L5.03: Background on the Problem


View the National Geographic video about a Doctors Without Borders Ebola clinic in Monrovia, the capital of Liberia. Read: "Liberia: Ebola clinic fills up within hours of opening" about Monrovia's desperate shortage of available beds for those struck by the vicious Ebola virus. Sick and dying people have been sent to holding areas because the Ebola Treatment Unit beds in the city are full.

Ebola Virus Disease (EVD)

The following summary of the Ebola disease is from the US Centers for Disease Control and Prevention and World Health Organization.

The Ebola virus causes an acute, serious illness which is often fatal if untreated. Ebola virus disease (EVD) first appeared in 1976 in 2 simultaneous outbreaks, one in Nzara, Sudan, and the other in Yambuku, Democratic Republic of Congo. The latter occurred in a village near the Ebola River, from which the disease takes its name.

The number of recent EVD cases is growing faster than the abilities of West Africa health officials to handle them. In the three hardest hit countries, Guinea, Liberia and Sierra Leone, the number of new cases is growing faster than the capacity to manage them in the Ebola-specific treatment centers. Ebola treatment centers are being established to provide comprehensive care to people diagnosed with EVD.

The current outbreak in West Africa is the largest and most complex Ebola outbreak since the Ebola virus was first discovered in 1976. There have been more cases and deaths in this outbreak than all others combined. It has also spread between countries, starting in Guinea and then spreading across land borders to Sierra Leone and Liberia, by air (1 traveler only) to Nigeria, and by land (1 traveler) to Senegal.

The most severely affected countries, Guinea, Sierra Leone, and Liberia, have very weak health systems, lacking human and infrastructural resources, having only recently emerged from long periods of conflict and instability. On August 8, the WHO Director-General declared this outbreak a Public Health Emergency of International Concern.


It is thought that fruit bats are natural Ebola virus hosts. Ebola is introduced into the human population through close contact with the blood, secretions, organs, or other bodily fluids of infected animals such as chimpanzees, gorillas, fruit bats, monkeys, forest antelope, and porcupines found ill or dead or in the rainforest.

Ebola then spreads through human-to-human transmission via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e.g. bedding, clothing) contaminated with these fluids. Health-care workers have frequently been infected while treating patients. This has occurred through close contact with patients when infection control precautions are not strictly practiced. Burial ceremonies in which mourners have direct contact with the body of the deceased person can also play a role in the transmission of Ebola.

Control relies on effective case management, surveillance and contact tracing, a good laboratory service, safe burials and social mobilization. Community engagement is key to successfully controlling outbreaks. Raising awareness of risk factors for Ebola infection and protective measures that individuals can take is an effective way to reduce human transmission. Risk reduction messaging focuses on several factors:

  • Reducing the risk of wildlife-to-human transmission from contact with infected fruit bats or monkeys/apes and the consumption of their raw meat. Animals should be handled with gloves and other appropriate protective clothing. Animal products (blood and meat) should be thoroughly cooked before consumption.
  • Reducing the risk of human-to-human transmission from direct or close contact with people with Ebola symptoms, particularly with their bodily fluids. Gloves and appropriate personal protective equipment should be worn when taking care of ill patients at home. Regular hand washing is required after visiting patients in hospital, as well as after taking care of patients at home.
  • Outbreak containment measures including prompt and safe burial of the dead, identifying people who may have been in contact with someone infected with Ebola, monitoring the health of contacts for 21 days, the importance of separating the healthy from the sick to prevent further spread, and the importance of good hygiene and maintaining a clean environment.

Ebola Story Map—Explore Ebola Outbreaks 1976-2014

Story maps combine interactive maps and multimedia content into elegant and informative user experiences. They make it easier to harness the power of maps to tell a story. Story maps are designed for general, non-technical audiences. However, story maps can also serve highly specialized audiences. They can summarize issues for managers and decision makers. They can help departments or teams within organizations to communicate with their colleagues.