After killing more than 11,000 people, the world’s worst outbreak of Ebola is now down to a few cases, however they all remain in Guinea, where the disease first emerged nearly two years ago and where health workers continue to battle community resistance in their bid to end the outbreak.
According to officials, Guinea’s fight against Ebola has been hampered by residents who have abandoned preventive measures, which helped halt the spread of the deadly virus. According to Guinea task force spokesman Fode Tass Sylla, people shake hands, don’t was their hands and continue to consult with traditional healers instead of medics. Minister of Health Col. Remy Lama has disclosed that the recent reporting of new cases in the district of Forecariah “have taken us all by surprise,” adding that the district had been free of the disease for nearly forty days.
The Ebola epidemic in Sierra Leone is expected to be officially declared over on Saturday, when the West African nation will have gone 42 days without any new infections. However jubilation over the ending of the outbreak in Sierra Leone, where almost 4,000 deaths have been reported, has been tempered by caution as neighboring Guinea continues to battle the deadly virus.
Speaking at a news conference in Freetown on Wednesday, Palo Conteh, the head of Sierra Leone’s Ebola response, indicated that there were no plans for “an elaborate celebration,” adding that instead, the World Health organization (WHO) will deliver a formal declaration in the capital city on Saturday of the end of the epidemic. He warned however that “we have to be vigilant as it is not the end of Ebola, but the end of the current outbreak. We have fought the disease and we have won.” Since emerging in December 2013, the worst outbreak of Ebola on record has infected a reported 28,500 people, with 11,300 deaths registered, however officials believe that the real toll is significantly higher than the official data. This is largely due to under-reporting of probable cases during the early stages of the outbreak. Saturday’s announcement marks the official end of a battle, which was prematurely thought to have been nearing its end on previous occasions. On 24 August, President Ernest Bai Koroma led a festive ceremony, celebrating the discharge of the country’s last known patient. Optimism however was quickly shattered by the deaths of a 67-year-old woman and, two weeks later, a 16-year-old girl. While the primary cost of the outbreak has been in human life, the crisis has also wiped out development gains in Sierra Leone. The World Bank estimates that the West African country will lose at least US $1.4 billion in economic growth in 2015 as a result, which will lead to an “unprecedented” GDP contraction of 23.5 percent.
The World Health Organization (WHO) reported on Wednesday that no new Ebola cases were confirmed last week, effectively marking the first full week without any new cases of the deadly disease being recorded in a year an a half.
In its latest situation report on the West African Ebola outbreak, the WHO disclosed that ‘no confirmed cases of Ebola virus disease were reported in the week to 4 October,” adding, “this is the first time that a complete epidemiological week has elapsed with zero confirmed cases since march 2014.” On Wednesday, WHO officials noted that the epidemic had clearly entered a third phase, noting that the focus was no on driving “case incidence to zero, and ensure a sustained end to (Ebola) transmission.” He UN health agency also disclosed that all contacts had been completely followed up in Sierra Leone, which has seen no new cases for the past three weeks.
While Wednesday’s report is good news for the region, which has been severely affected by the outbreak, the WHO has warned that the danger is still not over, adding that two high-risk contacts in Sierra Leone, one from Bombali and one from Kambia, have gone missing. The WHO has indicated that “efforts to trace these missing contacts and mitigate the risk of any undetected transmission will continue until at least 42 days have elapsed since the last reported case in each district.” Meanwhile in neighbouring Guinea, over 500 contacts remain under follow-up in three of the country’s prefectures, with the WHO noting that all the contacts were associated with a single chain of transmission centered on the Ratoma area of the capital, Conakry. Another 290 contacts had been identified but had not been traceable for the past 42 days. The four latest cases in Guinea, reported on September 26 and 27 in Forecariah, were people infected by an unregistered contact, likely linked to the Ratoma transmission chain.
The deadliest-ever outbreak of Ebola, since the virus was identified in central Africa in 1976, has killed to date 11,312 of the 28,457 people infected since December 2013, with nearly all the victims in Guinea, Liberia and Sierra Leone. In early September, Liberia was declared free of Ebola transmission for a second time, while late last month, Sierra Leone officially began a 42-day countdown towards becoming Ebola free.
During the week leading up to 6 September 2015, there were a total of two confirmed cases of Ebola virus disease (EVD) that were reported: 1 in Guinea and 1 in Sierra Leone. Both cases that were reported during this period were registered contacts associated with previous cases in the same areas of Conakry, Guinea, and Kambia, Sierra Leone, in the past two weeks. According to officials, the overall case incidence has remained stable, with 2 – 3 confirmed cases being reported per week for six consecutive weeks. Currently, there are a total of three active chains of transmission: two in and around the capital Conakry, Guinea; and one in the western district of Kambia, Sierra Leone. All remaining contacts associated with transmission chains in Forecariah, Guinea completed follow-up in the week leading up to 6 September. Additionally, during this recording period, Liberia was declare free of Ebola virus transmission for a second time on 3 September, 42 days after the country’s last laboratory-confirmed case, which was associated with the Margibi cluster of cases. Liberia has now entered a 90-day period of heightened surveillance. The total number of contacts currently under observation in Guinea and Sierra Leone has increased from approximately 450 on 30 August to approximately 1300 on 6 September. Officials have indicated that this increase is largely attributed to the single high-risk community death that was reported in Kambia, Sierra Leone, at the end of the previous reporting week (week leading up to 30 August.)
There have been a total of 28,141 reported confirmed, probable and suspected cases of EVD in Guinea, Liberia and Sierra Leone, with 11,291 reported deaths.
The single confirmed case that was reported in Guinea in the week leading up to 6 September had onset of symptoms in the Ratoma area of the capital, Conakry. The case is a 13-year-old girl, who is a registered contact and relative of 2 cases that were reported from the same area of the city during the previous two weeks. There are currently 292 contacts who are under follow-up in 2 adjacent prefectures: Conakry (266 contacts) and Dubreka (26 contacts).
In the week leading up to 6 September, there was one new confirmed case that was reported in Sierra Leone. The case is the daughter of the high-risk case that was reported from Kambia the pervious week. While over 900 contacts have been identified in association with the chain of transmission, the majority of these contacts have been defined by geographical proximity rather than by history of possible exposure and are therefore considered to be at a very low risk. Authorities however have warned that further cases are expected amongst the approximately 40-high risk contacts that have been identified so far. The origin of infection of the 67-year-old woman remains under investigation.
Authorities in Sierra Leone reported Tuesday that three more patients have tested positive for Ebola in a village in the northern region of the country that is already under quarantine in the wake of the death of a 67-year-old woman.
According to the National Ebola Response Centre (NERC), the new cases, which were diagnosed on Monday, bring the total in a recent outbreak in Sella Kafta in the district of Kambia to five. Speaking to reporters in the capital Freetown, NERC spokesman Sidi Yahya Tunis disclosed that the three new cases were amongst the fifty “high risk persons” who have been identified as being close relatives of the food trader, who died on 28 August. He further disclosed that “the development remains a concern for us but since it has taken place within a quarantined home, it can be adequately monitored and further transmission can be contained.”
The latest outbreak brought to an abrupt end the optimism that was fuelled by the release of what had been the West African country’s last known Ebola patient from a hospital in the central city of Makeni in late August. In the wake of the latest Ebola death, Sella Kafta, a village of almost 1,000 people, was placed under a three-week quarantine lockdown.