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CDC Director Reports On Field Visit To Ebola Affected Countries

 “I visited all three countries where Ebola is spreading. The men, women and children I met and spoke with, the health care workers responding to people from within countries, patients, the survivors and relatives of those who died will always be with me.”

With these haunting words, CDC Director Tom Frieden opened his press briefing on September 2, 2014 to report on his recent trip to Guinea, Liberia, and Sierra Leone in West Africa where Ebola is spreading.

Hopeful About Control

According to Frieden, the number of cases continues to increase and is increasing rapidly. CDC has called the situation “daunting” but Frieden appeared still hopeful the outbreak could be brought under control, primarily because we know what to do. According to Frieden, “In theory, its not hard to stop Ebola…There’s nothing mysterious about what we need to do. The only real question is whether we will do it fast enough.”

Put another way, Frieden told the press “…the epidemic is so overwhelming what it requires is an overwhelming response. Rapidly, effectively deploying resources to tamp it down where it’s spreading wildly.”

To Do List

The list of things to do is not difficult but poses several challenges in the West African context where so many deficiencies and shortcomings in resources of all kinds persist. Included on the to do list are the following which Frieden said need to be carried out consistently and at the scale needed.

  • Find patients quickly

  • Isolate them effectively and promptly.

  • Treat them.

  • Make sure their contacts are traced and tracked for 21 days.

  • If contacts develop fever, make sure they are tested and treated.

  • Make sure health care is safe.

  • Make sure burial practices are safe.

Examples of Success

He gave two examples, one with Firestone rubber company in Liberia and one with a military hospital there. Both of these groups had Ebola cases but were able to halt transmission by doing what we know to do with Ebola. Thus, the immediate challenge, according to Frieden, is not to discover new knowledge or develop new treatments or vaccines, as helpful as these might be someday, but to apply what we already know about how to stop Ebola. The examples cited demonstrate that it can be done in West Africa as has been done elsewhere in Africa.

Expert Comment

He quoted one of the most experienced Ebola experts in the world who was in West Africa during his visit and the expert’s statement to Frieden summed up his visit, said Frieden. According to the expert, “What has worked to stop every Ebola outbreak until now will work here if we can get it to scale. That’s the number one challenge”.

Routes of Transmission

According to Frieden, the outbreak is spreading through only two principal means of transmission, namely people caring for other people in hospitals and homes, and unsafe burial practices where people come into contact with body fluids of someone who has died from Ebola.

New Learning

Asked by one of the reporters what he had learned differently about the outbreak after being there, Frieden responded that despite understanding the data as well as they do at CDC, seeing the tremendous increases in cases first hand is different and very difficult. Also, he reiterated, “The challenge is not knowing what to do. The challenge is doing it now. And I come back with that perspective even more forcefully in my mind than [when] I left with it.”  ■


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