National Geographic News
Staff of the 'Doctors without Borders' ('Medecin sans frontieres') medical aid organisation carry the body of a person killed by viral haemorrhagic fever, at a center for victims of the Ebola virus in Guekedou, on April 1, 2014. The viral haemorrhagic fever epidemic raging in Guinea is caused by several viruses which have similar symptoms -- the deadliest and most feared of which is Ebola. AFP PHOTO / SEYLLOU        (Photo credit should read SEYLLOU/AFP/Getty Images)

Staff of Doctors Without Borders carry a body at a center for victims of the Ebola virus in Guéckédou, Guinea, on April 1, 2014.


Karen Weintraub

for National Geographic

Published June 27, 2014

The deadliest-ever outbreak of Ebola is spreading rapidly through West Africa and has now infected 635 people, killing more than 60 percent of them so far.

The World Health Organization warned Thursday of the need for drastic action to contain the virus, and organized a meeting for next week with the ministers of health in Guinea, Liberia, Sierra Leone, and eight surrounding nations.

National Geographic talked with W. Ian Lipkin, an expert in viral diseases and the John Snow Professor of Epidemiology at the Mailman School of Public Health at Columbia University, about why this outbreak is so much more widespread than previous ones. (Related: "Why Is This Ebola Outbreak Spreading?")

Previous outbreaks of Ebola have been small and localized, but this one is much broader. Why the difference?

Typically, when we have an outbreak of Ebola, a team goes in, they identify the cases, they identify people who might come into contact with the cases. And as a result of isolation, we're able to contain the outbreak and it peters out fairly rapidly. Here, it's in urban areas as opposed to rural areas. There isn't enough manpower to track all these cases and make certain we educate people, and that's what's essential.

How contagious is Ebola?

This is not a highly transmissible disease, where the number of people who can be infected by a single individual is high. You have to come into very close contact with blood, organs, or bodily fluids of infected animals, including people. If you educate people properly and isolate those who are potentially infected, it should be something you can bring under control.

Members of the Guinean Red Cross speak with a resident during an awareness campaign on the Ebola virus on April 11, 2014 in Conakry.
Members of the Guinean Red Cross speak with a resident in Conakry during an awareness campaign on the Ebola virus on April 11, 2014.

Originally, this outbreak spread because of ritual burial practices that brought people into contact with fluids from dead bodies. Is that still a primary source of transmission?

It is an issue. With urbanization, you have people who are moving into urban areas who are not completely divorced from the practices they had in the rural areas. They're recent transplants and they carry with them that culture.

Is this one outbreak or have there been new introductions in the meantime?

Since the spring, it's just continued to spread. I can't tell you for certain there haven't been new point source introductions, but there seems to be no reason to think that.

What likely caused the initial infection?

What typically happens is somebody comes into contact with bush meat. Frequently, there's a harbinger of an outbreak. You [first] see deaths in great apes. When hunters handle infected chimpanzees, gorillas, or monkeys that are infected, they then become infected, chiefly through breaks in their skin or mucous membranes. They become the Trojan horse that carries the infected material back to the villages.

What does the Ebola virus do to the body?

It's a hemorrhagic fever virus. It causes an intensive inflammatory response. You wind up going into shock. You can't maintain your blood pressure. Ultimately, all your organs fail.

How long does it take to get sick once you're infected?

You may not show signs of disease for up to three weeks, but most people begin to show signs roughly a week after infection. Death comes within a few days to another week.

Is it possible to treat Ebola, to survive infection?

It's typically a lethal infection [with up to a 90 percent fatality rate]. People can recover, but it's not common. There are no treatments. The only thing we can do is try to maintain people's blood volumes by giving them fluids.

Are treatments under development?

There are people who are trying to develop antibodies from people who've recovered from infection and have antibodies that will neutralize the virus. And others [are] trying to work on drugs that may interfere with ability of the virus to reproduce itself.

Do we need to be concerned about Ebola spreading to the U.S. or other developed countries?

Is it possible that somebody could be infected in one of these countries and fly to the U.S.? It is certainly possible. Given our health care system, it's unlikely that we would have widespread disease as a result. We would be on top of it, and we would be able to contain it. Our health care system affords people access to gloves and gowns and personal protective equipment. I don't think there's reason for panic that we're going to be hit with an outbreak of Ebola.

With other pathogens, like the Middle Eastern Respiratory Virus (MERS), there's concern about the virus mutating and becoming more dangerous. Is that a concern with Ebola infections?

They kill so quickly that I don't envision there's going to be a major shift in transmission.

Do you think the West African countries are responding well to the crisis?

These are not wealthy countries. They don't have strong health care infrastructure. They need help. They don't have the resources to handle this. (Related: "Q&A: Challenges of Containing Ebola's Spread in West Africa.")

Robert Lall
Robert Lall

Intraveneous Vitamin C will cure this disease.  The resistance to using it boggles my mind.  There is enormous documented evidence of its effectiveness.  It just needs to be given in massive doses and repeated over the first few days.

David Higgins
David Higgins

When there is an outbreak in a large population of people who may be infected with OTHER viruses - Like INFLUENZA there is always the possibility that this virus will MUTATE and pick-up the ability to infect through Airborne Transmission.  After that - the first Infected Person to make it to an International Airport will End the World

jim williams
jim williams

If our gover,ment can hand out BILLIONS why not just give evry american 1 million dollars ???????????????????that would still be far less than a billion

Amanda Bailey
Amanda Bailey

If you want to read something absolutely terrifying, gruesome, eye-opening, and a book you can't put down read The Hot Zone.  I loved it, wanted to vomit, was terrified, empathized with Bob (from What about Bob?), and have been fascinated with information that comes about regarding the Ebola virus.  Go on, check it out from the library.  That is if you want to sleep tonight.  

Tom Mengel
Tom Mengel

All the more to consider that we ARE a small world, and simply begging off indifferently and saying one region's health/economic/educational problems are their own and that we should not interfere is no longer a viable option when such problems are now only a short plane flight or boat ride away from us all.  If we had invested the two trillion dollars we blew off in two useless mid-eastern wars and instead used that for helping to improve the education, healthcare, and basic infrastructures in the now infected areas and elsewhere in Africa we probably would never have seen this kind of outbreak happen (and would probably also would have lessened the amount of militarily backed opportunism by small extremist groups that keeps such areas in such backwards levels).  This should be a now obvious deduction on the part of any thinking voter, and any politician linked to shadowy capitalistic mover and shaker money changers who ignores this to exploit a dangerous and corrupted system should pay dearly when the next outbreak comes and infects the masses on their own turf. 

Rita Falwell
Rita Falwell

Hot Zone is a necessary read....and as Paul says, it is only a mutation or two away from being an air born pathogen...mutate is what these viruses do....we are all meat....

Paul Scutts
Paul Scutts

This is absolutely terrifying. If one of these hemorrhagic viruses becomes air borne its going to be worse than the Titanic on a global scale!

Ginger Mcmahan
Ginger Mcmahan

I agree Morgan. I also read the book. Something has to be done.

Morgan Soller
Morgan Soller

I read the book Hot Zone and I've been terrified of Ebola ever since. This is not something to take lightly and I'm quite confused why we just don't make it a top priority to help out the affected areas.

Matt Fleming
Matt Fleming

@David Higgins A mutated virus wouldn't end the world. We need the world but this planet doesn't need us. It would just end civilization as we know it. Massive human population decimation would occur, but some people would likely survive.

Gerard Van der Leun
Gerard Van der Leun

@Tom Mengel "If we had invested the two trillion dollars we blew off in two useless mid-eastern wars and instead used that for helping to improve...."

Stop being a boring, "stick in my thumb pull out a plum and say what a good boy am I" colonized mind. None of what you propose would have ever happened. If you could actually think instead of just replicate like a brain virus you'd vote accordingly. Since you can you vote with  the Borg. Shame on you if you could feel shame.


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