The World Health Organization, in its Aug. 22 Ebola situation statement, reported that there had been 142 new illnesses reported in the two days between Aug. 19 and 20. Liberia reported 110 new cases alone. In addition, the outbreak in Nigeria changed for the worse.
Liberia has now reported the largest number of Ebola illnesses in the West African outbreak as well as the highest death toll. Through Aug. 20, the country reports 1,082 confirmed, probable or suspected Ebola cases and 624 deaths. The total from the four nations reporting illnesses is 2,615 cases and 1,427 deaths.
In an assessment released Aug. 22, the WHO noted that they were encountering behaviors that had never been seen in previous Ebola outbreaks. The opening of a new treatment center is being greeted with the appearance of a host of new patients, few of which had previously been identified as at risk. The WHO believes that this is a sign of "an invisible caseload of patients."
The WHO also describes the existence of "shadow zones." These are regions in the country that are very difficult to reach, or where there has been active community resistance to public health efforts. Rumors are emerging from these zones, leading to a strong suspicion that there are a great number of Ebola cases that have not been discovered.
In the capital of Liberia, Monrovia, the situation is grim. The WHO states that "virtually all health services have shut down." The agency notes the looting of a clinic in a Monrovia slum on Aug. 16.
The slow spread of Ebola in Nigeria continues. Nigeria was brought to the capital, Lagos, by a Liberian-American named Patrick Sawyer. Since his arrival, illness and death, a number of people who had contact with him have developed Ebola and four have died. The first secondary infections have been diagnosed in two spouses of the original patients infected by Sawyer.
The WHO and the Nigerian government differ in their reported data. Including Patrick Sawyer, the WHO reports a total of 16 Ebola illnesses and five deaths. The Nigerians report 14 cases with five deaths. There are four patients in isolation and five patients have been released from the hospital.
The Nigerian authorities have a number of individuals under surveillance who are either contacts of Sawyer or contacts of the others who contracted Ebola from him. While the containment effort appears to be working at this time, there may be additional illnesses and deaths in the group being monitored. Thus far, there is no sign the illness has moved into the general population.