Category Archives: West Africa

Ebola Cases Continue To Rise; Nigeria and Senegal Could Be Declared Ebola-Free in Days

New figures released by the World Health Organisation on Tuesday 14 October revealed that over 8,900 confirmed, probable and suspected cases of the Ebola Virus Disease (EVD) have been reported in seven affected countries: Guinea, Liberia, Nigeria, Senegal, Sierra Leone, Spain and the United States of America. As of 14 October there have been 4,447 deaths. Health workers have been hit hard by the outbreak, with Doctors Without Borders reporting that sixteen of its employees have been infected with Ebola, in which nine of them have died. A top United Nations official warned this week that Ebola was winning the race as the WHO warned that within the next two months, West Africa could face up to 10,000 new Ebola cases per week if the outbreak is not contained.

Speaking at a news conference in Geneva, WHO assistant director-general Dr Bruce Aylward, disclosed that the death rate in the current outbreak had risen to 70 percent, from the previously estimated mortality rate of 50 percent. Acknowledging that Ebola was “a high mortality disease,” Dr Aylward noted that the UN health agency was still focused on getting six people into isolation and providing treatment to them as early as possible, adding that if the global response to the current Ebola outbreak is not stepped up in the coming sixty days, “a lot more people will die” and health workers will be stretched even further.

Experts in the field have indicated that the epidemic is doubling in size about every three weeks, with Dr Aylward indicating that over the last month, there have been about 1,000 new Ebola cases per week. This included confirmed, suspected and probable cases. Guinea, Liberia and Sierra Leone continue to the be the hardest-hit countries in the current epidemic, with WHO officials particularly concerned about the spread of Ebola in their capital cities – Conakry, Monrovia and Freetown – where people move freely across borders. While some regions in these countries have seen the number of Ebola cases either stabilize or fall, this does not mean that the regions are Ebola-free. Neighbouring countries, including Guinea-Bissau, the Ivory Coast and Mali are currently at a high risk of importing the disease.

The WHO also announced Tuesday that Nigeria and Senegal could be declared Ebola-free in the coming days after completing a 42-day period with no new cases. A statement released on Tuesday revealed “if the active surveillance for new cases that is currently in place continues, and no new cases are detected, WHO will declare the end of the outbreak of Ebola virus disease in Senegal on Friday 17 October.” If no new cases are reported in Nigeria, then the WHO will declare it Ebola-free on 20 October.

Senegal had one patient who was confirmed to have EVD. He has since recovered and it does not appear that anyone else was infected with the deadly disease. In Nigeria, one traveller from Liberia triggered an outbreak in which eight people died, most of them health workers.   The virus spread from the initial case in Lagos to Port Harcourt however it has since been contained with no new reported cases. The situation in Guinea, Liberia and Sierra Leone however is far different as, according to the WHO, “new cases continue to explode in areas that looked like they were coming under control.” Adding “an unusual characteristic of this epidemic is a persistent cyclical pattern of gradual dips in the number of new cases, followed by sudden flare-ups.”

Officials at the WHO indicate that waiting for forty-two days from the time when the last person with high risk exposure has tested negative for the disease effectively provides sufficient confidence to declare that the outbreak is over. The 42-day period is twice the generally accepted maximum incubation period of the virus however some incubation periods are longer, with the WHO is indicating that in 95 percent of Ebola cases, the incubation period was between one and 21 days while in 98 percent, it was no longer than 42 days.

2014 Ebola Outbreak – October Review

Executive Summary

Total Cases and Deaths: As of 23 September 2014 (WHO)

 3,083 people have died from Ebola in Guinea, Liberia, Nigeria and Sierra Leone.  6,553 (probable, confirmed and suspected) cases.

The current Ebola Virus Disease (EVD) outbreak in West Africa has not been contained, with transmission continuing to occur in both community and healthcare settings. Resistance to efforts to control the disease, including outright denials that EVD exists and fears that healthcare workers deployed to combat the virus are spreading it, have further hindered efforts to prevent the disease from spreading and have effectively resulted in the region developing into a fertile ground for speculation and mistaken beliefs. This has sparked a rise in attacks on healthcare workers, including the recent death of an eight-member team in Guinea.

Over the past several weeks, the spread of EVD in West Africa has continued to accelerate. As of 23 September 2014, a total of 3,083 people have died of EVD, with another 6,553 reported cases. While the disease remains concentrated in three countries – Guinea, Liberia and Sierra Leone – it has continued to spread to new regions within these affected countries. On 30 September 2014, officials in the United States confirmed the first Ebola case. The current West Africa Ebola outbreak is likely to continue for another six – nine months before it is completely contained, with World Health Organization (WHO) officials predicting upwards of 20,000 cases.

Affected countries currently fall into two categories: Those with widespread and intense transmission – Guinea, Liberia and Sierra Leone – and those with either an initial case or cases, or with localized transmission – Lagos and Port Harcourt in Nigeria; Dakar in Senegal; Dallas, Texas in the United States. The capital cities of Guinea (Conakry), Liberia (Monrovia) and Sierra Leone (Freetown) have all been affected by the current outbreak.

The World Health Organization (WHO) has identified three patterns of transmission:

1. In rural communities, which is facilitated by strong cultural practices and traditional beliefs;
2. In densely populated urban communities;
3. Cross-border transmission

1. Countries with Widespread and Intense Transmission

Guinea

Total Cases: As of 23 September 2014

1074 clinical cases (876 confirmed; 162 probable; 36 suspected);  648 deaths (481 confirmed; 162 probable; 5 suspected)

Current Affected Areas:  Conakry, Coyah, Forecariah, Gueckedou, Kouroussa, Macenta, Siguiri, Pita, Nzerekore, Dubreka, Youmou, Kerouane.

No Longer Active:  Boffa, Dabola, Dinguiraya, Kissidougou, Telimele

In September, the district of Kindia reported its first confirmed case of EVD. While there have been a number of other areas across the country that have not reported any new cases of EVD, currently there is no indication of a sustained reduction in case incidence in Guinea.

In mid-September, eight people, involved in Ebola awareness-raising activities, were killed near Womey, near the town of Nzerekore in the Forest region of Guinea.   Police officials in the region have confirmed that the team was targeted on suspicion that they were attempting to spread the virus. In a separate incident on 24 September, a Red Cross team was attacked while collecting bodies believed to be infected with Ebola in south-eastern Guinea. Further such incidents in the coming weeks are likely to occur.

Land borders with Liberia, Senegal and Sierra Leone have been closed. Health screenings at all border crossings have been set up and all travellers displaying a fever, or EVD-like symptoms, will be subject to quarantine and/or denied entry/exit, from the country. Expect to experience delays at land border crossings. Enhanced screening measures have been introduced for outbound passengers at Conakry airport.

Liberia

Total Cases: As of 23 September 2014

3458 clinical cases (914 confirmed, 1539 probable, 1005 suspected);  1830 deaths (792 confirmed; 623 probably; 415 suspected)

 Current Affected Areas:  Lofa, Montserrado, Margibi, Bomi, Bong, Grand Cape Mount, Nimba, Grand Bassa, Grand Gedeh, River Cess, River Gee, Sinoe, Gbarpolu, Grand Kru

Liberia remains the most-affected country in the current Ebola outbreak. The number of newly reported cases continues to rise on a week-to-week basis. This is primarily driven by a continuation of a recent surge in cases in the capital city, Monrovia, coupled with a lack of capacity in Ebola treatment centres.

In September, six confirmed cases of EVD and four deaths were reported in the district of Grand Kru, a rural area located near the border with the Ivory Coast. This is the first time the EVD cases have been reported in this area of the country.

Since 20 August, a state of emergency has been in place, with security forces enforcing a nationwide curfew. Between 11PM and 6AM every night no movement is allowed anywhere in the entire country. Liberian authorities have set up road blocks in a bid to restrict movement around the country while security forces have been deployed in order to enforce quarantine for certain areas, including Lofa county. In Monrovia, the army and police have sealed off the neighbourhood of West Point with the area being placed under quarantine. There have been a number of outbreaks of violence, with civilians rioting at hospitals and attacking health workers.

All borders of Liberia have been closed, with the exception of major entry points, including the Roberts International Airport and James Spriggs Payne Airport. The Bo Waterside Crossing to Sierra Leone remains closed along with the Foya Crossing to Guinea. Any remaining border crossings may be closed with minimal notice. The Liberia Airport Authority has introduced enhanced screening measures for both inbound and outbound travellers at airport facilities.

The Ministry of Health and Social Welfare has established hotlines for the public to get basic information on Ebola: Call 0770198517 or 0777549805 or 0886530260 or 0886549805.

General medical facilities throughout the country are currently under severe strain as a result of the Ebola outbreak. Dedicated healthcare facilities for Ebola are overwhelmed and may not accept further cases.

Sierra Leone

Total Cases: As of 23 September 2014

2021 clinical cases (1816 confirmed, 37 probable, 168 suspected);  605 deaths (557 confirmed; 37 probable; 11 suspected)

Current Affected Areas:  Kailahun, Kenema, Kono, Kambia, Bombali, Tonkolili, Port Loko, Pujehun, Bo, Moyamba, Bonthe, Western Area

EVD cases in Sierra Leone continue to increase. Transmission remains high in the capital city, Freetown, and in the surrounding urban areas. Although over the past several weeks the number of newly reported cases in the districts of Kailahun and Kenema appear to have stabilized, a number of other districts have reported an increase. These include Port Loko, a district adjacent to Freetown, Bo, Bombali and Tonkolili.

Between 19 – 21 September, the Sierra Leonean government imposed a three-day nationwide shutdown. During this period, civilians were required to remain in their homes while Ebola awareness teams were deployed across the country to search for possible EVD patients. The government has since deemed the programme a success, adding that further such shutdowns may be implemented in the near future.

2. Countries with Initial Case/Cases or Localized Transmission

Three countries, Nigeria and Senegal and most recently the United States, have reported a case or cases imported from a country with widespread and intense transmission.

Nigeria

Total Cases: As of 23 September 2014

 20 clinical cases (19 confirmed; 1 probable; 0 suspected); 8 deaths (7 confirmed; 1 probable)

Current Affected Areas:  Lagos and Port Harcourt

While Nigeria has not reported any new EVD cases since the first week of September, the country has not been deemed Ebola-free however the spread of EVD has been contained. All EVD cases in Nigeria occurred in Lagos and Port Harcourt.

Nigeria’s first Ebola case was an imported one and all cases in the transmission chain have been linked to a single person. Contact tracing and follow-up is on-going. In Nigeria, 847 contacts (out of a total of 872) have now completed the 21-day follow-up (349 contacts in Lagos; 498 in Port Harcourt). The last confirmed case in Lagos was reported on 5 September while the last confirmed case in Port Harcourt was reported on 1 September. In Lagos, all contacts have completed the 21-day follow-up.

Senegal

In Senegal, all contacts have now completed the 21-day follow-up and there have been no further reported cases of EVD. The last confirmed case of EVD was reported on 28 August. While the country has not been confirmed to be Ebola-free, the spread of EVD has been contained.

United States

Total Cases: As of 23 September 2014

1 Confirmed Case; 0 deaths

Current Affected Areas:  Dakar

On 30 September, officials confirmed the first Ebola case in Dallas, Texas. Officials have confirmed that the unidentified male patient is being kept in isolation at Texas Health Presbyterian Hospital. It is believed that the man contracted the virus in Liberia prior to travelling to the US nearly two weeks ago. He arrived in the US on September 20. Symptoms of the virus became apparent on September 24 and the patient was admitted and placed in isolation on 28 September. While previously US aid workers have come back to the US, after catching Ebola in West Africa, this is the first case of a patient developing the virus on US soil. Health officials are currently identifying all people who came into contact with the unnamed patient while he was infectious. Those people will then be monitored for a period of 21 days.

Ebola Outbreak in Democratic Republic of Congo (DRC)

Total Cases: As of 24 September 2014

70 clinical cases (30 confirmed; 26 probable; 14 suspected); 40 deaths

Current Affected Areas:  Equateur province

An epidemic has since been declared in the region of Djera, in the territory of Boende in the province of Equateur. Officials however believe that the infections are of a different strain to those in the outbreak in West Africa.   One of the two cases tested positive for the Sudanese strain of the disease, while the other tested positive for a mixture between the Sudanese and the Zaire strain. The outbreak in West Africa is due to the Zaire strain.

Ebola Outbreaks in Senegal and Nigeria Contained

While the deadliest Ebola epidemic ever has now killed 2,793 people in West Africa, World Health Organisation (WHO) officials disclosed Monday that outbreaks in Senegal and Nigeria have been basically contained.  A statement released by the UN health agency also published the results of the latest meeting of its Ebola emergency committee.

According to new figures released by the WHO, as of 18 September a total of 5,762 people have been infected with the Ebola Virus Disease (EVD) in five Western countries.  Guinea, where the outbreak initially began at the art of this year, along with neighbouring Liberia and Sierra Leone currently account for the most cases and continue to see their numbers rise.  Liberia has especially been the hardest hit, with 3,022 cases and 1,578 deaths.

The WHO did note however “the outbreaks in Senegal and Nigeria are pretty much contained.” According to officials, Senegal has not reported any new cases of the deadly virus since it registered its first and only case on August 29 – a Guinean student who has since recovered.  Meanwhile Nigeria, where twenty-one people have been infected, eight of whom have died, has not reported any new cases since September 8.  While no reports of new cases in Senegal and Nigeria does signify that both countries are slowly recovering, the WHO has not yet deemed them transmission free as the incubation period for Ebola is 21 days and double this time must pass without any new cases arising before a country can be deemed transmission free.

In a statement released Monday, the WHO also indicated that during a meeting of its Ebola emergency committee last week, officials had determined that the outbreak remains to be a “public health emergency of international concern.”  The WHO has disclosed that the committee reiterated its opposition to general bans on international travel or trade, noting that people infected with Ebola, or those who had come into contact with Ebola patients, should not be permitted to travel.  The committee also warned that blocking flights to or from affected areas and other travel restrictions only served to “isolate affected countries, resulting in detrimental economic consequences, and hinder relief and response efforts risking further international spread.”  The emergency committee did stress that in cases where measures like quarantines are deemed necessary, countries must ensure that “they are proportionate and evidence-based, and that accurate information, essential services and commodities, including food and water are provided to the affected populations,” insisting that “adequate security measures” should be put in place in order to ensure the safety and protection of heath workers, who face high infection rates and sometimes violence from frustrated and frightened populations.  Last week, eight members of an Ebola education team, said to include local health officials and journalists, were found dead after they were attacked by angry locals in southern.  This is the first such incident where health workers combatting EVD were killed.

Guinea Confirms Health Workers Killed While Raising Awareness About Ebola

Days after a team of officials went missing while visiting a village in Guinea in a bid to raise awareness about Ebola, officials confirmed late Thursday that all nine members were killed by local villagers. In August, MS Risk analysts warned that attacks on Ebola workers in West Africa may spark similar reactions to those carried out against polio workers, in which a number of volunteers have been killed while administering polio vaccinations. This death of nine members of a team attempting to raise awareness about Ebola signifies that the threat to health workers and local authorities trying to combat the disease is high, and will likely intensify as the virus continues to spread. Further such incidents will be likely be reported in the affected countries. Steps to combat myths about the disease, which are common across the region, must be taken in order to ensure health workers’ safety and to curb the virus’ spread.

On Tuesday the group of nine Guineans, which included two journalists, local officials and several health workers, fled the village of Wome, located in the southern Nzerekore region, after their group was pelted with stones. A journalist who managed to escape later told officials that she could hear villages looking for the group while she was hiding. On Wednesday a government delegation, led by the country’s health minister Remy Lamah, had been dispatched to the region however they were unable to reach the village by road as the main bridge was blocked.

Officials disclosed Friday that seven of the bodies were located in a septic tank in a village school near the city of Nzerekore while the other two were located in the bush.   According to officials, the bodies showed signs of being attacked with machetes and clubs. Six people have been arrested, with on the ground sources reporting that the village is now deserted. According to local police officials, at least 21 people were wounded during the unrest. While the motive for the killings has not been confirmed, it is believed that the villagers’ suspicions of officials attempting to combat the disease lead to the group being attacked and its members murdered. Many Guineans believe that local and foreign health workers are part of a conspiracy, which either deliberately introduced the outbreak, or invented it as a means of luring Africans to clinics in order to harvest their blood and organs. Some still do not believe that the disease exists despite more than 2,600 people killed by the virus.

In recent weeks, tensions have been rising across West Africa as the Ebola epidemic continues to rise. A number of incidents of frustrated civilians attacking local officials have been reported however this is the first incident in which officials were killed for attempting to combat the deadly virus. Last month, riots erupted in Nzerekore, Guinea, 50 kilometres (30 miles) from Wome, after rumours emerged that medics who were disinfecting a market were contaminating people. There have also been a number of reports of people in the region refusing to cooperate with health authorities over fears that a diagnosis means certain death.

Myths such as these have emerged over the past few months and have greatly impacted the spread of the current outbreak. Officials at the World Health Organisation (WHO) have confirmed that the already difficult conditions are made more difficult by public misunderstand caused by “rumours on social media claiming that certain products or practices can prevent or cure Ebola Virus Disease.” Such myths have not only impacted Guinea, but other countries, including Nigeria, where at least two people died as a result of drinking salt water after stories circulated that doing so would protect against the deadly disease. Other supposed cures for the virus include raw onions, coffee, condensed milk and holy water. Some civilians have opted to hide infected family members at home, or prefer to take them to local doctors instead of an Ebola treatment centre. Health officials in Sierra Leone disclosed in August that the Ebola outbreak spread from Guinea after an herbalist in the remote eastern border village of Sokoma claimed to have powers to heal the deadly virus. Officials have since confirmed that the virus spread in Sierra Leone after cases from Guinea cross over the border, seeking treatment.

Fears over the deadly virus have also sparked riots and attacks on health workers. As the Ebola outbreak continues, such attacks may spark similar reactions to those carried out against polio workers.

At the start of the outbreak, a team from MSF had to stop working at an isolation ward in Guinea after local residents mistakenly believed that they had brought the virus with them. Groups of health workers from MSF, the Red Cross and from the ministry of health have been pelted with rocks as they attempted to reach Ebola-hit areas. In Liberia, a number of Ebola patients escaped a healthcare facility after it was attacked by rioters. Due to the region’s recent history of bloody civil war, some believe that the army’s deployment to control the affected areas is a sign that the government is deliberately infecting people in a bid to have an excuse to enforce martial law.

Ebola Death Toll Nears 2,000 Mark

According to new figures released Thursday by the World Health Organisation (WHO), more than 1,900 people have died in West Africa’s Ebola outbreak. There have also been 3,500 confirmed or probable cases reported in Guinea, Liberia and Sierra Leone. WHO chief Margaret Chan warned Thursday “the outbreaks are racing ahead of the control efforts in these countries,” adding that at least US $600 million (£360 million) is needed in order to fight the virus. Ms Chan has described the current outbreak as “the largest and most severe and most complex we have ever seen.”

The latest statistics represent a significant increase from the 1,552 deaths and 3,069 cases that were reported by the Geneva-based organisation last week. According to the WHO, more than 40% of the deaths have occurred in the three weeks leading up to 3 September. This indicates that the epidemic is fast outpacing efforts to control it. According to Ms Chan, the WHO “…would like to reverse the trend in three months” in those countries where there is a “very tense transmission.” This includes Guinea, Liberia and Sierra Leone. In countries with “localized transmission,” such as Senegal, where so far only one case has been reported, and the Democratic Republic of Congo, which now has reported 31 deaths, the WHO “would like to stop all transmission within eight weeks.”

The speed of the deadly virus has prompted WHO officials to meet on Thursday in order to examine the most promising treatments and to discuss how to fast-track testing and production. According to sources, disease control experts, medical researchers, officials from affected countries and specialists in medical ethics will be represented at the meeting, which will take place in Geneva.

The Ebola virus has continued to spread in Nigeria, despite WHO officials stating that they were hopeful it would remain under control. On Wednesday, Nigerian authorities reported two additional cases in the city of Port Harcourt. Until the Port Harcourt case was announced, Nigeria’s government had indicated that the virus was contained in Lagos. On Thursday, the WHO warned “the outbreak of Ebola virus disease in Port Harcourt has the potential to grow larger and spread faster than the one in Lagos.” The UN health body has disclosed that the virus’ arrival in Port Harcourt, located 435 kilometres (270 miles) east of Lagos and home to oil and gas majors including Chevron, Shell and Total, showed “multiple high-risk opportunities for transmission of the virus to others.” Out of 255 people currently under surveillance for signs of the disease, 60 are considered to have had “high-risk or very high-risk exposure.

Tagged as: Democratic Republic of Congo, Ebola, Guinea, Lagos, Liberia, Nigeria, Port Harcourt, Senegal, Sierra Leone, West Africa, WHO, World Health Organisation