This morning (August 28), the World Health Organization (WHO) released a response roadmap that outlines a six to nine month timeline to contain and end the Ebola virus disease (EVD) outbreak that continues to rage on in West Africa. The roadmap operates under certain assumptions based on knowledge from previous outbreaks along with features that are unique to the current emergency. In order to implement containment strategies for the three main objectives listed in the roadmap, the WHO will require a total of roughly $490 million.
One of the major assumptions made by the WHO is how many people this outbreak will ultimately affect. As of today, there have officially been 3,069 suspected or confirmed cases in Guinea, Sierra Leone, Liberia and Nigeria—with 1,552 deaths (a 50.5% mortality rate). However, due to the lack of reporting in some areas they suspect those numbers could be two to four times higher. It is safest for the roadmap to overestimate how many people will be affected, so the WHO is prepared for as many as 20,000 patients before the outbreak is contained, though they don’t expect it to reach that high.
The WHO’s first objective is to identify and contain all EVD cases within the known affected areas and ultimately reverse the trend. This includes ensuring treatment centers have adequate staffing, necessary personal, protective equipment to keep the staff safe, laboratory equipment capable of confirming EVD diagnosis and safe burials of all bodies to prevent transmission at funerals. Affected countries will also need to ensure that those who may be sick are not allowed to travel and that infected individuals are kept away from metropolitan areas.
The roadmap also operates under the assumption that other countries in West Africa might be exposed to the virus. Therefore, the second objective of the roadmap is to have containment resources that are immediately available to swoop in and prevent the virus from widely spreading within eight weeks of the arrival of the index case.
The roadmap’s third and last object is to prepare unaffected countries that share their borders with affected regions for the possibility of exposure. Such precautions will require readily available areas for quarantine, the ability to recognize and diagnose EVD, and to report any suspected cases to the WHO.
In the US, safety trials are being expedited for an experimental vaccine by GlaxoSmithKline that attacks the surface proteins of two strains of Ebola. The vaccine contains only one gene from Ebola that has been inserted into a different virus that is unable to reproduce. This makes it impossible for the vaccine to cause EVD. Even still, GSK wants to perform a safety trial to ensure that it will not cause other negative side effects. An estimated 10,000 units will be manufactured during the trials and, assuming all goes well, will be sent to West Africa where volunteer patients in the hardest-hit areas will receive the first doses.
