A. Situation analysis
Description of the disaster
On 14 February 2021, the Government of Guinea declared a new outbreak of Ebola Virus Disease (EVD) in Gouécké sub-prefecture which is part of N’Zérékoré prefecture in Guinée Forrestière Region. This is the first known resurgence of Ebola in West Africa since the 2013-2016 epidemic that began in Guinea and killed more than 11,300 people across the region. Following an alert by the director of the regional hospital of N’Zérékoré of cases of vomiting, bloody diarrhoea, and total haematuria, bleeding at the injection sites of five (05) patients from the same family hospitalized in the intensive care unit and followed by a transfer to Conakry (CHU Donka). The surveillance team from the regional health authorities (DRS) and prefectural health authorities (DPS) went to the hospital and the subprefecture of Gouécké respectively for an investigation.
Based on known information, seven (07) people have been infected to date including three deaths, three patients hospitalized in N’Zérékoré and one hospitalized in Conakry. Although the first case was confirmed in February, it is unclear when the outbreak started, which means the virus might have spread beyond the current known cases and there have been at least two unsecure burials of community deaths. The origins of the outbreak are unknown for the moment and all known cases so far are within the same family (Gouécké and N'Zérékoré) and in people aged over 25 years.
As of 16 February, a joint mission of the Ministry of Health has already deployed to support Gouecké team for the field assessment. Several actions have been launched to prevent transmission and identify new infections: case isolation, investigations & data collecting for tracing potential new cases, mobilization of vaccines and diagnostic kits, opening of a treatment centre, and safe and dignified burials to prevent post-mortem transmission. A national level coordination mechanism has also been launched to mobilize partners, while neighbouring countries including Côte d’Ivoire, Liberia and Sierra Leone are on high alert.
As investigations and contact tracing are ongoing to determine the scale of the outbreak and the geography of the risk, all humanitarian partners are expected to meet on 19 February to strategize on intervention. The probable impact areas are the prefectures of N’Zérékoré, Guékédou, Macenta, Lola, Yomou and Beyla. The number of people at risk in these areas is estimated at 1,042,251 inhabitants. The expected effect is a considerable increase in cases and the spread of the disease due to the displacement of infected people.
To note, N'zérékoré region is the third most populated region in Guinea, covering 18% of the national territory. It is at the same time the furthest from Conakry (870 km away), the most landlocked and the least urbanized. Socio-cultural conflicts (ethnic, religious or socio-economic) have led to unprecedented violence in Guinea Forest region since 2010. The region's rugged terrain makes access difficult, which highlights the isolation of several villages in the region.
The response to the Covid-19 epidemic has set a positive dynamic in terms of epidemic control and increased hygiene measures amongst the population to curb the spread of the disease. However, this should not be considered sufficient to prevent a 2014 scenario with the EVD outbreak spreading in the region. In that remote area, isolation of population and behaviours guided by fear of stigma and social impacts of the last Ebola outbreak remain an issue and community burials are both standard practice and a high risk for rapid transmission of the virus. In this context, the next few weeks will be crucial and must be spent building robust protection and control actions to avoid the spread of the outbreak.