The number of new cases of Ebola in Sierra Leone has jumped dramatically, putting to rest any hopes that the infection rate is slowing, while in Liberia the virus appears to have taken hold in the community of Jenewonde and sparked a new hotspot for the outbreak there.
Official figures released by the minister of health and sanitation in Sierra Leone show there were 111 new cases registered on Sunday, the highest daily rate since the ministry started publishing figures in August. There were 45 new cases the day before, including 24 in the capital, Freetown. Laboratory results for patients in Freetown, which include the new British army-built Ebola hospital, showed 40 new cases on Sunday.
There was also a spike in the number of cases in Port Loko, a district north of Freetown where there is still no treatment center and where, until recently, corpses were left lying on roads, in hospitals and in houses for days before collection.
The figures come days after warnings by the UN that Ebola cases in Sierra Leone are being underreported by up to 50 percent. It is thought that some patients are still not turning up to hospital over fears that they will be turned away because there are no beds or that they will die isolated from their families.
Sierra Leone’s deadliest day was October 5th, when 121 deaths were recorded from Ebola. Daily statistics compiled by Sierra Leone’s Emergency Operations Center for that day showed 81 new cases of the virus — far fewer than those registered on Sunday.
Escalating crisis in Sierra Leone
With 596 confirmed cases and still no treatment center, the rise in the number of cases in Port Loko will cause deep concern among medical aid agencies such as Médecins sans Frontières (Doctors Without Borders) and the Red Cross, who have been pleading for more beds and resources since the beginning of August. The latest figures make Port Loko the third most affected of the 14 districts in the country.
International Medical Corps, a humanitarian group working in the region, is constructing a 100-bed Ebola treatment center in Port Loko but it will not be open until the end of November, by which time the World Health Organization has warned there may be a need for more than 4,000 beds across the country, which has fewer than 500 at the moment.
In the district of Koinadugu, where an infection chain started three weeks ago when a man carrying the virus returned to the remote chiefdom of Niene, the Red Cross on Monday said the number of dead had increased in recent days. Last week it reported that as many as 30 had died, but the number is now closer to 50, the agency said.
Koinadugu had prided itself on being the only district in Sierra Leone to have been Ebola-free after local chiefs imposed a quarantine, barring farmers and traders traveling to neighboring districts or over the border to Guinea. About 250 people who had confirmed contact with dead bodies are being monitored in Koinadugu, where food is now in short supply because local farmers have been cut off from their crops. The area is particularly challenging because of the isolated, mountainous terrain; the nearest big town, Kabala, is three hours away, while the nearest Ebola treatment center is between five and eight hours by road.
New hotspot in Liberia
The rise in figures in Sierra Leone comes as medical charity Medecins sans Frontieres warns that the international aid response much not get complacent in Liberia, where the infection rate appears to be slowing in some areas. MSF is witnessing a decline in patients at its hospitals with two hundred empty beds in its 250-bed Monrovia hospital and no new patients in its Foya hospital in the north of the country. However, officials on the ground warn that the outbreak is still raging in hard-to-reach places, including many towns around the capital city of Monrovia.
Reports this week indicate that the small town of Jenewonde, in Grand Cape Mount County near the border with Sierra Leone, is quickly becoming a new hotspot for the Ebola outbreak in Liberia after a single infected resident spread the virus to others in the community. Jenewonde has reportedly lost about 10 percent of its population to Ebola since late September. Markets and farms nearby have been abandoned, and residents say there is no health care at all in the community. Ebola is also hitting the town of Gorzohn in Rivercess County, which lies on Liberia’s central coast.
The international response must adapt to this new phase, MSF warned. The outbreak now needs a series of “rapid response teams” that can bring care to remote villages, rather than trying to get sick people out, MSF says. Such teams would include medics, disinfection specialists and psychologists or social workers and could stamp out a budding outbreak in a village before it has a chance to spread. And they could work much faster than a treatment center can be built.
Experts warn that the disease could flare again in Monrovia or other places where it seems to have subsided. As Jenewonde saw, just one case can ignite a chain of transmission that leads to a dozen more infections. As long as Ebola is circulating in this highly mobile region, no area is safe, said MSF, and with cases continuing to rise in Guinea and Sierra Leone, the threat remains imminent.