Ebola Update (10 July 2015)

In the week leading up to 5 July, there were a total of 30 confirmed cases of Ebola virus disease (EVD): 18 in Guinea; 3 in Liberia; 9 in Sierra Leone. According to the World Health Organization (WHO), while “this is the highest weekly total since mid-May, improvements to case investigation and contact tracing, together with enhanced incentives to encourage case reporting and compliance with quarantine measures have led to a better understanding of chains of transmission than was the case a month ago.” Consequently, this has resulted in a decreasing proportion of cases arising from as-yet unknown sources of infection. This is especially the case in problematic areas, including Boke and Forecariah in Guinea; and Kambia and Port Loko in Sierra Leone. Officials however have warned that significant challenges remain, specifically a lack of trust in the response amongst some affected communities, which means that some cases still evade detection for too long.

To date, there have been a total of 27,573 reported confirmed, probable and suspected cases of EVD reported in Guinea, Liberia and Sierra Leone, with 11,246 reported deaths.

Guinea

During this reporting period, a total of 18 cases were reported in Guinea. Cases were reported from the same 3 prefecture as in the previous week: Boke, Conakry and Forecariah.

During the seven days leading up to 5 July, the northern prefecture of Boke, which borders Guinea-Bissau, reported a total of 6 cases, a decline compared with the 10 cases that were reported in the previous week. Accoridng to local medical officials, all but one of the reported cases was a registered contact, with a single cases reported to have arisen from an as-yet unknown source of infection.

There was one case reported in Conakry, with officials indicating that it came from the Matam commune (municipal district) of the city and that it was a known contact of a previous case from Benty sub-prefecture in Forecariah.

The remaining 11 cases were reported in the prefecture of Forecariah, in which 9 of the cases were reported from the sub-prefecture of Benty. All but 2 of the 11 cases reported in the prefecture of Forecariah were known contacts of a previous case or have an established epidemiological link to one.

Liberia

On 9 May, the WHO declared Liberia Ebola-free, after the West African country reported no new cases for 42 consecutive days. Since being declared free of the deadly virus, the country subsequently entered a 3-month period of heightened surveillance. During this time, there were approximately 30 blood samples and oral swabs collected each day from potential cases and tested for EVD. On 29 June, a confirmed case of EVD was detected in Margibi County, the first new confirmed case to be reported in Liberia since 20 March. The case involved a 17-year-old male who first became ill on 21 June. He died on 28 June and subsequently tested positive for EVD. Two contacts of the first-detected case have since tested positive for EVD. These cases are from the same small community as the first detected case. They are currently being treated in an Ebola Treatment Centre in the capital, Monrovia. Additionally another probable EVD case is currently in isolation.

Officials are currently investigating the origin of infection of this cluster of cases. Currently, these cases are considered to constitute a separate outbreak from that which was declared over on 9 May.

Sierra Leone

During this reporting period, 9 cases were reported in Sierra Leone. The cases were reported in the same three districts as the previous weeks: Kambia, Port Loko and Western Area Urban, which includes the capital city Freetown.

Three of the cases reported during this period were recorded in the densely populated Magazine Wharf area of Freetown. Officials have disclosed that all three cases were registered contacts of a previous case.

Four chiefdoms in Kambia each reported a single confirmed case of EVD, as did two chiefdoms in the neighbouring district of Port Loko. According to officials, all but one of these cases were known contacts of a previous case or have an established epidemiological link to one.

On 8 July, Sierra Leonean officials reported that they will extend curfews, which were imposed on the worst-affected communities last month, until the deadly virus has been eradicated. While Operation Northern Push, a drive aimed at ending infections in the northwestern region of the country, was due to last 21 days, with residents of chiefdoms subjected to night-time lockdowns expecting the restrictions to end on Tuesday, Palo Conteh, head of the government’s National Ebola Response Centre, told reporters in Freetown that the 6:00 PM to 6:00 AM lockdowns will continue indefinitely. Speaking to reporters, Conteh stated, “I am pleased to announce that due to the successes we are seeing in a number of key areas Operation Northern Push will continue to run until we get to zero (cases),” adding, “curfew times will remain the same and there will be regular reviews so that we can adapt the response to meet the requirements as they change.”