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A man prepares to take off his protective suit at Biankouma hospital, Ivory Coast, during a simulation on Aug. 14. / Issouf Sanogo, AFP/Getty Images

The Ebola virus spreading through West Africa could infect more than 20,000 people before the outbreak is brought under control, the World Health Organization says in a report out Thursday.

The grim assessment is in a 27-page document outlining a "road map" to end the outbreak. That will take six to nine months and $490 million, WHO says.

While Ebola outbreaks have happened before, they have been limited to a few hundred cases. "20,000 is a scale that has never been anticipated," Bruce Aylward, an assistant director general of WHO, told reporters in Geneva. "That's not saying we expect 20,000 cases. That's not saying we accept 20,000." But he says it's crucial to have a plan now to deal with an outbreak that big.

WHO also released the latest official toll of the outbreak: 3,069 cases and 1,552 deaths in Guinea, Liberia, Nigeria, and Sierra Leone. The overall death rate is 51%. Though the outbreak started in March, more than 40% of the cases have occurred in the past three weeks, the agency says.

As bad as those numbers are, "in many areas of intense transmission the actual number of cases may be two-to-four-fold higher than that currently reported," WHO says in the report.

The report comes as U.S. officials and drugmaker GlaxoSmithKline are announcing the first safety trial of an Ebola vaccine. It will begin next week at the National Institutes of Health in Bethesda, Md.

"There is an urgent need for a protective Ebola vaccine," National Institute of Allergy and Infectious Diseases director Anthony Fauci said in a press release. But, he added, "today we know the best way to prevent the spread of Ebola infection is through public health measures." He said those include good infection control practices, isolating patients and tracing their contacts, and providing proper protective equipment to medical workers.

Those are the kinds of the measures stressed in the WHO road map. WHO also says affected countries must do more to address "deep-rooted fear and stigmatization," hampering control efforts in some hard-hit areas.

An effective response will take 750 international health workers and 12,000 workers from the affected countries, Aylward said. Right now, he says, a few hot spots have adequate staffing and facilities but "in other areas we have 10% of what we need. In some areas we have zero." Flight restrictions into affected countries are hampering efforts to get enough people in place, he added.

On Wednesday, the humanitarian group Doctors Without Borders said the international response to Ebola so far had been "chaotic and entirely inadequate." Aylward praised the group in his remarks, saying it deserves another Nobel Peace Prize for its work in the ongoing outbreak. The group won one in 1999.

Nigerian authorities, meanwhile, announced the first Ebola fatality outside the commercial capital of Lagos. It was the sixth death in Africa's most populous nation and occurred when an apparently infected traveler from Liberia evaded surveillance and infected a doctor in southern Nigeria. The doctor died, authorities said.

More than 240 health workers have been infected and more than 120 have died in the outbreak, WHO reported earlier this week.

Contributing: The Associated Press



Copyright 2014 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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