Emergency Appeal Operation Update - Ebola Virus Disease Emergency Appeals (Guinea, Liberia, Sierra Leone and Global Coordination & Preparedness) - Update No. 27

Current epidemiological situation + country-specific information

There has been considerable development in slowing down the Ebola Virus Disease Outbreak in Guinea, Liberia and Sierra Leone. On 7 November 2015, the Government of Sierra Leone declared that the Ebola outbreak is over. This meant that no cases had been declared in Sierra Leone over the last 42 days.

Despite the World Health Organisation (WHO) declaration marking the end of the Ebola outbreak in Sierra Leone being well received, the world must remain focused on getting to, and sustaining, zero cases. Until there are zero cases in each affected country, there is still a risk to the people and economies in these previously badly affected countries in the West Africa region and beyond.

On 11 November, Liberia was on day 69 of 90 days of active surveillance after being declared Ebola free for the second time on 3 September 2015. Communities are being urged to remain vigilant and report all deaths. Most organisations that were involved in the EVD response are in the process of scaling down their operations and planning for the coming year.

On 3 September 2015, the WHO had declared the Government of Liberia free of the Ebola virus transmission in human beings. This was after the passage of 42 days since Liberia’s last laboratory-confirmed second negative test case (on 22 July 2015). Liberia is currently in a 90-day period of heightened surveillance and continues to intensify vigilance in the fight against the EVD epidemic. Both Liberia and Sierra Leone have now achieved objective 1 of the phase 3 response framework: to interrupt all remaining chains of Ebola virus transmission.

Guinea reported no confirmed cases in the week to 8 November. A total of 4 cases have been reported from Guinea in the past 21 days, all of whom are members of the same family from the village of Kondeyah, in the sub prefecture of Kaliah in Forecariah. All 69 contacts currently being followed in Guinea are located in Kaliah and are scheduled to complete their 21-day follow-up period on 14 November.

According to the 04 November WHO Ebola Situation Report, one new confirmed case of Ebola Virus Disease was reported from Guinea in the week to 1 November. The case is the new-born child of a 25-year-old woman who was confirmed as a case in the prefecture of Forecariah during the previous week. The child was delivered in an Ebola treatment centre (ETC) in Conakry, and is currently undergoing treatment. The mother died after giving birth. Her other two young children were also confirmed as cases during the previous week and are receiving treatment. The 3 confirmed cases reported the previous week generated a large number of high-risk contacts in Forecariah who are now entering the second week of their 21-day post-exposure follow-up period.

On 1 November there were 382 contacts under follow-up in Guinea (compared with 364 the previous week), 141 of whom are high-risk. Therefore there remains a near-term risk of further cases among both registered and untraced contacts. The WHO Situation Report observed that case incidence had remained at 5 confirmed cases or fewer per week for 14 consecutive weeks. Over the same period, transmission of the virus has been geographically confined to several small areas in western Guinea and Sierra Leone, marking a transition to a distinct, third phase of the epidemic. The phase-3 response2 coordinated by the Interagency Collaboration on Ebola3 builds on existing measures to drive case incidence to zero, and ensure a sustained end to EVD transmission. Enhanced capacity to rapidly identify a reintroduction (either from an area of active transmission or from an animal reservoir), or re-emergence of virus from a survivor, and capacity for testing and counselling as part of a comprehensive package to safeguard the welfare of survivors are central to the phase-3 response framework.