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WHO / EBOLA UPDATE
STORY: WHO/EBOLA UPDATE
TRT: 3.11
SOURCE: WHO
RESTRICTIONS: NONE
LANGUAGE: ENGLISH /NATS
DATELINE: 22 SEPTEMBER 2014, GENEVA, SWITZERLAND
1. Wide shot, press room
2. SOUNDBITE (English) Dr Christopher Dye, Director of Strategy, WHO Office of the Director-General, and co-author of the NEJM article:
“The Ebola Outbreak will not be remove from the human population within the overall weeks or months. That’s what happened in the previous outbreaks. Now we know that this Outbreak is bigger and it is going to take longer. But what we expect to happen if all the control measure are put in place is that on the order of weeks or a few months from now Ebola will disappear from human population and that’s the experience we had before. The alternative possibility that we are talking about is that the epidemic is simply rumbles on as it as for the last few months for the next few years of the order years rather that months. Under those circumstances the fear is that Ebola will be more or less a permanent feature of the population of course it could be extinguish later on but that is the concern that we have this will be an epidemic that last years not weeks or months."
3. Cutaway, notepad
4. SOUNDBITE (English) Dr Christopher Dye, Director of Strategy, WHO Office of the Director-General, and co-author of the NEJM article:
“In terms of community awareness a three day lock down has a huge effect so people who were possibly unaware of Ebola before in Sierra Leone even in fairly remote areas will be aware if it now.”
5. Wide shot, press room
6. SOUNDBITE (English) Dr Christopher Dye, Director of Strategy, WHO Office of the Director-General, and co-author of the NEJM article:
“The best quality of patients care reduces the risk of death and what we know is that there is a great scope for increasing the quality of patient care and we would expect therefore to see these estimated cases mortality that we put at around about 60% or 70% at the moment we would expect to see that to come down. The trouble is as you know we don’t have specific drugs for treating Ebola, we don’t anti-viral treatment which would reduce at least not in any quantity at the moment anti viral treatment that would reduce viral load. So the extent to which mortality can be reduced even with good patient care under the circumstances where people are working is not clear but we would expect the mortality rate to go down.”
7. Cutaway, notepad
8. SOUNDBITE (English) Dr Christopher Dye, Director of Strategy, WHO Office of the Director-General, and co-author of the NEJM article:
“We are talking about 5000, 6000 cases that we have seen at the moment and as we stressed that’s many many more that we have ever seen before but remember also it’s in a population a combine population of these countries of 22 million people so there are many, many people who haven’t been exposed to Ebola yet who could potentially be expose and are potential new sources of cases.”
9. Wide shot, press room
Experts from the World Health Organization (WHO) and Imperial College, London said on Monday (22 Sept)that unless Ebola control measures in West Africa are enhanced quickly, the numbers will continue to climb exponentially, and more than 20,000 people could get infected by early November.
In a study published in the New England Journal of Medicine released six months after WHO was first notified of the outbreak in West Africa, public health epidemiologists and statisticians reviewed data since the beginning of the outbreak in December 2013 to determine the scale of the epidemic, better understand the spread of the disease, and what it will take to reverse the trend of infections.
Although WHO was first notified of the outbreak on 23 March 2014, investigations retroactively revealed the outbreak started in December 2013. Between 30 December 2013 and 14 September 2014, a total of 4507 cases were reported to WHO.
The data in the study help clarify some details of who is most affected by this outbreak. For example, there have been mixed reports on whether women might be harder hit because they are more likely to care for sick, or whether it would be men who might be more likely to bury the highly-infectious dead bodies.
The extensive review of data also allowed for a closer look at case fatality rate,
but the case fatality rate was lower when only hospitalized patients were considered, supporting evidence that getting patients to good, supportive health care quickly makes a difference.
The examination of the data also showed the spread more clearly. In late December, the first cases were reported in the forest areas of Guinea. By March, when the government sounded the alarm to WHO, cases had already spread from the forest area to the capital of Conakry. In May, the focus of the outbreak in Guinea expanded strongly to Sierra Leone and in June it really took hold in Liberia. From July onward, there were sharp increases in case numbers in all three countries.
Although the current epidemic in West Africa is unprecedented in scale, the clinical course of infection and the transmissibility of the virus are similar to those in previous Ebola outbreaks.
There are challenges in this region that exacerbate the struggles to contain the virus quickly. Most importantly the health systems in all three countries were shattered after years of conflict and there was a significant shortage of health workers, leaving the system weaker than in other countries with Ebola outbreaks.
In addition, certain characteristics of the population may have led to the rapid spread of the disease, for example, the populations of Guinea, Liberia, and Sierra Leone are highly interconnected, with extensive cross-border traffic at the epicentre and relatively easy connections by road between rural towns and villages and the densely populated capital cities.
The critical determinant of outbreak size appears to be the speed of implementation of rigorous control measures.
Experimental therapeutics and vaccines offer promise for the future, but are unlikely to be available in the quantities needed to make a substantial difference in control efforts for many months, even if they are proved to be safe and effective.
The risk of continued expansion of the Ebola outbreak is real. This study provides the evidence needed for an urgent wakeup call requiring intensive scaling up of control measures while working towards rapid development and deployment of new medicines and vaccines.
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