The fight against Ebola in West Africa.
:Photo © EC/ECHO/Jean-Louis Mosser

How to deal with the largest Ebola outbreak ever

West Africa faces the largest Ebola outbreak ever recorded. The WHO declared the current Ebola outbreak a Public Health Emergency of International Concern and considers it ethical to offer unproven interventions.

The current Ebola outbreak in West Africa was declared a Public Health Emergency of International Concern (PHEIC) by the World Health Organization (WHO) on 8 August 2014. A Public Health Emergency of International Concern is defined as "an extraordinary event which is determined to constitute a public health risk to other States through the international spread of disease and to potentially require a coordinated international response".

The WHO rating of the Ebola outbreak as a Public Health Emergency of International Concern was justified as follows: Firstly, there is a very large number of cases and deaths. Secondly, these cases are widely distributed, and this is a quite severe disease, but importantly, one of the critical parts is that community transmission goes on. 

Is it ethical to offer unproven interventions?

Over the past decade, research efforts have been invested into developing drugs and vaccines for the Ebola virus disease. Some of these have shown promising results in the laboratory, but they have not yet been evaluated for safety and efficacy in human beings. The large number of people affected by the 2014 West Africa outbreak, and the high case-fatality rate, have prompted calls to use investigational medical interventions to try to save the lives of patients and to curb the epidemic.

WHO announced on 12 August 2014 that in the particular circumstances of this outbreak it is ethical to offer unproven interventions with as yet unknown efficacy and adverse effects, as potential treatment or prevention.

Largest Ebola outbreak ever recorded

The Ebola outbreak began in Guinea in December 2013. The outbreak now involves transmission in Guinea, Liberia, Nigeria, and Sierra Leone. This is currently the largest Ebola outbreak ever recorded. In response to the outbreak, a number of unaffected countries have made a range of travel-related advice or recommendations.

Ebola is a severe acute viral illness often characterised by the sudden onset of fever, intense weakness, muscle pain, headache and sore throat. This is followed by vomiting, diarrhoea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding. Ebola spreads in the community through human-to-human transmission, with infection result-ing from direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other body fluids of infected people, and indirect contact with environments contam-inated with such fluids.

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