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Sierra Leone still is recovering from a decade of civil war in which children were forced into fighting. Liberia, originally founded by freed American slaves, also endured civil war in the 1990s. Guinea is trying to establish a young and fragile democracy.
Nigeria, Africa’s most populous country, boasts great oil wealth but most of its people are poor. The government is battling Islamic militants in the north who have killed thousands of people and kidnapped more than 200 schoolgirls in April.
This outbreak has proved more difficult to control than previous ones because the disease is crossing national borders, and is spreading in more urban areas.
Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, predicts that within a few weeks, Ebola will sicken more people than all previous occurrences combined. Already more than 1,700 cases have been reported.
Global health officials say it will take months to fully contain the outbreak, even if all goes as well as can be hoped.
Reasons not to be afraid • Ebola is devastating for those it affects. But most people don’t need to fear it. Why?
• Ebola doesn’t spread easily, the way a cold virus or the flu does. It is only spread by direct contact with bodily fluids such as blood, saliva, sweat and urine. Family members have contracted it by caring for their relatives or handling an infected body as part of burial practices. People aren’t contagious until they show symptoms, Frieden said. Symptoms may not appear until 21 days after exposure.
"People should not be afraid of casual exposure on a subway or an airplane," said Dr. Robert Black, professor of international health at Johns Hopkins University.
• Health officials around the developed world know how to stop Ebola. Frieden described tried-and-true measures: find and isolate all possible patients, track down people they may have exposed, and ensure strict infection-control procedures while caring for patients. Every past outbreak of Ebola has been brought under control.
The CDC is sending at least 50 staff members to West Africa to help fight the disease, while more than 200 work on the problem from the agency’s headquarters in Atlanta. The WHO is urging nations worldwide to send money and resources to help.
• It’s true that Ebola could be carried into the United States by a traveler, possibly putting family members or health care workers at risk. It’s never happened before. But if the disease does show up in the U.S., Frieden said, doctors and hospitals know how to contain it quickly.
"We are confident that a large Ebola outbreak in the United States will not occur," Frieden told a congressional hearing Thursday.
Other things to worry about • Ebola’s toll is minuscule compared with other diseases that are killing millions of people.
"The difference is the diseases that do kill a lot of people — malaria, diarrhea, pneumonia — they cause their problems over time," Black said. "They’re not generally epidemic. They’re not the kind of sudden burst of disease and death that creates fear like this."
The common diseases have far lower mortality rates. They kill so many people because such huge numbers are infected.
In comparison, Ebola is manageable.
"The order of magnitude of the resources to control Ebola in small communities in three or four countries is very small compared to controlling malaria in all of Asia and Africa," Black said. "I don’t at all think we should hold back on the resources to control Ebola, but we need more resources to control these major killers of children and adults that we’re making too little effort against."
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