TIME Infectious Disease

New Fears About Ebola Spread After Plane Scare

Sierra Leone West Africa Ebola
In this photo taken on Sunday, July 27, 2014, medical personnel inside a clinic take care of Ebola patients on the outskirts of Kenema, Sierra Leone Youssouf Bah—AP

It's an unprecedented public-health scenario: since 1976, when the virus was first discovered, Ebola outbreaks were limited to remote corners of Congo and Uganda

(DAKAR, Senegal) — No one knows for sure just how many people Patrick Sawyer came into contact with the day he boarded a flight in Liberia, had a stopover in Ghana, changed planes in Togo, and then arrived in Nigeria, where authorities say he died days later from Ebola, one of the deadliest diseases known to man.

Now health workers are scrambling to trace those who may have been exposed to Sawyer across West Africa, including flight attendants and fellow passengers.

Health experts say it is unlikely he could have infected others with the virus that can cause victims to bleed from the eyes, mouth and ears. Still, unsettling questions remain: How could a man whose sister recently died from Ebola manage to board a plane leaving the country? And worse: Could Ebola become the latest disease to be spread by international air travel?

Sawyer’s death on Friday has led to tighter screening of airline passengers in West Africa, where an unprecedented outbreak that emerged in March has killed more than 670 people in Guinea, Sierra Leone and Liberia. But some health authorities expressed little confidence in such precautions.

“The best thing would be if people did not travel when they were sick, but the problem is people won’t say when they’re sick. They will lie in order to travel, so it is doubtful travel recommendations would have a big impact,” said Dr. David Heymann, professor of infectious diseases at the London School of Hygiene and Tropical Medicine.

“The important thing is for countries to be prepared when they get patients infected with Ebola, that they are isolated, family members are told what to do and health workers take the right steps.”

The World Health Organization is awaiting laboratory confirmation after Nigerian health authorities said Sawyer tested positive for Ebola, WHO spokesman Gregory Hartl said. The WHO has not recommended any travel restrictions since the outbreak came to light.

“We would have to consider any travel recommendations very carefully, but the best way to stop this outbreak is to put the necessary measures in place at the source of infection,” Hartl said. Closing borders “might help, but it won’t be exhaustive or foolproof.”

The risk of travelers contracting Ebola is considered low because it requires direct contact with bodily fluids or secretions such as urine, blood, sweat or saliva, experts say. Ebola can’t be spread like flu through casual contact or breathing in the same air.

Patients are contagious only once the disease has progressed to the point they show symptoms, according to the WHO. And the most vulnerable are health care workers and relatives who come in much closer contact with the sick.

Still, witnesses say Sawyer, a 40-year-old Liberian Finance Ministry employee en route to a conference in Nigeria, was vomiting and had diarrhea aboard at least one of his flights with some 50 other passengers aboard. Ebola can be contracted from traces of feces or vomit, experts say.

Sawyer was immediately quarantined upon arrival in Lagos — a city of 21 million people — and Nigerian authorities say his fellow travelers were advised of Ebola’s symptoms and then were allowed to leave. The incubation period can be as long as 21 days, meaning anyone infected may not fall ill for several weeks.

Health officials rely on “contact tracing” — locating anyone who may have been exposed, and then anyone who may have come into contact with that person. That may prove impossible, given that other passengers journeyed on to dozens of other cities.

Patrick Sawyer had planned to visit his family in Minnesota next month to attend two of his three daughters’ birthdays, his wife, Decontee Sawyer, told KSTP-TV in Minnesota.

“It’s a global problem because Patrick could have easily come home with Ebola, easy,” she said. The Associated Press left phone and email messages for her Monday.

International travel has made the spread of disease via airplanes almost routine. Outbreaks of measles, polio and cholera have been traced back to countries thousands of miles away. Even Ebola previously traveled the globe this way: During an outbreak in Ivory Coast in the 1990s, the virus infected a veterinarian who traveled to Switzerland, where the disease was snuffed out upon arrival and she ultimately survived, experts say.

Two American aid workers in Liberia have tested positive for the virus and are being treated there. U.S. health officials said Monday that the risk of the deadly germ spreading to the United States is remote.

The mere prospect of Ebola in Africa’s most populous nation has Nigerians on edge.

In Nigeria’s capital, Abuja, Alex Akinwale, a 35-year-old entrepreneur, said he is particularly concerned about taking the bus, which is the only affordable way to travel.

“It’s actually making me very nervous. If I had my own car, I would be safer,” he said. “The doctors are on strike, and that means they are not prepared for it. For now I’m trying to be very careful.”

It’s an unprecedented public health scenario: Since 1976, when the virus was first discovered, Ebola outbreaks were limited to remote corners of Congo and Uganda, far from urban centers, and stayed within the borders of a single country. This time, cases first emerged in Guinea, and before long hundreds of others were stricken in Liberia and Sierra Leone.

Those are some of the poorest countries in the world, with few doctors and nurses to treat sick patients let alone determine who is well enough to travel. In Sawyer’s case, it appears nothing was done to question him until he fell sick on his second flight with Asky Airlines. An airline spokesman would not comment on what precautions were being taken in the aftermath of Sawyer’s journey.

Liberian Assistant Health Minister Tolbert Nyenswah told The Associated Press last week that there had been no screening at Liberia’s Monrovia airport. That changed quickly over the weekend, when President Ellen Johnson Sirleaf said a new policy on inspecting and testing all outgoing and incoming passengers will be strictly observed. She also announced that some borders were being closed and communities with large numbers of Ebola cases would be quarantined.

International travelers departing from the capitals of Sierra Leone and Guinea are also being checked for signs of fever, airport officials said. Buckets of chlorine are also on hand at Sierra Leone’s airport in Freetown for disinfection, authorities said.

Still, detecting Ebola in departing passengers might be tricky, since its initial symptoms are similar to many other diseases, including malaria and typhoid fever.

“It will be very difficult now to contain this outbreak because it’s spread,” Heymann said. “The chance to stop it quickly was months ago before it crossed borders … but this can still be stopped if there is good hospital infection control, contact tracing and collaboration between countries.”

Nigerian authorities so far have identified 59 people who came into contact with Sawyer and have tested 20, said Lagos State Health Commissioner Jide Idris. Among them were officials from ECOWAS, a West African governing body, airline employees, health workers and the Nigerian ambassador to Liberia, he said. He said there have been no new cases of the disease.

___

Associated Press Medical Writer Maria Cheng reported from London. Jonathan Paye-Layleh in Monrovia, Liberia; Clarence Roy-Macaulay in Freetown, Sierra Leone; Erick Kaglan in Lome, Togo; and Heather Murdock in Abuja, Nigeria, also contributed to this report.

TIME Infectious Disease

Here’s What You Need to Know Now About the Ebola Crisis

After a passenger brought Ebola to Africa’s largest city, health officials are on alert for signs of the infection among passengers. Here's the latest

The Ebola outbreak has already led to more than 670 deaths in West Africa, but a man who became ill on a flight from Liberia to Lagos, Africa’s largest city, has raised alarms for public-health officials after he later died of the virus.

Liberia has closed most of its borders, and airports in Nigeria are now screening passengers arriving from foreign countries for Ebola’s symptoms, which include fever, headache, joint pain, lack of appetite, difficult breathing and sore throat. In its advanced stages, Ebola leads to diarrhea, vomiting and internal bleeding. While the airport screenings are meant to ease travelers’ minds, the reality is that the Ebola virus can’t be detected soon after infection — the first signs of the virus are red eyes and a rash, which could be caused by many different things. Plus, outgoing flyers are not being tested and its unclear at this point if over countries will follow suit. People have recovered from infection with the virus, but the mortality rate ranges from 50% to 90%.

(MORE: Here’s What It Will Take to Contain the Worst Ebola Outbreak in History)

Who can spread the virus?

The virus takes anywhere from two to 21 days to incubate and start causing symptoms, but Dr. Stephan Monroe, deputy director of the National Center for Emerging and Zoonotic Infectious Diseases at the U.S. Centers for Disease Control and Prevention (CDC), said during a telebriefing Monday that infected patients only spread the disease when they have symptoms. Because the virus is transmitted through direct contact with fluids like saliva or blood from infected patients, airport officials are essentially looking for passengers who might have severe vomiting, diarrhea or other bodily secretions that could reach other travelers.

Are Nigeria’s airport screenings enough?

Nigeria is screening incoming passengers for such symptoms and may also take passengers’ temperature. Nigerian officials have also created holding rooms to isolate patients or passengers who are suspected of being infected, so they can be triaged to further medical care.

But because some of the early symptoms of Ebola mirror those of other ailments, including malaria, CDC officials say the strongest way to contain spread of infectious diseases is by instituting travel restrictions at the source. That’s why Liberia has closed all its borders except for three land crossings where travelers can be screened and treatment services provided if needed.

Dr. Marty Cetrone, director of the division of global migration and quarantine at the CDC, said during the briefing that officials can also try to contain the outbreak by using questionnaires asking travelers at these checkpoints about their recent travel history as well as their potential exposure to the virus through friends or other close contacts.

How did this outbreak get so bad?

Health officials aren’t sure why this particular outbreak has led to a historic number of deaths, but note that social and cultural practices may be driving spread of the virus. In many of the communities where the virus remains active, there is still denial about the disease, and stigma associated with getting ill, which discourages patients from getting early hydration and nutrition that can help them to overcome the infection. While there is no treatment for the virus, these measures can lower the death rate for some. Funeral practices that involve touching the deceased may also help the virus move from host to host.

How at-risk are Americans?

Monroe says the risk of Ebola for U.S. citizens who haven’t traveled to West Africa remains low. There are no restrictions on travelers entering the U.S., but the CDC has issued a Level 2 travel advisory for people traveling to Guinea, Liberia or Sierra Leone, recommending that they avoid contact with blood or other bodily fluids that might contain the virus, and use the proper protective equipment to avoid infection. The advisory applies mostly to health care or humanitarian aid workers, who so far make up the largest group of people affected by Ebola. “[Transmission] involves not only touching the contaminated body fluid but introducing it through some mucous membrane or cut on the skin,” said Monroe.

For anyone who has recently traveled to those countries or might have been exposed to someone who was ill in that area, health officials are advising a 21-day fever watch to ensure that no active infection is occurring.

What if an infected person flies into the U.S.?

The CDC is also preparing for the remote possibility that a passenger from the region who is ill boards a plane and lands in the U.S. and starts infecting residents. The agency is informing its network of physicians in state and local public-health facilities about how to look for signs of Ebola. “We are sending Health Alert Network notices about the importance of taking steps to prevent spread of the virus,” said Monroe. That includes procedures on asking patients about their recent travel history, as well as using the proper personal protective equipment, such as masks, gloves and gowns if they suspect an Ebola infection.

They’re confident that these measures will be effective, since infection with a virus related to Ebola, Marburg, was successfully contained in the Netherlands with isolation and barrier procedures. No health care workers contracted the virus from that patient. Health officials hope that with the proper preparation and education, that record can apply to Ebola as well, if it makes it beyond the heavily affected countries in West Africa.

TIME infectious diseases

Liberia Closes Borders to Curb Ebola Outbreak

Ebola in Liberia
Liberian health workers in protective gear on the way to bury a woman who died of the Ebola virus from the isolation unit in Foya, Lofa County, Liberia on July 2, 2014. Ahmed Jallanzo—EPA

Outbreak is already the largest on record

The Liberian government closed off most of the country’s border crossings Sunday in an effort to curb an Ebola outbreak that has already killed over 670 people across Guinea, Liberia, and Sierra Leone and become the largest outbreak of the virus on record.

President Ellen Johnson Sirleaf said the airport will remain open, but that all travelers coming in and out will be tested for the virus, Reuters reports. “All borders of Liberia will be closed with the exception of major entry points,” she said. “At these entry points, preventive and testing centers will be established, and stringent preventive measures to be announced will be scrupulously adhered to.”

Ebola kills around 90% of those who contract it, although the current outbreak has only killed around 60%. Numerous medical personnel have succumbed to the most recent outbreak, including Dr. Samuel Brisbane, one of Liberia’s most high-profile doctors, who died Saturday.

Two Americans, Dr. Kent Brantly and missionary Nancy Writebol, have contracted the virus and are currently in stable condition, NBC reports. Both worked for North Carolina-based aid group Samaritan’s Purse, and spokeswoman Melissa Strickland said that they are both “alert.”

Brantly and Writebol had followed all CDC and WHO guidelines and worn full protective equipment when treating Ebola patients, including gloves, goggles, face protection, and full body coverings, Strickland said.

Since Ebola is highly contagious, Liberia has also restricted public gatherings such as marches and demonstrations until the outbreak is brought under control. “No doubt, the Ebola virus is a national health problem,” President Sirleaf said in a statement. “And as we have also begun to see, it attacks our way of life, with serious economic and social consequences.”

TIME Liberia

Ebola Kills Liberian Doctor, 2 Americans Infected

Handout of Dr. Kent Brantly of Samitan's Purse relief organization in Monrovia
Dr. Kent Brantly, left, cares for Ebola patients at the ELWA Hospital in Monrovia, Liberia Samaritan's Purse—Reuters

(MONROVIA, Liberia) — One of Liberia’s most high-profile doctors has died of Ebola, officials said Sunday, and an American physician was being treated for the deadly virus, highlighting the risks facing health workers trying to combat an outbreak that has killed more than 670 people in West Africa — the largest ever recorded.

A second American, a missionary working in the Liberian capital, was also taken ill and was being treated in isolation there, said the pastor of a North Carolina church that sponsored her work.

Dr. Samuel Brisbane, a top Liberian health official, was treating Ebola patients at the country’s largest hospital, the John F. Kennedy Memorial Medical Center in Monrovia, when he fell ill. He died Saturday, said Tolbert Nyenswah, an assistant health minister. A Ugandan doctor died earlier this month.

The American physician, 33-year-old Dr. Kent Brantly, was in Liberia helping to respond to the outbreak that has killed 129 people nationwide when he fell ill, according to the North Carolina-based medical charity, Samaritan’s Purse.

He was receiving intensive medical care in a Monrovia hospital and was in stable condition, according to a spokeswoman for the aid group, Melissa Strickland.

“We are hopeful, but he is certainly not out of the woods yet,” she said.Early treatment improves a patient’s chances of survival, and Brantly recognized his own symptoms and began receiving care immediately, Strickland said.

The American missionary, Nancy Writebol, was gravely ill and in isolation in Monrovia, her husband, David, told a church elder via Skype, according to the Rev. John Munro, pastor of Calvary Church in Charlotte, N.C.

Munro said the couple, who had been in Liberia for about a year, insisted on staying there despite the Ebola threat. “These are real heroes — people who do things quietly behind the scenes, people with a very strong vocation and very strong faith,” Munro said.

There is no known cure for the highly contagious virus, which is one of the deadliest in the world. At least 1,201 people have been infected in Liberia, Sierra Leone and Guinea, according to the World Health Organization, and 672 have died. Besides the Liberian fatalities, 319 people have died in Guinea and 224 in Sierra Leone.

Ominously, Nigerian authorities said Friday that a Liberian man died of Ebola after flying from Monrovia to Lagos via Lome, Togo. The case underscored the difficulty of preventing Ebola victims from traveling given weak screening systems and the fact that the initial symptoms of the disease — including fever and sore throat — resemble many other illnesses.

Health workers are among those at greatest risk of contracting the disease, which spreads through contact with bodily fluids.

Photos of Brantly working in Liberia show him swathed head-to-toe in white protective coveralls, gloves and a head-and-face mask that he wore for hours a day while treating Ebola patients.

Earlier this year, the American was quoted in a posting about the dangers facing health workers trying to contain the disease. “In past Ebola outbreaks, many of the casualties have been health care workers who contracted the disease through their work caring for infected individuals,” he said.

There is no known cure for Ebola, which begins with symptoms including fever and sore throat and escalates to vomiting, diarrhea and internal and external bleeding.

The WHO says the disease is not contagious until a person begins to show symptoms. Brantly’s wife and children had been living with him in Liberia but flew home to the U.S. about a week ago, before the doctor started showing any signs of illness, Strickland said.

“They have absolutely shown no symptoms,” she said.

A woman who identified herself as Brantly’s mother said the family was declining immediate comment when reached by phone in Indiana.

Besides Brantly and the two doctors in Liberia, Sierra Leone’s top Ebola doctor and a doctor in Liberia’s central Bong County have also fallen ill.

The situation “is getting more and more scary,” said Nyenswah, the country’s assistant health minister.

Meanwhile, the fact that a sick Liberian could board a flight to Nigeria raised new fears that other passengers could take the disease beyond Africa.

Nigeria’s international airports were screening passengers arriving from foreign countries, and health officials were also working with ports and land borders to raise awareness of the disease. Togo’s government also said it was on high alert.

Security analysts were skeptical about the usefulness of these measures.

“In Nigeria’s case, the security set-up is currently bad, so I doubt it will help or have the minimum effectiveness they are hoping for,” said Yan St. Pierre, CEO of the Berlin-based security consulting firm MOSECON.

An outbreak in Lagos, a megacity where many lived in cramped conditions, could be a major public health disaster.

The West Africa outbreak is believed to have begun as far back as January in southeast Guinea, though the first cases weren’t confirmed until March.

Since then, officials have tried to contain the disease by isolating victims and educating populations on how to avoid transmission, though porous borders and widespread distrust of health workers have made the outbreak difficult to bring under control.

News of Brisbane’s death first began circulating on Saturday, a national holiday marking Liberia’s independence in 1847.

President Ellen Johnson Sirleaf used her Independence Day address to discuss a new taskforce to combat Ebola. Information Minister Lewis Brown said the taskforce would go “from community to community, from village to village, from town to town” to try to increase awareness.

In Sierra Leone, which has recorded the highest number of new cases in recent days, the first case originating in Freetown, the capital, came when a hairdresser, Saudata Koroma, fell ill. She was forcibly removed from a government hospital by her family, sparking a frantic search that ended Friday. Kargbo, the chief medical officer, said Sunday that Koroma died while being transported to a treatment center in the east of the country.

TIME infectious diseases

Ebola Virus Suspected in Lagos, Nigeria

Members of Doctors Without Borders (MSF) put on protective gear at the isolation ward of the Donka Hospital in Conakry, Guinea on July 23, 2014.
Members of Doctors Without Borders (MSF) put on protective gear at the isolation ward of the Donka Hospital in Conakry, Guinea on July 23, 2014. Cellou Binani—AFP/Getty Images

Samples have been sent to the WHO for testing

The deadly Ebola virus that has killed hundreds across West Africa may have hit Africa’s most populous city, according to a Thursday statement from the country’s ministry of health.

Officials in Lagos, Nigeria are testing a Liberian man after he collapsed at the city’s airport displaying symptoms of the disease. Government representatives also expressed concern because the man worked and lived in Liberia where the disease is prevalent. Blood samples have been sent to the World Health Organization to be tested.

The virus has spread rapidly since an outbreak earlier this year, and health organizations have said they are struggling to control its spread.

In a statement, Nigerian health officials asked that residents “remain calm and take appropriate measures for the prevention and control of the disease.” These prevention measures include avoiding contact with people or animals suspected of having the disease.

While the outbreak has killed hundreds already in Guinea, Liberia and Sierra Leone, it could be especially damaging if it hit Lagos, an urban center with a population of 21 million.

TIME Infectious Disease

Sierra Leone’s Chief Ebola Doctor Contracts the Deadly Virus

Sheik Umar Khan, head doctor fighting the deadly tropical virus Ebola in Sierra Leone, poses for a picture in Freetown, June 25, 2014.
Sheik Umar Khan, head doctor fighting the deadly tropical virus Ebola in Sierra Leone, poses for a picture in Freetown, June 25, 2014. Reuters Staff—REUTERS

Symptoms of Ebola include high fevers, diarrhea and vomiting

The top doctor fighting Sierra Leone’s deadly ebola outbreak has contracted the virus himself, the country’s government said Tuesday.

Sheik Umar Khan, 39, is leading an assault on the virus that the World Health Organization says has already claimed 632 lives—206 in Sierra Leone alone as of July 17.

The ebola virus is ruthless, with a mortality rate of 90%. Transmitted through direct contact with the body fluid, blood and infected tissue of victims, ebola can easily spread to the health workers working hard to fight it.

“Health workers are prone to the disease because we are the first port of call for somebody who is sickened by disease. Even with the full protective clothing you put on, you are at risk,” Khan said in an interview with Reuters, before displaying the illness.

Khan is credited with treating more than 100 Ebola victims, Reuters reports, and is considered a “national hero” by the nation’s health ministry. The doctor has been moved to a treatment facility run by the medical charity Doctors Without Borders, according to a statement released Tuesday from the president’s office.

The outbreak began in Guinea this February, but has quickly spread across West Africa.

[Reuters]

TIME Infectious Disease

Report: U.S. Citizen Tested for Ebola in Ghana

This scanning electron micrograph, SEM, depicts a number of Ebola virions. UIG/Getty Images

U.S. Embassy is working to confirm case of deadly virus

A U.S. citizen who traveled in regions of West Africa in the grip of an ebola virus outbreak is being tested for the disease in Ghana.

“He is an American and records showed that he had been to Guinea and Sierra Leone in the past few weeks,” a senior health ministry official told Reuters in an interview. The patient is reportedly quarantined in a clinic in the capital Accra and test results, which should be available later on Monday, are being examined at the Noguchi Memorial Institute of Medical Research.

According to Reuters, the U.S. embassy in Ghana has been informed of the case and is working to confirm it.

The ebola outbreak, which started in Guinea, has been declared “out of control” by the health group Doctors Without Borders, which is treating patients in Western Africa. Ebola causes fevers, vomiting, diarrhea and death, and has spread from Guinea to Sierra Leone and Liberia.

[Reuters]

TIME

Here’s What It Will Take to Contain the Worst Ebola Outbreak in History

Doctors Without Borders is calling the latest outbreak in west Africa “out of control,” and here’s why

+ READ ARTICLE

The “perfect storm” analogy is often over-used when it comes to disease outbreaks–all the elements that you don’t want to see converge to make conditions ripe for a bacteria, or, in this case, a virus, to rip through a population at lightning speed: geography, society, culture, a potent virus, reluctant politicians and a weak health care system. But all those factors are contributing to history’s largest-ever Ebola outbreak, which the World Health Organization now calls a “crisis.” Since early spring, Ebola has spread to two additional countries, Sierra Leone and Liberia, infecting 635 people and claiming nearly 400 lives.

MORE: Ebola Outbreak Beyond Our Control, Doctors Without Borders Says

The Ebola virus causes a nasty infection that triggers an inflammatory reaction so intense, patients essentially drown in their own fluids as they bleed internally and externally — victims’ bodies are overtaken with a well-intentioned defensive system run amok. Anyone who comes into contact with the infected fluids can also get infected. As of now, there are no treatments for Ebola. The only hope is for the body to remain strong enough to overcome the initial onslaught from the virus and start to develop antibodies to fight it. As patients get sick, they stop eating and drinking, becoming too weak to develop these critical antibodies. Left alone, nine out of 10 infected people die. At treatment centers, where doctors can provide supportive care with nutrients and hydration, that figure improves to seven out of 10.

Those aren’t great odds, and social and cultural practices in west Africa may be stacking the deck even further. Dr. Michel Van Herp, a physician and epidemiologist with Doctors Without Borders who traveled to Guinea when the outbreak began, says he has been confronted by hostile villagers who did not welcome the medical help.

“I have had aggressive people in front of me in the village,” Van Herp says, as he tried to bring infected patients to treatment centers. “Most villagers are denying the existence of Ebola.”

MORE: 6 Things to Know About the Latest Ebola Outbreak

That denial is fueled by a strong stigma against the disease. In other parts of central Africa where smaller outbreaks occurred, survivors of Ebola returned to their villages only to find their homes burned and their remaining family members ostracized for having been infected.

Such denial not only increases the risk that the close contacts of those infected by Ebola will be affected, but it also creates the ideal situation for the virus to gain an even broader foothold. A critical first step in containing any outbreak of infectious disease involves carefully tracing which people patients have been in contact with. Only then can scientists start to create barriers against the virus by keeping it contained to people known to have already been exposed. In Guinea, denial and stigma against Ebola means some patients who believe they are infected are fleeing to other villages or even crossing the border to another country.

“If you have a guy who runs away to a village 20 kilometers away, then you need to start from scratch in that village to trace his contacts,” says Van Herp.

MORE: What You Need to Know About the Ebola Virus

Making things worse is the fact that in the part of western Africa where the outbreak is centered, the population is particularly mobile, often traveling to nearby Sierra Leone and Liberia in search of work.

“We’ve seen kids who travel between three or four villages, and between the countries before they are too sick and weak that they aren’t able to work any more,” says Van Herp. “In the meantime they have contaminated three or four villages.”

Cultural practices mean that the potential for transmitting Ebola is also amplified if a respected elder is affected.

“If a guy like this falls sick, then more people try to cure him,” says Van Herp. “If he dies, more people are involved in the process of the funeral–in cleaning the dead body, and preparing the body. We have seen that one patient can give disease to 15 or 20 other people.”

Van Herp plans to return to Guinea in July, but he says that so far, there hasn’t been much improvement in people’s education and acceptance about Ebola, despite the rising number of deaths. The WHO has called an emergency meeting of 11 nations next week to discuss ways of containing the outbreak. Attending will be the Minister of Health from Uganda, where the government has made efforts to address the stigma associated with Ebola by creating a survivors network to educate and inform the public about the disease–and hopefully reduce fear and misperceptions about the virus.

TIME Infectious Disease

Ebola Outbreak Beyond Our Control, Doctors Without Borders Says

Doctors Without Borders/Médecins Sans Frontières staff carrying the body of a person killed by viral hemorrhagic fever at a center for victims of the Ebola virus in Gueckedou on April 1, 2014.
Doctors Without Borders/Médecins Sans Frontières staff carrying the body of a person killed by viral hemorrhagic fever at a center for victims of the Ebola virus in Gueckedou on April 1, 2014. Seyllou—AFP/Getty Images

The medical group treating Ebola patients in Africa says it can't keep up with emerging cases

Doctors Without Borders/Médecins Sans Frontières (MSF), the medical organization treating Ebola patients in West Africa, says it has reached the limit of what the group can do to fight the worsening outbreak there.

In a statement released Monday, the organization said it is the only group treating people infected with the disease in Guinea, Sierra Leone and Liberia. “We have reached our limits. Despite the human resources and equipment deployed by MSF in the three affected countries, we are no longer able to send teams to the new outbreak sites,” said Dr. Bart Janssens, MSF director of operations, in a statement.

Since the outbreak started in March in Guinea, MSF says it has treated 470 patients (215 of them confirmed cases) related to Ebola. The group has 300 international and national staff working in West Africa and has sent more than 40 tons of equipment and supplies. But with new cases emerging in new places like Sierra Leone and Liberia, the organization says it cannot keep up. Earlier, the group said the outbreak is “out of control.”

Since the disease emerged earlier this year, there have been over 520 cases and 330 deaths. Ebola is a very infectious hemorrhagic fever that has up to a 90% fatality rate. In April, Guinea’s Health Ministry said deaths from Ebola slowed and that the outbreak was close to being brought under control. But the World Health Organization reported earlier this month that in Guinea alone, there were 37 new cases and 21 new deaths between May 29 and June 1, 2014.

MSF said more groups need to help quell public anxiety over the disease, and that people are distrusting health facilities and not heeding warnings about funeral rituals that put them at risk. “Civil society and political and religious authorities are failing to acknowledge the scale of the epidemic, with few prominent figures spreading messages promoting the fight against the disease,” the organization said. In the statement, Janssens says the WHO and neighboring countries need to provide resources necessary for an epidemic.

The WHO has not released a response to the MSF statement but says it is working with local governments and is planning a regional meeting in Ghana on July 2, the Associated Press reports. The WHO does not currently recommend any restrictions to travel or trade in Guinea, Liberia or Sierra Leone.

TIME Infectious Disease

Ebola Still On The Rise in West Africa, WHO Reports

GUINEA-HEALTH-EBOLA
Health workers wearing protective suits walk in an isolation center for people infected with Ebola at Donka Hospital in Conakry on April 14, 2014. CELLOU BINANI—AFP/Getty Images

The global health body says 21 deaths and 37 new suspected cases have made this outbreak one of the largest in 7 years, defying local claims that the virus is under control

Ebola cases have spiked in the west African nations of Guinea and Sierra Leone, according to new figures released by the World Health Organization on Wednesday, undermining local officials’ claims that the virus has been contained.

The outbreak caused a suspected 21 deaths and 37 infections in Guinea between May 29 and June 1. In the same period, Sierra Leone recorded 13 new cases.

The updated tally brings the total number of suspected cases to 328. Health officials have confirmed the presence of Ebola in 193 of the cases so far, making it one of the largest recorded outbreaks in seven years.

Ebola is a highly infectious haemorrhagic fever that can have up to 90% fatality rates.

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