Ebola – the WHO overview

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The World Health Organization (WHO) has been sending out bulletins on the spread of the Ebola virus, and there is no doubting that we have an epidemic on our hands.

The WHO gives the total number of probable, confirmed and suspected cases in the current outbreak of Ebola virus disease (EVD) in West Africa as 4366, with 2218 deaths, as at 7 September 2014. Countries affected are Guinea, Liberia, Nigeria, Senegal and Sierra Leone

There has been no indication of any down-turn in the epidemic in the three countries that have widespread and intense transmission (Guinea, Liberia, and Sierra Leone), with a surge in new cases in Liberia a particular cause for concern. Transmission is continuing in urban areas, with the surge in Liberia being driven primarily by a sharp increase in the number of cases reported in the capital, Monrovia.

Guinea

In line with the past two weeks, there continues to be a high number of confirmed new cases, with just over 100 cases newly reported in the 7 days up to the end of 7 September.

Most new cases have been reported in Macenta. Persistent transmission is ongoing in Gueckedou, which borders Macenta and was the origin of the outbreak, and in areas in and around the capital Conakry. In contrast with Liberia and Sierra Leone, several districts have not reported any cases, or have no newly reported cases in epidemiological week 36.

Liberia

Liberia has reported the most cases and deaths of any affected country in the outbreak, and reported a marked increase in cases during epidemiological week 36. The past week has seen almost 400 confirmed and probable cases reported – almost double the number of newly reported cases in the preceding week. The sharp increase has mainly been driven by a surge in cases in the capital, Monrovia. There is also evidence of substantial underreporting of cases and deaths and this is being investigated. There continues to be a high number of new cases in Lofa county, which borders the Guinean districts of Macenta and Gueckedou. An increase in new cases has also been reported in districts throughout the country, including Bong, Bomi, Grand Bassa, Margibi and Nimba.

Sierra Leone

The incidence of EVD in Sierra Leone remains very high, with almost 200 new cases reported in the past week. Transmission remains high in the capital, Freetown, and is stable and high in Kailahun and Kenema. There has been an increase in the number of new cases reported in the districts of Bo, Bombali, and Port Loko.

Responses in countries with widespread and intense transmission: Increases in demand for Ebola Treatment Centre (ETC) beds and referral unit places are continuing to outstrip capacity in Guinea, Liberia, and Sierra Leone. In Guinea, additional support is needed in Macenta (N’Zerekoré prefecture) and Forcariah (Kindia prefecture). In Liberia, the need for new treatment and referral centers is critical in the capital, Monrovia, in Nimba, and Margibi counties. In Sierra Leone there remains a need for additional support in the capital, Freetown and in Port Loko.

WHO continues to mobilize partners in response to these needs.

Infections among healthcare workers continue to be a concern during this outbreak. To date, 301 healthcare workers have developed the disease, almost half of whom have died. Lead national staff for Infection Prevention and Control (IPC), along with additional IPC staff for key ETCs, have now been deployed in Guinea, Liberia, and Sierra Leone. Coordination is underway to initiate global training plans for IPC in affected and countries and those neighboring affected countries.

The above is from the WHO report, which is quite detailed, showing the virus is not on the wane at this stage.

However, when we look at world statistics we must not forget that Malaria is one of the most severe public health problems worldwide. It is a leading cause of death and disease in many developing countries. According to the World Health Organization’s World Malaria 2013 Report, 3.4 billion people (half the world’s population) live in areas at risk of malaria transmission, and in 2012, malaria caused an estimated 207 million clinical episodes, and 627,000 deaths. An estimated 91 percent of deaths in 2010 were in the African Region.