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Military Responders Help Battle Ebola Outbreak

By Terri Moon Cronk and Cheryl Pellerin
DoD News, Defense Media Activity

WASHINGTON, Aug. 1, 2014 – Defense Department personnel are on the ground in West Africa and in U.S. laboratories fighting to control the worst outbreak in the African history of the Ebola virus, which a senior Army infectious disease doctor called a "scourge of mankind."

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Entomologist Dr. Erica Lindroth from the Walter Reed Army Institute of Research and Lawerence Fakoli from the Liberian Institute of Biomedical Research set a new ruggedized BG-Sentinel mosquito trap for field evaluation in Liberia, Africa. Courtesy photo

(Click photo for screen-resolution image);high-resolution image available.

Army Col. (Dr.) James Cummings, director of the Global Emerging Infections Surveillance and Response System, or GEIS, a division of the Armed Forces Health Surveillance Center, said the battle against the virus since the outbreak began in West Africa in March focuses on trying to stop disease transmission and supportive care of those infected.

At the Centers for Disease Prevention and Control, or CDC, in Atlanta, Director Dr. Tom Frieden has announced that the health agency has raised the travel advisory to Liberia, Guinea and Sierra Leone where he said the Ebola outbreak is worsening, to Level 3 -- a warning to avoid unnecessary travel to those countries.

CDC already has disease detectives and other staff in those countries to track the epidemic, advise embassies, coordinate with the World Health Organization, or WHO, strengthen ministries of health, and improve case finding, contact tracing, infection control and health communication.

Over the next 30 days, in what Frieden described as a surge, CDC will send another 50 disease-control specialists into the three countries to help establish emergency operations centers and develop structured ways to address the outbreak.

"They will also help strengthen laboratory networks so testing for the disease can be done rapidly," the director said.

For travelers in and out of the three West African countries, CDC experts will strengthen country capacity to monitor those who may have been exposed to Ebola, and each country in the region has committed to doing this, Frieden said.

"It's not easy to do," he added, "but we will have experts from our division that do airport screening and try to ensure that people who shouldn't be traveling aren't traveling."

Frieden said CDC has spoken with air carriers that service the West African region.

"We understand they will continue to fly, which is very important to continue to support the response and maintain essential functions in the country," he explained.

CDC gives information to travelers to the region and health care providers in the United States who might care for people returning from the infected area. Frieden said that includes medical consultation and testing for patients who may have Ebola.

Frieden said that in the United States, "we are confident that we will not have significant spread of Ebola, even if we were to have a patient with Ebola here. We work actively to educate American health care workers on how to isolate patients and how to protect themselves against infection."

In fact, he added, "any advanced hospital in the U.S., any hospital with an intensive care unit has the capacity to isolate patients. There is nothing particularly special about the isolation of an Ebola patient, other than it's really important to do it right. So ensuring that there is meticulous care of patients with suspected or … confirmed Ebola is what's critically important."

The Ebola virus has no known cure and up to a 90 percent fatality rate, although the mortality rate in this current outbreak is about 60 percent and only supportive care can be offered to patients diagnosed with the disease. Supportive care is the treatment of choice to maximize patient survival of this infection, something that is difficult in the current austere and somewhat unstable environments, he said.

Efforts at the DoD Army Medical Research and Materiel Command U.S. Army Medical Research Institute of Infectious Diseases, or USAMRIID, have developed diagnostic assays, or investigative analytic procedures, that are seminal to identifying infected individuals, Cummings said. But current efforts for vaccines and treatments still are several months to years away, he added.

“It is generally postulated that the viral infection of index cases early in the outbreak originated in rural populations that prepare and eat meat from Ebola-carrying gorillas and monkeys,” he said, “while later cases stem from exposure to infected bodily fluids of infected patients already symptomatic with this disease.”

The virus is passed among animals or people through body fluids. Only a person who is infected and is showing signs of illness can pass the disease to others.

Health care workers and home caretakers who have direct patient contact and those who prepare bodies for burial also are at risk, the infectious disease doctor said.

"We have a long history in Africa," Cummings said. The first Ebola cases were reported in 1976 in the Democratic Republic of the Congo, formerly Zaire. Since that time, DoD has answered numerous calls for assistance from WHO, nongovernmental organizations and ministries of heath and defense.

DoD personnel provide a wide array of support to the Ebola-stricken African nations, from logistical help to guides for clinical management of the virus, Cummings said.

"Partnership with DoD personnel bring a level of excellence second to none, working in host nations and WHO in the most-affected countries of Sierra Leone, Guinea and Liberia," he said.

(Follow Terri Moon Cronk and Cheryl Pellerin on Twitter: @MoonCronkDoDNews @PellerinDoDNews)

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Global Emerging Infections Surveillance and Response System
Statement on Request for Support to Department of State for American Citizen Transportation from Africa to Emory University Hospital from Secretary of Defense
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Click photo for screen-resolution imageThis colorized transmission electron micrograph shows some of the ultrastructural morphology of an Ebola virus virion. Ebola virus disease is a severe, often-fatal disease in people and in monkeys, gorillas and chimpanzees that has appeared sporadically since its initial recognition in 1976. The disease is caused by infection with Ebola virus, named after a river in the Democratic Republic of the Congo, formerly Zaire, in Africa, where it was first recognized. The virus is one of two members of a family of RNA viruses called the Filoviridae. CDC photo by microbiologist Frederick A. Murphy, National Center for Infectious Diseases, Special Pathogens Branch  
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