By
Kemo Cham
[First
published on www.politicosl.com] Sierra
Leone was declared free-of the Ebola virus transmission for the second time
last week after 42 days of countdown.
But
unlike the first Ebola-free declaration at the end of last year, this time there
was less buoyancy in the celebrations on March 17.The Ministry of Health and
Sanitation (MoHS) and the World Health Organisaion (WHO) used the occasion to warnof
a possible resurgence of the virus that has plagued the West Africa region for
the last over two years.
Sierra
Leone was first declared free of the virus on 7 November 2015. And in January
this year the death of a school girl in the Tonkolili District sparked a new
flare-up. Hundreds of people were quarantined subsequently.One person, besides
the index case, died. A second case was
successfully treated and discharged by
officials at the 34-Military Hospital in Freetown.
As
required by WHO regulations, the country embarked on a fresh countdown. 42-days
is two incubation cycles of the virus since the last person confirmed to have
it in the country tests negative for a second time.
“Whiles
we mark today as a great achievement in the control of this outbreak, it is
crucial that we remain prepared to respond to possible new flare-ups,” Dr
Anders Nordstrom, WHO Country Representative, said in a joint-statement by the world
health agency and the Ministry of Health.
The
death of 22-year old Mariama Jalloh in Tonkolili, north of the country, came as
the country was observing a period of enhanced surveillance activities which
was due to end on February 5. Later, investigations by the defunct National
Ebola Response Center (NERC) revealed that she’d traveled through three other
districts in the north and northwest of the country: Kambia, Port Loko and
Bombali. Up to date there has been no official confirmation as to where exactly
she might have come in contact with the virus.
ButIshmail
Tarawally, National Coordinator of the Office of National Security (ONS), said that
that event was not completely unexpected as the World Health Organisation had
warned of more flare-ups.
“We
saw this in neighboring Liberia as well and it signaled the need for continued vigilance,”
Tarawally, who is co-chair of the Emergency Operations Center (EOC), said at a
press conference at the EOC officeson Wilkinson in Freetown.The EOC succeeded
the NERC.
Health
Minister Dr Abu Bakarr Fofanah praised the effort of health officials and
partners in tackling the epidemic.
“Our
response to control the unwelcomed event through our national structures with
support of our partners was prompt and effective and it reaffirmed the local
capacity that was built during the previous encounter with the disease, to
manage public health events and to say never again shall we be overtaken by any
public emergency,” the minister said in a prepared statement.
Some
3, 956 people have died out of 14, 124 cases in Sierra Leone alone, according
to figures from WHO as of March 16. Among the dead are 221 healthcare workers.
Tarawally
paid tribute to these healthcare workers who sacrificed their lives to fight
the epidemic.
“We
continue to remember but at the same time celebrate the courage of our
healthcare workers who confronted the disease with bravery despite its deadly
nature,” he said.
Amidst
the celebration there was a restrained feeling of caution in the air. Much
attention was on survivors of the disease. Sierra Leone has nearly 4000 of
them. There is widespread suspicion around them in terms of transmission of the
virus, especially through sexual intercourse.
Health
authorities face a dilemma as to how to deal with this situation, for fear of
not fuelling stigmatisation.
The
last three cases in the country have still not been linked to any known source.
This has focused attention on the survivors, who themselves already face an
avalanche of health complications related to the virus.
“WHO
continues to stress that Sierra Leone, as well as Liberia and Guinea, are still
at risk of Ebola flare-ups, largely due to virus persistence in some survivors,
and must remain on high alert and ready to respond,” the UN health agency said
in its statement.
It
added: “Strong surveillance and emergency response capacity need to be
maintained, along with rigorous hygiene practices at home and in health
facilities and active community participation.”
WHO
is also urging the government to continue to care, screen and provide
counselingfor survivors as part of improved health services for them.
Before
the 2014 outbreak Ebola virus fragments were known to be found in the semen of
male survivors for up to three months. Studies conducted in Sierra Leone showed
last year that they can now remain for up to nine months.
Reports
of relapses, as has been seen in the case of Scottish nurse
Pauline Cafferkey, also raise further questions about the prospect of
transmission from survivors.
But
there is no definitive evidence that these viral fragments have been
responsible for any transmission, and this complicates the confusion on how to
deal with them.
There
might have been a few cases resulting from survivors although this is not yet
scientifically certain, noted Dr Nordstrom in an interview.
“We
have a few cases that might be [the result of sexual transmission] but we are
not still very sure,” he said in a telephone interview.
“We
know that the virus still exist in semen…but it’s the number of people who have
it that declines. That we know…But the risk of infecting somebody is extremely
small and we need to focus on protection and monitoring,” he said.
WHO
has also urged the government to continue conducting swab test on all dead
bodies until June this year, he said at the press conference earlier.
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