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By CNN Library
updated 12:24 PM EST, Wed December 17, 2014
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The Ebola epidemic


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(CNN) -- Here's some background information about Ebola, a virus


with a high fatality rate that was first identified in Africa in 1976.
Facts:
Ebola hemorrhagic fever is a disease caused by one of five different
Ebola viruses. Four of the strains can cause severe illness in
humans and animals. The fifth, Reston virus, has caused illness in
some animals, but not in humans.
The first human outbreaks occurred in 1976, one in northern Zaire
(now Democratic Republic of the Congo) in Central Africa: and the
other, in southern Sudan (now South Sudan). The virus is named
after the Ebola River, where the virus was first recognized in 1976,
according to the Centers for Disease Control and Prevention.
Ebola is extremely infectious but not extremely contagious. It is
infectious, because an infinitesimally small amount can cause
illness. Laboratory experiments on nonhuman primates suggest that
even a single virus may be enough to trigger a fatal infection.

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Instead, Ebola could be considered moderately contagious,


because the virus is not transmitted through the air. The most
contagious diseases, such as measles or influenza, virus particles
are airborne.
Humans can be infected by other humans if they come in contact
with body fluids from an infected person or contaminated objects
from infected persons. Humans can also be exposed to the virus, for

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example, by butchering infected animals.

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While the exact reservoir of Ebola viruses is still unknown,


researchers believe the most likely natural hosts are fruit bats.
Symptoms of Ebola typically include: weakness, fever, aches,
diarrhea, vomiting and stomach pain. Additional experiences include
rash, red eyes, chest pain, throat soreness, difficulty breathing or
swallowing and bleeding (including internal).

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Typically, symptoms appear 8-10 days after exposure to the virus,


but the incubation period can span two to 21 days.
Unprotected health care workers are susceptible to infection
because of their close contact with patients during treatment.
Ebola is not transmissible if someone is asymptomatic or once
someone has recovered from it. However, the virus has been found
in semen for up to three months.
Deadly human Ebola outbreaks have been confirmed in the
following countries: Democratic Republic of the Congo (DRC),
Gabon, South Sudan, Ivory Coast, Uganda, Republic of the Congo
(ROC), Guinea and Liberia.
According to the World Health Organization, "there is no specific
treatment or vaccine," and the fatality rate can be up to 90%.
Patients are given supportive care, which includes providing fluids
and electrolytes and food.
There are five subspecies of the Ebola virus: Zaire ebolavirus
(EBOV), Bundibugyo ebolavirus (BDBV), Sudan ebolavirus (SUDV),
Ta Forest ebolavirus (TAFV) and Reston ebolavirus (RESTV)

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Part of complete coverage on

Ebola outbreak
How the world reacted as Ebola spread
The largest Ebola epidemic in
history began with the simple
act of caring for a child. Soon,
it spread from the remote
village in Guinea.

Countries with travel restrictions


Click here for the CDC's list of known cases and outbreaks.
Map: 2014 Ebola Outbreak
2014 West Africa Outbreak:
(Full historical timeline at bottom)
Cases listed below include confirmed, probable or suspected cases
of Ebola as of December 9, 2014 (World Health Organization and
CDC):
Guinea - 2394 cases, 1518 deaths

updated 9:27 AM EST, Tue November 4, 2014

The worst-ever outbreak of


Ebola virus is stretching the
medical capacities of Guinea,
Liberia and Sierra Leone.

Who is patient zero?


updated 4:11 PM EDT, Tue October 28, 2014

Before the deaths soared into


the thousands, before the
outbreak triggered global fears,
Ebola struck a toddler named
Emile Ouamouno.

Liberia - 7797 cases, 3290 deaths


Mali - 8 cases, 6 deaths
Nigeria - 20 cases, 8 deaths

The messy truth about Ebola


updated 7:51 AM EDT, Mon October 13, 2014

What happens when you get


Ebola? CNN's Miguel Marquez
explains.

Senegal - 1 case, 0 deaths (infection originated in Guinea)


Sierra Leone - 8273 cases, 2033 deaths

Millions of vaccines planned by 2015


updated 3:52 PM EDT, Sat October 25, 2014

Spain - 1 case, 0 deaths


United States - 4 cases, 1 death (two infections originated in the
United States, one in Liberia and one in Guinea)
March 25, 2014 - The CDC issues its initial announcement on an
outbreak in Guinea, and reports of cases in Liberia and Sierra
Leone. "In Guinea, a total of 86 suspected cases, including 59
deaths (case fatality ratio: 68.5%), had been reported as of March
24, 2014. Preliminary results from the Pasteur Institute in Lyon,
France suggest Zaire ebolavirus as the causative agent."
April 16, 2014 - The New England Journal of Medicine publishes a
report, speculating that the current outbreak's Patient Zero was a
two-year-old from Guinea. The child died on December 6, 2013,
followed by his mother, sister and grandmother over the next month.

Health experts are fasttracking tests for various


vaccines, and hope to have
millions of experimental doses
by next year.

How the Ebola virus spreads


updated 7:54 PM EDT, Tue September 30, 2014

Ebola is a scary infectious


disease but the first thing you
should know is that it's not
very contagious. Here is how it
spreads.

What you need to know


updated 12:46 PM EDT, Mon October 20, 2014

July 2014 - Patrick Sawyer, a top government official in the Liberian


Ministry of Finance, dies at a local Nigerian hospital. He is the first
American to die in what officials are calling "deadliest Ebola
outbreak in history."
July 2014 - Nancy Writebol, an American aid worker in Liberia, tests
positive for Ebola. According to Samaritan's Purse, Writebol is
infected while treating Ebola patients in Liberia.
July 26, 2014 - Kent Brantly, medical director for Samaritan Purse's
Ebola Consolidated Case Management Center in Liberia, is infected
with the virus. According to Samaritan's Purse, Brantly is infected
while treating Ebola patients.

These questions and answers


will give you the latest
information on the deadly virus
and what's being done to stop
its spread.

3 with Ebola will fly each month


updated 11:32 AM EDT, Tue October 21, 2014

Up to three Ebola-infected
travelers might board an
international flight each month
in West Africa, according to a
new study, and potentially
spread the deadly virus.

Why some survive, some don't


July 29, 2014 - According to Doctors Without Borders, Dr. Sheik
Humarr Khan who was overseeing Ebola treatment at Kenema
Government Hospital in Sierra Leone dies from complications of the
disease.
July 30, 2014 - The Peace Corps announces it is removing its
volunteers from Liberia, Sierra Leone and Guinea.

updated 9:45 PM EDT, Mon October 20, 2014

There's no cure for Ebola. So


why have some patients
walked away healthy while
others in the West died?

Inside the world's worst outbreak


updated 6:25 AM EDT, Mon October 20, 2014

July 31, 2014 - CDC raises its warning to Level 3. It warns U.S.
residents to avoid "nonessential travel" to Sierra Leone, Guinea,
and Liberia.
August 2, 2014 - A specially equipped medical plane carrying Ebola
patient Dr. Kent Brantly lands at Dobbins Air Reserve Base in
Marietta, Georgia. He is then driven by ambulance to Emory
University Hospital in Atlanta.
August 4, 2014 - CNN reports that three top secret, experimental
vials of the drug, "ZMapp," were flown into Liberia last week in a lastditch effort to save Brantly and Writebol, according to a source
familiar with details of the treatment. Doctors report "significant
improvement."

A doctor at a government-run
Ebola treatment center in
Monrovia is too busy to mince
words.

Stigmatized, abandoned orphans


updated 7:33 AM EDT, Mon October 20, 2014

Two children orphaned by


Ebola play in the empty corner
of a Liberian orphanage. Their
parents died last month, and
none of the extended family is
willing to claim them.

Five ways the CDC got it wrong


updated 12:55 PM EDT, Tue October 14, 2014

August 6, 2014 - Nancy Writebol arrives at Emory in Atlanta for


treatment.
August 8, 2014 - Experts at the World Health Organization declare
the Ebola epidemic ravaging West Africa an international health
emergency that requires a coordinated global approach, describing
it as the worst outbreak in the four-decade history of tracking the
disease.
August 19, 2014 - Liberia's President Ellen Johnson Sirleaf
declares a nationwide curfew beginning August 20 and orders two
communities to be completely quarantined, with no movement in or
out of the areas.
August 21, 2014 - Dr. Kent Brantly is discharged from Emory
University Hospital. It is also announced that Nancy Writebol had
been released on Tuesday, August 19. The releases come after
Emory staff are confident Brantly and Writebol pose "no public
health threat."
September 6, 2014 - The government of Sierra Leone announces
plans for a nationwide lockdown from September 19-21, in order to
stop the spread of Ebola. The lockdown is being billed as a
predominantly social campaign rather than a medical one, in which
volunteers will go door-to-door to talk to people.
September 16, 2014 - President Barack Obama calls the efforts to
combat the Ebola outbreak centered in West Africa "the largest
international response in the history of the CDC." Speaking from the
CDC headquarters in Atlanta, Obama adds that "faced with this
outbreak, the world is looking to" the United States to lead
international efforts to combat the virus. He says the United States is
ready to take on that leadership role.
September 30, 2014 - Dr. Thomas Frieden, director of the CDC,
announces the first diagnosed case of Ebola in the United States.

Public health experts are


asking whether the CDC is
partly to blame for problems
with Ebola in the U.S. Here are
5 things they say the CDC is
getting wrong.

Can pets get or spread Ebola?


updated 3:59 PM EDT, Sat October 18, 2014

The lack of solid protocol on


what to do with Ebola victims'
pets and what little is known
about the risk has caused one
dog to be euthanized and
another quarantined.

A look at Ebola protective gear


updated 1:58 AM EDT, Tue October 14, 2014

Rosie Tomkins takes a look at


the protective suits that are
worn by some Ebola medical
workers in Africa.

How hospitals handle Ebola patients


updated 8:52 AM EDT, Mon October 13, 2014

What's the protocol for health


care workers if they suspect a
patient has the virus

Ebola outbreak in West Africa


updated 2:08 PM EST, Wed December 10, 2014

Click through our gallery as we


track the Ebola outbreak in
West Africa.

Complete coverage on Ebola

A look at CNN's complete


coverage on the Ebola crisis.

The person has been hospitalized and isolated at Texas Health


Presbyterian Hospital in Dallas, Texas, since September 28.
October 1, 2014 - Liberian government officials release the name
of the first diagnosed case of Ebola in the United States: Thomas
Eric Duncan.
October 6, 2014 - A nurse's assistant in Spain becomes the first
person known to have contracted Ebola outside Africa in the current
outbreak. The woman helped treat two Spanish missionaries, both
of whom had contracted Ebola in West Africa, one in Liberia and the
other in Sierra Leone. Both died after returning to Spain. On
October 19, Spain's Special Ebola Committee says that nurse's aide
Teresa Romero Ramos is considered free of the Ebola virus.
October 6, 2014 - NBC freelance cameraman Ashoka Mukpo
arrives at Nebraska Medical Center for treatment after contracting
Ebola in Liberia. On October 21, the hospital says that Mukpo no
longer has the Ebola virus in his bloodstream and will be allowed to
leave.
October 8, 2014 - Thomas Eric Duncan dies of Ebola in Dallas.
October 11, 2014 - Nina Pham, a Dallas nurse who cared for the
now-deceased Ebola patient Thomas Eric Duncan, tests positive for
Ebola during a preliminary blood test. She is the first person to
contract Ebola on American soil.
October 15, 2014 - Amber Vinson, a second Dallas nurse who also
cared for Thomas Eric Duncan, is diagnosed with Ebola. Authorities
say Vinson flew on a commercial jet from Cleveland to Dallas days
before testing positive for Ebola.
October 20, 2014 - Under fire in the wake of Ebola cases involving
two Dallas nurses, the CDC issues updated Ebola guidelines that
stress the importance of more training and supervision, and
recommend that no skin be exposed when workers are wearing
personal protective equipment, or PPE.

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October 23, 2014 - Craig Spencer, a 33 year-old doctor who


recently returned from Guinea has tested positive for Ebola -- the
first case of the deadly virus in New York City and the fourth
diagnosed in the United States.
October 24, 2014 - The National Institutes of Health announces
one of the Dallas nurses, Nina Pham, has been declared free of the
Ebola virus. Doctors at Emory University Hospital say tests no longer
detect the virus in the blood of the other nurse, Amber Vinson.
Pham is released from a Maryland hospital on October 24, and
Vinson is released from an Atlanta hospital on October 28.
October 24, 2014 - In response to the New York Ebola case, the
governors of New York and New Jersey announce that their states
were stepping up airport screening beyond federal requirements for
travelers from West Africa. The new protocol mandates a quarantine
for any individual, including medical personnel, who has had direct
contact with individuals infected with Ebola while in Liberia, Sierra
Leone, or Guinea. The policy allows the states to determine
hospitalization or quarantine for up to 21 days for other travelers
from affected countries.
November 5, 2014 - Nurse's aide Maria Teresa Romero Ramos,
believed to be the first person to contract Ebola outside of Africa, is
released from the hospital in Madrid, Spain.
November 11, 2014 - Dr. Craig Spencer, the first person to test
positive for Ebola in New York City, is released from Bellevue
Hospital. With Spencer free of the virus, all U.S. patients who had
Ebola have recovered.
November 15, 2014 - Dr. Martin Salia, who became infected with
Ebola while treating patients in Sierra Leone, arrives at Nebraska
Medical Center in Omaha. Salia, a native of Sierra Leone, is a legal

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November 17, 2014 - Dr. Salia dies at Nebraska Medical Center.
Historical Timeline:
*Includes outbreaks resulting in more than 100 deaths or special
cases.
1976 - First recognition of the EBOV disease is in Zaire (now
Democratic Republic of the Congo). The outbreak has 318 reported
human cases, leading to 280 deaths. An SUDV outbreak also
occurs in Sudan (now South Sudan), which incurs 284 cases and
151 deaths.
1989 - In Reston, Virginia, macaque monkeys imported from the
Philippines are found to be infected with the Ebola virus (later
named the Ebola-Reston virus).
1990 - In Texas and Virginia quarantine facilities, four humans
develop Ebola antibodies after contact with monkeys imported from
the Philippines. None of the humans has symptoms.
1995 - An outbreak in Democratic Republic of the Congo (formerly
Zaire) leads to 315 reported cases and at least 250 deaths.
2000-2001 - A Ugandan outbreak (SUDV) results in 425 human
cases and 224 deaths.
2001-2002 - An EBOV outbreak occurs on the border of Gabon and
Republic of the Congo (ROC), which results in 53 deaths on the
Gabon side and at least 43 deaths on the Republic of the Congo
side.
December 2002-April 2003 - An EBOV outbreak in Republic of the
Congo results in 143 reported cases and 128 deaths.
2007 - An EBOV outbreak occurs in the Democratic Republic of the
Congo (DRC), 187 of the 264 cases reported result in death. In late
2007, an outbreak in Uganda leads to 37 deaths. 149 cases were
reported.
November 2008 - The Ebola-Reston virus (RESTV) is detected in
five humans in the Philippines. They are workers on a pig farm and
slaughterhouse and suffer no symptoms. This is the first known
occurrence of the Reston virus in pigs.
August 26, 2014 - The Ministry of Health in the Democratic
Republic of the Congo notifies the World Health Organization of an
Ebola outbreak in the country. It is the seventh outbreak in the
country since 1976, when the virus was first identified near the
Ebola river. The outbreak is not related to the ongoing outbreak in
Guinea, Liberia, Nigeria and Sierra Leone.
November 21, 2014 - The World Health Organization declares an
end to the Ebola outbreak in the Democratic Republic of Congo. A
total of 66 cases and 49 deaths were recorded.

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