Ebola reaches Guinean capital, stirring fears

Relief workers from Doctors Without Borders carried a body on Tuesday at a center for Ebola victims in Guéckédou, a town in Guinea at the heart of an epidemic that has killed more than 80 people

An outbreak of the deadly Ebola virus in the West African nation of Guinea has reached the crowded capital, Conakry, prompting new fears about its spread, health officials said Tuesday.

Over the past month, the disease has traveled from Guinea’s remote forest regions near the Liberia and Sierra Leone borders and has already killed 83 people, including four in Conakry.

Now, with 13 cases in a densely populated capital of two million people, health officials say the challenge of containing the outbreak has become more acute. Ebola has killed hundreds in rural Central Africa over the past four decades, but it is unusual for it to reach urban centers.

Residents of Conakry said Tuesday that disquiet had set in, though markets were crowded and the capital’s monstrous traffic jams continued unabated. Some were carrying around small bottles of bleach, people were avoiding shaking hands, and pharmacies were selling out of hand sanitizer.

“In Conakry everybody is worried,” said Fodé Abass Bangoura, a lawyer with an office downtown. “People are really preoccupied about this. There is a sort of psychosis about this now. I’m avoiding physical contact with people, and I’m eating at home.”

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Major clean-up underway in Guinea’s capital in the fight to contain what could be an unprecented epidemic. Paul Chapman reports.

At some grocery stores that serve expatriates, clerks are wearing gloves, and sanitizer is being distributed at restaurants. Health workers have been going into the capital’s crowded markets, warning people about the disease through megaphones and distributing chlorine soap.

Marker shows the location of Macenta, in the southern interior. The capital Conakry is on the coast

Even more worrying than the presence of Ebola in Conakry, health officials said, is its deadly presence at both ends of the country.

“It’s the combination of having quite a number of cases, and also the geographical dispersion,” said Dr. Hilde de Clerck of Doctors Without Borders, the global medical charity. “Now that it has reached Conakry, it is also special, and a bit more scary.”

Senegal has closed its border with Guinea. About half a dozen suspected cases and two confirmed cases have been identified in neighboring Liberia, officials said. The center of the epidemic remains in Guinea’s remote forest region, around the towns of Macenta and Guéckédou, where isolation wards have been set up.

The Ebola virus is rare but deadly. Its point of origin is often the consumption of bush meat, including meat from apes or possibly bats, and it has a fatality rate of up to 90%. Human transmission occurs through contact with bodily fluids. Already, the Guinea outbreak is more serious than the most recent previous one, in Uganda in 2012, when fewer than 50 died. In that outbreak, cases were also recorded in the capital, Kampala. But in some previous outbreaks in Central and Eastern Africa, as many as 400 cases were recorded, health officials said.

Death is painful, with high fever, severe headache, vomiting, diarrhea and profuse bleeding. Health workers are often among the first to die, and they must take extraordinary precautions to avoid being infected when helping patients, including wearing head-to-toe biohazard suits. The heat inside the suits can be intense, and health workers are counseled not to wear them for more than 15 minutes.

The remaining cases in Conakry are in an isolation ward at the city’s main hospital, Dr. de Clerck said. The current Conakry cases all emanate from an initial infection — five medical workers who treated it, and eight family members — so there is some hope that the disease in the capital can be contained.

“It’s a good sign that the epidemic has not yet spread,” Dr. de Clerck said. “There is no evidence, for now, that it is spreading to other parts of the city. So there is a little bit of hope for the city.”

The World Health Organization is monitoring about 400 people in Guinea for 21 days in order to “break the chain of transmission,” said Gregory Hartl, its chief spokesman. “If they start showing symptoms, we ask them to isolate.”

“The fortunate thing with Ebola is, it’s quite difficult to transmit,” Mr. Hartl said. “You have to touch someone. Fortunately for the greater population, the risks are quite small.”