As the world's worst Ebola outbreak surpasses 16,000 reported cases, the rate of infection in Sierra Leone is such that it will soon overtake Liberia, which has been the epicenter of the disease hot zone since August.
According to the most recent figures from the World Health Organization (WHO), as of Friday there were more than 16,100 total cases and nearly 7,000 deaths in the hardest hit countries of Sierra Leone, Liberia, and Guinea — with a small number of cases and deaths reported in the US, Spain, Mali, Nigeria, and one imported case in Senegal. Reporting more than 6,800 Ebola infections, Sierra Leone is quickly approaching Liberia's tally of more than 7,200. In Guinea, where the epidemic first took hold last December, more than 2,100 cases have been recorded.
"The total number of cases reported in Sierra Leone since the outbreak began will soon eclipse the number reported from Liberia," states a WHO report from Wednesday.
While the WHO said more than 70 percent of Guinea's Ebola patients have been isolated — the target number set by the United Nations agency in order to successfully contain the spread of the virus — Sierra Leone and Liberia have not hit that goal. Also hindering the fight against the disease, the number of burial teams that follow "safe and dignified" WHO protocols in the handling of infected bodies is only at about 25 percent of the target capacity in either country, while the number sits at more than 80 percent in Guinea.
According to a statement from WHO Ebola expert Dr. Pierre Formenty in early November, at least 20 percent of new infections occur during burials of patients who have died from Ebola.
"Introducing components such as inviting the family to be involved in digging the grave and offering options for dry ablution and shrouding will make a significant difference in curbing Ebola transmission," Formenty said.
Despite the fact that Liberia is falling behind in meeting those goals, infections have stabilized nationally with just 67 cases reported in the week leading up to November 23. A majority of the cases were recorded in Montserrado district, where the capital is located, and the rest in just five other districts. Sierra Leone, on the other hand, reported 385 cases during the same week and Guinea saw 148.
This wouldn't the first time that Liberia and Sierra Leone have swapped places in the infection tally for the hemorrhagic fever since they began reporting cases in April and May, respectively.
Throughout the last year, transmission rates have by and large remained steady in Guinea, neither severely spiking or dramatically dropping off, but in June and July the situation seemed to be spiraling out of control in Sierra Leone. As of July 31, there had been a total of 533 cases in the country, coupled with an atmosphere of civil unrest. But Liberia spent most of August catching up and by August 20 had surpassed its neighbor, reporting 972 total cases and compared to 907 in Sierra Leone.
When discussing new outbreaks in parts of Sierra Leone in October, when the growing rate of infection first became apparent, George Mason University epidemiologist Dr. Kathryn Jacobsen told VICE News that it was "a reminder that Ebola is not uniformly occurring across Guinea, Liberia, and Sierra Leone."
According to Reuters, Sierra Leone's government has requested military assistance from the United States to stop the spread of the deadly disease that has already infected nine local doctors.
Interestingly, while infection rates have remained relatively consistent and smaller in Guinea, the death rate is almost identical to that of the other countries. In both Guinea and Sierra Leone the death rate is at 60 percent, while the number sits at 61 percent in Liberia.
One of the main factors that appears to determine a patient's likelihood of survival is early recognition and treatment for the virus. Early detection has also been identified by WHO as a key factor for reducing the spread.
Rapid testing mechanisms has been cited by many experts as an important development needed to fight the Ebola outbreak, it appears an Ebola detection test is set to be put through trials in Guinea. According to reports on Friday, the blood and saliva diagnostic test would return results in 15 minutes. The system will run out of a solar-powered mobile laboratory, and the trial run will be carried out on patients in the capital, Conakry.
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Image via Flickr/European Commission