Ebola Situation Report - 25 March 2015

SUMMARY

• A total of 79 new confirmed cases of Ebola virus disease (EVD) were reported in the week to 22 March: the lowest weekly total in 2015. There were 45 new confirmed cases reported from Guinea. Having reported no cases for 3 consecutive weeks, a new confirmed case was reported from Liberia on 20 March. Sierra Leone reported 33 new confirmed cases in the week to 22 March.
• With the exception of the case in Liberia, transmission has been restricted to districts in and around Conakry to the north and Freetown to the south. A total of 10 districts in Guinea, Liberia, and Sierra Leone reported a confirmed case in the week to 22 March. An additional 4 districts have reported a confirmed case in the past 21 days: Boffa, Dubreka, and Kindia in Guinea, and Koinadugu in Sierra Leone. The epicentre of the outbreak, in the tri-border area around the Guinean prefecture of Gueckedou, the Liberian county of Lofa, and the Sierra Leonean district of Kailahun, has not reported a confirmed case of EVD for over 90 days.
• Response indicators for Guinea suggest some improvements compared with recent weeks. Case incidence declined compared with the previous week in every prefecture to have reported a case in the past 21 days. Of 37 total reported EVD deaths in the week to 22 March, 7 were identified post-mortem in the community, compared with 28 of 49 the previous week. Similarly, in the week to 15 March, 38% of confirmed cases arose from registered contacts, compared with 28% the previous week. However, 26 unsafe burials were reported in the week to 22 March, compared with 22 the previous week. Notwithstanding these improvements, the fact that fewer than half of cases arose from known contacts, and the number of reported unsafe burials has increased suggests that the outbreak in Guinea continues to be driven by unknown chains of transmission.
• Investigations into the origin of the newly reported case in Liberia are ongoing. Heightened vigilance is being maintained throughout the country. In the week to 22 March, 238 laboratory samples were tested for EVD.
• Response indicators for Sierra Leone continue to improve. In the week to 15 March 84% of confirmed cases came from registered contacts, compared with 67% the previous week. There were no reports of unsafe burials in the week to 22 March; however, over the same period, 7 of 56 confirmed deaths from EVD were identified from post-mortem testing in the community.
• WHO is supporting the Liberian Ministry of Health to implement a heightened surveillance framework. Cross-border surveillance capacity has already been reinforced in Nimba and Grand Cape Mount counties; preliminary work to reinforce cross-border controls has already started in other border counties.
• In the context of falling case incidence and a receding zone of transmission, treatment capacity now far exceeds demand in both Liberia and Sierra Leone. Accordingly, and with technical guidance from WHO, national authorities in both countries have begun to implement plans for the phased safe decommissioning of surplus facilities. Each country will retain a core capacity of high-quality Ebola treatment centres, strategically located to ensure complete geographic coverage, with additional rapid-response capacity held in reserve.
• There was 1 new health worker infection in the week to 22 March, reported from Conakry, Guinea. This brings the total number of health worker infections reported across the three most-affected countries since the start of the outbreak to 853, with 494 deaths.