It's too soon to declare victory over Ebola

This was originally published at Global Health TV on Aug. 24, 2015.

There has been a welcome spate of good news coming out of West Africa in recent weeks on the apparent demise of Ebola, which has caused the region nothing but misery, illness (27,952 reported cases) and death (11,284 reported deaths) for over a year.

Ebola cases continue to fall. For the week ending Aug. 16, no new cases were reported in Liberia and Sierra Leone, for the first time, has gone one full week without any new cases. Guinea was the only country to report any new cases — but just three.

And The Lancet published “interim results” from research on the efficacy of an Ebola vaccine in Guinea showing a vaccine efficacy of 100%.

The news is undeniably good. In the last week, I read these headlines:

Associated Press: “UN official: Ebola epidemic could be defeated by end of 2015.”

Scientific American: “Does This Ebola Vaccine Herald the End of the Virus?”

National Public Radio: “Zero Ebola Cases Reported in Sierra Leone as Epidemic Peters Out”

This is all welcome news but if you go beyond the headlines you quickly realize that this epidemic is not yet over.

How Mali conquered Ebola

These signs — which say “Stop the Ebola virus: Wash your hands regularly with soap” are still ubiquitous around Bamako three months after WHO declared Mali Ebola-free.

This blog originally appeared on Global Health TV on April 28, 2015.

BAMAKO, Mali — In the year-old Ebola epidemic, most of the attention has justifiably been focused on Guinea, Liberia and Sierra Leone, where the vast majority of the cases (26,044) and deaths (10,808) have taken place. But what about those countries that have successfully controlled Ebola — Mali, Nigeria, Senegal, Spain, the UK and the US — which account for only 35 cases and 15 deaths? 

I am spending two months in one of those countries and wondered how Mali conquered Ebola. Even though the World Health Organization (WHO) had declared Mali Ebola-free in January, I had barely stepped off my airplane at Bamako–Sénou International Airport on March 14 when I encountered Ebola control: I was scanned for a fever and offered hand sanitizer before entering the airport terminal.

Mali went on high alert after confirming its first case of Ebola in late October of last year, when a 2-year-old girl who had traveled from Guinea to Mali died. The country moved quickly in what the government considered an emergency situation. The child, who was symptomatic upon her arrival in Mali, had traveled extensively in the country using public transportation. Aggressive contact tracing was undertaken but none of the contacts showed symptoms.

It looked like the country had dodged a bullet, with only one death. But then an imam from Guinea was admitted to Bamako’s prestigious Pasteur Clinic with a diagnosis of acute kidney failure, and died on Oct. 27. That case set off a chain of transmission that led to seven additional Ebola cases and five deaths, including a doctor and nurse who had treated the imam. He was buried with full traditional rites, including washing of his highly contagious body, which may have exposed mourners to the virus.