The largest Ebola virus disease (EVD) outbreak in history continues to rage on in West Africa. As of September 19, there have been 5,864 suspected or confirmed cases of EVD since December 2013, resulting in 2,811 deaths. This is a mortality rate of 47.9%, a vast improvement over figures from August 13, when 54.8% of suspected EVD cases resulted in death. The CDC released a report today (September 23) estimating the future number of cases in Liberia and Sierra Leone if action is not taken.
A significant problem in containing the outbreak has been due to public mistrust of health officials, causing many to hide their symptoms. Without infected persons going into quarantine, they risk infecting healthy family and friends. The CDC’s report has accounted for underreporting in the estimated number of cases. The report claims that the outbreak can be contained and ended if 70% of all patients are treated in an approved quarantined area by December 2014. For every 30 days that this does not happen, the number needed to account for those 70% could triple.
Without scaling up intervention efforts, the CDC estimates that the number of total cases in the outbreak could reach over 20,000 by September 30. The number of reported cases in Liberia is doubling every 20 days, while Sierra Leone is doubling every 30-40 days. As a worst case scenario, the outbreak could reach 1.4 million by January 2015. These figures correct for unreported cases by a factor of 2.5.
However, the CDC also believes worst case scenarios can be avoided, provided the number of beds at treatment facilities are increased and if more people come forward with their illness, rather than hiding it. Luckily, recent announcements regarding international support could help contain the outbreak.
It was finally announced last week that the United States will be sending US$750 million as well as 3,000 troops to help secure and stabilize the area. Two days later, the United Nations Security Council also pledged support against the outbreak, calling it “an imminent threat to international peace and security—not only for health, but also for food, housing, travel, trade, and commerce in an entire region.” An astonishing total of 130 countries pledged to send money or supplies to the affected region.
Though the money and support are desperately needed, there has been some criticism surrounding the fact that it was not done sooner. As an ounce of prevention is worth a pound of cure, getting that level of support now won’t be able to go as far as if it had been given even a month or two ago, or when the outbreak was declared in March.
However, helping with the outbreak will require a different skill set than entering violent territory, as the troops have been trained to do. It was only after regular containment measures failed that the US promised troops. Their mission will be to open 17 new 100-bed treatment centers in Liberia, and train medical staff to run them.
The weeks and months to come could change the course of the outbreak, and this level of support could also up the ante when dealing with outbreaks of infectious disease in the future.
