Ebola crisis ‘vastly underestimated’, says WHO and could take ‘six months to control’ says MSF

Ebola crisis vastly underestimated, says WHO 15 August 2014

Medecins Sans Frontieres (MSF) medical workers disinfect the body bag of an Ebola victim at the MSF facility in Kailahun, Sierra Leone, 14 August 2014The WHO says the international response to the outbreak needs to be scaled up
The scale of the Ebola outbreak appears to be “vastly underestimated”, the UN’s health agency says, as the death toll from the disease reaches 1,069.

The World Health Organization said its staff had seen evidence that the numbers of reported cases and deaths do not reflect the scale of the crisis.

It said in a statement that “extraordinary measures” were needed.

The outbreak began in Guinea in February and has since spread to Liberia, Sierra Leone and Nigeria.

The WHO said the outbreak was expected to continue “for some time”.

“Staff at the outbreak sites see evidence that the numbers of reported cases and deaths vastly underestimate the magnitude of the outbreak,” its statement said.

A Liberian health department burial team disinfects their protective clothing after retrieving the body of a woman suspected of dying of the Ebola virus in Monrovia, Liberia, 14 August 2014
The Ebola disease is spread by contact with the bodily fluids of those infected

“WHO is co-ordinating a massive scaling up of the international response.”

Part of the challenge was the fact that the outbreak was in “settings characterised by extreme poverty, dysfunctional health systems, a severe shortage of doctors and rampant fear”, the WHO added.

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Ebola virus disease (EVD)

Coloured transmission electron micro graph of a single Ebola virus, the cause of Ebola fever
  • Symptoms include high fever, bleeding and central nervous system damage
  • Fatality rate can reach 90% – but the current outbreak is about 55%
  • Incubation period is two to 21 days
  • There is no vaccine or cure
  • Supportive care such as rehydrating patients who have diarrhoea and vomiting can help recovery
  • Fruit bats are considered to be virus’ natural host
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In Nigeria – where four people have now died of Ebola – the residency training programme for doctors who work in government-run hospitals has been halted amid a nationwide doctors’ strike that began in July.

BBC Africa’s Chris Ewokor says the termination of the scheme – affecting an estimated 16,000 doctors – is likely to be linked to the ongoing strike as constitutionally other personnel are not allowed to be brought in to do their work.

With fears about the spread of Ebola, the authorities want to be able to bring military doctors into hospitals as part of contingency plans, he says.

The Ebola cases in Nigeria are linked to the late Liberian government employee, Patrick Sawyer, who brought the disease to the city of Lagos in July.

The outbreak is affecting the Youth Olympic Games about to start in China, as the International Olympic Committee (IOC) has ruled that athletes from Ebola-hit countries will not be allowed to compete in combat sports or in the pool, and Sierra Leone and Nigeria have withdrawn from the Games.

Ebola is transmitted by direct contact with the body fluids of a person who is infected.

Initial flu-like symptoms can lead to external haemorrhaging from areas such as eyes and gums, and internal bleeding which can lead to organ failure.

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Ebola: Mapping the outbreak

Map: Ebola outbreak in West Africa
  • Outbreak of an undetermined viral haemorrhagic fever begins in Guinea in February
  • Identified as Ebola in March
  • Researchers have since traced the first case to the death of two-year-old Guinean child in December 2013

Air passengers arriving in Nigeria are having their temperature taken as a precaution, as Tomi Oladipo reports

The outbreak of Ebola in West Africa will take at least six months to bring under control, the medical charity Medecins Sans Frontieres (MSF) says.

Speaking in Geneva, MSF President Joanne Lui said the situation was “deteriorating faster, and moving faster, than we can respond to”.

Earlier, the World Health Organization (WHO) said the scale of the outbreak appeared to be “vastly underestimated”.

It said that “extraordinary measures” were needed.

The epidemic began in Guinea in February and has since spread to Liberia, Sierra Leone and Nigeria.

On Friday, the death toll rose to 1,145 after WHO said 76 new deaths had been reported in the two days to 13 August. There have been 2,127 cases reported.

Ms Lui said that although Guinea was the initial epicentre, the pace there had slowed, and other countries – particularly Liberia – were now the focus.

“If we don’t stabilise Liberia, we will never stabilise the region,” she said.

Man on a stretcher in an ambulance at the district hospital of Biankouma, Ivory Coast.
Health systems in West Africa are being severely strained by the Ebola outbreak

“In terms of timeline, we’re not talking in terms of weeks, we’re talking in terms of months. We need a commitment for months, at least I would say six months, and I’m being, I would say, very optimistic.”

Ms Lui also called for more action from the international community and stronger leadership from WHO – the UN’s health agency.

“All governments must act. It must be done now if we want to contain this epidemic,” she said.

“WHO needs to take leadership and bring some strong elements into the field at all operational levels. It’s already started but it needs to happen at all levels.”

Ebola is transmitted by direct contact with the body fluids of a person who is infected.

Initial flu-like symptoms can lead to external haemorrhaging from areas such as eyes and gums, and internal bleeding which can lead to organ failure.

The WHO – which declared a global health emergency last week – recently said that the risk of transmission of Ebola during air travel remained low, as the disease is not airborne.

As a consequence, Kenya Airways has rejected pressure to suspend its flights to the Ebola-hit states of West Africa.

Kenyan media response to continued flights to West Africa

Mutuma Mathiu in The Daily Nation describes the move as “reckless” while The Star says the airline is “holding on to its lucrative West African routes as if they were the only business on its portfolio”.

“The government needs to get serious. An Ebola outbreak… would result in serious long term-damage” to the national brand, it continues.

The Standard notes that while it makes business sense for Kenya Airways to take advantage of West African destinations, the “economic escapade could be costly. The safety of Kenyans supersedes any profits and must come first.”

However, George Bodo in Kenya’s Business Daily recalls the carrier’s ailing share prices. “In calling on Kenya Airways to suspend nearly half of its high-margin flights, someone should, ideally, be ready with some form of compensation. Otherwise, its stock price will continue being more vulnerable in the coming weeks.”

The WHO said in a statement that its staff had seen evidence that the number of reported cases and deaths did not reflect the scale of the crisis.

WHO spokesman Gregory Hartl said that experts going house-to-house in Kenema, Sierra Leone, in search of infected people were discovering more cases.

“We have seen with the opening of new treatment centres, many more Ebola patients come forward, and so this has given rise to the belief that there are probably a lot of patients out there that we haven’t traced or contacted yet,” he said.

He said that an 80-bed treatment centre that recently opened in Liberia’s capital Monrovia filled up immediately and that the next day, dozens more people turned up to be treated.

Tarnue Karbbar, of the aid group Plan International in northern Liberia, said medical teams were not able to document all the cases erupting.

He said many of the sick were being hidden at home by relatives, and many victims were buried before teams could get to the area.

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Why Ebola won’t become a pandemic

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