West Africans Worried About Ebola Outbreak

The deadly Ebola outbreak in the West African country of Guinea has reached the nation's capital. Now healthcare officials are scrambling for answers. Dr. Armand Sprecher explains.

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MICHEL MARTIN, HOST:

I'm Michel Martin and this is TELL ME MORE from NPR News. We'd like to stay on international affairs for a few more minutes and turn to West Africa, where an outbreak of the deadly Ebola virus has the country of Guinea on high alert. More than 60 people have died there. Officials say the disease has spread to the capital city of Conakry. Bats are thought to carry the virus, and officials have taken precautionary measures, like banning bat soup, which is a popular dish there. But despite that and other efforts, the death toll is still rising. We wanted to hear more about this, so we've called Dr. Armand Sprecher. He's a public health specialist and Ebola expert with Doctors Without Borders. Welcome. Thank you so much for joining us.

ARMAND SPRECHER: Glad to join you.

MARTIN: Dr. Sprecher, would you just begin by telling us a little bit about Ebola. And what is it, what are its symptoms and why is it so worrisome?

SPRECHER: Well, Ebola is not nearly as dramatic as Hollywood makes it out to be. It starts off with a fever and a general feeling of malaise and aches. It goes on to have vomiting and diarrhea, looking a lot like the flu. And then a couple days in, people will maybe have some bleeding around the guns or some blood showing up in the vomit or diarrhea. And then they get profoundly weak and go into a shock-like state, and many of them will die after that. That doesn't mean that it looks like you see it in Hollywood. It's not - there's no profuse bleeding or strange splotches or the like.

MARTIN: OK. I think we've got it. Thank you for that. I appreciate that. I think we've got enough to get the picture here.

SPRECHER: OK.

MARTIN: So is the concern about it that it's so contagious because as I understand it, when Ebola was kind of first identified back in 1976, that the virus is actually fairly easy to contain? So is this a matter of the fact that it's so virulent or is the fact that it's easily spread?

SPRECHER: It's an interesting question because it's - there are diseases that are easier to spread, like influenza. There are diseases that are more lethal, like rabies. It's some combination of that, that it is a disease that people are unfamiliar with, that has a very high likelihood of death, and that involves bleeding, which I guess it evokes some sort of a visceral response and that it - when it comes, it tends to kill people in groups of family or nearby people. It kills caregivers. And all of these things provoke a rather strong response from people that other diseases don't seem to generate.

MARTIN: There's no known cure or vaccine, but it has been treated and contained before. How does that work?

SPRECHER: Well, containing means going out into the communities and finding the cases and bringing them into a treatment unit that we construct that allows care to be given safely. And then we ask the cases who they came into contact with in the community while they were ill. And then we go and visit all of those people on a daily basis to keep an eye on them. As long as they're OK, we let them go about their business, but if they start getting ill, we bring them as well into the treatment unit. And that stops the spread of the virus and also gives the best opportunity to care for these people.

MARTIN: So I understand that officials in neighboring countries, like Liberia and Sierra Leone, are starting to be concerned that the virus has crossed the border. Is there any evidence of that?

SPRECHER: It's likely. The outbreak is taking place very close to the borders with Liberia and Sierra Leone, and there are people moving back and forth all the time. And so we have stories of people from Sierra Leone and Liberia who came into Guinea for events like funerals, which are unfortunately very high risk for transmission of Ebola. They go home and they become ill in their home countries. And that's - that complicates matters because anytime you have to do outbreak control across multiple countries, you have to coordinate many more people, more ministries of health and the like.

MARTIN: What are you hearing from people on the ground in Guinea? Is everyday life being affected at this point? We understand that - as we mentioned - that, you know, bats are thought to carry the virus, and bat soup has been banned. What are other effects on everyday life there at the moment?

SPRECHER: Well, this disease always has a profound effect on the local communities. I haven't been there for this outbreak, but I will tell you that, on the assumption that this is like it has been in the past, people are very scared when things that they do normally become so dangerous, they have to change their behavior patterns. People who survive the disease, unfortunately, go home from the hospital to find that they're no longer welcome.

I've had people come back to the treatment unit after they've been released saying that their house was burned down while they were away or they can't buy food because nobody will take money out of their hands. Any person who is ill is viewed with suspicion. And then in some places, in the very remote communities, even the disease control agencies can be viewed with suspicion because anybody who shows up at a time of such great consternation is viewed as maybe the possible cause of all of this. So we always bring an anthropologist with us for these reasons.

MARTIN: If somebody is planning a trip to West Africa, are there any specific precautions that they should take?

SPRECHER: Well, I think these outbreaks are generally very localized, and relative to the population, the numbers are small so most of West Africa will be as safe today as it was a month ago. And the - people's biggest risks are the things that are common. If you go to West Africa today, your biggest risk will still be getting malaria or getting some other of the normal everyday diseases of West Africa, which are preventable.

MARTIN: Before we let you go, we have about a - go ahead. We have about a minute and a half left, so I just wanted to ask you about that. I mean, a lot - a number of the people who've been talking about this say this is really a failure of health care systems more than anything else. Is that true? I mean, what are some of the things that could prevent this that people should keep in mind just as - to improve the system so that we're not continuing to talk about this?

SPRECHER: Well, yeah, I think you're right there. We can spend a lot of time worrying about Ebola, but, I mean, these people live in very remote areas. They have rudimentary health care, and their daily burden of common diseases, like typhoid and malaria, is high. And to a certain extent, if we were able to strengthen these systems, sure, surveillance for Ebola would certainly be improved, and we would detect outbreaks more quickly. And, you know, we would be able to relieve their burden of suffering beyond Ebola if we were able to reinforce the system.

MARTIN: All right. We have to leave it there for now. Dr. Armand Sprecher is a public health specialist with Doctors Without Borders, and we reached him at his office in Brussels in Belgium. Dr. Sprecher, thank you so much for speaking with us.

SPRECHER: My pleasure.

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