The Ebola outbreak could grow to 10 000 new cases a week within two months, the World Health Organisation (WHO) warned this week as the death toll from the virus reached 4 447 people, most of them in West Africa.
Dr Bruce Aylward, WHO assistant director general, told a news conference in Geneva that the number of new cases was likely to be between 5 000 and 10 000 a week by early December.
WHO’s regular updates show that deaths have resulted from 4 447 of the 8 914 reported cases, but Aylward said any assumption that the death rate was 50% would be wrong. He put the death rate at 70% because many deaths are not reported or recorded officially.
Where detailed investigations have been carried out, it was clear that only 30% of people were surviving, he said, adding that the figure was similar in the three hardest-hit countries: Guinea, Liberia and Sierra Leone.
“This is a high mortality disease in any circumstances but particularly in these places,” said Aylward.
The grim forecast came as the first returning passengers from West Africa to London’s Heathrow airport were asked to undergo temperature checks and to complete questionnaires about their contacts with Ebola patients. The £9-million screening exercise has been criticised by some, who say it will not pick up those who have the virus but are not yet symptomatic.
In the United States it emerged that a nurse who contracted Ebola had been given a blood transfusion from Dr John Brantly, who has recovered from the disease.
The nurse, Nina Pham, was infected while caring for Thomas Duncan, who took ill on a visit from Liberia and died in Texas Health Presbyterian Hospital in Dallas. A second worker at the hospital was also diagnosed this week with the virus after reporting fever.
Brantly has donated blood for three Ebola patients, including Pham. “He’s a doctor. That’s what he’s there to do. That’s his heart,” said Jeremy Blume, a spokesperson for the nonprofit medical mission group Samaritan’s Purse, which Brantly was working for in Liberia.
The WHO said plasma from people who had overcome Ebola, which contains antibodies against the virus, should be tried as a treatment, but it is hard to use outside the sophisticated healthcare settings of the West.
The United Nation Mission for Ebola Emergency Response, set up to co-ordinate the fight against the disease, has set targets to isolate 70% of suspected cases in West Africa and to safely bury 70% of the dead within the next 60 days. It is called the 70-70-60 plan.
It is a tough target, but, said Aylward, if it took 90 days rather than 60, “a lot more people will die who shouldn’t and we will need that much more capacity on the ground to manage the caseload”.
As the numbers continue to rise, the need for beds and health personnel to treat the sick will increase. There is a serious shortage of trained and experienced people to lead the effort, according to Aylward.
Good training programmes are being put in place, particularly by the United Kingdom and the US, “but there is still the challenge of getting internationals on the ground who have expertise – in Ebola ideally”.
For the past four weeks, about 1 000 new infections a week – including suspected, confirmed and probable cases – have come to light.
Aylward said the WHO was concerned about the continued spread, especially in the capital cities of Sierra Leone, Guinea and Liberia.
“The virus is still moving geographically and escalating in the capitals,” he said. Large treatment centres are taking a long time to build and those that exist are full.
A new strategy, which the UK is supporting in Sierra Leone, is to set up a lot of community care units with a handful of beds, where people can stay and get basic care rather than endangering their families at home while waiting for a treatment centre bed.
The units will help people with fever from malaria. At the moment, they are not being treated or are afraid to go to hospital.
In Berlin, a UN medical worker infected with Ebola in Liberia has died despite “intensive medical procedures”.
The St Georg Hospital in Leipzig, Germany, said on Tuesday that the 56-year-old man, whose name has not been released, died overnight of the infection. The man tested positive for Ebola on October 6, prompting Liberia’s UN peacekeeping mission to place 41 other staff members under close medical observation.
He arrived in Leipzig for treatment on October 9. The hospital’s chief executive, Dr Iris Minde, said at the time there was no risk of infection for other people because he was kept in a secure isolation ward specially equipped with negative pressure in hermetically sealed rooms.
He was the third Ebola patient to be flown to Germany for treatment. The first man recovered and returned home to Senegal. A Uganda aid worker is still being treated in Frankfurt.
Facebook chief executive Mark Zuckerberg and his wife are donating $25-million to the Centre for Disease Control and Prevention (CDCP) to help address the Ebola epidemic. The money will be used by the US CDCP.
Zuckerberg wrote on his Facebook page: “We need to get Ebola under control in the near term so that it doesn’t spread further and become a long-term global health crisis that we end up fighting for decades.” – © Guardian News & Media 2014