Ebola continues in Sierra Leone...

Since writing about Ebola two months ago, the number of confirmed cases continues to increase in Sierra Leone. According to today's report there are a total of 458 confirmed cases, most of which are in Kailahun and Kenema. However, seven other districts have had confirmed cases as well, three of these districts had their first cases in the past week. Unfortunately travel within the country and in some cases lack of containment of suspected or confirmed cases has led to the spread of Ebola. In many cases, people’s beliefs and behaviors have contributed to the ongoing transmission of the disease. I will write more about this next time.

This past week has been particularly challenging. The news of three of the nurses at Kenema government hospital, the site of one of the Ebola treatment centers, dying of Ebola early this week was a shock to many. It also led to health workers going on strike and the treatment centre being depleted of staff. Also, the news of Dr. Sheik Umar Kahn, head of the Lassa Fever Unit and current Ebola treatment centre, testing positive on Tuesday was also a big blow. Dr. Kahn, a 39 year old Sierra Leonean doctor, is one of the world's leading clinical experts in viral haemorrhagic diseases, so to hear that he had been infected with Ebola was a big concern. He has treated over 100 patients in the treatment centre, spending long hours trying to save their lives. Thankfully the news is that he is recovering in the treatment centre in Kailahun, run by MSF. Let’s hope he pulls through and that his story can be a testimony to the Sierra Leoneans that this disease is real and that treatment early on can save lives. Maybe this will urge people who are sick to seek care at nearby hospitals rather than hiding in their homes.

Another big concern for Freetown was when relatives forcefully removed a lady in her thirties, suspected of Ebola, from an isolation area in a government hospital on Wednesday afternoon. Very quickly health facilities were on the alert to look out for this patient and officers were trying to track her down. On Thursday morning her result came back positive for Ebola and at this stage it was even more of a concern that she was somewhere in the community. On Saturday morning she returned to her residence and agreed to go to the treatment centre with her parents. Meanwhile, her home was under quarantine with some of the contacts inside. Although she has been found, there is obvious concern that she was in the community for some time (60 hours?) and likely transmitted the disease to others. Transmission is through contact with bodily fluids, so hopefully very few people came in such close contact with her. With an incubation period of 2-21 days (average of 5-7), it’s probably a matter of days before we know what the impact is of her escape.

While I am writing this I am watching SLBC news and over the past hour I have seen multiple news stories about Ebola. One story featured an event held today: "Pharmacists, Pharmacy Technicians and Pharmacy Owners sensitized on Ebola". It was said that 80% of sick people seek pharmacies first for healthcare (rather than going to a clinic or hospital) and so pharmacy staff is advised to take precautions and refer any suspected cases to the nearest hospital so that the patient can be isolated to break the chain of transmission. Unfortunately in Sierra Leone, many pharmacies are like little clinics where patients can opt to be treated in a back room with drips and injections. This practice is strongly discouraged, especially with the presence of Ebola in the country. According to the report, two pharmacy workers have already contracted the disease. Another news item was about a sensitization day for youth in Kono, a district which to date has not had any cases. It is good to see that sensitization is taking place – this is essential!

So, the story continues. I am wondering if we have already reached the climax, or if it is still to come. More soon…