The current Ebola outbreak now requires a "rapid response at a massive global scale," according to experts at the London School of Hygiene & Tropical Medicine. Writing an editorial in Science, professor Peter Piot, co-discoverer of the virus, says that the epidemic in West Africa is the result of a "perfect storm" involving dysfunctional health services, low trust in governments and western medicine, denials about the virus's existence, and unhygienic burial practices.
The outbreak which began in December 2013 now spans five countries in West Africa and has so far killed nearly 2,000 people, with the World Health Organization (WHO) predicting that 20,000 may become infected.
Piot, director of the London School of Hygiene & Tropical Medicine, writes: "This fast pace of Ebola's spread is a grim reminder that epidemics are a global threat and that the only way to get this virus under control is through a rapid response at a massive global scale—much stronger than the current efforts."
According to Piot, international assistance to the growing local efforts must include support for disease-control activities such as the provision of protective equipment, patient care and addressing the health, nutritional and other needs of populations in quarantine.
It is also an opportune time to accelerate evaluation of experimental therapies and vaccines. With the WHO announcing that compassionate use of experimental therapies is ethically justified, even if they have not been tested in humans, Piot comments that "an exceptional crisis requires an exceptional response."
In a separate article in Eurosurveillance, Piot and colleague Dr. Adam Kucharski, research fellow in infectious disease epidemiology at the London School of Hygiene & Tropical Medicine, delve deeper into the challenges currently facing West Africa. They warn that the exponential growth in numbers makes tracing and surveillance for Ebola increasingly difficult, and that cases could double every fortnight if the situation remains the same.
Piot and Kucharski write: "Fear and mistrust of health authorities has contributed to this problem, but increasingly it is also because isolation centres have reached capacity. As well as creating potential for further transmission, large numbers of untreated – and therefore unreported – cases make it difficult to measure the true spread of infection, and hence to plan and allocate resources."
They also warn that it is not just Ebola patients who are affected by the outbreak. In cities like Monrovia in Liberia, the infection has led to the closure of most health facilities, and as a result, untreated injuries and illnesses have caused further loss of life.
Piot P. Ebola's Perfect Storm. Science. DOI: 10.1126/science.1260695
Kucharski AJ and Piot P. Containing Ebola virus infection in West Africa. Eurosurveillance. 2014;19(36):pii=20899
Source: London School of Hygiene & Tropical Medicine