More than 20,000 people could become infected with the deadly ebola virus, the World Health Organisation has said. 
 
 The UN health agency warned the actual number of current ebola cases in hard-hit areas could be 12,000 - four times higher than the number confirmed at present. 
 
 In what amounted to be a bleak assessment of the disease, the WHO said it believed the virus was still being spread in a "substantial number of localities" and added that "the outbreak continues to accelerate". 
 
 It also expressed concern at the unprecedented number of health workers who have died after treating patients in West African countries including Liberia, Guinea, Nigeria and Sierra Leone. 
 
 The WHO's assistant director-general, Dr Bruce Aylward, said: "This far outstrips any historic ebola outbreak in numbers, as the largest outbreak in the past was about 400 cases. 
 
 The outbreak has put immense strain on medical resources in West Africa 
 
 "What we are seeing today, in contrast to previous ebola outbreaks, are multiple hotspots within these countries - not a single, remote forested area, the kind of environments that have been tackled in the past. And then not multiple hotspots within one country, but international disease." 
 
 Of the 3,069 cases reported since the outbreak began, 40% of them have emerged in the past three weeks, according to the latest figures. 
 
 Its update on the outbreak came shortly after GlaxoSmithKline announced it was forming a new consortium to accelerate development of a vaccine to treat ebola. 
 
 Developed in partnership with the US National Institute of Health, it is set to be tested on healthy human volunteers within the next couple of weeks to see if it is safe and effective. 
 
 As the trials take place, the pharmaceuticals giant is set to manufacture 10,000 extra doses of the vaccine which can be used by the WHO if the clinical tests are successful. 
 
 William Pooley, a health worker, was the first Briton to contract ebola 
 
 Speaking in Geneva, the agency said it hopes to stop the spread of ebola across West Africa in the next six to nine months, with a particular focus on ensuring the virus doesn't spread internationally. 
 
 Dr Aylward said its plan will cost £300m to implement, with 12,750 health workers needed around the globe to tend to patients. 
 
 "Response activities must be adapted in areas of very intense transmission and particular attention must be given to stopping transmission in capital cities and major ports, thereby facilitating the larger response and relief effort," he added. ||||| Image copyright AFP Image caption More than 240 health workers have been infected with Ebola in West Africa 
 
 Nigeria has confirmed its first Ebola death outside Lagos – a doctor in the oil hub of Port Harcourt. 
 
 His wife has been put under quarantine, while a further 70 people in the city are under surveillance. 
 
 Latest figures show more than 1,550 people have died of Ebola, with at least 3,000 confirmed cases - mostly in Guinea, Liberia and Sierra Leone. 
 
 The World Health Organization (WHO) estimates that the total number of cases could potentially exceed 20,000. 
 
 In an action plan to deal with the outbreak, the WHO said that "the actual number of cases may be 2-4 fold higher than that currently reported" in some areas. 
 
 Speaking to reporters, the WHO assistant director-general, Bruce Aylward, said the possibility of 20,000 cases "is a scale that I think has not ever been anticipated in terms of an Ebola outbreak". 
 
 He added: "That's not saying we expect 20,000... but we have got to have a system in place that we can deal with robust numbers.'' 
 
 This unprecedented outbreak is currently out of control as medical agencies struggle to cope with the increasing number of cases on the ground and continue to face hostility from communities in certain affected areas, the BBC's West Africa correspondent Thomas Fessy reports. 
 
 Before any results are seen on the ground, the number of infected people will probably continue to grow given that most treatment centres are already operating at full capacity, our correspondent adds. 
 
 Vaccine trial 
 
 West Africa's health ministers are meeting in Ghana to discuss how to tackle the world's most deadly Ebola outbreak. 
 
 Meanwhile, an international health consortium says that a trial vaccine against Ebola could be given to healthy volunteers in the UK in September, followed by trials in The Gambia and Mali. 
 
 Image copyright Getty Images Image caption Fruit bats are believed to be a major carrier of the Ebola virus but do not show symptoms 
 
 Ebola Virus Disease (EVD) 
 
 Symptoms include high fever, bleeding and central nervous system damage 
 
 Fatality rate can reach 90% - but current outbreak has mortality rate of about 55% 
 
 Incubation period is two to 21 days 
 
 There is no vaccine or cure 
 
 Supportive care such as rehydrating patients who have diarrhoea and vomiting can help recovery 
 
 Fruit bats, a delicacy for some West Africans, are considered to be virus's natural host 
 
 Ebola was taken to Nigeria by Patrick Sawyer, a Liberian-American man who travelled to Lagos before dying. 
 
 One of his contacts evaded Nigeria's surveillance team and travelled to Port Harcourt, where he sought medical treatment, Health Minister Onyebuchi Chukwu said. 
 
 Although the man later recovered, the doctor who treated him died and tests showed he had Ebola, the minister said. 
 
 The doctor had died last Friday but the results of the tests have only just been announced by the health minister. 
 
 The doctor who treated Mr Sawyer also died. 
 
 Nigeria schools shut 
 
 More than 240 health workers have been infected with Ebola - a rate which the World Health Organization (WHO) said was "unprecedented". 
 
 It noted that in many cases protective suits, even rubber gloves and face masks, were not available. 
 
 The doctor becomes the sixth fatality in Nigeria, which is Africa's most populous country. 
 
 On Wednesday, Nigeria announced that schools would not reopen until 13 October in order to try and contain the disease. 
 
 Nigerian voices: Ali Sadiq, public servant based in Abuja 
 
 "The postponement of the schools' resumption by the federal government is a good move but the extension is too long. I can't imagine my two kids wasting six more weeks at home. Two to three weeks would have been enough for all that." 
 
 Mixed reaction to Nigeria schools closure ||||| New figures published Monday by the World Health Organization reveal a far worse outlook than it had previously anticipated for the Ebola epidemic in West Africa. 
 
 In addition to predicting many more cases and deaths, the new report for the first time raises the possibility that the epidemic will not be brought under control and that the disease will become endemic in West Africa, meaning that it could reach a steady state and become a constant presence there. 
 
 “The epidemiologic outlook is bleak,” the report said. 
 
 If control does not improve now, there will be more than 20,000 cases by Nov. 2, and the numbers of cases and deaths will continue increasing from hundreds to thousands per week for months to come, according to the report. The death rate is about 70 percent in each of the heavily affected countries, Guinea, Liberia and Sierra Leone. 
 
 The new estimates were published online in The New England Journal of Medicine by a team of more than 50 scientists. An earlier prediction by the health organization was far less dire, saying there might be 20,000 cases in nine months. 
 
 So far, there have been 5,843 cases, including 2,803 deaths, with the most cases, 3,022, reported by Liberia. But the scientists say it is likely that many cases have not been detected. 
 
 Although researchers are scrambling to produce and test drugs to treat the disease and vaccines to prevent it, the report says they are unlikely to be available for months — and have not yet been fully tested in humans. 
 
 An editorial in the same journal called the epidemic “an avoidable crisis,” and faulted a “highly inadequate and late global response” for letting it surge out of control. It was written by Dr. Jeremy J. Farrar of the Wellcome Trust, and Dr. Peter Piot of the London School of Hygiene and Tropical Medicine. Dr. Piot helped discover the Ebola virus in 1976. 
 
 The editorial also warns that it will be impossible to control the epidemic “without a massive increase in the response, way beyond what is being planned,” and says that drugs and vaccines are urgently needed. The epidemic is growing so large, they write, that standard containment measures — isolating the sick and monitoring their contacts for signs of illness every day for 21 days — may not be feasible. One patient can easily have 10 contacts, so the number to be traced has already reached into the tens of thousands. No organization now has the staffing to follow that many people. 
 
 If Ebola becomes endemic in West Africa, Dr. Piot and Dr. Farrar say, the region could become a reservoir of the virus and pose a constant threat to the rest of Africa and other parts of the world. 
 
 Guinea, Liberia and Sierra Leone are among the world’s poorest countries, and the epidemic has overwhelmed their health care systems, which were weak to begin with. The editorial predicts that these nations will see many more deaths from childbirth, malaria, tuberculosis, AIDS, dysentery, pneumonia and chronic diseases. “Indeed,” the authors say, “there is a very real danger of a complete breakdown in civic society.” ||||| Health authorities struggling to control the worst outbreak of Ebola on record said drastic action is needed to prevent more deaths. 
 
 More than 390 people have died in the outbreak in Guinea, Sierra Leone and Liberia, the World Health Organization said in a statement today. That toll is greater than the 280 people killed in 1976, when the virus was first identified near the Ebola River in what is now the Democratic Republic of Congo. 
 
 The WHO plans to meet with health ministers from 11 countries July 2-3 in Accra, Ghana, to agree on a plan to bring the outbreak under control. Health workers will have to tackle resistance from local people who are hiding infected family members, destroying medicines intended to help and adhering to rituals that fuel the spread of the virus. 
 
 “This is no longer a country-specific outbreak but a sub-regional crisis that requires firm action by governments and partners,” said Luis Sambo, the WHO’s regional director for Africa. “WHO is gravely concerned of the ongoing cross-border transmission into neighboring countries as well as the potential for further international spread.” 
 
 The outbreak is expected to last another three to four months, focused around the “hot spot” in the rural border areas where the three countries meet, said Francis Kasolo, the WHO’s director of disease prevention and control for Africa. 
 
 Crossing Borders 
 
 “What we are seeing is a lot of cross-border movement,” Kasolo said in a telephone interview. “When somebody comes in contact with a sick person in Guinea and crosses into Sierra Leone, as long as they don’t report having come into contact with an Ebola patient, there is a grave possibility that that person will transmit the disease.” 
 
 At next week’s meeting, the WHO will discuss forming a multi-country team that will share information daily on Ebola cases and people who have come into contact with those infected, Kasolo said. The Geneva-based organization has deployed more than 150 people to fight the epidemic, with tasks including surveillance, communication, infection control, logistics and data management. 
 
 The virus is also spreading because some hospitals are allowing infected patients to leave. Unsafe burial practices are also contributing. 
 
 Effective communication of safe measures to local communities is a major challenge that will be discussed in Accra, said WHO spokesman Daniel Epstein. 
 
 Educational Effort 
 
 “If there isn’t a strong public-health information and education component to the control activities, then people don’t understand and end up infecting themselves and doing things they shouldn’t be doing,” said David Heymann, a professor at the London School of Hygiene and Tropical Medicine who has studied Ebola since the first outbreak in 1976. 
 
 Guinea has pockets of resistance, mainly in the town of Gueckedou, the epicenter of the disease, said Remy Lamah, the country’s health minister. 
 
 “There are always citizens who remain attached to their rites, their traditions and others do not even believe that Ebola exists,” he said by phone today from Conakry, Guinea’s capital. “We want to use teachers and students during the holidays for awareness caravans in their communities.” 
 
 The WHO is also recruiting Ebola survivors to speak at next week’s meeting and share their experience with their own communities to try to end resistance to control efforts. 
 
 ‘Denial Barrier’ 
 
 “That’s one of the ways of trying to break the denial barrier of saying Ebola is just another disease,” Kasolo said. “We want them to be advocates within the communities where they come from on this particular disease.” 
 
 Suspicion of health workers’ motives has thwarted initiatives in some places. In Sierra Leone, youths in Kailahun burned drugs and other supplies, claiming the medicines were meant to kill Ebola patients, the country’s ministry of health and sanitation said this week. 
 
 Some households in Sierra Leone’s Kenema district are also hiding infected family members until they become very ill, health minister Miatta Kargbo said in an interview. Bogus vaccination programs are also causing undue confusion. 
 
 “The ministry wishes the general public to know that there is no vaccine for Ebola and it has not instituted any Ebola vaccine immunization in schools,” the ministry said in a statement. “The act of spreading this misleading and scaring information is a criminal offense and people involved in this act are warned to desist forthwith.” 
 
 In Liberia, traditions of waiting to bury bodies for months and touching the dead have made controlling the spread harder, Tolbert Nyesuah, assistant minister for health said. Denial that that disease exists has also complicated containment, he said. 
 
 Neighboring Countries 
 
 There is low risk at present that the outbreak will spread to other nations, Kasolo said. Still, officials from neighboring countries such as Mali, Guinea-Bissau, Senegal, Ghana, Ivory Coast and Gambia have been invited to attend the Accra meeting in case the disease spreads, he said. The Democratic Republic of Congo and Uganda will share their experiences dealing with past outbreaks. 
 
 “We still think we have another three to four months to go with the epidemic, but the duration will be influenced by how national governments and affected communities respond,” Kasolo said. 
 
 For Related News and Information: Sierra Leone Youths Burn Drugs Claiming to Prevent Ebola Deaths 
 
 To contact the reporter on this story: Makiko Kitamura in London at mkitamura1@bloomberg.net 
 
 To contact the editors responsible for this story: Phil Serafino at pserafino@bloomberg.net David Risser, Kristen Hallam
– Ebola cases in West Africa could multiply sixfold, affecting up to 20,000 as the virus "continues to accelerate," the World Health Organization said today, per Reuters. Some 1,552 people have now died out of the 3,069 cases reported—though the actual number of cases could be four times that amount, the AP reports. "More than 40% of the total number of cases have occurred within the past 21 days," the UN health agency said, noting an "unprecedented" number of health workers have been hit. The latest figures do not include cases in the Democratic Republic of Congo, where a different strain of Ebola is wreaking havoc. Though the majority of cases in the outbreak are in Guinea, Liberia, and Sierra Leone, the BBC reports Nigeria has seen its sixth Ebola death, and the first outside the city of Lagos, in the oil hub of Port Harcourt. To help combat the spread, pharmaceutical giant GlaxoSmithKline notes it is working with the National Institutes of Health on a vaccine to treat Ebola and will begin human trials on healthy volunteers in the coming weeks. If effective, the company will provide 10,000 doses to WHO workers, Sky News reports. Meanwhile, the WHO has revealed a new plan to tackle the virus, which includes focusing on "stopping transmission in capital cities and major ports."