Category Archives: West Africa

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.

Scores Abducted in Nigeria; Cameroon Kills Suspected Boko Haram Fighters

Nigeria’s Government on Friday disclosed that it is “outraged and deeply saddened” after militants attacked a remote village in northeastern Nigeria and reportedly kidnapped around 200 people. While no group has claimed responsibility, the attack bore resemblance to past attacks carried out by Boko Haram militants, who abducted more than 200 women in April from a secondary school in Chibok, which is located 24 kilometres (15 miles) from this latest incident.

Boko Haram militants have kidnapped at least 185 people, including women and children, from a Nigerian village, with local sources reporting that civilians were forced away on trucks towards Sambisa Forest, which is known to be one of Boko Haram’s strongholds. The mass abduction, which was part of an attack that also killed thirty-two people, occurred Sunday in the village of Gumsuri, Borno state. While officials have not confirmed the number of those kidnapped, local sources have reported that the number is likely to increase in the coming days and weeks as many civilians return after having fled the area during the attack.

Details of the attack took four days to emerge as the mobile phone network in the region has completely collapsed and many roads are impassable. News emerged Thursday as many of the survivors reached the city of Maiduguri, the capital of Borno state. Two local officials and a vigilante leader also confirmed the attack, stating that the local government had established the number of those abducted by contacting families. Late on Thursday, government spokesman Mike Omeri released a statement, condemning the “deplorable act,” adding that it was currently “…impossible to verify the number of those missing at this early stage because it is presumed that many civilians fled during the attack.”

Gumsuri is located roughly 70 kilometres (43 miles) south of Maiduguri and is located on the road that leads to Chibok, where Boko Haram kidnapped more than 200 schoolgirls. Boko Haram has been increasingly using kidnappings to boost its supply of child fighters, protesters and young women. It is believed that the schoolgirls kidnapped in Chibok are now being forced to carryout suicide bombings across northeastern Nigeria. In recent month, a number of deadly attacks have been carried out young female suicide bombers. The mass abductions in Chibok brought unprecedented attention to Boko Haram’s five-year uprising. Despite President Goodluck Jonathan vowing to end the conflict, the violence has escalated since April and Sunday’s attack in Gumsuri will likely cast further doubt on Nigeria’s ability to contain the crisis.

 Meanwhile in neighbouring Cameroon, officials disclosed Thursday that troops have killed 116 Nigerian Boko Haram fighters in the far north. According to the defence ministry, insurgents attacked an army base in Amchide, which lies on the border with Nigeria, on Wednesday but were repelled by soldiers. Sources have reported that Boko Haram sustained heavy losses during the attack.

A statement released by the Cameroonian army disclosed “a column made up of a military truck and four pick-ups from the BIR (elite Rapid Intervention Battalion) were caught in an ambush that began with an explosion of a roadside bomb,” adding “at the same time… the Amchide military base was attacked by hundreds of fighters from the sect, but the response from our defence forces was instant and appropriate.” The statement further indicated, “there are 116 of the assailants dead on Cameroonian territory and undetermined casualties on the Nigerian territory from our artillery fire…there is one dead on the Cameroonian side and one officer missing.” According to the Cameroonian army, Boko Haram fighters destroyed a pick-up and a troop truck and managed to capture another military truck.

Boko Haram has increasingly threatened the northern region of Cameroon. While in the past, the militants have carried out repeated massacres of civilians and have attacked villages near the border with Nigeria, the militant group now appears to be increasingly targeting the military. It is believed that Boko Haram is seeking to replenish its military supplies in a bid to maintain power over the current towns and villages under its control and to seize further territory in northeastern Nigeria.

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.

WHO Declares Nigeria and Senegal Ebola-Free

With six weeks of no new Ebola cases, on Monday officials at the World Health Organization (WHO) declared Nigeria officially free of Ebola, just three days after officials declared Senegal Ebola-free. While it is a containment victory in an outbreak that continues to rage in three West African countries, both states are not immune from another outbreak however their methods of containment may be used in future outbreaks.

Nigeria

On Monday, officials at the WHO declared Nigeria Ebola-free after six weeks of no new reported cases. For officials to declare the country Ebola-free, Nigeria had to make it 42 days with no new cases, effectively double the incubation period, verify that it actively sought out all possible contacts, and show negative test results for any remaining suspected cases.

Nigeria had a total of twenty cases after a Liberian-American man, Patrick Sawyer, flew into Lagos international airport on July 20 and collapsed shortly afterwards. As Nigeria had no previous screening procedures in place, the deadly virus ultimately killed eight people, a low number in comparison to the thousands of cases and deaths in other countries, with the disease spreading from Lagos to Port Harcourt before it was contained. Amongst those who died was Dr Ameyo Stella Adadevo, who diagnosed Mr Sawyer and who is credited with helping to contain the outbreak at its source. The last reported case in Nigeria, which is Africa’s most populous country, was discovered on 5 September.

Speaking to reporters shortly after the declaration, Nigerian Minister of Health Onyebuchi Chukwu disclosed “its possible to control Ebola. Its possible to defeat Ebola. We’ve seen it here in Nigeria,” adding “if any cases emerge in the future, it will be considered – by international standards – a separate outbreak. If that happens, Nigeria will be ready and able to confront it exactly as we have done with this outbreak.”

Nigeria has won praise for its swift response to the outbreak. With the epidemic raging in Western Africa since March, officials knew that there was a likelihood that a case of Ebola could surface within its borders. This prompted officials to train health care workers on how to manage the disease and to disseminate information across the country about the disease and how it spreads. Shortly after Mr Sawyer’s death, the Nigerian government declared a national public health emergency. This effectively enabled the Ministry of Health to set up its Ebola Emergency Operations Centre (EOC), which is an assembly of public health experts within Nigeria, and which includes officials from the WHO, Centres for Disease Control (CDC) and medical aid groups such as Doctors Without Borders. The EOC was tasked with contact tracing, implementing strict procedures for handling and treating patients, screening all individuals arriving or departing the country by land, air and sea and communicating with the community. Some EOC workers were involved in going door-to-door to offer Ebola-related education while others worked with religious and professional leaders to spread information about the disease. While in the beginning, there had been some misinformation about available cures and rumours circulating across the country, Nigerian officials used social media in order to increase awareness efforts and publicized those patients who had been successfully treated and discharged from hospital. While other regional countries opted to close their borders with those affected countries, Nigeria chose to keep its borders open with Guinea, Liberia and Sierra Leone, indicating that such a move would have been counterproductive. According to Dr Faisal Shuaib of the EOC, “closing borders tends to reinforce panic and the notion of helplessness….When you close the legal points of entry, then you potentially drive people to use illegal passages, thus compounding the problem,” adding that if “public health strategies are implemented, outbreaks can be controlled, and that closing borders would only stifle commercial activities in the countries where economies are already struggling due to Ebola.”

Despite being declared Ebola-free, Nigerian authorities are preparing for any additional outbreaks as the current Ebola epidemic in West Africa is far from over and a spread to additional countries, including Nigeria and Senegal, remains possible. Nigeria has not slowed down its training and preparations for the possibility of more cases, with Dr Shuaib disclosing “outbreak response preparedness is a continuous process that requires constant review of the level of the response mechanisms in place to ensure that the health system is ready to jump into action at all levels.” 

Senegal

On Friday, the WHO declared Senegal, which borders with Guinea, clear of the disease. The agency made the assessment after the West African country went forty-two days, without reporting any new cases. The WHO has commended the Senegalese government’s efforts at preventing the spread of the virus. In late August, Senegal had one confirmed case of Ebola, an imported one from Guinea, which prompted officials to monitor seventy-four contacts of the patient and increase surveillance at the country’s entry points.

In new figures released by the UN health Agency Friday, 4,555 people have died of confirmed, suspected or probable cases of Ebola, with almost all of the deaths occurring in Guinea, Liberia and Sierra Leone. A total of 9,216 cases have been reported. An estimated 70% of those infected with the deadly disease have died in those countries. The situation in all three West African countries has continued to worsen, with deaths attributed to the disease on the rise in all three.