Ebola in West Africa – The Deadly Virus is Still Undefeated

In Sierra Leone, the cheerful new year’s Eve celebrations on the beaches failed this year in the face of the Ebola epidemic. Instead, President Ernest Koroma urged people to stay at home and pray for the end of the fight against the virus in the new year. It’s not certain whether the worst Ebola outbreak in history can actually be defeated by the of 2015.

In Liberia, the spread of the virus seems to be slowing down, while no improvement is reported in West Sierra Leone. The situation in Guinea is totally unclear. Since the beginning of the epidemic a year ago more than 8200 people have died of the Ebola virus according to the WHO. Approximately 21,000 were registered as safe or infected with Ebola. The real figure is, however, estimated to be much higher.

“Our national New Year’s resolution for 2015 is surely we must defeat Ebola, and to snuff out this vile and ungodly disease,”

says retired Maj. Alfred Palo Conteh, who is the head of the country’s National Ebola Response Center. The worst affected countries of Guinea, Liberia and Sierra Leone have come a long way in their fight against the spread of the disease, but their efforts are still not enough.

The World Health Organization says that they now have enough beds available to isolate and treat Ebola patients. These beds are available, but not always where the disease is spreading fastest. The WHO is pushing the testing of an experimental preventive vaccine against the virus to be tested on humans in the epidemic area by the end of January.

In Liberia, 9000 volunteers will take part, in Sierra Leone and Guinea several thousand people are expected to be vaccinated. But even if an effective vaccine is found, the production of an agent takes months. In addition, the current ingredients intended for the vaccine must be stored at minus 80 degrees Celsius. For a widespread use in West Africa, however, the active ingredient must be changed so that a storage temperature of about two to eight degrees Celsius – ie refrigerator temperature – is sufficient.

UN experts also estimate that the number of scientists on the ground would have to be tripled, to track the routes of infection. One of the biggest problems at present is to find all the contacts of Ebola-infected individuals. For this task, the teams of scientists are required in Guinea, Sierra Leone and Liberia. Each Ebola patient came in contact with between 12 and 20 other people and each of these contacts must be found. In Sierra Leone, where the situation is at its worst, the authorities on average log about eight contacts. This difference gives rise to the suspicion that the contact tracing is deficient.

Adikalie Kamara, a 25-year-old member of an Ebola burial team in Port Loko, Sierra Leone. Kamara was studying to be a teacher when the outbreak struck; he now works for the Sierra Leone Red Cross.
Adikalie Kamara, a 25-year-old member of an Ebola burial team in Port Loko, Sierra Leone. Kamara was studying to be a teacher when the outbreak struck; he now works for the Sierra Leone Red Cross.

Trained gravediggers are used for the burial of casualties because the risk of infection is greatest shortly after death. However, since not all deaths are reported, it’s unclear whether all Ebola dead are buried according to the safety regulations and whether there are unknown transmission chains.

How Do We Know When It’s Over?

UN Secretary-General Ban Ki-moon previously stated that the Ebola epidemic could be over by mid-2015 but the WHO is declining to set a specific timeline after having been burned on previous predictions. Since the crisis gained internationally attention last summer, the United Nations is able to report some concrete progress in the construction of 41 Ebola treatment centers, the establishment of 23 laboratories and the deployment of hundreds of volunteers from around the world.

Nevertheless, more helpers are needed. Moreover, there’s still a lack of basic centers that wouldn’t treat patients, but simply isolate suspected cases while awaiting their test results. The UN wants to send more mobile laboratories and anthropologists to villages that still reject Western aid and medicine. Some people believe that the doctors in their protective suits only bring the virus into their villages – rather than to saving them from it.

“We cannot control the outbreak if there is no trust from the population. We need to spend a lot more time listening to the people and readapting our messages because there is no ‘one size fits all’ approach to this,”

said Brice de la Vigne, director of operations for Doctors Without Borders in Belgium.  To persuade people to give up their traditional funeral rituals or help with Western doctors instead of looking for their healers, is difficult.

The UN claims that they lack the amount of money to fund all necessary containment measures of Ebola. By the end of late December the WHO reported that they have received about $215 million (nearly 182 million euros) for fighting Ebola. But UN experts estimate the actual financial need is up to $4 billion.

Peter Piot, one of the co-discoverer of the Ebola virus and director of the London School of Hygiene and Tropical Medicine, said it is worrisome that some regions are not reporting any suspected cases, a sign of poor surveillance.

How on Earth are we going to know when this is over? Ebola is a moving target and could continue to circulate for years and never truly be over,”

said Piot.

However, Palo Conteh, who leads the Ebola fighting in Sierra Leone, is cautiously optimistic.

“We are winning the war but we have a long way to go and we cannot be complacent. Day after day we progress further toward the ultimate goal of zero cases. This will take every Sierra Leonean to engage in this battle and I truly believe that this year we will achieve this goal,”

said Conteh.

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