Guinea has declared an outbreak of Ebola after seven confirmed cases and at least three deaths, a leading health official in the West African nation said on Sunday.  

In a region that was previously the starting point for the world’s worst outbreak of Ebola, the cases mark the first known resurgence of the disease since the 2013-2016 epidemic that killed more than 11,300 people. 

Although the COVID-19 pandemic has limited the availability of health resources worldwide, the World Health Organization (WHO) is rushing newly developed vaccines to Guinea to help contain the outbreak, as well as setting up testing, contract tracing and treatment facilities.

1. How did the outbreak occur?  

The exact origin of the original infection is unknown, but health officials in Guinea have traced the outbreak back to the funeral of a nurse at the beginning of February in Goueké, near the south-eastern city of Nzérékoré.      

All seven cases attended the funeral and later reported symptoms of diarrhea, vomiting and bleeding. At least three of these people have died, the others remain in hospital.  

Traditional burials in west Africa, where washing the corpses — which can be especially toxic if infected with Ebola — of the deceased is commonplace, have previously been identified as a common way of spreading the disease. The incubation period for the disease can last from two days to three weeks.

Guinea's outbreak comes one week after the Democratic Republic of Congo (DRC) confirmed two Ebola deaths —  three months after the central African nation declared the end of a six-month epidemic in November 2020, which claimed 55 lives out of 130 cases.

The cases in Guinea and the Congo are not thought to be linked. 

2. What is Ebola? 

Ebola is a zoonotic disease that passes to humans from infected animals — such as fruit bats, chimpanzees and forest antelopes — through direct contact with bodily fluids, organs and blood, or indirectly through contact with contaminated areas. Studies have shown that some species of fruit bats, in particular, can harbor Ebola.

Sufferers can experience fevers, muscle pain, a sore throat, diarrhea, vomiting, and bleeding both internally and externally. They usually die from dehydration or multiple organ failure. It's highly contagious and has a high mortality rate — but unlike the coronavirus, patients experience obvious and immediate symptoms that make the disease much easier to track. 

Experts traced the 2014 Ebola outbreak back to bats that lived in a hollow tree where children played in a remote part of Guinea, pinpointing the first victim as an 18-month-old boy. The virus was identified for the first time much earlier, though — in 1976 in Zaire, now known as the Democratic Republic of the Congo. 

3. What vaccinations can help?  

In response to the 2014-2016 Ebola epidemic, several vaccines were developed and trialed and have been successfully used to stamp out outbreaks in the Democratic Republic of Congo. 

The main vaccine used against Ebola is the Ervebo vaccine, manufactured by Merck, which is a single-dose injection that needs to be cooled at about -80 degrees Celsius — four times colder than a household freezer. 

Ervebo was first trialed in Guinea in 2015 and is a live, attenuated vaccine that has been genetically engineered to contain a protein from the Zaire ebolavirus. Some 16,000 people have already received the Ervebo vaccine in Guinea, and around 350,000 in the DRC.

Another vaccine licensed for use against Ebola is the Johnson&Johnson vaccine, Zabdeno, which requires two doses, 56 days apart, and thus tends to be more difficult to administrate in emergency scenarios.  

In January 2021, the WHO said it was creating an emergency stockpile of 500,000 doses of the Merck Ebola vaccine, but only 7,000 were available at that point in time. 

"The WHO is on full alert and is in contact with the manufacturer [of a vaccine] to ensure the necessary doses are made available as quickly as possible to help fight back," Alfred George Ki-Zerbo, the WHO representative in Guinea, told the AFP news agency. 

Guinea and neighboring Liberia and Sierra Leone have a combined population of 22.5 million, which has raised some concerns that manufacturers may struggle to produce enough of the vaccine — especially during a time when coronavirus vaccines are seen as a priority.

4. How can we stop outbreaks? 

Experts say containment is key to fighting the disease.  

One reason the previous outbreak was so deadly and long-lasting was because it wasn't detected immediately and the response from health authorities was slow, the AP news agency reported.

This time around, health officials are working to trace all contacts, isolate all suspected cases, and administer vaccines from the WHO as fast as possible, the Guinean minister of health said in a statement posted on Facebook. 

Neighboring Liberia and Sierra Leone have already been put on high alert as a precaution, despite not recording any infections as of yet.

Traditional burial practices and the ongoing consumption of bushmeat have often been called into question when considering how best to stamp out Ebola infections.

Previous research has shown that the criminalization of bushmeat as a prevention strategy can fuel distrust around public health messaging. This is particularly the case in communities struggling with the economic and social knock-on effects of Ebola outbreaks. It can also drive it underground.

Although the risk of transmission between animals and humans, as opposed to humans to humans, is comparatively low, experts warn that increasing encroachment into wildlife habitats only further raises the risk of infection  — as the world has witnessed with the coronavirus pandemic.