Ebola virus particles (red) on a larger cell. Image Credit: NIAID
As Guinea grapples with a renewed Ebola outbreak, popular resistance to measures to contain the deadly virus remains dangerously high, a senior Red Cross official warned.
Guinea confirmed the disease was back in mid-February after the first deaths in the previous month.
The West African country and international actors have reacted quickly to stop the spread, isolate and treat cases, follow up contacts and launch a vaccination campaign.
However, Emanuele Capobianco, the chief health officer for the International Federation of Red Cross and Red Crescent Societies (IFRC), said the reluctance of communities to take action was an obstacle.
“What we see on the ground is quite a bit of community resistance and also some religious resistance,” he told AFP in an interview on Friday.
This is not surprising, he said, pointing out that “Ebola is a disease that scares people. It is a dramatic disease that kills a lot.”
Ebola, which is transmitted through close contact with body fluids, causes a severe fever and, in the worst case, unstoppable bleeding.
The data from the World Health Organization show that the mortality rate is high with an average of around 50 percent of those infected and up to 90 percent for some epidemics.
Guinea recorded new cases of Ebola near the town of Gouecke in southeast Nzerekore on February 13 and declared an epidemic shortly afterwards.
So far, 18 cases have been reported, 14 of which have been confirmed as Ebola, including four deceased, the WHO said on Friday.
These are the first Ebola cases in West Africa since a devastating epidemic from 2013 to 2016 that killed more than 11,300 people in Guinea, Liberia and Sierra Leone.
“There is of course a lot of fear that this disease will come back,” said Capobianco.
“We have a lot of trauma,” he said, adding that in some cases it “actually manifests itself in some resistance”.
During the last epidemic, communities across West Africa, particularly Guinea, rose up when outsiders dressed in protective suits arrived to stop the spread.
In 2014, eight members of a task force were killed by demonstrators in the southeastern city of Womey – just 50 kilometers from the current epicenter in Nzerekore.
The resistance sparked a postponement of response, with more efforts being made to engage communities and gain support from traditional and religious leaders to explain the disease and the need for the action taken.
“Safe and Dignified” burials
And the IFRC, which is deeply involved in many aspects of the response, has helped develop an approach to burying people who may be carrying Ebola safely, while respecting traditions as much as possible.
People infected with Ebola are most contagious immediately after death, making traditional burial practices, which often include washing, touching, and kissing corpses, dangerous.
For example, the current Guinea outbreak began when several people were infected at the funeral of a 51-year-old nurse, which is the first known case.
But Capobianco said the IFRC encountered resistance when it tried to conduct so-called safe and dignified burials of anyone who dies in communities where Ebola is spreading.
Such funerals “have a massive impact on reducing transmission,” he said, adding that “we have not always been able to conduct them because the community simply refused to let Red Cross teams conduct the burials.”
While this was worrying, Capobianco insisted that the resistance “is a problem that can be solved”.
“It can be solved by listening to communities, thinking about their fears, explaining what this disease is, and showing that people are actually not being sentenced to death from Ebola,” he said.
Those fighting Ebola in Guinea today had tools that weren’t available during the last epidemic, including vaccines and therapeutics that lower the death rate, he said.
According to the WHO, more than 1,600 people have been vaccinated so far, including contact persons of cases, their contacts and health workers.
Capobianco said the first IFRC health workers received their pokes on Friday.
“This time we have tools that are very powerful and that we can deploy,” he said.
“As long as we can win the churches over and make sure they are part of the response, we should be able to get this under control.”
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