Ebola Outbreak 'Tip of the Iceberg,' Experts Say

by Maggie Fox, NBC News

   An "out of control" outbreak of Ebola in West Africa that's being called the deadliest ever is far from over and it's likely to get worse before it gets better, experts predict.

   And health workers who have been fighting the outbreak, which spans three countries and has killed more than 300 people, say they are certain many cases go unreported as they see gruesome infections, dangerous myths and people fleeing the virus, spreading it further. 

   "This is the tip of the iceberg," said Robert Garry, a microbiology professor at the Tulane University School of Medicine who's been leading relief efforts in Sierra Leone for the Viral Hemorrhagic Fever Consortium. 

   Dr. Mwayabo Kazadi, from the health unit for Catholic Relief Services, agreed that many cases could go uncounted and undiagnosed in the region, where Guinea, Sierra Leone and Liberia come together.

   "When you don't have a proper health system in place, it is pretty difficult," Kazadi said. 

   Garry says team members arrived in at least one village to find it deserted, and the body of an Ebola victim left unattended in a house. It's not hard to imagine what happened, but it makes it impossible to track down people who might have been infected and get them to hospitals for what care can be provided, and to prevent them from infecting others. 

   A Doctors Without Borders official said Friday that the outbreak was out of control. And the numbers make it clear this is the biggest outbreak yet of Ebola since the virus was first identified in 1976. The virus, which causes a particularly nasty form of hemorrhagic fever, has killed 337 people out of 528 infected.

   "This is the biggest outbreak we have ever actually seen of Ebola," Kazadi said. "It's the biggest both in numbers and in terms of geography," Garry agreed. 

   The biggest outbreak affected 425 people in Uganda in 2000, killing 224 of them.

   Ebola is spread in bodily fluids, and the worst stages of the disease make that frighteningly easy. "People are throwing up. They have diarrhea," Garry said. Patients can develop blood hemorrhages on their skin and in their eyes. 

   At least a dozen women were infected by a healer, probably as they washed and kissed her body when she died of Ebola and they were preparing her for her funeral. The case illustrates just why this outbreak is so difficult to fight.

   The healer, who used snakes as part of her practice, made some frightening and dire predictions from her death bed. "She said she was going to release the snakes and said anybody who saw the snakes would die the way she did," Garry said.

   This frightened some of the people in her village, and they attacked some volunteers from Garry's team, throwing rocks at their vehicle.

   Garry's back in the U.S. for a few days trying to scrape up funding to buy protective gear for health care workers. The WHO and other groups are also providing such gear, but it's getting spread thin.

   If workers start re-using gloves, gowns or goggles, they could end up spreading the virus. There's no cure and no vaccine, and the outbreak is killing 60 percent of its victims.