Ebola Update (18 June 2015)
June 18, 2015 in Ebola, Guinea, Sierra LeoneIn the week leading up to 14 June, there was a total of 24 confirmed cases of Ebola virus disease (EVD) reported, compared with 27 cases that were recorded in the previous week. In Guinea, 10 cases were reported during this period in four prefectures: Boke, Conakry, Dubreka and Forecariah. Sierra Leone reported 14 cases in 2 districts, Kambia and Port Loko, during this reporting period.
Of the 76 confirmed cases of EVD that have been reported in Guinea and Sierra Leone over the past 21 days leading up to 14 June, 69 (91%) were reported in 3 prefectures in Guinea (Boke, Dubreka and Forecariah) and 2 districts in Sierra Leone (Kambia and Port Loko).
As of 14 June, there have been a total of 27,305 confirmed, probable and suspected cases of EVD in Guinea, Liberia and Sierra Leone, with 11,169 reported deaths.
Guinea
During this reporting period, a total of 10 confirmed cases of EVD were reported, compared with 12 cases from 4 prefectures that were reported in the previous week.
Cases were reported in 4 prefectures: Boke (2 cases); Conakry (1 case); Dubreka (4 cases); and Forecariah (3 cases). Of these 10 cases, 5 were registered contacts, including all four cases in Dubreka. Of the remaining five cases, 4 arose from an unknown source of infection. This includes both cases from Boke prefecture and 2 of the 3 cases that were reported in Forecariah.
In Guinea, health checkpoints have been set up in the western prefectures of Boke and Coyah. On 7 June officials in Dubreka carried out a 6-day door-to-door case-finding campaign, which led to the discovery of 1 confirmed case. Additionally, intensive investigations are currently underway in order to trace a number of high-risk contacts associated with 3 cases that were reported in the capital, Conakry, over the past two weeks.
Sierra Leone
During this reporting period, a total of 14 confirmed cases were recorded in 2 districts: Kambia and Port Loko, compared to the 15 cases that were reported in the same 2 districts the previous week.
For the third consecutive week, Kaffu Bullom in Port Loko reported the most cases, six in total, of any single chiefdom. According to officials, five of the six cases from Kaffu Bullom were contacts of previous cases in quarantined homes located in a small, densely populated area near the international airport. One case, however, was reported from a new area of the chiefdom, Targrin, and upon further investigation, the case was determined to have acquired infection after sharing a ward with a confirmed case in a privately run health facility. A total of twenty health workers have since been registered as having a medium – high-risk contact with the case and are currently being monitored by officials. The remaining 8 cases that were reported in Sierra Leone were registered contacts of known cases and were reported from quarantined homes in 4 chiefdoms: Magbema (1 case); Samu (1 case); and Tonko Limba (4 cases) in Kambia and Bureh Kasseh Ma (2 cases) in Port Loko. As of 14 June, the Western Urban Area, which includes the capital city Freetown, has reported no cases for over 16 consecutive days.
Officials have disclosed that all 14 cases that were reported in the week leading up to 14 June can be traced back to the secret movement of cases, contacts and secret burials of EVD-related deaths during April. Consequently, officials are planning to carry out a large-scale operation in the districts of Kambia and Port Loko.
On Friday 12 June, Sierra Leone’s President Ernest Bai Koroma announced that he was imposing a three-week daytime curfew in the last Ebola-hit areas in a bid to curb a resurgence of the deadly virus. The curfew announcement comes after the country on Thursday extended its nationwide state of emergency for 90 days, despite calls from opposition politicians to relax restrictions in the country’s Ebola-free districts.
The president made the announcement on state television, stating that he was imposing “with immediate effect a 6:00 AM to 6:00 PM chiefdom-level curfew” in parts of the northwestern districts of Kambia and Port Loko, which are the only areas that are still reporting new infections. The president has indicated that people in the worst-hit chiefdoms, or areas, of those districts will be confined to their homes for 21 days, warning that anyone found flouting the order would find themselves in jail for the same period. Grocery stores and markets, which have been ordered to close at 6:00 PM, will now be allowed to stay open until 9:00 PM in most parts of the country, while restaurants, which also had a 6:00 PM curfew, have been granted an extension until 10:00 PM. Motorbike taxis, which were previously barred from operating after 7:00 PM, have been given an extra two hours.
The latest lockdown has been called over fears that the disease, which has killed about 3,900 people in Sierra Leone, was making a comeback in the northwestern region of the country. Palo Conteh, head of the National Ebola Response Centre, has attributed the recent spike in Port Loko and Kambia to “people just being stubborn and engaged in the wrong things that fuel the transmission,” adding “some washing of bodies and secret burials are going on and people are taking the sick to herbalists.” A lawmaker is on bail awaiting trial for allegedly ordering the washing, dressing and burial of his 106-year-old father in Kambia in May. Amadu Koroma, a local government clerk in Kambia, has disclosed that herbalists were frequently bypassing official entry and exit points to treat patients in southern Guinea, the epicentre of the outbreak, adding “people have also been escaping from quarantined homes at night and ending up in Port Loko where relatives bring in herbalists to threat them in locked rooms.”
While neighbouring Liberia was declared Ebola-free in May, hopes that Sierra Leone and Guinea would quickly follow suit have, in recent weeks, been dashed. On Wednesday, the World Health Organization (WHO) announced that the retreat of the virus “that was apparent throughout April and early May has stalled.” Sierra Leone’s health ministry has reported that 22 people are in Ebola treatment centres, all in Kambia and Port Loko, while 342 people are in quarantine in those districts and the Western Area, which includes the capital city, Freetown.
Ebola Cases in Guinea & Sierra Leone Rising Again
June 15, 2015 in Ebola, Guinea, Sierra LeoneResearchers reported Tuesday that the Ebola strain in the current outbreak in West Africa is less virulent than the first one that appeared in 1976. The news comes as the latest figures released by the World Health Organization (WHO) show that the number of Ebola cases reported in Guinea and neighbouring Sierra Leone has risen for a second consecutive week.
According to a recent study, the results of the test on monkeys carried out by scientists at the National Institutes of Health (NIH) are considered important as they suggest that the virus, which has caused at least 11,000 deaths, is not becoming more severe. Instead, “…the new study suggests the current virus has a decreased ability to cause disease in their animal model compared to the 1976 strain.”
The 1976 strain is known as the Mayinga strain while the one that emerged in Guinea, Liberia and Sierra Leone late in 2013 is known as the Makona Strain. The 1976 Ebola outbreak was limited, killing 318 people in the Democratic Republic of Congo, formerly known as Zaire. The deadliest outbreak with this strain occurred in Uganda in 2000, when 425 people died. Both of these outbreaks had a weaker impact as they occurred in rural and sparsely populated areas.
The latest figures released by the WHO on Wednesday indicate that the number of Ebola cases in Guinea and Sierra Leone has risen for the second consecutive week. According to the latest report, in Guinea, 16 new cases were confirmed in the week ending 7 June, with 15 more reported in neighbouring Sierra Leone. In its latest situation report, the WHO indicates that the Ebola virus has infected 27,237 people and killed 11,158.
In the previous week, 13 new cases had been reported in Guinea, which represented a clear increase to the nine that were reported a week before that. The global health agency has voiced concerns that the areas affected in Guinea have increased as in the week leading up to 7 June, two new cases were confirmed in Guinea’s capital city, Conakry, which had been Ebola-free during the previous three weeks. The virus also reappeared in the western Guinean region of Kindia, where three new cases were confirmed during this reporting period. Officials have reported that the pattern is similar in neighbouring Sierra Leone, where 12 new cases were confirmed in the last week of May, compared to just three that were confirmed in the previous week.
Ebola Update (4 June 2015)
June 4, 2015 in Ebola, Guinea, Sierra Leone, West AfricaOn Tuesday, Secretary General Ban Ki-moon warned that as long as there is one Ebola case in the West African region “all countries are at risk,” urging all nations to support the final battles aimed at wiping out the deadly disease in Guinea and Sierra Leone.
Speaking to a General Assembly meeting on efforts to end the Ebola epidemic, which has killed over 11,100 people mainly in Liberia, Guinea and Sierra Leone, the UN chief stated, “we are on the home stretch now and what happens now is critical.” While Liberia, which was once the worst affected country, has now been declared Ebola-free, Ban has warned that in Guinea and Sierra Leone, “the battle has not yet been won,” and “any lapse in vigilance could allow the virus to spread.” Dr David Nabarro, the UN Ebola chief, told the assembly that the priority is to ensure that the outbreak ends as soon as possible, “which will take several weeks and may take a number of months… But everybody should be ready in case the disease recurs and needs to be controlled, especially in the coming 12 months.” Ban also disclosed that UN agencies who will be taking over responsibility for tackling the outbreak as the UN Mission for Ebola Emergency Repose (UNMEER) scales down “will need considerable resources to go the distance and support recovery” in the three hardest-hit countries. UNMEER’s acting chief Peter Jan Graaff has indicated that UNMEER’s office in Mali closed on 31 March while its office in Liberia has handed over its operations to the UN country team. The Sierra Leone office is expected to end operations by the end of June, with Graaff indicating, “UNMEER could complete its transition by July 31 and be closed by the end of August,” noting however that if the situation deteriorates, the timeline could be changed “to ensure that the UN’s political leverage and convening power is maintained.” The UN Secretary General has indicated that he will convene an International Ebola Recovery Conference in New York on 10 July, which will aim to mobilize resources to start early recovery in Guinea, Liberia and Sierra Leone.
On Wednesday, the World Health Organization (WHO) released its latest figures on the Ebola outbreak in West Africa. As of 31 May, there have been a total of 27,145 reported confirmed, probable and suspected cases of EVD in Guinea, Liberia and Sierra Leone, with 11,147 reported deaths. In the seven days leading up to 31 May, a total of 25 confirmed cases of EVD were reported from 4 prefectures in Guinea and 3 districts of Sierra Leone,
According to the WHO, “since the week ending 10 May, when a 10-month low of 9 cases of Ebola Virus Disease (EVD) were reported from 2 prefectures of Guinea and 1 district of Sierra Leone, both the intensity and geographical area of EVD transmission have increased.” In the 7 days leading up to 31 May, a total of 13 new confirmed cases were reported in Guinea and 12 in Sierra Leone, with officials indicating that several cases in both countries arose from unknown sources of infection in areas that have not reported confirmed EVD cases for several weeks. This effectively indicates that chains of transmission continue to go undetected. Officials have noted that “rigours contact tracing, active case finding, and infection prevention and control must be maintained at current intensive levels in order to uncover and break every chain of transmission,” and have warned that the onset of the rainy season will make field operations more difficult from now onwards.
Two response teams from Guinea-Bissau have been deployed to the border with Guinea to assess several points of entry and sensitive communities. This is due to the proximity to Guinea-Bissau of the recent cluster of cases that have been reported in the northwestern Guinean prefecture of Boke. So far, the investigation team has not been able to locate the contact who had attended the funeral of a case in Boke and who is believed to have returned to a fishing community in Guinea-Bissau.
Guinea
In the week leading up to 31 May, a total of 13 cases were reported in 4 western prefectures of Guinea.
Seven of these cases were reported from the prefecture of Forecariah, which borders Sierra Leone. Multiple chains of transmission gave rise to cases in 4 of Forcariah’s 10 sub-prefectures, however all cases were either registered contacts of a previous case or had an established epidemiological link to one. Five cases were concentrated in the central areas of the prefecture where the sub-prefectures of Farmoriah, Kaliah, and Moussayah intersect. The remaining cases were reported from the northwestern prefecture of Boke (1 case), which borders Guinea-Bissau; the west coast prefecture of Dubreka (4 cases), which borders the capital city Conakry; and the western inland prefecture of Fria (1 case). The cases in Boke and Dubreka were all registered contacts of cases linked to localized chains of transmission. The case that was reported in Fria however arose from an unknown source and is suspected to have originated from an as-yet unidentified chain of transmission in the neighbouring prefecture of Telimele. Officials have indicated that investigations into the origin of the case in Fria have been complicated by active and passive resistance from communities both in Fria and neighbouring Telimele.
On the ground sources in Guinea have reported that community engagement continues to prove challenging, particularly in all the 4 affected prefectures. There have been several reported incidents of violence that has been directed at field staff during the past week.
Sierra Leone
In the week leading up to 31 May, Sierra Leone reported a total of 12 cases in three districts.
Eight of these cases were reported from a densely populated area of the Kaffu Bullom chiefdom in the district of Port Loko, which is located just north of the capital, Freetown. All but one of these cases were registered contacts of previous cases within quarantined houses in the chiefdom. The additional case is from the same neighbourhood however it was not on a contact list and was living in a non-quarantined home at the time of symptom onset. The other cases were reported in the following districts: Kambia reported its first case for over 2 weeks on 31 May. The case was identified after a post-mortem test of a community death and was not a known contact of a previous case. The remaining three cases were reported from the capital city, Freetown. Officials in Freetown have indicated that at this time, none of those 3 cases can be linked to previous chains of transmission however investigations are at an early stage.
Six People Placed in Isolation in Guinea after Transporting Ebola Victim in Taxi
May 27, 2015 in GuineaSix people have been put in isolation in prison after being accused of travelling with a corpse of a relative who had died of Ebola. If after twenty-one days they do not show any signs of having contracted the deadly virus, they will be tried for violating the health emergency.
According to Guinean authorities, the body was seated upright in a taxi, dressed in a T-shirt and jeans with sunglasses and sandwiched between three others. The head of Guinea’s Ebola response, Dr Sakoba Keita, has indicated that those now in quarantine in prison had been travelling in a taxi with the body of the police recruit from the town of Forecariah towards the capital, Conakry. They were stopped at an Ebola checkpoint where security officials became suspicious when the seemingly well-dressed passenger remained motionless.
Guinea is currently battling to control a recent flare up in Ebola cases. Authorities have reported that relatives of Ebola victims are increasingly transporting their bodies on public transportation, seating the corpses upright between other passengers in a bid to avoid health controls. According to Dr Keita, actions, such as transporting corpses in taxis, account for the continued spread of the Ebola epidemic. Figures released by the World Health Organization (WHO) last week reported the highest number of cases in Guinea in more than a month, with at least twenty-seven new cases reported in one week. They comes as officials were hoping that the outbreak in Guinea was finally coming under control, with neighbouring Liberia recently being declared Ebola-free and Sierra Leone registering only eight cases during the same period. While it is against the law to transport bodies of Ebola victims from one community to another, according to Rabiatou Serah, a member of an anti-Ebola committee, relatives who are concealing bodies are managing to get past inspection agents. Nearly 2,500 people have died in the West African country since the Ebola outbreak began more than a year ago.
Due to “a substantial increase” in the weekly total of new Ebola cases in Guinea, the WHO has deployed a response team to the border with Guinea-Bissau because the country’s proximity to a recent cluster of cases reported in the neighbouring Guinean prefecture. In its latest update, the WHO reported that in the week ending on 17 May, 35 new cases were reported in Guinea and Sierra Leone, effectively the highest weekly total of confirmed cases of Ebola in over a month. Guinea reported 27 of those cases, compared with seven that were recorded the week before. A statement released by the WHO disclosed that “this is a substantial increase compared with nine cases reported the previous week.” It further reported, “the geographical area of transmission has also expanded compared with recent weeks, with a total of six districts reporting cases (three in Guinea, three in Sierra Leone) compared with three the previous week (three in Guinea, one in Sierra Leone),” adding, “because of the proximity to Guinea-Bissau of the recent cluster of cases in the Guinean prefecture of Boke, a response team from Guinea-Bissau has been deployed to the border to assess points of entry… An epidemiological investigation team has also mobilized to ensure any contacts who cross the border are traced.” The statement further noted, “the cases in Boke were tightly clustered in the coastal sub-prefecture of Kamsar, and initial investigations suggest they may have originated from a chain of transmission in Conakry.” WHO officials have indicated that while the exact origin of the cluster in Boke remains unknown, an investigation has linked most of the confirmed cases to four probable cases who attended a funeral of another probable case in mid-April, which may have been the source of the outbreak. Guinea-Bissau has not reported any cases of Ebola.
Liberia Celebrates End of Ebola
May 12, 2015 in LiberiaOn Monday, thousands of Liberians gathered to celebrate the end of Ebola after the country was declared free of the deadly disease that has killed more than 4,700 people. Several dignitaries participated in the celebration, including the President of Togo, along with guests from the African Union, Ghana and Nigeria. Liberian President Ellen Johnson Sirleaf closed the celebrations by recommitting herself to helping the governments and people of neighbouring Guinea and Sierra Leone to overcome the disease.
In a statement released Saturday 9 May, the World Health Organization (WHO) indicated that 42 days had passed since the last person confirmed with the virus in Liberia was buried. On Monday, the Liberian government declared a public holiday in order to allow workers and students to take part in a festival in the capital city, Monrovia. The ceremony however began on a sombre note, with testimonials from health workers and other staff in the country’s Ebola treatment units (ETU’s) as well as survivors and body disposal team members.
The WHO has hailed the eradication of the deadly disease in Liberia as an enormous development in the crisis, which has affected the West African region for over a year. However the United Nations agency has warned that because outbreaks are continuing in neighbouring Guinea and Sierra Leone, the risk remains high that infected people could re-enter the country. More than 4,700 people died during the Ebola crisis in Liberia, which remains the hardest-hit country by the outbreak. Neighbouring Guinea and Sierra Leone continue to report new cases on a weekly basis. While the number of new cases being reported has significantly declined in recent months, officials in both countries have noted that they have had difficulty in tracing new cases.
Latest figures released by the WHO indicate that 26,720 cases have been reported and 11,079 people have died from Ebola in Guinea, Liberia, Nigeria, Mali, Sierra Leone and the United States, however officials have warned that the full scale of the Ebola outbreak may have been underreported. The latest outbreak, which was officially confirmed in March 2014, has killed five times more people than all the other known outbreaks combined.