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The Public Health Emergency of International Concern (PHEIC) related to Ebola in West Africa was lifted on 29 March 2016. A total of 28 616 confirmed, probable and suspected cases have been reported in Guinea, Liberia and Sierra Leone, with 11 310 deaths.
In the latest cluster, seven confirmed and three probable cases of Ebola virus disease (EVD) were reported between 17 March and 6 April from the prefectures of N’Zerekore (nine cases) and Macenta (one case) in south-eastern Guinea. In addition, having travelled to Monrovia, Liberia, the wife and two children of the Macenta case were confirmed as Ebola cases between 1 and 5 April.
The index case of this cluster (a 37-year-old female from Koropara sub-prefecture in N’Zerekore) had symptom onset on or around 15 February and died on 27 February without a confirmed diagnosis. The source of her infection is likely to have been due to exposure to infected body fluid from an Ebola survivor.
All contacts that were linked to the 13 cases (including nine deaths) in Guinea and Liberia completed the 21-day follow-up period on 27 April.
In Guinea, the last case tested negative for Ebola virus for the second time on 19 April. In Liberia, the last case tested negative for the second time on 28 April.
The 42-day (two incubation periods) countdown must elapse before the outbreak can be declared over in Guinea and Liberia. In Guinea, this is due to end on 31 May and in Liberia, this is due to end on 9 June. The response to this outbreak was supported in Guinea by vaccination of contacts and contacts of contacts. This campaign began on 22 March and vaccinated over 1500 people.
Risk assessment:Active surveillance is ongoing in Guinea and Liberia and will continue 42 days after the last case tested negative for Ebola virus. The performance indicators suggest that the Guinea, Liberia and Sierra Leone still have variable capacity to prevent (EVD survivor programme), detect (epidemiological and laboratory surveillance) and respond to new outbreaks (Table 1). The risk of additional outbreaks originating from exposure to infected survivor body fluids remains.
