CDC Chief On West African Ebola: 'We Know What To Do, But It's Not Easy'

Aug 1, 2014
Originally published on August 1, 2014 7:14 am
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There have been some grim milestones this week in West Africa's Ebola outbreak.


The World Health Organization says more than 700 people have died, with the number of cases jumping 10 percent in just the last few days. The WHO also announced a $100 million plan to send in hundreds more health workers to combat a disease that is usually fatal.

MONTAGNE: The Centers for Disease Control and Prevention has warned Americans to avoid nonessential travel to the affected countries - Liberia, Guinea and Sierra Leone. Two American medical missionaries in the region are seriously ill with Ebola. And Emory University in Atlanta, which has a special isolation unit, says it expects to receive an American with the disease in the next few days. Dr. Thomas Frieden, director of the CDC, described Ebola to reporters yesterday as a tragic virus.

THOMAS FRIEDEN: There is no proven treatment. There is no proven vaccine, and there is not likely to be one for at least a year - even in the best case scenario. So we're not going to treat or vaccinate our way out of these outbreaks.

MONTAGNE: We called the CDC's Dr. Frieden for more on the containment efforts.

FRIEDEN: The multiple outbreaks of Ebola in West Africa are worsening right now. This is the biggest, most complex and most difficult outbreak of Ebola that we've had to deal with. In response, CDC, along with our partners, are surging. And over the next 30 days, we will be sending at least 50 more disease control experts into the countries to help them do a better job of finding patients, tracking them, strengthening infection control - basically figuring out where the infections are spreading and stopping them.

MONTAGNE: Up until now, what kind of a job have these countries been able to do?

FRIEDEN: I think the fact is there are two major challenges which each of these countries is facing. The first is that even before Ebola, they had relatively weak health care systems. And second, they're dealing with, in some focal areas, a lot of community resistance and lack of understanding. It's very different from the East African outbreaks where Ebola has been known for some time. And there we've been able to - working with the countries - develop very constructive relationships with traditional healers and others who will refer patients in for care and help in the control measures. And I think that will happen here, but it's not going to be quick. It's not going to be easy.

MONTAGNE: Well, I think this would seem to be rather difficult because you're talking about areas - many of them are rural areas and villages. And you're talking about people who may not appreciate Western health care workers coming in telling them what to do.

FRIEDEN: There are many challenges. What we've gotten a better handle on in the past couple of weeks is the different types of outbreaks we're having in different places. So for example, in Liberia, the epicenter is really an area that borders both Sierra Leone and Guinea. And that's really one outbreak. And that's only going to be controlled by cross-border collaboration among the three countries.

In contrast, there are cases in Monrovia that are largely related to things that have traditionally spread Ebola, like lack of good infection control in hospitals and burial practices. The bottom line with Ebola is we know what to do, but it's not easy. It requires meticulous contact tracing, meticulous isolation. And like a forest fire, if you leave one ember burning, it flares up again. So this is a very challenging situation.

Ebola can be stopped, but it won't be quick. It won't be easy. It will take many months. And if the security situation doesn't get better, it could take even longer.

MONTAGNE: Well, you know, last week, there was a passenger who turned out to have Ebola who boarded a plane in Liberia which made stops in two other African nations. And this man - his name is Patrick Sawyer - he's a Liberian-American. He died soon after he arrived in Nigeria. But he was headed for Minneapolis. How troubling is that?

FRIEDEN: We understand that people are concerned about Ebola coming to the U.S. And that's why we're communicating with doctors, with hospitals, with health departments to say if you have someone who comes from the region and has a fever, here's what you do. Here's how you isolate. Here's how you test. And if someone has contact, here's how you track them for 21 days.

The good news - if there is any good news about Ebola - is that you don't spread it when you don't have symptoms. So you can't get it from someone who's healthy. You can only get it from someone who is really quite sick with the disease. And you can't get it through the airborne route. So it takes intense contact with body fluids of someone who's very sick.

So in terms of spread within the U.S., it may be a challenge for individual hospitals which may be a concern. They have a case, and they have to isolate. But we don't think it has the conditions to spread widely.

And the virus hasn't changed. We've looked at the genetic sequence. It's just a very difficult virus to control. It's a merciless and dreadful virus.

MONTAGNE: Although you say we, as in the U.S., have the capacity to deal with this virus. But during this outbreak, health care workers have been infected, including a doctor who died of this disease who really knew what he was doing, who was really taking care. So one gets the impression that there is no 100 percent certain protection from infection.

FRIEDEN: Tragically, many healthcare workers in the West African region have been infected. More than 100 have become ill with Ebola and about 70 have died from it. So it takes a terrible toll on the health care system. However, we are confident that with meticulous infection control, it is possible to protect healthcare workers. And that's one thing we have to make sure happens.

MONTAGNE: Dr. Frieden, thank you very much.

FRIEDEN: Thank you very much.

MONTAGNE: Dr. Thomas Frieden is Director of the Centers for Disease Control and Prevention. Transcript provided by NPR, Copyright NPR.