 |
| Because of the large amount of virus that has been in circulation, small outbreaks could occur for some time … a scanning electron micrograph of red Ebola virus particles. Photograph: NIAID/EPA |
The 17-year-old whose death signalled the outbreak in Liberia may have come into contact with an infected animal or picked up the virus from a person in whom it had lingered beyond the 21-day quarantine period, experts believe.
Two new Ebola cases in Liberia, seven weeks after country declared virus-free
Read more
Two more people from the teenager’s village have fallen ill since the boy’s death last Sunday, but although the new cases have dismayed the government, population and health experts, Nabarro said that because of the large amount of virus that has been in circulation, this could be the pattern for some time to come.
“We’re still pretty confident it is going to end, in a period which is not unreasonable, but I don’t think the end will necessarily be the end. There will be subsequent mini flare-ups occurring all over the place,” he said.
How the teenager became infected is the subject of rumour and speculation, because he is not thought to have come into contact with anybody from Sierra Leone or Guinea, where there are still cases.
But, said Nabarro, “there has been an awful lot of virus around. Some of it may have gone back into the animal kingdom”. That could mean the virus occurring in animals in locations where there was none in the past, increasing the chances of disease if people eat or are in physical contact with infected animals, such as fruit bats.
This epidemic has also shown that the virus can linger beyond the 21-day quarantine period in the prostate in men and in the eyes in both men and women, he said. It has been found in amniotic fluid and in the foetuses of women who were pregnant when they became infected with Ebola but survived.
“We don’t know yet whether they are an undetected chain of transmission, because Margibi [the county where the cases occurred] was one of the last parts of Liberia to be declared Ebola-free, or whether they are the result of some kind of perpetuation of the virus, survivors that we hadn’t known about, or whether they represent a brand-new arrival of the virus from outside the human race – a new Ebola appearance – and that answer will not be known for some time,” Nabarro said.
Examination of past Ebola outbreaks since the disease was first identified four decades ago shows a 50% probability of isolated mini outbreaks within a year after the main one has been declared over, he said. While there is not absolute clarity on this, it appeared that the reasons were perpetuation of the virus in survivors or re-introduction from animals which may have picked it up from infected humans.
Nabarro praised the calm and confident Liberian response to the new cases, as well as the handling of the continuing epidemic in the other affected countries. The communities in Sierra Leone and Guinea where there are still cases now need to be approached with great sensitivity, said Nabarro.
These are communities that want to be left alone, with their cultural values and traditions undisturbed, he said. It was important to focus on individual households in a quiet and non-aggressive way and listen to them. “People are very, very scared,” he said. “They are scared they are going to get into trouble with the authorities but they are scared that they will get into trouble with the spiritual world if they don’t do their burials right. It needs a very sensitive response.”
Nabarro was speaking before a major UN conference aimed at encouraging donations to help the three hard-hit west African countries recover from the damage of the epidemic.
At the secretary general’s international conference on early recovery, which begins on Friday in New York, donors are expected to offer help with restoring health and education systems, but it is thought likely the governments of Liberia, Sierra Leone and Guinea will hope for more assistance to rebuild their economies.
No comments:
Post a Comment