Photograph by Youssouf Bah, AP

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Health care workers teach people about the Ebola virus and how to prevent infection in Conakry, Guinea, on March 31, 2014.

Photograph by Youssouf Bah, AP

Q&A: Challenges of Containing Ebola's Spread in West Africa

Health care workers struggle to stop infection from spreading.

The deadly Ebola virus has broken out in the West African country of Guinea for the first time, alarming the public and catching health care workers off guard.

Since January the virus has spread from rural areas to the capital city of Conakry, so far infecting at least 122 patients and killing 83. Other cases, suspected or diagnosed, were also found recently in Sierra Leone and Liberia, making this a regional outbreak.

The disease, which first appeared in the Democratic Republic of Congo in 1976, is marked by fever and severe internal bleeding. Transmission is human to human. There is no known cure. Patients normally receive supportive care consisting of balancing their fluids, maintaining oxygen and blood pressure levels, and treating other infections. The Ebola virus is fatal in up to 90 percent of patients.

We spoke to two experts about efforts to contain the outbreak. Tarik Jasarevic, a spokesperson for the World Health Organization, spoke to us from Conakry. And Roland Berenger, West Africa emergency manager for Plan International, an aid organization that works in developing countries around the world, spoke to us from Dakar just after returning from ten days in Guinea.

What are the basic strategies for controlling this outbreak in Guinea?

Jasarevic: We need to provide isolation wards, where infected people are treated and health workers are safeguarded. Where that is in place, health workers are using standardized protective equipment, like gloves, masks, eye protection, gowns, boots. It's all single use, discarded after each use, except for the boots that can be disinfected.

Another strategy is contact tracing—looking for those who have been in contact with an infected person. We've deployed two mobile labs to provide testing and supportive care. And very important is information and communication. This is the first time Guinea is facing Ebola, so we need a big effort to educate the people.

At least 11 health care workers are among those infected. So did even local health care workers need a quick course in Ebola?

Berenger: Yes, the first people to be affected were health care workers themselves. People were thinking about cholera and lassa fever. They didn't know what they were dealing with.

Jasarevic: Educating health care workers was the first thing to be done. Immediately, the Minister of Health organized meetings with all health authorities. We sent brochures to all health centers in the country.

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Workers from Doctors Without Borders prepare isolation and treatment areas for Ebola patients in Guéckédou, Guinea, on March 28, 2014.

How is information getting out to the general population in Guinea?

Jasarevic: Several things are happening. The president [of Guinea, Alpha Condé] gave a televised speech on Sunday on the outbreak. Journalists are getting really well briefed. People are going out to religious organizations to provide information. We're in the process of designing posters that even illiterate people can understand, with images, say, of a hand with the international red circle and line through it. It indicates: Don't touch. Don't touch a person who is infected or dead.

Berenger: There are some gaps in providing the information to all the people. We need to reach all the people in the farthest villages. We need to do more with social media, radio, and using posters. We need to be more proactive. People are getting adequate information through TV and radio, but there is a part of the population who do not have access to those things, in very remote areas.

How are the people in Guinea dealing with this outbreak?

Jasarevic: Of course people are worried. But they are going about their business. Like anywhere, no one can afford to stay home all day.

Berenger: People understand the outbreak when you take time to explain things clearly. The people who have seen cases of Ebola are really scared. When you see people dying, bleeding to death, and there is nothing anyone can do, you get scared. In Conakry, they are going about their daily business, but I think many avoid going to crowded places. You see many people using hand sanitizers.

Some neighboring countries, including Liberia, have closed their borders, or are considering closing borders. Is this an effective strategy for control?

Berenger: The borders in many places are really porous. You can't really prevent people from crossing the forest and going to other countries. It has already become a regional threat. I think it's time for people to wake up and work on this as one planet.