Category Archives: Sierra Leone

Three New Cases of Ebola Reported in Sierra Leone

Authorities in Sierra Leone reported Tuesday that three more patients have tested positive for Ebola in a village in the northern region of the country that is already under quarantine in the wake of the death of a 67-year-old woman.

According to the National Ebola Response Centre (NERC), the new cases, which were diagnosed on Monday, bring the total in a recent outbreak in Sella Kafta in the district of Kambia to five. Speaking to reporters in the capital Freetown, NERC spokesman Sidi Yahya Tunis disclosed that the three new cases were amongst the fifty “high risk persons” who have been identified as being close relatives of the food trader, who died on 28 August. He further disclosed that “the development remains a concern for us but since it has taken place within a quarantined home, it can be adequately monitored and further transmission can be contained.”

The latest outbreak brought to an abrupt end the optimism that was fuelled by the release of what had been the West African country’s last known Ebola patient from a hospital in the central city of Makeni in late August. In the wake of the latest Ebola death, Sella Kafta, a village of almost 1,000 people, was placed under a three-week quarantine lockdown.

Ebola Update (25 June 2015)

Despite hopes rising that the Ebola outbreak in West Africa could soon be contained, after Liberia was declared free of the deadly virus in early May, the latest figures released Wednesday by the World Health Organization (WHO) indicate that the outbreak is showing no signs of abating in Guinea and may be flaring up once again in neighbouring Sierra Leone.

In the week leading up to 21 June, there were 20 confirmed cases of Ebola virus disease (EVD) compared with 24 cases that were recorded the week before. According to officials, while the weekly case incidence has stalled between 20 – 27 cases since the end of May, cases continue to arise from unknown sources of infection and are typically detected only after post-mortem testing.

During this reporting period, only 6 of the 12 cases that were reported in Guinea and 4 of the 8 cases reported in Sierra Leone were registered contacts of previous cases. As of 21 June, there were 2,003 contacts being monitored across 4 prefectures in Guinea and 1,023 contacts were under follow-up in 3 districts in Sierra Leone.

There have been a total of 27,443 reported confirmed, probable and suspected cases of EVD in Guinea, Liberia and Sierra Leone, with 11,207 reported deaths.

Guinea

During this reporting period, Guinea confirmed 12 cases in the same four prefectures as reported cases in the previous week: Boke, Conakry, Dubreka and Forecariah. According to WHO officials, while cases have been reported from the same 4 prefectures over the past three weeks, data indicates that the area of active transmission within these prefectures has changed and in some cases, it has expanded.

In the northern prefecture of Boke, which borders Guinea-Bissau, officials have reported that the main focus of transmission has switched from the coastal sub-prefecture of Kamsar to the more urbanized sub-prefecture of Boke Centre. In the week leading up to 21 June, two cases that were reported in Boke were health workers.

During this reporting period there was one case reported in the capital Conakry. The case was recorded in the Matam area of the city and arose from an unknown source of infection. Three cases that were reported in the capital city in the previous two weeks are suspected to have generated a large number of high-risk, untraced contacts.

In Dubreka, one case was reported during this period in the sub-prefecture of Tanene. While the origin of this case currently remains unknown, officials have disclosed that preliminary investigations indicate that it is linked to previous cases in the same sub-prefecture.

The prefecture of Forecariah continues to be the most complex in terms of transmission, with multiple chains of transmission remaining active across 3 sub-prefectures. This has been an issue that has affected this prefecture over the past several months. In the week leading up to 21 June, three of the 5 cases that were reported in Forecariah arose from an unknown chain or chains of transmission.   Furthermore, two of those three cases were reported from a sub-prefecture, Benty, which has not reported a confirmed case since mid-March. Both cases in Benty and another possible related case from a neighbouring sub-prefecture were identified after post-mortem testing was carried out.

The upcoming election, due to be held in October, is now adding another layer of worry to both Guineans and local health workers, with some residents stating that campaign events, where people crowd together, should not be held yet. 

Sierra Leone 

During this reporting period, Sierra Leone recorded 8 cases in three districts: Kambia, Port Loko and the district that includes the capital city, Freetown, which reported confirmed cases for the first time in over two weeks.

Compared with neighbouring Guinea, transmission in Sierra Leone has been more geographically confined over the past three weeks, with cases remaining clustered in several chiefdoms of the districts of Kambia and Port Loko. However, figures for this reporting period indicated a worrisome development, as 2 cases were reported from the Marampa chiefdom in Port Loko for the first time since the beginning of March. Additionally, two cases were also reported from the area that includes the capital city for the first time in over two weeks.

In Kambia, both cases were reported in the Tonko Limba chiefdom, which has been the primary focus of transmission in Kambia over the past three weeks. According to local officials, both cases are registered contacts and were residing in a quarantined dwelling at the time of symptom onset.

During this reporting period, four cases were recorded in Port Loko. Two cases were reported from the Kaffu Bullom chiefdom, which has been the origin of the majority of cases that have been reported in the West African country over the past three weeks. One of the cases, a health worker, is a registered contact of a previous case while the remaining two cases arose from an as-yet unknown source of transmission.

Officials reported Monday that over the past few days, the country has recorded two new cases of Ebola in the capital Freetown, effectively disproving the assumption that the deadly virus no longer affected the city. According to Sidi Yahya Tunis, a spokesman for the National Ebola Response Centre (NERC), “this is worrisome because we had already closed all Ebola quarantine structures in Freetown since we had gone for weeks without a case.” Tunis further disclosed that there were concerns about further infection as the two cases were reported in Magazine Wharf, which is a densely populated neighbourhood that lacks adequate hygiene facilities. Health officials have disclosed that the first case to be reported in Freetown since 29 May is a fishermen who caught the virus from his girlfriend in the northern district of Port Loko, a northern province that remains affected by Ebola. Shortly afterwards, a family member who lived in the same household also caught the virus.

Ebola Update (18 June 2015)

In the week leading up to 14 June, there was a total of 24 confirmed cases of Ebola virus disease (EVD) reported, compared with 27 cases that were recorded in the previous week. In Guinea, 10 cases were reported during this period in four prefectures: Boke, Conakry, Dubreka and Forecariah. Sierra Leone reported 14 cases in 2 districts, Kambia and Port Loko, during this reporting period.

Of the 76 confirmed cases of EVD that have been reported in Guinea and Sierra Leone over the past 21 days leading up to 14 June, 69 (91%) were reported in 3 prefectures in Guinea (Boke, Dubreka and Forecariah) and 2 districts in Sierra Leone (Kambia and Port Loko).

As of 14 June, there have been a total of 27,305 confirmed, probable and suspected cases of EVD in Guinea, Liberia and Sierra Leone, with 11,169 reported deaths.

Guinea

During this reporting period, a total of 10 confirmed cases of EVD were reported, compared with 12 cases from 4 prefectures that were reported in the previous week.

Cases were reported in 4 prefectures: Boke (2 cases); Conakry (1 case); Dubreka (4 cases); and Forecariah (3 cases). Of these 10 cases, 5 were registered contacts, including all four cases in Dubreka. Of the remaining five cases, 4 arose from an unknown source of infection. This includes both cases from Boke prefecture and 2 of the 3 cases that were reported in Forecariah.

In Guinea, health checkpoints have been set up in the western prefectures of Boke and Coyah. On 7 June officials in Dubreka carried out a 6-day door-to-door case-finding campaign, which led to the discovery of 1 confirmed case. Additionally, intensive investigations are currently underway in order to trace a number of high-risk contacts associated with 3 cases that were reported in the capital, Conakry, over the past two weeks.

Sierra Leone

During this reporting period, a total of 14 confirmed cases were recorded in 2 districts: Kambia and Port Loko, compared to the 15 cases that were reported in the same 2 districts the previous week.

For the third consecutive week, Kaffu Bullom in Port Loko reported the most cases, six in total, of any single chiefdom. According to officials, five of the six cases from Kaffu Bullom were contacts of previous cases in quarantined homes located in a small, densely populated area near the international airport. One case, however, was reported from a new area of the chiefdom, Targrin, and upon further investigation, the case was determined to have acquired infection after sharing a ward with a confirmed case in a privately run health facility. A total of twenty health workers have since been registered as having a medium – high-risk contact with the case and are currently being monitored by officials. The remaining 8 cases that were reported in Sierra Leone were registered contacts of known cases and were reported from quarantined homes in 4 chiefdoms: Magbema (1 case); Samu (1 case); and Tonko Limba (4 cases) in Kambia and Bureh Kasseh Ma (2 cases) in Port Loko. As of 14 June, the Western Urban Area, which includes the capital city Freetown, has reported no cases for over 16 consecutive days.

Officials have disclosed that all 14 cases that were reported in the week leading up to 14 June can be traced back to the secret movement of cases, contacts and secret burials of EVD-related deaths during April. Consequently, officials are planning to carry out a large-scale operation in the districts of Kambia and Port Loko.

On Friday 12 June, Sierra Leone’s President Ernest Bai Koroma announced that he was imposing a three-week daytime curfew in the last Ebola-hit areas in a bid to curb a resurgence of the deadly virus. The curfew announcement comes after the country on Thursday extended its nationwide state of emergency for 90 days, despite calls from opposition politicians to relax restrictions in the country’s Ebola-free districts.

The president made the announcement on state television, stating that he was imposing “with immediate effect a 6:00 AM to 6:00 PM chiefdom-level curfew” in parts of the northwestern districts of Kambia and Port Loko, which are the only areas that are still reporting new infections. The president has indicated that people in the worst-hit chiefdoms, or areas, of those districts will be confined to their homes for 21 days, warning that anyone found flouting the order would find themselves in jail for the same period. Grocery stores and markets, which have been ordered to close at 6:00 PM, will now be allowed to stay open until 9:00 PM in most parts of the country, while restaurants, which also had a 6:00 PM curfew, have been granted an extension until 10:00 PM. Motorbike taxis, which were previously barred from operating after 7:00 PM, have been given an extra two hours.

The latest lockdown has been called over fears that the disease, which has killed about 3,900 people in Sierra Leone, was making a comeback in the northwestern region of the country. Palo Conteh, head of the National Ebola Response Centre, has attributed the recent spike in Port Loko and Kambia to “people just being stubborn and engaged in the wrong things that fuel the transmission,” adding “some washing of bodies and secret burials are going on and people are taking the sick to herbalists.” A lawmaker is on bail awaiting trial for allegedly ordering the washing, dressing and burial of his 106-year-old father in Kambia in May. Amadu Koroma, a local government clerk in Kambia, has disclosed that herbalists were frequently bypassing official entry and exit points to treat patients in southern Guinea, the epicentre of the outbreak, adding “people have also been escaping from quarantined homes at night and ending up in Port Loko where relatives bring in herbalists to threat them in locked rooms.”

While neighbouring Liberia was declared Ebola-free in May, hopes that Sierra Leone and Guinea would quickly follow suit have, in recent weeks, been dashed. On Wednesday, the World Health Organization (WHO) announced that the retreat of the virus “that was apparent throughout April and early May has stalled.”   Sierra Leone’s health ministry has reported that 22 people are in Ebola treatment centres, all in Kambia and Port Loko, while 342 people are in quarantine in those districts and the Western Area, which includes the capital city, Freetown.

Ebola Cases in Guinea & Sierra Leone Rising Again

Researchers reported Tuesday that the Ebola strain in the current outbreak in West Africa is less virulent than the first one that appeared in 1976. The news comes as the latest figures released by the World Health Organization (WHO) show that the number of Ebola cases reported in Guinea and neighbouring Sierra Leone has risen for a second consecutive week.

According to a recent study, the results of the test on monkeys carried out by scientists at the National Institutes of Health (NIH) are considered important as they suggest that the virus, which has caused at least 11,000 deaths, is not becoming more severe. Instead, “…the new study suggests the current virus has a decreased ability to cause disease in their animal model compared to the 1976 strain.”

The 1976 strain is known as the Mayinga strain while the one that emerged in Guinea, Liberia and Sierra Leone late in 2013 is known as the Makona Strain. The 1976 Ebola outbreak was limited, killing 318 people in the Democratic Republic of Congo, formerly known as Zaire. The deadliest outbreak with this strain occurred in Uganda in 2000, when 425 people died. Both of these outbreaks had a weaker impact as they occurred in rural and sparsely populated areas.

The latest figures released by the WHO on Wednesday indicate that the number of Ebola cases in Guinea and Sierra Leone has risen for the second consecutive week. According to the latest report, in Guinea, 16 new cases were confirmed in the week ending 7 June, with 15 more reported in neighbouring Sierra Leone. In its latest situation report, the WHO indicates that the Ebola virus has infected 27,237 people and killed 11,158.

In the previous week, 13 new cases had been reported in Guinea, which represented a clear increase to the nine that were reported a week before that. The global health agency has voiced concerns that the areas affected in Guinea have increased as in the week leading up to 7 June, two new cases were confirmed in Guinea’s capital city, Conakry, which had been Ebola-free during the previous three weeks. The virus also reappeared in the western Guinean region of Kindia, where three new cases were confirmed during this reporting period. Officials have reported that the pattern is similar in neighbouring Sierra Leone, where 12 new cases were confirmed in the last week of May, compared to just three that were confirmed in the previous week.

Ebola Update (4 June 2015)

On Tuesday, Secretary General Ban Ki-moon warned that as long as there is one Ebola case in the West African region “all countries are at risk,” urging all nations to support the final battles aimed at wiping out the deadly disease in Guinea and Sierra Leone.

Speaking to a General Assembly meeting on efforts to end the Ebola epidemic, which has killed over 11,100 people mainly in Liberia, Guinea and Sierra Leone, the UN chief stated, “we are on the home stretch now and what happens now is critical.” While Liberia, which was once the worst affected country, has now been declared Ebola-free, Ban has warned that in Guinea and Sierra Leone, “the battle has not yet been won,” and “any lapse in vigilance could allow the virus to spread.” Dr David Nabarro, the UN Ebola chief, told the assembly that the priority is to ensure that the outbreak ends as soon as possible, “which will take several weeks and may take a number of months… But everybody should be ready in case the disease recurs and needs to be controlled, especially in the coming 12 months.” Ban also disclosed that UN agencies who will be taking over responsibility for tackling the outbreak as the UN Mission for Ebola Emergency Repose (UNMEER) scales down “will need considerable resources to go the distance and support recovery” in the three hardest-hit countries. UNMEER’s acting chief Peter Jan Graaff has indicated that UNMEER’s office in Mali closed on 31 March while its office in Liberia has handed over its operations to the UN country team. The Sierra Leone office is expected to end operations by the end of June, with Graaff indicating, “UNMEER could complete its transition by July 31 and be closed by the end of August,” noting however that if the situation deteriorates, the timeline could be changed “to ensure that the UN’s political leverage and convening power is maintained.” The UN Secretary General has indicated that he will convene an International Ebola Recovery Conference in New York on 10 July, which will aim to mobilize resources to start early recovery in Guinea, Liberia and Sierra Leone.

On Wednesday, the World Health Organization (WHO) released its latest figures on the Ebola outbreak in West Africa. As of 31 May, there have been a total of 27,145 reported confirmed, probable and suspected cases of EVD in Guinea, Liberia and Sierra Leone, with 11,147 reported deaths. In the seven days leading up to 31 May, a total of 25 confirmed cases of EVD were reported from 4 prefectures in Guinea and 3 districts of Sierra Leone,

According to the WHO, “since the week ending 10 May, when a 10-month low of 9 cases of Ebola Virus Disease (EVD) were reported from 2 prefectures of Guinea and 1 district of Sierra Leone, both the intensity and geographical area of EVD transmission have increased.” In the 7 days leading up to 31 May, a total of 13 new confirmed cases were reported in Guinea and 12 in Sierra Leone, with officials indicating that several cases in both countries arose from unknown sources of infection in areas that have not reported confirmed EVD cases for several weeks. This effectively indicates that chains of transmission continue to go undetected. Officials have noted that “rigours contact tracing, active case finding, and infection prevention and control must be maintained at current intensive levels in order to uncover and break every chain of transmission,” and have warned that the onset of the rainy season will make field operations more difficult from now onwards.

Two response teams from Guinea-Bissau have been deployed to the border with Guinea to assess several points of entry and sensitive communities. This is due to the proximity to Guinea-Bissau of the recent cluster of cases that have been reported in the northwestern Guinean prefecture of Boke. So far, the investigation team has not been able to locate the contact who had attended the funeral of a case in Boke and who is believed to have returned to a fishing community in Guinea-Bissau.

Guinea

In the week leading up to 31 May, a total of 13 cases were reported in 4 western prefectures of Guinea.

Seven of these cases were reported from the prefecture of Forecariah, which borders Sierra Leone. Multiple chains of transmission gave rise to cases in 4 of Forcariah’s 10 sub-prefectures, however all cases were either registered contacts of a previous case or had an established epidemiological link to one. Five cases were concentrated in the central areas of the prefecture where the sub-prefectures of Farmoriah, Kaliah, and Moussayah intersect. The remaining cases were reported from the northwestern prefecture of Boke (1 case), which borders Guinea-Bissau; the west coast prefecture of Dubreka (4 cases), which borders the capital city Conakry; and the western inland prefecture of Fria (1 case). The cases in Boke and Dubreka were all registered contacts of cases linked to localized chains of transmission. The case that was reported in Fria however arose from an unknown source and is suspected to have originated from an as-yet unidentified chain of transmission in the neighbouring prefecture of Telimele. Officials have indicated that investigations into the origin of the case in Fria have been complicated by active and passive resistance from communities both in Fria and neighbouring Telimele.

On the ground sources in Guinea have reported that community engagement continues to prove challenging, particularly in all the 4 affected prefectures. There have been several reported incidents of violence that has been directed at field staff during the past week.

Sierra Leone

In the week leading up to 31 May, Sierra Leone reported a total of 12 cases in three districts.

Eight of these cases were reported from a densely populated area of the Kaffu Bullom chiefdom in the district of Port Loko, which is located just north of the capital, Freetown. All but one of these cases were registered contacts of previous cases within quarantined houses in the chiefdom. The additional case is from the same neighbourhood however it was not on a contact list and was living in a non-quarantined home at the time of symptom onset. The other cases were reported in the following districts: Kambia reported its first case for over 2 weeks on 31 May. The case was identified after a post-mortem test of a community death and was not a known contact of a previous case. The remaining three cases were reported from the capital city, Freetown. Officials in Freetown have indicated that at this time, none of those 3 cases can be linked to previous chains of transmission however investigations are at an early stage.