Guinea Is Seeing More Ebola Cases: Can The Trend Be Stopped?

In the current Ebola crisis, much of the focus has been on Liberia and Sierra Leone. But the virus also continues to spread in Guinea, where the first case in the current outbreak was identified in March.

According to the latest figures from the World Health Organization, Guinea has had fewer cases than either Sierra Leone (4,759) or Liberia (6,525). WHO has recorded 1,731 Ebola cases and 1,041 deaths in Guinea. This, however, is just a few dozen fatalities fewer than in Sierra Leone. And despite the lower numbers in Guinea, some data suggest the outbreak is spreading faster there than in the neighboring countries.

Goats and Soda spoke with Marc Poncin, response coordinator for Doctors Without Borders in the Guinean capital of Conakry, to get a better picture of the outbreak.

Where does the epidemic stand in Guinea right now?

There's clearly been a new phase starting in mid-August. From mid-August until now we've seen a much higher number of cases compared to the first and second peaks of the epidemic. So we are clearly in a serious situation.

This Ebola outbreak first came to light in Guinea. Several times the outbreak has appeared to be almost finished. What happened?

Very clearly at the end of May we were almost over with the epidemic. Again at the end of July things were looking much better compared to the month before. I think that it's mainly the importation of cases from Sierra Leone and Liberia that creates a very difficult situation in Guinea. As of June, when the epidemic began to hit the fan, there've been a lot of people leaving those countries [Liberia and Sierra Leone] to come back to their family [in Guinea]. Some of those people were sick without knowing it. When they were back, they started to show symptoms and contaminate their own family and the people around them. We've seen that many, many times. This explains why the epidemic re-launched and why it was very difficult to control it again.

So this reverse migration of Guineans has spread the virus all over the country.

The epidemic is now covering 14 districts out of 33 in the country. Some of those districts are highly affected. Since mid-August we've seen a regular increase of cases each week. We don't know if we've reached the peak.

You worked on an Ebola outbreak in Uganda in 2008 and have cited four elements necessary to get the virus under control: treatment of patients, surveillance, public awareness and safe burials of victims. Those sound like basic steps.

The complexity is to have those four principles functioning at the same time. If you have just treatment, it is not enough. If you don't have good surveillance, if you don't have good contact tracing, then you cannot stop the transmission chain. You will always run after the epidemic, like we've seen in Liberia.

How have Guinean officials responded to the outbreak?

The situation in Guinea is very different than the situation in the two other countries. In Guinea the situation is very bad, but it's clear that the authorities never gave up on the epidemic. They've been always trying to do something — maybe not enough, but they've been always present and trying to coordinate the response. If you come to Guinea, you'll be very surprised. You arrive in a country that's functioning normally. Generally speaking, you can have a normal life. The markets are functioning.

The schools did not restart because they are trying to find a way to make sure they protect children, but they have a strong willingness to restart the schools.

In Liberia and Sierra Leone, international aid agencies have stepped up their response to the epidemic. What's the situation been in Guinea?

This is a big difference with other countries. From the beginning of the crisis until now, MSF [Doctors Without Borders] is running all the beds for Ebola in Guinea, and this is not a good thing.

Just as the U.S. has pledged to help Liberia and the U.K. is sending troops to Sierra Leone, France has vowed to help Guinea [its former colony] battle this outbreak.

The French Red Cross and the French aid agency Alima are both opening new Ebola centers in Guinea. And the Guinean government has launched a plan to eliminate the disease by Jan. 31. Is that possible?

I think it's unrealistic that we can control it by January of 2015, but there is a strong will to increase the response and to have a quick impact on the epidemic.