The current epidemic and two USA medical professionals contracting it, but all I read suggests it is basically like HIV in that it requires transfer of bodily fluids pretty much directly into someone’s blood stream or open wounds.
I don’t get it, I know it causes massive hemorrhaging or bleeding but it would still seem hard to infect unless the patient is vomiting blood into an open wound, even in primitive conditions it seems like some barrier or shields could be set up before bringing water or food to patients.
First of all, you have to remember that the initial symptoms of ebola can be similar to those of other serious diseases, so other people might not be aware the sick person has ebola as opposed to something else and may be less cautious than they would be otherwise.
Second, sanitation is a problem in some of the most strongly affected areas. Clean water might be in short supply, as may electrical power, so proper laundering of bed linens, cleaning of beds; floors and walls might be difficult; and cleaning/sterilizing medical equipment may also be more difficult than in more modern surroundings. There are shortages of things like protective gloves and gowns.
As a result, it spreads more easily in the remote and primitive locations. This includes spreading to first world doctors and nurses who go into those locations to help out.
People do try to set up isolation wards, but when you’re lacking basic materials, or they’re in short supply, doing so effectively is difficult.
The spread of the Ebola in the countries of the Sierre Leone and the Liberia is from bad infrastructures in all areas. If you read this New York Times article you can begin to understand
Most Westerns do not even think of what the problems that pose themselves if you only have the electrical power for 3 or 4 hours a day - and this in the capital - and there is not the availability of the gloves, the chlorine solutions, the many other very basic things to allow the sanitation to stop the transmission.
There is also the problem of the traditional beliefs about the witchcraft and the traditional beliefs about spirits and the absolute necessity in the beliefs like this to have some funeral rites.
But it is most of all that the systems in the Sierre Leone and the Liberia are very bad, they are in fact the worst of all the region. Very weak governments with great distrusts after they both experienced very savage civil war for most of the past two decades and only have peace for ten years.
You see in the comment here in this article“By contrast, in Guinea, where the first cases appeared, the outbreak is “more under control than not,” said Dr. Frieden, the C.D.C. director.” The Guinea Conakry did not have civil war, although it has bad medical care systems. It is also the case that the francophone zone has stronger government systems, it is the positive side of the french colonisation, the stronger administration culture.
And look at the latest news item you see about ebola:
"A quarantine centre for suspected Ebola patients in the Liberian capital Monrovia has been attacked and looted by protesters, police say…
At least 20 patients who were being monitored for signs of the illness have left the centre.
Officials said blood-stained bedding looted from the centre posed a serious infection risk."
The terrible problem of the Liberian situation is the great lack of social cohesion and great distrust. the many years under the taylor regime are paying a second evil price.
Why is it you think this population are thinking of “primary infection vector” at all? This population will think of witchcraft first.
They will take the beds and the clothes because these are the populations that are the most poor of the poor, who live in the slums so terrible a comfortable western person will never enter it.
The poor uneducated population in this slum have never had any access to educaiton. The Liberian civil war - or the two if you want to count it that way - that ran from 1989 to 2003 destroyed the education and almost all of the society in Libiera.
This is why in the Guinea Conakry the Ebola is being mastered, but in the Liberia it is like an apocalypse.
In addition to all of the issues listed above, there is some evidence from animal studies that exposure to Ebola through intact conjunctiva or oral membranes is sufficient for infection. HIV does not infect intact tissues. Also, the infectious does for Ebola is believed to be quite low (<100 viral particles). Both of these things, combined with the heavy contamination of surfaces due to symptomology, long survival on these surfaces, and poor sanitation in the affected countries, makes the spread of Ebola difficult to control.
It should be pointed out that the spread of Ebola is still fairly low, much lower than is seen with influenza, SARS, measles, etc.