Friday, August 29, 2014

WHO: Ebola Response Roadmap Situation Report # 1


# 9017


This morning the World Health Organization has released as 7 page PDF SitRep (Situation Report) on the Ebola Outbreak in Western Africa.   This comes one day after releasing their Ebola Response Roadmap, which calls for a massive international effort and nearly 500 million dollars to respond to the crisis.


A few excerpts from the report, but follow the link to download and read it in its entirety.



WHO: Ebola Response Roadmap Situation Report 1

29 August 2014


The figures below show the distribution of confirmed and probable cases in each of these countries, accompanied by numbers of cases over time in capital cities.


These data indicate that the reporting of cases in Guinea appears to have been relatively stable, but with a marked increase in the recent week. Priorities continue to be to reduce incidence in the epicentre (Gueckedou), and to address threatening foci in Conakry.



By contrast, in Liberia, cases are increasing in the epicentre (Lofa) and in the capital, Monrovia.



The incidence of cases in Sierra Leone has been relatively flat, although with increases in the past week. Problems in scaling up response measures persist, notably in two districts, Kenema and Kailahun. Numbers of cases increased in the capital, Freetown.


Regarding Nigeria, the news yesterday that two new cases (1 confirmed, 1 suspected) had turned up in Port Harcourt means that containment of the virus has yet to be accomplished.



To date, the only country with cases linked to a case imported from a country with widespread and intense transmission is Nigeria. The table below shows the distribution of cases in that country.


The first 14 confirmed cases were all linked to persons, including health care workers, in close contact with an air traveller from Liberia, who entered Lagos on 20 July and died five days later. On 27 August, 1 additional case was confirmed in Port Harcourt by the Ministry of Health. A Ministry of Health and WHO team is in Port Harcourt supporting contact tracing and further investigation of the incident.


And lastly, a look at some of the response challenges on the ground.


There are serious problems with case management and infection prevention and control. The situation is worsening in Liberia and Sierra Leone.

  • In Guinea, the capacity to manage the current load of EVD cases is currently adequate in Gueckedou and in Conakry.
  • In Liberia, the capacity to cope with the increasing caseload remains dramatically low, especially in the capital, Monrovia, as well as in Bong and Nimba counties.
  • In Nigeria, a 40-bed isolation unit has been set up in the Mainland Hospital, and is sufficient to accommodate the patients currently isolated. The Ministry of Health has set up an isolation unit in Lagos town to care for cases.
  • In Sierra Leone, there is inadequate capacity to accommodate patients in Freetown. Patients must be transferred to Kenema, which is already overwhelmed by local demand.
  • Health care workers continue to be seriously affected in all countries, especially in Liberia and Nigeria.

Laboratory capacity

In Guinea, laboratory capacity currently appears to be sufficient. Support is being provided by the Pasteur Institute Dakar in Conakry, the European Union Mobile Laboratory in Gueckedou, and WHO.

  • In Liberia, specimens from Lofa county are tested in Guinea. Additional laboratory support is needed in Lofa to alleviate this burden. Specimens from other counties far from Lofa are sent to Monrovia, where laboratory capacity, supported by the United States Army Medical Research Institute of Infectious Diseases, US National Institutes of Health, and US Centers for Disease Control and Prevention, is stretched. The need for more laboratory support is being assessed in Bong (Pheebe hospital), Nimba and Bomi counties.
  • In Sierra Leone, additional laboratory support is needed in addition to the Kenema laboratory (supported by Metabiota and the US Department of Defense Critical Reagent Team) to cope with the increasing disease burden. A mobile laboratory from South Africa has been deployed to Freetown, where Ebola treatment centres are being constructed to care for patients locally and in better conditions, rather than referring them to Kenema.
  • In Nigeria, the Lagos University Teaching Hospital virology lab and the Lagos University Laboratory are being supported by WHO and an EU mobile team from the WHO Collaborating Centre in Hamburg, Germany.


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