UNITED NATIONS – In a communiqué issued at the end of the U.N. World Health Organization’s two-day emergency ministerial meeting on the Ebola virus in Accra, Ghana, health ministers from 11 West African nations called for immediate action, agreeing that the current outbreak poses a serious threat to all countries in the region and beyond.
The ministers expressed concern for the adverse social and economic impact of the outbreak and stressed the need for coordinated actions by all stakeholders. The urged enhanced cross-border collaboration and community participation in the response.
“We have adopted an inter-country strategy to tackle this outbreak,” said the regional director for Africa, Dr. Luis Sambo. “It’s time for concrete action to put an end to the suffering and deaths caused by Ebola virus disease and prevent its further spread.”
Three countries in West Africa have been affected by the unprecedented outbreak, with reports of more than 750 confirmed cases and 445 deaths in Guinea, Sierra Leone and Liberia since March.
WHO spokesman Daniel Epstein, in an exclusive telephone interview from Geneva, characterized the meeting in Accra as a “huge, major, global effort to halt the disease.”
The meeting also was attended by representatives from international health agencies, including the U.N., the WHO, the Centers for Disease Control in Atlanta, Médecins Sans Frontières, the European Union, the International Red Cross and GOARN, the Global Outbreak Alert & Response Network.
“The Western countries are pouring pretty much everything they have to help Guinea, Sierra Leone, and Liberia to contain this unprecedented outbreak in West Africa,” he said.
Epstein confirmed the current strategy aims to confine Ebola cases to the three West African nations already affected by the outbreak.
He said that, so far, there are not confirmed reports of the disease spreading further.
“There were two suspected cases – one in Spain and the other in Italy in the last few days – where someone became very sick after visiting West Africa. Both were sent to hospitals and monitored but their disease turned out not to be Ebola.”
While Epstein was hopeful the disease could be contained, he still noted several difficulties.
“It’s tough to control, because the methodology involves field immunology where health officials have to find and confirm a case of Ebola and trace their contacts for the past 21 days when they may have been contagious,” he said.
“So if you have a person that is working in a village and is affected with Ebola, and that disease is confirmed, you have to trace his family, the people he contacts at the workplace, the people he may socialize with, as well as other close family and friends to monitor them to make sure they are not also infected. If they are infected, you have to do the same things with those people.”
Epstein said the other big challenge was communicating with people in the rural villages where Ebola has broken out the myths and facts of disease.
“It’s a myth that if you eat three large onions you will not get Ebola,” he said. “You have to explain that if you get Ebola, you have to go to a treatment center and get treated.”
Another major main factor in the transmittal of Ebola in rural villages, Epstein noted, has been the traditional burial practices.
“The tribes in West Africa wash the body of the deceased and mourn in very close proximity to the body, without realizing that the person who has died is still infectious for a time. Any type of contact of bodily fluids from the deceased – blood, urine, any of those – risks transmitting the disease if the bodily fluids enter through the mucus membranes or any break in the skin. It’s hard for people to understand you can’t mourn the dead the same way you’ve done in the past. You have to bury them right away, with protective equipment.”
He noted that even within the clinics, a lack of adequate protective gear has contributed to the transmittal of Ebola.
Another difficulty in containing the disease is fear.
WND has reported that Red Cross efforts to treat the afflicted were forced to temporarily suspend some operations in the country’s southeast after a marked Red Cross vehicle was confronted and stopped by a knife-wielding mob that was concerned the medical workers were responsible for spreading the disease.
“The fear is understandable,” Epstein explained.
“If you have a disease that kills 60 percent of those infected, people are going to be afraid. We’ve seen cases where teams have gone into villages and they have been run out by people throwing stones at them, saying, ‘Get out – we don’t want you here.’ We’ve seen cases of health clinics where people taken there for Ebola treatment get fearful and leave. We’ve seen cases of people hiding, where someone gets sick and they don’t want to go to the hospital because they fear that in the hospital they will get Ebola, even though they may already have Ebola.”
Epstein said there is a lot of health promotion and communication to be done in West Africa to convince people to get treatment.
“Once a family has turned over a patient, the family pretty much loses contact because the Ebola patient is placed in an isolation ward,” he continued. “In many cases, the family is not wrong to feel fear in that 60 percent of the cases are going to result in death. But the person infected with Ebola is going to die faster and more frequently if they don’t get treatment. At least in the clinic, the infected person has a chance to survive because they are given oral rehydration and medicine for the pain. In the clinic, they are monitored, they receive treatment to bring their fevers down.”
He stressed that some people do survive Ebola.
“I understand that at the Accra meeting, two Ebola survivors came forward and told their stories, what it was like to have Ebola and to survive,” he said.
The final communiqué of the Accra ministerial meeting noted the WHO has agreed to establish a Sub-Regional Control Center in Guinea to act as a coordinating platform to consolidate and harmonize the technical support to West African countries by all major partners, as well as to assist in resource mobilization.
“We’ve had Ebola outbreaks before and the have been contained once you do all the right things in terms of epidemiology, infection control in the clinics, communication in the villages and the places where there are cases, training for local health workers to always wear full masks and personal protective equipment when treating patients and good logistics so you have enough medical supplies,” Epstein stressed.
“If you get all those things done and you are able to trace the contact and monitor the contact of the people who are infected with Ebola and their close family and friends, then can contain the disease.”
The Centers for Disease Control and Prevention warn the symptoms of Ebola include fever, headache, joint and muscle aches, weakness, diarrhea, vomiting, stomach pain and lack of appetite, while some patients also experience a rash, red eyes, hiccups, cough, sore throat, chest pain, difficulty breathing and swallowing, as well as bleeding inside and outside of the body.
After an incubation period of between two and 21days, the Ebola virus can cause death a few days after the virus appears in particularly virulent cases where the body organs shut down and internal bleeding becomes unstoppable.
The Ebola virus has alarmed international health officials because the frequency of international air travel has increased the possibility the outbreak of the violence in one nation might quickly be transmitted to other countries by patients in the incubation phase of the infection.
Delia M. Arias De Léon, a Wellesley College political science student currently serving as a WND intern at the U.N. in New York City, contributed to this article.