CDC Morbidity and Mortality Weekly Report (MMWR)                                                                   

 by Aimee Summers, PhD1,2, Tolbert G. Nyenswah, MPH 3, Joel M. Montgomery, PhD2,4, John Neatherlin, MPH2,4,       Jordan W. Tappero, MD                                                                                                              Dec. 16, 2014

...The Ebola epidemic in Liberia presents unique challenges not only from its spread into crowded urban environments (10) but also its occurrence in remote communities. As in urban counties, county and district health teams in rural counties with remote regions need adequate training in 1) case reporting; 2) case investigation; 3) case management; 4) contact tracing; 5) safe burials; 6) safe collection, processing, and transport of blood specimens for testing; and 7) development of a county-level incident management system.

However, in rural counties, few roads, poor road conditions, and an overall lack of vehicles, vehicle maintenance, Internet connectivity, and limited telephone network coverage impedes epidemic control. Development of innovative communication and transportation network strategies for communities with limited access to roads and limited means of communication is critical for successful management of Ebola in remote areas. These strategies are needed to ensure essential supplies such as personal protective equipment, chlorine/disinfectants, body bags, and sprayers can reach county health teams and suspected, probable, and confirmed Ebola patients can be transported and isolated in Ebola treatment units as soon as they are identified (10).

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http://www.cdc.gov/mmwr/preview/mmwrhtml/mm63e1216a2.htm?s_cid=mm63e1216a2_w