Africa stems Ebola via border closings, luck

NAIROBI, Kenya (AP) — Health officials battling the Ebola outbreak that has killed more than 4,500 people in West Africa have managed to limit its spread on the continent to five countries — and two of them appear to have snuffed out the disease.

The developments constitute a modest success in an otherwise bleak situation.

Officials credit tighter border controls, good patient-tracking and other medical practices, and just plain luck with keeping Ebola confined mostly to Liberia, Sierra Leone and Guinea since the outbreak was first identified nearly seven months ago.

Senegal did so well in finding and isolating a man with Ebola who had slipped across the border from Guinea in August that the World Health Organisation on Friday will declare the end of the disease in Senegal if no new cases surface.

Nigeria is another success story. It had 20 cases and eight deaths after the virus was brought by a Liberian-American who flew from Liberia to Lagos, Nigeria’s commercial capital of 21 million people, in July. Nearly 900 people were potentially exposed to the virus by the traveller, who died, and the disease could have wreaked havoc in Africa’s most populous nation.

Instead, Ebola appears to have been beaten, in large part through aggressive tracking of Ebola contacts, with no new cases since August 31.

WHO, the UN health agency, called it “a piece of world-class epidemiological detective work”. The organisation is set to declare an end to the outbreak in Nigeria on Monday.

Nigeria had a head start compared with other West African countries: Officials were able to use an emergency command centre that had been built by the Bill and Melinda Gates Foundation to combat polio.

Border closings may also be helping halt the spread of Ebola.

Ivory Coast, Guinea-Bissau and Senegal, all of which share borders with at least one of the three most affected countries, have closed those borders.

The disease continues to ravage Liberia, Guinea and Sierra Leone, overwhelming their health systems.

And some observers warn that border closings can have limited effect in a region with highly porous boundaries and few resources to patrol them. Border posts are sometimes easily skirted.

There is also concern that travel restrictions will make things worse in the affected countries by creating what amounts to an economic embargo.‏