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Up to 1.4 million could become infected with Ebola, CDC says

A local Liberian artist paints a mural forming part of the country's fight against the deadly Ebola virus by education in the city of Monrovia, Liberia, Tuesday, Sept. 23, 2014. U.S. health officials Tuesday presented worst-case and best-case scenarios for the Ebola epidemic in West Africa, calculating that as many as 1.4 million people could be sickened in two countries alone by mid-January _ or the outbreak could be winding down by then, if control efforts substantially increase. (AP Photo/Abbas Dulleh)
A local Liberian artist paints a mural forming part of the country's fight against the deadly Ebola virus by education in the city of Monrovia, Liberia, Tuesday, Sept. 23, 2014. U.S. health officials Tuesday presented worst-case and best-case scenarios for the Ebola epidemic in West Africa, calculating that as many as 1.4 million people could be sickened in two countries alone by mid-January _ or the outbreak could be winding down by then, if control efforts substantially increase. (AP Photo/Abbas Dulleh) AP

Without strong efforts to counter the ongoing Ebola epidemic, the West African countries of Liberia and Sierra Leone would likely see 550,000 to 1.4 million new cases by the end of January, according to a new report by U.S. Centers for Disease Control and Prevention.

While that scenario is highly unlikely because of growing international assistance to help fight the outbreak, CDC Director Tom Frieden said that failure to sustain these efforts could ruin an opportunity to stop the deadly disease.

“A surge (of global support) now can break the back of the epidemic, but delay is extremely costly in terms of lives and effort,” Frieden said Tuesday in a conference call with reporters. “Even in dire scenarios, if we move fast enough, we can turn it around.”

Frieden’s confidence reflects the findings of a new CDC modeling tool that allows local governments and international organizations to project how activities like isolating patients and using safe burial practices will affect the spread and resulting deaths from Ebola going forward in Sierra Leone and Liberia.

The “Ebola Response” tool suggests that once 70 percent of Ebola patients are in treatment facilities or receiving proper care, “cases will decline about as rapidly as they had increased,” according to a CDC fact sheet.

“If by late December, roughly 70 percent of patients were in an Ebola treatment facility, or in a home-based or community setting where the appropriate measures are in place to stop the spread of the disease, then the epidemic in both countries could be nearly over by January 20, 2015,” according to the CDC report.

But if Ebola cases continue to double at the current rate of every 15 to 20 days in Liberia and every 30 to 40 days in Sierra Leone, both countries could have a collective 8,000 to 21,000 cases by the end of September, the report found.

Frieden said the CDC was unable to model the trajectory of cases in Guinea, which is subject to continued importations of the disease because of its porous borders.

A World Health Organization study published Tuesday in the New England Journal of Medicine estimates that more than 20,000 people will be infected with Ebola in West Africa by early November. The WHO currently lists 5,800 Ebola cases in Africa, with an estimated death rate of roughly 71 percent.

“For each day that we’re not effectively isolating people, not only are people potentially dying and potentially infecting others, but the job of stopping the outbreak, of turning it around, gets much bigger and much, much more difficult,” Frieden said.

The WHO report also suggested that the Ebola outbreak might not come under control and could become indigenous to the region; in other words, an ongoing concern.

The CDC projections of up to 1.4 million new cases was based on conditions in late August and doesn’t account for upcoming and current assistance from other countries. In another month, the CDC will be able to make a more informed estimate, Frieden said.

The recent surge in international support includes 3,000 U.S. military personnel being sent to West Africa to provide assistance and establish a regional staging base in Monrovia, the Liberian capital, where the disease has begun to spread.

It’s unclear when the 1,700 treatment beds promised by President Barack Obama would be up and running, but U.S. forces are moving “extremely quickly” to get that work done, said Gayle Smith, a special assistant to the president and senior director of the National Security Council.

The United Kingdom also intends to send 700 beds, or the equivalent of seven treatment facilities, to Sierra Leone. In addition, the African Union is deploying health care workers to the area and the United Nations has advance teams in West Africa working to establish a response mission.

“We think it’s imperative that we keep the pressure on the international community to respond as fulsomely as possible so that we can get ahead of this and get ahead of it quickly,” Smith said.

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