Ebola, The Contagion

20,200 cases, 7,900 deaths and counting. 2014 had its share of highs and lows, and yet nothing was as disquieting and unsettling as the largest and the deadliest Ebola outbreak we had to cope up with in history. What began as a mysterious epidemic in Guinea on December 28, 2013 assumed pandemic proportions as the zoonotic disease quickly spread to Liberia, Sierra Leone, Nigeria, Senegal and Mali, with secondary infections being reported in the United States, Spain and most recently in the United Kingdom. Recent findings published in EMBO Molecular Medicine in fact reveal that the patient zero, a two-year-old toddler called Emile Ouamouno from Meliandou, Guinea, may have been infected by playing in a hollow tree housing a colony of bats. That the flying mammals have been long suspected in the transmission of several zoonoses (including Ebola) notwithstanding, what's revealing is the outbreak's spread, which after a deceptive lull in Guinea struck back with ruthless force across West Africa. The entire investigative report from The New York Times makes for a compelling read:

Ebola's Patient Zero Emile Ouamouno (Image: The New York Times)

Tracing those exposed to Ebola and checking them for symptoms, the key to containing any outbreak, had been lacking in many areas. Health workers had been chased out of fearful neighborhoods. Ebola treatment centers had gained such reputations as deathtraps that even desperately ill patients devoted their waning strength to avoiding them. 

With the affected countries often lacking the most basic medical infrastructure, the health care challenges proved staggering. But the most tragically missed opportunities stemmed from the poor flow of information about who was infected and whom they might have exposed. 

A two-month investigation by The New York Times into this largely unexamined period discovered that the W.H.O. and the Guinean health ministry documented in March that a handful of people had recently died or been sick with Ebola-like symptoms across the border in Sierra Leone. But information about two of those possible infections never reached senior health officials and the team investigating suspected cases in Sierra Leone. 

As a result, it was not until late May, after more than two months of unchecked contagion, that Sierra Leone recorded its first confirmed cases. The chain of illnesses and deaths links those cases directly to the two cases that were never followed up in March. Sierra Leone has since tallied about 9,400 reported Ebola infections, more than any other country. The same missed cases are linked to Liberia’s vast second-wave outbreak, identified in late May, with almost 8,000 reported infections to date. >>