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WHO: Ebola virus disease, West Africa –update August 05, 2015 - cumulative number of cases stands at 27 862 ; deaths 11 281 total - WHO admits these counts are very conservative (Nov 6)

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  • #61
    Ebola Situation Report - 29 April 2015
    ...
    SUMMARY

    A total of 33 confirmed cases of Ebola virus disease (EVD) was reported in the week to 26 April. Two areas, Forecariah in Guinea and Kambia in Sierra Leone, accounted for 25 (76%) of all confirmed cases reported. Improved community engagement in these areas is required to ensure that all remaining chains of transmission can be tracked and ultimately brought to an end.

    Guinea reported 22 confirmed cases in the week to 26 April, compared with 19 cases the previous week. Sierra Leone reported 11 confirmed cases, compared with 12 cases the previous week. Liberia reported no confirmed cases for the fifth consecutive week. Of 55 districts in Guinea, Liberia, and Sierra Leone that have reported at least one confirmed case of EVD since the start of the outbreak, 39 have not reported a case for over 6 weeks.

    A total of 5 Guinean prefectures reported at least one confirmed case in the week to 26 April. No cases were reported from the capital, Conakry. The vast majority of cases (17 of 22: 77% were reported from the western prefecture of Forecariah, which borders the Sierra Leonean district of Kambia.

    Three districts in Sierra Leone reported new confirmed cases in the week to 26 April, compared with 4 districts the previous week. In addition to 8 confirmed cases reported from Kambia, 1 case was reported from Western Area Urban, which includes the capital Freetown, and 2 new cases were reported from Western Area Rural.

    In Sierra Leone, a total of 4 confirmed cases were identified in the community after post-mortem testing (all from Kambia) in the week to 26 April, compared with 3 the previous week. Additionally, half (50%) of new cases reported in the week to 19 April (the most recent period for which data are available) arose among known contacts of previous cases. Laboratory indicators reflect a heightened degree of vigilance, with 1406 new samples tested in the week to 26 April. Less than 1% of samples tested positive for EVD.

    Response indicators for Guinea present a similarly mixed picture. A total of 8 confirmed EVD cases in the week to 26 April were identified after post-mortem testing of deaths identified in the community, compared with 6 the previous week. A total of 66 unsafe burials were reported in the week to 26 April. The percentage of confirmed cases that arose among registered contacts decreased to 27% (6 of 22) in the week to 26 April, from 53% the previous week. However, laboratory indicators continue to improve with a seventh consecutive weekly rise in the number of laboratory samples tested to 585.

    In both Guinea and Sierra Leone, the fact that cases continue to be identified after post-mortem testing, together with the fact that around half of all cases arise in people not identified as contacts of previous cases, suggest that surveillance and community engagement still require improvement in some areas. A case-finding and community-awareness campaign took place in the Guinean prefecture of Coyah from 24 to 27 April, with over 57 000 households visited over 4 days. 44 alerts were reported over the 4-day operation: an increase of 91% compared with the previous week. None of the alerts resulted in confirmed cases, although 10 laboratory samples are still pending. Similar initiatives are planned for the prefectures of Boffa, Conakry, Dubreka, and Kindia.

    The last confirmed case in Liberia died on 27 March and was buried on 28 March. Heightened vigilance is being maintained throughout the country. In the 4 days to 23 April, 194 new laboratory samples were tested for EVD, with no confirmed cases. On 9 May, 42 days will have elapsed since the burial of the last confirmed case.

    For the second consecutive week, no new health worker infections were reported in the week to 26 April.

    COUNTRIES WITH WIDESPREAD AND INTENSE TRANSMISSION

    There have been a total of 26 277 reported confirmed, probable, and suspected cases of EVD in Guinea, Liberia and Sierra Leone (figure 1, table 1), with 10 884 reported deaths (outcomes for many cases are unknown). A total of 22 new confirmed cases were reported in Guinea, 0 in Liberia, and 11 in Sierra Leone in the 7 days to 26 April.
    The total number of confirmed and probable cases is similar in males and females (table 2). Compared with children (people aged 14 years and under), people aged 15 to 44 are approximately three times more likely to be affected. People aged 45 and over are three to five times more likely to be affected than children.
    A total of 865 confirmed health worker infections have been reported in Guinea, Liberia, and Sierra Leone; there have been 504 reported deaths (table 5).
    ... Table 1: Confirmed, probable, and suspected EVD cases in Guinea, Liberia, and Sierra Leone
    Guinea Confirmed 3158 69 1962
    Probable 415 * 415
    Suspected 11 *
    Total 3584 69 2377
    Liberia** Confirmed 3151 0
    Probable 1879 *
    Suspected 5292 *
    Total 10 322 0 4608
    Sierra Leone Confirmed 8586 32 3533
    Probable 287 * 208
    Suspected 3498 * 158
    Total 12 371 32 3899
    Total Confirmed 14 895 101
    Probable 2581 *
    Suspected 8801 *
    Total 26 277 101 10 884

    Data are based on official information reported by ministries of health. These numbers are subject to change due to ongoing reclassification, retrospective investigation and availability of laboratory results. *Not reported due to the high proportion of probable and suspected cases that are reclassified. ‡Data not available. **Data missing for 24 to 26 April. ...
    http://apps.who.int/ebola/current-si...-29-april-2015
    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
    -Nelson Mandela

    Comment


    • #62
      Ebola Situation Report - 20 May 2015

      ...
      SUMMARY
      • The week to 17 May saw the highest weekly total of confirmed cases of Ebola virus disease (EVD) for over a month, with 35 cases reported from Guinea and Sierra Leone. This is a substantial increase compared with 9 cases reported the previous week. The geographical area of transmission has also expanded compared with recent weeks, with a total of 6 districts reporting cases (3 in Guinea, 3 in Sierra Leone), compared with 3 the previous week (2 in Guinea, 1 in Sierra Leone). Capacity for improved community engagement, case investigation, and targeted, active surveillance continues to be strengthened in areas of continuing transmission to ensure that remaining chains of transmission are detected, contained, and brought to an end.
      • Guinea reported a total of 27 cases, compared with 7 cases the previous week. The majority of cases were reported from the western prefectures of Dubreka (11 cases) and Forecariah (11 cases), with the remaining 5 cases reported from the north western prefecture of Boke, which borders Guinea-Bissau. The cases in Boke were tightly clustered in the coastal sub-prefecture of Kamsar, and initial investigations suggest they may have originated from a chain of transmission in Conakry. All 11 cases reported from Dubreka came from the sub-prefecture of Tanene. Although the exact origin of the cluster is unknown, retrospective investigation has linked most of the confirmed cases to 4 probable cases who attended a funeral of another probable case in Dubreka in mid-April, which may have been the source of the outbreak. Difficulty engaging local communities has made case investigation and contact tracing in the area challenging. In Forecariah, 11 cases were distributed across 6 of the prefecture’s 10 sub-prefectures. A total of 9 of the 27 cases reported from Guinea originated from an unknown source, indicating that chains of transmission continue to evade detection in several areas.
      • Because of the proximity to Guinea-Bissau of the recent cluster of cases in the Guinean prefecture of Boke, a response team from Guinea-Bissau has been deployed to the border to assess points of entry. An epidemiological investigation team has also mobilized to ensure any contacts who cross the border are traced.
      • In Sierra Leone, 8 confirmed cases were reported from Freetown (4 cases), Kambia (1 case), and Port Loko (3 cases). In Freetown, cases were clustered in 3 neighbourhoods in the north of the city near to the Moa Wharf area, which was the only part of Sierra Leone to report cases in the previous week. The single case in Kambia was reported from the Chiefdom of Magbema, which had been the main focus of transmission in the district in recent weeks. The 3 cases in the Port Loko Chiefdom of Kaffu Bullom are linked to a chain of transmission in Kambia. A total of 4 of the 8 cases reported from Sierra Leone were registered contacts of a previous case. An additional 3 cases were not registered contacts, but were found on further investigation to have had contact with a previous case. The remaining case, reported from Freetown, was identified after post-mortem testing of a community death. The source of infection is unknown, but the case was found in the Moa Wharf area.
      • The last health worker infection in Guinea was reported on 6 April. However, a new health worker infection in Sierra Leone was laboratory confirmed on 14 May. The case is a Sierra Leone national who was working at an Ebola treatment centre near Freetown at the time of symptom onset. This is the same facility at which the recent Italian health worker case was stationed prior to their return to Italy. Investigations are ongoing into how both health workers came to be exposed to EVD. A total of 13 contacts are currently being monitored in Italy, none of whom are considered to have had a high-risk exposure. There have been a total of 869 confirmed health worker infections reported from Guinea, Liberia, and Sierra Leone since the start of the outbreak, with 507 reported deaths.
      COUNTRIES WITH WIDESPREAD AND INTENSE TRANSMISSION
      • There have been a total of 26 933 reported confirmed, probable, and suspected cases of EVD in Guinea, Liberia and Sierra Leone (figure 1, table 1), with 11 120 reported deaths (this total includes reported deaths among probable and suspected cases, although outcomes for many cases are unknown). A total of 27 new confirmed cases were reported in Guinea and 8 in Sierra Leone in the 7 days to 17 May. The outbreak in Liberia was declared over on 9 May.
      • The total number of confirmed cases is similar in males and females (table 2). Compared with children (people aged 14 years and under), people aged 15 to 44 are approximately 3 to 4 times more likely to be affected. People aged 45 and over are 4 to 5 times more likely to be affected than children.
      • A total of 869 confirmed health worker infections have been reported in Guinea, Liberia, and Sierra Leone; there have been 507 reported deaths (table 5).
      Figure 1: Confirmed, probable, and suspected EVD cases worldwide

      Table 1: Confirmed, probable, and suspected EVD cases in Guinea, Liberia, and Sierra Leone
      Guinea Confirmed 3201 43 1988
      Probable 419 * 419
      Suspected 15 *
      Total 3635 43 2407
      Liberia§ Confirmed 3151 0
      Probable 1879 *
      Suspected 5636 *
      Total 10 666 0 4806
      Sierra Leone Confirmed 8605 19 3541
      Probable 287 * 208
      Suspected 3740 * 158
      Total 12 632 19 3907
      Total Confirmed 14 957 62
      Probable 2585 *
      Suspected 9391 *
      Total 26 933 62 11 120
      Data are based on official information reported by ministries of health. These numbers are subject to change due to ongoing reclassification, retrospective investigation and availability of laboratory results. *Not reported due to the high proportion of probable and suspected cases that are reclassified. ‡Data not available. §The outbreak in Liberia was declared over on 9 May, after 42 complete days elapsed since the burial of the last confirmed case. The country has now entered a 3-month period of heightened vigilance.

      .../

      http://apps.who.int/ebola/en/current...rt-20-may-2015





      "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
      -Nelson Mandela

      Comment


      • #63
        Ebola Situation Report - 10 June 2015

        ...
        SUMMARY
        In recent weeks, the decline in case incidence and the contraction of the geographic area affected by Ebola virus disease (EVD) transmission that was apparent throughout April and early May has stalled. In total, 31 confirmed cases of EVD were reported in the week ending 7 June: 16 cases in Guinea and 15 in Sierra Leone. This is the second consecutive weekly increase in case incidence, and the highest weekly total number of cases reported from Sierra Leone since late March. In addition, cases were reported from a widening geographical area in Guinea and Sierra

        Leone, and the continued occurrence of cases that arise from unknown sources of infection highlights the challenges still faced in finding and eliminating every chain of transmission.

        A total of 16 cases were reported from 5 western prefectures of Guinea in the week to 7 June. Half of all cases were reported from the south western prefecture of Forecariah, which borders Sierra Leone. In the north west of the country, on the border with Guinea-Bissau, a case was reported from the prefecture of Boke for the fourth consecutive week. The capital, Conakry, reported 2 cases, as did the neighbouring coastal prefecture of Dubreka, with the remaining 3 cases reported from the inland prefecture of Kindia, which borders the Sierra Leonean district of Bombali. Conakry and Kindia had previously not reported a case for over 40 days.

        A total of 5 of the 16 cases reported from Guinea arose from unknown sources of infection, including all 3 cases reported from Kindia. Investigations are ongoing to trace the origin of those cases. In addition, 3 cases in Guinea, including 1 of those from Kindia, were identified after post-mortem testing of community deaths. As at 7 June, there were 1693 contacts being monitored across 8 prefectures in Guinea.

        Sierra Leone reported a total of 15 confirmed cases from 2 districts in the week to 7 June. Similar to the previous week, most cases (7) were reported from quarantined homes in a small area of Kaffu Bullom chiefdom in the district of Port Loko. However, a cluster of 3 cases was also reported from the Bureh Kasseh Ma chiefdom of the same district. The cases are not thought to be directly linked to Kaffu Bullom, but rather to a chain of transmission in the neighbouring district of Kambia. After reporting its first case in more than 2 weeks the previous week, 5 cases were reported from 2 chiefdoms in Kambia during the week ending 7 June.

        The Western Urban Area of Sierra Leone, which includes the capital Freetown, reported no cases for the first time since August 2014. However, there were still 195 contacts under follow-up in the district as at 7 June, and a total of 392 contacts nationally in 3 districts (Kambia and Port Loko are the other 2 districts).

        Efforts are ongoing to augment the ability of contact tracing and case-investigation teams to engage effectively with affected communities in Guinea and Sierra Leone. In Guinea, 19 unsafe burials were reported during the week to 7 June. Although no unsafe burials have been reported for many weeks in Sierra Leone, investigations into recent cases in Kambia have found clear evidence that they are still taking place in some areas. Improved communication with local communities is essential to understand and address any concerns that prevent cases and deaths from being reported, and chains of transmission from being detected.

        All contacts associated with the case confirmed in Italy on 12 May have now completed the 21-day follow-up period.

        The last health worker infections in Guinea and Sierra Leone were reported on 6 April and 14 May, respectively. There have been a total of 869 confirmed health worker infections reported from

        Guinea, Liberia, and Sierra Leone since the start of the outbreak, with 507 reported deaths.

        COUNTRIES WITH WIDESPREAD AND INTENSE TRANSMISSION

        There have been a total of 27 237 reported confirmed, probable, and suspected cases of EVD in Guinea, Liberia and Sierra Leone (figure 1, table 1), with 11 158 reported deaths (this total includes reported deaths among probable and suspected cases, although outcomes for many cases are unknown). A total of 16 new confirmed cases were reported in Guinea and 15 in Sierra

        Leone in the 7 days to 7 June. The outbreak in Liberia was declared over on 9 May.

        The total number of confirmed cases is similar in males and females (table 2). Compared with children (people aged 14 years and under), people aged 15 to 44 are approximately 3 to 4 times more likely to be affected. People aged 45 and over are 4 to 5 times more likely to be affected than children.

        A total of 869 confirmed health worker infections have been reported in Guinea, Liberia, and Sierra Leone; there have been 507 reported deaths (table 5).
        ... Table 1: Confirmed, probable, and suspected EVD cases in Guinea, Liberia, and Sierra Leone
        Guinea Confirmed 3239 38 2018
        Probable 419 * 419
        Suspected 12 *
        Total 3670 38 2437
        Liberia§ Confirmed 3151 0
        Probable 1879 *
        Suspected 5636 *
        Total 10 666 0 4806
        Sierra Leone Confirmed 8635 30 3549
        Probable 287 * 208
        Suspected 3979 * 158
        Total 12 901 30 3915
        Total Confirmed 15 025 68
        Probable 2585 *
        Suspected 9627 *
        Total 27 237 68 11 158

        Data are based on official information reported by ministries of health. These numbers are subject to change due to ongoing reclassification, retrospective investigation and availability of laboratory results. *Not reported due to the high proportion of probable and suspected cases that are reclassified. Data not available. §The outbreak in Liberia was declared over on 9 May, after 42 complete days elapsed since the burial of the last confirmed case. The country has now entered a 3-month period of heightened vigilance.
        ...
        http://apps.who.int/ebola/en/current...t-10-june-2015
        "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
        -Nelson Mandela

        Comment


        • #64
          Ebola Situation Report - 1 July 2015
          ...
          SUMMARY


          • There were 20 confirmed cases of Ebola virus disease (EVD) reported in the week to 28 June, the same as the previous week. Weekly case incidence has been between 20 and 27 cases for 5 consecutive weeks. In Guinea, 12 cases were reported from 3 prefectures: Boke, Conakry, and Forecariah. All 3 prefectures reported cases the previous week. In Sierra Leone, 8 cases were reported from the same 3 districts as the previous week: Kambia, Port Loko, and the district that includes the capital, Freetown. Challenges tracing and monitoring contacts continue to hamper efforts to end transmission, with a proportion of cases not detected until after death, increasing the risk of further transmission.
          • On 29 June, routine surveillance detected a confirmed case of EVD in Margibi County, Liberia—the first new confirmed case in the country since 20 March. The case is a 17-year-old male who first became ill on 21 June. After presenting at a local health facility the patient was treated for malaria and discharged. He died on 28 June and received a safe burial the same day. An oral swab taken before the burial subsequently tested positive twice for EVD. 102 contacts have been identified, although that number is expected to increase as investigations continue. At this stage the origin of infection is not known. The case reportedly had no recent history of travel, contact with visitors from affected areas, or funeral attendance.
          • All 3 Guinean prefectures that reported cases in the week to 28 June have reported cases for the past 4 weeks or more, although the area and nature of transmission within those prefectures continues to change. In the northern prefecture of Boke, which borders Guinea-Bissau, 9 of 10 cases were registered contacts. One of these cases is a health worker. The remaining case from Boke is from the coastal sub-prefecture of Kamsar. This case is also a health worker and has generated a substantial number of high-risk contacts. The single case reported this week from Conakry came from the Dixinn commune (municipal district) of the city, and arose from an unknown source of infection. Dixinn is the third commune of Conakry to report a case in the past 4 weeks—the others being Matam and Matoto. The remaining case was reported from the prefecture of Forecariah and was a registered contact of a previous case.
          • Transmission in Sierra Leone remains concentrated in several chiefdoms of Kambia and Port Loko districts, and a single neighbourhood of the capital, Freetown. Half (4) of the 8 cases reported from Sierra Leone arose in the densely populated Magazine Wharf area of Freetown, all of whom have a known link to a case reported from the area the previous week, although the origin of that case is not yet known. Both of the cases reported from the district of Kambia came from quarantined homes in the chiefdom of Tonko Limba. The remaining two cases were reported from two chiefdoms in the district of Port Loko. One of these cases, which was reported from the chiefdom of Masimera, is linked to the Magazine Wharf chain of transmission.
          • Ten of the 12 cases reported from Guinea and 4 of the 8 cases reported from Sierra Leone in the week to 28 June were registered contacts of previous cases. Five of the 20 cases reported were identified after post-mortem testing of community deaths.
          • Two new health worker infections were reported from Boke, Guinea, for a second consecutive week. No new health worker infections were reported from Sierra Leone. There have been a total of 874 confirmed health worker infections reported from Guinea, Liberia, and Sierra Leone since the start of the outbreak, with 509 reported deaths.
          COUNTRIES WITH WIDESPREAD AND INTENSE TRANSMISSION

          • There have been a total of 27 443 reported confirmed, probable, and suspected cases of EVD in Guinea, Liberia and Sierra Leone (figure 1, table 1) up to 28 June, with 11 220 reported deaths (this total includes reported deaths among probable and suspected cases, although outcomes for many cases are unknown). A total of 12 new confirmed cases were reported in Guinea and 8 in Sierra Leone in the 7 days to 28 June.
          • The total number of confirmed cases is similar in males and females (table 2). Compared with children (people aged 14 years and under), adults aged 15 to 44 are approximately four times more likely to be affected in Guinea and Liberia, and three times more likely to be affected in Sierra Leone.
          • A total of 874 confirmed health worker infections have been reported in Guinea, Liberia, and Sierra Leone; there have been 509 reported deaths (table 5).
          • ...
          Table 1: Confirmed, probable, and suspected EVD cases in Guinea, Liberia, and Sierra Leone
          Guinea Confirmed 3269 34 2039
          Probable 443 * 443
          Suspected 17 *
          Total 3729 34 2482
          Liberia§ Confirmed 3151 0
          Probable 1879 *
          Suspected 5636 *
          Total 10 666 0 4806
          Sierra Leone Confirmed 8665 30 3566
          Probable 287 * 208
          Suspected 4167 * 158
          Total 13 119 30 3932
          Total Confirmed 15 085 64
          Probable 2609 *
          Suspected 9820 *
          Total 27 514 64 11 220

          Data are based on official information reported by ministries of health. These numbers are subject to change due to ongoing reclassification, retrospective investigation and availability of laboratory results. *Not reported due to the high proportion of probable and suspected cases that are reclassified. ‡Data not available.§Date are until 9 May.
          ...


          http://apps.who.int/ebola/current-si...rt-1-july-2015
          "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
          -Nelson Mandela

          Comment


          • #65
            Ebola Situation Report - 8 July 2015
            ...

            SUMMARY

            There were 30 confirmed cases of Ebola virus disease (EVD) reported in the week to 5 July: 18 in Guinea, 3 in Liberia, and 9 in Sierra Leone. Although this is the highest weekly total since mid-May, improvements to case investigation and contact tracing, together with enhanced incentives to encourage case reporting and compliance with quarantine measures have led to a better understanding of chains of transmission than was the case a month ago. This, in turn, has resulted in a decreasing proportion of cases arising from as-yet unknown sources of infection (5 of 30 cases in the week to 5 July), particularly in previously problematic areas such as Boke and Forecariah in Guinea, and Kambia and Port Loko in Sierra Leone. However, significant challenges remain. A residual lack of trust in the response among some affected communities means that some cases still evade detection for too long, increasing the risk of further hidden transmission.

            The exportation of cases to densely populated urban areas such as Freetown and Conakry remains a risk, whilst the origin of the new cluster of cases in Liberia is not yet well understood.

            In Guinea, cases were reported from the same 3 prefectures—Boke, Conakry, and Forecariah—that reported cases the previous week. The northern prefecture of Boke, which borders Guinea-Bissau, reported 6 cases, compared with 10 the previous week. All but one of these cases was a registered contact, with a single case reported to have arisen from an as-yet unknown source of infection. The single case reported from Conakry came from the Matam commune (municipal district) of the city, and was a known contact of a previous case from Benty sub-prefecture in Forecariah. The remaining 11 cases were reported from the prefecture of Forecariah, 9 of which were reported from the sub-prefecture of Benty. All but 2 of the 11 cases reported from Forecariah were known contacts of a previous case or have an established epidemiological link to one.

            Liberia was declared free of Ebola transmission on 9 May 2015, after reporting no new cases for 42 consecutive days. The country subsequently entered a 3-month period of heightened surveillance, during which approximately 30 blood samples and oral swabs are collected each day from potential cases and tested for EVD. On 29 June, this routine surveillance detected a confirmed case of EVD in Margibi County, Liberia—the first new confirmed case reported from the country since 20 March. The case was a 17-year-old male who first became ill on 21 June, died on 28 June, and subsequently tested positive for EVD. Two contacts of the first-detected case have since been confirmed as EVD-positive. These additional cases are from the same small community as the first-detected case, and are now being treated in an Ebola Treatment Centre (ETC) in the capital, Monrovia. In addition, a probable case is in isolation at an ETC. The case has a strong epidemiological link to the first-detected case and is showing some symptoms of EVD, but has indeterminate test results for EVD. The origin of infection of the cluster of cases is currently under investigation. At present, these cases are considered to constitute a separate outbreak from that which was declared over on 9 May.

            In Sierra Leone, 9 cases were reported from the same 3 districts as the previous weeks: Kambia, Port Loko, and the district that includes the capital, Freetown. One-third (3) of all cases reported from Sierra Leone arose in the densely populated Magazine Wharf area of Freetown. All 3 cases were registered contacts of a previous case. Four chiefdoms in Kambia each reported a single confirmed case of EVD, as did two chiefdoms in the neighbouring district of Port Loko. All but one of these cases were known contacts of a previous case or have an established epidemiological link to one.

            COUNTRIES WITH WIDESPREAD AND INTENSE TRANSMISSION

            There have been a total of 27 573 reported confirmed, probable, and suspected cases of EVD in Guinea, Liberia and Sierra Leone (figure 1, table 1) up to 5 July, with 11 246 reported deaths (this total includes reported deaths among probable and suspected cases, although outcomes for many cases are unknown). A total of 18 new confirmed cases were reported in Guinea, 3 in Liberia, and 9 in Sierra Leone in the week to 5 July.

            The total number of confirmed cases is similar in males and females (table 2). Compared with children (people aged 14 years and under), adults aged 15 to 44 are approximately four times more likely to be affected in Guinea and Liberia, and three times more likely to be affected in Sierra Leone.

            In the week to 5 July, one new health worker infection was reported from Kambia, Sierra Leone. A total of 875 confirmed health worker infections have been reported in Guinea, Liberia, and Sierra Leone; there have been 509 reported deaths (table 5).
            ... Table 1: Confirmed, probable, and suspected EVD cases in Guinea, Liberia, and Sierra Leone
            Guinea Confirmed 3287 42 2049
            Probable 450 * 450
            Suspected 11 *
            Total 3748 42 2499
            Liberia§ Confirmed 3151§ -
            Probable 1879§ -
            Suspected 5636§ -
            Total 10 666§ - 4806§
            Liberia** Confirmed 3 3 1
            Probable 1 1
            Suspected *
            Total 4 4 1
            Sierra Leone Confirmed 8674 25 3574
            Probable 287 * 208
            Suspected 4194 * 158
            Total 13 155 25 3940
            Total Confirmed 15 115 70
            Probable 2617 1
            Suspected 9841 *
            Total 27 573 71 11 246

            Data are based on official information reported by ministries of health. These numbers are subject to change due to ongoing reclassification, retrospective investigation and availability of laboratory results. *Not reported due to the high proportion of probable and suspected cases that are reclassified. ‡Data not available. **The outbreak in Liberia was declared over on 9 May 2015. Due to ongoing surveillance and retrospective validation of cases and deaths, these totals may be subject to revision. At present, cases and deaths reported after 9 May 2015 are considered to constitute a separate outbreak to that which was declared over on 9 May. ...

            http://apps.who.int/ebola/current-si...rt-8-july-2015
            "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
            -Nelson Mandela

            Comment


            • #66
              Ebola Situation Report - 15 July 2015
              ...
              SUMMARY

              There were 30 confirmed cases of Ebola virus disease (EVD) reported in the week to 12 July: 13 in Guinea, 3 in Liberia, and 14 in Sierra Leone. Although the total number of confirmed cases is the same as the previous week, there has been a shift in the foci of transmission. For the first time in several months, most cases were reported from Conakry and Freetown, the capitals of Guinea and Sierra Leone, respectively. All 9 of the cases reported from Conakry and all 10 of the cases reported from Freetown were either registered contacts of a previous case or have an established epidemiological link to a known chain of transmission. One of the 30 cases reported in the week to 12 July arose from a yet unknown source of infection. However, a substantial proportion of cases (7 of 30: 23%) continue to be identified as EVD-positive only after post-mortem testing. This suggests that although improvements to case investigation are increasing our understanding of chains of transmission, contact tracing, which aims to minimise transmission by identifying symptoms among contacts at the earliest stage of infection, is still a challenge in several areas.

              In Guinea, cases were reported from the prefectures of Conakry, Forecariah, and Fria. The northern prefecture of Boke, which has been a focus of transmission for over a month, has not reported a case for 11 days. Nine cases were reported from Conakry, 7 of which are linked to a chain of transmission in the Ratoma area. Three cases, one of whom is a health worker, were reported from Forecariah. The source of exposure of the health worker is under investigation. The remaining case in Guinea was reported from the prefecture of Fria, which had not reported a case for over 40 days. The case is a contact from Boke who had been lost to follow-up.

              Three new cases were reported from Liberia in the week to 12 July, taking the total number of cases since 29 June to 6. The country had not previously reported a case since 20 March. All 3 confirmed cases reported in the week to 12 July were registered contacts associated with the same chain of transmission as the 3 cases reported the previous week. One of the cases reported in the week to 12 July had symptom onset in a quarantined home in Montserrado County, near to the capital, Monrovia, before being transferred to an Ebola Treatment Centre. The origin of the cluster of cases remains under investigation. Preliminary evidence from genomic sequencing strongly suggests that the most likely origin of transmission is a re-emergence of the virus from a survivor within Liberia.

              In Sierra Leone, 14 cases were reported from Freetown, Kambia, and Port Loko. Of the 10 cases reported from Freetown, 8 came from quarantined homes in the Magazine Wharf area of the city, which has been a focus of transmission for several weeks. The remaining 2 cases from Freetown were reported from other areas of the city but are associated with the Magazine Wharf chain of transmission. Two chiefdoms in Kambia reported cases this week, compared with 4 the previous week. Two cases were reported from the northwestern chiefdom of Samu, one of which was a community death. The remaining case from Kambia was reported from Tonko Limba chiefdom. In Port Loko, a single case was reported from the chiefdom of Marampa.

              On 12 July there were 3552 contacts being monitored across 6 prefectures in Guinea, 2 counties in Liberia, and 3 districts in Sierra Leone.

              One new health worker infection was reported from Forecariah, Guinea, in the week to 12 July. There have been a total of 876 confirmed health worker infections reported from Guinea, Liberia, and Sierra Leone since the start of the outbreak, with 509 reported deaths.

              COUNTRIES WITH WIDESPREAD AND INTENSE TRANSMISSION

              There have been a total of 27 642 reported confirmed, probable, and suspected cases of EVD in Guinea, Liberia and Sierra Leone (figure 1, table 1) up to 12 July, with 11 261 reported deaths (this total includes reported deaths among probable and suspected cases, although outcomes for many cases are unknown). A total of 13 new confirmed cases were reported in Guinea, 3 in Liberia, and 14 in Sierra Leone in the week to 12 July.

              The total number of confirmed cases is similar in males and females (table 2). Compared with children (people aged 14 years and under), adults aged 15 to 44 are approximately four times more likely to be affected in Guinea and Liberia, and three times more likely to be affected in Sierra Leone.

              One new health worker infection was reported in Forecariah, Guinea, in the week to 12 July. Since the start of the outbreak a total of 876 confirmed health worker infections have been reported in Guinea, Liberia, and Sierra Leone; there have been 509 reported deaths (table 5). Table 1: Confirmed, probable, and suspected EVD cases in Guinea, Liberia, and Sierra Leone
              Guinea Confirmed 3300 43 2056
              Probable 450 * 450
              Suspected 10 *
              Total 3760 43 2506
              Liberia§ Confirmed 3151 -
              Probable 1879 -
              Suspected 5636 -
              Total 10 666 - 4806
              Liberia** Confirmed 6 6 2
              Probable 1 1
              Suspected *
              Total 7 7 2
              Sierra Leone Confirmed 8688 31 3581
              Probable 287 * 208
              Suspected 4234 * 158
              Total 13 209 31 3947
              Total Confirmed 15 145 80
              Probable 2617 1
              Suspected 9880 *
              Total 27 642 81 11 261

              Data are based on official information reported by ministries of health. These numbers are subject to change due to ongoing reclassification, retrospective investigation and availability of laboratory results. *Not reported due to the high proportion of probable and suspected cases that are reclassified. ‡Data not available. **Cases reported before 9 May 2015 are shaded blue. Due to ongoing surveillance and retrospective validation of cases and deaths, these totals may be subject to revision.
              ...
              Figure 2: Geographical distribution of confirmed cases reported in the week to 12 July 2015 The location of one case in Western Area Urban, Sierra Leone, is not shown. The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement.

              ...
              http://apps.who.int/ebola/current-si...t-15-july-2015
              "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
              -Nelson Mandela

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              • #67

                Ebola Situation Report - 5 August 2015

                ...
                SUMMARY

                There were 2 confirmed cases of Ebola virus disease (EVD) reported in the week to 2 August: 1 in Guinea and 1 in Sierra Leone. This is the lowest weekly total to have been reported since March 2014, and marks a third consecutive decline in weekly case incidence. This decline is underpinned by continued refinements to all elements of the response. In particular, strengthened capacity for contact tracing and case investigation has increased confidence that the few remaining known chains of transmission are better understood and controlled than was the case several months ago. Maintaining these resources in the months ahead will be critical, as there remains a significant risk of further transmission and an increase in case incidence in the near and medium term.

                Almost 2000 contacts remain under observation across 5 prefectures in Guinea and 4 districts in Sierra Leone, and despite intensive efforts a small number of contacts in both countries have not been traced or have been lost to follow-up. In addition, recent high-risk transmission events in Guinea and Sierra Leone are very likely to result in further cases in the coming weeks.

                Illustrating the continuing challenges, the single case reported from Guinea is a contact who was lost to follow-up, and who is likely to have generated a substantial number of further high-risk contacts. The case, a 28-year-old woman, is a registered contact associated with a known chain of transmission that has given rise to several generations of cases in the Ratoma area of the capital, Conakry, over the past several weeks. After being lost to follow-up the case travelled south from Conakry through Forecariah and into Kambia, Sierra Leone, where she reportedly visited a traditional healer, before returning to Ratoma via Forecariah. Intensive efforts are underway to identify and trace all contacts in Guinea and Sierra Leone. 1080 contacts remain under follow-up in 5 western prefectures in Guinea, with the vast majority (>90%) of contacts located in Conakry and Forecariah.

                An interim analysis of the Ebola ça suffit! ring vaccination trial in Guinea suggests that the investigational rVSV-ZEBOV Ebola vaccine protects people exposed to EVD. The trial will continue in Guinea, with all rings around confirmed cases now receiving immediate vaccination. Previously, rings were randomly allocated to receive either immediate vaccination or vaccination 21 days after the confirmation of a case.

                No new cases were reported from Liberia in the week to 2 August. All contacts have now completed their 21-day follow-up period. The last case was discharged after testing negative for EVD for a second time on 23 July.

                In Sierra Leone, the case reported this week is one of over 600 contacts generated by the single case reported in Tonkolili the previous week (the index case). The new case is a family member who provided care to the index case. Over 40 contacts are considered to be at high risk of infection because of the nature of their contact with the index case, and there is a high probability that further cases will arise. Investigations into the source of infection of the index case, who is thought to have acquired infection in Freetown before traveling to Tonkolili, are still ongoing. Across the country a total of 811 contacts remain under follow-up, with the vast majority located in Tonkolili. All contacts associated with known chains of transmission in Kambia have now completed the 21-day follow-up period, although intensive efforts are underway to identify any contacts associated with the case reported from Ratoma, Guinea, in the week ending 2 August.

                For the first time in 3 weeks, no health worker infections were reported from any of the affected countries. There have been a total of 880 confirmed health worker infections reported from Guinea, Liberia, and Sierra Leone since the start of the outbreak, with 512 reported deaths.

                COUNTRIES WITH WIDESPREAD AND INTENSE TRANSMISSION

                There have been a total of 27 862 reported confirmed, probable, and suspected cases of EVD in Guinea, Liberia and Sierra Leone (figure 1, table 1) up to 2 August, with 11 281 reported deaths (this total includes reported deaths among probable and suspected cases, although outcomes for many cases are unknown). One new confirmed cases was reported in Guinea and one in Sierra Leone in the week to 2 August.

                The total number of confirmed cases is similar in males and females (table 2). Compared with children (people aged 14 years and under), adults aged 15 to 44 are approximately four times more likely to be affected in Guinea and Liberia, and three times more likely to be affected in Sierra Leone.

                No new health worker infections were reported in the week to 2 August. Since the start of the outbreak a total of 880 confirmed health worker infections have been reported in Guinea, Liberia, and Sierra Leone; there have been 512 reported deaths (table 5).
                ... Figure 3: Geographical distribution of new and total confirmed cases in Guinea, Liberia and Sierra Leone The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement.
                ...
                http://apps.who.int/ebola/current-si...-5-august-2015
                "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                -Nelson Mandela

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