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A Liberian policeman, right, speaks with residents of the West Point area, calling on calm as they wait for a second consignment of food from the Liberian government to be handed out near the central city area of Monrovia, Liberia, on Aug. 22. / Abbas Dulleh, AP

As Ebola cases continued to climb, particularly in Liberia and Sierra Leone, the World Health Organization admitted Friday that it probably isn't capturing the full scope of the outbreak.

The WHO and the United Nations promised a redoubled effort to bring the epidemic under control.

Between Aug. 19 and 20, 142 new cases of Ebola and 77 deaths were reported from Liberia, Sierra Leone, Guinea and Nigeria. The current outbreak has led to 2,615 total cases and 1,427 deaths, but those numbers don't tell the whole story.

In a news release Friday, the WHO conceded that it has likely been undercounting cases of Ebola because families are in denial or afraid to admit their loved ones might have the dreaded disease.

"In parts of Liberia, a phenomenon is occurring that has never before been seen in an Ebola outbreak. As soon as a new treatment facility is opened, it is immediately filled with patients, many of whom were not previously identified," according to the statement. "This phenomenon strongly suggests the existence of an invisible caseload of patients who are not being detected by the surveillance system."

Keiji Fukuda, WHO's assistant director-general, said he hopes to reduce the number of new cases in the near future, but he estimated that it will take six to nine months to bring the outbreak under control. "We expect several months of very hard work," he said.

The WHO promised to add 500 treatment beds to Liberia's capital of Monrovia within the next six weeks to address the surge in cases.

Fukuda and a United Nations official also said they would be stepping up efforts to provide other medical care to people in Liberia, where the already-shaky medical systems have collapsed in the face of Ebola, and to support the nation's economy.

"We want to make sure it happens as quickly as possible. That's our mission," said David Nabarro, senior United Nations system coordinator for Ebola, who has been in Liberia for the past week.

Sophie Delaunay, executive director of Doctors Without Borders/Médecins Sans Frontières, which has led the medical fight against Ebola, said the international community has been slow to address the crisis in West Africa, but she welcomed a more robust response.

"Humanitarian action alone is not going to solve this problem," she said by phone.

Delaunay also called on all countries that have expertise in the type of infection control needed to fight Ebola - including the United States, Australia, Japan and European nations - to figure out how they can best support the effort.

The need is particularly acute for people trained to work under strict infection controls. People without such training are a hazard, she said, because they risk spreading the infection.

"We don't expect to have people with Ebola experience, because there are few in the world, but people with long-term experience in dealing with highly infectious environments can be a good resource," she said.

Despite the dangers of the assignment, Delaunay said she has been happily surprised that health care providers from around the world continue to volunteer for the work.

In a Friday news conference, Fukuda emphasized that Ebola is a treatable disease, with more than half of patients surviving if they get proper care early. Many Liberians have been reluctant to go to health care centers or bring their sick loved ones there, because they assume there is no chance of survival.

"This is not a hopeless situation," he said.

In addition to direct medical care, more education is sorely needed to adequately fight Ebola, said Stephen Morse an infectious-disease expert at the Mailman School of Public Health at Columbia University in New York.

"We really need a public education effort at the village level to explain to people not only how to understand Ebola, but what they should do so they can protect themselves while they're caring for their loved ones before they are able to get medical care," Morse said.

In figures released Friday, the WHO said there has been one new Ebola case and death in Nigeria, bringing the total to 16, including five deaths. All of those cases are tied to Liberian-American Patrick Sawyer, who traveled to Nigeria in late July, getting very ill along the way.

In Guinea, the WHO reported 28 new cases and 10 deaths. In Sierra Leone, three new cases have been reported and 18 deaths; and in Liberia, there were 110 new cases and 48 deaths. Although Ebola is reported to kill as many as 90% of its victims, the death rate has varied widely by country, so far, with Guinea reporting that roughly 31% of its patients have died and 58% of Liberians dying.

It is not clear how those figures would change if the reports of the disease were more accurate.

John Brownstein, an associate professor at Harvard Medical School and director of the Computational Epidemiology Group at Boston Children's Hospital, said he is not surprised that the WHO is undercounting cases of Ebola; most infectious diseases are undercounted. With diseases that are well understood, such as the flu, epidemiologists can adjust counts to cover for undercounting. But Ebola is so rare and little-understood that it is very hard to do in this case, he said.



Copyright 2014USAToday

Read the original story: WHO: Ebola outbreak in Africa likely underestimated

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