Two of the five countries affected by the world's worst-ever Ebola outbreak are managing to halt the spread of the disease, the World Health Organization said on Monday, although the overall death toll rose over the weekend.
“On the whole, the outbreaks in Senegal and Nigeria are pretty much contained,” a WHO statement said, adding that there were no new deaths in Guinea, but four in Sierra Leone and 39 in Liberia.
To date, a total of 2,793 people have died from 5,762 recorded cases in the outbreak. A separate Ebola outbreak has killed 40 people in the Democratic Republic of Congo, where there have been 71 cases as of Sept. 18, the WHO said.
Sierra Leone recorded 130 new cases of the virus during a three-day lockdown and it is waiting for test results on a further 39 suspected cases, Stephen Gaojia, head of the Ebola Emergency Operations Center, said on Monday.
The country had ordered its six million citizens to stay indoors until Sunday night in the most extreme strategy employed by a West African nation since the start of an epidemic that has infected thousands of people since March.
"The exercise has been largely successful … The outreach was just overwhelming. There was massive awareness of the disease," Gaojia said, noting that authorities reached more than 80 percent of the households they had intended to target.
Sierra Leone now needs to focus on treatment and case management, and it urgently needs treatment centers in all its 14 districts as well as "foot soldiers" in clinics and hospitals, he said.
"We need clinicians, epidemiologists, lab technicians, infection-control practitioners and nurses," he said.
The lockdown was intended to allow 30,000 health workers, volunteers and teachers to visit every household. Some argued it might have a negative impact on Sierra Leone's poor.
Joe Amon, director of health and human rights for Human Rights Watch, said there was little reason to believe the lockdown had been effective in ending transmission since such measures are so hard to enforce. Frustrated residents complained of food shortages in some neighborhoods.
"You could argue that it's strictly necessary not because it's an effective way to break transmission but because it's necessary to reach people with communication messages," he said.
Teams carrying soap and information about Ebola reached about 75 percent of 1.5 million households in this nation, the health ministry said. Some residents complained of food shortages, as others sat out on verandas. Rumors that the soap being distributed had been poisoned called into question the education efforts.
More than 560 people are believed to have died from the disease in Sierra Leone, a nation of 6 million people. Ebola has also spread rampantly through Liberia and Guinea, and a limited number of cases have been reported in Nigeria and one in Senegal.
Treatment centers are overwhelmed with patients almost as soon as they are built and health workers struggle to keep up with monitoring the contacts of thousands of sick people. So the hardest-hit countries have resorted to extraordinary measures. Liberia has cordoned off entire towns or neighborhoods, and Sierra Leone's nationwide shutdown was a first.
WHO has not said clearly whether it supports such measures, saying they should only be undertaken if people's rights are protected and the measures are proportionate and evidence-based. But so much in this outbreak is new — from its large geographic spread to the number of people infected to the government response — that evidence on the best way to contain it is scarce.
The U.N. health agency has, however, repeatedly said that the border closures and flight bans many countries have put in place to protect themselves from Ebola are counterproductive.
"Flight cancellations and other travel restrictions continue to isolate affected countries, resulting in detrimental economic consequences, and hinder relief and response efforts risking further international spread," the statement said.
An independent panel advising the WHO urged authorities in the affected countries — Guinea, Liberia, Nigeria, Senegal and Sierra Leone — to work with the aviation and maritime sectors to resolve differences and "develop a coordinated response" to transport issues.
Quarantines may be deemed necessary in areas of intense and widespread transmission of the deadly virus, the committee statement went on.
The committee, composed of some 20 experts who advise WHO Director-General Margaret Chan, declared on Aug. 8 that the epidemic constituted a public health emergency of international concern. The medical charity Doctors Without Borders (MSF) has warned since late March that the outbreak, which began in the remote Gueckedou area of southeastern Guinea, is "unprecedented.”