U.N.: Ebola cases could hit 20,000 in West Africa

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GENEVA — The Ebola out­break in West Africa is ac­cel­er­at­ing and could grow six times larger to in­fect as many as 20,000 peo­ple, the World Health Or­ga­ni­za­tion said Thurs­day. The U.N. health agency un­veiled a new road map for con­tain­ing the vi­rus, and sci­en­tists are fast-track­ing ef­forts to find a treat­ment or vac­cine.

Ebola has men­aced Africa for 40 years, but pre­vi­ously struck in re­mote vil­lages and was con­tained fairly quickly. This time, it has spread to ma­jor cit­ies in four coun­tries, pro­vok­ing un­rest as whole neigh­bor­hoods and towns have been sealed to the out­side.

An ex­per­i­men­tal vac­cine de­vel­oped by the U.S. gov­ern­ment and Glax­oSmithKline will be tested on hu­mans start­ing next week, the U.S. Na­tional In­sti­tutes of Health an­nounced Thurs­day. The NIH trial will use healthy adult vol­un­teers in Mary­land, and Brit­ish ex­perts will si­mul­ta­ne­ously test the same vac­cine in healthy peo­ple in the U.K., Gam­bia and Mali.

Pre­lim­i­nary re­sults on the vac­cine’s safety — not its ef­fec­tive­ness — could be avail­able in months.

Sci­en­tists also an­nounced that they have mapped the ge­netic code of this strain of Ebola to bet­ter un­der­stand how it kills. In a study pub­lished Thurs­day in the jour­nal Science, re­search­ers traced an ex­plo­sion of cases in this out­break to a sin­gle fu­neral in Guinea in May. They hope to use DNA map­ping to track mu­ta­tions that could be­come more wor­ri­some the lon­ger the out­break lasts, and make a dif­fer­ence in the how doc­tors spot and fight the dis­ease as vac­cines are de­vel­oped.

The out­break has now killed at least 1,552 peo­ple among 3,069 re­ported cases in Libe­ria, Si­erra Leone, Guinea and Ni­ge­ria, and the real case­load in ur­ban ar­eas could be two to four times higher. Mean­while, an en­tirely sep­a­rate Ebola out­break has killed 13 of 42 peo­ple sick­ened in a re­mote area of Congo, in Cen­tral Africa, the agency said.

With about a 50 per­cent mor­tal­ity rate among those known to be in­fected, the over­all death toll could reach 10,000 in the worst-case sce­nario. “I think that’s com­pletely un­ac­cept­able,” said the WHO’s emer­gency op­er­a­tions di­rec­tor, Bruce Ay­l­ward.

The new WHO plan would cost $489 mil­lion to sup­port 750 in­ter­na­tional health work­ers and 12,000 na­tional ones. It aims to:

• stop Ebola trans­mis­sion in af­fected coun­tries within six to nine months;

• pre­vent the spread of any new in­fec­tions within eight weeks of a case be­ing iden­ti­fied any­where in the world;

• and im­prove the pub­lic health re­sponses to Ebola in any na­tion with ma­jor trans­por­ta­tion hubs or bor­ders shared with af­fected coun­tries.

With the world’s sup­port, med­i­cal work­ers hope to take “the heat out of this out­break” within three months, Dr. Ay­l­ward said.

The U.N. agency’s an­nounce­ment was im­me­di­ately crit­i­cized by Doc­tors With­out Borders, a med­i­cal char­ity run­ning many of the treat­ment cen­ters in West Africa. “The WHO road map is wel­come, but it should not give a false sense of hope. A plan needs to be acted upon. Huge ques­tions re­main,” the char­ity’s op­er­a­tions di­rec­tor, Bruce de le Vingne, said in a state­ment. “States with the ca­pac­ity to help have the re­spon­si­bil­ity to mo­bi­lize re­sources to the af­fected coun­tries, rather than watch­ing from the side­lines, with a na­ive hope that the sit­u­a­tion will im­prove.”

Con­tain­ment is key, but it has to be done care­fully, in ways that don’t cause panic or ham­per the re­sponse, the WHO said. The U.N. agency has sup­ported the quar­an­tine of sick peo­ple, and said cor­don­ing off en­tire neigh­bor­hoods can be use­ful, as long as civil rights are re­spected.

But the WHO has called upon air­lines to re­sume flights to af­fected coun­tries, since Ebola is un­likely to spread through air travel. Health checks at air­ports should pro­vide suf­fi­cient pro­tec­tion, while still en­abling hu­man­i­tar­ian work­ers to get in. “Right now, there is a su­per risk of the re­sponse ef­fort be­ing choked off, be­ing re­stricted, be­cause we sim­ply can­not get enough seats on enough air­planes to get peo­ple in and out, and ro­tat­ing, to get goods and sup­plies in and out. ...,” Dr. Ay­l­ward said.

Ebola and the mea­sures used to con­trol it are mak­ing it harder for some of the world’s poor­est peo­ple to feed them­selves and seek med­i­cal care. Many thou­sands of peo­ple have been cut off from mar­kets; food prices have soared, and farm­ers are sep­a­rated from their fields. People who are now fear­ing in­fec­tion in hos­pi­tals are go­ing with­out treat­ment for other dis­eases, such as ma­laria, which kills around 600,000 each year — 90 per­cent of them in Africa.

The World Food Pro­gram says it needs $70 mil­lion im­me­di­ately to help feed 1.3 mil­lion peo­ple in Guinea, Libe­ria and Si­erra Leone in com­ing months, be­cause con­trol mea­sures have threat­ened food sup­plies.

Ni­ge­rian au­thor­i­ties, mean­while, con­firmed their first fa­tal­ity out­side the com­mer­cial cap­i­tal of Lagos, where a dy­ing Libe­rian-Amer­i­can air­line pas­sen­ger in­fected oth­ers in late July. They said a man sick­ened af­ter com­ing into con­tact with the pas­sen­ger had evaded sur­veil­lance and in­fected a doc­tor in south­ern Ni­ge­ria, who later died.

united nations - Nigeria - West Africa - Africa - Liberia - GlaxoSmithKline - World Health Organization - Sierra Leone - Guinea


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