Geneva - The scale of the world's worst Ebola
outbreak has been concealed by families
hiding infected loved ones in their homes
and the existence of "shadow zones" that
medics cannot enter, the World Health
Organization (WHO) said on Friday.
The U.N. agency issued a statement detailing
why the outbreak in West Africa had been
underestimated, following criticism that it
had moved too slowly to contain the killer
virus, now spreading out of control.
Independent experts raised similar concerns
a month ago that the contagion could be
worse than reported because suspicious local
inhabitants are chasing away health workers
and shunning treatment.
More than 1,300 people have died from the
disease and many experts do not expect the
epidemic to be brought under control this
year.
Under-reporting of cases is a problem
especially in Liberia and Sierra Leone. The
WHO said it was now working with Medecins
Sans Frontières (MSF) and the U.S. Centers
for Disease Control and Prevention to
produce "more realistic estimates".
The head of MSF, which has urged the WHO
to do more, told Reuters in an interview on
Thursday that the fight against Ebola was
being undermined by a lack of international
leadership and emergency management skills.
The stigma surrounding Ebola poses a serious
obstacle to efforts to calibrate the outbreak
in Liberia, Sierra Leone, Guinea and Nigeria,
which has claimed far more victims than any
other episode of the disease that was first
discovered nearly 40 years ago in the forests
of central Africa.
"As Ebola has no cure, some believe infected
loved ones will be more comfortable dying at
home," the WHO statement said.
"Others deny that a patient has Ebola and
believe that care in an isolation ward -
viewed as an incubator of the disease - will
lead to infection and certain death. Most fear
the stigma and social rejection that come to
patients and families when a diagnosis of
Ebola is confirmed."
Corpses are often buried without official
notification, the WHO said, while an
additional problem is the existence of
numerous "shadow zones", or rural villages
where there are rumours of cases and deaths
that cannot be investigated because of
community resistance or lack of staff and
transport.
In other cases, where treatment is available,
health centres are being immediately
overwhelmed with patients, suggesting there
is an invisible caseload of patients that is not
on the radar of the official surveillance
systems.
