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DANIEL BEREHULAK / Redux Pictures
Ebola Virus Outbreak
STORYLINEContinuing coverage of the Ebola outbreak in West Africa
DANIEL BEREHULAK / Redux Pictures
Ebola Spreading 'Exponentially' as Patients Seek Beds in Liberia
The
Ebola virus is spreading exponentially across Liberia as patients fill
taxis in a fruitless search for medical care, the World Health
Organization said Monday.
In Sierra Leone, a
doctor working for WHO tested positive and was preparing to be evacuated
from the country. Meanwhile, the newest U.S. patient, a doctor infected
in Liberia, was feeling a little better and could even eat a little, doctors treating him in Nebraska said.
The various reports
illustrated in the clearest possible way the disparities driving the
epidemic in West Africa, where there’s almost no medical system
structure. The three patients evacuated to the United States have all
begun to recover quickly once they get good supportive care, which
includes around-the-clock nursing care and good nutrition.
WHO and other groups have been warning that the situation in Liberia and Sierra Leone and Guinea is dire. It’s especially bad in Liberia, WHO said Monday.
“Transmission of the
Ebola virus in Liberia is already intense and the number of new cases is
increasing exponentially,” WHO said in a statement.
"No free beds for Ebola treatment exist anywhere in the country.”
“In
Monrovia, taxis filled with entire families, of whom some members are
thought to be infected with the Ebola virus, crisscross the city,
searching for a treatment bed. There are none. As WHO staff in Liberia
confirm, no free beds for Ebola treatment exist anywhere in the
country.”
For example, in
Montserrado county, 1,000 beds are urgently needed but only 240 beds are
available. WHO has said more than 3,600 people have been infected with
Ebola in this West African epidemic, and 2,000 have died, but the
organization predicts as many as 20,000 will be sickened before it’s
over. Half of those infected have been dying.
“According to a WHO
staff member who has been in Liberia for the past several weeks,
motorbike-taxis and regular taxis are a hot source of potential Ebola
virus transmission, as these vehicles are not disinfected at all, much
less before new passengers are taken on board,” WHO said.
“When patients are
turned away at Ebola treatment centers, they have no choice but to
return to their communities and homes, where they inevitably infect
others, perpetuating constantly higher flare-ups in the number of
cases.”
The need for beds,
supplies and staff have “completely outstripped” capacity, both of the
Liberia government and of outside groups such as Who and Medecins Sans
Frontieres (Doctors Without Borders) to help.
Healthcare workers are
being especially hard hit. “Some 152 health care workers have been
infected and 79 have died,” WHO said. When the outbreak began, Liberia
had only one doctor to treat nearly 100,000 people in a total population
of 4.4 million people. Every infection or death of a doctor or nurse
depletes response capacity significantly.”
"Motorbike-taxis and regular taxis are a hot source of potential Ebola virus transmission."
One
WHO doctor in Sierra Leone is sick and will be sent out of the country
for treatment, WHO said, but declined to say where the doctor was from.
Three of the healthcare
workers affected were American medical missionaries working for the
groups Samaritan’s Purse and SIM USA in Monrovia. All three were
evacuated to the U.S. Dr. Kent Brantly and Nancy Writebol have recovered, while Dr. Rick Sacra is being treated at the University of Nebraska’s special biocontainment unit.
Debbie Sacra said her
husband, a 51-year-old family physician, was eating and listening to
music while he receives an experimental drug.
“He had some breakfast
this morning, which is a change,” Debbie Sacra said in a statement. “He
hasn’t been able to eat much since he got here, but he had some toast
and apple sauce. He also tolerated the research drug well — better than
he had the previous doses he was given.”
The hospital hasn’t said what treatment Sacra is receiving. Brantly and Writebol each received one treatment course of ZMapp, an experimental drug made by Mapp Biopharmaceutical Inc, but doctors stress they cannot tell if it helped.
“It’s hard to derive a
lot of meaningful data from the care of just two patients,” said Dr.
Aneesh Mehta, one of the medical team at Emory University Hospital who
treated Brantly and Writebol. High quality nutrition given intravenously
may have helped, Mehta said, as did carefully balanced fluid
replacement formulas. Ebola patients often suffer intense vomiting and
diarrhea.
The epidemic has
demonstrated “how one disease outbreak can cause a whole country to go
into crisis,” said Dr. Barbara Knust, team leader for the U.S. Centers
for Disease Control and Prevention’s Ebola response.
“The Ebola outbreak has just driven home the inadequacy that’s there,” Knust told an American Society for Microbiology meeting.
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