Ebola virus reappears mysteriously
New cases in Liberia stump experts, spread fear in West Africa.
JOHANNESBURG, South Africa — Ebola, the virus that killed more than 4,800 people in Liberia since the outbreak began in December 2013, is back after the West African country was twice declared free of the disease. And no one is sure why.
After a 15-year-old boy recently contracted the virus, his father and brother also tested positive for the disease. Health officials said they have placed 153 people under surveillance, including 22 nurses and six patients from a hospital in Monrovia, the capital.
The new cases raise fear that neighboring Sierra Leone, recently declared Ebola-free, may suffer similar setbacks in eradicating the disease. Guinea, the third West African nation hit hard by the outbreak, has not reported a new case since the end of last month and has begun a 42-day countdown to be declared Ebola-free.
By last week, 28,634 people had contracted Ebola, and 11,314 had died from confirmed or suspected cases, according to the World Health Organization.
In the latest case, how Ebola was transmitted to Nathan Groote, the 15-yearold from the Monrovia neighborhood of Paynesville, remains a mystery.
It’s known that the virus can stay in survivors’ semen, ocular fluid, breast milk and spinal fluid for months after their recovery, according to the Centers for Disease Control and Prevention. And many survivors suffer enduring problems, such as joint pain, eye problems and headaches. But little is known about why the symptoms persist, the CDC says.
“The fight against Ebola is not over yet, but we must not lose hope and must continue the practices we used to beat Ebola before. We can win this battle again with your participation and support of the communities,” the Liberian Ministry of Health and Social Welfare said in a statement.
Liberia was declared Ebola-free in May, only to see a 17-year-old boy and a woman die from the disease in July. In September, the World Health Organization again declared the country to be Ebola-free.
Liberian Chief Medical Officer Francis Kateh told journalists that investigations were continuing into how the disease was transmitted. CDC officials will travel to Liberia to help determine the cause, Kateh told the Associated Press.
One issue in recent West African cases has been the failure to monitor people for the full 21-day incubation period after they came in contact with the disease, according to the CDC.
The new cases come as a panel of experts described the global response to the 2013 outbreak as slow and ineffective, singling out the WHO for pointed criticism in a report released Monday. A Liberian member of the panel, Mosoka Fallah of Action Against Hunger, described the global response as “late, feeble and uncoordinated.”
The outbreak led to “immense human suffering, fear and chaos, largely unchecked by high-level political leadership or reliable and rapid institutional responses,” the report says.
“The most egregious failure was by WHO in the delay in sounding the alarm,” another panel member, Ashish K. Jha, director of the Harvard Global Health Institute, said in a statement. “People at WHO were aware that there was an Ebola outbreak that was getting out of control by spring [of 2014] and yet, it took until August to declare a public health emergency. The cost of the delay was enormous.”
The panel of experts behind the report, which was published in the Lancet medical journal, was organized by the health institute and the London School of Hygiene and Tropical Medicine. The report recommends key reforms to ensure the next outbreak doesn’t get out of hand, including strengthening the WHO and making it more accountable, and setting up a more nimble and effective global health committee under the U.N. Security Council to speed the response to major health crises.
In a sharp criticism of WHO Director-General Margaret Chan, the report says member states must “insist on a director-general with the character and capacity to challenge even the most powerful governments when necessary to protect public health.”
Panel chairman Peter Piot said there was a need to improve the capacity of countries to detect small outbreaks early to prevent them from turning into major emergencies.
It followed a similar report by the London School of Hygiene and Tropical Medicine last month, “Saving Lives,” which said that the global health community wasn’t able to deal with a large-scale epidemic and that the epidemic would not have been contained without the deployment of 5,000 military members from the United States, Britain, Canada, China, France and Germany.