Saturday 26 June 2021

Outbreak of Ebola Fever in Guinea declared to have ended.

On 19 June 2021, the Ministry of Health of Guinea declared the end of the Ebola outbreak that affected Nzérékoré Prefecture, Nzérékoré Region, Guinea, according to a press release from the World Health Organization. This was the first Ebola outbreak in Guinea since the large outbreak that affected West Africa in 2014-2016. 

This recent outbreak was announced on 14 February 2021 following the identification of a cluster of seven suspected Ebola cases in Gouécké and Nzérékoré City sub-prefectures in N’zérékoré prefecture. Between 14 February and 19 June 2021, a total of 23 cases (16 confirmed, 7 probable) were identified in four sub-prefectures of N’zérékoré Prefecture. Of these confirmed and probable cases 11 survived and 12 died. Five of the cases were health workers and one was a traditional health practitioner.  

The index case of this recent outbreak was a health worker.  She had onset of symptoms on 15 January 2021 and after seeking care at two health facilities and a traditional practitioner, died on 28 January 2021. She was buried on 1 February 2021 in Gouécké sub-prefecture without using safe and dignified burial practices. 

Seventeen secondary cases were reported with epidemiological links to the initial probable case between 5 February and 4 March 2021. After more than three weeks with no new cases reported, on 27 March 2021, a cluster of three community deaths was identified in Soulouta sub-prefecture, and were later classified as probable cases. Two individuals who had cared for and/ or attended these burials, were confirmed with Ebola infection in early April 2021. One of these last two confirmed cases was lost to follow up soon after he was confirmed on 1 April 2021 and until 18 June 2021 where he was found in apparent good health. Since 2 April 2021, no new confirmed or probable cases have been reported.  

The Ministry of Health, together with the World Health Organization and other partners, initiated measures to control the outbreak and prevent further spread of the disease. The Ministry of Health activated national and district emergency management committees to coordinate the response. Multidisciplinary teams were deployed to the field to actively search for cases and provide care for patients; identify and follow-up contacts; and to engage with communities about outbreak prevention and control  measures.  

Ebola Virus Disease is caused by RNA Viruses of the genus Ebolavirus. It has a reputation for being the world's deadliest viral disease, at least in part due to the 1995 film Outbreak, though this is probably slightly inaccurate as about 50% of victims survive, making it less deadly than diseases such as Rabies. However, it is extremely contagious, with know known cure, and has a tendency to rapidly overwhelm local health systems as health workers themselves are infected.

Electron micrograph of an Ebola Virus particle. Frederick Murphy/Centers for Disease Control and Prevention/Wikimedia Commons.

Ebola begins with a fever similar to that caused by Influenza or Malaria, which tends to come on rapidly two-to-three weeks after infection (during at least part of which time the patient is already infectious). This tends to be followed by extreme respiratory tract infection, headaches, confusion, rashes and tissue necrosis and heavy bleeding. Death is generally caused by multiple organ failure.

The only known treatment for Ebola is intensive rehydration, which can improve the survival prospects of patients greatly, accompanied by anticoagulants and procoagulants to mange the diseases attacks on the circulatory system, analgesia to cope with the pain of the disease and antibiotics and antimycotics to prevent secondary infection. Due to the highly contagious nature of the disease it is recommended that healthcare workers wear full-body protection to maintain a barrier between them and their patients; a daunting prospect in the tropical regions of Africa where the disease is endemic. 

Ebolavirus is thought to have a non-human animal vector, since its rapid onset and high mortality rate appears to preclude a permanent residence within Human hosts. Surveys of wild animals have found Ebola infections in Rodents and Great Apes, however these were affected by the disease in a similar way to Humans, and are therefore unlikely permanent hosts. The most likely vectors are thought to be Fruit Bats or small Primates, which are endemic to the areas where the disease occurs and which are widely eaten; cooking meat probably kills the virus, but there is a distinct danger of infection while preparing carcasses.  

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