On July 15, the WHO reported a total of 964 cases including 603 deaths in Guinea, Sierra Leone, and Liberia. Guinea still has the greatest number of cases with 406 confirmed, probable, and suspected cases, including 304 deaths. Sierra Leone is next with 386 cases and 194 deaths, and Liberia follows with 172 cases and 105 deaths. While Guinea’s outbreak seems to be slowing down, Sierra Leone’s continues to grow rapidly—of the 68 new deaths reported, 52 were in Sierra Leone, 13 in Liberia, and only three in Guinea.
Fear of Ebola has caused other nations, including Nigeria, to educate citizens on Ebola and implement preventive measures. Fear has also led the Ivory Coast to refuse entry to around 400 refugees attempting to return to their home country from Liberia. In Accra, Ghana, a U.S. citizen was quarantined under suspicions of Ebola, but initial tests were negative for the disease.
This outbreak has been particularly hard to contain because of a lack of sufficient protective equipment for healthcare workers, mistrust of Western medicine, frequent cross-border movement, and traditional practices that unintentionally spread the disease. Many infected individuals refuse to go to the hospital because they fear stigmatization or they believe that hospitalization is a “death sentence.” In Liberia, Chief Medical Officer Dr. Bernice Dahn reports that some individuals seek treatment in churches rather than hospitals because they believe the disease is a spiritual ailment. Hostility towards medical workers in all three countries has also barred treatment. In one such incident, locals wielding knives surrounded a Red Cross vehicle in Gueckedou, Guinea, leading the organization to suspend operations at their treatment center there.
This outbreak, which began in March 2014 and is still ongoing, is the largest on record in terms of the number of cases, deaths, and countries affected. Previously, the largest Ebola outbreak had been in Uganda in 2000-2001, when 425 people were affected and 224 died (see the CDC’s Ebola outbreak table for more information on this and other outbreaks). During the current outbreak in West Africa, 664 cases have been confirmed of the 964 reported cases. Though the case fatality rate of Ebola—the percentage of cases that result in death—is usually reported as 90%, this figure is based on the first recorded outbreak in Zaire in 1976 and is significantly higher than the case fatality rate of the current outbreak. Guinea’s case fatality rate (including suspected, probable, and confirmed cases and deaths) is about 75%, Sierra Leone’s is 50%, and Liberia’s is 61%. Combined, the three countries have a case fatality rate of 62.6%.