Downward Ebola trend suddenly reverses itself

The volatility of the Ebola epidemic that has raged across West Africa the past year was evident this week when an encouraging downward trend in infection rates suddenly reversed itself.

Health officials recorded a jump to 124 new cases of the deadly virus this week over the previous seven-day tally of 99. It's the first time all three stricken countries — Guinea, Sierra Leone and Liberia —- simultaneously recorded increases, however small.

In Liberia, which has seen the highest success rate in abating the disease, five new cases were reported, compared with four the prior week. Guinea went to 39 cases from 30, and Sierra Leone to 80 new infections from 65.

"One week does not make a trend," said Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, which has more than 200 staff working in West Africa on tracing people exposed to the virus, among other duties. "But it shows how long and hard the road to zero is."

USA TODAY reported Wednesday that President Obama has chosen to largely shut down the U.S. military operation in Liberia over the next several weeks. At one time, nearly 3,000 troops were busy building clinics and training staffers. But infection rates in Liberia have declined to fewer than one per day, and the clinics are largely empty now.

Hundreds of troops are heading home in a series of flights, to be replaced by a residual force of about 100 servicemembers by the end of March.

"In Liberia, we're clearly in much better shape (fighting Ebola) than the other two countries," Frieden said.

The outbreak in Guinea was blamed in part on an unsafe burial, according to the World Health Organization (WHO), a circumstance where traditional rituals result in the body of an Ebola victim being touched and washed repeatedly, the remains teeming with the virus.

Health workers are struggling in remote areas of Guinea to convince villagers that these traditional burial rites must be set aside in favor or of immediate, safe disposal through burial or cremation.

"It's not easy to persuade people to change burial practices," David Nabarro, the United Nations special envoy on Ebola, told reporters Thursday in Geneva.

The current infection rate, however, still pales in comparison with weekly sums of several hundred new cases back in September, when the virus was out of control. But U.N. officials said the "uptick" was a wake-up call that full control over the virus remains out of reach.

"The outbreak still presents a grave threat," Nabarro said. "And we really hope there will be no complacency among anybody involved in the response."

Defeating the disease requires identifying and tracking every person who had contact to someone who was ill. About 11,000 workers are doing contact tracing in West Africa, Nabarro said. Bruce Aylward, a WHO special representative on the Ebola response, said the investment is paying off.

In Liberia, all five new infections were among people who were being tracked, and the same was true with well over 50% of the new infections in both Guinea and Sierra Leone, Aylward said.

"I think there is a spring in our step," Frieden said of his CDC workers working in West Africa, "because we see that zero is definitely possible."