Ebola activity stabilized in West Africa last week, with the case increase slowing in Guinea and more signs in Sierra Leone that the steep drop over the past several weeks has leveled off, the World Health Organization (WHO) said today in its weekly epidemiology report on the epidemic.
All three countries are still grappling with incidents of community resistance, the agency said. And in Guinea and Sierra Leone a fair number of Ebola cases aren't detected until someone has died from the disease in the community, a sign that illnesses aren't always being reported, which poses a serious threat of ongoing disease transmission.
Overall, 128 newly confirmed Ebola cases were reported in the three countries last week, lifting the total of confirmed, probable, and suspected cases in the three countries to 23,218. The number of deaths has reached 9,365.
Three countries show different patterns
Guinea reported 52 of the new confirmed cases, down from 65 the week before, signifying the country's first week-to-week decline since Jan 25, the WHO said. Most were in the capital city of Conakry (13) and in Forecariah district (24) in the western part of the country. Three neighboring districts also reported cases.
Two of the new cases were reported in Mali district in northern Guinea, an area that borders Senegal. The WHO said those infections are linked to a single chain of transmission that started with a man who had traveled from Monrovia, Liberia's capital.
Last week 16 Ebola cases were confirmed during postmortem testing and 39 unsafe burials were reported, markers of situations that increase the risk of transmission. The WHO said, however, that responders successfully engaged people in Lola district, which had been a hot spot in the eastern part of the country. Community engagement allowed responders to track cases and contacts linked to an unsafe burial, which helped bring a localized outbreak under control quickly.
Serious security incidents—which hamper response efforts and increase the risk of transmission—have recently been reported in several of Guinea's districts, including Boffa, Conakry, Coyah, Dubreka, and Forecariah. A total of 13 districts reported at least one such incident last week.
The United Nations Mission for Ebola Emergency Response (UNMEER) said 58 people were convicted 2 days ago for a January attack on Ebola workers in Guinea's Forecariah district, with charged that included assault and battery of government workers and Doctors without Borders (MSF) staff, destroying public buildings, threats, and rebellion. UNMEER also said radio-based sensitization activities are under way in parts of Guinea to dispel rumors about chlorine spraying in schools, which fueled community suspicions that the schools were contaminated with Ebola.
Sierra Leone reported 74 confirmed Ebola cases last week, down slightly from 76 the week before, according to the WHO. The largest portion of new cases (45) were reported in the capital, Freetown, where a cluster of cases were reported in a highly mobile fishing community in the city's Aberdeen area. The WHO said that event is likely to lead to more cases. Responders are working on tracing more than 2,000 contacts linked to the Aberdeen cluster.
Neighboring Port Loko district reported fewer new cases than in the previous week, and two other western districts also reported a handful of cases: Kambia and Western Rural. Other districts reporting cases were Tonkolili in the central part of the country and Koinadugu in the north.
Four of Sierra Leone's 14 districts reported at least one recent security incident. During the same period, 45 unsafe burials were reported and 25 new Ebola cases were identified only after people had died in the community.
Liberia reported only two confirmed cases in the 4 days leading up to Feb 12, the WHO said. Both were from Montserrado County, which includes Monrovia, and were linked to the same transmission chain. The WHO added that the county is the only one in Liberia to report a confirmed case over the last 29 days.
Despite the low number of Ebola cases in Liberia, the country had its share of security incidents. Myths about routine vaccines contaminated with the Ebola virus fueled the incidents, and six of the country's districts reported at least one incident, up from two the week before.
Regarding health worker infections, four more were reported in the outbreak region over the past week: one in Liberia and three in Sierra Leone. The WHO said the number of infected healthcare workers now stands at 833, and 448 of them died.
Surge plan ahead of rainy season
Global health officials and officials in the affected countries have been alarmed about stalled overall progress in the Ebola battle, especially ahead of the region's rainy season, which will make it difficult for responders to reach new hot spots in rural areas.
At a UN General Assembly meeting on Ebola today in New York City, Secretary-General Ban Ki-moon said the rainy season is a complicating factor that will lead to increases in other diseases and will swamp roads for responders. He said the UN system through UNMEER is mobilizing surge responses for Guinea and Sierra Leone to get a tighter grip on the outbreak before the rains start. West Africa's rainy season runs from May to October.
Ban also said UNMEER is speeding up its response to help reach targets set on Feb 15 by presidents of the Mano River Union (MRU): zero cases in 60 days by mid April. The MRU includes Liberia, Sierra Leone, Guinea, and Ivory Coast, and was formed to ease economic cooperation between the countries.
While praising the response of the affected countries, their international partners, and UN member countries, he said the world faces a critical turning point with West Africa's Ebola epidemic. Recent increases in Guinea and Sierra Leone are a reminder that setbacks can quickly follow gains, highlighting the need for constant vigilance, even in unaffected areas.
"Too much progress has been made and too much is at stake to afford complacency," Ban said. "We must finish the job."
He called on responders to redouble their efforts and for donors to stay the course. "Let us provide the resources needed to get to zero. Let us ensure that reconstruction and recovery can occur without delay," Ban said, also urging countries to translate the lessons learned from the outbreak into building stronger national systems for health security.
See also:
Feb 18 WHO update
Feb 18 UNMEER update
Feb 18 UN press release
