West Africa has long way to go to stop Ebola, Frieden says

Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention, lauded progress made in recent months toward slowing the pace of the spread of Ebola among the West African countries hardest hit by the virus, but he warned more work would be needed before the outbreak comes to an end.

Frieden spoke with reporters Monday after returning Sunday from West Africa, his second trip to the region since the start of the Ebola outbreak. He described the current situation in Sierra Leone, Guinea and Liberia as “a world of difference” from what he saw during his last trip in September, but he also expressed concern that some local health workers were beginning to become complacent in adhering to safety protocols when treating Ebola patients.

“As cases have come down, we've seen in parts of all of the three countries healthcare workers relaxing their grip on the (Ebola) response—not using protective equipment and not thinking of Ebola at every opportunity,” Frieden said.

The World Health Organization estimates in its latest assessment that the total number of infected cases since March had risen to more than 19,000 as of Dec. 22, with more than 7,500 reported deaths.

Much of the progress made throughout the region has been found within the country of Liberia, where incidents of transmission have reportedly declined in recent weeks. Over the past three weeks, 185 confirmed cases were reported in Liberia compared with 1,261 in Sierra Leone, according to a WHO situation report released Dec. 17.

“It is clear that as of today, Liberia has the upper hand against the virus,” Frieden said. “But that’s as of today.”

Challenges remain in Guinea and Sierra Leone, where transmission remains high in various parts of both countries while a shortage of available treatment beds has slowed efforts.

Frieden said the next phase in the CDC’s Ebola response will focus on three components in an effort to bring down the number of new transmissions within the three countries to zero, such as what has been achieved in Nigeria and Senegal. The next steps will be to focus on stopping the spread of the disease, tracing all contact points of transmission and strengthening resources within areas that have been declared free of the virus to prevent a recurrence of the outbreak.

“I think the challenge is to get to zero,” Frieden said. “Until we get to zero in these countries, they won’t be able to fully move on to rebuilding their healthcare systems.”

Frieden could not provide a timeline for realizing that goal. More than 150 CDC staff members are working in West Africa offering help in running test laboratories and training health workers, as well as tracking cases and advising hospitals on infection-control practices.

The $5.4 billion in emergency funding approved this month by Congress, Frieden said, is already allowing the agency to “move faster” and “see the possibility of an end to this epidemic more clearly.”

Follow Steven Ross Johnson on Twitter: @MHsjohnson