SUMMARY
There were 24 confirmed cases of Ebola virus disease (EVD) reported in the week to 14 June, compared with 27 cases the previous week. In Guinea, 10 cases were reported from 4 prefectures (Boke, Conakry, Dubreka, and Forecariah). A total of 14 cases were reported from 2 districts (Kambia and Port Loko) in Sierra Leone.
Of 76 confirmed cases reported from Guinea and Sierra Leone in the 21 days to 14 June, 69 (91%) have come from 3 prefectures in Guinea (Boke, Dubreka, and Forecariah) and 2 districts in Sierra Leone (Kambia and Port Loko). Most (55) of these 69 cases came from well-characterised chains of transmission, and arose among registered, monitored contacts of previous cases. Each of these cases presents a risk of further transmission, but in most instances that risk is well understood and can be planned for accordingly. However, 14 of those 69 cases, and 5 of the 7 cases that were reported from other prefectures and districts during the same period, arose from unknown sources of infection, and/or are associated with a large number of high-risk contacts, some of whom it was not possible to trace. Effectively managing the risks associated with cases such as these will be crucial to getting to zero. To that end, a package of enhanced surveillance and response measures has been introduced in both Guinea and Sierra Leone:
In Guinea, health checkpoints have been established in the western prefectures of Boke and Coyah. A 6-day door-to-door case-finding and sensitization campaign was carried out in Dubreka from 7 June, leading to the detection of 1 confirmed case. In addition, intensive investigations are underway to trace a number of high-risk contacts associated with 3 cases reported from the Guinean capital, Conakry, over the past 2 weeks. All of the 3 cases acquired infection outside the capital.
In Sierra Leone, a large-scale operation is planned in the districts of Kambia and Port Loko, aimed at ending the secret movement of cases, contacts, and dead bodies that has propagated transmission over the past 2 months. Measures include broadened criteria for identifying and tracing contacts, improved incentives to increase compliance with quarantine measures and encourage the timely reporting and isolation of cases, and expanded use of rapid diagnostic tests.
As at 14 June, there were 1927 contacts being monitored across 8 prefectures in Guinea. In Sierra Leone, 443 contacts were under follow-up in 3 districts. A total of 660 laboratory samples were tested in Guinea in the week to 14 June: 4% tested positive. Over the same period, 1787 new samples were tested in Sierra Leone, with less than 1% testing positive.
In Guinea there were a total of 15 unsafe burials in the week to 14 June, representing 4% of 357 community deaths. In the week to 7 June, 1 unsafe burial was reported in Sierra Leone.
The last health worker infections in Guinea and Sierra Leone were reported on 6 April and 14 May, respectively. However, a case reported this week from the Targrin area of Port Loko, Sierra Leone, acquired infection after being treated in the same private healthcare facility as another confirmed case. There is an extremely high likelihood that this case will lead to further transmission, with 20 health workers who came into direct or indirect contact with the case defined as medium or high-risk contacts, along with many patients who were treated at the same facility. There have been a total of 869 confirmed health worker infections reported from Guinea, Liberia, and Sierra Leone since the start of the outbreak, with 507 reported deaths.