NPR reported: “The latest numbers on the Ebola outbreak are grim: 2,473 people infected and 1,350 deaths.

That’s the World Health Organization’s official tally of confirmed, probable and suspect cases across Guinea, Liberia, Sierra Leone and Nigeria. But the WHO has previously warned that its official figures may vastly underestimate the magnitude of the outbreak.

So how bad is it really?

That’s the question NPR put to several people who have been carefully watching the outbreak.

There’s no scientific way of knowing exactly how wrong the official numbers are, says Joseph Fair, an infectious disease doctor who has been acting as a special adviser to the health minister of Sierra Leone. “At a bare minimum, I would guess they’re probably off by 20 percent,” he says.

Once public health workers identify someone with this disease, Fair says, they have to find everyone else who might have gotten exposed through contact with that person. And that hasn’t been easy.

Even if someone tests positive for Ebola, he says, public health workers may return and find that the person has simply disappeared.

“They’re traveling, usually by public transport, and coming into contact with a lot more people,” Fair says.

The health agencies of these poverty-stricken countries don’t have the staff they need to track down all these people who may have been exposed. Unlike previous Ebola outbreaks that hit isolated, rural areas, this one is affecting many more people in a more urban environment.

Adding to the difficulty is a climate of distrust created by years of war and conflict.

“Because people are so afraid, in some instances, if a relative dies in a home, all the others run away instead of going toward the clinic to report themselves,” says Roseda Marshall, a Liberian pediatrician who is president of the Liberia College of Physicians and Surgeons. She’s currently in the U.S., trying to raise funds and support to help fight Ebola.”

Click here to read the full NPR story “How Much Bigger Is The Ebola Outbreak Than Official Reports Show?” by Nell Greenfieldboyce.

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Doctor, Did You Wash Your Hands? ™ provides information to consumers on understanding, managing and navigating health care options.

Jonathan M. Metsch, Dr.P.H., is Clinical Professor, Preventive Medicine, Icahn School of Medicine at Mount Sinai; and Adjunct Professor, Baruch College ( C.U.N.Y.), Rutgers School of Public Health, and Rutgers School of Public Affairs and Administration.

This blog shares general information about understanding and navigating the health care system. For specific medical advice about your own problems, issues and options talk to your personal physician.

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