Ebola in Mali: The Guinea-Mali Connection

Potential for Ebola Spread Along Route from Guinea to SW Mali

Some important details were revealed by WHO today regarding Mali’s first recorded case of Ebola, and the situation does not look good.

The two-year-old girl who died on 23 October had recently arrived from Guinea accompanied by her grandmother. Her first contact with the country’s health services occurred on 20 October, when she was examined by a health care worker at Quartier Plateau in Kayes, a city of about 12,000 people near the border with Senegal.

The health-care worker referred the grandmother and child to the Fousseyni Daou Hospital, in the same city, where she was admitted to the pediatric ward on the following day. Symptoms on admission included a fever of 39°C (102.2°F), cough, bleeding from the nose, and bloody diarrhea.

She tested positive for typhoid fever, but not malaria, and was given acetaminophen for fever, but did not improve. It wasn’t until three days after she initially presented that Ebola was confirmed. She died that day.

Long, infectious travel route a concern

Of major concern is the extensive travel history of the child and her grandmother. The grandmother traveled from her home in Mali to attend a funeral in the town of Kissidougou, in southern Guinea. This is home to the Mel-speaking Kissi, and very close to the Mande-speaking Koranko, both ethnic groups with Poro (variously called Poro, Tɔɔma vandiamua, or Komo by the former, and Gbangbani among the Koranko).

The region near Kissidougou in Guinea where the first Mali Ebola patient attended her mother’s funeral. This is home to the Kissi, and very close to the Koranko. (From Carey 2007).

The funeral may have been for the child’s mother, who was reportedly symptomatic with Ebola before her death, but this has yet to be confirmed. On 19 October, the grandmother left Kissidougou to return to Mali, taking the child with her on public transportation. The girl’s nasal bleeding began while they were still in Guinea, meaning that the child was symptomatic, and therefore infectious, during their travels through Guinea and Mali. Travel was by public bus through the towns of Keweni, Kankan, Sigouri, and Kouremale to Bamako. They stayed in Bamako for two hours before travelling on to Kayes.

Considering that the first patient out of the more than 10,000 cases to date was one 2-year-old boy in Guédéckou, Guinea, the tremendous opportunity for viral spread all along this travel route in ominous.

Kayes is near the borders of Guinea-Bissau and Senegal, and only 420 kilometres (260 mi) northwest of the capital Bamako.

Carey, Neil. 2007. Masks of the Koranko Poro: Form, Function and Comparison to the Toma. Amherst: Ethnos.

_________. 2013. Comparative Native Terminology of Poro Groups. Secrecy: Journal of  the Poro Studies Association, 1(1), 1-21.

_________. (2014). Art of the Kissi.  Retrieved October 8, 2014, from HTTPS://www.porostudiesassociation.org/art-liberian-kissi/

WHO. (2014). Mali Confirms its First Case of Ebola: Ebola SitRep 24 October 2014.  Retrieved October 25, 2014, from HTTPS://www.who.int/mediacentre/news/ebola/24-october-2014/en/

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