Mali is racing to control a fresh Ebola outbreak after confirming its second death from the disease, just when it appeared the country would be given the all clear.
Officials said a 25-year-old nurse died on Tuesday after treating a man who arrived from Guinea at a clinic in the Malian capital, Bamako. The clinic is now in quarantine and under police guard.
Thirty one people are isolated at the clinic, 16 of them are patients, the rest are staff, according to hospital director Dramane Maiga.
The fatality was not related to Mali’s first case, the death of a two-year-old girl travelling home from Guinea to the north-western town of Kayes last month.There had not been any confirmed cases since then and 108 people linked to the girl were due to complete their 21-day quarantine period on Tuesday.
Ebola emerged in Guinea in December, spreading to neighbouring Liberia and then Sierra Leone, infecting at least 13,000 people.
Latest figures published by the World Health Organisation (WHO) on Wednesday show that the number of recorded Ebola deaths now stands at 5,160, with 14,098 reported cases. The WHO warns that the true scale of the epidemic could be far worse.
The nurse is thought to have been infected by an imam from Guinea who died in late October, according to Dr Samba Sow, who’s leading the Ebola response in Mali.
The imam traveled to Bamako with four family members. On 25 October he was admitted to Clinique Pasteur hospital in the capital, suffering from kidney failure and later died, medical sources said on Tuesday.
The body was transported back to Kouremale, on the border of Mali and Guinea, where it was buried without the necessary precautions being taken, according to health officials. All four family members traveling with the imam later fell ill. One man died, another tested positive for Ebola. The two remaining travel companions are in Kouremale where they have refused to seek medical care.
Separately, the imam’s daughter died on 9 November. It has not been confirmed if she died of Ebola. Two other suspected cases, another relative of the imam and a doctor who treated the man at the clinic, are hospitalised and being monitored. Six members of hospital staff at Clinique Pasteur, who handled the nurse’s body, have been isolated.
In Bamako 45 people, most of them family members of the Muslim cleric, are isolated in their homes. They are being monitored regularly, according to Sow. He said the people in the clinic in Bamako will remain there for 21 days, unless another solution is found.
At least 200 people are believed to have been in contact with the imam since he fell ill. On Wednesday health workers and volunteers began tracing these people in Mali and Guinea.
The bodies of Ebola victims are contagious for up to three days after death, raising the prospect of further infections. In a statement on Twitter, Mali’s information minister, Mahamadou Camara, said “prevention measures” were being taken but gave no details on the case.
Outside Clinique Pasteur a woman in a purple dress with a baby on her arm appears and is urged to go back inside by the dozen or so policemen stationed at the entrance.
“We are not prisoners here, or are we?” she asks.
“Since last night the patients [have been] left without care and food,” said Maiga. Our regular cleaning team was not let in this morning. There are staff left to give proper care to the patients.”
He feared the situation would get tense. “The government can’t keep patients and staff locked up like this. They are making a very bad decision.”
The new case came a day after the WHO said it had released from isolation 25 of 108 people thought to have come into contact with Mali’s first victim: 29 people in Bamako have been isolated and are being monitored in their homes, while the authorities are still looking for nearly 50 people who may have been infected.
The two-year-old died in Kayes on 24 October after returning from a trip to Guinea. The infection triggered panic as the child had travelled more than 750 miles by bus and taxi with her grandmother, sister and uncle, making frequent stops. They also spent two hours in Bamako, visiting relatives in a house of 25 people.
The national laboratory in Bamako has tested seven people suspected of having the virus – including the girl’s grandmother and sister – and all tests have been negative.
Dr Abdouramane Koungoulba, the paediatrician who first examined the girl, said: “We never had Ebola in Mali before. Even if we knew how to recognise the symptoms and how to treat the person, we lacked experience.” But now, he added, “we know what to expect”, raising hopes that Mali will be able to act swiftly in containing the second case.
Meanwhile, the WHO said Ebola cases are “still skyrocketing” in the west of Sierra Leone, including the capital Freetown. In Liberia, however, the government reports that new cases have dropped from a daily peak of more than 500 in September to around 50. Cases have been identified on a much smaller scale in Nigeria, Senegal, Spain and the US.
The virus kills around 70% of its victims, often shutting down their organs and causing unstoppable bleeding.
