Ebola Situation Report - 18 March 2015

SUMMARY

• A total of 150 new confirmed cases of Ebola virus disease (EVD) were reported in the week to 15 March, compared with 116 the previous week. There were 95 new confirmed cases reported in Guinea: the highest weekly total for the country in 2015. Sierra Leone reported 55 new confirmed cases over the same period: the country’s lowest weekly total since late June 2014. Liberia reported no new confirmed cases for the third consecutive week. March 15 was day 12 since the final patient in Liberia had a second negative test for EVD (42 days must elapse before transmission can be considered to have ended).
• A total of 12 districts in Guinea and Sierra Leone reported a confirmed case in the week to 15 March, all of which lie on a geographically contiguous arc in and around Conakry to the north and Freetown to the south. An additional 4 districts have reported a confirmed case in the past 21 days: Kono and Tonkolili in central and eastern Sierra Leone, and Lola and Macenta in eastern Guinea.
• Though transmission is currently confined to a relatively narrow geographic corridor, the population is highly mobile, with a great deal of movement throughout surrounding districts and countries. Limiting the movements of cases and contacts is challenging but essential to prevent the seeding of new outbreaks.
• Key response indicators for Guinea suggest that there remain significant challenges to overcome before transmission is brought under control. Of 41 total reported EVD deaths in the week to 15 March, over half (23) were identified post-mortem in the community. In the week to 8 March, a low proportion (28%) of confirmed cases arose from registered contacts, and there were a reported 18 unsafe burials. Taken together, these indicators suggest that the outbreak in Guinea is still being driven by unknown chains of transmission.
• In the week to 15 March a total of 125 suspected cases of EVD were reported in Liberia, none of whom tested positive for EVD. All contacts associated with the last known chain of transmission have now completed 21-day follow-up.
• By contrast with Guinea, key response indicators for Sierra Leone present a more promising outlook. In the week to 8 March over two-thirds (67%) of confirmed cases came from registered contacts, whilst in the week to 15 March, 6 of 62 total EVD-confirmed deaths were identified post-mortem in the community. There was 1 reported unsafe burial over the same period. However, there are still areas where most new cases arise from unknown chains of transmission. Kambia, a district north of Freetown on the border with the Guinean prefecture of Forecariah, reported 7 new cases in the week to 8 March, 5 of which came from post-mortem testing of people who had died in the community and who were not known to be contacts of a previous case.
• A meeting was held in Freetown on 14–15 March to finalise guidelines for the safe decommissioning of Ebola Treatment Centres and Community Care Centres when and where appropriate.
• 11 new health worker infections were reported in the week to 15 March: 3 in Conakry and 1 in Forecariah, Guinea, and 7 in Sierra Leone (4 in Bombali, and 3 in Port Loko). This brings the total number of health worker infections reported across the three most-affected countries since the start of the outbreak to 852, with 492 deaths. In addition, 2 EVD-positive health workers and a number of close contacts were medically evacuated to Denmark, the United Kingdom, and the United States of America in the week to 15 March.