Guinea + 3 more

IOM Flash Appeal: Ebola - Guinea, February - July 2021 (Published on 4 March 2021)

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On 14 February 2021, the Ministry of Health (MoH) of Guinea declared a cluster of Ebola virus disease (EVD) cases in the subprefecture of Gouecke, N'Zerekore region, Guinea. Gouecke, the epicentre of the outbreak, is one of IO sub-prefectures that make up the N'Zerekore prefecture. Gouecke is located 42 km (26 miles) from central N'Zerekore with a total population of about 23,458 inhabitants in 3,364 households.

As of 3 March, 17 cumulative cases (4 probable and 13 confirmed) have been declared and among those cases, eight have died (4 probable and 3/4 confirmed). Nine confirmed cases and two suspected case are currently in isolation in dedicated health care facilities in N'Zerekore and two have been released from the treatment centres in of Conakry and N'Zerekore.

Currently 579 contacts have been identified including 548 contacts in the N'Zerekore region (N'Zerekore and Lola), 18 in the Conakry region (Ratoma, Dixinn and Matoto), 11 in the Dubreka and 2 in Coyah prefecture (with 538 having been followed which represents an overall 93% rate of contact tracing). Among the contacts, 41 are lost from follow-up as of 3 March.

The N'Zerekore region of Guinea borders Cote d'Ivoire, Liberia and Sierra Leone, the latter two countries where EVD outbreaks occurred previously. Despite some movement restrictions across official borders due to the ongoing COVID-19 pandemic, a significant proportion of cross-border movements continue to take place and pose a risk for EVD spread. IOM monitors mobility restrictions at points of entry (PoEs) globally and current data indicates that the majority of PoEs monitored in the region (63%) have existing restrictions on movement across the border.

Gouecke, the epicentre of the current epidemic, is an important crossroads for travellers, hosting a market every Saturday attracting more than 5,000 people from neighbouring prefectures, the Kankan, Kindia and Conakry regions and neighbouring countries. As such, the prefectures of N'Zerekore, Guekedou, Macenta, Lola, Yomou and Beyla (bordering Cote d'Ivoire, Liberia and Sierra Leone) are considered at high risk due to the connection to one another and porous nature of the borders. Conakry is also considered high risk given one person who was later confirmed to have Ebola travelled from N'Zerekore to Conakry and was subsequently hospitalized in Conakry.

To date, no contacts have been reported to have travelled to neighbouring countries. However, N'Zerekore is the second largest city in Guinea and lies at the intersection of roads from Ganta (in Liberia), Danane (Cote d'Ivoire), and roads to other major hubs in Guinea like Kankan and Macenta. Therefore, there is concern about the transmission of EVD cases across the borders into neighbouring countries as seen during the 2014-2016 public health crisis. The Mano River subregion, composed of Guinea, Liberia and Sierra Leone, is also an area of concern as population movement across porous borders is high due to trade and insecurity in the region.

Findings from the World Health Organization (WHO) Rapid Risk Assessment ( 17 February 2021) concluded that the risk of spread of Ebola in the country is very high given the unknown size, duration and origin of the outbreak; potentially large number of contacts; limited response capacity currently on the ground; and unknown virus strain. The assessment also noted that the risk of spread within the region is high, while globally the risk is low. In addition, the response to Ebola is further straining a public health system already responding to multiple disease outbreaks in the country, including the COVID-19 pandemic, and recent yellow fever and measles outbreaks.

International Organization for Migration
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