Doctors: Ebola 'out of control'

West African epidemic in 2nd wave, medical charity warns

DAKAR, Senegal -- The Ebola outbreak ravaging West Africa is "totally out of control," according to a senior official for Doctors Without Borders, who says the medical group is stretched to the limit in its capacity to respond.

The current outbreak has caused more deaths than any other on record, said another official with the medical charity. Ebola has been linked to more than 330 deaths in Guinea, Sierra Leone and Liberia, according to the latest numbers from the World Health Organization.

International organizations and the governments involved need to send in more health experts and increase public education messages about how to stop the spread of the disease, Bart Janssens, the director of operations for Doctors Without Borders in Brussels, said Friday.

"The reality is clear that the epidemic is now in a second wave," Janssens said. "And, for me, it is totally out of control."

The outbreak, which began in Guinea either late last year or early this year, had appeared to slow before picking up pace again in recent weeks, including spreading to the Liberian capital, Monrovia, for the first time.

"This is the highest outbreak on record and has the highest number of deaths, so this is unprecedented so far," said Armand Sprecher, a public health specialist with Doctors Without Borders.

According to a World Health Organization list, the highest previous death toll was in the first recorded Ebola outbreak in Congo in 1976, when 280 deaths were reported.

Because Ebola often touches remote areas and the first cases sometimes go unrecognized, it is likely that there are deaths that go uncounted, both in this outbreak and previous ones.

The multiple locations of the current outbreak and its movement across borders make it one of the "most challenging Ebola outbreaks ever," Fadela Chaib, a spokesman for the World Health Organization, said earlier in the week.

The outbreak shows no sign of abating and governments and international organizations were "far from winning this battle," Unni Krishnan, head of disaster preparedness and response for Plan International, said Friday.

But Janssens' description of the Ebola outbreak was even more alarming, and he warned that the governments affected had not recognized the gravity of the situation.

He criticized the World Health Organization for not doing enough to prod leaders and said it needs to bring in more experts to trace all of the people who have been in contact with the sick.

The World Health Organization did not immediately respond to requests for comment.

But Tolbert Nyenswah, Liberia's deputy minister of health, said people in the highest levels of government are working to contain the outbreak, as proved by the fact that that Liberia had a long period with no new cases before this second wave.

The governments involved and international agencies are definitely struggling to keep up with the severity of the outbreak, said Krishnan. Plan International is providing equipment to the three affected countries and spreading information about how people can protect themselves against the disease.

But he noted that the disease is striking in one of the world's poorest regions, where public health systems are already fragile.

"The affected countries are at the bottom of the human development index," he said in an emailed statement. "Ebola is seriously crippling their capacities to respond effectively in containing the spread."

The situation requires a more effective response, Janssens said.

With more than 40 international staff members currently on the ground and four treatment centers, Doctors Without Borders has reached its limit to respond, he said.

"It's the first time in an Ebola epidemic where [Doctors Without Borders] teams cannot cover all the needs, at least for treatment centers," he said.

It is unclear, for instance, whether the group will be able to set up a treatment center in Liberia, like the ones it is running in Guinea and Sierra Leone, he said.

For one thing, Janssens said, the group doesn't have any more experienced people in its network to call.

Janssens said this outbreak is particularly challenging because it began in an area where people are very mobile and has spread to even more densely populated areas.

The disease typically strikes sparsely populated areas in central or eastern Africa, where it spreads less easily, he said.

By contrast, the epicenter of this outbreak is near a major regional transport hub, the Guinean city of Gueckedou.

He said the only way to stop the disease's spread is to persuade people to come forward when symptoms occur and to avoid touching the sick and dead.

"There is still not a real change of behavior of the people," he said. "So a lot of sick people still remain in hiding or continue to travel. And there is still news that burial practices are remaining dangerous."

Information for this article was contributed by Bishr Eltouni and Jonathan Paye-Layleh of The Associated Press.

A Section on 06/21/2014

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