Last Ebola patient discharged in Liberia

Liberia’s last Ebola patient was discharged Thursday after a ceremony in the capital, Monrovia, bringing to zero the number of known cases in the country and marking a milestone in West Africa’s battle against the disease.

Officials in Monrovia, the city where the raging epidemic littered the streets with bodies only five months ago, celebrated even as they warned that Liberia was at least weeks away from being officially declared free of Ebola.

They also noted that the disease had flared up recently in neighbouring Sierra Leone and Guinea, the two other countries hardest hit by Ebola.

"It was touching, it was pleasing," Tolbert Nyenswah, the deputy health minister in charge of Liberia's fight against Ebola, said in a telephone interview about the ceremony. "There was a lot of excitement because we feel that this is a victory."

“But it’s not over yet,” he added. “We are still cautioning people. We told them they must still protect their villages, their towns. They should report any suspicion of Ebola to the health teams. We still have a response that is tight. Yeah, we made that point.”

“But,” Mr Nyenswah said, “it’s exciting, man.” The authorities are still tracking more than 100 people for possible exposure to the virus. As of Thursday, no new cases of Ebola had been confirmed inside Liberia for the past 13 days, Mr Nyenswah said. If no new cases emerge, the epidemic in Liberia will be considered over officially April 4, or 42 days after the last known infection.

The 42-day marker is twice the longest incubation period for Ebola, 21 days. Liberia has suffered the highest number of deaths during the epidemic, with 4,117 recorded victims, according to the World Health Organisation.

More than 9,800 people have died in total. The health organisation reported Wednesday that new cases had increased sharply - to 132 from 99 - in Sierra Leone and Guinea in the week before March 1st.

Transmission remains widespread in Sierra Leone, and Conakry, the capital of Guinea, suffered a marked increase, according to the organization.

On Thursday, the last patient being treated in Liberia, Beatrice Yardolo, a 58-year-old English teacher, was released from a treatment centre in Monrovia built by the Chinese government. Mrs Yardolo, who lost two sons and a daughter to the disease, was treated for Ebola at the centre and tested negative Tuesday.

"I feel fine to be back home with my family after being away for almost three weeks - I feel very proud,"Mrs Yardolo said in a telephone interview. "I'm very grateful to God because he does everything." Music could be heard from inside her family home in Monrovia, the sound of the festivities amplified by a loud rooster. Her husband, Steve Yardolo, said: "I think you hear the music. We are happy. The family is sitting around here, and we continue to celebrate." Mrs Yardolo's case was part of a recent outbreak in a community called St Paul's Bridge, located in what was one of the biggest Ebola hot spots in Monrovia, New Kru Town. The outbreak was unusually violent and far-reaching, in part because it involved criminal gangs that did not cooperate with the authorities and fears that it could be spread through a knife fight with one member nicknamed Time Bomb.

The recent outbreak in St Paul’s Bridge also exposed the continuing weakness in Liberia’s health care system, as patients with Ebola were admitted to health clinics that had failed to carry out proper triage. Hundreds of health care workers at half a dozen health clinics were placed under quarantine for possible exposure, although none of them became infected.

In Mrs Yardolo's case, her infection was traced to her oldest son, Steve (32) who worked as a hygienist at an Ebola treatment centre. He was infected fatally while performing his duties or interacting with a sick neighbour, Dr Mosoka Fallah, Liberia's chief epidemiologist, said by telephone.

“Steve was a popular member of the community and a member of a local group of intellectuals,” Dr Fallah said. “It’s a big loss.” The virus was transmitted to other members of his family, including a brother, Elijah (30) and a sister, Amanda (20), both of whom died. Believing that Amanda was suffering from appendicitis, her family took her to a clinic where she was treated.

Dr Fallah said the transmission inside this family was typical of how the disease had spread during the epidemic as a whole. "It started from somebody getting it from outside the family and bringing it to the family, a caregiver who gives it to the rest," he said.

Mrs Yardolo, who was taking care of Amanda, was eventually also infected. But unlike her family members, she reacted quickly and survived. “The moment I started getting the signs and the symptoms, the next day I said they should send an ambulance to carry me to the centre,” Mrs Yardolo said. “So because of going early I felt that God will take care of things, and he did.” Although her family, including three other children, could still be heard celebrating, Mrs Yardolo grew silent for several seconds at the thought of the three who had died. “It’s so heartbreaking,” she said. “However, we have to let go somehow and celebrate my life with the rest of the children.”

NYT