Saturday, October 25, 2014

WHO Ebola Roadmap Update – Oct 25th

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# 9248

 

Delayed a day, I suspect, because of the fast breaking news about NYC and Mali, the World Health Organization has released their latest end-of-week situation report on the Ebola outbreak in West Africa, showing an increase of 950 cases over the past week. 


About a 15% increase over the previous week’s tally (n=820).

 

Exactly how representative these numbers really are of the situation in the these hot zone countries is a matter of some debate, although it is widely assumed they are significant undercounts. While the total number of cases reported is just over 10,000 – many observers peg the actual number as likely being 2 or even 3 times higher. 

 

Media reports suggest many cases are hidden from view, in part over family’s fears that their loved ones would be cremated if they did not survive. We’ve also seen variations in reporting on this outbreak in the past that has led – prematurely and erroneously – to speculation that this outbreak could be on the wane. 

 

 

SUMMARY

A total of 10 141 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 23 October. There have been 4922 reported deaths.


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 1).


1. COUNTRIES WITH WIDESPREAD AND INTENSE TRANSMISSION

A total of 10 114 confirmed, probable, and suspected cases of EVD and 4912 deaths have been reported up to the end of 18 October 2014 by the Ministry of Health of Liberia, 21 October by the Ministry of Health of Guinea, and 22 October by the Ministry of Health of Sierra Leone (table 1). All but one district in Liberia and all districts in 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 C te d voire, only two are yet to report a confirmed or probable case of EVD.


A total of 450 health-care workers (HCWs) are known to have been infected with EVD up to the end of 23 October: 80 in Guinea; 228 in Liberia; 11 in Nigeria; 127 in Sierra Leone; one in Spain; and three in the United States of America. A total of 244 HCWs have died.

(Continue . . .)

While a separate event with no connection to the West African epidemic, the outbreak in the DRC (Democratic Republic of Congo) is also updated in this report.   Unlike in West Africa, this outbreak appears to have been quickly brought under control.

 

ANNEX 2: EBOLA OUTBREAK IN DEMOCRATIC REPUBLIC OF THE CONGO

As at 21 October 2014 there have been 67 cases (38 confirmed, 28 probable, 1 suspected) of Ebola virus disease (EVD) reported in the Democratic Republic of the Congo, including eight among health-care workers (HCWs). In total, 49 deaths have been reported, including eight among HCWs.


Of 1121 total contacts, 1116 have now completed 21-day follow-up. Of five contacts currently being monitored, all were seen on 21 October, the last date for which data has been reported. On 10 October, the last reported case tested negative for the second time and was discharged. The Democratic Republic of the Congo will therefore be declared free of EVD 42 days after the date of the second negative test if no new cases are reported. This outbreak is unrelated to the outbreak that originated in West Africa.