On October 1 the WHO released a new report on the spread of Ebola in West Africa.[1] This report was probably prepared before the announcement of Eric Duncan’s confirmed case in Dallas as it did not mention it. The number of reported confirmed and probable cases in Liberia has gone down for the first time but this is likely due to widespread under-reporting.[2] The conditions in Liberia and its capital Monrovia are said to be deteriorating and the numbers are not likely a reflection of the true situation.[3] Also, the number of confirmed cases is dwarfed by the number of probable cases; the WHO believes that a “substantial proportion” of the probable cases are indeed Ebola but that “the reported fall in confirmed cases reflects delays in matching laboratory results with clinical surveillance data.”[4] In Sierra Leone lower cases reports are also thought to be a result of under-reporting, and three districts adjacent to Freetown, the capital, have also been quarantined (Port Loko, Bombali, and Moyamba).[5]
Even with the low report rate around 40% of all cases have been reported in just the past 3 weeks in Liberia and Sierra Leone.[6] This is an important number because it shows the increase of the rate of transmission and shows a near-doubling of cases in a 3 week span.[7] This is exponential growth and can get out hand quickly as we are currently seeing. Guinea had a much lower 3-week case reporting[8] which may reflect some improvement.
Health care workers are still facing dire chances of infection. As of September 28 377 health care workers have been infected with 216 dying.[9] The hardest hit are Liberia and Sierra Leone, with 185 cases and 114 cases, respectively.[10] Even Nigeria, which has done a good job controlling the outbreak, has 11 confirmed cases of Ebola in health care workers.[11]
Cases of Ebola have been spreading further south and nearly every border district Guinea and Liberia share with Cote d’Ivoire now has active cases.[12] In Senegal and Nigeria, all contacts have completed a 21-day follow-up with no additional cases reported.[13] Two U.S. Navy mobile laboratories are now in Liberia, and a Chinese mobile laboratory is now in Sierra Leone.[14]
Sources after the cut.
[1] WHO, Ebola Response Roadmap Situation Report; http://apps.who.int/iris/bitstream/10665/135600/1/roadmapsitrep_1Oct2014_eng.pdf
[2] Id. at 3.
[3] Id.
[4] Id.
[5] Id.
[6] Id. at 2.
[7] UN Secretary-General Ban Ki-moon, New York, 18 September 2014 – Secretary-General’s Remarks to the Security Council on Ebola; http://www.un.org/sg/statements/index.asp?nid=7999
[8] Ebola Response Roadmap Situation Report at 2, supra at 1.
[9] Id. at 4.
[10] Id.
[11] Id.
[12] Id. at 5.
[13] Id. at 8.
[14] Id. at 7
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