The new outbreak of the Ebola virus in Gouéké in Guinea’s N’Zerekore province is a worrying development. It is the first time the disease has been reported in Guinea since 2016. The first known victim was a nurse. Two attendees at her funeral have since died. As with the outbreak in 2014, this occurrence has also happened in a border area with two other countries.
During the 2014 West Africa Ebola outbreak there were 28,000 cases, including 11,000 fatalities. That outbreak started in the village of Méliandou, in Guinea’s Guéckédou province and moved across land borders to Sierra Leone and Liberia. Senegal, Nigeria and Mali also reported limited local cases.
The latest outbreak is seeing Guinean health authorities and the WHO rapidly set up teams to trace and contain the virus. A major advantage is the lessons learnt from the 2014 outbreak. The WHO is already working with health authorities in both Liberia and Sierra Leone to ensure capacity for community surveillance of cases in their border districts. It is also supporting tracing efforts in Cote d’Ivoire, Mali and Senegal. In addition, The 2013-16 outbreak accelerated the development of a vaccine against Ebola, and there is a global emergency stockpile of 500,000 vaccine doses available to respond to any outbreak.
Currently, Guinea’s land borders are already closed because of COVID-19. However, in practice land borders remain porous and, for example, the Kpelle ethnic group span both Guinea and Liberia. Similarly, Mano speakers can be found on both sides of the Guinea and Liberia borders. N’Zérékoré, near the site of this new outbreak, is the second-largest city in Guinea by population after the capital Conakry and is an important trading town. Because of recent civil wars in Liberia, Sierra Leone and Cote d’Ivoire it has a significant migrant population.
A key concern is that health authorities are too late to get a hold on the outbreak, raising the spectre of another pandemic of Ebola across West Africa, with the shut down of local economies. That remains a less likely option for now. But the outbreak is in its infancy, which means that contact tracers have not yet determined patient zero. It is important to note that no cases of Ebola have yet been detected in Liberia since the virus was first re-identified in Guinea late last week.