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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

Some Gave All: 507 Healthcare Workers have Died in African Ebola Outbreak

In the historic Ebola outbreak in West Africa that still smolders on, 507 healthcare workers have given their lives trying to save others.

The deaths translate to a mortality rate of 58% of the 869 health care workers infected as June 17, 2015, the World Health Organization reports. The last healthcare worker infections in Guinea and Sierra Leone were reported on April 6 and May 14, respectively. However, a case reported this week from the Targrin area of Port Loko, Sierra Leone, acquired infection after being treated in the same private healthcare facility as another confirmed case, the WHO reported.

“There is an extremely high likelihood that this case will lead to further transmission, with 20 health workers who came into direct or indirect contact with the case defined as medium or high-risk contacts, along with many patients who were treated at the same facility,” the WHO warned.

Factors that have been cited by the WHO for the occupational Ebola infections include shortages of personal protective equipment, improper use of PPE, and for much of the outbreak, far too few medical staff for the overwhelming number of cases. In such circumstances, healthcare workers demonstrate a compassion that contributes to working in isolation wards far beyond the number of hours recommended as safe, the WHO notes.

With a few exceptions -- like some of the U.S. healthcare workers -- many of the infected care givers were treated under the very conditions of the epidemic they were fighting, making it difficult to deliver the full measure of care needed. Consider that with one death among the nine U.S. cases we have a mortality rate of 11%, suggesting that part of the reason Ebola is so deadly in Africa is that the level of patient care demanded cannot be adequately delivered. In particular, Bruce Ribner,MD, who treated some of the first cases at Emory University Hospital in Atlanta, said Ebola patients have massive fluid loss — rivaling conditions seen in cholera — that can be difficult to restore.

The outbreak has been declared over in Liberia but there are still infections being reported in Guinea and Sierra Leone, which had a total 76 confirmed cases in a recent three-week period. There have been a total of 27,305 reported confirmed, probable, and suspected cases of Ebola and 11,169 deaths as of June 17, the WHO reports. That translates to a mortality rate of 40%.