The Next Phase In The Fight Against Ebola: Medical Detective Work

The Next Phase In The Fight Against Ebola: Medical Detective Work
FILE - In this Thursday, Oct. 16, 2014 file photo, a healthcare worker dons protective gear before entering an Ebola treatment center in the west of Freetown, Sierra Leone. Dr. Brima Kargbo, Sierra Leone's chief medical officer, confirmed Thursday Dec. 18, 2014, that Dr. Victor Willoughby died earlier in the day after being tested positive for Ebola on Saturday, the 11th doctor in the country to die from the disease that is ravaging West Africa. (AP Photo/Michael Duff, FILE)
FILE - In this Thursday, Oct. 16, 2014 file photo, a healthcare worker dons protective gear before entering an Ebola treatment center in the west of Freetown, Sierra Leone. Dr. Brima Kargbo, Sierra Leone's chief medical officer, confirmed Thursday Dec. 18, 2014, that Dr. Victor Willoughby died earlier in the day after being tested positive for Ebola on Saturday, the 11th doctor in the country to die from the disease that is ravaging West Africa. (AP Photo/Michael Duff, FILE)

By Matthew Mpoke Bigg

ACCRA, Dec 24 (Reuters) - Medical detective work will be the next big phase in the fight against Ebola when the United Nations deploys hundreds of health workers to identify chains of infection as the virus passes from person to person, top U.N. health workers said.

The health teams will travel to each district and region of Guinea, Sierra Leone and Liberia, the three countries at the center of the epidemic, to trace who each infected person has potentially contacted.

The effort will run in parallel with measures to minimize the spread of infection, such as treating all Ebola patients in specialized centers and burying all victims safely.

But Phase Two of the plan is to contain the virus by understanding its lines of transmission, said World Health Organization Director-General Margaret Chan.

"You chase the virus. You hunt the virus. The virus lives in an infected person so you chase every case, isolate them and then all the people who come into contact with the infected person," Chan told Reuters on a visit to West Africa.

She was accompanying U.N. Secretary General Ban Ki-moon on a four-country tour to encourage health workers and focus global attention on the fight against the epidemic.

The world's worst Ebola outbreak has killed 7,518 of 19,340 confirmed cases, according to WHO figures on Monday, though the number of new cases is slowing in most places.

The disease spreads through contact with an infected person or corpse, so family members who care for patients or people who prepare victims for burial are at risk.

As a result, people often know how they fell ill. Patients who say they do not know are a concern because their cases can signify chains of transmission yet to be identified, Chan said.

"You don't have control of Ebola until you know where all your transmission chains are and until your cases are coming from known contact lists," said Bruce Aylward, WHO's head of Ebola response.

"You always hear about disease detective work and that is what Ebola is about now," he said. Contact-tracing involves visiting households to pick up signs of illness, and requires cooperation from local authorities and community leaders.

Illustrating the scale of the challenge, 25 percent of new cases in Liberia are coming from new sources, Aylward said. By contrast, officials in Guinea said in November all the cases in the capital stemmed from just four chains of transmission.

The overall cost of the Ebola response could rise to around $4.1 billion, said U.N. Special Envoy on Ebola David Nabarro.

To accomplish Phase Two, the U.N. health agency will mobilize 900 epidemiologists, triple the number currently available, he said. Around half will be foreigners.

The aim is to get teams in place by the end of January, following a separate plan to get all patients treated and all victims safely buried by the end of this month. (Editing by Ed Cropley and Giles Elgood)

Before You Go

James and Tamah Mulbah
John Moore via Getty Images
Ebola survivor James Mulbah, 2, stands with his mother, Tamah Mulbah, 28, who also recovered from Ebola in the low-risk section of the Doctors Without Borders Ebola treatment center, after a survivors' meeting on October 16, 2014 in Paynesville, Liberia.
Benetha Coleman
John Moore via Getty Images
Ebola survivor Benetha Coleman, 24, stands in the low-risk section of the Doctors Without Borders Ebola treatment center after attending a survivors' meeting on October 16, 2014 in Paynesville, Liberia. She said that her husband and two children died due to the disease.
Jeremra Cooper
John Moore via Getty Images
Ebola survivor Jeremra Cooper, 16, wipes his face from the heat while in the low-risk section of the Doctors Without Borders Ebola treatment center on October 16, 2014 in Paynesville, Liberia. The 8th grade student said he lost six family members to the Ebola epidemic before coming down sick with the disease himself and being sent to the MSF center, where he recovered after one month.
Zaizay Mulbah and Mark Jerry
John Moore via Getty Images
Ebola survivors Zaizay Mulbah, 34, and Mark Jerry, 30, right, stand together before their shifts as nurse's assistants at the Doctors Without Borders Ebola treatment center on October 12, 2014 in Paynesville, Liberia. Jerry was a money changer and Mulbah a delivery driver before they caught the disease and went to the center, where they recovered. Doctors Without Borders hired them afterward to counsel and comfort others stricken by the disease.
Eric Forkpa
John Moore via Getty Images
Ebola survivor Eric Forkpa, 23, stands in the low-risk section of the Doctors Without Borders Ebola treatment center after meeting with fellow survivors on October 16, 2014 in Paynesville, Liberia. The college student, who is majoring in civil engineering, said he thinks he caught Ebola while caring for his sick uncle, who died of the disease. He spent 18 days at the center recovering from the virus.
Emanuel Jolo
John Moore via Getty Images
Ebola survivor Emanuel Jolo, 19, stands in the low-risk section of the Doctors Without Borders Ebola treatment center after a survivors' meeting on October 16, 2014 in Paynesville, Liberia. The high school student lost six family members and believes he caught the disease while washing the body of his father, who died of Ebola.
Sontay Massaley
John Moore via Getty Images
Ebola survivor Sontay Massaley, 37, smiles upon her release from the Doctors Without Borders Ebola treatment center on October 12, 2014 in Paynesville, Liberia. Massaley, who spent 8 days recovering from the disease in the center, said she worked as a vendor in a market before contracting the virus.
Victoria Masah
John Moore via Getty Images
Ebola survivor Victoria Masah, 28, stands in the low-risk section of the Doctors Without Borders Ebola treatment center on October 16, 2014 in Paynesville, Liberia. She said her husband and two children died of Ebola.
Abrahim Quota
John Moore via Getty Images
Ebola survivor Abrahim Quota, 5, stands outside the JFK Ebola treatment center after recovering from the disease on October 13, 2014 in Monrovia, Liberia. He had arrived at the treatment center 10 days before with his parents, who both died there from the virus. The Ministry of Health was to deliver him home after his release to live with relatives.
Lassana Jabeteh
John Moore via Getty Images
Ebola survivor Lassana Jabeteh, 36, smiles before his shift as a nurse's assistant at the Doctors Without Borders Ebola treatment center on October 12, 2014 in Paynesville, Liberia. He said that he previously worked as a taxi driver and that he thinks he caught Ebola when he transported a sick policeman who vomited in his car on the way to the hospital. Doctors Without Borders hired Jabeteh after he recovered in their treatment center and he now counsels and comforts others stricken by the disease.

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