By Stephanie Nebehay
GENEVA (Reuters) - The death toll from the Ebola outbreak in West Africa's three hardest-hit countries, Guinea, Liberia and Sierra Leone, has risen to 5,147 out of 14,068 cases at the end of Nov. 9, the World Health Organization (WHO) said on Wednesday.
A further 13 deaths and 30 cases have been recorded in five other countries - Nigeria, Senegal, Mali, Spain and the United States, the U.N. agency said.
"There is some evidence that case incidence is no longer increasing nationally in Guinea and Liberia, but steep increases persist in Sierra Leone," the WHO said in a statement. "Cases and deaths continue to be under-reported in this outbreak."
Some 421 new infections were reported in Sierra Leone in the week to Nov. 9, especially in the west and north, it said.
Ebola is still spreading intensely in Sierra Leone's capital of Freetown, with Koinadugu and Kambia northern regions now "emerging areas of concern", it added.
The virus is spreading rapidly in Macenta in Guinea's southwest near the Liberian border and to a lesser extent in Siguiri bordering Mali, it said, calling for a high level of vigilance due to the district's proximity to its neighbor.
There have been a total of four confirmed and probable cases in Mali and four deaths, the WHO said. A two-year-old girl who died of Ebola last month in Mali was among the fatalities, but her infection was not linked to the latest cases, it added.
More than 90 people were quarantined across the Mali capital of Bamako on Wednesday after a 25-year-old nurse died of Ebola after treating a Guinea man who died after showing Ebola-like symptoms.
In Liberia, which reported 97 new cases in the week to Nov. 8, the Montserrado district which includes the capital Monrovia accounted for nearly half, the WHO said. However, cases continue to decline in Lofa county.
Only 19 of 53 Ebola treatment centers planned in Guinea, Liberia and Sierra Leone are in operation, the WHO said.
An estimated 370 trained teams are needed to conduct safe burials in the three countries with widespread and intense spread of Ebola, but only 140 teams are on the ground, it said.
(Reporting by Stephanie Nebehay; Editing by Andrew Roche)