SUMMARY
There were 26 confirmed cases of Ebola virus disease (EVD) reported in the week to 19 July: 22 in Guinea and 4 in Sierra Leone. Liberia reported no new cases. For the second consecutive week more than half of all cases were reported from the capitals of Guinea and Sierra Leone, Conakry and Freetown. By contrast, other recent hotspots of transmission such as Boke in Guinea and Kambia in Sierra Leone have now reported no cases for 18 and 9 days, respectively. There are also indications of a continuation of the improvements in contact tracing and case investigation seen in recent weeks, with all but 2 cases arising among registered contacts of previous cases, including all 13 of the cases reported from the Guinean capital Conakry. This is the highest proportion of cases to arise among contacts since the beginning of the outbreak. However, one of the 2 cases reported from Freetown arose from an unknown source of infection, and is considered to represent a high risk of further transmission. In addition, 2 cases, both from Guinea, were identified as EVD-positive only after post-mortem testing of community deaths.
In Guinea, cases were reported from the prefectures of Conakry, Coyah, and Forecariah. Thirteen cases were reported from Conakry, all of whom were registered contacts associated with 2 chains of transmission. Two of these cases were health workers. In the neighbouring prefecture of Coyah 2 cases were reported from the sub-prefecture of Maneah. These are the first cases reported from Coyah since April. Both are registered contacts associated with a chain of transmission that stems from the sub-prefecture of Benty in Forecariah. Six of the 7 cases reported from Forecariah were registered contacts associated with the same chain of transmission in Benty. The remaining case from Forecariah arose from an unknown source in the sub-prefecture of Alassoyah.
No new cases were reported from Liberia in the week to 19 July. Of the 6 confirmed cases reported since 29 June, 2 have died, 2 have been discharged after treatment, and 2 remain under observation in an Ebola Treatment Centre. As of 21 July, 56 contacts associated with the chain of transmission are under follow-up. A total of 18 contacts have completed the 21-day follow up period. If there are no further cases all contacts will have completed follow-up on 2 August.
The 4 cases confirmed in Sierra Leone were reported from Freetown and Port Loko. The first of 2 cases from Freetown was a health worker who tested positive for EVD whilst residing in a voluntary quarantine facility. The second case was found with advanced disease (symptoms including vomiting and diarrhoea) outside a community health facility near the Magazine Wharf neighbourhood of the city, which reported 8 cases in the previous week. However, the case is not a registered contact of any case from the Magazine Wharf transmission chain. Contact tracing has been complicated by the fact that the case has no fixed address and was infectious for an unknown period prior to identification. The remaining 2 cases in Sierra Leone were reported from the chiefdom of Marampa in Port Loko. Both are registered contacts associated with a transmission chain linked to an EVD-positive mother who died during childbirth in mid-June.
On 20 July, Italy was declared free of EVD transmission after the completion of 42 days without a case since the country’s first and only case of EVD to date was confirmed EVD-negative and discharged from hospital.
Two new health worker infections were reported from Guinea and one from Sierra Leone in the week to 19 July. There have been a total of 879 confirmed health worker infections reported from Guinea, Liberia, and Sierra Leone since the start of the outbreak, with 510 reported deaths.