SUMMARY
One new confirmed case of Ebola virus disease (EVD) was reported from Guinea in the week to 1 November. The case is the newborn 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. Sierra Leone reported zero cases for a seventh consecutive week, and will be declared free of EVD transmission on 7 November if no further cases are reported.
Case incidence has 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 response1 coordinated by the Interagency Collaboration on Ebola2 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.
The single new confirmed case reported from Guinea in the week to 1 November is the tenth case in the Forecariah branch of the Ratoma transmission chain, and the fourth confirmed case from the same family and household from the village of Kondeyah, in the subprefecture of Kaliah, Forecariah. Of 382 contacts under follow-up in Guinea on 1 November, 43 were located in Conakry with 339 located in Forecariah. Of a total 141 high-risk contacts, 7 are located in Conakry with 134 located in Forecariah. In the past 42 days, 1 contact from Forecariah has been lost to follow-up.
In Sierra Leone, all contacts linked to the country’s 2 most recently active chains of transmission, Bombali and Kambia, have completed 21-day follow-up. The last case to receive treatment was confirmed free of EVD after a second consecutive negative test on 25 September. The country will be declared free of EVD transmission on 7 November if no further cases are reported.
Robust surveillance measures are essential to ensure the rapid detection of any reintroduction or re- emergence of EVD in currently unaffected areas. Nine operational laboratories in Guinea tested a total of 615 new and repeat samples in the week to 1 November. In Liberia, 1162 new and repeat samples were tested over the same period in the country’s 4 operational laboratories. 1437 new samples were collected in Sierra Leone and tested by 9 operational laboratories.