SUMMARY
There were 3 confirmed cases of Ebola virus disease (EVD) reported in the week to 30 August: 2 in Guinea and 1 in Sierra Leone. The case in Sierra Leone is the first in the country for over 2 weeks. Overall case incidence has remained stable at 3 confirmed cases per week for 5 consecutive weeks. In addition, the number of contacts under observation continues to fall, from approximately 600 on 23 August to approximately 450 on 30 August. Of those, over 400 are located in Guinea. All 48 contacts under follow-up in Sierra Leone are associated with the most recently reported case from the western district of Kambia, which borders Guinea. A rapid-response team has been deployed to the area due to the likelihood of further localised transmission associated with the case. Both cases reported from Guinea this week had symptom onset in or near the capital, Conakry. One of the cases was symptomatic for an extended period in the community. There remains a risk of short-term increases in case incidence as a result of isolated, high-risk cases, and rapid-response teams are on alert to deal with any such cases.
The 2 confirmed cases reported from Guinea in the week to 30 August were identified in or near the Ratoma area of the capital, Conakry. The first case, a 9-month-old girl, was not a registered contact and had onset of symptoms on the outskirts of Conakry in Dubreka, before being taken to the Ratoma area of the capital by her family, where she died before she could be admitted to an Ebola treatment centre. The second case is a 56-year-old male and registered contact of a case reported from Ratoma on 18 August. Of 410 contacts who were under follow-up on 30 August in Guinea, 289 were located in Conakry, with 26 in Dubreka and 95 in Forecariah. The previous week 600 contacts were located in 4 western prefectures (Conakry, Coyah, Dubreka, and Forecariah).
No new cases were reported from Liberia in the week to 30 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 30 August.
One new confirmed case was reported from Sierra Leone in the week to 30 August: the first case reported from the country for over 2 weeks. The case was a woman approximately 60 years of age who was identified as EVD-positive after post-mortem testing. She had symptom onset in the village of Sella Kafta, Tonko Limba chiefdom in Kambia, and was treated in the community before her death. Kambia, which borders the Guinean prefecture of Forecariah, had not reported a confirmed case for 48 days. A rapid-response team was immediately deployed to the area. As at 30 August a total of 48 contacts had been identified, although this figure is expected to rise in due course. The origin of infection remains under investigation. The Phase 3 efficacy trial of the VSV-EBOV vaccine has now been extended from Guinea to Sierra Leone. Contacts and contacts of contacts associated with the confirmed case in Kambia will therefore be offered the vaccine. Contacts associated with all other chains of transmission in Sierra Leone have now completed follow-up.
No new health worker infections were reported in the week to 30 August. 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 513 reported deaths.