The World Health Organization (WHO) has declared the outbreak of Ebola virus that began in February 2014 officially over, nearly two years after doctors diagnosed the first case of Ebola in this outbreak in a rural town in Guinea.
Medical professionals have not recorded any new cases of Ebola in Liberia in 42 days, the time frame the WHO gives nations before they officially declare the threat of contracting Ebola from a survivor negligible. The last known Ebola patient has tested negative for the virus twice, the other major requirement to declare the threat over. In declaring Liberia Ebola-free, the nation joins the other two west African nations devastated by the virus: Sierra Leone, which was ruled Ebola-free in November; and Guinea, declared Ebola-free in late December.
The declaration has arrived with words of extreme caution from WHO officials. “While this is an important milestone and a very important step forward, we have to say that the job is still not done… there is still ongoing risk of re-emergence of the disease because of persistence of the virus in a proportion of survivors.” Rick Brennan, WHO director of emergency risk assessment and humanitarian response, warned.
“The risk of re-introduction of infection is diminishing as the virus gradually clears from the survivor population, but we still anticipate more flare-ups and must be prepared for them,” a statement by Dr. Bruce Aylward, WHO’s Special Representative for the Ebola Response, read. LiveScience notes that scientists now believe Ebola can be transmitted sexually to a new patient from a male patient for up to a year after he has contracted the disease.
The 2014 Ebola outbreak has taken the lives of more than 11,300 people and infected another 28,500. Scientists estimate that more than 10,000 survivors remain in Sierra Leone, Guinea, and Liberia.
Liberia was previously declared Ebola-free but had its status rescinded in November, when Nathan Gbotoe, identified as being either ten or fifteen years old, tested positive for Ebola and died. Doctors have not yet discovered where Gbotoe contracted the virus, save to identify the social cluster from which his strain of Ebola came from. It is not believed that he is a second patient zero.
Scientists believe the patient zero of this outbreak was a boy in rural Guinea who ate contaminated “bush meat,” a catch-all term for animal protein from forests that may include mice and bats. Experts warn that the end of this particular outbreak does not mean that Ebola has been eliminated, and the consumption of contaminated bush meat could spark a new outbreak at any time.
In addition to the need of expanded awareness in how to avoid to Ebola virus, the affected nations are now left to repair the social damage of losing a sizable percentage of its population to the virus and the indelible trauma left to the survivors. In Liberia, officials are struggling to quell uprisings led by burial workers who say the government owes them money for their labor, money they cannot get anywhere else as no one will hire workers who interacted with the bodies of Ebola victims out of fear.
“They brought more than 10 dead bodies that very night and we were using car lights just to carry on this safe burial. And these people really they are not treating us well. We have been doing well. As I speak to you right now, we have buried more than 3,000 dead bodies,” Timothy Kai, one of the workers, told the Liberian Observer. The government is refusing to pay them the $1500 they are demanding, insisting they have already been paid.
Those who are not protesting must still endure the stigma of working with Ebola-stricken remains, particularly those who performed the arduous task of burning bodies to prevent the further spread of the disease. Burning a body is strictly forbidden in Liberian culture, where a burial following a thorough cleaning of the body is most common. This burial practice resulted in widespread contamination, as many handled Ebola remains without proper protection and subsequently died of the disease.
Those who burned bodies say they have been “hounded out” of their neighborhoods, with some even being forced into exile by families who want nothing to do with them.
Renewed distrust in medical care has also created new health problems, as patients seek medical care outside of proper facilities to avoid contact with Ebola patients. In Sierra Leone, a spike in the number of women choosing to give birth at home to avoid Ebola patients has led to a significant increase in infant mortality and death of mothers during childbirth.