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It is now three months since the first reports of deaths from a hemorrhagic fever began to emerge from the West African nation of Guinea. In late March the illness was diagnosed as Ebola, and over the next month additional cases were reported in neighboring Sierra Leone and Liberia.
Some earlier blog coverage of this epidemic includes:
Ebola: NEJM - New Clade, WHO Messaging & Updated FAQ
Overnight the World Health Organization has posted a GAR update on the Ebola outbreak, which has now affected 344 people in Guinea, 81 people in Sierra Leone, and (as reported in April) 5 lab confirmed cases in Liberia. Based on the Guinea numbers alone, this would make this easily the second worst Ebola outbreak recorded to date (surpassed only by Uganda, 2000-2001 with 425 cases).
First the latest update from the WHO, then I’ll be back with a little more:
Ebola virus disease, West Africa – update
06/06/2014
GuineaBetween 2 and 3 June 2014, 11 new cases (8 confirmed, 1 probable and 2 suspected) and 3 new deaths were reported from Conakry (7 new cases and 1 death), Gueckedou (2 new cases and 1 death), Telimele (1 new case and 0 deaths), and Boffa (1 new case and 1 death). This brings the cumulative total number of cases and deaths attributable to Ebola virus disease (EVD) in Guinea to 344 (207 confirmed, 81 probable, and 56 suspected cases) including 215 deaths.
The geographical distribution of these cases and deaths is as follows: Conakry, 65 cases and 27 deaths; Gueckedou, 193 cases and 143 deaths; Macenta, 44 cases and 26 deaths; Dabola, 4 cases and 4 deaths; Kissidougou, 7 cases and 5 deaths; Dinguiraye, 1 case and 1 death; Telimele, 23 cases and 5 deaths; and Boffa, 7 cases and 4 deaths. In terms of isolation, 31 patients are currently hospitalized – 6 in Conakry, 9 in Gueckedou, 15 in Telimele, and 1 in Boffa. The number of contacts currently being followed-up countrywide is 987 distributed as follows: Conakry, 329 contacts; Gueckedou, 323 contacts; Macenta, 176 contacts; Telimele, 104 contacts; and Boffa, 55 contacts.
Sierra Leone
Between 2 and 5 June 2014, 9 new suspected cases were reported bringing the total number of EVD clinical cases to 81 (31 confirmed, 3 probable, and 47 suspected), including 6 deaths. Kailahun district is the epicentre of the outbreak in Sierra Leone. Eleven cases are currently in isolation at Kenema Hospital. The number of contacts currently being followed-up is 30. Community resistance is hindering the identification and follow-up of contacts.
Liberia
There have been no new confirmed cases since 6 April 2014. Eleven contacts (5 health-care workers and 6 community relatives) are currently being followed-up. These contacts are of the probable case from nearby Kailahun, Sierra Leone who died in Foya, Liberia. The dead body was taken back to Kailahun for burial.
The total number of cases is subject to change due to reclassification, retrospective investigation, consolidation of cases and laboratory data and enhanced surveillance.
WHO response
WHO and partners continue to support the implementation of preventive and control measures in affected countries. Six experts and over 5,000 PPEs have been deployed to Sierra Leone to support the response operations.
WHO also supported Sierra Leone in developing proposals which were submitted to CERF ($238,000) and OCHA Emergency Fund (about $50,000) and DFID (£200,000). A joint WHO/HQ and AFRO mission provided support to Guinea on reviewing the outbreak response operations. The total estimated budget for Sierra Leone's EVD outbreak response is about US $1.8 million. On 3 June 2014, WHO facilitated a cross-border collaboration meeting between Guinea, Liberia, and Sierra Leone. They agreed to reinforce cross-border surveillance and harmonize social mobilization communication tools to address community resistance.
WHO does not recommend any travel or trade restrictions be applied to Guinea, Liberia, or Sierra Leone based on the current information available for this event.
While Ebola rarely travels far – and outbreaks tend to burn themselves out due to its virulence – it is possible that someone visiting the area could be exposed, and travel to another country or region while incubating the disease. Hence the concerns expressed yesterday in The ECDC Risk Assessment On Brazil’s FIFA World Cup which mentioned the (very slim) possibility of an imported case during the games.
This week the CDC has also issued its third travel notice on this Ebola outbreak, this time for Sierra Leone.
Alert - Level 2, Practice Enhanced Precautions
Released: June 04, 2014
At a Glance
- Suspected and Confirmed Case Count: 112
- Suspected Case Deaths: 7
- Laboratory Confirmed Cases: 31
What is the current situation?
As of May 27, 2014, the Sierra Leone Ministry of Health reported 7 confirmed cases of and several deaths from Ebola in Kailahun District, Sierra Leone. The district is located in the eastern region of the country, near the borders with Guinea and Liberia. Guinea and Liberia have also reported cases of Ebola. For more information, visit www.cdc.gov/vhf/ebola/outbreaks/guinea/index.html.
CDC recommends that travelers to Sierra Leone avoid contact with blood and body fluids of infected people to protect themselves.
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What can travelers do to prevent Ebola?
There is no vaccine for Ebola and no specific treatment. Although travelers are at low risk for the disease, it is important to take steps to prevent Ebola.
- Practice careful hygiene. Avoid contact with blood and body fluids of severely ill people. Do not handle items that may have come in contact with an infected person’s blood or body fluids.
- Avoid contact with animals.
- Seek medical care if you develop fever, headache, achiness, sore throat, diarrhea, vomiting, stomach pain, rash, or red eyes.
- Health care workers who may be exposed to people with the disease should follow these steps:
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- Wear protective clothing, including masks, gloves, gowns, and eye protection.
- Practice proper infection control and sterilization measures. For more information, see “Infection Control for Viral Hemorrhagic Fevers in the African Health Care Setting.”
- Isolate Ebola patients from unprotected people.
- Avoid direct contact with the bodies of people who died from Ebola.
