a headline announcing government efforts to screen for Ebola at a newsstand in Lagos on July 27, 2014. (PIUS UTOMI EKPEI/AFP/Getty Images)
A Liberian government worker took a flight to Nigeria on July 20 and died of Ebola just five days later, illustrating how air travel presents the potential for the disease to travel outside of its current area. Liberia’s international airport in Monrovia is now screening passengers for symptoms with a police presence for enforcement. The airline the government worker flew on, ASKY, has also temporarily suspended service to Monrovia and Freetown in Sierra Leone.
For the minority of patients who do survive Ebola, they are considered noncontagious and free to go home once the virus stops appearing in fluid samples. The only lingering threat is in semen, where the virus can linger for another seven weeks, according to the World Health Organization.
Canadian doctor Marc Forget just finished seven weeks working with MSF in Guinea treating Ebola patients. He told Postmedia that although he’s witnessed horrific tragedy, its the survivors that keep workers motivated. He plans to return in October.
“I will join forces again,” he said. “This is an unprecedented Ebola outbreak, in terms of the numbers of people affected and geographic distribution. It’s the worst crisis we’ve ever had.”
With files from the Associated Press.
Photo: Screenshot 
