A report in The New England Journal of Medicine traces the spread of the recent Ebola outbreak from Gueckedou, Guinea, to nations worldwide. As The NY Times reports, West African governments have gone 'medieval' as they have revived a disease-fighting tactic not used in nearly a century: the “cordon sanitaire,” in which a line is drawn around the infected area and no one is allowed out. And most worryingly, Reuters reports that a nurse who had close contact with a Liberian Ebola patient skipped quarantine in Lagos and went to her home in the eastern city of Enugu, where she made contact with 20 other people.
Cordons, common in the medieval era of the Black Death, have not been seen since the border between Poland and Russia was closed in 1918 to stop typhus from spreading west.
The phrase cordon sanitaire, or sanitary barrier, appears to date from 1821, when France sent 30,000 troops into the Pyrenees to stop a lethal fever raging in Spain from crossing the border.
Plans for the new cordon were announced on Aug. 1 at an emergency meeting in Conakry, Guinea, of the Mano River Union, a regional association of Guinea, Sierra Leone and Liberia, the three countries hardest hit by Ebola, according to Agence France-Presse. The plan was to isolate a triangular area where the three countries meet, separated only by porous borders, and where 70 percent of the cases known at that time had been found.
“It might work,” said Dr. Martin S. Cetron, the disease center’s chief quarantine expert. “But it has a lot of potential to go poorly if it’s not done with an ethical approach. Just letting the disease burn out and considering that the price of controlling it — we don’t live in that era anymore. And as soon as cases are under control, one should dial back the restrictions.”
* * *
But here is how it started...
* * *
But, as Reuters reports, containment is a problem:
A nurse who had close contact with a Liberian Ebola patient skipped quarantine in Lagos and went to her home in the eastern city of Enugu, where she made contact with 20 other people, the government said on Wednesday.
Information Minister Labaran Maku said the nurse, herself a suspected case, and her 20 contacts were all under surveillance in Enugu, bringing the total number being watched in Nigeria to 189.