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Texas Virologist: We`ll Need More Resources to Beat Ebola

Harvey Rice

10/02/2014

Oct. 02--GALVESTON -- The reports of despair amid the Ebola outbreak came across Dr. Thomas Ksiazek's desk all day during his recent job at the World Health Organization offices in Freetown, Sierra Leone. They continued at night as he pored over emails at his room in the Radisson Blue hotel, sometimes until 2 a.m. "Today five new cases were discovered and couldn't be moved because of a lack of ambulances," read one. Another complained that bodies could not be buried because there were no trucks to move them.

He compiled the dismal reports and sent them to CDC headquarters in Atlanta.

Ksiazek, a virologist at the University of Texas Medical Branch, had seen Ebola outbreaks before when he served as chief of the Special Pathogens Branch for the U.S. Centers for Disease Control and Prevention. He had helped devise a system to cope with such outbreaks in 1995 in what is now the Democratic Republic of the Congo. But this was worse than anything he had ever seen.

Ksiazek had arrived Aug. 13 in Freeport to relieve the wornout CDC officials who had been struggling to help contain an Ebola outbreak that the World Health Organization says has killed at least 3,000 so far. Lacking enough experienced personnel, the CDC had asked Ksiazek to work in West Africa for a month and UTMB agreed to let him go, eventually extending his stay an additional two weeks.

Ksiazek's stay in Sierra Leone led him to the realization that only a massive influx of resources like the one promised by President Barack Obama last week can stem the spread of the deadly Ebola virus.

The countries where Ebola is rampant are some of the poorest in the world and lack some of the key resources that would be taken for granted in U.S. hospitals, such as disposable gloves to protect doctors and nurses, Ksiazek said.

"It's certainly going to take a lot of effort," Ksiazek said, now that the world is finally awakening to the need to do more. "They all realize this is a tremendous catastrophe and its going to take a lot of effort to control it."

Obama said the United States would send as many as 3,000 troops to erect treatment centers with 1,700 beds in Liberia, the country where Ebola is most out of control.

In Sierra Leone, which shares its southern border with Liberia, Ksiazek found a country willing to do whatever is needed but lacking the material and the training. Ksiazek met President Ernest Bai Koroma four times in meetings to discuss how to organize a response to the virus in the country of 5.7 million.

"I think he's thrown the entire resources of the country behind this," Ksiazek said.

After his stay in the country about half the size of Illinois, Ksiazek said things had improved, but the virus was outpacing efforts to control it.

"In Sierra Leone there is some improvement but overall it's headed in the wrong direction," he said. "I'm cautiously optimistic that with the resources coming available .. Sierra Leone will come under control."

Even more effort will be required in neighboring Liberia. "It will take a gargantuan effort ... at a very very high level," Ksiazek said.

The system for containing Ebola was devised in 1995 and has been used successfully to combat previous outbreaks of Ebola and Marburg, another exotic virus.

The system on the surface is simple: isolate Ebola cases and keep a close eye on everyone who might have come in contact with the victim. The problem, Ksiazek said, is that health workers lack the training to carry out those tasks and the equipment, such as disposable gloves, to keep themselves from becoming infected. The equipment is being flown in weekly now, but even more is needed, Ksiazek said.

The lack of protective equipment resulted in health workers being among the first victims after Ebola emerged in March. Those health workers who survived initially were reluctant to return to work. By the time the CDC arrived in Sierra Leone, one of the three worst affected countries, Ebola was out of control, Ksiazek said.

Ksiazek worked with high-level Sierra Leone officials and other foreign health organizations to create a national data base so health officials could keep track of the victims. The government was able to reduce the number of Ebola cases in two cities that were epicenters of the outbreak, but its efforts have been less successful in the rest of the country, he said.