The three West African nations ravaged by Ebola could struggle to prevent another major outbreak as vigilance fades among health workers and the public, a health expert said on Monday.

Ebola victims in recent flare-ups in Liberia and Sierra Leone were inspected by health workers who were not wearing protective clothing, while the corpse of one woman victim was washed by several people, contrary to best practice.

Health facilities must reinforce infection prevention and control measures or risk widening the spread of new Ebola outbreaks, according to Armand Sprecher, public health specialist at medical charity Medecins Sans Frontieres (MSF).

 How the outbreak and WHO's response unfolded

WHO's response to the Ebola virus disease outbreak in West Africa had 3 phases. Phase 1 focused on rapid scale-up of the response; phase 2 focused on increasing capacities, phase 3 focused on interrupting all remaining chains of Ebola transmission, and responding to the consequences of residual risks.

Phase 1: Rapid scale-up of the response

In Phase 1 (August – December 2014), WHO and its partners focused on rapid scale-up of the response. This included:

• Increasing the number of Ebola treatment centres and patient beds.
• Rapidly hiring and training teams in safe and dignified burials.
• Strengthening social mobilization capacities.

Work in these areas began in August 2014, as the outbreak exploded, and continued through the end of December. During this period, the UN Mission for Ebola Emergency Response (UNMEER) was launched.

The World Health Organization has joined the government of Sierra Leone in marking the end of the recent flare-up of Ebola virus disease in the country, but warned that the country, Liberia and Guinea are still at risk.

“As of today, March 17, 42 days have passed, two incubation cycles of the virus, since the last person confirmed to have Ebola virus disease in the country tested negative for a  second time,” a statement issued by the WHO and copied to the Ghana News Agency said.

“This latest flare-up of Ebola brings to 3,590 the number of lives lost in Sierra Leone to an epidemic that devastated families and communities across the country and disrupted every aspect of life. Today marks another milestone in the country’s effort to defeat Ebola,” it said.

When the Ebola outbreak was confirmed in Guinea two years ago, one of the reasons the virus spread so quickly was due to the high amount of people traffic across the borders of Guinea, Liberia, and Sierra Leone. To mitigate the introduction of new Ebola cases or other diseases by cross border travellers, the Red Cross has introduced a community event-based surveillance system. It is successful, in large part, due to the engagement of community members.