Updated October 03, 2014.

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

In 2000, a small area in Uganda faced an Ebola epidemic. Initially 3 in 4 patients died. Nurses died. Then health care reinforcements arrived with training for workers and community. Only 1 in 5 (20%) died after that. The epidemic stopped within 2 months.

What happened?

Public Health worked. Case finding, Isolation/Quarantine, Protective Supplies, Health Care Staffing, and Supportive Care saved lives.

Ebola is spread by contact with patient's and their body fluids and droplets. Mortality could have risen higher.

Supportive care - IV fluids, feeding, cleaning - help people survive

That is to say, much of what we need to control Ebola is not fancy. It's hard Public Health work.

Case Finding

The number of patients in the hospital may not be the number sick. Patients, afraid and distrustful, may remain at home. They may spread the disease to their caregiving loved ones. They may come to the hospital only when too ill to improve. Trust within the community must develop for patients to be isolated and hospitalized as many, though fewer, will indeed die there.

Quarantine and Isolation

Key measures for control are a) Quarantine: prevents well (but possibly exposed and later infectious) individuals from contacting others. b) Isolation: separates ill and infectious individuals from contact with others.

Supplies

Where there isn't funding for prevention of transmission, hospitals have even more work - and less funding.

 There may not even have gloves.

Ebola spreads quickest when someone is ill - when the virus in blood and body fluids is highest. At this point, the patient may have diarrhea, vomiting, or even blood oozing from IVs. Cough, vomit or diarrhea may have blood. Personal Protective Equipment protects against close contact with these risks. Gloves - and gowns, boots, face masks, eye protection - prevent transmission when copious fluids may splash or spray from an infected individual. To consistently use this equipment, training and monitoring help. Without these measures, health care workers die. Without health care workers and good morale among those left, care greatly suffers.

Enough Hands to Help

Those highest risk are caregivers for Ebola patients. Health care systems where Ebola spreads are short-staffed already. When Ebola takes health care providers through illness or fear, one individual may be left caring for a room of patients with diarrhea, too ill to move. Ebola transmission increases and care worsens when nurses and doctors are overworked - and more likely to make a grave error.

Supportive Care

Mortality can drop to about  "33% with correct supportive care" as the WHO Public Relations Head, Gregory Haertl, wrote.

This means providing hydration (either by mouth or intravenously) and nutrition (by mouth, through a tube, or possibly intravenously). This means keeping patients clean, especially when they have severe diarrhea and cannot move. This may also involve providing oxygen for breathing, antibiotics for secondary infections, and correcting electrolyte levels in the blood (by monitoring and supplementing).

Some patient's immune systems will overcome Ebola

Supportive care allows a patient to survive while their body begins to control the virus. 

Within 2 weeks of infection, patients either become dramatically better or worse. Patients will do best if they have supportive care. What we do know is they lose lymphocytes, an immune cell that fights viruses. They have a large cytokine release, another immune response, and disordered clotting, leading to bleeding. Survivors may have a neutralizing antibody. In laboratory studies, those who survive have different gene expression related to clotting. Many patients can survive if the health system can support them.

New Treatments

New treatments and vaccines will hopefully, but likely will not, be quickly available to the thousands in need in West Africa. There are not the drug stocks or knowledge of what works. The supply logistics will also be complicated.

There is also a difficult ethical quandary here. Where resources are stretched, any additional work or treatment may distract from lifesaving care. Treatment must truly be lifesaving. We need to test drugs to know they are lifesaving. At the same time, a promising drug for a deadly disease is something we want to provide to save every life we can.

Ebola can be controlled

We hope Ebola can be stopped without waiting for treatments that may be a long way off. Many diseases have been curbed without a cure: prior Ebola, cholera, even norovirus outbreaks. In the early 1900s, public health measures curbed TB, malaria, and yellow fever in the US without a vaccine or treatment. Ebola can be controlled the same way.