An NGO warned this month that Sierra Leone and Liberia are at risk for a new deadly epidemic akin to the impact of the Ebola virus because of a lack of clean water and hygienic conditions in most homes.
WaterAid has reported that the two provisions were the “first line of defense” against infectious diseases, noting however they needed to be put in place before outbreaks began. In a statement, the British-based group disclosed that in Liberia, 24.5 percent of people do not have access to clean water. In Sierra Leone, this figure stands at more than 37 percent. WaterAid further added that when it comes to basic sanitation, the figures are even higher, with just over 83 percent in Liberia living without access to it and 86.7 percent of people in Sierra Leone. In the statement WaterAid’s Joe Lambongang disclosed that “the terrible suffering of the people of Sierra Leone and Liberia during the Ebola crisis is at high risk of being repeated in another disease epidemic if we do not see action to improve water, sanitation and hygiene practices in our communities, schools and healthcare facilities. It further indicated that “these basic provisions are the first line of defense against infectious diseases including Ebola,” adding, “to ask healthcare professionals to battle an epidemic without clean water, safe toilets and somewhere to wash their hands is unrealistic and needlessly puts lives at risk.” In June, Liberia confirmed that it was free of Ebola, effectively meaning that there were no known cases in West Africa of the tropical virus, which left more than 11,300 people dead in the region since late 2013. The World Health Organization (WHO) declared an end on 1 June to Ebola cases in Guinea, where it first broke out in December 2013, and in Sierra Leone on 17 March. According to Sierra Leone’s health ministry figures, 30 percent of the population dies every year of diseases that are passed on by contaminated water.
On Thursday, the World Health Organization (WHO) reported that a recent flare-up of Ebola in Sierra Leone is over after no new transmission of the disease were detected in the West African country. The UN health agency however warned that the virus could still resurface at any time.
The WHO has reported that Sierra Leone has had no new cases of the virus for 42 days, twice the length of the virus’s incubation period – the time that elapses between transmission of the disease and the appearance of symptoms. The WHO further indicated that it marked a milestone in the fight against Ebola, which has cost the lives of more than 11,300 people since 2013 in Guinea, Liberia and Sierra Leone in what was the world’s worst recorded outbreak of the disease. It warned however that more flare-ups are possible because the virus can persist in the eyes, central nervous system and bodily fluids of some survivors. In a statement, the WHO noted that “strong surveillance and emergency response capacity need to be maintained along with rigorous hygiene practices at home and in health facilities and active community participation.”
Sierra Leone was first declared free of Ebola transmissions in November 2015 before tests revealed one woman had died of the disease in January 2016, the same week that the WHO had declared the West African region free of new transmissions of the virus. The case of Mariatu Jalloh, a female student, displayed how easily Ebola can return if precautions are not taken and patients do not seek quick medical attention. Jalloh had travelled across the country and come into contact with dozens of people after contracting the illness. Family members washed her corpse after she died, considered dangerous since the virus is contagious for days after death. Experts say that while residents and authorities remain on edge across the region, in many areas, procedures to combat Ebola remain lax.
At least three people from the same family have died in recent weeks from diarrhea and vomiting in a remote village in southeastern Guinea, raising further concern about the disease spreading again. According to Fode Tass Sylla, spokesman for the National Coordination of the fight against Ebola in Guinea, “there is in the same family a woman who died on 29 February and husband a week later. Their child died yesterday.” Since 23 March, 5 people have died in the town, and over 800 have been placed under quarantine.
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.
According to officials, Sierra Leone has not recorded a single new case of Ebola in the past four weeks, which effectively keeps the West African country on course to being declared free of the virus next month.
At a press conference, the head of the government’s National Ebola Response Centre, Palo Conteh, disclosed that “Sierra Leone has no Ebola-positive case recorded in the country for the fourth consecutive week,” adding that there were no more people in quarantine either.
The last known Ebola patients were discharged from hospital in late September, which allowed Sierra Leone to begin the standard 42-day countdown towards becoming Ebola-free. If no further cases are recorded, the World Health Organization (WHO) will declare Sierra Leone Ebola-free on 8 November.
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.