EBOLA OUT BREAK IN AFRICA POISED TO EXPLODE
The Ebola virus
disease epidemic already devastating swaths of West Africa will likely get far
worse in the coming weeks and months unless international commitments are
significantly and immediately increased, new research led by Yale researchers
predicts.
The findings are
published in the Oct. 24 issue of The Lancet Infectious Diseases.
A team of seven
scientists from Yale's Schools of Public Health and Medicine and the Ministry
of Health and Social Welfare in Liberia developed a mathematical transmission
model of the viral disease and applied it to Liberia's most populous county,
Montserrado, an area already hard hit. The researchers determined that tens of
thousands of new Ebola cases -- and deaths -- are likely by Dec. 15 if the
epidemic continues on its present course.
"Our predictions
highlight the rapidly closing window of opportunity for controlling the
outbreak and averting a catastrophic toll of new Ebola cases and deaths in the
coming months," said Alison Galvani, professor of epidemiology at the
School of Public Health and the paper's senior author. "Although we might
still be within the midst of what will ultimately be viewed as the early phase
of the current outbreak, the possibility of averting calamitous repercussions
from an initially delayed and insufficient response is quickly eroding."
The model developed by
Galvani and colleagues projects as many as 170,996 total reported and
unreported cases of the disease, representing 12% of the overall population of
some 1.38 million people, and 90,122 deaths in Montserrado alone by Dec. 15. Of
these, the authors estimate 42,669 cases and 27,175 deaths will have been
reported by that time.
Much of this suffering
-- some 97,940 cases of the disease -- could be averted if the international
community steps up control measures immediately, starting Oct. 31, the model
predicts. This would require additional Ebola treatment center beds, a fivefold
increase in the speed with which cases are detected, and allocation of
protective kits to households of patients awaiting treatment center admission.
The study predicts that, at best, just over half as many cases (53,957) can be
averted if the interventions are delayed to Nov. 15. Had all of these measures
been in place by Oct. 15, the model calculates that 137,432 cases in
Montserrado could have been avoided.
There have been
approximately 9,000 reported cases and 4,500 deaths from the disease in
Liberia, Sierra Leone, and Guinea since the latest outbreak began with a case
in a toddler in rural Guinea in December 2013. For the first time cases have
been confirmed among health-care workers treating patients in the United States
and parts of Europe.
"The current
global health strategy is woefully inadequate to stop the current volatile
Ebola epidemic," co-author Dr. Frederick Altice, professor of internal
medicine and public health added. "At a minimum, capable logisticians are
needed to construct a sufficient number of Ebola treatment units in order to
avoid the unnecessary deaths of tens, if not hundreds, of thousands of
people."
Other authors include
lead author Joseph Lewnard, Martial L. Ndeffo Mbah, Jorge A. Alfaro-Murillo,
Luke Bawo, and Tolbert G. Nyenswah.
The National
Institutes of Health funded the study.
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