Troops cordon off Ebola-struck areas—a tactic unseen since 1918

NYT: Cordon sanitaire was last used to stop spread of typhus

Governments in West Africa have implemented a "cordon sanitaire," drawing a line around areas affected by an out-of-control Ebola outbreak and allowing no one in or out, the New York Times' Donald McNeil reports.

According to NcNeil, the cordon strategy was last used when the border between Poland and Russia was shut down in 1918 to prevent a typhus outbreak from spreading west.

The plan was announced earlier this month at a meeting of officials from Guinea, Sierra Leone, and Liberia, the nation's hardest hit by the biggest Ebola outbreak in history. The World Health Organization (WHO) reported 1,848 cases and 1,013 deaths as of Monday.

Our timeline: How the Ebola outbreak spread

Officials from CDC and WHO believe the cordon strategy could contain the outbreak.

"It might work," says Martin Cetron, CDC's chief quarantine expert. "But it has a lot of potential to go poorly if it’s not done with an ethical approach. Just letting the disease burn out and considering that the price of controlling it—we don't live in that era anymore. And as soon as cases are under control, one should dial back the restrictions."

Experts say the cordon must allow food, water, and medical care to get to those inside the cordon area.

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How the cordon is working

Last week, troops began shutting down internal roads in Liberia and Sierra Leone, where the number of new cases continues to grow quickly. Military roadblocks check credentials and temperatures of anyone trying to move in or out of the area.

WHO says it will work with the World Food Program to make sure food and supplies get to people inside the cordon area. (WHO did not attend the meeting where the cordon was announced, but it has not opposed the move.) The Times notes that there have already been reports of rising food prices and fears of starvation.  

There have been nearly 20 Ebola outbreaks in Africa since the disease first emerged in 1976. Usually, the outbreaks are contained by outside health teams who recruit local health teams to trace contacts and hospitalize anyone potentially exposed to the virus.

But experts say this outbreak is spreading too fast for traditional containment efforts.

"It seems like a reflexive movement by the governments to show that they’re doing something, and since they have armies more elaborate than their health care systems, they use the army," says William Schaffner, the head of preventive medicine at Vanderbilt University's medical school (McNeil, New York Times, 8/12).


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