Ebola’s Deadly Spread In Africa Driven By Public Health Failures, Cultural Beliefs

Dick Thompson | National Geographic | July 2, 2014

A late response, the disease's spread to urban areas, and superstition have allowed the virus get out of hand.

As the largest Ebola outbreak in history continues unabated, health authorities from 11 West African countries and international agencies began a two-day crisis meeting today in Accra, Ghana, on how to combat the crisis. The World Health Organization (WHO) says "drastic action" is needed to stem the outbreak, which since March has grown to 759 confirmed cases in Guinea, Sierra Leone, and Liberia, including 467 deaths.

Given that surveillance and response measures have held this terrifying disease in check for the past decade, why has the situation gotten so far out of hand this time?  As with earlier outbreaks elsewhere in Africa, containment and treatment measures are often hampered by tradition, superstition, and poor public health infrastructure. But this epidemic is especially pernicious for several reasons.

In the early stages of the epidemic, when it could have been more easily contained, few health professionals in the region even knew it was taking place. Though outbreaks are common in central Africa, the disease had almost never been seen before in western Africa. And many of the first patients did not have symptoms consistent with a hemorrhagic fever, which initially obscured its identification. The public health response was therefore slow, and officials who made statements were often trying to calm people's fears, giving inaccurate and sometimes contradictory information...