The number of Ebola cases in three West African nations may jump to between 5,000 and 10,000 a week by Dec. 1 as the deadly viral infection spreads, the World Health Organization said.
The outbreak is still expanding geographically in Guinea, Sierra Leone, and Liberia and accelerating in capital cities, Bruce Aylward, the WHO's assistant director-general in charge of the Ebola response, said in a briefing with reporters in Geneva. There have been about 1,000 new cases a week for the past three to four weeks, he said.
"Any sense that the great effort that's been kicked off over the last couple of months is already starting to see an impact, that would be really, really premature," Aylward said. "The virus is still moving geographically and still escalating in capitals, and that's what concerns me."
He also said the virus still kills most of those it infects.
"What we're finding is 70 percent mortality," said Aylward.
The WHO's forecast shows the magnitude of the task facing governments and aid groups as they try to bring the worst-ever Ebola outbreak under control. More than 8,900 people have been infected with Ebola in the three countries, with more than 4,400 deaths, the WHO said.
The effects of the epidemic have rippled outward in recent weeks, adding to concerns that Ebola may spread in the U.S. and Europe. The first two cases of Ebola being contracted outside Africa have happened, with health workers in Madrid and Dallas falling ill after caring for infected patients. The U.S. and the U.K. began screening some airline passengers on arrival in the past few days.
There is no cure for Ebola, which jumps to humans from animals such as fruit bats and chimpanzees. The virus spreads from contact with bodily fluids such as blood, vomit, and feces. Burial practices in West Africa, where mourners come in contact with corpses, have fueled the spread.
To bring the outbreak under control, there needs to be a common operational plan among all aid groups and governments, Aylward said. That means having people in every county or district responsible for burials, finding infected people, and tracing who they've been in contact with, and isolating those who are ill and managing their care, he said.
"Those pieces are not systematically in place," he said.
By Dec. 1, the WHO's goal is for 70 percent of those who die from the disease to be buried safely and 70 percent of cases to be properly managed, Aylward said. If those goals are met, that should allow for the number of new cases to decline from week to week beginning in January, he said.
The number of new cases is slowing in some areas, such as Lofa County, Liberia, and Kenema and Kailahun in Sierra Leone, he said. Aylward, a Canadian epidemiologist, went to Sierra Leone and Guinea last week and is returning tomorrow to Accra, Ghana, where the United Nations has established an office to coordinate the response to the outbreak.
"There's a lot of bleak news out there about this outbreak, and there should be," Aylward said. Still, "there are a lot of things that are positive," he said.
Only 30 percent at most of those who fall ill in Guinea, Sierra Leone, and Liberia survive infection with Ebola, Aylward said. "This is a horrible, unforgiving disease," he said. "You've got to get to zero" cases.
Ebola is pushing economies in the region to the breaking point and billions of dollars are needed to offset the economic damage wrought by the virus, Guinean President Alpha Conde said in an interview with Bloomberg Africa TV.
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