3 December – Ebola Situation ReportDecember 5, 2014 in Ebola, Guinea, Liberia, Sierra Leone
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%.
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.
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.
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.
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.