Guinea - Ebola outbreak - 2021 - 23 cases including 12 deaths - declared over

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Ebola: the resistance of the Guinean village of Kpaghalaye against the "response"

Published on : 04/11/2021 - 04:02

Ebola has reappeared in Guinea since the beginning of 2021. 23 cases have been reported, including five deaths, in the region of Nz?r?kor?, in the south of the country. In this forest Guinea close to the borders of Liberia and C?te d'Ivoire, the village of Kpaghalaye is resisting the interventions of the "response", the team responsible for fighting the epidemic. They have not been able to return there since the beginning of the month. Older women oppose it.

They put on the loincloth in which they traditionally initiate young girls, which is supposed to command respect. Since the beginning of the month, the elderly women of Kpaghalaye have blocked the entrance to the village to medical teams, who are responsible for identifying Ebola cases and vaccinating the population.

Installed a few kilometers away, to help the Guinea Infectious Disease Research and Training Center, anthropologist Fr?d?ric Le Marcis believes that the traumas linked to the previous epidemic are still in people's minds: ? We must remember that during Ebola in the first epidemic, 70 % of people treated in treatment centers died. And this situation, which was related to the lack of effective treatment, at the time aroused among the population a feeling of fear and anguish, assimilating the therapeutic response in fact to a disguised desire to exterminate the population. "

Mutual distrust
? In addition to that, in the same region where the epidemic is unfolding today, is the village of Womey where in 2014 a delegation that came to do prevention was murdered, cut into pieces and thrown in the toilet. of the village, ?recalls Fr?d?ric Le Marcis. This event remained at the heart of the memory of the population and of the Response.

Reciprocal mistrust explains the communication errors of La Riposte. When the first case of Ebola appeared in Kpaghalaye, the person was taken to the Epidemic Treatment Center (CT-Epi) without informing the other villagers, who today refuse any intervention, including vaccination. Which does not mean, believes the anthropologist, that this resistance will last forever.

https://www.rfi.fr/fr/afrique/20210...halaye-contre-les-interventions-de-la-riposte

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EBOLA IN GUINEA: WOMEN END THE BLOCKADE OF THEIR VILLAGE

APRIL 12, 2021 AT 6:27 P.M. BY AFP

The vaccination campaign against Ebola hemorrhagic fever has resumed in Kpaghalaye, a village in southern Guinea whose women have blocked access to health personnel for several days, we learned from health authorities on Monday. "The vaccination began immediately on Saturday morning since the women lifted the siege on Friday evening," Sory II K?ira, the communications officer of the National Health Security Agency (ANSS), told AFP.
...
https://www.africaradio.com/news/eb...-mettent-fin-au-blocus-de-leur-village-184987

 

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An imam, a priest and the Ebola fight in Guinea

13 April 2021

Gouecke, Guinea ? Imam El hadj Moussa Soumahoro wears a serious face. He has just ended a morning sermon that concluded with Ebola preventive messages and the importance of vaccination against the virus that recently re-emerged in Guinea for the first time since the 2014?2016 outbreak. Soumahoro has joined the fight against the disease.

?Four of my brothers and cousins died of Ebola in 2015, so I know what I?m committing myself to,? says Soumahoro, as the congregation disperses while greeting each other from a distance. A handwashing station has been set up at the entrance to the mosque as has been done in all places of worship.

Since the first confirmed cases on 14 February, the imam of Gouecke ? a rural community in south-eastern Guinea where the virus re-appeared ? has taken to encouraging the community to cooperate with the health authorities to curb the outbreak in which 23 cases and 12 deaths have been reported so far.

Ebola claimed more than 11 000 lives in Guinea, Liberia and Sierra Leone in the previous outbreak. However, some still doubt that the disease exists. "Trust underpins everything," Soumahoro says. ?The disease is real ? It is a fight that should not be taken lightly. That is why ? I felt it necessary to commit to the [Ebola] response by raising awareness.?

Since the latest outbreak was declared, he has concluded each prayer with preventive messages and the importance of contacting the authorities in case of death. Funerals and burials are important cultural practices.

Overcoming barriers

Among many Guinean communities, burials are based on the social status, beliefs, gender and age of the deceased. Religion also plays a central role. The fear of not being able to carry out burials according to tradition has led some people not to report certain deaths to the authorities. ?The organization of [burial] ceremonies must strictly adhere to a number of age-old traditions that have remained unchanged in the community,? Sonah Mady Camara, a social anthropologist and a consultant with the World Health Organization (WHO), explains.

?The involvement of religious leaders in Gouecke in the response has been beneficial and has helped in overcoming a lot of reluctance within the community,? says Ibrahima Kone, the subprefect of Gouecke.

Imam Soumahoro was among the first people to receive the Ebola vaccine, helping to convince many in his community to accept to be vaccinated. So far around 4000 people have received the vaccine, including 2400 frontline workers.

While vaccination has been successful, screening for cases has been more challenging. Since the re-emergence of Ebola, personnel at the Gouecke health centre only carry out two or three consultations a day, compared with about 30 previously. ?Ebola is scary, and fear makes people hide as soon as they observe the first signs of the disease,? says Jean-Baptiste Goumou, the Gouecke parish priest who is also encouraging community collaboration.

?There were rumours that this disease was a big lie invented by the health authorities with the complicity of the government to make money at the expense of the Gouecke community,? says Kangbe Camara, a resident of Gouecke. ?It was also said that the vaccine had been brought to kill people. Thanks to the imam I got the courage to go and get vaccinated.?

Monitoring Ebola

Imam Soumahoro and the Gouecke parish priest are also members of the WHO Ebola monitoring committee tasked with addressing community reluctance in Gouecke. The committee has persuaded the population to participate in disease surveillance, screening and safe and dignified burials.

?The imam and the priest play a fundamental role in strengthening social bonds within the community. They are the confidants of everyone. This confers them a special status among the faithful and the community hence the importance of including them in the committee,? says social anthropologist Camara, who helped to set up the committee.

?When our teams work on the ground, they always start by visiting them [religious leaders]. As members of the monitoring committee tasked with overcoming reluctance, they are expected to significantly contribute in terms of observance of health measures and greater involvement of the communities in [Ebola] surveillance.?

https://www.afro.who.int/news/imam-priest-and-ebola-fight-guinea

 

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WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 15: 5-11 April 2021
Data as reported by: 17:00; 11 April 2021

...
Ebola virus disease Guinea

Cases 23
Deaths 12
CFR 52.2%

...
EVENT DESCRIPTION

In the last 21 days, there have been two confirmed and three
probable cases reported from the sub-prefecture of Soulouta,
Nzerekore prefecture. Three sub-prefectures are on alert,
including one in Lola. There are continued investigations into the
Soulouta sub-prefecture cluster, with 34 notified alerts, of which
three are suspicious deaths.

As of 10 April 2021, a total of 23 cases have been reported,
including 16 confirmed cases, and 7 probable cases, of which 9
have recovered, and 12 have died (case fatality ratio 52.2%). The
number of health workers infected remains five.

Most of the confirmed and probable cases reported are female
(13/23; 60.9%) and the most affected age group are those over
40 years.

As of 10 April 2021, a total of 84 (40%) out of 209 contacts
have been followed up in Nzerekore. A total of 140 contacts have
been vaccinated. There were 77 alerts notified on 10 April 2021,
64 in Nzerekore and 13 in Conakry, of which 34 (44%) were
investigated within 24 hours. Of these, four were validated, three
of which were deaths. Two of the deaths were sampled.

PUBLIC HEALTH ACTIONS

Daily incident management system meetings take place
with WHO, and have been moved to the WHO sub-office in
Nzerekore.

Community resistance is slowly being overcome, although
contact follow-up is still compromised.

A cumulative total of 6100 people have been vaccinated,
including 444 high-risk contacts, 5 182 contacts-of-contacts
and 474 probable contacts, including 2 368 frontline workers.

Three patients, one confirmed and two suspected, are
currently hospitalized in the Epidemic Diseases Hospital
treatment centre.

Infection prevention and control activities have been carried
out in two health facilities in Conakry, with briefings on waste
sorting, using gloves, hand hygiene, personal protective
equipment, donning and doffing and development of the
local improvement plan.

A joint mission has been organized to assess water points
requiring rehabilitation, along with the health infrastructure
of 11 health facilities in Nzerekore.

Risk communication and community engagement included
a workshop with a group in charge of prevention who are
addressing community resistance to response activities in
Nzerekore; support for two awareness-raising session for
975 people in Gou?ck? market on rumours around Ebola
treatment centres via mobile radio; and continued advocacy
for support of response activities.

SITUATION INTERPRETATION

Challenges still remain around the response to the ongoing
EVD outbreak in Guinea, with continuing problems with
locating contacts lost to follow-up and isolating suspected
patients in Kpagalaye village. Community surveillance requires
strengthening in the affected prefectures, as well as identification
of the source of infection in Gou?ck?. The funding gap for
response activities has not yet been closed.These challenges
require urgent attention from authorities and partners, since it
is possible that there are unrecognised chains of transmission,
which could reveal further clusters of disease, along with the risk
of geographical spread.

...
https://apps.who.int/iris/bitstream/handle/10665/340773/OEW15-0511042021.pdf

 

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Ebola: lull in Guinea and DRC, but WHO experts remain cautious

Published on : 04/16/2021 - 03:16
Text by:
RFI
...
The Ebola epidemic is experiencing a lull in Guinea and the Democratic Republic of the Congo, the two countries where the virus reappeared earlier this year. But WHO Africa experts remain very cautious because they still lack reliable indicators on its evolution.

Without contamination recorded for 12 days in Guinea, the Ebola virus seems to be taking a break. But according to Dr. Mory Keita, there are still many questions about the fate of a confirmed case, hidden in his community.

" Is he already dead?" And if he's dead, how was his body handled? Who are the people who have been exposed? If he's not dead, who are the people around him, are they taking action? Have they been contaminated? As we have no information on this case, it remains a great challenge. Certainly there is progress but today, it remains very difficult to tell you with confidence when we will be able to end the epidemic. "

In the DRC, there are also security problems which, underlines Dr Thierno Balde, make the Ebola epidemic much more difficult to follow. " We are 42 days today without a new case, but the security situation in Beni, Butembo, leads us to speak with great caution because we do not have a lot of visibility on what is going on. past. "
...

https://www.rfi.fr/fr/afrique/20210...dc-mais-les-experts-de-l-oms-restent-prudents

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Ebola in Guinea: Dr Mory Ke?ta looks back on community issues and challenges

Published by :
Thierno Souleymane Diallo
Thursday, April 15, 2021 at 1:13 p.m.

Along with the fight against the coronavirus, Guinea continues to face Ebola hemorrhagic fever. Despite the cumulative efforts in surveillance and vaccination, and the results recorded, the task remains difficult on this second front. Dr Mory Ke?ta took stock this Thursday, April 15, 2021, during the press conference hosted by the Africa regional office of the World Health Organization (WHO).

If the "Manager of the incident in the response to Ebola (in N'z?r?kor?) on behalf of the WHO", Dr Mory Ke?ta admits that results have been produced by the authorities and partners since the resurgence of the Eboba virus in Guinea, he remains very measured or even cautious on the subject. Due to external factors that negatively influence the response.

? We have already vaccinated 95% of the contacts identified by the on-site surveillance team. Which is a good number, ?he announces at the start of his speech. " Nevertheless , tempers the public health specialist , one of our confirmed cases and suspected cases are still in the communities ".

Faced with the delicacy of the task, with an unfortunate precedent in the region during the onset of the disease (2024-2016), Dr Ke?ta displays a certain determination in the response but remains cautious and reasons in terms of prospects. ? We are trying to find them and isolate them. We also have challenges in terms of contact tracing because 25 contacts have not yet been found, ?he laments.

Coming back to the facts, the manager of the incident in the response to Ebola recalls that " last week , we had community resistance which delayed our implementation of actions around the conformed cases ". Suddenly, he admits, " the alert is always optimal in N'Z?r?kor? which is the epicenter and in the neighboring districts ". Especially since, in his own words, " we are not performing well in terms of surveillance ".

The evaluation made, "(...) we will improve these indicators ", he promises. Insisting on the fact that " we do not yet have too much confidence because we encounter challenges at the level of surveillance ", even if, " we have 12 consecutive days (without new case editor's note)".

Nevertheless, " coordination efforts are underway to find these confirmed cases and all suspected cases on the ground also within the community ", promises Dr Ke?ta in his conclusion.

https://www.guineenews.org/ebola-en...t-sur-les-enjeux-et-les-defis-communautaires/

 

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Ebola in N'z?r?kor?: still no news of the confirmed case, hidden in the community

Mohamed bangouraBy Mohamed Bangoura 2 hours ago in News , Latest News , Health

The Ebola virus seems to be observing a truce in Guinea because for 19 days now, the country has not recorded any new case of the epidemic which is raging in the sub-prefecture of Soulouta in the forest region.

While the countdown to the end of the disease should be triggered 21 days later, as many questions about the disappearance of a patient tap on many lips, especially among the actors of the response who are worried about the fate of a confirmed case ? hidden in his community?.

?Is he already dead? And if he's dead, how was his body handled? Who are the people who have been exposed? If he's not dead, who are the people around him, are they taking action? Have they been contaminated? As we have no information on this case, it remains a big challenge. Certainly, there is progress, but today, it remains very difficult to tell you with confidence when we will be able to end the epidemic ?, declared last week a WHO expert at our office. colleagues from RFI.

Clearly, the patient is a national of Kpagalaye, the district where the Ebola virus reappeared for the second time in the sub-prefecture of Soulouta, in Forest Guinea.

Alias ??Pythagoras, since it is him, is a pupil in a school of health care in the prefecture of N'z?r?kor?. Aged in his thirties, he had recently been involved in the fight against Ebola so it is said

"To help lift reluctance in his native village of Kpagalaye", where citizens had banned access to Ebola response teams last month.

According to a health source, the diagnostic test that was offered to him had turned out positive before it became extinct in the wild.

"He was hiccupping and he would have been tested. It was after the results that he decided to go get his phone, which was connected to the DPS. It is from there, he managed to escape but we did not know what really happened so that he could not be found, ? a good source told us.

The epidemiological monitoring commission in the hot seat

With Dr. Angelo at its head, the epidemiological monitoring commission of the prefectural coordination of the fight against Ebola is the only questioned about the circumstances of the patient's disappearance.

It has now been several days that Pythagoras has had no news and the fear of a rebound in the disease seizes the local health authorities who have just stepped up the search for the fugitive.

According to our information, the Minister of Health cannot digest this state of affairs and threatened to sanction the members of the monitoring commission if the patient is not found in a short time.

Although the patient's wife tested negative for the virus, the actors in the response are still very cautious because, they say, the fight is not yet won.

Alexis Koli

https://mosaiqueguinee.com/ebola-a-...les-du-cas-confirme-cache-dans-la-communaute/

 

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Disease name Ebola virus disease (EVD)
Notification date of the 1st confirmed case 02/13/2021
Report date 04/21/2021


I. Highlights
Sensitization of the community of Kpagalaye by the Deputy Chief of Staff of the Army
on the search for the confirmed case lost to follow-up,
No new confirmed cases reported to date
111 alerts reported (109 alive and 2 deaths), 49 investigated, 62 under investigation
141 new alerts, including 42 investigated (7 deaths and 35 alive)
? 14 validated (9 deaths including 5 swabs), 5 suspected cases including 4 transferred to the CT-EPI (1 in Nz?r?kor?,
and 3 in Gou?ck?) and 1 sample at the hospital
...
Supported
...
Follow-up and management of six (6) suspected cases and one (1) confirmed case of CT-PPE of
Nz?r?kor? and Gou?ck?
End of the training of 22 Soulouta Red Cross volunteers in psychosocial support and psychological first aid
...
.Challenges

Find the confirmed case of Gonia
...
https://www.humanitarianresponse.in...ep_ndeg_67_epidemie_de_mve_2021_nzerekore.pdf

 

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Ebola in N'z?r?kor?: the last patient finally leaves the epidemiological treatment center

By Mohamed Bangoura 3 days ago

The one we prefer not to name is a housewife by profession, aged about forty and a citizen of the district of Kpagalaye in the sub-prefecture of Soulouta in the forest region.

She was admitted to the CT-Epi in N'z?r?kor? on April 2, before she was officially declared cured on the evening of Friday April 23, 2021.

She was escorted this afternoon by the response actors to her native village of Kpagalaye, epicenter of the second wave of the Ebola epidemic in Guinea.

To date, 5 suspected cases are staying at the N'z?r?kor? epidemiological treatment center according to the medical referent of the NGO ALIMA who stresses that their first test for the Ebola virus has been negative.

It must be said that the countdown to the end of the epidemic can soon be triggered even if a confirmed case remains hidden in its community.

Alexis Koli

https://mosaiqueguinee.com/ebola-a-...nfin-du-centre-de-traitement-epidemiologique/

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Fight against Ebola: a new countdown has started

NEWS APRIL 27, 2021 CREATED: APRIL 27, 2021
...
For Doctor Bouna Yatassaye, Deputy Director General of the agency, interviewed this Monday April 26 at our colleagues from the RTG, Guinea could soon declare the end of the disease and the countdown began two days ago. ''It has been two days since we have had any new cases of Ebola in the forest region. The patient who was in the treatment center came out cured two days ago. And the suspected cases that were there also came out cured after being tested for negativity. So from there we open the 42 day countdown, we are at D 2. Today this epidemic is contained so it is a major challenge that has been taken up. When it comes to covid, we are not only the best in this area, we continue to do what we can to contain the disease as much as possible. I am pleased to announce that the epidemic is confined to Conakry, although prefectures have recorded cases but we are continuing the fight against covid with the availability of vaccines. Currently,He said on national television.
...

MLYans

http://www.aconakrylive.com/index.p...re-ebola-un-nouveau-compte-a-rebours-commence

 

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WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 18: 26 April to 2 May 2021
Data as reported by: 17:00; 2 May 2021
...
Ebola virus disease Guinea

23 Cases
12 Deaths
52.2% CFR

EVENT DESCRIPTION

No new confirmed Ebola virus disease (EVD) cases have been
reported in Nzerekore prefecture, the site of the current EVD
outbreak in Guinea, as of 1 May 2021. There are no active
subprefectures within the prefecture of Nzerekore, and no new
confirmed cases have been reported in the past 21 days. There
are, however, 19 new suspected cases, of which one has been
transferred into isolation and sampled, two have been sampled in
the community and 16 have refused sampling.

As of 1 May 2021, a total of 23 cases have been reported,
including 16 confirmed cases, and 7 probable cases, of which
9 have recovered, and 12 have died (case fatality ratio 52.2%).
The number of health workers infected remains five. The missing
confirmed case is still unaccounted for and the validated start
date of the countdown to end of outbreak is 8 May 2021, taking
this case into account.

The majority of the confirmed and probable cases reported are
female (13/23; 60.9%) and the most affected age group are those
over 40 years.

A total of 1 114 contacts have been listed, and 56% of these have
been vaccinated. As of 1 May 2021 a total of 110 alerts were
notified, of which 10 were deaths. Of these alerts, 46 (45%) were
investigated within 24 hours. A total of 29 alerts were validated
and six of the 10 death alerts have been sampled. The majority of
alerts came from active case search, with few coming from the
community.

PUBLIC HEALTH ACTIONS

Monitoring and coordination meetings are now taking place
in a newly equipped emergency operations centre, supported
by WHO.

A ?sweep vaccination? approach is being used to catch up
with contacts, contacts-of-contacts and probable contacts in
the remaining hotspots in order to prevent possible chains
of transmission.

A cumulative total of 8 638 people has been vaccinated,
including 622 high-risk contacts, 7 482 contacts-of-contacts
and 534 probable contacts, including 2 529 frontline workers.
Three patients, all suspected cases, are currently hospitalized
in the Epidemic Diseases Hospital treatment centre.

Infection prevention and control (IPC) activities included an
information session on swabbing techniques and biosafety
of samples for staff at the Nzerekore Regional Hospital
mortuary. In addition, IPC kits were distributed to four health
facilities in Nzerekore; and five of the 15 water drilling points
in the rural community of Soulouta were rehabilitated.

Ten new community deaths were reported, with six samples
collected and no safe and dignified burials carried out.

Risk communication and community engagement (RCCE)
included continued supervision of the socio-anthropological
study into reasons for refusal of safe and dignified burials
and sampling from the bodies, and additionally supported
organization of an awareness-raising tour of communities of
the nine rural districts of Soulouta by community leaders; a
meeting with the youth movement ?never again? in Nzerekore
to plan information sessions on EVD; elaboration of the terms
of reference with UNFPA for organization of an educational
talk with traditional birth attendants and pregnant women
in Kpagalaye; and continued support to the communication
commission.

SITUATION INTERPRETATION

The situation in Guinea is still not stable with contacts lost to
follow up and one confirmed case remaining in the community.
The appearance of 19 new suspected cases is also of concern.
Alerts continue to be received, although few are reported by the
community and 24-hour follow-up is inadequate. Community
surveillance in Nzerekore and neighbouring provinces requires
strengthening. In addition, the WHO response plan is still only
17% funded. This gap needs urgently to be filled if the momentum
of response is to continue.

https://apps.who.int/iris/bitstream/handle/10665/341115/OEW18-2602052021.pdf

 

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WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 19: 3-9 May 2021
Data as reported by: 17:00; 9 May 2021
...
Ebola virus disease Guinea

23 Cases
12 Deaths
52.2% CFR

EVENT DESCRIPTION

No new confirmed Ebola virus disease (EVD) cases have been
reported in Nzerekore prefecture, the site of the current EVD
outbreak in Guinea, as of 9 May 2021. There are no active
sub-prefectures within the prefecture of Nzerekore, and no
new confirmed cases have been reported in the past 21 days.
However, four new suspected cases have been notified; one has
been sampled and three have declined sampling.

As of 9 May 2021, a total of 23 cases have been reported,
including 16 confirmed cases, and 7 probable cases, of which 9
have recovered, giving a recovery rate of 39.1%. Of the 23 cases,
12 have died (case fatality ratio 52.2%). The number of health
workers infected remains five.

The majority of the confirmed and probable cases reported are
female (13/23; 60.9%) and the most affected age group are those
over 40 years.

A total of 1 114 contacts have been listed, and 56.0% of these
have been vaccinated. As of 9 May 2021 a total of 35 new alerts
were notified in Nzerekore, including three deaths. Of these, 10
(29.0%) were investigated within 24 hours and six were validated.
Six new alerts were received in neighbouring prefectures, all
community deaths, all were investigated and none validated.

PUBLIC HEALTH ACTIONS

The 42-day countdown to the end of the outbreak started on
8 May 2021, with the expected date for the declaration of the
end of the outbreak the 19 June 2021.

Continued support is being provided to Nzerekore and all
neighbouring prefectures for enhanced surveillance during
this period.

A cumulative total of 9 569 people have been vaccinated,
including 622 high-risk contacts, 8 413 contacts-of-contacts
and 534 probable contacts, including 2 694 frontline
workers. Four vaccination teams are deployed in the field,
supported by WHO.

One suspected case is currently hospitalized in the Epidemic
Diseases Hospital treatment centre in Nzerekore and one
suspected patient is hospitalized in Goueke Epidemic
Diseases hospital; a total of four patients, all suspected
cases, are currently being managed in treatment centres.
Infection prevention and control (IPC) activities included
an orientation session on biosafety principles and the
management of suspected EVD cases held for 40 health
workers from four isolation sites at Nzerekore; organization
of a briefing session on EVD standard and supplementary
precautions for six health workers in the Koropara Health
Centre, followed by provision of IPC kits.

Eleven new community deaths were reported, with seven
samples collected and no safe and dignified burials carried
out.

Risk communication and community engagement (RCCE)
included two in-depth interviews on the EVD experience of a
survivor and a local elected official in the Goueke community;
and integrated briefing of 50 religious leaders on community
surveillance in order to help manage response resistance
and increase the number of alerts in Nzerekore.

SITUATION INTERPRETATION

As the 42-day countdown to the end of outbreak declaration
starts, the situation in Guinea is still not stable with contacts
still lost to follow up and one confirmed case remaining in the
community. Alerts continue to be received, although few are
reported by the community and 24-hour follow-up is inadequate.
Community surveillance in Nzerekore and neighbouring
provinces requires strengthening. In addition, the WHO response
plan is still only 17% funded. This gap needs urgently to be filled
if the momentum of response is to continue.

https://apps.who.int/iris/bitstream/handle/10665/341246/OEW19-0309052021.pdf

 

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WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 20: 10-16 May 2021
Data as reported by: 17:00; 16 May 2021
...
Ebola virus disease Guinea

23 Cases
12 Deaths
52.2% CFR

EVENT DESCRIPTION

No new confirmed Ebola virus disease (EVD) cases have been
reported in Nzerekore prefecture, the site of the current EVD
outbreak in Guinea, since 8 April 2021. This is 43 consecutive
days with no new confirmed cases. However, 26 new suspected
cases were notified, one of whom was transferred to an isolation
centre. Four cases were sampled and 21 refused sampling.
As of 16 May 2021, a total of 23 cases have been reported,
including 16 confirmed cases, and 7 probable cases, of which 9
have recovered, and 12 have died (case fatality ratio 52.2%). The
number of health workers infected remains five.

The majority of the confirmed and probable cases reported are
female (13/23; 60.9%) and the most affected age group are those
over 40 years.

There are currently no active contacts under follow-up. On 16
May 2021 there were 66 new alerts in Nzerekore, including five
deaths. Of these, 32 (48.0%) were investigated and 26 validated,
including the five deaths. In neighbouring prefectures, there
were 17 new alerts (6 in Beyla, 3 in Gueckedou, 3 in Lola, 3 in
Macenta and 2 in Yomou) including 9 community deaths. All
were investigated and none validated. In Conakry, there were no
new alerts.

PUBLIC HEALTH ACTIONS

The 42-day countdown to the end of the outbreak started on
8 May 2021, with the expected date for the declaration of the
end of the outbreak the 19 June 2021.

Continued support is being provided to Nzerekore and all
neighbouring prefectures for enhanced surveillance during
this period.

A cumulative total of 10 081 people has been vaccinated,
including 622 high-risk contacts, 8 925 contacts-of-contacts
and 534 probable contacts, including 2 714 frontline
workers. Four vaccination teams are deployed in the field,
supported by WHO.

Two suspected cases are currently hospitalized in the
Epidemic Diseases Hospital treatment centres.

Infection prevention and control (IPC) activities included
training 24 local health workers on swab collection
techniques and biosafety during safe and dignified burials;
22 health workers were trained in active case finding of
suspected cases; and disinfection solution was distributed
to 14 health facilities in Conakry.

Five new community deaths were reported, with five samples
collected and no safe and dignified burials carried out.

Risk communication and community engagement (RCCE)
included briefing on the management of response resistance
for 30 health workers from private and public health facilities.
In addition, there was participation in the joint meeting of the
communication and surveillance pillars to discuss response
resistance; presentation of the socio-anthropological study
on the reasons for refusing sampling and continued support
to the communication commission.

SITUATION INTERPRETATION

As the 41-day countdown to the end of outbreak declaration
continues, now standing at 34 days, the situation in Guinea is
still not stable with contacts lost to follow up and one confirmed
case remaining in the community. Alerts continue to be received,
although few are reported by the community and 24-hour followup
is inadequate. Community surveillance in Nzerekore and
neighbouring provinces requires strengthening. In addition, the
WHO response plan is still only 17% funded. This gap needs
urgently to be filled if the momentum of response is to continue.

https://apps.who.int/iris/bitstream/handle/10665/341343/OEW20-1016052021.pdf

 

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WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 21: 17-23 May 2021
Data as reported by: 17:00; 23 May 2021
...

Ebola virus disease Guinea

23 Cases
12 Deaths
52.2% CFR

EVENT DESCRIPTION

No new confirmed Ebola virus disease (EVD) cases have been
reported in Nzerekore prefecture, the site of the current EVD
outbreak in Guinea, since 23 May 2021. It is now day 27 before
the end of outbreak declaration, scheduled for 19 June 2021.
As of 23 May 2021, a total of 23 cases have been reported,
including 16 confirmed cases, and 7 probable cases, of which 9
have recovered, and 12 have died (case fatality ratio 52.2%). The
number of health workers infected remains five.

The majority of the confirmed and probable cases reported are
female (13/23; 60.9%) and the most affected age group are those
over 40 years.

There are currently no active contacts under follow-up. On 23
May 2021, there were 56 new alerts received in Nzerekore,
including 10 deaths, of which 28 (50%) were investigated. A
total of 26 were validated, including two deaths. In neighbouring
prefectures, nine new alerts were received, all of which were
investigated and none validated.

PUBLIC HEALTH ACTIONS

The 42-day countdown to the end of the outbreak started on
8 May 2021, with the expected date for the declaration of the
end of the outbreak the 19 June 2021.

Continued support is being provided to Nzerekore and all
neighbouring prefectures for enhanced surveillance during
this period.

A cumulative total of 10 733 people has been vaccinated,
including 622 high-risk contacts, 9 577 contacts-of-contacts
and 534 probable contacts, including 2 767 frontline workers.

Four vaccination teams are deployed in the field, supported
by WHO; the teams will end operations at the end of May
2021.

Five suspected cases are currently hospitalized in the
Epidemic Diseases Hospital treatment centres.

Four new community deaths were reported, with three
samples collected and no safe and dignified burials carried
out.

Risk communication and community engagement (RCCE)
included support for training 21 data entry operators for
the collection of community feedback data; support for
installation of RCCE focal points and new supervisors in five
health facilities to strengthen surveillance and improve alert
reporting; support to Youmou and Bignamou authorities
in sensitizing 120 people for acceptance of Lassa fever
response teams in these rural communities.

SITUATION INTERPRETATION

The 42-day countdown to the end of outbreak declaration
continues, now standing at 27 days. Alerts continue to be received,
although few are reported by the community and 24-hour followup is
inadequate. Community surveillance in Nzerekore and
neighbouring provinces still requires strengthening. In addition,
the WHO response plan is still only 17% funded. This gap needs
urgently to be filled if the momentum of response is to continue.

https://apps.who.int/iris/bitstream/handle/10665/341457/OEW21-1723052021.pdf

 

[Pathfinder]

WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 22: 24 - 30 May 2021
Data as reported by: 17:00; 30 May 2021

...

Ebola virus disease Guinea

23 Cases
12 Deaths
52.2% CFR

EVENT DESCRIPTION

No new confirmed Ebola virus disease (EVD) cases have been
reported in Nzerekore prefecture, the site of the current EVD
outbreak in Guinea, as of 30 May 2021, which was day 20 to the
end-of-outbreak. A total of 45 new suspected cases were notified
in this period, of which 40 were not validated.

As of 29 May 2021, a total of 23 cases have been reported,
including 16 confirmed cases, and 7 probable cases, of which 9
have recovered, and 12 have died (case fatality ratio 52.2%). The
number of health workers infected remains five.

The majority of the confirmed and probable cases reported are
female (13/23; 60.9%) and the most affected age group are those
over 40 years.

There are currently no active contacts under follow-up. On 29 May
2021, there were 58 new alerts received in Nzerekore, including
eight deaths, of which 38 (66.0%) were investigated. A total of 23
were validated, including the deaths. In neighbouring prefectures,
11 new alerts were received, all of which were investigated and
none validated.

PUBLIC HEALTH ACTIONS

The 42-day countdown to the end of the outbreak started on
8 May 2021, with the expected date for the declaration of the
end of the outbreak the 19 June 2021.

Continued support is being provided to Nzerekore and all
neighbouring prefectures for enhanced surveillance during
this period.

A cumulative total of 10 873 people has been vaccinated,
including 622 high-risk contacts, 9 717 contacts-of-contacts
and 534 probable contacts, including 2 879 frontline workers.
No new vaccines are being administered.

Five suspected cases are currently hospitalized in the
Epidemic Diseases Hospital treatment centres.

Eight new community deaths were reported, with eight
samples collected and no safe and dignified burials carried
out.

Infection prevention and control (IPC) activities include a
performance assessment of Yalenzou community health
centre and Yomou Prefecture Hospital, followed by a briefing
of 10 health workers in handling reusable materials.

Risk communication and community engagement (RCCE)
included support to the communication commission;
reports on the socio-anthropological research into the Ebola
virus outbreak and support to the surveillance commission
in training health workers in Koropara.

SITUATION INTERPRETATION

The 42-day countdown to the end of outbreak declaration
continues, now standing at 21 days. Few community alerts
are received, and 24-hour follow-up remains poor. Community
surveillance in Nzerekore and neighbouring provinces still
requires strengthening. In addition, the WHO response plan is
still only 17% funded. This gap needs urgently to be filled if the
momentum of response is to continue.

https://apps.who.int/iris/bitstream/handle/10665/341556/OEW22-2430052021.pdf

 

[Pathfinder]

WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 23: 31 May to 6 June 2021
Data as reported by: 17:00; 6 June 2021
...

Ebola virus disease Guinea 52.2%

23 Cases
12 Deaths
52.2% CFR

EVENT DESCRIPTION

No new confirmed Ebola virus disease (EVD) cases have been
reported in Nzerekore prefecture, the site of the current EVD
outbreak in Guinea, as of 6 June 2021, which was day 13 to the
end-of-outbreak.

As of 6 June 2021, a total of 23 cases have been reported,
including 16 confirmed cases, and 7 probable cases, of which 9
have recovered, and 12 have died (case fatality ratio 52.2%). The
number of health workers infected remains five.

The majority of the confirmed and probable cases reported are
female (13/23; 60.9%) and the most affected age group are those
over 40 years.

There are currently no active contacts under follow-up. On
6 June 2021, there were 62 new alerts received in Nzerekore,
including nine deaths, of which 31 (50.0%) were investigated.
A total of 23 were validated, including the nine deaths. In
neighbouring prefectures, 20 new alerts were received including
eight community deaths, all of which were investigated and none
validated.

PUBLIC HEALTH ACTIONS

The 42-day countdown to the end of the outbreak started on
8 May 2021, with the expected date for the declaration of the
end of the outbreak, the 19 June 2021.

Continued support is being provided to Nzerekore and all
neighbouring prefectures for enhanced surveillance during
this period.

A cumulative total of 10 873 people have been vaccinated,
including 622 high-risk contacts, 9 717 contacts-of-contacts
and 534 probable contacts, including 2 879 frontline workers.

No new vaccines are being administered.

Six suspected cases are currently hospitalized in the
Epidemic Diseases Hospital treatment centres.

Eighteen new community deaths were reported, with nine
samples collected and no safe and dignified burials carried
out.

Infection prevention and control (IPC) activities included
swabbing seven community death alerts.

Risk communication and community engagement (RCCE)
included continued in-depth research into the experience
of EVD in communities in Nzerekore; documentation
of the contribution of risk communication, community
engagement and social science by WHO and support to the
communication commission.

SITUATION INTERPRETATION

The 42-day countdown to the end of outbreak declaration
continues, now standing at 13 days. Community surveillance
in Nzerekore and neighbouring provinces still requires
strengthening. The 90-day resilience plan requires revision,
which is being planned. All authorities and partners need to
continue full support for response operations at this critical stage
of the outbreak.

https://apps.who.int/iris/bitstream/handle/10665/341673/OEW23-310506062021.pdf

 

[Pathfinder]

Outbreaks and Emergencies Bulletin, Week 24: 07 - 13 June 2021
...

Ebola virus disease Guinea

23 Cases
12 Deaths
52.2% CFR

EVENT DESCRIPTION

No new confirmed Ebola virus disease (EVD) cases have been
reported in Nzerekore prefecture, the site of the current EVD
outbreak in Guinea, as of 12 June 2021, which was day seven
to the end-of-outbreak. However, 46 new suspected cases were
notified, of which four were transferred to Ebola treatment
centres, and 38 were not validated as suspected cases.
As of 12 June 2021, a total of 23 cases have been reported,
including 16 confirmed cases, and 7 probable cases, of which 9
have recovered, and 12 have died (case fatality ratio 52.2%). The
number of health workers infected remains five.

The majority of the confirmed and probable cases reported are
female (13/23; 60.9%) and the most affected age group are those
over 40 years.

There are currently no active contacts under follow-up. On 13
June 2021, there were 139 new alerts received in Nzerekore, of
which 95 (68.0%) were investigated. A total of 46 were validated,
including two deaths, which were swabbed. In neighbouring
prefectures, 36 new alerts were received, 35 (97.0%) of which
were investigated and none validated.

PUBLIC HEALTH ACTIONS

The 42-day countdown to the end of the outbreak started on
8 May 2021, with the expected date for the declaration of the
end of the outbreak the 19 June 2021.

Continued support is being provided to Nzerekore and all
neighbouring prefectures for enhanced surveillance during
this period.

A cumulative total of 10 873 people has been vaccinated,
including 622 high-risk contacts, 9 717 contacts-of-contacts
and 534 probable contacts, including 2 879 frontline workers.
No new vaccines are being administered.

Fifteen suspected cases are currently hospitalized in the
Epidemic Diseases Hospital treatment centres.

Two new community deaths were reported, with one sample
collected and no safe and dignified burials carried out.
Infection prevention and control (IPC) activities included the
start of the last cohort of the joint training of health workers
in the use of Oraquick tests in Nzerekore.

Risk communication and community engagement (RCCE)
included continued training and supervision of the RCCE
focal point and supervisor deployed in Gonia; continued
support to the Supervisory Board in overcoming community
resistance for transfer suspected cases to Ebola treatment
centre; and continued documentation of the contribution of
the WHO RCCE activities in the response to EVD in Nzerekore.

SITUATION INTERPRETATION

The 42-day countdown to the end of outbreak declaration
continues, now standing at seven days. Community surveillance
in Nzerekore and neighbouring provinces still requires
strengthening. The 90-day resilience plan requires revision,
which is being planned. All authorities and partners need to
continue full support for response operations at this critical stage
of the outbreak.

https://apps.who.int/iris/bitstream/handle/10665/341808/OEW24-0713062021.pdf

 

[Pathfinder]

Ebola outbreak in Guinea declared over

19 June 2021

Brazzaville/Conakry – The Ebola outbreak that emerged in Guinea in mid-February was declared over today. It was the first time the disease resurfaced in the country since the deadly outbreak in West Africa that ended in 2016.

Guinean health authorities declared the outbreak on 14 February 2021 after three cases were detected in Gouecke, a rural community in the southern N’zerekore prefecture, the same region where the 2014–2016 outbreak first emerged before spreading into neighbouring Liberia and Sierra Leone and beyond.

A total of 16 confirmed and seven probable cases were reported in Guinea’s latest outbreak in which 11 patients survived and 12 lives lost. Shortly after the infections were detected, national health authorities, with support from World Health Organization (WHO) and partners, mounted a swift response, tapping into the expertise gained in fighting recent outbreaks both in Guinea and in the Democratic Republic of the Congo.

“I commend the affected communities, the government and people of Guinea, health workers, partners and everyone else whose dedicated efforts made it possible to contain this Ebola outbreak,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Based on the lessons learned from the 2014–16 outbreak and through rapid, coordinated response efforts, community engagement, effective public health measures and the equitable use of vaccines, Guinea managed to control the outbreak and prevent its spread beyond its borders. Our work in Guinea continues, including supporting survivors to access post-illness care.”

WHO helped ship around 24 000 Ebola vaccine doses and supported the vaccination of nearly 11 000 people at high risk, including over 2800 frontline workers. More than 100 WHO experts were on the ground coordinating key aspects of the response such as infection prevention and control, disease surveillance, testing, vaccination and treatment using new drugs. Collaboration with communities was also enhanced to raise awareness about the virus and ensure their involvement and ownership of the efforts to curb the disease.

“Although this Ebola outbreak flared up in the same area as the West Africa one which killed 11 000 people, thanks to new innovations and lessons learned, Guinea managed to contain the virus in four months,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “We are getting faster, better and smarter at fighting Ebola. But while this outbreak is over, we must stay alert for a possible resurgence and ensure the expertise in Ebola expands to other health threats such as COVID-19.”

WHO continues to support Guinea in its efforts to remain vigilant, maintain surveillance and build capacity to respond quickly to a possible resurgence of the virus. An Ebola laboratory, treatment infrastructure, logistics capacity and infection prevention measures have been reinforced to better respond to the disease as well as other health emergencies.

While the latest Ebola outbreak was limited to Guinea, to prevent cross-border infections, WHO supported six of the country’s neighbours to ramp up preparedness measures, including stepping up surveillance and screening at border crossings and within high-risk communities, as well as enhancing coordination between governments and the respective health services.

Support to Ebola survivors is also crucial. Genome sequencing found that the virus behind Guinea’s just-ended outbreak was similar to that identified in the 2014–2016 outbreak. Though more studies are needed to fully understand how the two outbreaks may be linked, Guinean health authorities reactivated a surveillance programme for survivors to provide long-term monitoring and after-care support.

In support of the government’s efforts to curb the outbreak, WHO worked with other United Nations agencies and partners such as the African Development Bank, Alliance for International Medical Action, African Centres for Disease Control and Prevention, European Civil Protection and Humanitarian Aid Operations, Gavi, the Vaccine Alliance, the International Organization for Migration, Global Outbreak Alert and Response Network, Terre des Hommes, United Nations Central Emergency Response Fund, United Nations Children’s Fund, United States Agency for International Development, World Bank and World Food Programme.

https://www.afro.who.int/news/ebola-outbreak-guinea-declared-over

 

[Pathfinder]

Translation Google

Ebola: a new lead on the origin of the recent epidemic in Guinea

Published on : 09/16/2021 - 19:11

Text by:
Leopold Picot

In a study published in the prestigious scientific journal Nature , Guinean and French researchers show for the first time that an Ebola epidemic, like the one that occurred in Guinea in 2021, can be declared from a “sleeper” viral strain in a person, more than five years after being infected. Even if the phenomenon would be extremely rare, this discovery underlines the importance of the follow-up of the survivors.

On February 14, 2021, the Guinean government announced that an Ebola virus epidemic had broken out in the N'Zérékoré prefecture. In mid-June, the epidemic is over, it has caused the death of 12 people out of 23 identified cases. The study published in Nature on Wednesday September 15, entitled " Resurgence of the Ebola virus in 2021, Guinea: A new paradigm on epidemics " , confirms that the strain of the virus responsible for this epidemic is the same as that which affected the country five years earlier. The 2021 epidemic is therefore not of animal but of human origin, and patient 0 is probably a survivor of the previous epidemic.

Supporting survivors to understand Ebola

Some 17,000 patients survived the epidemic that spanned from December 2013 to June 2016 in West Africa. Alongside Guinean researchers Saliou Sow, Abdoulaye Touré and Alpha Keita, Frenchman Eric Delaporte, professor of infectious diseases at the University of Montpellier, followed more than 800 survivors in Guinea, out of the 1,270 counted in the country.

“We had to take care of the survivors on leaving Ebola treatment centers, because they were most often traumatized psychologically and physically,” he explains. We followed them for five years at the Guinea Infectious Disease Research and Training Center (Cerfig), in Conakry. And in doing so, we have been able to make enormous progress in understanding the infection ”. During the pandemic, after leaving the treatment center, most survivors were sent home without special follow-up. " It's as if you come out of intensive care and let you fend for yourself ."

“ The centers were proceeding according to the recommendations of the time. The survivors were declared cured, but on a biological basis, that is - that there was more of virus in the blood, there was no support program yet , "explains Eric Door. However, we know today, thanks to a previous study by these same researchers, that the sequelae linked to the infection are numerous and that the virus can nest in liquids other than blood.

Persistent symptoms were thus observed in three quarters of the survivors at the start of the follow-up, in particular bone and joint pain, neurological disorders, or even inflammatory glaucoma. " Over time, these manifestations decrease significantly - today it is only a third of the survivors who are concerned - with very moderate attacks ", assures the professor.

The results of analyzes of the strain of the 2021 epidemic surprised researchers at Cerfig, associated with the Institute for Research for Development (IRD) and the German Robert Koch Institute. Eric Delaporte, IRD, testifies: “ We did not expect to find the same strain as at the end of the 2013-2015 epidemic. We said to ourselves that we had to verify that it was not a laboratory contamination. Three other laboratories, including a Guinean and a Senegalese, carried out new analyzes. All find the same result, which upsets the perception of the Ebola virus disease: this strain could only be transmitted by a human being, a survivor of the previous epidemic, whose virus has reactivated.

Support, vaccinate, without stigmatizing

In their press release announcing the publication of the study, the researchers insist: we must fight against the stigmatization of survivors, who could be put aside by their loved ones for fear of a resurgence. " The phenomenon remains extremely rare, " insists Professor Delaporte. Having observed clinical sequelae after the acute phase of infection, the researchers would like the survivors to be followed up systematically. They also suggest that those with low antibody levels be vaccinated against Ebola: without a vaccine, some might not be able to control a reactivation of their quiescent virus.

Natalie Roberts, an emergency doctor at MSF who has studied the Ebola disease virus, insists that vaccination should be offered to everyone. “ In some affected countries, population movements are significant and public health infrastructure is weak. It is probably not realistic to want to follow all the survivors for years, ”she warns. On the other hand, vaccination seemed to him to be a more realistic solution: “ Besides vaccination of survivors, which should strengthen their antibodies, we could consider that of their sexual partners and other people around them who will be exposed to bodily fluids of the survivor. ".

Basic research on treatments should also be stepped up. “ It has been shown that well-targeted monoclonal, ie artificial, antibodies can control the infection but do not kill the virus. Today, we need drugs that are virucidal if we want to permanently eliminate the virus from the body in the rare cases where it remains asleep, quiescent, ”claims Professor Delaporte.

https://www.rfi.fr/fr/science/20210...ur-l-origine-de-la-récente-épidémie-en-guinée