The World Health Organization and the West Africa nations hit hardest by deadly Ebola will pump $100 million into an intensified push against the disease that will deploy several hundred more health workers.
The outbreak, which has killed 729 people, “requires WHO and Guinea, Liberia and Sierra Leone to take the response to a new level,” said Margaret Chan, WHO’s director-general, in a statement. It requires “increased resources, in-country medical expertise, regional preparedness and coordination.”
The U.S. Centers for Disease Control and Prevention also promised increased aid. The agency plans to add 50 more health workers to its present staff in West Africa, Director Tom Frieden said in a call today. Non-essential travel to the region should be avoided, the CDC said.
Stemming the tide of the outbreak could take 3 to 6 months, according to Frieden. The CDC is “surging our response,” he said. “And though it will not be quick and it will not be easy, we do know how to stop Ebola.”
The efforts come as the governments of Sierra Leone and Liberia took drastic actions to control their citizens’ movements around the countries. At the same time, the U.S. Peace Corps said it would evacuate 340 volunteers from the area and Nestle SA, the world’s largest food company, said business activities in the region will be affected.
The WHO’s latest survey, announced today, found that 57 people have died from Ebola in the last week.
State of Emergency
In Sierra Leone, which had 8 new cases and 9 deaths in the last week, President Ernest Bai Koroma declared a state of emergency that included quarantines for areas where the disease is found and a ban on public gatherings. President Ellen Johnson-Sirleaf of Liberia, where there were 80 new cases and 27 deaths, announced similar efforts a day earlier. Both canceled trips to Washington for a summit next week.
“The government will do its part, but you must do yours,” Johnson-Sirleaf told Liberians yesterday in a radio and television broadcast. “Denying the disease exists is not doing your part to keep yourself and your loved ones safe.”
The $100 million campaign, which both Liberia and Sierra Leone are supporting, “emphasizes the importance of surveillance, particularly in border areas, of risk assessments and of laboratory-based diagnostic testing of suspected cases,” Chan said in the statement. She also cited the need to better protect health workers from infection.
The WHO now has more about 120 staff in the region, according to the statement. They are seeking doctors, nurses, epidemiologists, social mobilization experts, logisticians and data managers to support that group, the group said.
Nestle, with about 6,000 employees operating in West and Central Africa, is monitoring the outbreak and following all precautions set out by local governments, Peggy Diby, a spokeswoman for the Vevey, Switzerland-based company, said in an e-mailed response to questions.
The West Africa countries hit “just aren’t prepared for something like this,” said Fiona Mclysaght of Concern Worldwide, a Dublin-based relief organization. Sierra Leone, where Mclysaght is based, “already has a high level of child and maternal mortality,” she said by telephone. “It has a very weak health system.”
Some needs are very basic, including a “real shortage of gloves” for community workers, Mclysaght said.
Unlike past outbreaks in isolated areas in single countries, the current one spans at least three countries with “very migrant populations moving across borders all the time,” said Jeremy Farrar, an infectious disease expert at Oxford University and director of the Wellcome Trust, a London-based medical research charity.
“We’ve got a broader issue around leadership in health care, particularly when it comes to rapidly emerging health problems, whether it’s malaria resistance in southeast Asia, or Ebola in Africa or flu,” Farrar said in an interview. “Our ability to respond to those I don’t think is fit for purpose.”
The region has never experienced an Ebola outbreak and the countries there have health-care infrastructure systems that can barely cope with everyday problems, let alone Ebola, he said.
The Peace Corps began evacuating its volunteers after a top official from Liberia’s education ministry died of Ebola after vomiting in his office and Sierra Leone’s top doctor in charge of the response to the disease died.
Two Peace Corps volunteers are being monitored after contact with a person who later died of Ebola, said Shira Kramer, a spokeswoman, in an e-mail. They don’t have symptoms and will return to the U.S. once they get medical clearance. The last time the group suspended operations in a country because of health concerns was 2003, when volunteers were recalled during a SARS outbreak in China, Kramer said.
Containing the spread of the disease has been complicated by local beliefs that the disease doesn’t exist, suspicion of medical workers and a lack of basic health-care services.
Ebola is believed to be carried by rats, bats and other animals and spread to humans through contact with bodily fluids. Humans pass the virus on to each other through contact with secretions. The disease, first reported in what is now the Democratic Republic of Congo in 1976, has shown an incubation period of 4-6 days in the latest outbreak and can cause bleeding from the eyes, ears and nose.
While Ebola has historically killed as many as 90 percent of those who contract it, the current outbreak has seen a fatality rate of only 60 percent, probably because of early treatment efforts, officials have said.
There is no cure for Ebola. Treatment relies on the immune system to fight off the disease. Patients are given replenishing fluids, their blood pressure is maintained through infusions, and infections are fought with antibiotics.
The U.S. White House also weighed in yesterday. Eric Schultz, a spokesman for President Barack Obama, said Obama is receiving regular updates on the situation in West Africa.
The government is “continuing to provide a range of support and assistance to those countries and multinational organizations responding to the outbreak,” Schultz said. The schedule for a planned Africa summit in Washington with leaders from that continent hasn’t been altered, he added.
“We have no higher priority than the protection of U.S. citizens overseas,” Schultz said during a briefing with reporters. “But again, as the CDC has stated, there’s no significant risk to the United States,” he said, referring to previous comments from the U.S. health agency.
Robert Quigley, a doctor and official at International SOS, a London and Singapore-based medical and travel security services firm, said the company had a 400 percent increase in requests for advice and information from May to June.
“It’s bringing back memories of the SARS endemic, which began in Asia and ended up over in Canada,” Quigley said by telephone. “It’s very reminiscent of the level of alertness.”
The difference between the outbreaks is that “with this disease, if you’re using proper hygienic practices and proper equipment, you should be able to protect yourself from contamination.”
The Peace Corps decision to leave West Africa follows by a day the announcement by two North Carolina-based charities providing medical care in Liberia that they would evacuate workers who aren’t essential to the Ebola efforts.
Two American citizens volunteering with those groups, Kent Brantly and Nancy Writebol, were infected with Ebola and are still receiving intensive care at the isolation center in Monrovia, Liberia’s capital, according to a statement released today by Samaritan’s Purse, one of the organizations.
Writebol received treatment using “an experimental serum,” according to the statement. While the group did not identify the product, some experimental drugs have shown promise against the disease in animal tests.
A safety trial could begin next year of an antibody cocktail developed by the National Microbiology Laboratory in Winnipeg, Canada, the U.S. Army and two drug companies, Mapp Biopharmaceutical Inc. of San Diego and Toronto-based Defyrus Inc., said Defyrus Chief Executive Officer Jeffrey Turner.
International aid groups are stepping up the response to the outbreak, said Catholic Relief Services country director Meredith Dyson by phone from Bo, Sierra Leone.
While there have been reports of unrest and attacks on some medical workers, Dyson said her group, which has about 140 local staff, is using established relationships within the communities it serves. They’ve stopped organizing large gatherings and limit travel by workers in regions with a high number of cases, she said.
Now the focus has turned to radio and less direct education efforts, Dyson said.
Doctors Without Borders is shifting more resources toward Sierra Leone, according to a statement on the group’s website. Even supplies at treatment centers can be limited, said Billy Fischer, a doctor with the University of North Carolina at Chapel Hill who returned to the U.S. after working on the Ebola response in Guinea on June 10.
“We did not have ability to check potassium and magnesium levels,” Fischer said in a telephone interview. That’s essential for Ebola patients who may be vomiting or have diarrhea and experience dangerous dehydration, he said.