Health authorities struggling to control the worst outbreak of Ebola on record said drastic action is needed to prevent more deaths. 
 
 More than 390 people have died in the outbreak in Guinea, Sierra Leone and Liberia, the World Health Organization said in a statement today. That toll is greater than the 280 people killed in 1976, when the virus was first identified near the Ebola River in what is now the Democratic Republic of Congo. 
 
 The WHO plans to meet with health ministers from 11 countries July 2-3 in Accra, Ghana, to agree on a plan to bring the outbreak under control. Health workers will have to tackle resistance from local people who are hiding infected family members, destroying medicines intended to help and adhering to rituals that fuel the spread of the virus. 
 
 “This is no longer a country-specific outbreak but a sub-regional crisis that requires firm action by governments and partners,” said Luis Sambo, the WHO’s regional director for Africa. “WHO is gravely concerned of the ongoing cross-border transmission into neighboring countries as well as the potential for further international spread.” 
 
 The outbreak is expected to last another three to four months, focused around the “hot spot” in the rural border areas where the three countries meet, said Francis Kasolo, the WHO’s director of disease prevention and control for Africa. 
 
 Crossing Borders 
 
 “What we are seeing is a lot of cross-border movement,” Kasolo said in a telephone interview. “When somebody comes in contact with a sick person in Guinea and crosses into Sierra Leone, as long as they don’t report having come into contact with an Ebola patient, there is a grave possibility that that person will transmit the disease.” 
 
 At next week’s meeting, the WHO will discuss forming a multi-country team that will share information daily on Ebola cases and people who have come into contact with those infected, Kasolo said. The Geneva-based organization has deployed more than 150 people to fight the epidemic, with tasks including surveillance, communication, infection control, logistics and data management. 
 
 The virus is also spreading because some hospitals are allowing infected patients to leave. Unsafe burial practices are also contributing. 
 
 Effective communication of safe measures to local communities is a major challenge that will be discussed in Accra, said WHO spokesman Daniel Epstein. 
 
 Educational Effort 
 
 “If there isn’t a strong public-health information and education component to the control activities, then people don’t understand and end up infecting themselves and doing things they shouldn’t be doing,” said David Heymann, a professor at the London School of Hygiene and Tropical Medicine who has studied Ebola since the first outbreak in 1976. 
 
 Guinea has pockets of resistance, mainly in the town of Gueckedou, the epicenter of the disease, said Remy Lamah, the country’s health minister. 
 
 “There are always citizens who remain attached to their rites, their traditions and others do not even believe that Ebola exists,” he said by phone today from Conakry, Guinea’s capital. “We want to use teachers and students during the holidays for awareness caravans in their communities.” 
 
 The WHO is also recruiting Ebola survivors to speak at next week’s meeting and share their experience with their own communities to try to end resistance to control efforts. 
 
 ‘Denial Barrier’ 
 
 “That’s one of the ways of trying to break the denial barrier of saying Ebola is just another disease,” Kasolo said. “We want them to be advocates within the communities where they come from on this particular disease.” 
 
 Suspicion of health workers’ motives has thwarted initiatives in some places. In Sierra Leone, youths in Kailahun burned drugs and other supplies, claiming the medicines were meant to kill Ebola patients, the country’s ministry of health and sanitation said this week. 
 
 Some households in Sierra Leone’s Kenema district are also hiding infected family members until they become very ill, health minister Miatta Kargbo said in an interview. Bogus vaccination programs are also causing undue confusion. 
 
 “The ministry wishes the general public to know that there is no vaccine for Ebola and it has not instituted any Ebola vaccine immunization in schools,” the ministry said in a statement. “The act of spreading this misleading and scaring information is a criminal offense and people involved in this act are warned to desist forthwith.” 
 
 In Liberia, traditions of waiting to bury bodies for months and touching the dead have made controlling the spread harder, Tolbert Nyesuah, assistant minister for health said. Denial that that disease exists has also complicated containment, he said. 
 
 Neighboring Countries 
 
 There is low risk at present that the outbreak will spread to other nations, Kasolo said. Still, officials from neighboring countries such as Mali, Guinea-Bissau, Senegal, Ghana, Ivory Coast and Gambia have been invited to attend the Accra meeting in case the disease spreads, he said. The Democratic Republic of Congo and Uganda will share their experiences dealing with past outbreaks. 
 
 “We still think we have another three to four months to go with the epidemic, but the duration will be influenced by how national governments and affected communities respond,” Kasolo said. 
 
 For Related News and Information: Sierra Leone Youths Burn Drugs Claiming to Prevent Ebola Deaths 
 
 To contact the reporter on this story: Makiko Kitamura in London at mkitamura1@bloomberg.net 
 
 To contact the editors responsible for this story: Phil Serafino at pserafino@bloomberg.net David Risser, Kristen Hallam ||||| Staff of medical aid organization Doctors without Borders carry the body of a person killed by viral haemorrhagic fever, at a center for victims of the Ebola virus in Guinea. 
 
 The deadliest Ebola outbreak in recorded history is happening right now. The outbreak is unprecedented both in the number of cases and in its geographic scope. And so far, it doesn't look like it's slowing down. 
 
 The outbreak has now hit three countries: Guinea, Sierra Leone, and Liberia. And the virus — which starts off with flu-like symptoms and often ends with horrific hemorrhaging — has infected about 600 people and killed an estimated 367 since this winter, according to the numbers on June 26 from the World Health Organization. 
 
 On June 23, the humanitarian group Doctors Without Borders sent out a distress call. As the only aid organization treating people with Ebola, the group said it was "overwhelmed," that the epidemic was out of control, and that it couldn't send workers to new outbreak sites without getting more resources. 
 
 Ebola is both rare and very deadly. Since the first outbreak in 1976, Ebola viruses have infected roughly 2,400 people and killed about one-third of them. Symptoms can come on very quickly and kill fast: 
 
 Journalist David Quammen put it well in a recent New York Times op-ed: "Ebola is more inimical to humans than perhaps any known virus on Earth, except rabies and HIV-1. And it does its damage much faster than either." 
 
 So why is Ebola doing so much damage right now? Here's a primer on what's going on. 
 
 Why is Ebola back in the news? 
 
 Ebola tends to come and go over time. 
 
 Every now and again, the disease spills over from animals to humAns 
 
 The viruses are constantly circulating in animals, most likely bats. Every once in a while, the disease spills over into humans, often when someone handles or eats undercooked or raw meat from a diseased ape, monkey, or bat. An outbreak can then happen for several months. And then it becomes quiet, again. 
 
 Ebola can completely disappear from humans for years at a time. For example, there were zero recorded cases of Ebola in 2005 or 2006. 
 
 Where is the current Ebola outbreak? 
 
 This outbreak started in Guinea sometime in late 2013 or early 2014. (The majority of cases have been in that country.) It has since spread to Sierra Leone and Liberia, including some major capital cities. It's the first time Ebola has ever reached a state capital. 
 
 Why is this particular outbreak so deadly? 
 
 First, this outbreak concerns the most deadly of the five Ebola viruses — Zaire ebolavirus, which has killed 79 percent of the people it has infected. (The virus is called that after the formerly named Zaire, which, along with Sudan, experienced the first Ebola outbreak back in 1976.) 
 
 
 
 There are also social and political factors contributing to the current disaster. Because this is the first major Ebola outbreak in West Africa, many of the region's health workers didn't have experience or training in how to protect themselves or care for patients with this disease. 
 
 What's more, an NPR story suggests that people in these countries tend to travel more than those in Central Africa (where outbreaks usually occur). That may have helped the virus disperse geographically, and it made it difficult to track down people who might be infected. 
 
 MANY OF WEST AFRICA'S HEALTH WORKERS DIDN'T HAVE TRAINING DEALING WITH EBOLA 
 
 Meanwhile, as an editorial in the medical journal Lancet noted, social stigmas and a lack of awareness may be preventing people from seeking medical care (or even actively avoiding it). Another often-cited problem is that some people have had direct contact with victims' dead bodies during funerals and preparations for burial, which can spread the disease. 
 
 In many ways, how well a country can deal with an Ebola outbreak comes down to basic health-care practices and public education. With enough resources poured into the effort, people should be able to contain this outbreak. So far, however, these countries are struggling. 
 
 Does Ebola really make people bleed from their eyes? 
 
 Yes. Bleeding from orifices is one of the more unusual and memorable symptoms of viral hemorrhagic fevers like Ebola. In later stages of the disease, some people bleed from the eyes, nose, ears, mouth, and rectum. They may also bleed from puncture sites if they've had an IV. 
 
 External bleeding can be one of the main symptoms that can help people realize they're dealing with a case of Ebola, since other signs — first fevers and headache, then vomiting and diarrhea — can be caused by any number of illnesses. Internal bleeding can happen, as well. 
 
 But it doesn't always happen. For example, this study of a 1995 outbreak found external bleeding in 41 percent of cases. And bleeding didn't correlate with who survived and who didn't. 
 
 What actually kills people is shock from multiple organ failure, including problems with the liver, kidneys, and central nervous system. 
 
 Symptoms come on abruptly after an incubation period of 2 to 21 days. And people generally die between day 6 and 16 of the illness. 
 
 Why is Ebola so deadly? 
 
 
 
 One of the main things that seems to make Ebola viruses especially deadly is that they seem to be able to evade much of the human immune system. Among other problems, white blood cells from the immune system are often seen to die off in patients. And if the body can't fight fully back, the virus can just keep taking over. 
 
 Scientists are still figuring out exactly how this happens, and they have several promising leads. One is that the virus is making proteins that act as decoys, interfering with the body's ability to fight back. 
 
 How hard is it to catch Ebola? 
 
 Ebola is relatively hard to catch. Unlike measles or the flu, it's not spreadable over the air through casual contact. 
 
 In order to get Ebola, someone must touch the blood or bodily fluids (including sweat, urine, and semen) of a person or animal who's infected (alive or dead). People can also catch it through indirect contact with victims' fluids, such as via bedding or medical equipment. 
 
 People generally aren't infectious until they get sick. 
 
 This limited transmission ability is one of the main reasons why Ebola outbreaks can often be stopped within weeks or months. What it takes is public education and good health-care hygiene like patient isolation, sterilization procedures, and the use of gloves and masks. 
 
 What are the chances of Ebola spreading to the US? 
 
 The ebola viruses known today don't spread from person-to-person well enough to have much risk of causing a wide pandemic across several continents. The risk of Ebola coming to the US is very low. 
 
 How do you treat Ebola? 
 
 Patients are treated for symptoms, including IV fluids for dehydration. It's important to remember that some people do survive an Ebola infection. 
 
 Hopefully, in the future there will be more options. For example, researchers are working to find drugs, including a recent $50 million push at the National Institutes of Health. And scientists are working on vaccines, including looking into ones that might be able to help wild chimpanzees, which are also susceptible to the disease. 
 
 Update: Incorporated the newest case counts from the WHO on June 26. ||||| Conakry (AFP) - West Africa's Ebola-hit nations have agreed to impose a cross-border isolation zone at the epicentre of the world's worst-ever outbreak, amid warnings that the deadly epidemic is spiralling out of control. 
 
 The announcement came at an emergency summit in the Guinean capital on Friday to discuss the outbreak, which has killed more than 700 people, with the World Health Organization warning Ebola could cause "catastrophic" loss of life and severe economic disruption if it continued to spread. 
 
 View photo . 
 
 "These areas will be isolated by police and military. The people in these areas being isolated will be provided with material support," she said at the meeting in Conakry. 
 
 Opening the summit, WHO chief Margaret Chan told leaders that the response of the three countries to the epidemic had been "woefully inadequate", revealing that the outbreak was "moving faster than our efforts to control it". 
 
 "If the situation continues to deteriorate, the consequences can be catastrophic in terms of lost lives but also severe socio-economic disruption and a high risk of spread to other countries," Chan said. 
 
 She described the outbreak as "by far the largest ever in the nearly four-decade history of this disease". 
 
 "It is taking place in areas with fluid population movements over porous borders, and it has demonstrated its ability to spread via air travel, contrary to what has been seen in past outbreaks," she told the summit. 
 
 "Cases are occurring in rural areas which are difficult to access, but also in densely populated capital cities. This meeting must mark a turning point in the outbreak response." 
 
 - $100 million action plan - 
 
 The leaders of Sierra Leone, Liberia and Guinea used the summit to launch a $100 million (75 million euro) action plan that will see several hundred more medical staff deployed to battle the epidemic. 
 
 The three countries will also bolster efforts to prevent and detect suspected cases, urge better border surveillance, and reinforce the WHO's sub-regional outbreak coordination centre in Guinea. 
 
 Darab did not outline the exact area to be part of the isolation zone, but the epicentre of the outbreak has a diameter of almost 300 kilometres (185 miles), spreading from Kenema in eastern Sierra Leone to Macenta in southern Guinea, and taking in most of Liberia's extreme northern forests. 
 
 "The healthcare services in these zones will be strengthened for treatment, testing and contact tracing to be carried out effectively," she said. 
 
 The meeting came after Dubai's Emirates became the first global airline to announce it was suspending flights to the stricken area, while the United States, Germany, France and Italy have issued warnings against travel to the three African countries. 
 
 US President Barack Obama announced on Friday that the United States would screen delegates travelling from Ebola-hit countries to Washington for a three-day Africa summit next week. 
 
 Two Americans infected with Ebola in West Africa will be evacuated back to the United States in the coming days to be cared for in strict isolation, US officials said. 
 
 Kent Brantly, a doctor who was treating Ebola patients in Liberia, and Christian missionary worker Nancy Writebol, were being flown home, but it was not immediately clear when they would arrive back in the US. 
 
 Meanwhile Nigeria quarantined two people who had "primary contact" with a man who died of Ebola in Lagos last week. 
 
 The WHO raised the death toll by 57 to 729 on Thursday, announcing that 122 new cases had been detected between Thursday and Sunday last week, bringing the total to more than 1,300. 
 
 "Current numbers of national and international response staff are woefully inadequate," Chan said, revealing that 60 health workers had died treating patients in the outbreak. 
 
 - State of emergency - 
 
 Sierra Leone's leader Ernest Bai Koroma has announced a state of emergency, quarantining Ebola-hit areas and cancelling foreign trips by ministers, while Liberia has closed all of its schools and put government workers on leave. 
 
 Liberian President Ellen Johnson Sirleaf warned ahead of the summit that the crisis was "nearing a catastrophe" and appealed for more doctors and supplies. 
 
 Ebola, which has no vaccine, causes severe muscular pain, fever, headaches and, in the worst cases, unstoppable bleeding. 
 
 It has killed around two-thirds of those it has infected since its emergence in 1976, with two outbreaks registering fatality rates approaching 90 percent. 
 
 The death rate in the current outbreak is a lower-than-average 55 percent. 
 
 Fears that it could spread to other continents through air travel have been growing, with European and Asian countries on alert alongside African countries outside the Ebola crisis zone. 
 
 In Britain, Sierra Leone cyclist Moses Sesay was quarantined and tested for Ebola at the Commonwealth Games in Glasgow, before being given the all-clear, the athlete told a British newspaper. 
 
 Kenya, Ethiopia, Democratic Republic of Congo and Benin said they had enhanced screening at border points and airports. ||||| The Ebola outbreak in West Africa was first reported in March 2014, and rapidly became the deadliest occurrence of the disease since its discovery in 1976. 
 
 In fact, the epidemic killed five times more than all other known Ebola outbreaks combined. 
 
 More than 21 months on from the first confirmed case recorded on 23 March 2014, 11,315 people have been reported as having died from the disease in six countries; Liberia, Guinea, Sierra Leone, Nigeria, the US and Mali. 
 
 The total number of reported cases is about 28,637. 
 
 But on 13 January, 2016, the World Health Organisation declared the last of the countries affected, Liberia, to be Ebola-free. 
 
 The World Health Organization (WHO) admits the figures are underestimates, given the difficulty collecting the data. 
 
 There needs to be 42 days without any new cases for a country to be declared Ebola-free. 
 
 The outbreaks in Nigeria and Senegal were declared officially over by the WHO in October 2014. Sierra Leone and Guinea both had much larger outbreaks and it took a little longer. Sierra Leone was declared Ebola-free on 7 November 2015, Guinea followed in December. 
 
 Liberia has been the worst-hit, with more than 4,800 dead and 10,672 becoming infected. The WHO said that at the peak of transmission, during August and September 2014, Liberia was reporting between 300 and 400 new cases every week. 
 
 The epidemic seemed to abate and the outbreak in Liberia was declared over on 9 May 2015 - only to re-emerge seven weeks later when a 17-year-old man died from the disease and more cases were reported. The same happened in September, which is why the latest declaration of Liberia being Ebola-free, while welcome, should be treated with caution, say correspondents. 
 
 The WHO has warned that West Africa may see flare-ups of the virus. 
 
 How the virus spread 
 
 Researchers from the New England Journal of Medicine traced the outbreak to a two-year-old toddler, who died in December 2013 in Meliandou, a small village in south-eastern Guinea. 
 
 In March, hospital staff alerted Guinea's Ministry of Health and then medical charity Medecins Sans Frontieres (MSF). They reported a mysterious disease in the south-eastern regions of Gueckedou, Macenta, Nzerekore, and Kissidougou. 
 
 It caused fever, diarrhoea and vomiting. It also had a high death rate. Of the first 86 cases, 59 people died. 
 
 The WHO later confirmed the disease as Ebola. 
 
 Ebola death toll 
 
 Image copyright AP 
 
 Ebola outbreak: Key stories 
 
 "Biggest health challenge since Aids" 
 
 How not to catch Ebola 
 
 Why is Ebola so dangerous? 
 
 Ebola diary 
 
 Tracing the outbreak 
 
 Full special report 
 
 Disease spreads 
 
 The Gueckedou prefecture in Guinea, where the outbreak started, is a major regional trading centre and, by the end of March, Ebola had crossed the border into Liberia. It was confirmed in Sierra Leone in May. 
 
 In June, MSF described the Ebola outbreak as out of control. 
 
 Nigeria had its first case of the disease in July and, in the same month, two leading doctors died from Ebola in Liberia and Sierra Leone. 
 
 In August, the United Nations health agency declared an "international public health emergency", saying that a co-ordinated response was essential to halt the spread of the virus. 
 
 Senegal reported its first case of Ebola on 29 August. A young man from Guinea had travelled to Senegal despite having been infected with the virus, officials said. 
 
 By September, WHO director general Margaret Chan said the number of patients was "moving far faster than the capacity to manage them". 
 
 Director of the Centers for Disease Control and Prevention (CDC) in the US, Thomas Frieden, said in October that the Ebola outbreak in West Africa was unlike anything since the emergence of HIV/Aids. But Senegal managed to halt transmissions by mid October. 
 
 Authorities in Mali confirmed the death of the country's first Ebola patient, a two-year-old girl, on 25 October. The girl had travelled hundreds of kilometres by bus from Guinea through Mali showing symptoms of the disease, the WHO said. 
 
 An infected Islamic preacher from Guinea, who was initially diagnosed with a kidney problem, was treated at a clinic in Bamako. The preacher died a few days after entering the country. 
 
 Two health workers who cared for the preacher also died after contracting the virus. In total, Mali recorded six deaths from Ebola. By January 2015 however, the country was declared ebola-free. 
 
 Ebola outside West Africa 
 
 *In all but three cases the patient was infected with Ebola while in West Africa. Infection outside Africa has been restricted to health workers in Madrid and in Dallas. DR Congo also reported a separate outbreak of an unrelated strain of Ebola. 
 
 The first case of the deadly virus diagnosed on US soil was announced on 1 October. Thomas Eric Duncan, 42, who contracted the virus in Liberia before travelling to the US, died on 8 October. 
 
 He had not displayed symptoms of the disease until 24 September, five days after his arrival. Other people with whom he came into contact are being monitored for symptoms. 
 
 Two medical workers in Dallas, Texas, who treated Duncan tested positive for Ebola since his death but have both recovered. The second death on US soil was surgeon Martin Salia, from Sierra Leone. He was flown back to the United States in November and treated for Ebola at a hospital in Nebraska. But Dr Salia, who had US residency and was married to an American, died a short time later. 
 
 Spanish nurse Teresa Romero was the first person to contract the virus outside West Africa. She was part of a team of about 30 staff at the Carlos II hospital in Madrid looking after two missionaries who returned from Liberia and Sierra Leone after becoming infected. 
 
 Germany, Norway, France, Italy, Switzerland and the UK have all treated patients who contracted the virus in West Africa. 
 
 2014 outbreak in context 
 
 Ebola was first identified in 1976 and occurs in regions of sub-Saharan Africa. There are normally fewer than 500 cases reported each year, and no cases were reported at all between 1979 and 1994. 
 
 In August 2014, the WHO confirmed a separate outbreak of Ebola in the Democratic Republic of Congo. By the beginning of October there had been 70 cases reported and 43 deaths. 
 
 However, the outbreak in DR Congo was a different strain of the virus and unrelated to the epidemic in West Africa, which now dwarfs all previous outbreaks. 
 
 Past epidemics
– The World Health Organization is calling an emergency meeting of health ministers from 11 countries next week in hopes of coming up with a plan to combat the worst outbreak of Ebola the world has ever seen. So far more than 390 people have died in the outbreak, which is stretching across Guinea, Sierra Leone, and Liberia, Bloomberg reports. That far exceeds the 280 killed when the disease debuted in 1976. "This epidemic is out of control," a Doctors Without Borders official said this week, according to the Guardian. This outbreak is proving especially deadly because it involves the most devastating of the five Ebola viruses; Zaire ebolavirus kills 79% of those infected, Vox explains. It's also the first major outbreak to hit West Africa, and workers there aren't sure how to deal with it—many hospitals, for example, are releasing infected patients. Among the general populace, education is even worse. In Sierra Leone, for instance, young people have burned drugs and supplies, believing that it was the medicine killing the patients. At its meeting next week, the WHO will seek to form a multi-country team to close that information gap. On the bright side, "the chance of Ebola spreading out of West Africa is very, very low," one specialist tells NPR—although if it did it would likely hit Paris next, because 10% of Guinea's air traffic out of its Conakry airport heads there.