Less than two months after Liberia was declared Ebola-free, two new cases in the West African nation have health officials on edge, perplexed about what could have caused a resurgence of the deadly illness.
Authorities said the corpse of a 17-year-old Liberian boy who died under unexplainable circumstances last week tested positive for Ebola. The youngster died in Nedowein — a town located near the country’s international airport and 30 miles south of Monrovia, Liberia’s capital city — three days after falling ill. One of the boy’s neighbors has also tested posted.
By the time the World Health Organization designated Liberia as Ebola-free in early May, the country hadn’t experienced new cases for more than 40 days. More than a year after the disease appeared in Liberia, the Centers for Disease Control and Prevention (CDC) reported more than 10,000 infections and nearly 5,000 deaths from the illness.
Symptoms — including fever, severe headache, vomiting, and unexplained hemorrhage — often became visible within two days to three weeks after exposure to the disease. Government officials credited an influx of food, medical personnel, and supplies sent to Liberia with the eventual slowdown of the infection rate.
Months before Liberia reached its Ebola-free status, CDC Director Tom Frieden warned against letting up against the virus, stressing that the epidemic could be a problem for Africa and much of the world for years to come. For Liberians, that fear has become a reality: Quarantines in the area where the young man died have resurfaced, a sign of a not-so-distant past.
“Liberia has got a re-infection of Ebola,” Tolbert Nyenswah, deputy health minister and head of Liberia’s Ebola response team, told the Associated Press. “We have said over and over again there was possibility that there could be a resurgence of the virus in Liberia.”
Even with the help of the U.S. and other nations, leaders of affected West African nations still want to strengthen their capacity to meet future outbreaks head on. U.S. officials had similar sentiments, forging a partnership with the African Union in April to form an African CDC, set to launch sometime this year. In a press statement, Frieden said that a centralized health care institution in the Motherland could better support globalized efforts to prevent, detect, and respond to epidemics.
Perhaps such an institution could have helped African officials better coordinate efforts to quell Ebola’s spread in West Africa over the past year. Even though the disease disappeared from Liberia for a few weeks, neighboring Guinea and Sierra Leone experienced flare ups, and eventually a significant increase in new cases shortly after reporting the lowest tallies since the outbreak started. The developments spurred action from response partners, particularly Guinea-Bissau, which sits Northwest of Guinea.
Liberian health officials didn’t dismiss the possibility that Ebola could reemerge in their country. Margibi County, where Liberia’s newest Ebola case appeared, borders Bong County, an area adjacent to Guinea. During the 2014 epidemic, that region counted among the worst affected areas. In the weeks since WHO declared Liberia declared Ebola-free, some infected Guineans have crossed the border in search of care, a scenario that a team of security representatives from the bordering counties of Bong and Yomou, located in Guinea, work to curb during monthly meetings. Strategies include building and referring patients to Guinea’s Ebola Treatment Center, provide shelter for infected people, and active case finding — during which health care workers seek out those attempted to enter Liberia in search of care.
The recent news, though discouraging, provides some opportunity for Liberian President Ellen Johnson Sirleaf to reaffirm goals she outlined in a February interview with the Associated Press that she said would strengthen the country’s medical infrastructure. Her priorities include electric power that would keep hospital equipment running, roads that would allow the sick to access medical facilities, and water to prevent the spread of disease. At the height of Liberia’s Ebola outbreak, a dearth of medical supplies precluded medical health care professionals from effectively tackling the disease.
This past fall, critics of the rampant xenophobia in the United States that prompted calls to close travel to West Africa made similar assertions, arguing that the best way to protect the world from Ebola would be to strengthen the health systems at the outbreak’s epicenter.
“Our own limited resources have not enabled us to take them to the level where they could be in a preventive mode. And that’s the support we want,” Sirleaf said. “The great lesson in all these things, you know, whether you’re dealing with conflict or whether you’re dealing with disease, is to emphasize prevention rather than cure. It costs so much when you have to fix it.”