WHO: Ebola Response Roadmap Situation Report 8 October 2014 The total number of confirmed, probable, and suspected cases in the West African epidemic of Ebola virus disease (EVD) reported up to the end of 5 October 2014 (epidemiological week 40) is 8033 with 3879 deaths. Countries affected are Guinea, Liberia, Nigeria, Senegal, Sierra Leone, and the United States of America. A confirmed case of EVD has been reported in Spain 1, but because the case was confirmed during the week ending 12 October (epidemiological week 41), information on this case will be included in the next Ebola Response Roadmap update. The past week has seen a continuation of recent trends: the situation in Guinea, Liberia, and Sierra Leone continues to deteriorate, with widespread and persistent transmission of EVD. Problems with data gathering in Liberia continue. It should be emphasized that the reported fall in the number of new cases in Liberia over the past three weeks is unlikely to be genuine. Rather, it reflects a deterioration in the ability of overwhelmed responders to record accurate epidemiological data. It is clear from field reports and first responders that EVD cases are being under-reported from several key locations, and laboratory data that have not yet been integrated into official estimates indicate an increase in the number of new cases in Liberia. There is no evidence that the EVD epidemic in West Africa is being brought under control, though there is evidence of a decline in incidence in the districts of Lofa in Liberia, and Kailahun and Kenema in Sierra Leone. OUTLINE This is the seventh in a series of regular situation reports on the Ebola Response Roadmap 2. The report contains a review of the epidemiological situation based on official information reported by ministries of health, and an assessment of the response measured against the core Roadmap indicators where available. The data contained in this report are the best available. Substantial efforts are ongoing to improve the availability and accuracy of information about both the epidemiological situation and the implementation of response measures. Following the roadmap structure, country reports fall into three categories: (1) those with widespread and intense transmission (Guinea, Liberia, and Sierra Leone); (2) those with an initial case or cases, or with localized transmission (Nigeria, Senegal, and the United States of America); and (3), those countries that neighbour areas of active transmission (Benin, Burkina Faso, Côte d’Ivoire, Guinea-Bissau, Mali, Senegal). An overview of the situation in the Democratic Republic of the Congo, where there is a separate, unrelated outbreak of EVD, is also provided. 1. COUNTRIES WITH WIDESPREAD AND INTENSE TRANSMISSION The upward epidemic trend continues in Guinea, Liberia, and Sierra Leone. GUINEA Transmission in Guinea is persistent, with approximately 100 new confirmed cases of EVD reported in the past week. For many weeks the outbreak in Guinea has been driven by transmission in three areas: the capital Conakry, Macenta, and Gueckedou, the region in which the outbreak originated. Although the number of reported new confirmed and probable cases in Gueckedou has been stable and low over the past four weeks, with between four and six cases reported each week, the number of new cases reported from Macenta varied between 15 and 71 cases reported each week over the same period. Transmission remains high in Conakry, with 15 new confirmed and probable cases reported in epidemiological week 40. The district of N’Zerekore has also reported a marked increase in the number of new cases reported, with 20 reported in epidemiological week 40. In the east of country, on the border with Côte d’Ivoire, the district of Lola has now reported cases of EVD for the first time. The neighboring district of Beyla reported its first confirmed cases the previous week. LIBERIA There continue to be profound problems affecting data acquisition in Liberia. Evidence obtained from responders and laboratory staff in the country indicates beyond doubt that there is widespread 2under-reporting of new cases, and that the situation in Liberia, and in Monrovia in particular, continues to deteriorate from week to week. Approximately 200 new probable and suspected cases, but very few confirmed cases, have been reported in the capital Monrovia in each of the past three weeks. A substantial proportion of these suspected cases are most probably genuine cases of EVD, and the reported fall in confirmed cases over the past three weeks reflects delays in matching laboratory results with clinical surveillance data. Efforts continue to urgently address problems with data acquisition in what is an extremely challenging environment, and it is likely that the figures will be revised upwards in due course. The district of Margibi continues to report high numbers of new confirmed and probable cases (31 in the past week), while the district of Grand Cape Mount has reported new cases for the first time in three weeks. There continues to be a fall in the number of new cases reported in Lofa, which borders Gueckedou in Guinea, with 12 confirmed and probable cases reported this week compared with 39 the previous week. This appears to be a genuine reduction. SIERRA LEONE Nationally, the situation in Sierra Leone continues to deteriorate, with an increase in the number of new confirmed cases reported over each of the past seven weeks. The capital, Freetown, and the neighbouring districts of Bombali, Port Loko, and Moyamba, have all reported a surge in cases over the past seven to eight weeks. The districts of Bo and Tonkolili have also reported an increase in the number of new confirmed and probable cases over the same period. By contrast, a low number of new cases have been reported from Kailahun (three cases in epidemiological week 40) and Kenema (five cases in epidemiological week 40) for the past four weeks. These areas had previously reported high levels of transmission. Reports from responders suggest this fall is a genuine decline in incidence, although further investigation will be required before this can be confirmed. HEALTH-CARE WORKERS The high number of EVD infections in health-care workers (HCWs) continues to be a cause of great concern. 401 HCWs are known to have been infected with EVD up to the end of 5 October. 232 HCWs have died.
Posted on: Fri, 10 Oct 2014 12:52:41 +0000
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