GENEVA, Switzerland, Jan. 4 (UPI) -- The number of people under close medical monitoring for direct or suspected contact with Ebola virus patients in Gabon and the Congo in Africa has jumped, the World Health Organization said Friday.
As of Jan. 2, individuals monitored increased by approximately 50 to 242, according to the WHO. "All contacts are being closely monitored for signs or symptoms of Ebola haemorrhagic fever," the global health agency said in a statement.
Gregory Hartl, WHO spokesman, told United Press International most of increase was in Gabon.
But the number of deaths from Ebola, considered by the WHO as the most virulent disease known to mankind, "has not moved (up) in the last two to three days," Hartl said.
As of Wednesday, "32 confirmed cases of the disease had been reported, including 23 deaths (17 in Gabon and six in the Congo)," said the WHO's communicable Disease Surveillance and Response unit in a statement.
"There is some concern it might spread," Dr. Herve Zeller, director of the reference center for viral haemmorhagic diseases at the Paris-based Pasteur Institute, told UPI in a telephone interview.
Zeller -- a leading authority on Ebola, which to date has no specific treatment and for which no vaccine exits -- emphasized the problem "of within-family chain transmission of secondary infections" and noted the difficulty in tracking individuals who have had contact with sick patients or infected fluids.
The Ebola symptoms are the onset of fever, followed by muscle pain, abdomen pain, vomiting and bloody diarrhea, limited kidney and liver functions, and finally, external bleeding.
Ebola is transmitted by direct contact with the blood, secretions, organs or semen of infected persons, and kills 50 to 90 percent of patients, according to the WHO. Transmission of the virus has taken place through handling or eating infected chimpanzees. The incubation period ranges from 2 to 21 days.
Medical authorities also are worried some infected patients refusing seek hospital treatment would be hidden by families.
Hartl said the suspected contacts are monitored for two full incubation periods -- 42 days.
International teams working closely with the medical authorities in the two affected countries have set up isolation procedures for those known to have contracted the disease. They also are tracking the contacts and conducting community education campaigns, Hartl said.
The persistence of the most recent outbreak of Ebola in Gabon -- and the news that the dread disease has now spread to neighboring Congo-Brazzaville -- is being watched closely by medical authorities in Johannesburg, South Africa and beyond.
Thus far Ebola outbreaks have occurred only in African village environments, which has made isolation and monitoring relatively easy. The great fear is the disease could travel to a major urban center, such as Johannesburg, South Africa, a major airline hub and a city with quality health care facilities that attract sick ill patients from throughout the continent.
In 1997, a Congolese businessman flew into the city and booked into an exclusive Johannesburg clinic. By the time it was discovered he had Ebola, it was too late to save the nurse who had tended him, as well as the man himself.
Johannesburg is the commercial capital of all Africa and large numbers of Congolese, Gabonese, Ugandans and every other African nationality pile into the city, many of them migrating illegally.
"In public health terms, Johannesburg is a disaster waiting to happen, a Johannesburg public health physician, who asked not to be identified, told UPI. "We have seen a rapid run-down in the standards of public health care and at the same time a build-up of unmonitored illegal immigrants, many of them arriving from extremely unhealthy environments."
The physician said, "To be quite cynical, what is worrying about the current outbreak in Gabon is not just that it's been going on for three weeks now but that, thanks to its oil, Gabon has the highest per capita income in Africa. There are lots of wealthy Gabonese and Johannesburg is the only First World health center within their easy reach. Normally we welcome such custom but you can't help getting jittery when you know they're coming from a country with an ongoing Ebola epidemic."
The poor, however, generally travel by road. Were they to contract Ebola in their home country, they likely would die en route without reaching Johannesburg. But the wealthy, like the Congolese businessman in 1997, travel by air and would arrive with the victim still only in the incubation stage.
The Ebola virus was first identified in Sudan and the Congo in 1976. That outbreak infected 284 Sudanese and led to 117 deaths; in the Congo, of 318 cases, 280 claimed lives.
More recently, a 1995 epidemic in the Congo took 244 lives. Outbreaks were reported in Gabon in 1996 and in Uganda in 2000.
(With additional reporting by R.W. Johnson in Durban, South Africa.)
