Ebola in West Africa — What’s Going On at the Start of 2015?

The Ebola epidemic continues in the three affected countries in West Africa (Guinea, Liberia and Sierra Leone). Sierra Leone continues to struggle with the ongoing spread of this serious infection. Last week, there were 337 new cases reported. Even though this is likely an underestimation of the real number of cases, the World Health Organization (WHO) states that this was more than double the number of cases reported in Guinea and Liberia combined.

The disease does not spread randomly through the population. Because transmission requires very close, unprotected personal contact with an ill person’s body fluids (i.e. while caring for them or preparing them for burial), the disease spreads mostly within family clusters and close friends. As a result, there are “hot spots” where the disease flares up.

Where are the “hot spots”?

The most intense spreading of this disease is occurring in the western districts of Sierra Leone, although there are still signs that transmission may be slowing down. Other “hot spots” include the capital city, Freetown, the neighbouring Port Loko, and the Kono district in the east.

The situation is variable across Guinea, with persisting transmission of the virus in areas in and around the capital Conakry. Kindia, which borders Sierra Leone, and the Dubreka area are reporting a sharp rise in cases last week. Meanwhile, transmission has dropped in some southeastern areas, including Macenta and Kerouane.

Although the overall level of disease is finally decreasing in Liberia, the main “hot spot” is still Montserrado County, which includes the capital Monrovia.

Globally, the number of Ebola cases has reached 20,206, with 7,905 deaths.

Take Away Messages

So what does the future look like? Here are some of the issues to consider:

• The epidemic in these 3 countries will not go away soon. More months of intense effort will be needed to eliminate this disease.
• There will continue to be a very low risk that someone who is infected will show up in another country where they will become clinically ill after the incubation period ends.
• Community resistance and population movements continue to be barriers to containing the disease.
• While there are now enough treatment sites in the countries to isolate infected persons and contain any spread, treatment beds are unevenly distributed. As a result, some individuals have to travel long distances to get treatment. During travels, they may spread the disease to their companions and other travellers.
• Identifying and tracing close personal contacts is a challenge wherever there is considerable population movement, and the capacity for visiting all contacts every day to check if they are becoming ill is not easy.
• Still, the risk for the general traveller to these countries is low as long as you avoid any close contact with sick individuals. The risk for health care workers, however, is high (so far, 660 doctors, nurses and other health care workers have become infected and 375 of them have died).

Should You Avoid Travelling to These Countries?

Although the risk is low, it is probably best to avoid travelling to any of the three affected countries at this time (Sierra Leone, Guinea, and Liberia). It is difficult to obtain air tickets due to airline resistance to fly to these countries and so it is also difficult to obtain passage if you want to leave in a hurry. Additionally, if you have any pre-existing medical conditions, such as heart disease, diabetes, or lung problems, or if you become injured while visiting these countries and require medical care, you may have some difficulties obtaining emergency care due to the priority given for treating Ebola patients.

Thanks to the European Commission DG ECHO for the use of their photo in the featured image.