“Nearly Halted in Sierra Leone, Ebola Makes Comeback by Sea”
The New York Times, March 1, 2015, p.A1
“It seemed as if the Ebola crisis was abating. New cases were plummeting. The president lifted travel restrictions, and schools were to reopen. A local politician announced on the radio that two 21-day incubation cycles had passed with no new infections in his Freetown neighborhood. [Sierra Leone], many health officials said, was ‘on the road to zero.’ Then Ebola washed in from the sea. Sick fishermen came ashore in early February to the packed wharf-side slums that surround the country’s fanciest hotels, which were filled with public health workers. Volunteers fanned out to contain the outbreak, but the virus jumped quarantine lines and cascaded into the countryside, bringing dozens of new infections and deaths. … Public health experts preparing for an international conference on Ebola on Tuesday seem to have no doubt that the disease can be vanquished in the West African countries ravaged by it in the last year. But the steep downward trajectory of new cases late last year and into January did not lead to the end of the epidemic. In Sierra Leone, the hardest hit of the countries, the decline leveled off in late January, and the country has reported 60 to 80 new cases weekly since then. Guinea has experienced months of lower-level spread. Even in Liberia, where only a handful of treatment beds remain occupied, responders lament that a health care worker who recently became ill might have exposed dozens of colleagues and patients, and that a knife fight had exposed gang members to the blood of a man who tested positive for Ebola. … When the cluster erupted at the wharf area — part of a large neighborhood known as Aberdeen, with about 9,000 residents — some Ebola prevention workers were taken by surprise because they had been continuing surveillance efforts. Officials imposed a quarantine, prompting many fishermen to take to the sea to avoid it.”
Quickie Analysis: This article highlights the difficulties of finishing off an outbreak without full popular buy-in.