SUMMARY
Guinea reported no confirmed cases of Ebola virus disease (EVD) in the week to 15 November. The most recent case from Guinea was reported on 29 October. That case is a child who was born in an Ebola treatment centre, and who was delivered by medical staff wearing full personal protective equipment (PPE). As such, no contacts are associated with this case, and all contacts associated with previous cases have completed their 21-day follow-up period. A second consecutive blood sample from the child tested negative for Ebola virus on 16 November.
On 7 November WHO declared that Ebola virus transmission had been stopped in Sierra Leone. The country has now entered a 90-day period of enhanced surveillance, which is scheduled to conclude on 5 February 2016. Both Liberia and Sierra Leone have now achieved objective 1 of the phase 3 response framework: to interrupt all remaining chains of Ebola virus transmission.
Robust surveillance measures are essential to ensure the rapid detection of any reintroduction or reemergence of EVD in currently unaffected areas, and are central to the attainment of objective 2 of the phase 3 response framework: to manage and respond to the consequences of residual Ebola risks. To that end, Guinea, Liberia, and Sierra Leone have each put surveillance systems in place to enable health workers and members of the public to report any case of illness or death that they suspect may be related to EVD. In the week to 15 November, 26 493 such alerts were reported in Guinea, with alerts reported from all of the country’s 34 prefectures. Equivalent data are not currently available for Liberia. In Sierra Leone, 1496 alerts were reported from 14 of 14 districts in the week ending 8 November (the most recent week for which data are available).
As part of each country’s EVD surveillance strategy, blood samples or oral swabs should be collected from any live or deceased individuals who have or had clinical symptoms compatible with EVD. In the week to 15 November, 9 operational laboratories in Guinea tested a total of 587 new and repeat samples from 14 of the country’s 34 prefectures. 91% of all samples tested in Guinea were swabs collected from dead bodies. By contrast, 85% of the 757 new and repeat samples tested in Liberia over the same period were blood samples collected from live patients. In addition, all 15 counties in Liberia submitted samples for testing by the country’s 4 operational laboratories. 1164 new samples (the lowest total reported in 2015) were collected from all 14 districts in Sierra Leone and tested by 9 operational laboratories. 93% of samples in Sierra Leone were swabs collected from dead bodies.
463 deaths in the community were reported from Guinea in the week to 15 November. This represents approximately 21% of the 2248 deaths expected based on estimates of the population and a crude mortality rate of 11 deaths per 1000 people per year. All but 1 of the 463 reported deaths were buried safely. Equivalent data are not yet available for Liberia. In Sierra Leone, 1332 reports of community deaths were received through the alert system during the week ending 8 November (the most recent week for which data are available), representing approximately 64% of the 2075 deaths expected each week based on estimates of the population and a crude mortality rate of 17 deaths per 1000 people per year.