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WHO declares Ebola in West Africa a health emergency

Stops short of suggesting trade or travel bans

A quarantine officer checked the body temperature of a passenger at Incheon International Airport in South Korea.
A quarantine officer checked the body temperature of a passenger at Incheon International Airport in South Korea.(Choe Jae-koo/Yonhap via Associated Press)

LONDON — Facing the worst known outbreak of the Ebola virus, with almost 1,000 fatalities in West Africa, the World Health Organization declared an international public health emergency Friday, demanding an “extraordinary” response — only the third such declaration of its kind since regulations permitting such alarms were adopted in 2007.

The organization stopped short of saying there should be general international travel or trade bans but acknowledged that the outbreak, in its sixth month, was far from being contained.

One major international medical organization, Doctors Without Borders, responded to the statement with a renewed call for a “massive deployment” of health specialists to the stricken countries.

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“Lives are being lost because the response is too slow,” it said.

Margaret Chan, the World Health Organization’s director general, told a news conference at the body’s Geneva headquarters: “This is the largest, most severe, most complex outbreak in the nearly four-decade history of the disease.”

“I am declaring the current outbreak of the Ebola virus disease a public health emergency of international concern,” she said. “Countries affected to date simply don’t have the capacity to manage an outbreak on this scale on their own.”

Dr. Keiji Fukuda, WHO’s head of health security, said that “things will get worse for a while,” and “we are fully prepared for addressing this for some months.”

WHO urged all states where the disease is spreading to declare a state of emergency, to screen all people leaving at international airports, seaports, and land crossings, and to prevent travel by anyone suspected of having the Ebola virus.

But the organization did not recommend a ban on travel to or from places with outbreaks because of the low risk of infection.

“We don’t believe a general ban on that kind of travel makes any kind of sense at all,” Fukuda said.

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The declaration was apparently intended to display a more aggressive stance by the health organization. In the past, it has often bent to pressure from member states demanding that there be no consequences even as epidemics have raged inside their borders and sometimes slipped over them.

But health specialists remain critical of the international response.

“Declaring Ebola an international public health emergency shows how seriously WHO is taking the current outbreak, but statements won’t save lives,” said Bart Janssens, the director of operations at Doctors Without Borders, which says it has hundreds of specialists in the field in West Africa. “It is clear the epidemic will not be contained without a massive deployment on the ground.”

According to figures released by WHO on Friday, the virus is thought to have claimed 961 lives since March. Most of the cases are in Guinea, Liberia, and Sierra Leone, but 13 cases have also been reported in Nigeria, including two deaths, after a person brought the disease there by plane from Liberia.

The total number of confirmed, probable, and suspected cases, including the fatalities, in the region was 1,779.

“A coordinated international response is deemed essential to stop and reverse the international spread of Ebola,” WHO said in a statement after a two-day meeting of its emergency committee on the outbreak.

The organization made similar emergency declarations to counter swine flu in 2009 and polio in May. But public health experts say the declaration on polio has not reversed or slowed its international spread.

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The WHO declaration on Ebola comes months after the outbreak was first identified in Guinea in March. Janssens said that a combination of factors — including denials by the authorities in affected countries and the international community’s slow recognition of the gravity of the crisis — had contributed to delays in gearing up an effective response.

Unlike previous outbreaks of the Ebola virus, which had occurred in isolated areas, the West African epidemic erupted in areas with more traffic, trade, and freedom of movement, facilitating transmission of the disease, he said. The affected countries also have extremely weak health infrastructures and lacked the capacity to respond effectively when the outbreak occurred.

Liberia, which saw what had happened in Guinea and Sierra Leone, responded more quickly but lacked the capacity to contain the disease and is now fighting the spread of the virus in the capital Monrovia, he said.

The international response has also been weak, Janssens said, pointing out that Doctors Without Borders had previously called for a major escalation in international support and had warned that the epidemic was out of control. WHO’s regional officers, he said, “played a critical role in that failure in the first two to three months.”

WHO listed a series of worrisome factors in its spread, including “the virulence of the virus, the intensive community and health facility transmission patterns, and the weak health systems in the currently affected and most at-risk countries.”

In dealing with the Ebola crisis, WHO said Friday, stricken countries faced an array of challenges, with inexperienced personnel confronting “misperceptions” of the disease among highly mobile populations.

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“A high number of infections have been identified among health care workers, highlighting inadequate infection control practices in many facilities,” the statement said.

Also Friday, news reports said a suspected case of Ebola had been detected in Uganda, the first such report from East Africa. A traveler from South Sudan was isolated with Ebola-like symptoms of fever, and physicians were awaiting the results of tests, airport officials were quoted as saying.