WHO: Severe Ebola outbreak in West Africa expected to continue

A severe outbreak of Ebola hemorrhagic fever in West Africa is expected to continue for the next 2 to 3 months, health officials said today during a press conference in Geneva.

“This is one of the most challenging Ebola outbreaks that we have ever faced,” said WHO Assistant Director-General Keiji Fukuda, MD, MPH. “Right now, we have documented cases both in Guinea and in Liberia.”

Keiji Fukuda

According to Fukuda, the outbreak has been difficult to contain because there has been a wide dispersion of cases in West Africa, and the disease is highly lethal, causing fear, anxiety and the spread of false rumors that interfere with efforts to prevent further transmission.

“It’s absolutely critical to get out as much accurate information as possible to the communities and countries that are affected,” he said.

To date, there have been 157 cases of infection and 101 deaths across three districts in Guinea, where the outbreak began in February. Of those cases, 67 were laboratory confirmed. Twenty cases of Ebola have been documented in the capital of Conakry, according to health officials. In Liberia, 21 cases and 10 deaths have been reported. Of these, five have been confirmed, all of whom have died.

According to Stéphane Hugonnet, MD, MSc, a medical officer at WHO’s department of global preparedness, surveillance and response, there has been no evidence so far that the infection has spread to Sierra Leone, Ghana and Mali, despite reports of suspected cases in all three countries. Investigations of these cases are ongoing.

The strain of Ebola virus responsible for this outbreak has been identified as the Zaire species, which can carry a 90% fatality rate. Symptoms include fever, weakness, muscle pain, headache, sore throat, vomiting, diarrhea, rash and impaired kidney and liver function, according to WHO. Internal and external bleeding also have been documented in some cases. However, the source of the outbreak affecting West Africa is not yet known.

Hugonnet said there are three groups that are at highest risk for infection: health care workers, family contacts and those attending funerals who may have direct contact with deceased patients.

In response to the outbreak, approximately 50 experts and support staff have been deployed to affected areas by WHO and other members of the Global Outbreak Alert Response Network, and an additional 17 are expected to mobilize shortly. WHO also is providing daily information updates through the International Health Regulations to continuously assess the threat in Guinea and other countries.

Two mobile laboratories have been installed in Guinea, one in Conakry and another in Guéckédou, located in the southern region of the country and one of the focal points of the outbreak. Hugonnet said the Guéckédou laboratory is capable of testing up to 50 samples per day, and should be “more than enough” to keep pace with new cases coming from Guinea and Liberia.

In addition, Médecins Sans Frontières have set up two isolation wards in Guinea to assist in the outbreak response.

Health officials said the priority is to identify new cases of infection, investigate contacts, implement prevention and control measures — particularly in health care settings — and treat and manage patients.

However, Fukuda noted that there are no vaccines or drugs that specifically target Ebola, and the disease must be treated symptomatically. Instead of developing new treatments, health officials currently are focused on identifying and breaking the chain of transmission.

“Ebola is clearly a severe disease,” Fukuda said. “This is an infection with a high fatality rate. But it is also an infection that can be controlled. We know very well how this virus is transmitted. We know the kinds of steps that can be taken to stop the transmission of this virus… And so, if people take the right precautions, this is an infection for which the transmission can be stopped.”

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