The window of opportunity to contain the rapidly spreading Ebola outbreak in West Africa is closing unless international groups make dramatic efforts, CDC Director Tom Frieden announced Tuesday after returning from a visit to the infected nations.
"The outbreak is so overwhelming that what it requires now is an overwhelming response," he says, adding, "As long as Ebola is spreading anywhere, all of us need to be concerned."
His plea echoed those of the United Nations (UN) and Doctors Without Borders (DWB), which both issued urgent appeals on Tuesday for international aid, including money, physicians, protective gear, and biohazard experts. UN deputy secretary general Jan Eliasson said that the outbreak is "a test to international solidarity."
The World Health Organization (WHO) has confirmed 3,069 cases and 1,552 Ebola-related deaths since the outbreak began in Guinea in March—making it the deadliest and most complex outbreak since Ebola was first identified in 1976. Guinea, Liberia, and Sierra Leone have been hit the hardest, with Nigeria also suffering a few cases and a few unconfirmed cases in Senegal. Health officials say the Democratic Republic of Congo is suffering from a different strain of the virus.
The disease kills about half of the people it infects by causing untreatable bleeding that can claim victims in a matter of days or weeks.
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As opposed to past outbreaks, which were mostly in central Africa, this one occurred in an area unprepared to identify, fight, and coordinate efforts to contain Ebola. Moreover, the interconnectedness of the countries has allowed the virus to "hop" easily and unpredictably from one city to another, health experts say. A number of airlines have stopped flying to West African capitals, but experts say airports should improve screening of passengers at airports instead.
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"[T]he outbreak will get worse before it gets better, and it requires a well-coordinated big surge of outbreak response urgently," said Margaret Chan, head of WHO. Chan added that WHO "underestimated" the magnitude of the outbreak.
Last week, WHO outlined a $490 million, six-month plan to contain the outbreak. The agency said the plan would require thousands of additional medical personnel.
Officials from DWB criticized WHO this week for not acting sooner to contain the outbreak. "Six months into the worst Ebola epidemic in history, the world is losing the battle to contain it," DWB President Joanne Liu told UN diplomats this week, adding, "We cannot cut off the affected countries and hope this epidemic will simply burn out. To put out this fire, we must run into the burning building."
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Liu called on countries with expertise in handling biological threats to lend aid to the affected African nations in the form of mobile laboratories and field hospitals.
Frieden also outlined three key items that are needed to control the outbreak:
- Medical personnel with technical expertise, including nurses, hospital managers, and rapid response teams who can remain in Africa for three months;
- Resources, such as beds, medical equipment, and supplies like oil; and
- A coordinated global effort that would organize all testing, treatment, and allocating donations.
HHS announced Tuesday that it has accelerated the development of drugs to treat Ebola under a $24.9 million contract with Mapp Biopharmaceutical, the company that produced the experimental serum Zmapp that was used to treat to American health workers with Ebola. It appears that the serum helped two infected workers, but there is still limited data on its safety and efficacy, HHS's Nicole Lurie cautioned.
Last week: Ebola has killed 120 health care workers in Africa
Meanwhile, Canada has offered to donate 1,000 doses of an Ebola vaccine that is still undergoing trials. WHO is expected to convene a meeting later this week to decide how to distribute the experimental vaccines and treatments.
"The whole world is responsible and accountable to bring the Ebola threat under control," Chan said, adding, "We have no other option but to act urgently" (Rice, Modern Healthcare, 9/2 [subscription required]; Sengupta, New York Times, 9/2; Sun/Dennis, Washington Post, 9/2).
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