Friday, April 04, 2014

Africa: Closing Guinea’s Ebola infection gap

Photo: Courtesy Dr. Yab Boun. Curbing Ebola in Uganda. In Guinea, where the disease erupted for the first time last month, authorities are racing to limit infections

Source: IRIN

DAKAR, 3 April 2014 (IRIN) - The Ebola outbreak in Guinea’s southern region which has spread to the capital, Conakry, and to neighbouring countries, has been propagated mainly through person-to-person contact, a gap that health experts and state authorities are struggling to close.

“It does not spread indiscriminately. It follows people and peoples’ movement and you have to be in contact with body fluids, sweat and diarrhoea. What we see is very sad because when people get ill then it’s the family who takes care of the ill, and then the whole family gets infected and dies,” said Panu Saaristo, head of the International Federation of Red Cross and Red Crescent Societies (IFRC) field assessment coordination team in Guinea.

“Theoretically, [the way] to stop the spread of Ebola or any infectious disease would be to make people stay where they are and not travel. But that is not realistic. People have to live their lives,” Saaristo told IRIN.

No new cases have been reported in the southern Forest Region, said Sakoba Kéïta, head of the disease prevention unit. However, 84 people have so far died and 122 others have been infected since January when haemorrhagic fever symptoms first appeared. The disease was only confirmed as Ebola in mid-March.

The Guinean government and aid groups that have deployed to help stem infections are working to identify and offer medical surveillance to those who have been in contact with Ebola victims, as well as informing the population on preventive health practices.

Suspected cases (normally people thought to have been in contact with victims) are quarantined only once Ebola symptoms appear, as symptoms like fever could be due to malaria or other diseases. Patients are supposed to be quarantined for 21 days, the incubation period for Ebola, said Facely Diawara, head of health at the Guinean Red Cross.

“In the beginning it was difficult to find suspected cases. But now people are better informed and they are the ones who alert the authorities to cases,” he said.

Jean-Louis Mosser, a health expert with ECHO (European aid body) in Dakar, explained that suspicion that the hemorrhagic fever was Ebola arose due to infections and deaths among family members of those who fell ill, as well as among health workers looking after the sick.

“The problem is that it took long to confirm because laboratories [in Guinea] could not test for the disease, and samples had to be sent [abroad] for testing,” he said.

“Between the time the disease was diagnosed and when prevention measures were put in place to avoid infections, all the sick but undiagnosed patients had had contact with others, and even medical personnel had [had] unprotected contacts. This is why cases have been high,” he told IRIN.

The disease was initially reported in Guinea’s southern districts of Guéckédou, Macenta, Nzérékoré and Kissidougou. Four suspected Ebola cases have now been reported in Conakry. Médecins Sans Frontières (MSF) said the outbreak was “of a magnitude never before seen in terms of the distribution of cases in the country.”

MSF doctor Reinaldo Ortuno said “all pockets of the disease in Guéckédou have been identified... We are following up on people who had contacts with the sick. The greatest difficulty is road access.” He warned that containing the spread of Ebola in Conakry, a city of two million people, will be difficult.

No new cases in Liberia, Sierra Leone

All the suspected and confirmed cases in neighbouring Liberia and Sierra Leone are people who had had travelled to Guinea. The two countries have reported no new cases, the World Health Organization (WHO) said in a statement.

Two deaths in Liberia’s northern Lofa County have been confirmed as resulting from Ebola, said Health Minister Walter Gwenigale. The ministry called on people to stop eating game meat. Ebola outbreaks in Africa have been reported following the handling of chimpanzees, gorillas, fruit bats, or antelopes and porcupines in tropical forests. Guinea has also banned the eating of fruit bats.

“I don’t know what to do. People are panicking. Even we sellers are wary of one another,” said Conakry bush meat seller Marima Koné, lamenting a slowdown in sales due to the outbreak.

In Sierra Leone, two people have died of suspected Ebola. The exact cause of the deaths is being investigated.

Fewer children in school

Daily commercial and social activities in Guinea have been disrupted by the outbreak. Ibrahima Kalil Konaté, the administrator of Conakry’s largest district of Matoto, said that fewer pupils were attending classes since the Ebola outbreak.

“Some teachers have told me that attendance has been greatly reduced. What is worrying is that this comes two months before the end of the year exams,” he told IRIN.

Movement has also been restricted. Mamadou Bah, in charge of the Conakry-Nzérékoré route at the capital city’s main bus terminus said fewer passengers were travelling. “Some come up to the bus stop, only to cancel their trips due to this disease.”

IFRC’s Saaristo explained that they were collaborating with the government and other aid groups to disseminate information aimed at lowering panic, and elaborating key facts about the spread of Ebola as well as how to keep safe.

“You have to balance the messaging so that the community gets a sense that `we are in this together and there will be a day when the epidemic will be over and then we have to live together again,’” he said. “Information is key in Guinea because there is no tradition of dealing with Ebola outbreaks.”

Due to fear, some residents are no longer shaking hands. Some burial rites are also being avoided.

The information campaign is to create the “trust of the population in the information that is given, so that there is as little space as possible for mysterious beliefs,” Saaristo explained.