Perfecting Ebola Contact Tracing — Factpod #13

I am professor Hans Rosling

I'm am participating in the fight against Ebola

here in Liberia.

In this country the number of new cases per day has come down

from almost 100 in the end of september

to now in the beginning in December

around 10 per day.

But that is still very dangerous!

Because the only safe and stable level for Ebola is zero cases per day.

So we say Ebola must go all the way down to zero.

We must stop transmission among humans.

But that is difficult now at the low level

because Ebola is hiding in between the other infectious diseases

So we have to be like detectives and hunt the virus

and we do that using a method called "contact tracing".

I will show you how it works.

Imagine that this is a patient that is very sick with Ebola.

It's a contagious disease and everyone that has been in contact with this patient may be infected.

So what we need to do are two things:

we need to take the patients to an Ebola Treatment Center and isolate them,

and then we have to list all the contacts.

We have to make a list with everyone that was in contact

with this patient during the days that he/she was sick.

Then we start what we call the 'contact tracing'.

In the next 21 days

we follow all these persons

and we have to follow them everyday, check the temperature and ask them how they feel

and if one of them is infected,

let's say that this one is infected

and this one is infected

we don't know, there is no test we can use.

So we just have to follow them.

Now those who are not infected, we follow them for 21 days and we find nothing

we follow this one, we find nothing

same here

same here

But this one that has the virus in the body

after 10 or 15 days, they get fever, headache, diarrhea

and then very fast we isolate them.

So when they develop full blown Ebola here

they are very contagious, they are already in the Treatment Center

and they are isolated.

Now this one here...

May not have confidence in our system

they are scared and they decide...

"no, I get a little fever today, hope it's malaria"

and they move away somewhere else

they avoid our contact tracers.

That's very dangerous!

Because then they would get Ebola outside our control

and they may infect other persons.

And we may also have missed one person down here

Let's say this is the brother to the case

and he took a bicycle and went to relatives' to live there.

If he was infected, we won't know it.

He will develop Ebola here and infect others.

So we need a perfect contact tracing system,

and perfect means that everyone has to be listed.

So that when they develop the disease

we can isolate them immediately.

And those who are scared and don't trust that it's the best to wait for the contact tracer

we have to convince them and have to be very kind

so that they would like to be included in our system

and we can isolate them like that.

Now the challenge today in Liberia is that

we have six thousand contacts we are following.

and they live throughout the country

most of them here in Monrovia.

And it's far from a perfect system.

We have a leakage of patients who are not in the system

like this one

and those who we loose during the control.

But they're getting better and better.

And we need more resources

today we don't need more Ebola Treatment Units

we need more international support for

this contact tracing.

And we need people who come and stay for several months

then we can find all these contacts

and we can follow them perfectly

So somewhere in the next year

when we have made this better and better

then we may end Ebola transmission completely.

And then it also has to be done in the neighbouring countries.

That is possible, but it requires lots of resources

and lots of endurance

that we don't give up

because we have only one objective:

Ebola must go! Go all the way down to zero.