New York: The outlook for the Ebola epidemic in West Africa is bleak, according to a new forecast predicting there could be almost 21,000 cases of the virus by November if control efforts in western Africa aren’t quickly increased.

The estimate, made by the World Health Organization’s (WHO) Ebola response team, was published in the New England Journal of Medicine on Tuesday. Presuming no additional aid, the model forecasts 9,939 cases in Liberia, 5,925 cases Guinea, and 5,063 in Sierra Leone by 2 November, more than three times the current total.

“Without drastic improvements in control measures, the number of cases of and deaths from Ebola virus disease are expected to continue increasing from hundreds to thousands per week in the coming months," the researchers said in the study.

The report joins a chorus of dire predictions by researchers warning the outbreak could spiral out of control. The US Centres for Disease Control and Prevention is working on a worst-case forecast that predicts 550,000 cases by the end of January without improved containment.

Relief agencies and governments last week renewed efforts to hasten aid, including a $1 billion commitment from the US and the creation of a United Nations special emergency mission.

Since the start of the outbreak, the virus has infected 5,864 people, killing 2,811, according to a 22 September WHO report. It has spread through five West African nations, accelerating in cities, including Monrovia, the capital of Liberia.

Endemic disease

The researchers warned of the possibility that Ebola “will become endemic among the human population of West Africa, a prospect that has never previously been contemplated."

While the spread of the disease was helped by highly interconnected populations and heavy cross-border traffic between Guinea, Liberia and Sierra Leone, “a large outbreak was not inevitable," the researchers said, pointing to Nigeria, which has strong health systems and has limited the number of cases despite the introduction of Ebola in Lagos and Port Harcourt, both large cities.

“The present epidemic is exceptionally large, not primarily because of biologic characteristics of the virus, but in part because of the attributes of the affected population, the condition of the health systems, and because control efforts have been insufficient," Christopher Dye, co-author of the study and director of strategy for WHO, said in a statement.

Experimental drugs

The outbreak has affected men and women equally, and killed 71% of people who were tracked by the health system, the study found. The actual fatality rate is probably lower, since not every infected person went to see a doctor.

While experimental vaccine and drugs are being explored, they “are unlikely to be available in the quantities needed to make a substantial difference in control effort for many months," the researchers said.

Instead, resources should be focused on improving control measures, such as adding beds in clinics and keeping better track of those who may have been infected, researchers said.

There is no cure for Ebola, which is spread by contact with the blood and bodily fluids of those infected. The disease normally is treated by keeping patients hydrated, replacing lost blood and using antibiotics to fight infections. The hope is that a patient’s immune system will fight off the aggressive attack of the virus. Bloomberg

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