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.