The Ebola epidemic in West Africa has infected more than 1,700 people and killed almost 950 victims. It has now been officially declared out of control, with the World Health Organisation meeting to ascertain whether it constitutes a "public health emergency of international concern" (PHEIC). 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 declaration of an Ebola PHEIC would lead to the imposition of travel and trade restrictions in the region.
The epidemic began in Guinea, where most deaths have occurred and has spread to Liberia, Sierra Leone and Nigeria. With cases confirmed in Lagos and the outbreak overwhelming local health resources in Liberia and Sierra Leone, further spread is almost certain.
A type of haemorrhagic fever, Ebola virus first emerged in 1976 in what is now the Democratic Republic of Congo. There have been several major outbreaks since then with the most severe registering fatality rates in the region of 90 per cent. With a natural reservoir in rainforests, most likely involving fruitbats, Ebola infects humans when they handle the blood and other bodily fluids of infected animals. The disease then spreads by human to human transmission, when blood and other secretions from an infected person enter the next victims broken skin or mucous membranes.
As a virus, Ebola cannot be treated with antibiotics; efforts to manage it are focused on the development of a vaccine. In the current epidemic, control will eventually be achieved through painstaking public health measures. This requires a level of infrastructure not usually present in the countries affected and so must be the major focus of international aid efforts. It also requires heroic care from local and international healthcare workers in the face of an extremely dangerous pathogen. The WHO must institute whatever measures are needed to stop cross-border infection.