Continued spread of the Ebola virus in West Africa has now hit levels that are not only making it the most severe outbreak since the virus was discovered four decades ago, but global health officials have now deemed the outbreak an extraordinary event worthy of being labeled an international public health emergency.
After a two-day emergency meeting hosted by the World Health Organization to evaluate the outbreak gripping the countries of Guinea, Sierra Leone, Liberia, and most recently Nigeria, attendees agreed the situation presents a public health risk to other states.
"The possible consequences of further international spread are particularly serious in view of the virulence of the virus, the intensive community and health facility transmission patterns, and the weak health systems in the currently affected and most at-risk countries," the WHO said in a statement on Friday, as the death toll mounted to more than 961 individuals, with nearly 30 deaths occurring on Tuesday and Wednesday alone, according to the latest WHO figures.
According to new recommendations by the WHO after the meeting, officials have asked the heads of states of affected countries to declare a national emergency, provide access to emergency financing, and activate their national disaster mechanisms to coordinate support across various public sectors.
During a press briefing today, Director-General Dr. Margaret Chan said the "outbreak is moving faster than we can control it," but also emphasized that Ebola "is an infectious disease which can be contained." She said this "by no means implies that all countries, or that many countries, will see Ebola cases."
The WHO stressed two main issues that are causing the largest obstacles: weak public health systems and fear.
The outbreak first took hold in April in Guinea and quickly jumped the border to Liberia and Sierra Leone — countries with weak infrastructure and coming off of periods of instability, including civil wars. According to Chan, some medical facilities treating patients lack basic needs, like water and electricity.
In other cases, doctors and nurses often do not receive pay — such is commonly the case in Liberia — nor the proper personal protective equipment to bar themselves from contracting the disease. Timely pay and proper security measures for staff is key, as health workers have proven highly vulnerable to infection, with at least 80 dead and 140 infected to date according to the WHO, creating even further unrest among local personnel.
The WHO said getting more local health care workers involved and better ensuring their safety is key. One of the main recommendations the WHO established after the meeting is that a "strong supply pipeline be established to ensure that sufficient medical commodities" for actors like health care providers, lab techs, and burial personnel.
Beyond the weak public health systems, WHO's assistant director-general Dr. Keiji Fukuda said it is critical to understand how anxiety in these communities is inhibiting response.
"Perhaps one of the most important factors contributing to this is fear and misinformation," Fukuda said, noting that Ebola was not, in fact, a "mysterious" disease.
"What it is doing is that it helps foster suspicion and anxiety in communities, and when that happens we see a situation where people are reluctant to go to health facilities or maybe reluctant to bring their family members there," he said, highlighting problems of people hiding symptoms or refusing to seek care.
In its recommendations released this morning, the WHO said "states should ensure that there is a large-scale and sustained effort to fully engage the community — through local, religious, and traditional leaders and healers — so communities play a central role in case identification, contact tracing, and risk education."
Specifically, Fukuda stressed the importance of effective contact tracing, symptom screening, and reassuring individuals that they need to seek medical care when they fall ill. He said evidence has shown an increased chance of survival if medical care is sought immediately.
Despite the fact that Ebola can be spread via airplane travel for the first time since it was discovered four decades ago, the WHO is not recommending travel or trade bans. The organization is, however, requesting that infected individuals and contacts do not travel.
At the emergency meeting, WHO officials stressed the importance of international coordination and response efforts in tackling the outbreak. But Chan said the international community was starting to come together, and highlighted important contribution from organizations like the CDC and Red Cross, but also noted assistance from health officials and groups out of Gabon, Cameroon, and Uganda.
Despite positives in collaboration, the underlying theme is that aid workers, experts, and health officials are overworked and operating at capacity. Chan noted that one of their most important allies and organizations on the ground, Doctors Without Borders (MSF), is providing important care, but stretched to the limit. Furthermore, she highlighted the fact that beyond Ebola, they have their work cut out for them with three ongoing, full-level humanitarian health crises in South Sudan, Central African Republic, and Syria, as well as outbreaks of MERS, Ebola, and the Avian Flu.
Follow Kayla Ruble on Twitter: @RubleKB
Photo by Flickr/European Commission