Sierra Leone + 8 more

Rapid risk assessment: Outbreak of Ebola virus disease in West Africa. 10th update, 14 April 2015

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Developments since the ninth update

As of 5 April 2015, WHO has reported 25 550 cases, including 10 587 deaths, linked to the West African outbreak of Ebola virus disease (EVD) with onset in December 2013. Altogether, nine countries have reported EVD cases.

Three countries (Guinea, Liberia and Sierra Leone) have experienced widespread and intense transmission. The disease continues to spread in Guinea and Sierra Leone, while Liberia has not reported a confirmed case since 20 March. Mali, Nigeria, Senegal, Spain, the United Kingdom and the USA have at some point reported imported cases or import-related local transmission linked to the epidemic in Guinea, Liberia and Sierra Leone, but all six countries have been declared Ebola-free.

The latest WHO report indicates that the number of new cases continues to decrease. Thirty cases were reported from just two countries, Guinea and Sierra Leone, for the week leading up to 5 April. This is the lowest weekly total since May 2014. Sierra Leone has reported a decreasing number of cases for five consecutive weeks, while in Guinea case numbers have continued to fluctuate in the past two months without a clear trend. It seems likely that human-to-human transmission has been interrupted in Liberia.
The geographical area of transmission is shrinking in both Guinea and Sierra Leone, and transmission is now concentrated in and around the capital cities of Conakry and Freetown.

The capacity for treating EVD patients now exceeds demand in Liberia and Sierra Leone, and decommissioning of Ebola care facilities has started.

There are concerns about the risk of outbreaks of vaccine-preventable diseases. The interruption of immunisation activities since the start of the epidemic has resulted in the accumulation of susceptible individuals in Guinea,

Liberia and Sierra Leone. There are ongoing outbreaks of measles and meningitis in Guinea, and there is a risk of further spread of vaccine-preventable diseases in all three countries.

The West African EVD epidemic was declared a Public Health Emergency of International Concern (PHEIC) by the Director General of WHO on 8 August 2014 on the recommendation of the Emergency Committee. The Committee met for the fifth time on 9 April 2015 and concluded that the event continues to constitute a PHEIC and recommended that all previous temporary recommendations should be extended.

The Committee strongly reiterated the need for continued exit screening in the three affected countries for at least 42 days after the last case has twice tested negative for Ebola.