Ebola fight in Liberia needs a 'more flexible approach,' say MSF

Date: Nov-12-2014 The Ebola epidemic in Liberia is entering a new phase that must

be met with a rapid and flexible response, otherwise there is a risk of

undermining the hard-won gains, say Doctors Without

Borders/MSF.

Humanitarian charity MSF warn that a new approach is needed to respond rapidly to new cases of Ebola in order to keep the outbreak contained.

The humanitarian charity says while they are seeing Ebola cases

still rising in neighboring Guinea and Sierra Leone, for the first time

since the epidemic started, they are witnessing a decline in numbers of

Ebola patients admitted to case management centers in Liberia.

However, they warn that while new cases of Ebola virus disease may

be falling overall in Liberia, hotspots are still breaking out, and a

new approach is needed to respond rapidly to these and keep the

outbreak contained.

"In Liberia, the international response is finally getting off the

ground," says Fasil Tezera, MSF head of operations in Liberia. He says

funds are starting to flow into the country and "huge resources are

being put into constructing large-scale Ebola isolation centers."

"Isolation units in Monrovia and some other parts of the country now

have adequate capacity and we must adapt the strategy if we want to

stay ahead of the curve and beat the epidemic," he adds, noting

that:

"Priority should be given to a more flexible approach that allows a

rapid response to new outbreaks and gets the regular health care system

safely up and running again."

MSF are currently treating around 50 patients in their 250-bed ELWA3

case management center in Monrovia, the largest Ebola management center ever built.

In Foya, in northern Liberia, the number of patients fell to zero on October 30th, and there have been no confirmed cases since then, says

the charity.

However, they warn that infections may surge again, as they have in

Guinea, where, after two significant drops in admissions to MSF

centers, Ebola patient numbers are rising again.

Rapid response teams needed to tackle new Ebola hotspots

Dr Nico Heijenberg, MSF emergency coordinator, says international

sponsors and organizations have earmarked much of the funding for

specific projects, but there needs to be a more flexible approach -

they should be prepared to deploy their resources so they can be used

where they are most needed.

MSF say agile and well-equipped rapid response teams should be

deployed to investigate and mount a comprehensive response to hotspots

as soon as they arise, wherever they occur.

A rapid response to a hotspot includes isolating patients, tracing

anyone who may have been in contact with them, organizing safe burials,

disinfecting contaminated areas and mobilizing local communities.

Dr. Heijenberg says in Foya District in Lofa County, they believe

this comprehensive approach - together with involvement of local

communities - has led to a steady reduction of cases across the

county.

"Trust and understanding by the community is hugely important in

acceptance of medical activities, and in successfully containing the

virus," he adds.

Rebuilding essential health care is an important part of the Ebola

response

Another important aspect of an Ebola response is the rebuilding of

essential health care systems. In Liberia, health care services have

virtually collapsed under the strain of the epidemic.

Many of Liberia's hospitals and clinics are closed, and those that

are open are turning away feverish or vomiting patients, fearing they

may have Ebola.

As an example of flexibility of response, MSF cite how they are

administering a mass distribution of anti-malarial treatments while at

the same time installing an Ebola screening point next to the

government-run 200-bed Redemption Hospital in Monrovia. These measures

have helped the hospital to reopen safely, says the charity.

Dr. Heijenberg explains:

"Infection control measures like triage points should be implemented

urgently within regular health facilities, in order to reduce the

spread of Ebola and stop people dying from preventable diseases and

unmanaged complications."

The current outbreak in West Africa - which came to global attention

when the first cases were reported in March 2014 - is the largest and

most complex Ebola outbreak the world has ever seen since the virus was

first discovered in 1976. It has produced more cases and claimed more

lives than all other outbreaks combined.

The World Health Organization (WHO) say that up to November 4, 2014, there have been 13,268

reported cases of Ebola virus disease and 4,960 reported deaths since

the outbreak began.

Six countries are currently affected by the outbreak (Guinea,

Liberia, Mali, Sierra Leone, Spain and the US), and two are no longer

affected (Nigeria and Senegal).

In the three most affected countries - Guinea, Liberia and Sierra

Leone - new Ebola infection rates appear to be declining in some

districts but rising in other districts.

Intense transmission in the three most affected countries "demands

widespread rigorous control measures," says the UN health agency,

urging unaffected neighboring countries to be prepared. And while there

have been no new cases in Mali, Spain and the US, they still need to

maintain a high level of vigilance, they add.

Meanwhile, Medical News Today recently reported that

the WHO have issued a new protocol on

"safe and dignified" Ebola burials. The new procedures should help

to bring down the rate of new infections that occur during burials of

Ebola patients, which currently stands at around 20%, says the UN health

agency.

Written by Catharine Paddock PhD

Not to be reproduced without permission.

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Courtesy: Medical News Today Note: Any medical information available in this news section is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional.