The Ebola outbreak may be over in two countries -- Nigeria and Senegal -- even as it continues to spread rapidly elsewhere in West Africa, U.S. health officials said Tuesday.
No new Ebola cases have been diagnosed in Nigeria since Aug. 31, suggesting that the outbreak has been contained, according to a report Tuesday from the Centers for Disease Control and Prevention. The only case confirmed in Senegal was reported Aug. 28 in a man who survived.
Ebola has infected 6,553 people and has killed 3,083 in the three countries hit hardest by the epidemic — Guinea, Sierra Leone and Liberia — the World Health Organization says. The number of cases has been doubling every three weeks, and the CDC estimates that the disease could affect up to 1.4 million people by January if it's not quickly put under control.
The Ebola epidemic took a different course in Nigeria from the beginning, and it affected how the world responded to the outbreak.
The first case of Ebola in Nigeria was in Patrick Sawyer, a Liberian-American who landed at the international airport in Lagos, the country's capital, on July 20. Sawyer potentially exposed 72 people, according to the CDC. He died July 25.
The spread of Ebola to Lagos, a city of 21 million, was a potential catastrophe. It was also a wake-up call, because it was the first time that an Ebola patient had boarded an airplane and crossed from one country to another. The incident drew intense media coverage to the Ebola epidemic for the first time, even though health officials had been battling the outbreak in Guinea since March.
Nigeria's ministry of health quickly declared Ebola to be a health emergency and began tracing not just Sawyer's contacts but also everyone that those people might have exposed. In all, health officials traced 894 of these contacts. As of Sept. 26, Nigeria had reported 20 Ebola cases, including eight deaths. All surviving patients, now immune to this strain of Ebola, have left the hospital.
Nigeria's swift and organized response to Ebola stands in contrast to the disorganized response seen in the countries hit hardest. The outbreak most likely began in December in Guinea, but doctors there didn't recognize that the growing number of sick people were sick with Ebola until March, after dozens of people had been infected. The disease then spread to neighboring states in areas with a lot of cross-border traffic.
Sierra Leone and Liberia are two of the poorest countries in the world, and the countries' lack of doctors and medical facilities allowed the disease to spread widely, according to the WHO.
Senegal's only case of Ebola was diagnosed in a 21-year-old Guinean man who traveled from his native country to Dakar, Senegal, in mid-August to see family, then fell sick. The Senegal Ministry of Health had been preparing for possible Ebola cases, and health officials traced 67 of the man's contacts. All of those contacts have passed the 21-day incubation period for Ebola, making it unlikely that they were infected, the CDC says. The 21-year-old man recovered and was released from an isolation unit Sept. 21.
Getting the epidemic under control in countries outside Nigeria will prove far more difficult, says Peter Hotez, dean of the National School of Tropical Medicine and professor at Baylor College of Medicine in Houston.
"There are light years' differences between Liberia and Sierra Leone versus Senegal and Nigeria," Hotez says. "The former have a massively depleted health care infrastructure, whereas Senegal-Nigeria, while still overall considered low-income or low-middle income countries, have an in-tact health system in place."
Devastating epidemics have often accompanied conflict in Africa, Hotez says. He notes that an outbreak of a deadly parasitic infection called kala-azar in southern Sudan broke out during the conflict there, killing 100,000 people. The disease is also known as visceral leishmaniasis and it affects the liver, spleen, and bone marrow to produce a fatal illness resembling leukemia, Hotez says.
War-torn countries such as Syria and Iraq are at high risk for deadly infectious diseases now, as well, Hotez says. Polio already broken out in Syria, where the civil war has disrupted routine vaccination programs.
Some experts now warn that Ebola could become endemic in the region, circulating as widely and commonly as diseases such as malaria.
Courtesy: US TODAY
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