According to the WHO, 'shadow zones' may be concealing the true magnitude of the Ebola outbreak in West Africa.
The magnitude of the world's worst Ebola outbreak, especially in Liberia and Sierra Leone, 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 Organisation (WHO) said on Friday.
The WHO's warning came as it announced that Ebola epidemic in West Africa has led to 1,427 deaths out of 2,615 known cases including two new cases reported in Nigeria.
The UN health agency issued a situation assessment 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.
"Many families hide infected loved ones in their homes. As Ebola has no cure, some believe infected loved ones will be more comfortable dying at home," the WHO statement said.
Others, it added, 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."
"These are fast-moving outbreaks, creating challenges for the many international partners providing support. Quantities of staff, supplies, and equipment, including personal protective equipment, cannot keep up with the need. Hospital and diagnostic capacities have been overwhelmed.
“Many treatment centres and general clinics have closed. Fear keeps patients out and causes medical staff to flee."
An additional problem is that 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, the UN health agency added.
It noted that the presence of patients from these other communities was resented by the West Point community in Liberia, and this resentment contributed to the riot and subsequent looting, in which potentially contaminated materials were carried into these communities.
The WHO said its epidemiologists in Sierra Leone and Liberia are working with other agencies, including Medecins Sans Frontieres (Doctors without Borders) and the US Centers for Disease Control and Prevention, to produce more realistic estimates and thus communicate the true magnitude of needs.