DAKAR, Mar 20 (Thomson Reuters Foundation) - The latest spike in Guinea's Ebola cases could be a sign that aid teams are at last gaining access to hidden patients, rather than a surge of new cases, a senior World Health Organization (WHO) official said.
The number of suspected cases in the West African country has more than doubled from last month, according to the health ministry, prompting fears the epidemic could mushroom as it did in Liberia and Sierra Leone in September.
However, Jean-Marie Dangou, the WHO's Guinea country representative, said the uptick in cases was explained by previously hostile communities opening up to Ebola teams, mainly lead by the Red Cross.
"Unfortunately this has led to the discovery, not unexpected, of a large number of hidden cases and community deaths," Dangou told the Thomson Reuters Foundation in an email.
"It also explains why most new cases are not linked to contacts under follow-up."
The worst Ebola outbreak in history, which has killed more than 10,000 people in West Africa, appears to be on the wane, especially in Liberia where there are no current cases.
But there is still resistance to the anti-Ebola effort in Guinea, which is struggling to control the outbreak and has overtaken Sierra Leone as the main hub for transmission.
The Red Cross intensified its campaign to win over suspicious locals in Guinea last month after the Thomson Reuters Foundation reported their Ebola teams were coming under increasingly violent attacks on a regular basis.
Hostility toward Ebola aid workers has declined from 30 known areas of resistance in January to a handful of areas in the capital Conakry and the surrounding districts in March, according to incident mapping by the health ministry.
However, some health workers involved in the Ebola response pin the rise in cases to a lack of resources and poor training.
Earlier this year, labs in Guinea botched more than 20 Ebola blood tests which led to the release of at least four positive patients, two of whom later died, health officials told Reuters.
Stemming the spread of the virus in and around the crowded city of Conakry presents the biggest challenge, especially in the districts of Coyah and Forecariah that are the source of most chains of transmission, said Dangou.
David Heymann, of Public Health England, who dealt with the Ebola outbreak in what was then Zaire in 1976 as well as subsequent epidemics in Africa, said the proven way to stop Ebola transmission is through isolation and knowledge.
"It doesn't surprise me that in Liberia where there has been a much more intense Ebola information campaign, quarantine and a military intervention that the disease has been brought under control faster than in Guinea," Heymann said by phone from London.
In an election year, Guinea President Alpha Conde has pledged to reach zero Ebola cases by mid-April, but has so far avoided quarantine measures or the foreign-backed military interventions used in Liberia and Sierra Leone.
(Additional reporting by Emma Farge; Editing by Ros Russell)