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Ebola epidemic will get worse before it gets better, top US health body warns Doctor dies in Nigeria's first Ebola case outside Lagos, health ministry says
(about 9 hours later)
The Ebola epidemic gripping west Africa will get worse before it gets better, the head of the top US health body warned, as health ministers from affected countries held crisis talks. A Nigerian man who contracted Ebola from a Liberian-American traveller, and evaded government surveillance officers, infected a doctor who died in Nigeria's first confirmed case of the disease outside Lagos, according to the health ministry.
The director of the Centres for Disease Control and Prevention, Tom Frieden, said there was no quick fix to what the World Health Organisation has called an "unprecedented" outbreak as he called for urgent action. The doctor's death in Port Harcourt – heart of the country's oil industry, where most expat oil workers are based – brings the total number of deaths in Africa's most populous country to six out of 15 confirmed cases. The doctor was not known to have Ebola until after he died, and his wife is now showing symptoms of the disease.
On Thursday, a doctor infected with the virus died in Port Harcourt, Nigeria, which is at the heart of the country's 2m-barrels-a-day oil industry and a hub for expat workers in major international oil companies. Reuters reported, however, that a World Health Organisation official said on Thursday that it was not confirmed that the doctor had died of Ebola and that a WHO team had flown to Port Harcourt to assess the case.
A total of 1,427 people have died from Ebola since the start of the year, with 2,615 people infected. Most of the deaths have been in Sierra Leone, Liberia and Guinea, with a handful of cases in Nigeria. The latest development comes as experts said that the economic fallout from Ebola, including travel restrictions, was hindering efforts to supply frontlines in the epidemic. News of more overseas doctors being infected is also hampering efforts to recruit international experts who are helping local volunteers prop up health systems stretched to breaking point in Liberia and Sierra Leone. The response from Guinea, where the outbreak began in December, has been encouraging, the WHO said.
Medical charities believe the WHO figures are likely to be far too low because of community resistance to outside medical staff and a lack of access to infected areas. The outbreak has claimed 1,546 lives across the four west African countries. Separately, two cases have been confirmed in the Democratic Republic of Congo, which has had seven previous outbreaks. Health officials said this outbreak was was unrelated to those in west Africa. The UN on Wednesday announced that it was giving Kinshasa $1.5m (£900,000) to help the DRC fight the disease.
Frieden told a news conference in the Liberian capital, Monrovia, on Wednesday evening: "The cases are increasing. I wish I did not have to say this but it is going to get worse before it gets better." Tom Frieden, director of the US Centres for Disease Control and Prevention, said there was no quick fix to an outbreak the World Health Organisation said continued to accelerate. Frieden told a news conference in the Liberian capital, Monrovia: "The cases are increasing. I wish I did not have to say this, but it is going to get worse before it gets better."
His comments, which follow warnings about the longer term threat posed by the outbreak and the need for a better global response, came as health ministers of the west African regional bloc ECOWAS gathered in Ghana. The Nigerian runaway's identity has not been released, but officials this month told the Guardian that the man who drove Patrick Sawyer, the Liberian-American, from the airport, where he was sick in the car, later went missing. Contact tracers immediately launched a manhunt and eventually located the man 600km (373 miles) away in Port Harcourt more than a week later.
The Economic Community of West African States said the talks in Accra aimed to strengthen its members' response to the epidemic. The man no longer had Ebola or any symptoms of the disease, but laboratory tests confirmed he had antibodies that showed he had previously had Ebola, health minister Onyebuchi Chukwu told reporters.
Ebola, which claimed the life of one ECOWAS official in Nigeria's financial capital, Lagos, was "a threat to regional and global public health safety as well as the economic and social security of the affected countries," it said in a statement. Chukwu said 70 people were now under surveillance in Port Harcourt and that the success at so far containing the disease showed that the government was "fully in control of the situation."
There has been mounting concern about the effect of the most lethal outbreak of the tropical virus in history after airlines stopped international flights to the crisis zone. Only one patient remained in isolation with the virus, but there was no room for complacency, Chukwu warned. "Nigeria has been successful at containment. But have we eliminated the disease? No," he said.
On Wednesday, Air France became the latest carrier to announce a suspension of its services to Sierra Leone, while British Airways said it was stopping its flights to Freetown and Monrovia until next year. Frontline health workers have been hardest hit by the epidemic, with more than 240 of them contracting the disease. This week the WHO and Médecins Sans Frontières recorded their first infections among staff. The WHO said that it was withdrawing its team, whose members it said were exhausted. Added stress over any colleagues contracting Ebola risked increased the chances of mistakes being made. A British nurse working at Sierra Leone's Kenama government hospital was evacuated to the UK for treatment, while Canada withdrew a three-member mobile laboratory team from the country this week.
Royal Air Moroc is now the only airline providing a regular service for both capitals, although the company said that flights from Casablanca were only about 10% full. In Sierra Leone's Kailahun district, at the centre of the country's outbreak, four ambulances serve almost half a million people. Teams of volunteers who carry out burials – during which most infections occur, as victims' bodily fluids contain high levels of the virus – are struggling with paltry resources.
The UN envoy on Ebola, David Nabarro, this week criticised airlines for scrapping flights, warning that Ebola-hit countries faced increased isolation and that it made it harder for the UN to carry out its work. "When we call the burial teams, sometimes they take one day to arrive, sometimes two days. There are not many of them and they have to carry out every burial in the district," said Tamba Morris, a health worker in a remote village where residents were once forced to leave a corpse unburied in stifling tropical heat for two days.
Liberia has been worst hit by the outbreak, with 624 deaths recorded. There has been sporadic violence, including against hospitals treating patients, and some areas of the city were placed under quarantine. Elsewhere, there have been warnings of food shortages in affected countries. The UN envoy on Ebola, David Nabarro, this week criticised airlines for scrapping flights, warning that Ebola-hit countries faced increased isolation and that that would make it harder for the UN to operate – including delivery of a $70m food-aid programme.
Last week, the Democratic Republic of the Congo said 13 people had died with symptoms of an unspecified haemmorrhagic fever. It later confirmed two Ebola cases but said they were unrelated to the west African epidemic. On Wednesday, Air France became the latest carrier to suspend services to Sierra Leone, while British Airways said it was stopping its flights to Freetown and Monrovia until next year.
The UN on Wednesday announced it was giving Kinshasa $1.5m (£900,000) to help the country fight the disease, which has seen seven outbreaks since it was first identified in the country in 1976.
The WHO has said it was encouraged by the response from Guinea and Nigeria, where far fewer cases of Ebola have been recorded than in Sierra Leone and Liberia and public awareness about the virus was higher.
Nabarro met Nigeria's president, Goodluck Jonathan, on Wednesday evening and said the country's health authorities had performed excellently in controlling the spread.
Nigeria's health minister, Onyebuchi Chukwu, however, warned there was no room for complacency, despite only one patient remaining in isolation with the virus.
"Nigeria has been successful at containment. But have we eliminated the disease? No," he told reporters.