West Africa struggles to contain Ebola outbreak.

Guinea is struggling to contain west Africa’s first major Ebola outbreak. Laboratory tests have confi rmed an appearance of the Zaire strain—the most deadly subtype of the virus— originating in the impoverished country’s rural southeast. Of the more than 100 suspected infections, at least 70 people have died, according to the country’s health offi cials. Four of the dead are health workers. If the initial fatality reports hold, Guinea’s outbreak is already deadlier than recent appearances of the disease in DR Congo in 2012 and in Uganda that same year. An estimated 25 people died during the DR Congo outbreak and 21 in total during the two occurrences in neighbouring Uganda. With no vaccine to stem the spread of the disease, there are worrying signals that the situation in Guinea will worsen. By late March the highly infectious disease had made its way to the densely populated coastal capital, Conakry—home to at least 15% of the country’s population. Concerns were immediately raised about the virus spreading to neighbouring Liberia and Sierra Leone. On March 30, Liberia notifi ed WHO that it had two laboratory-confi rmed cases. The disease’s spread complicates the job of the international teams who have been called in to contain the outbreak. They were already playing catch up—the consequence of a sparse health-care system and a location where many diseases, including Lassa fever, share Ebola’s symptoms. That made the appearance of the disease, which might have been as early as February, diffi cult to confi rm. And it continues to hinder eff orts to isolate and contain the ongoing outbreak. “In Guinea, Sierra Leone, and Liberia, the health systems are not so strong”, said Adinoyi Ben Adeiza, the International Federation of Red Cross and Red Crescent Societies’ (IFRC) health coordinator in Africa. “This is not the kind of outbreak they are used to dealing with on a day-to-day basis. It calls for additional expertise, additional resources.”