SUMMARY
There were 3 confirmed cases of Ebola virus disease (EVD) reported in the week to 23 August, all of which were reported from Guinea. No new confirmed cases were reported from Sierra Leone for the second consecutive week. Overall case incidence has held at 3 confirmed cases per week for 4 consecutive weeks. In addition, the number of contacts under observation continues to fall, from over 800 on 16 August to approximately 600 on 23 August throughout 4 prefectures in Guinea and 2 districts in Sierra Leone. All contacts associated with the recent cluster of cases in Tonkolili, Sierra Leone, have now completed the 21-day follow-up period. However, there remains a significant risk of further transmission. All 3 cases in Guinea this week were reported from the capital, Conakry, and have generated a substantial number of high-risk contacts.
One of the cases, who was detected after post-mortem testing of a community death, was one of 35 contacts to have been lost to follow-up in Conakry in the past 6 weeks.All of the 3 confirmed cases reported from Guinea in the week to 23 August were identified in the Ratoma area of the capital, Conakry. The first case, a male taxi driver in his early 40s, was not a registered contact, and is thought to have worked for a short time in Conakry whilst symptomatic. Efforts are ongoing to trace any passengers who may be contacts. A male health worker who was registered as a contact after treating the taxi driver at a private clinic subsequently also tested positive for EVD. Over 40 contacts from the private clinic and household have been identified so far. The remaining case, a woman in her early 40s, was a registered contact of a previous case in Conakry but was lost to follow-up. Investigations suggest she travelled outside Conakry to consult a traditional healer in the prefecture of Dubreka before her death. She was subsequently identified as an EVD-positive community death after post-mortem testing. 600 contacts were under follow-up on 23 August in 4 western prefectures (Conakry, Coyah, Dubreka, and Forecariah), compared with approximately 800 contacts in 3 prefectures the previous week.
No new cases were reported from Liberia in the week to 23 August. All contacts in Liberia have now completed their 21-day follow-up period. The last 2 patients with EVD in Liberia were discharged after completing treatment and testing negative for EVD for a second time on 23 July. Surveillance continues to be strengthened, with approximately 800 samples tested for EVD in the week to 23 August.
No cases were reported from Sierra Leone in the week to 23 August: the second consecutive week without a confirmed case. The last case to be diagnosed with EVD completed treatment and was discharged from an Ebola treatment centre on 24 August after testing negative twice for EVD. The number of contacts under follow-up has declined from 72 contacts across 3 districts (Tonkolili, Western Area Urban, and Western Area Rural) on 19 August to 29 contacts in Western Area Urban (Freetown) and Western Area Rural on 23 August, after all contacts associated with the Tonkolili cluster of cases completed follow-up.
For the first time in 4 weeks a new health worker infection was reported in the week to 23 August. The case was reported from Conakry, Guinea. There have been a total of 881 confirmed health worker infections reported from Guinea, Liberia, and Sierra Leone since the start of the outbreak, with 512 reported deaths.