The Ebola outbreak that has killed more than 1,000 people in West Africa could last another six months, Médecins Sans Frontières (MSF) said on Friday, and a medical worker acknowledged that the true death toll is unknown.

Tarnue Karbbar, who works for the aid group Plan International in northern Liberia, said response teams simply were not able to document all of the cases.

Many of the sick were being hidden at home by their relatives, too fearful of going to an Ebola treatment centre.

Others were buried before the teams could get to the area, he said. In the past several days, some 75 cases had emerged in a single district.

“Our challenge now is to quarantine the area to successfully break the transmission,” he said, referring to the Voinjama area in Liberia’s north. Many people may be hiding, but many are also finally beginning to seek treatment, as more centres open up.

Gregory Härtl, a spokesman for the World Health Organisation in Geneva, said beds in such centres were filling up faster than they could be provided, evidence that the outbreak in West Africa was far more severe than the official numbers showed.

At a treatment centre that MSF recently took over in one quarantined county in Liberia, there are 40 beds but 137 people have flocked there, packing the hallways until they can be sorted into those who are infected and those are not.

In pictures: Ebola virus Show all 62 1 /62 In pictures: Ebola virus In pictures: Ebola virus Ebola virus A health worker from Sierra Leone's Red Cross Society Burial Team 7 carries the corpse of a child in Freetown In pictures: Ebola virus Ebola virus A health workers from the Sierra Leone's Red Cross Society Burial Team 7 is sprayed with desinfectant after removing a corpse from a house in Freetown In pictures: Ebola virus Ebola virus Health workers from Sierra Leone's Red Cross Society Burial Team 7 prepare to remove a body from a house in Freetown AFP In pictures: Ebola virus Ebola virus Health workers from the Sierra Leone's Red Cross Society Burial Team 7 place a body in a grave at King Tom cemetary in Freetown In pictures: Ebola virus Ebola virus Mustapha Rogers of the Red Cross talks as health workers from the Sierra Leone's Red Cross Society Burial Team 7 remove a corpse from a house in Freetown In pictures: Ebola virus Ebola virus A citizen from Mali arrives at a hospital in Murcia city, south-eastern Spain. The protocol for a possible case of Ebola has been activated as the man, who arrived from Mali to Jumilla town in Murcia province five days ago, presents clinical symptoms of high fever and vomiting EPA In pictures: Ebola virus Ebola virus Kenyan medical workers show how to handle an infected Ebola patient on a portable negative pressure bed at the Kenyatta national hospital in Nairobi Getty Images In pictures: Ebola virus Ebola virus A health worker sprays disinfectant onto a college in Monrovia, Liberia AP In pictures: Ebola virus Ebola virus A burial team in protective gear bury the body of a woman suspected to have died from Ebola virus in Monrovia, Liberia In pictures: Ebola virus Ebola virus Healthcare workers in protective gear work at an Ebola treatment center in the west of Freetown, Sierra Leone AP Photo/Michael Duff In pictures: Ebola virus Ebola virus A healthcare worker in protective gear is sprayed with disinfectant after working in an Ebola treatment center in the west of Freetown, Sierra Leone In pictures: Ebola virus Ebola virus A member of the NGO U Fondation leaves a house after visiting quarantined family members suffering from the Ebola virus in Monrovia In pictures: Ebola virus Ebola virus An Ebola sign placed infront of a home in West Point slum area of Monrovia, Liberia In pictures: Ebola virus Ebola virus A Liberian man carries his sick brother suspected of having Ebola after being delayed admission to the Island Clinic Ebola Treatment Unit due to a lack of beds at the clinic on the outskirts of Monrovia, Liberia In pictures: Ebola virus Ebola virus Health workers remove the body a woman who died from the Ebola virus in the Aberdeen district of Freetown, Sierra Leone In pictures: Ebola virus Ebola virus A health worker fixes another health worker's protective suit in the Aberdeen district of Freetown, Sierra Leone In pictures: Ebola virus Ebola virus Health workers spray themselves with chlorine disinfectants after removing the body a woman who died of Ebola virus in the Aberdeen district of Freetown, Sierra Leone In pictures: Ebola virus Ebola virus A woman crawls towards the body of her sister as Ebola burial team members take her sister Mekie Nagbe (28) for cremation in Monrovia, Liberia In pictures: Ebola virus Ebola virus Sophia Doe sits with her grandchildren Beauty Mandi, 9 months (L) and Arthuneh Qunoh, 9, (R), while watching the arrival an Ebola burial team to take away the body of her daughter Mekie Nagbe, 28, for cremation in Monrovia, Liberia In pictures: Ebola virus Ebola virus Varney Jonson (46) grieves as an Ebola burial team takes away the body of his wife Nama Fambule for cremation in Monrovia, Liberia In pictures: Ebola virus Ebola virus Family members grieve as Ebola burial team members prepare to remove the body of Nama Fambule for cremation in Monrovia, Liberia In pictures: Ebola virus Ebola virus A Liberian burial squad carry the body of an Ebola victim in Marshall, Margini county, Liberia In pictures: Ebola virus Ebola virus An Ebola burial team dresses in protective clothing before collecting the body of a woman (54) from her home in the New Kru Town suburb of Monrovia, Liberia In pictures: Ebola virus Ebola virus An Ebola burial team carries the body of a woman (54) through the New Kru Town suburb of Monrovia, Liberia In pictures: Ebola virus Ebola virus An Ebola burial team dresses in protective clothing before collecting the body of a woman (54) from her home in the New Kru Town suburb of Monrovia, Liberia In pictures: Ebola virus Ebola virus Health workers in protective gear carry the body of a woman suspected to have died from Ebola virus, from a house in New Kru Town at the outskirt of Monrovia, Liberia In pictures: Ebola virus Ebola virus Volunteers in protective suit bury the body of a person who died from Ebola in Waterloo, some 30 kilometers southeast of Freetown FLORIAN PLAUCHEUR/AFP/Getty Images In pictures: Ebola virus Ebola virus Nowa Paye (9) is taken to an ambulance after showing signs of the Ebola infection in the village of Freeman Reserve, about 30 miles north of Monrovia, Liberia In pictures: Ebola virus Ebola virus Medical staff members burn clothes belonging to patients suffering from Ebola, at the French medical NGO Medecins Sans Frontieres (MSF) in Monrovia PASCAL GUYOT/AFP/Getty Images In pictures: Ebola virus Ebola virus A medical staff member wearing a protective suit walks past the crematorium where victims of Ebola are burned in Monrovia In pictures: Ebola virus Ebola virus A Liberian burial team wearing protective clothing loads the body of a 60-year-old Ebola victim after retrieving him from his home Getty Images In pictures: Ebola virus Ebola virus Sick women rest while hoping to enter the new Doctors Without Borders (MSF), Ebola treatment center near Monrovia, Liberia Getty Images In pictures: Ebola virus Ebola virus Hanah Siafa walks in the rain with her children Josephine, 10, and Elija, six, while waiting to enter the new Doctors Without Borders (MSF), Ebola treatment center in Monrovia, Liberia Getty Images In pictures: Ebola virus Ebola virus UNICEF health workers walk through the streets, going house to house to speak about Ebola prevention in New Kru Town, Liberia. The virus has killed more than 1,000 people in four African countries Getty Images In pictures: Ebola virus Ebola virus Local residents watch as public health advocates stage an Ebola awareness and prevention event in Monrovia, Liberia Getty Images In pictures: Ebola virus Ebola virus Public health advocates stage an Ebola awareness and prevention event in Monrovia, Liberia. The Liberian government and international groups are trying to convince residents of the danger and are urging people to wash their hands to help prevent the spread of the epidemic Getty Images In pictures: Ebola virus Ebola virus Hanah Siafa lies with her children Josephine, 10, and Elija, six, while hoping to enter the new Doctors Without Borders (MSF), Ebola treatment center Getty Images In pictures: Ebola virus Ebola virus A health worker examines patients for Ebola inside a screening tent, at the Kenema Government Hospital AP In pictures: Ebola virus Ebola virus A health worker cleans his hands with chlorinated water before entering an Ebola screening tent at the Kenema Government Hospital, about 86 miles from Sierra Leone’s capital Freetown AP In pictures: Ebola virus Ebola virus Aid workers and doctors transfer Miguel Pajares, a Spanish priest who was infected with the Ebola virus while working in Liberia, from a plane to an ambulance as he leaves the Torrejon de Ardoz military airbase, near Madrid, Spain AP Photo/Spanish Defense Ministry In pictures: Ebola virus Ebola virus A Liberian money exchanger washes hands between customers as a precaution to prevent infection with the deadly Ebola virus while conducting business in downtown Monrovia, Liberia EPA In pictures: Ebola virus Ebola virus A Liberian health worker sprays disinfectant on a drivers boots to stop the spread of the deadly Ebola virus at the Christian charity Samaritan Purse head offices in Monrovia, Liberia. Over 660 people have died of Ebola in West Africa in 2014 making it the world's deadliest outbreak to date according to statistics from the World Health Organisation EPA In pictures: Ebola virus Ebola virus A Liberian taxi driver wears protective gloves as a precaution to prevent infection with the deadly Ebola virus whilst driving in downtown Monrovia, Liberia. Many Liberians have taken to wearing gloves and washing hands after every interaction in an attempt to curb the spread of the deadly virus EPA In pictures: Ebola virus Ebola virus A Liberian money exchanger wears protective gloves as a precaution to prevent infection with the deadly Ebola virus while transacting business with customers in downtown Monrovia, Liberia EPA In pictures: Ebola virus Ebola virus A woman from Liberia takes food to a sick relative in the Ebola isolation unit at the ELWA Hospital where US doctor Kent Bradley is being quarantined having contracted the Ebola virus. Over 660 people have died of Ebola in West Africa in 2014 making it the world's deadliest outbreak to date according to statistics from the World Health Organisation EPA In pictures: Ebola virus Ebola virus The disease has now spread to Liberia and, for the first time, Sierra Leone and Nigeria, killing at least 672 people in 1,201 cases, according to the World Health Organisation’s latest figures AP In pictures: Ebola virus Ebola virus Health specialists prepare for work in an isolation ward for patients at the Medecins Sans Frontieres facility in southern Guinea AFP/Getty Images In pictures: Ebola virus Ebola virus A Liberian street vendor wears protective gloves as a precaution to prevent infection with the deadly Ebola virus while transacting business with customers in downtown Monrovia, Liberia EPA In pictures: Ebola virus Ebola virus A nurse from Liberia sprays preventives to disinfect the waiting area for visitors at the ELWA Hospital where a US doctor Kent Bradley is being quarantined in the hospitals isolation unit having contracted the Ebola virus, Monrovia, Liberia EPA In pictures: Ebola virus Ebola virus Staff of the 'Doctors without Borders' ('Medecin sans frontieres') medical aid organisation carry the body of a person killed by the virus In pictures: Ebola virus Ebola virus A Liberia man (right) talks to a nurse (left) about the health of his relative who is in the isolation unit of the ELWA Hospital where a US doctor Kent Bradley is being quarantined having contracted the Ebola virus, Monrovia, Liberia EPA In pictures: Ebola virus Ebola virus A nurse from Liberia walks to spray preventives to disinfect the waiting area for visitors at the ELWA Hospital where a US doctor Kent Bradley is being quarantined in the hospitals isolation unit having contracted the Ebola virus EPA In pictures: Ebola virus Ebola virus Staff of the Christian charity Samaritan's Purse put on protective gear in the ELWA hospital in the Liberian capital Monrovia AFP In pictures: Ebola virus Ebola virus Lagos State Health Commissioner Jide Idris, speaks, during a news conference in Lagos, Nigeria. No one knows for sure just how many people Patrick Sawyer came into contact with the day he boarded a flight in Liberia, had a stopover in Ghana, changed planes in Togo, and then arrived in Nigeria, where authorities say he died days later from Ebola AP Photo/Sunday Alamba In pictures: Ebola virus Ebola virus Staff of the Christian charity Samaritan's Purse put on protective gear in the ELWA hospital in the Liberian capital Monrovia. An American doctor battling West Africa's Ebola epidemic has himself fallen sick with the disease in Liberia, Samaritan's Purse said AP In pictures: Ebola virus Ebola virus Protective gear including boots, gloves, masks and suits, drying after being used in a treatment room in the ELWA hospital in the Liberian capital Monrovia AFP In pictures: Ebola virus Ebola virus A Liberian man holding a Civet being sold on a roadside as bush meat in Lofa County. Bush meat is one of the major carriers of the Ebola virus. The Liberian government and International partners have warned people to not eat it. The World Health Organisation (WHO) reported that a total of 888 Ebola cases including 539 deaths have been recorded in West Africa since February AFP In pictures: Ebola virus Ebola virus People unload protection and healthcare material at Conakry's airport, to help fight the spread of the Ebola virus and treat people who have been already infected AFP/Getty Images In pictures: Ebola virus Ebola virus Body of evidence: health workers transport a casket of a nun whose death resulted from an Ebola infection in Zaire in 1995 Getty In pictures: Ebola virus Ebola virus Peter Piot in Yambuku, northern Congo (then Zaire), in 1976, where he was part of the original team to discover the Ebola virus J Breman In pictures: Ebola virus Ebola virus A member of Doctors Without Borders helps to unload protection and healthcare materials in Guinea Getty In pictures: Ebola virus Ebola virus Doctors in protective gear work inside the Medecins Sans Frontieres isolation ward as Guinea faced the worst ever outbreak of the Ebola virus Getty Images

MSF’s international president, Joanne Liu, who recently returned from Guinea, Liberia and Sierra Leone, said: “It’s absolutely dangerous. With the massive influx of patients that we had over the last few days, we’re not able to keep zones of patients any more. Everybody is mixed.”

The charity will have 300 beds available once several dozen open in the coming days, but Dr Liu said it could not possibly provide more.

The WHO’s Mr Härtl noted that an 80-bed treatment centre which opened in Monrovia, Liberia’s capital, in recent days filled up immediately. The next day, dozens more people showed up to be treated. Dr Liu likened the situation to a state of war because the “frontline” was always moving and unpredictable. She said the outbreak could last six more months.

“We’re running behind a train that is going forward,” Dr Liu told reporters in Geneva. “And it literally is faster than what we’re bringing in terms of a response.”

The UN health agency warned on Thursday that the official counts of 1,069 dead and 1,975 infected could “vastly underestimate the magnitude of the outbreak”.

A mother and child stand atop their mattresses in a classroom now used as Ebola isolation ward (Getty Images)

It said extraordinary measures were needed “on a massive scale to contain the outbreak in settings characterised by extreme poverty, dysfunctional health systems, a severe shortage of doctors, and rampant fear.”

Ebola causes a high fever, bleeding and vomiting. It has no cure and no licensed treatment, and has been fatal in at least 50 per cent of cases, health experts say. The disease is usually found in eastern or central Africa, typically in rural, isolated communities, where outbreaks tended to be “self-limiting”, Mr Härtl said.

By contrast, the current outbreak spread quickly to cities and the capitals of Guinea, Liberia and Sierra Leone, making it difficult to contain.

AP

Women more at risk of catching virus due to roles as caregivers

Caelainn Hogan

©Washington Post

As the number of lives claimed by the Ebola epidemic in West Africa rises above 1,000, the rate of infection among women is outpacing that among men because women are the caregivers, nurses and cross-border traders, health officials report.

Outbreaks are thought to originate through contact with infected forest animals, often making men who hunt for bush meat or handle the meat the first targets of infection.

But as an outbreak pro-gresses, women tend to be disproportionately affected. Women account for 55 to 60 per cent of the dead in the current epidemic in Liberia, Guinea and Sierra Leone, according to Unicef. “Women constitute a large section of the health workers and are on the front lines of this crisis,” said Nyama Koroma, First Lady of Sierra Leone.

At a task force meeting in Liberia a few weeks ago, health teams reported that 75 per cent of those who were infected or died from Ebola were women, said Julia Duncan-Cassell, Liberia’s Minister for Gender and Development.

“Women are the caregivers – if a kid is sick, they say, ‘Go to your mom,’” she said.