Ebola virus disease is a viral hemorrhagic fever, a group of illnesses that includes Lassa fever, Rift Valley fever, Marburg hemorrhagic fever, Crimean-Congo hemorrhagic fever and yellow fever. Ebola virus disease is caused by the Ebola virus and is endemic to sub-Saharan Africa. The virus belongs to the Filoviridae family and comprises five species: Bundibugyo, Taï Forest (formerly Côte d’Ivoire), Reston, Sudan and Zaire.
The disease was named after the Ebola River in the Democratic Republic of the Congo (DRC), where the first case was recorded in 1976. Sporadic outbreaks have occurred since 1976 in the DRC, Sudan, Gabon, Uganda and Republic of the Congo. The 2014–2016 outbreak occurred mainly in the West African countries of Guinea, Liberia and Sierra Leone. Smaller outbreaks occurred in Nigeria and Senegal but were quickly contained. Outbreaks also occurred in the DRC in 2014 (which was unrelated to the outbreak in West Africa), 2017 and 2018.
With more than 28,600 suspected, probable and confirmed cases and 11,000 deaths,1 the 2014–2016 Ebola crisis dealt a devastating blow to West Africa, overwhelming health systems and crippling the health workforce. The World Health Organization (WHO) reported that more than 800 health workers had confirmed or probable cases of Ebola, and that two-thirds of these workers died. However, WHO also reported that health worker infections as a proportion of all cases dropped from 12% in July 2014 to a low of 1% in February 2015. This remarkable decline was likely the result of trainings and increased supplies for infection prevention and control (IPC) for health workers.2
As an international, nonprofit health organization, Jhpiego worked side by side with the governments of Liberia, Guinea and Nigeria to provide critical IPC training and assistance to ensure that health workers were safe on the job and prepared to provide life-saving care. Jhpiego, an affiliate of Johns Hopkins University with decades of experience in the region, assisted ministries of health and professional organizations as they addressed the crisis that disrupted many essential health services. Jhpiego’s expertise in IPC reinforced the competencies and skills needed by health workers to perform their jobs safely. This not only saved the lives of health workers and their patients but also was a crucial step in building clients’ confidence in health facilities so that they would return for life-saving services—of particular concern for pregnant women and new mothers.
These trainings presented the most up-to-date IPC interventions using Jhpiego’s learning resource package, Prevention and Control of Ebola Virus Disease in Health Care Facilities with Limited Resources, which was developed through a collaboration with Johns Hopkins Medicine.
Working with ministries of health, the United States Agency for International Development, WHO and the private sector, Jhpiego’s technical experts also held workshops in Ghana and Tanzania in 2014 and 2015 for ministry of health officials, physicians, nurses, other clinicians and expert trainers from across Africa. These workshops prepared participants to train additional frontline health workers and supervisors on best practices to protect themselves and their patients in health facilities should an outbreak occur in their respective countries.