Courtesy Dr. Phuoc LeDr. Phuoc Le

UCSF doctor returning from Liberia sees improvement in Ebola outbreak, but says rural areas remain vulnerable

The Ebola crisis appears to be improving in Liberia, but a number of ongoing challenges will likely hinder complete eradication of the deadly virus, at least in the immediate future, said a UC San Francisco doctor who recently returned from the West African nation.

Doctors and nurses have been instructed to wear personal protective equipment, even when treating patients not suspected of having Ebola, and to burn the used gear, said Dr. Phuoc Le, who spent last month teaching infection-control training to health care workers in Liberia.

But at the dozens of hospitals and clinics Le visited in Liberia, many of which require up to an entire day of travel to reach by vehicle or foot from densely populated towns, Le found that health care workers, for various reasons, would reuse their personal protective gear, he said.

“People are afraid that supplies will run out and they won't be able to provide care for their patients,” Le said.

And while the number of those becoming infected in larger cities such as the nation's capital of Monrovia has declined, upon the start of Liberia's dry season in November, the doctor said it will be easier to travel to rural regions and potentially spread the virus.

“The latest hot spots for Ebola [are in] rural areas,” he said.

As of Friday, there have been 3,016 deaths from Ebola in Liberia, more than any other affected West African country, according to the Centers for Disease Control and Prevention. The epidemic is considered the worst Ebola outbreak in history.

Le is one of about 10 UCSF-affiliated health care workers to have traveled to Ebola-stricken countries in West Africa since August, said Dr. George Rutherford, who co-chairs the UCSF Ebola Task Force.

While some doctors and nurses returning to the U.S. from countries devastated by Ebola have faced scrutiny amid quarantine concerns, UCSF is welcoming home its health care workers with open arms, university officials noted. The university is one of five UC medical centers designated by California health officials as those positioned to accept patients with Ebola.

“As far as we're concerned, as an institution, this is like somebody returning from war,” Rutherford said of Le. “His return is something to be celebrated.”

Prior to arriving in San Francisco on Saturday, Le was screened at airports in Monrovia, Brussels, Belgium, and finally Newark, N.J. He spoke with the San Francisco Department of Public Health on Sunday, and out of four risk categories was labeled “some risk.”

“Some risk” is for health care workers or other travelers who treated or had contact with Ebola patients, but had no known exposure, said Rachael Kagan, a spokeswoman with The City's health department.

They must report their temperatures and potential symptoms to the health department twice daily for 21 days, and out of caution are recommended to not travel unnecessarily or spend time in public places.

“Unless they have a symptom, there's really no reason to think that they're susceptible to Ebola, or even be contagious,” Kagan said of health care workers placed in the some risk category.

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