West African Countries Affected by the 2014 Ebola Outbreak

By Edward K. Chapnick

Ebola has hit three of the countries in West Africa the hardest. Some reports suggest that the increase of deforestation in West Africa for mining purposes and a longer and drier season than usual has pushed fruit bats closer to human habitats, thereby increasing the amount of exposure villagers have to the virus hosts.

The figure shows a map of the Western African countries most affected. The 2014 Ebola outbreak actually began in Guinea in December 2013 and then spread to Sierra Leone and Liberia. Nigeria and Senegal had small outbreaks, but both of those countries have been cleared of Ebola as of October 2014.

[Credit: CDC.gov]
Credit: CDC.gov

Guinea and the 2014 Ebola outbreak

Guinea, formerly known as French Guinea and sometimes referred to as Guinea-Conakry, is a country of approximately 10.5 million people located due north of Sierra Leone and Liberia.

The current outbreak started with a 2-year-old in Guinea, referred to as Patient 0 in the media. Nobody knows for sure how he initially contracted Ebola, but one theory is that his family hunted fruit bats, which is very common in that country and region.

Shortly after his death, his mother, sister, and grandmother also died from Ebola. People from around the area attending the funerals and burial rituals for the family contracted the virus unknowingly and brought it with them when they went back over the borders to go home.

Local health authorities estimate that 60 percent of all cases in Guinea are linked to funerals and burials of those who have died from Ebola. At publication time, the current case count in Guinea is 1,760, with 1,054 deaths, which is a death rate of about 60 percent.

Liberia hit by Ebola outbreak

Surrounded on three sides by Sierra Leone, Guinea, and the Ivory Coast, Liberia has been mentioned in most of the news concerning the present outbreak. Liberia is the only country in Africa founded by U.S. colonization when many freed slaves settled there in 1820. During the past 35 years, the country has faced economic and political upheaval.

Liberia’s Ebola outbreak began in March, probably due to travel from Guinea. For much of the outbreak, Liberia was the country whose caseload of infected patients grew the fastest and most exponentially.

In fact, the crisis level is the highest there out of any of the affected countries, mainly because of the number of cases in the densely populated capital of Monrovia and an intense mistrust of government, healthcare workers, and community activist directives — particularly in the slum of West Point. Additionally, the lack of beds and overall poor health system exacerbates the situation.

The good news is that the case rate in Liberia appears to be decreasing. At time of publication, 6,919 cases have been reported with 2,766 deaths. However because the situation is so dire, the true death toll may never be known, mostly due to improper reporting and disposal of bodies.

Sierra Leone hit by Ebola in 2014

Sierra Leone is on the west coast of Africa and borders Guinea and Liberia. A civil war plagued the country from 1991 to 2002, forcing two million refugees across the borders.

The first confirmed case of Ebola in Sierra Leone during the 2014 outbreak was a woman admitted to a hospital for miscarriage in May. She recovered from the virus, and local community health workers determined that she likely had contracted it from a healer who lived and worked in her village. Hundreds of people who were sick with Ebola had visited the healer, who then contracted the virus and spread it to others.

Additionally, the healer’s funeral drew hundreds of mourners. Because of the attendees’ observation of and participation in traditional funeral rituals, they also contracted the virus. In fact, up to 365 deaths may be attributed to that one funeral. At time of publication, 4,862 cases of Ebola have been reported in Sierra Leone with 1,130 deaths.

How Ebola impacted Nigeria and Senegal

Two countries, Nigeria and Senegal, had isolated illnesses that were swiftly dealt with, which prevented Ebola from becoming widespread. Senegal shares borders with Mali and Guinea, whereas Nigeria is the most populous country in Africa.

A small outbreak began in Nigeria in July when an infected traveler from Liberia — who lied about his health status and history — arrived at a Nigerian airport.

At the end of the country’s outbreak (declared in October by WHO), Nigeria had had only 20 reported cases and eight deaths. This small caseload (relative to outbreaks in Sierra Leone, Guinea, and Liberia) is due to the country’s fast and furious response. Health officials did what they were supposed to, in terms of quickly identifying and isolating patients, tracing, and monitoring their contacts, and those actions worked in preventing Ebola from spreading.

Senegal was even more effective in preventing the spread of Ebola than Nigeria. In August, a traveler who had contact with an Ebola patient arrived from Guinea. The government’s swift and proper response enabled the patient to recover and prevented Ebola from spreading to anyone else.

Granted independence from France in 1960, the citizens of Senegal speak French and are primarily Muslim. The country has strong relations with the West, especially France and the United States. As well, it’s been a member of the UN Security Council and UN Commission on Human Rights.

Mali affected by Ebola

Mali is one of the poorest countries in the world, but the United States has an ever-strengthening relationship with the country due to Mali’s evolving pro-Western stance and desire to resolve conflict in the area (such as in Liberia and Sierra Leone).

On October 23, a 2-year-old in Mali who had traveled through Guinea tested positive for Ebola and became that country’s first case. She died the next day, but because of Mali’s swift and proper response, the Ebola virus didn’t spread, and Mali was nearly declared Ebola-free until another case appeared on November 10 — this time a nurse in a private clinic.

Doctors determined through genetic analysis and contact tracing that the two cases weren’t linked; however, the second case also came from Guinea, when a man with Ebola sought treatment at the same hospital at which the nurse worked.

Additionally, because the man was a grand imam (a religious figure in the Islam faith), many people attended his funeral, generating a fear that this round of the outbreak could be substantially larger than the first. This turned out to be true, and at time of publication, Mali has had six Ebola cases and all patients have died.

As a result, Mali health officials have intensified its contact tracing and monitoring and currently have about 95 percent of the 327 identified contacts under daily monitoring for symptoms.