Sierra Leone: WHO Ebola Situation Report - 30 December 2015

SUMMARY

• No confirmed cases of Ebola virus disease (EVD) were reported in the week to 27 December. On 29 December, WHO declared that human-to-human transmission of Ebola virus has ended in Guinea, after the completion of 42 days with zero cases since the last person confirmed to have EVD received a second consecutive negative blood test for Ebola virus RNA. Guinea has now entered a 90-day period of heightened surveillance.
  
• Human-to-human transmission linked to the most recent cluster of cases in Liberia will be declared to have ended on 14 January 2016, 42 days after the 2 most-recent cases received a second consecutive negative test for Ebola virus, if no further cases are reported. In Sierra Leone, human-to-human transmission linked to the primary outbreak was declared to have ended on 7 November 2015. The country has now entered a 90-day period of enhanced surveillance scheduled to conclude on 5 February 2016.
  
• The 8th meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (2005) regarding the EVD outbreak in West Africa took place by teleconference on 15 December 2015. Based on the advice of the Committee, the Director-General declared that the 2014–15 Ebola outbreak continues to constitute a Public Health Emergency of International Concern.
  
• The most recent cluster of cases in Liberia was the result of the re-emergence of Ebola virus that had persisted in a previously infected individual. Although the probability of such re-emergence events is low, the risk of further transmission following a re-emergence underscores the importance of implementing a comprehensive package of services for survivors that includes the testing of appropriate bodily fluids for the presence of Ebola virus RNA. The governments of Liberia and Sierra Leone, with support from partners including WHO and US CDC, have implemented voluntary semen screening and counselling programmes for male survivors in order to help affected individuals understand their risk and take necessary precautions to protect close contacts. 405 male survivors had accessed semen screening services up to 27 December in Liberia and Sierra Leone. A network of clinical services for survivors is also being expanded in Liberia and Sierra Leone, with plans for comprehensive national policies for the care of EVD survivors due to be completed in January 2016.
  
• In order to effectively manage and respond to the consequences of residual Ebola risks, 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 to the relevant authorities. In the week to 27 December, 933 community death alerts were reported in Guinea from all of the country’s 34 prefectures. Over the same period 9 operational laboratories in Guinea tested a total of 541 new and repeat samples (6 samples from live patients and 535 from community deaths) from only 14 of the country’s 34 prefectures. In Liberia, 611 alerts were received from all 15 of the country’s counties. The country’s 5 operational laboratories tested 469 new and repeat samples (281 from live patients and 188 from community deaths) for Ebola virus over the same period. In Sierra Leone 1226 alerts were reported in the week to 20 December (the most recent week for which data are available). 734 new and repeat samples (10 from live patients and 724 from community deaths) were tested for Ebola virus by the country’s 8 operational laboratories in the week ending 27 December.
  
• The deployment of rapid-response teams following the detection of a new confirmed case continues to be a cornerstone of the national response strategy in Guinea, Liberia, and Sierra Leone. Each country has at least 1 national rapid-response team, with strengthening of national and subnational rapid-response capacity and validation of incident-response plans continuing through December and January.