Ebola and other viral haemorrhagic fevers

The ongoing Ebola outbreak in West Africa is the largest and most complicated that the world has even seen. Since it was first identified in the forested regions of south eastern Guinea in March,1 it has spread to Liberia, Sierra Leone, and Nigeria and has now been declared a “public health emergency of international concern” by the World Health Organization.2

Ebola virus is one of a group of zoonotic viruses that can cause severe disease in humans.3 4 5 Viruses that cause viral haemorrhagic fever include Lassa virus, Crimean-Congo haemorrhagic fever virus, Marburg virus, and emerging ones such as Lujo virus. These viruses are of particular public health importance because of their ability to spread to carers and healthcare workers, the often high case fatality rate, difficulties in their rapid recognition, and the lack of effective specific treatments.3 4 5 6

The current epidemic is caused by the Zaire strain of Ebola virus, which has a mortality of 50-90% in endemic settings. No licensed cure or vaccine is available, although research is in progress to develop these and two American healthcare workers are reported to have received an experimental monoclonal antibody preparation after acquiring Ebola virus infection in Liberia.7 The keys to case management are early recognition and isolation of cases, use of personal protective equipment, and …