Fresh concern after Patient Zero that Ebola will take root in Mali
BAMAKO, Mali: It all started with a sick nurse, whose positive test for Ebola came only after her death. In a busy clinic that treats Mali’s elite as well as wounded UN peacekeepers, which patient transmitted the virus?
Soon hospital officials were taking a second look at the case of a 70-year-old man who died after being brought to the capital late at night from Guinea suffering from kidney failure. A friend who visited him later died under suspicious circumstances, too.
It wasn’t renal disease, they realised. The man had Ebola and all three of the relatives who brought him to the clinic had all since been admitted to a treatment centre back home in Guinea.
On Friday, Malian health authorities went to disinfect the mosque where the old man’s body was prepared for burial – nearly three weeks ago. Some are criticising the Malian government for being too slow to react when health authorities announced his death as a suspected Ebola case earlier in the week.
“It has been 18 days since the Guinean man sick with Ebola died here. It’s just too late,” said Koumou Keita, his face full of worry.
For nearly a year, Mali had been spared the virus despite the fact the country shared a porous land border with Guinea, the country where the epidemic first erupted.
Now there are at least three confirmed Ebola deaths and two other suspected deaths in Mali’s capital. Residents fear the worst.
“I feel uneasy because I have the impression that our authorities are not giving us the whole truth,” said Ibrahim Traore, who works at a supermarket. “There are a lot of things not being said about how the Ebola virus came to Bamako.”
Health officials now must try to track down not only family and friends who visited the man at his hospital bed, but the scores of people who prepared his body for burial and attended his funeral. Teams of investigators are also headed to the border community where authorities believe Patient Zero in the Bamako cluster first fell ill.
“The future of Ebola in Mali will depend on the quality of the surveillance of these contacts. If they are rigorously followed, and any subsequent cases are quickly identified and isolated, the battle will be won. But if there are failures in the process, it will lead to further contamination and further problems,” said Ibrahima-Soce Fall, Mali’s WHO representative.
Among those placed under quarantine are about 20 members of the UN peacekeeping force treated for battlefield wounds at the hospital where the dead nurse had worked. The peacekeepers are based in the north of the country, where they are trying to stabilise a vast region where jihadists ruled until a French-led war last year.
On Sunday, US health officials said anyone arriving in the US from Mali will be subject to the same screening and monitoring procedures that were ordered last month for travellers from Liberia, Sierra Leone and Guinea. That includes taking arriving travellers’ temperatures and questioning them about their health and possible exposure to the Ebola virus. They will be asked to provide contact information and to agree to – for 21 days – have daily communi- cations with local health officials who will be asking them to take their temperatures twice daily and monitoring them to see if they develop symptoms.
“We can’t be confident that every exposed person has been identified or every identified person is being monitored daily,” said Dr Tom Frieden, director of the US Centers for Disease Control and Prevention.
In recent years, Mali has suffered a separatist rebel insurgency, a coup that overthrew its long-time leader and a war against jihadists. Now Ebola threatens to be another source of misery.
“Ebola could cause many deaths here in Mali,” said Aminata Samake, who works at a bank in the capital.
“We have a tradition of living closely together that could contribute to huge contamination. Take the example of public transport – you find people crammed into a bus. Large families share the same plates, even the same glasses for tea.”