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| Doctors Link Risky Burials to Ebola Rise in West Africa | |
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| DAKAR, Senegal — Only days after declaring the lowest number of new Ebola cases in Guinea and Sierra Leone this year, officials at the World Health Organization said Tuesday that there had been a nearly fourfold increase during the most recent week of reporting, to about 35 new cases. | DAKAR, Senegal — Only days after declaring the lowest number of new Ebola cases in Guinea and Sierra Leone this year, officials at the World Health Organization said Tuesday that there had been a nearly fourfold increase during the most recent week of reporting, to about 35 new cases. |
| With Liberia, the other West African nation at the center of the epidemic, being declared free of Ebola this month, the recent drop in infections in Sierra Leone and Guinea had offered hope that the worst Ebola outbreak in history might end soon. | With Liberia, the other West African nation at the center of the epidemic, being declared free of Ebola this month, the recent drop in infections in Sierra Leone and Guinea had offered hope that the worst Ebola outbreak in history might end soon. |
| Officials warned against reading too much into the latest uptick, given the steep overall decline in Ebola cases. As recently as the week of March 15, there were 95 new cases in Guinea alone. A May 13 report showed the lowest weekly total this year: nine new cases, seven in Guinea and two in Sierra Leone. | Officials warned against reading too much into the latest uptick, given the steep overall decline in Ebola cases. As recently as the week of March 15, there were 95 new cases in Guinea alone. A May 13 report showed the lowest weekly total this year: nine new cases, seven in Guinea and two in Sierra Leone. |
| Health officials said that sharp falls and rises were normal as an epidemic approached its end. But they also said that some persistent risky practices, like unsafe burials of Ebola victims in Guinea, had contributed to the rise. | Health officials said that sharp falls and rises were normal as an epidemic approached its end. But they also said that some persistent risky practices, like unsafe burials of Ebola victims in Guinea, had contributed to the rise. |
| Most of the new cases, about 27, are in Guinea, and one area in particular is a problem spot: the Forecariah district southeast of the capital, Conakry. It is far from where the outbreak started, in Guinea’s Forest Region, but it is in an area where there has been resistance to the sanitary burials necessary to contain Ebola. | Most of the new cases, about 27, are in Guinea, and one area in particular is a problem spot: the Forecariah district southeast of the capital, Conakry. It is far from where the outbreak started, in Guinea’s Forest Region, but it is in an area where there has been resistance to the sanitary burials necessary to contain Ebola. |
| “We’ve been concerned about a number of cases coming from there, of people dying in the community,” said Dr. Margaret Harris, a spokeswoman for the W.H.O., referring to the failure to turn corpses over to the authorities in Ebola hot spots, a refusal that has bedeviled health officials since the outbreak began. | “We’ve been concerned about a number of cases coming from there, of people dying in the community,” said Dr. Margaret Harris, a spokeswoman for the W.H.O., referring to the failure to turn corpses over to the authorities in Ebola hot spots, a refusal that has bedeviled health officials since the outbreak began. |
| “There is still some concern that there are unsafe burials going on,” she said. “The burial issue is still a very tough one.” | “There is still some concern that there are unsafe burials going on,” she said. “The burial issue is still a very tough one.” |
| Dr. Harris said a team of experts had been sent to the Forecariah area to help combat the spread of the disease. | Dr. Harris said a team of experts had been sent to the Forecariah area to help combat the spread of the disease. |
| “It doesn’t surprise us that within the tail of the epidemic there are peaks and valleys,” said Brice de la Vigne, the Brussels operations director of Doctors Without Borders, which has led the response to the epidemic over the last 14 months. | “It doesn’t surprise us that within the tail of the epidemic there are peaks and valleys,” said Brice de la Vigne, the Brussels operations director of Doctors Without Borders, which has led the response to the epidemic over the last 14 months. |
| “This is not scaring us beyond reason; it is normal,” Mr. de la Vigne said, but “we know that there are still people who are contaminating themselves at funerals.” | “This is not scaring us beyond reason; it is normal,” Mr. de la Vigne said, but “we know that there are still people who are contaminating themselves at funerals.” |
| Adding to the cases are renewed efforts by officials to find the sick, said Sylvie Jonckheere, a Doctors Without Borders official in Conakry. “They’ve been doing a roundup,” she said. “They have plenty of people looking for the sick in the villages. It’s not really different from what we’ve seen with Ebola in the past.” | Adding to the cases are renewed efforts by officials to find the sick, said Sylvie Jonckheere, a Doctors Without Borders official in Conakry. “They’ve been doing a roundup,” she said. “They have plenty of people looking for the sick in the villages. It’s not really different from what we’ve seen with Ebola in the past.” |
| It is not a coincidence that the disease is lingering longest in Guinea, where the outbreak began 18 months ago. In Guinea, resistance to the intervention of outsiders — doctors, health officials, politicians — has been stronger than in either Sierra Leone or Liberia. | It is not a coincidence that the disease is lingering longest in Guinea, where the outbreak began 18 months ago. In Guinea, resistance to the intervention of outsiders — doctors, health officials, politicians — has been stronger than in either Sierra Leone or Liberia. |
| Guinea has reacted with occasional violence to efforts to contain the disease. In the Forest Region, eight officials and journalists were killed by villagers during an anti-Ebola rally in September. Before that, doctors and health officials were repeatedly attacked, and villages were classified as “closed” or “open” by health officials, depending on whether they would allow outsiders in to fight the disease. | Guinea has reacted with occasional violence to efforts to contain the disease. In the Forest Region, eight officials and journalists were killed by villagers during an anti-Ebola rally in September. Before that, doctors and health officials were repeatedly attacked, and villages were classified as “closed” or “open” by health officials, depending on whether they would allow outsiders in to fight the disease. |
| More than 11,000 people have died of Ebola in the three countries, and there have been over 26,000 confirmed, probable and suspected cases, according to the W.H.O.’s May 13 situation report on the epidemic. | More than 11,000 people have died of Ebola in the three countries, and there have been over 26,000 confirmed, probable and suspected cases, according to the W.H.O.’s May 13 situation report on the epidemic. |
| But one telling statistic in the report indicates how sharply the Ebola epidemic has dropped off: Out of 55 districts in the three countries that had reported at least one case of the disease, 43 have not reported a single one for more than six weeks. | But one telling statistic in the report indicates how sharply the Ebola epidemic has dropped off: Out of 55 districts in the three countries that had reported at least one case of the disease, 43 have not reported a single one for more than six weeks. |