Community funerals, where people help to wash the body of the person who died, have been identified as a key transmission route – especially as the virus’ incubation period is between two days and three weeks, though generally around 10 days.
This means the nurse, who died on January 28 after being transferred to a hospital in Nzérékoré for treatment, may have been infected four weeks ago – providing space for the virus to spread.
“We simply won’t know until some surveillance has happened whether, or how widely, the virus has spread,” Anja Wolz, an Ebola emergency coordinator at Médecins Sans Frontières (MSF), told The Telegraph.
“Since the first known person to get the disease in this outbreak was a healthcare worker, it is a fair assumption that there were already other cases in the community. It would be realistic to think there has been some transmission.”
Dr Georges Ki-Zerbo, head of the World Health Organization’s (WHO) office in Guinea, added that responders are working on the assumption that more cases will be detected as “we are at the beginning of the outbreak.”
He said the first epidemiological surveillance team departed for Gouéké on Monday to trace how the outbreak began, while community surveillance has been enhanced and known contacts will be quarantined to “try and interrupt known chains of transmission”.
There have now been well over 30 outbreaks of Ebola since it was first detected in 1976, the vast majority in central Africa. This is the first resurgence of the virus in Guinea since a devastating outbreak between 2013 and 2016.
That epidemic began in a village called Meliandou – close to Guinea’s borders with Sierra Leone and Liberia – when a two year old boy fell ill and died in December 2013.
The virus silently spread for months before it was identified. When it reached Conakry, Guinea’s capital, in March 2014 “new cases hit like sparks from a fire landing on dry grass,” according to a WHO report. “The bushfire had begun.”
By the time the outbreak was contained in 2016, 28,616 people had been infected and 11,310 died – the worst Ebola epidemic in history. Guinea, Sierra Leone and Liberia bore the brunt.