Who, Zaire Official Disagree On Ebola Virologist Says Death Estimates Are Pessimistic

Zaire’s leading virologist Thursday revised the death toll of the incurable Ebola virus downward and took issue with World Health Organization (WHO) projections suggesting the epidemic is in danger of spreading.

Speaking by radio hookup from Kikwit, where the epidemic has been centered, Jean-Jacques Muyembe, a professor at the University of Kinshasa, also criticized the local and international quarantine measures as “neither effective nor necessary,” given the porous nature of roadblocks and other checkpoints in Zaire.

Several Arab and sub-Saharan African states have taken quarantine measures against travelers arriving not just from Zaire, but from elsewhere in central Africa.

Muyembe, who was involved in northern Zaire in combating the first Ebola virus epidemic in 1976, told health officials, doctors and reporters that the disease has proven fatal in 79 of the 114 cases detected so far. Two days ago the Ebola virus medical coordination committee reported 86 deaths; Muyembe provided no explanation of the revised death toll.

While stressing that the disease could be considered under control only with the appearance of the last case, he emphatically sided with public health and medical experts in Zaire who consistently have been less pessimistic about the future course of the epidemic than the Geneva-based WHO, which reported identical figures Thursday of 114 cases and 79 deaths.

WHO’s assistant director general, Ralph Henderson, warned, however, that “we are now beginning to see (sickness) spread” from the initial patients “to other household members, and that is very concerning to us,” the Reuter news agency reported. He said it should be known within the next few days how far the disease has spread in the affected households.

Henderson also said it is “clear that many patients can be substantially helped” by proper treatment “in a good health care facility.”

“We do know that there are many cases who are severely ill who, with good medical care … get better, whereas if they did not have it, they would have died.”

In answering questions, Muyembe emphasized that Ebola virus, which causes fatal bleeding among 90 percent of its victims, is not contagious during an incubation period of up to 21 days, but only after patients display the disease’s symptoms. These include bleeding through the eyes, ears and skin.

Muyembe said 44 percent of the victims so far were medical workers treating victims. That high proportion, he explained, reflected confusion during the initial outbreak in Kikwit, where medical workers also were fighting an epidemic of “red diarrhea” - so-called because of blood evacuated in stools.

Only when laboratory tests disclosed that some victims did not display standard signs of red diarrhea did Zaire’s doctors sound the alarm about Ebola fever.

Muyembe said the median age of Ebola victims in Kikwit, 250 miles east of Kinshasa, the capital, is 33, with the youngest fatality 2 years old and the oldest 71. Fifty-two percent of those afflicted were men.

The disease is passed principally by physical contact with patients. Even touching patients’ skin can spread the virus, as can handling their feces, vomit or urine, he said, and health workers now wear surgical gowns, gloves and goggles to avoid infection. Only too late, he said, did medical staff realize that many victims were infected while preparing bodies for burial.

(Medical experts from WHO and the Centers for Disease Control and Prevention in Atlanta have said Ebola virus spreads through contact with blood or other body fluids but not by touching skin.)

Thousands of Kikwit-area inhabitants bound for Kinshasa have been stopped by roadblocks at the provincial border some 100 miles from the capital. Muyembe said an information campaign now has sensitized the population not to move those with Ebola virus far afield, but rather take them to nearby medical facilities.

He reported local university students were moving throughout Bandundu province, where the outbreak is centered, on bicycles and motorcycles and using megaphones to inform the population and elicit information to detect suspected Ebola virus cases.

Muyembe said that strictly from his virologist’s vantage point, the present epidemic is a “unique opportunity” for Zaire’s doctors to become “experts in this rare disease,” which had disappeared for nearly 20 years.