Category Archives: Sierra Leone

Ebola Situation Report (17 December 2014)

In the days leading up to 14 December, there has been a total of 18,603 confirmed, probable and suspected cases of Ebola virus disease (EVD) that have been reported in five affected countries: Guinea, Liberia, Mali, Sierra Leone and the United States; and three previously affected countries: Nigeria, Senegal and Spain. There have been 6,915 reported deaths. Reported case incidence in Guinea is fluctuating and is on the decline in Liberia. In neighbouring Sierra Leone, there are signs that the increase in incidence is beginning to slow. The case fatality rate in the three intense-transmission countries remains at 70%.

Guinea

In the week leading up to 14 December, a total of 76 new confirmed cases were reported. Since September, the national trend in case reporting across Guinea has been fluctuating, with between 75 and 148 confirmed cases reported each week. World Health Organization (WHO) officials have reported that currently, there is no clear upward or downward trend in national case incidence.

Transmission remains high in the capital city of Conakry, which reported 18 confirmed cases in the week leading up to 14 December. EVD transmission remains high in the neighbouring district of Coyah, with 14 confirmed new cases. South of capital city, in Forecariah, officials have reported a surge in new cases, with 13 new confirmed cases in the past week. The district had reported its first case 12 weeks ago and until now, had reported no more than 4 confirmed cases each week.

Transmission remains persistent in the eastern district of N’Zerekore, with 6 new confirmed cases reported in the week leading up to 14 December. The district of Dubreka reported 3 confirmed cases, while new cases continue to be reported in the outbreak’s epicentre of Gueckedou (2 confirmed cases); Kerouane (5 confirmed cases) and Lola and Kouroussa (2 confirmed cases in each district). In the past week, Macenta reported only three confirmed cases, a sharp decline from the 15 cases that were reported in each of the two previous weeks. WHO officials however have warned that it remains too early to draw conclusions whether this decline in reporting in this district will be sustained. After reporting last week its first case since June, Telimele reported 5 new confirmed cases. While the districts of Kindia and Faranah did not report any new confirmed cases, officials in these two districts reported 21 and 12 probable cases respectively. The northern district of Siguiri reported 4 probable cases. This area requires continued vigilance, particularly due to its proximity to Mali.

Officials in the Guinean capital of Conakry have banned all public Christmas and New Year celebrations in a bid to curb the spread of EVD. A statement issued by Conakry governor Soriba Sorel Camara on 16 December indicated that “large-scale gatherings in public places are suspended for the moment,” adding “beaches will remain closed” and firecrackers and fireworks will also be banned. The capital city’s governor has appealed to residents to “refrain from anything” that would compromise efforts to contain the spread of Ebola. This means avoiding “all gatherings in markets, bus stations, ferry landing stages, hospital and the airport.”

Liberia

At the national level, case incidence in Liberia has been on the decline, with 6 districts reporting new confirmed or probable cases in the week leading up to 14 December.

Transmission remains intense in Montserrado, which includes the capital Monrovia. The district reported 3 confirmed cases and 9 probable cases. Grand Bassa experienced a decline in cases, reporting only one confirmed case after having reported 7 in the previous week. The other districts to report confirmed cases during this period included Bong (1 confirmed case); Grand Cape Mount (2 confirmed cases) and Marigibi (1 confirmed case). In the northern region of the country, Lofa reported no cases for the seventh consecutive week. This is likely due to the strength of response efforts being carried out across the district.

Sierra Leone

EVD transmission across Sierra Leone remains intense, with the country reporting 327 new confirmed cases in the week leading up to 14 December. While WHO officials have reported that there are signs that the increase in case incidence has slowed, and that the incidence may no longer be on the rise, the country reported the highest number of confirmed cases in epidemiological week 50.

EVD transmission remains most intense and persistent in the western and northern districts of the country. The capital city Freetown accounted for 125 of all new confirmed cases. Other western districts that reported new confirmed cases include Port Loko (56 cases); Western Rural Area (52 cases); Bombali (23 cases) and Kambia (11 cases).

In the country’s eastern region, the district of Kono, which has experienced high transmission over the past five weeks, reported 12 confirmed cases in the week leading to 14 December. The neighbouring district of Koinadugu in the northeast reported three cases. Although transmission has been intense in Tonkolili for the past three weeks, in recent weeks the number of new weekly cases has declined from a peak of 56 four weeks ago to 14 cases over the past week. In the southern region of the country, the district of Bo continues to report a high number of new cases, with 24 confirmed cases in the week leading up to 14 December. By contrast, the south-eastern districts of Kenema and Kailahun reported 1 and 3 new cases respectively. Only two districts in Sierra Leone did not report any new cases during this reporting period: Bonthe and Pujehun.

Officials in Sierra Leone have banned any public Christmas celebrations in a bid to halt the spread of EVD. According to the government’s Ebola response unit, soldiers will be deployed across the country throughout the holiday period to ensure that all residents remain indoors. Officials in Sierra Leone have also imposed a two-week lockdown on the eastern diamond-mining district of Kono. The lockdown will effectively limit residents’ movements until 23 December.

Countries with an Initial Case/Cases or with Localized Transmission

Five countries: Mali, Nigeria, Senegal, Spain and the United States of America; have reported a case or cases of EVD imported from a country with widespread and intense transmission.

In Mali, a total of 8 cases (7 confirmed and 1 probable) including 6 deaths (5 confirmed and 1 probable) have been reported. The most recent seven cases were reported in the Malian capital Bamako and are not related to the country’s first EVD case, which was reported in Kayes on 24 October. The last confirmed case tested negative for the second time on 6 December and was discharged from hospital on 11 December. All identified contacts of both the initial case and the outbreak in Bamako have now completed the 21-day-follow up. If there are no more reported cases of EVD in Mali, the West African country will be declared Ebola-free by the WHO in mid January.

In the United States, there have been four confirmed cases of EVD and 1 death. All contacts in the country have now completed the 21-day follow-up period. If no further cases are reported in the US, the country will be declared Ebola-free at the end of December.

Nigeria, Senegal and Spain have all been declared Ebola free by the WHO.

Guinea-Bissau Confirms Possible Ebola Case While Sierra Leone Cancels Christmas Festivities

A medical official in Guinea-Bissau reported Friday that a man, who had entered the West African country from Guinea one day after the border reopened, is now being treated for suspected Ebola. Meanwhile in Sierra Leone, which recently surpassed Liberia to report the most cases of the deadly disease, officials have banned any Christmas celebrations as the caseload of Ebola infections continues to spread at an alarming rate.

On Friday, a medical official in Guinea-Bissau reported that a traveller was placed under surveillance as he attempted to pass through the Fulamori border crossing on Wednesday. Sources have reported that the traveller, who had a high fever, had taken advantage of the lax security amongst border guards in order to escape observation. He later boarded a bus and headed for the eastern city of Gabu, where he was apprehended. The traveller, along with eight fellow passengers on board the bus, has been quarantined.

On Tuesday, the government in Guinea-Bissau reopened the country’s 300-kilometre (185-mile) land border with Guinea after officials closed it on 12 August due to the Ebola outbreak. In November, a team from the World Health Organization (WHO) included Guinea-Bissau on its list of fifteen countries at risk of an Ebola outbreak, concluding that the West African country had an “inefficient health system, which would not be able to cope with an outbreak of Ebola.” So far, Guinea-Bissau has not reported any cases of Ebola and a confirmed Ebola case would demonstrate that the outbreak is continuing to spread, nearly one year after it was first identified.

Officials in Sierra Leone have banned any public Christmas celebrations as the caseload of Ebola infections continues to spread at an alarming rate. According to the government’s Ebola response unit, soldiers will be deployed across the country throughout the holiday period to ensure that all residents remain indoors. Palo Conteh, head of the department, has not disclosed the exact dates or specified any exceptions however during previous local and nationwide anti-Ebola curfews, people have been allowed out in order to worship and for “essential business.” Under the current emergency regulations, bars and nightspots have been shut down while public gatherings have been outlawed however there is currently no general ban on walking outdoors or working. Sierra Leone, which has now overtaken Liberia to report the most cases of the deadly virus, has in the past three weeks recorded 1,319 new cases.

Ebola Situation Report (10 December 2014)

Up to the end of 7 December 2014, there has been a total of 17,942 confirmed, probable and suspected cases of Ebola virus disease (EVD) reported in five affected countries: Guinea, Liberia, Mali, Sierra Leona and the United States of America. The region has recorded 6,388 deaths.

In the week leading up to December 7, reported case incidence in Guinea increased, with 103 confirmed and probable cases; in Liberia, reported case incidence is declining, with 29 new confirmed cases over a period of three days leading up to 3 December. The situation in Sierra Leone is still worsening, with 397 new confirmed cases in the week leading up to 7 December. The case fatality rate across the three most-affected countries currently stands at 76%.

Guinea

A total of 103 new confirmed and probable cases of EVD were reported across the country in the week leading up to 7 December. Since early October, the national trend in Ebola cases has been increasing, with between 75 and 148 confirmed cases reported in each of the past seven weeks.

The previously reported surge of new cases in the eastern district of N’Zerekore, which had only 4 new confirmed cases in the week leading up to 7 December, appears to have abated however transmission in the neighbouring district of Macenta continues to be intense, with 15 new confirmed cases. Several districts in central and northern Guinea have reported persistent transmission. These include Faranah, with 8 confirmed and probable cases; and Kankan, with 4 new confirmed cases. In the western region of the country, the capital city Conakry reported 16 new confirmed cases in the week leading up to 7 December. Along with the neighbouring district of Coyah, which confirmed 18 new cases in the week leading up 7 December, Conakry has now reported an increase in the number of new confirmed cases during each of the past three weeks. Telimele has reported a case for the first time in over twelve weeks.

While ten of Guinea’s districts have yet to report a case of EVD, according to the World Health Organization (WHO), “there has been a geographical expansion in transmission: as of 1 October, 9 districts had reported a confirmed or probable case during the past 7 days; as of 1 December, 14 districts reported a case during the past 7 days.

Liberia

Over the past four weeks, case incidence in Liberia has been on the decline, with five districts reporting new cases in the three days leading up to 3 December. In the three days leading up to 3 December, there were a total of 29 confirmed cases reported across Liberia.

The district of Montserrado, which includes the capital Monrovia, reported 15 confirmed cases and accounted for more than half of all confirmed cases nationally over the reporting period. The other districts to report a case during this period include Bong, with 1 confirmed case; Grand Bassa, 7 confirmed cases; Grand Cape Mount, 5 confirmed cases; and Sinoe, with 1 confirmed case. The district of Lofa, which is located in the northern region of the country near the border with Guinea and Sierra Leone, reported no cases for the sixth consecutive week.

Sierra Leone

EVD transmission across Sierra Leone remains intense with 397 new confirmed cases reported in the week leading up to 7 December. This is three times as many as Guinea and Liberia combined.

The worst affected area remains the capital city, Freetown, which reported 133, or one-third, of all new confirmed cases during this reporting period. Transmission remains persistent and intense in other areas of the country, including in the districts of Bo, 14 cases; Bombali, 57 cases; Kambia, 10 cases; Kono, 24 cases; Koinadugu, 2 cases; Moyamba, 10 cases; Port Loko, 76 cases; Tonkolili, 13 cases; and the Western Rural Area, 57 cases. In the southern districts of the country, Kenema and Kailahun reported zero cases. Since 1 November, Kenema has reported only one case of EVD. Pujehun was the only other district not to report a new case. Bonthe, which over the past two weeks had previously not reported any cases, reported a single confirmed case of EVD in the week leading up to 7 December.

On 10 December, Sierra Leonean authorities imposed a two-week lockdown on the eastern diamond-mining district of Kono after eight cases of Ebola were confirmed in one day. The lockdown will effectively limit residents’ movements until 23 December. Only essential vehicles, including fuel-carrying tankers, military, police, NGO workers and UN-associated vehicles will be allowed through the heavily monitored checkpoints into the district. Private and commercial vehicles and motorcycle taxes will be barred while mining activity has ceased. According to Sierra Leone’s health ministry, Tuesday’s spate of Ebola reports increased the cumulative total of confirmed cases in the region to 119. Officials from the World Health Organization (WHO) and the US Centre for Disease Control are assisting Sierra Leone’s National Ebola Response Centre in preventing the deadly virus from spreading throughout Kono, which has a population of 350,000. While the rapid reaction has helped contain the virus to about half of the fifteen chiefdoms in Kono, WHO teams that arrived in the area ten days ago were taken aback by the situation. According to sources, in the space of eleven days, two WHO teams buried 87 victims, including a nurse and an ambulance driver who were enlisted to help dispose of corpses that were piling up in the local hospital.

Mali

On 12 December, Mali’s Health Ministry reported that the last Ebola patient treated in the West African country has been released from hospital, leaving no known cases of the deadly virus in Mali. A statement released by the ministry disclosed that the last patient was discharged from hospital on Thursday after several Ebola tests came back negative.

The deadly Ebola virus had first entered Mali through an infant girl who died of the disease in October after arriving from neighboring Guinea. Later that month, an imam who also arrived from Guinea with the disease, died in Mali. The recent eight recorded cases of Ebola were all linked to the imam. According to officials from the Health Ministry, the country now has no confirmed or suspected cases of Ebola however authorities are still monitoring twenty-six people who had contact with the sick. The government has warned that because people are still being monitored for symptoms, and with the fact that another sick person could cross the border, all Malians must remain vigilant. Mali will officially be declared Ebola-free forty-two days after the last Ebola patient tested negative for the disease.

3 December – Ebola Situation Report

According to the World Health Organization’s newly released data, as of 3 December there have been 12,145 reported cases of Ebola virus disease (EVD), with 6,070 reported deaths. The WHO has also reported the UN Mission for Ebola Emergency Response (UNMEER) targets of isolating and threating 70 percent of EVD cases and burying 70 percent of EVD-related deaths safely have likely been met in most of the districts in Guinea, Liberia and Sierra Leone. In the three most affected countries, the case fatality rate is at 72% while in hospitalized patients, the case fatality rate stands at 60%.

Guinea

Case incidence in Guinea has slightly increased. In the week leading up to 30 November, there were seventy-seven confirmed cases reported in Guinea, compared with the 148 cases that were reported in the week before.

Since early October, the national transmission trend in Guinea has been slightly increasing, with between 75 and 148 confirmed cases reported in each of the past six weeks. Over the past three weeks, the eastern districts of N’Zerekore, Macenta and Kankan each saw a large number of new cases. In the week to 30 November, N’Zerekore reported 6 new confirmed cases, in comparison to 29 that were reported in the previous week. Macenta saw 15 new confirmed cases and 26 in the previous week; while Kankan saw 7 new confirmed cases, the same number as in the previous week. Officials have indicated that the persistent transmission in Kankan, and in the surrounding areas of Kerouane, Kouroussa and Kissidougou, is of particular concern as local populations infected with Ebola are likely to seek treatment either in the northern region of the country or in neighbouring Mali rather than at the existing facilities, which are located in the nearby south-eastern districts of Gueckedou and Macenta. The first imported Ebola case in Mali travelled from a city in the northern district of Siguiri, which borders Mali, and where there has been persistent transmission since early November. Two new cases were reported in Siguiri this week and between 1 and 3 cases have been reported over the past 7 weeks. According to the WHO, “the lack of established EVD treatment and isolation facilities in this northern, Sahelian zone of the country, combined with a higher than usual degree of resistance among communities to safe burial practices, make this area vulnerable to an increase in cases.”

In the central region of the country, the district of Faranah, which borders the northern Sierra Leonean district of Koinadugu, reported an average of 8 cases per week for each of the past 4 weeks. In the western region of the country, the capital, Conakry, reported 14 new confirmed cases in the week leading up to 30 November. Both Conakry and the neighbouring district of Coyah have reported an increase in the number of new cases during each of the past 2 weeks. In the week to 30 November, Coyah reported 15 new confirmed cases.

Liberia

Over the past five weeks, case incidence in Liberia has stabilized in some regions and is on the decline in others. In the five days leading up to 28 November, Liberia reported 43 new confirmed cases.

The district of Montserrado, which includes the capital Monrovia, reported 34 confirmed cases and accounted for 79% of all confirmed cases reported nationally in the week leading up to 28 November. Bomi (2 confirmed cases); Grand Bassa (4 confirmed cases); Grand Cape Mount (2 confirmed cases); and Margibi (1 confirmed case) are the only other districts to have reported a case/cases during this period.

In the northern region of the country, the district of Lofa, which is located on the border with Guinea and Sierra Leone, reported no cases for a fifth consecutive week.

Sierra Leone

Case incidence may still be increasing in Sierra Leone. In the week leading up to 30 November, officials in Sierra Leone reported 537 new confirmed cases. This is more cases than Guinea and Liberia combined.

The capital Freetown remains the worst affected area, reporting 202 new confirmed cases. Transmission also remains persistent and intense across the country with the exception of the south. The districts of Bo (23 cases); Bombali (66 cases); Kambia (14 cases); Kono (15 cases); Koinadugu (6 cases); Moyamba (3 cases); Port Loko (94 cases); Tonkolili (40 cases); and Western Rural Area (72 cases) continued to report high numbers of new confirmed cases.

In the southern districts of Kenema and Kailahun, both districts reported 0 and 1 case respectively. Since 1 November, Kenema has reported only one case. Bonthe has not reported a case in the past two weeks.

Spain

On 2 December 2014, the WHO declared Spain Ebola free after no new cases were reported since a nurse’s assistant who contracted the virus there tested negative for the deadly disease. Since then, 42 days have passed – effectively double the maximum known incubation period for the virus – without any further confirmed cases.

The WHO Achieves December 1 Ebola Targets

On Monday, World Health Organization (WHO) officials indicated that they have met what they call interim targets that were put in place in October in a bid to end the upward trend in new Ebola cases. While progress has been made, with some countries seeing the spread of the disease either stabilize or decline, reports of new cases in Mali and high transmission levels in some parts of Sierra Leone have shown that more work is required in order to end the worst Ebola outbreak on record.

Two months ago, the WHO launched a plan to stop the Ebola outbreak in West Africa. It aimed to isolate 70 percent of the sick and safely bury 70 percent of the victims in the three hardest hit countries – Guinea, Liberia and Sierra Leone – by 1 December. According to the latest figures released by the UN health agency, both Liberia and Guinea have met the targets, with Sierra Leone likely to fully achieve its goal in the coming weeks.

New figures released Monday indicate that both Liberia and Guinea have met the 1 December target for isolating 70 percent of people infected with Ebola, and have safely buried 70 percent of those who died. Sierra Leone however has not fully met the target. At a news conference in Geneva, the WHO’s Dr Bruce Aylward disclosed that Sierra Leone’s western region probably met the targets and likely will improve to the 70 percent target nationwide “in the coming weeks.” Dr Aylward further disclosed that the WHO’s plan to stop the spread of the deadly Ebola virus had shown that it was possible to quickly reduce the “yawning gap” between disease levels and the capacity to respond.

In recent weeks there have been a number of successes in the fight against Ebola. Amongst these are the fact that Ebola cases in Liberia and Guinea are either stabilizing or are on the decline. The case in Sierra Leone however is quite different as the country’s capital city Freetown and the town of Port Loko are seeing a severe surge in cases. Additionally, a new outbreak in Mali has caused concern that the deadly disease will spread into other West African countries.

When the deadline was first announced in October, Dr. Aylward acknowledged that to reach the 1 December goal would be “really pushing the system hard.” Dr Aylward, who is directing the WHO’s Ebola response, further disclosed “if we don’t do it in 60 days and we take 90 days: No. 1, a lot more people will die that shouldn’t; and No. 2, we will need that much more capacity on the ground to be able to manage the caseload.”

The Ebola outbreak was first reported in Guinea in March of this year. It has since spiralled out of control and was declared a public health emergency in August.   Latest figures released by the WHO indicate that the Ebola virus has sickened more than 16,000 people, of whom 7,000 have died. Tony Banbury, the head of the UN Ebola response mission in West Africa has warned that there is still a “huge risk” that the deadly disease could spread to other parts of the world.