Ebola returns.

• Author: Reinhardt, Erika
• Position: Follow-Up

On 4 December 2001, the World Health Organization (WHO) received reports of seven deaths from an outbreak of suspected viral haemorrhagic fever in Ogooue lvindo province in the northeastern part of the Gabon. Laboratory testing carried out at the Centre International de Recherches Medicales de Franceville (CIRMF) in Gabon confirmed that it was the Ebola virus. This is the fourth outbreak of the disease in that country since 1994 and as of 8 February 2002 the death toll was 54.

WHO is supporting Gabon's Ministry of Health and the national task force in disease containment by coordinating the international response to the outbreak and implementing control measures, including finding cases, tracing and monitoring contacts, and supplying protective equipment. The international aid group Medecins Sans Frontieres (MSF)/Doctors Without Borders is also helping to contain the virus. Gabon's Red Cross Society is carrying out health education activities in the villages.

The first Ebola outbreak in Gabon occurred in December 1994 in the gold mining encampments. Two other epidemics were confirmed, in February 1996 when 13 people became ill after butchering a dead chimpanzee, and then later that year in October. As was documented in Cote d'Ivoire and Gabon, transmission of the virus has occurred by handling ill or dead infected chimpanzees. Although nonhuman primates have been the source of infection for humans, they are not thought to be the reservoir (see box). In Mekambo, bushmeat has been banned since the latest outbreak, and controls on hunting have been reinforced. One of the problems the Government faces is informing people in remote forest villages who do not have access to radios and are not aware of the bushmeat link.

A team of scientists from the WHO Global Outbreak Alert and Response Network went to Gabon to help coordinate the international response to its latest outbreak. "Once we had the original confirmation on 7 December, we were able to start contacting our Network to say we had Ebola and that we were probably going to the field. On the 9th or 10th of December, we received the request for assistance from WHO, and on the 11th the international team arrived in Libreville", says Dr. Mike Ryan, Coordinator of the WHO Response Network in Geneva.

"Ebola is only a tiny fraction of the burden of infectious diseases around the world and as such the sheer numbers don't even put it on the map when it comes to disease. I think the thing for us with...