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.
In the week leading up to 14 June, there was a total of 24 confirmed cases of Ebola virus disease (EVD) reported, compared with 27 cases that were recorded in the previous week. In Guinea, 10 cases were reported during this period in four prefectures: Boke, Conakry, Dubreka and Forecariah. Sierra Leone reported 14 cases in 2 districts, Kambia and Port Loko, during this reporting period.
Of the 76 confirmed cases of EVD that have been reported in Guinea and Sierra Leone over the past 21 days leading up to 14 June, 69 (91%) were reported in 3 prefectures in Guinea (Boke, Dubreka and Forecariah) and 2 districts in Sierra Leone (Kambia and Port Loko).
As of 14 June, there have been a total of 27,305 confirmed, probable and suspected cases of EVD in Guinea, Liberia and Sierra Leone, with 11,169 reported deaths.
During this reporting period, a total of 10 confirmed cases of EVD were reported, compared with 12 cases from 4 prefectures that were reported in the previous week.
Cases were reported in 4 prefectures: Boke (2 cases); Conakry (1 case); Dubreka (4 cases); and Forecariah (3 cases). Of these 10 cases, 5 were registered contacts, including all four cases in Dubreka. Of the remaining five cases, 4 arose from an unknown source of infection. This includes both cases from Boke prefecture and 2 of the 3 cases that were reported in Forecariah.
In Guinea, health checkpoints have been set up in the western prefectures of Boke and Coyah. On 7 June officials in Dubreka carried out a 6-day door-to-door case-finding campaign, which led to the discovery of 1 confirmed case. Additionally, intensive investigations are currently underway in order to trace a number of high-risk contacts associated with 3 cases that were reported in the capital, Conakry, over the past two weeks.
During this reporting period, a total of 14 confirmed cases were recorded in 2 districts: Kambia and Port Loko, compared to the 15 cases that were reported in the same 2 districts the previous week.
For the third consecutive week, Kaffu Bullom in Port Loko reported the most cases, six in total, of any single chiefdom. According to officials, five of the six cases from Kaffu Bullom were contacts of previous cases in quarantined homes located in a small, densely populated area near the international airport. One case, however, was reported from a new area of the chiefdom, Targrin, and upon further investigation, the case was determined to have acquired infection after sharing a ward with a confirmed case in a privately run health facility. A total of twenty health workers have since been registered as having a medium – high-risk contact with the case and are currently being monitored by officials. The remaining 8 cases that were reported in Sierra Leone were registered contacts of known cases and were reported from quarantined homes in 4 chiefdoms: Magbema (1 case); Samu (1 case); and Tonko Limba (4 cases) in Kambia and Bureh Kasseh Ma (2 cases) in Port Loko. As of 14 June, the Western Urban Area, which includes the capital city Freetown, has reported no cases for over 16 consecutive days.
Officials have disclosed that all 14 cases that were reported in the week leading up to 14 June can be traced back to the secret movement of cases, contacts and secret burials of EVD-related deaths during April. Consequently, officials are planning to carry out a large-scale operation in the districts of Kambia and Port Loko.
On Friday 12 June, Sierra Leone’s President Ernest Bai Koroma announced that he was imposing a three-week daytime curfew in the last Ebola-hit areas in a bid to curb a resurgence of the deadly virus. The curfew announcement comes after the country on Thursday extended its nationwide state of emergency for 90 days, despite calls from opposition politicians to relax restrictions in the country’s Ebola-free districts.
The president made the announcement on state television, stating that he was imposing “with immediate effect a 6:00 AM to 6:00 PM chiefdom-level curfew” in parts of the northwestern districts of Kambia and Port Loko, which are the only areas that are still reporting new infections. The president has indicated that people in the worst-hit chiefdoms, or areas, of those districts will be confined to their homes for 21 days, warning that anyone found flouting the order would find themselves in jail for the same period. Grocery stores and markets, which have been ordered to close at 6:00 PM, will now be allowed to stay open until 9:00 PM in most parts of the country, while restaurants, which also had a 6:00 PM curfew, have been granted an extension until 10:00 PM. Motorbike taxis, which were previously barred from operating after 7:00 PM, have been given an extra two hours.
The latest lockdown has been called over fears that the disease, which has killed about 3,900 people in Sierra Leone, was making a comeback in the northwestern region of the country. Palo Conteh, head of the National Ebola Response Centre, has attributed the recent spike in Port Loko and Kambia to “people just being stubborn and engaged in the wrong things that fuel the transmission,” adding “some washing of bodies and secret burials are going on and people are taking the sick to herbalists.” A lawmaker is on bail awaiting trial for allegedly ordering the washing, dressing and burial of his 106-year-old father in Kambia in May. Amadu Koroma, a local government clerk in Kambia, has disclosed that herbalists were frequently bypassing official entry and exit points to treat patients in southern Guinea, the epicentre of the outbreak, adding “people have also been escaping from quarantined homes at night and ending up in Port Loko where relatives bring in herbalists to threat them in locked rooms.”
While neighbouring Liberia was declared Ebola-free in May, hopes that Sierra Leone and Guinea would quickly follow suit have, in recent weeks, been dashed. On Wednesday, the World Health Organization (WHO) announced that the retreat of the virus “that was apparent throughout April and early May has stalled.” Sierra Leone’s health ministry has reported that 22 people are in Ebola treatment centres, all in Kambia and Port Loko, while 342 people are in quarantine in those districts and the Western Area, which includes the capital city, Freetown.