WHO declares Ebola epidemic an international health emergency

West Africa's Ebola epidemic is an "extraordinary event" and now constitutes an international health risk, the World Health Organization (WHO) said on Friday. The Geneva-based UN health agency said the possible consequences of a further international spread of the outbreak, which has killed almost 1,000 people in four West African countries, were "particularly serious" in view of the virulence of the virus.

"A coordinated international response is deemed essential to stop and reverse the international spread of Ebola," the WHO said in a statement after a two-day meeting of its emergency committee on Ebola. The declaration of an international emergency will have the effect of raising the level of vigilance on the virus. "The outbreak is moving faster than we can control it," WHO's Director-General Margaret Chan told reporters on a telephone briefing from the agency's Geneva headquarters.

"The declaration ... will galvanise the attention of leaders of all countries at the top level. It cannot be done by the ministries of health alone."

India on alert
Indian authorities are on alert for the Ebola virus, Health Minister Harsh Vardhan said, suggesting there is a risk the virus could be imported into the country if the large population of Indians working in the four affected West African nations returns. There are nearly 45,000 Indians living and working in Guinea, Liberia, Sierra Leone and Nigeria - where an outbreak of the disease has killed 932 people - the health minister told Parliament on Wednesday.

The agency said that, while all states with Ebola transmission - so far Guinea, Liberia, Nigeria and Sierra Leone - should declare a national emergency, there should be no general ban on international travel or trade.

Ebola has no proven cures and there is no vaccine to prevent infection, so treatment focuses on alleviating symptoms such as fever, vomiting and diarrhoea - all of which can contribute to severe dehydration.

Keiji Fukuda, the WHO's head of health security, stressed that with the right measures to deal with infected people, the spread of Ebola - which is transmitted through direct contact with bodily fluids - could be stopped.

"This is not a mysterious disease. This is an infectious disease that can be contained," he told reporters. "It is not a virus that is spread through the air."

Fukuda said it was important that anyone known to have Ebola should be immediately isolated and treated and kept in isolation for 30 days. "Based on scientific studies, people who have infection can shed virus for up to 30 days," he said.

The current outbreak, in which at least 1,711 people have so far been infected, of whom 932 have died, is the most severe in the almost 40 years since Ebola was identified in humans.

The WHO said this was partly because of the weakness of the health systems in the countries currently affected, which lacked human, financial and material resources.

It also said inexperience in dealing with Ebola outbreaks and misperceptions of the disease, including how it is transmitted, "continue to be a major challenge in some communities".

"If we do not in global solidarity come together to help these countries, they will be set back for many years," Chan said. She noted the three hardest-hit nations had only begun to emerge and rebuild after "years of conflict and difficulties".

Although most cases of Ebola are in the remote area where Guinea borders Sierra Leone and Liberia, alarm over the spread of the disease increased last month when a US citizen died in Nigeria after travelling there by plane from Liberia.

After an experimental drug was administered to two US charity workers who were infected in Liberia, Ebola specialists urged the WHO to offer such drugs to Africans. The UN agency has asked medical ethics experts to explore this option next week.

David Heymann, a former WHO official and now director of the Chatham House Centre on Global Health Security, who this week urged the WHO to show greater leadership and to consider allowing the use of experimental drugs for Africans affected by Ebola, said governments should step up their response.

The major message, he said, was that the three known measures that stop Ebola outbreaks - hospital infection control, community understanding of risks of infection, and contact tracing - "appear not to have been robustly enough applied".

"Governments appear to not have been engaged as necessary," he said in an emailed response to the WHO's statement.

India on alert as thousands of nationals in West Africa

Indian authorities are on alert for the Ebola virus, the health minister said, suggesting there is a risk the deadly virus could be imported into country if the large population of Indians working in the four affected West African nations returns.

There are nearly 45,000 Indian nationals living and working in Guinea, Liberia, Sierra Leone and Nigeria - where an outbreak of the disease has killed 932 people - Health Minister Harsh Vardhan told Parliament on Wednesday.

"If the situation worsens in the affected countries, there could be possibility of these Indians travelling back to India," Vardhan said. "While the risk of Ebola virus cases in India is low, preparedness measures are in place to deal with any case of the virus imported to India."
EBOLA A PRIMER
Ebola virus disease (EVD) has no proven cures and there is no vaccine. Treatment focuses on alleviating symptoms
KEY FACTS

• Fatality rate of up to 90%
• Outbreaks occur primarily in remote villages in Central and West Africa, near tropical rainforests
• Fruit bats of the Pteropodidae family considered natural host of virus

SYMPTOMS

• Sudden onset of fever, intense weakness, muscle pain, headache and sore throat
• Followed by vomiting, diarrhoea, rash, impaired kidney and liver function
• Sometimes there is internal and external bleeding

REDUCING INFECTION RISK IN PEOPLE

• Reduce contact with infected fruit bats or monkeys/apes and consumption of their raw meat
• Handle animals with gloves and other protective clothing
• Avoid close contact with infected patients
• Wear gloves and personal protective equipment when taking care of patients
• Wash hands after visiting patients
• Maintain basic hand and respiratory hygiene
• Use safe injection practices and safe burial practices

TRANSMISSION

• Introduced into humans through close contact with blood, secretions, organs or bodily fluids of infected animals
• Infection due to direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or bodily fluids
• Indirect contact with environments contaminated with such fluids
• Burial ceremonies in which mourners have direct contact with the body can also play a role
• Men who have recovered from the disease can still transmit the virus through semen for up to 7 weeks after recovery