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WHO: Ebola Outbreak 'Vastly Underestimated'

WHO: Ebola Crisis 'Vastly Underestimated'i
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Zlatica Hoke
August 16, 2014 3:06 PM
The World Health Organization now says the Ebola crisis that has struck West Africa and taken more than 1,000 lives has been "vastly underestimated." In addition, the Doctors Without Borders humanitarian group says the crisis is likely to last at least another six months. Zlatica Hoke has more on the fight to contain the deadly disease.

Video report by Zlatica Hoke

Anne Look

World Health Organization (WHO) officials on Thursday warned the magnitude of the Ebola outbreak had been "vastly" underestimated.

The U.N. agency said 1,069 people have died of Ebola this year in Guinea, Liberia, Nigeria and Sierra Leone. The total number of cases is estimated at just under 2,000, but some public health experts, including Dr. Joanne Liu, president of Doctors Without Borders (MSF), say many cases are going unreported as patients resist hospitalization and isolation wards, preferring to entrust their care to family members instead.

WHO officials also said in a Thursday statement that they share concerns that current numbers do not reflect the true gravity of the situation. Liberia and Sierra Leone, the two hardest hit countries so far, have reported at least 182 new cases in the past week, and public health authorities in affected countries say additional resources are desperately needed as they scramble to stop the spread of the disease and isolate those already infected.

In Liberia's capital, Monrovia, MSF is building its largest Ebola treatment center yet, which will have 120 beds. MSF also runs a treatment unit in the northern border town of Foya, in Lofa County.

The group’s emergency coordinator, Lindis Hurum, said it is still not enough. 

“Unfortunately, neither of these two units will be sufficient to cover for the need to isolate and care for the patients," she said. "At this stage the outbreak is totally out of control and we need to come up with other strategies to cope with the situation."

Lofa and Montserrado counties are among the hardest hit in Liberia, where health ministry officials are rolling out a new strategy to manage the high volume of suspected cases in those districts. Assistant Health Minister Tolbert Nyensuah says health workers will go to the patients, instead of the other way around, 

"If there are too many patients in the community, we can move them to a community structure like a school building [to] provide mattresses, provide feeding, provide hygiene kits to them and health promotion kits that we can manage the people until they can transition to a treatment unit,” he said.

In August, both Liberia and Sierra Leone enacted emergency rule and quarantined the most affected districts. Security forces have set up roadblocks and shut borders.

In the Kenema district of Sierra Leone, security forces have stopped movement in or out, measures that residents call drastic. Locals say the restricted mobility and flow of goods is pushing up food prices, but that they are also necessary and overdue.

“When the first time we heard about Ebola, if the measures that are in place now was in place, I want to believe we should have not reached the peak we are presently in,” said one Kenema resident who withheld her identity.

Complexities of containment

Public health officials say an Ebola outbreak can be contained, but that it must to be snuffed out like a forest fire. No embers can be left to burn, and authorities must isolate both confirmed and suspected cases, after which they must then monitor everyone who may have been exposed to a patient’s bodily fluids for 21 days, Ebola's incubation period.

If any one of those people shows symptoms, they too must go into isolation.

But implementing this procedure is easier said than done. Nigeria, for example, has been monitoring nearly 200 contacts related to just one confirmed case, the country’s first, an air traveler from Liberia who died in Lagos in late July.

In Liberia and Sierra Leone, even as quarantine measures have slowed the large-scale movement of people outside their communities, authorities say the sheer number of cases and contacts to trace is overwhelming.

Sierra Leone’s health minister, Miatta Kargbo, says they need more logistical support.

“We need ambulances. We need vehicles for contact tracing and surveillance," she said. "You may have the funds but the ambulances are not available. This is a challenge that we do have. The logistical support, what is needed to support the fight against Ebola, needs to come faster than we’re seeing from the international community.”

Public health experts say it will likely be months before the outbreak is over. Never have there been so many cases of Ebola in so many places at once.

Dr. Liu, international head of Doctors Without Borders, said Friday that Liberia remains a particular problem. She said stabilizing the outbreak there is key for the whole region.

Adam Bailes contributed to this report from Freetown, Prince Collins contributed from Monrovia and Patrick Jackema from Kenema, Sierra Leone.

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Comments
     
by: yataro from: Japan
August 17, 2014 2:45 AM
Ebola outbreak must be underestimated because to report the case of Ebola leads tragedy for example, losing their house as the movie shows, making their family's life worse.
But making sure the exact number of case and stopping the outbreak of Ebola is really important even some people feel sad.


by: Not Again from: Canada
August 16, 2014 11:32 AM
WHO failed in a massive way to get preventive measures and take effective action to rapidly coordinate and raise the alarm over the Ebola sit in Western Africa, in the early stages of this epidemic. People in charge at WHO have demonstrated poor leadership, they need to be replaced = fired. For months Doctors Without Borders were raising the alarm and were requesting help, all of it to no avail, WHO failed to perform as it should have, those in charge FAILED!
The more human hosts the virus infects, the more the likelyhood that it will mutate and it will become easier to spread. Ebola is out of control, and the fact that people in the affected areas are still clamoring for resources, is indicative that it is nowhere near any potential control. The fact that there are still many, in the affected populations, that do not understand the issue of segregation/ full isolation of the patients, indicates that the necessary educational measures have not been udertaken, or worse that the educational campaign is ineffective.
The chances/possibility of controlling the spread of Ebola, without a clear understanding and cooperation of the affected population is ZERO. Far more needs to be done to ensure the population understands, accepts, and complies with the isolation requirements of potential patients/affected victims.
A regional medical crisis organization needs to be established, with adequate resources, to coordinate and lead the information and educational campaign against Ebola; the campaign needs to be addressed to all the regional tribes and extend into the remote areas/hinterlands of the affected regions and beyond.
In my view, this Ebola epidemic is nearing or maybe it has reached the point of continued active sustainability in the human population = it will continue to expand until such time as an effective vaccine is deployed and the majority of the population is fully vaccinated in the regions in which Ebola has spread. This Ebola epidemic will have a very negative impact on the economies of the region and on regional stability.


by: David Kent from: Florida, USA
August 16, 2014 12:16 AM
Historically, most Ebola outbreaks have around 300 infections, although one had around 400. The current outbreak has around 2000. This one has the potential to be a worldwide epidemic. The Reston, VA virus resulted in the whole Lab being incased in cement. Scientists were afraid that one had gone airborne, although they were mistaken.

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