The numbers coming out of West Africa continue to bounce around, with the total number of cases actually down by nearly 200 over the report from October 29th, but the number of fatalities slightly higher.
This drop in cases was attributed to some suspected cases in Guinea being ruled out.
Given the limits of surveillance and reporting in these three countries, there’s not a great deal of faith that the numbers we are getting truly represent the size or scope of this epidemic.
total of 13 567 confirmed, probable, and suspected cases of Ebola virus disease (EVD) have been reported in six affected countries (Guinea, Liberia, Mali, Sierra Leone, Spain, and the United States of America) and two previously affected countries (Nigeria, Senegal) up to the end of 29 October. There have been 4951 reported deaths. The cases reported are fewer than those reported in the Situation Report of 29 October, due mainly to suspected cases in Guinea being discarded.
Following the WHO Ebola Response Roadmap structure1, country reports fall into two categories: 1) those with widespread and intense transmission (Guinea, Liberia, and Sierra Leone); and 2) those with or that have had an initial case or cases, or with localized transmission (Mali, Nigeria, Senegal, Spain, and the United States of America). An overview of the situation in the Democratic Republic of the Congo, where a separate, unrelated outbreak of EVD is occurring, is also provided (see Annex 2).
1. COUNTRIES WITH WIDESPREAD AND INTENSE TRANSMISSION
A total of 13 540 confirmed, probable, and suspected cases of EVD and 4941 deaths have been reported up to the end of the 29 October 2014 by the ministries of health of Guinea and Sierra Leone, and 25 October by the Ministry of Health of Liberia (table 1). All districts in Liberia and Sierra Leone have now reported at least one case of EVD since the start of the outbreak (figure 1). Of the eight Guinean and Liberian districts that share a border with Cote d Ivoire, only one in Guinea is yet to report a confirmed or probable case of EVD.
A total of 523 health-care workers (HCWs) are known to have been infected with EVD up to the end of 29 October: 82 in Guinea; 299 in Liberia; 11 in Nigeria; 127 in Sierra Leone; one in Spain; and three in the United States of America (two were infected in the USA and one in Guinea). A total of 269 HCWs have died.
WHO is undertaking extensive investigations to determine the cause of infection in each case. Early indications are that a substantial proportion of infections occurred outside the context of Ebola treatment and care. Infection prevention and control quality assurance checks are now underway at every Ebola treatment unit in the three intense-transmission countries. At the same time, exhaustive efforts are ongoing to ensure an ample supply of optimal personal protective equipment to all Ebola treatment facilities, along with the provision of training and relevant guidelines to ensure that all HCWs are exposed to the minimum possible level of risk.