A total of 37 confirmed cases of Ebola virus disease (EVD) was reported in the week to 12 April, compared with 30 the previous week. Case incidence in Guinea increased to 28, compared with 21 confirmed cases the previous week. Sierra Leone reported 9 confirmed cases, the same total as in the previous week. Liberia reported no confirmed cases.
A total of 5 Guinean prefectures reported at least one confirmed case in the week to 12 April, compared with 6 the previous week. Transmission remains confined to the western area, and is primarily focused on the prefecture of Forecariah, which borders Sierra Leone. In total, 8 prefectures/districts in Guinea and Sierra Leone reported a confirmed case in the week to 12 April, compared with 10 the previous week. This is the lowest number of districts to report a confirmed case since the end of May 2014. 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.
In the context of falling case incidence and a receding zone of transmission, treatment capacity exceeds demand in Liberia and Sierra Leone. Accordingly, and with technical guidance from WHO, national authorities in both countries have begun to implement plans for the phased safe decommissioning of surplus facilities.
Each country will retain a core capacity of high-quality Ebola treatment centres, strategically located to ensure complete geographic coverage, with additional rapid-response capacity held in reserve.
In Sierra Leone, cases were reported from 3 western districts: Kambia (4 cases), Port Loko (1 case), and Western Area Urban (4 cases), which includes the capital, Freetown.
Response indicators from Sierra Leone continue to be encouraging. The number of EVD-positive deaths that were identified in the community after post-mortem testing was 3 in the week to 12 April. The low proportion of laboratory samples that tested EVD-positive (9 of 1338: <1%) and the increasing proportion of cases that arise among registered contacts (67% for the most recent reporting period) strengthen confidence that the downward trend in case incidence over the past 5 weeks will continue.
By contrast, response indicators for Guinea continue to present a mixed picture. A total of 8 confirmed deaths from EVD in the week to 12 April were identified post-mortem in the community. In addition, the proportion of confirmed cases that arose among registered contacts remained below 50% for the second consecutive week, at 44%. More positively, the number of laboratory samples tested increased for a fourth consecutive week to 518 in the week to 12 April: but 10% of samples tested positive for EVD.
A case-finding and community sensitization operation took place in the Guinean prefecture of Forecariah from 12 to 15 April. In the first 3 days over 29 000 households were visited, with 23 suspected cases identified and tested. Similar operations will take place in the prefectures of Boffa, Conakry, Coyah, Dubreka, and Kindia.
The last confirmed case in Liberia died on 27 March. Investigations are ongoing to establish the origin of infection. A total of 2 contacts associated with the case were being monitored as at 11 April. Heightened vigilance is being maintained throughout the country. In the 6 days to 11 April, 332 laboratory samples were tested for EVD, with no confirmed cases. 42 days will have elapsed since the last confirmed case on 8 May.
There was one new health worker infection in the week to 12 April, with the cumulative total increasing to 864 since the start of the outbreak.