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Kikwit, Zaire -- Under a canopy of bright stars, in a building surrounded by bushes that glowed with the lights of millions of fireflies, the Ebola epidemic control team compared notes on yesterday's battle against the deadly disease, and planned their efforts for today. Their conclusions were grim. "There may be another wave yet to come," said the team's leader, Dr. David Heymann of the World Health Organization. The number of cases is quadrupling every three to four days, he said, "and now transmission is occurring further and further out" from Kikwit's major medical facility, where the original cases occured. The city and the province around it have been under a quarantine order since last week as the Kinshasa government seeks to contain the outbreak, the first in Zaire since 1976. Many residents in Kikwit yesterday said the situation was made worse by the fact that people had come to associate the hospital with death, and were refusing to take their sick relatives there. "There are people dying in the city. People are dying in the community," Dr. Mungala Kipasa, director of Kikwit General Hospital, told reporters. "I can't even take a taxi," he said. "People won't let me in. They are afraid of medical staff." The 326-bed hospital, considered by many to be the best in the region, is all but empty, with volunteer staff and international experts there preoccupied mainly with observing those in quarantine. Perhaps for lack of data, doctors in Kinshasa said for the second day that the death toll was 86. The World Health Organization in Geneva said yesterday its experts in Zaire had registered 101 Ebola cases, of whom 77 had died. It said it expected a considerable increase by week's end. The virus is passed through contact with blood or bodily fluids, and kills by causing uncontrollable bleeding. Because the incubation time for Ebola can in some cases be as long as three weeks, Heymann said there still may be many undiscovered carriers in Kikwit and surrounding villages. There is widespread concern in Kinshasa that the Ebola quarantine is being violated by large numbers of merchants, truckers and other travelers from Kikwit. But a low-level flight over the 250 miles of vast and largely unpopulated countryside between the two cities revealed virtually no vehicles on either main arteries or side roads. And the city of Kikwit, which is home to some 400,000 people, has few paved roads and an obvious lack of motorized vehicles. Though the epidemic has left rows of fresh white crosses in the Catholic cemetary, the city continues to buzz with commerce, and most of its residents are compelled by economic circumstances to go on with their normal lives. Zaire's President Mobutu Sese Seko yesterday issued his first comments on the epidemic that began in February and became the focus of global attention on May 10. Appearing before reporters in Kinshasa, Mobutu said he was concerned about the people of Kikwit but would not travel there because his doctors "have forbidden me to go in that area." |