This article is more than 5 years old. Information may no longer be current.
Controlling rural outbreaks critical to eliminating Ebola
Researchers found that 85 confirmed Ebola cases in the Kissidougou prefecture in Guinea were linked to a single funeral.
“The findings of this investigation highlight the importance of controlling local outbreaks in difficult-to-reach communities as a key component of the effort to eliminate Ebola,” Kerton R. Victory, PhD, of the CDC, and colleagues wrote in MMWR.
In mid-December, rapid response teams were sent to villages in Kissidougou, where suspected Ebola cases had been reported. The teams of epidemiologists, clinicians and local public health officials interviewed patients and their household contacts and conducted testing.
The teams admitted patients with suspected Ebola to a treatment center for confirmation testing, according to the researchers. In all, 62 patients, all from the Kissidougou prefecture, tested positive for Ebola, the researchers wrote. Of these patients, 90% had Ebola-compatible symptoms. Fifty-one patients died; 33 died in an Ebola treatment center. Eighteen deaths were community deaths.
“Patients who died in the community had not sought medical treatment; instead, family members reported the deaths to local health authorities, who considered them as suspected Ebola cases,” the researchers wrote.
The rapid response teams collected oral swabs from all the decedents within 24 hours of notification of death. All swabs tested positive for Ebola.
Household contact interviews revealed that all of the dead had attended the funeral of a well known midwife assistant, patient 1, in early December. Patient 1 traveled to a village in mid-November to perform a circumcision on an infant, who later died of an unknown cause, the researchers wrote. About 1 week after his return, patient 1 became ill with Ebola-like symptoms; he died on Dec. 4, without seeking medical attention.
His funeral was attended by about 100 people from his own and other nearby villages. In Guinea, it is typical for funeral attendees to wash, touch and kiss the body of the deceased, according to the researchers. Several funeral attendees probably had direct contact with the body and body fluids.
“Improved training for prompt reporting of cases, investigation and contact tracing and community acceptance of safe burial methods can reduce the risk for Ebola transmission in rural communities,” Victory and colleagues wrote. – by Colleen Owens
Disclosure: The researchers report no relevant financial disclosures.