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NewsHealth

CDC projects Ebola cases in West Africa could reach 1.4M by late January

Ebola cases could rise as high as 1.4 million by late January unless aggressive action is taken to stem infections in hard-hit West African countries, federal health officials said Tuesday.

The new projections, announced Tuesday by Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention, showed between 550,000 and 1.4 million Ebola cases within four months in Liberia and Sierra Leone.

The CDC projected 21,000 more cases in those countries by the end of this month. Guinea -- epicenter of the epidemic -- was not included in the figures because its epidemiologic data is unreliable. And other countries, such as Nigeria, have "imported" cases, those brought in from elsewhere, Frieden said.

Though the CDC projects an epidemic that is increasing exponentially, it also suggests wiggle room for change.

"The data tell us that if we move now and quickly, we can bend the curve," Gayle Smith, a special assistant to President Barack Obama, said Tuesday during a CDC news briefing. She referred to efforts to drive the trajectory of the epidemic downward.

Disease fighters must act swiftly, otherwise "the curve can very quickly go the other way," added Smith, a senior director of the National Security Council.

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Obama last week called the epidemic a smoldering security threat and announced expanding U.S. efforts to control the West African viral outbreak, which began earlier this year.

The CDC's grim portrait came a day after the World Health Organization released a far more conservative -- but nevertheless dire -- prediction of its own: 20,000 cases by November. The WHO's actual count to date is 5,843 total cases and 2,803 deaths.

WHO epidemiologists, like their counterparts at the CDC, analyze a range of factors to reach their conclusions. The CDC's top estimate -- 1.4 million -- assumes that cases are significantly underreported.

Dr. Matthew Bank, a trauma surgeon at North Shore University Hospital in Manhasset, said he was not stunned by the figures, including the CDC's high estimate of cases.

"No, not surprised at all," said Bank, who worked in Nigeria seven years ago as a volunteer for Doctors Without Borders.

"I think the CDC projections are accurate but I don't think they're going to come true because I think Western countries are moving in resources to prevent that from happening."

All numbers in the CDC's model reflect "a moment in time," according to the report published Tuesday in Morbidity and Mortality Weekly Report based on scientific and epidemiological data available in August.

Frieden said the numbers are "mathematical documentation of the urgency we feel in the field." But, like Smith, Frieden said ramping up the U.S. response can turn around the epidemic.

"A surge now can break the back of the epidemic," Frieden said, referring to efforts such as those led by the Department of Defense, which is building treatment facilities in Liberia.

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