The World Health Organization (WHO) with headquarters in Geneva, Switzerland has released an update on the Ebola virus disease (EVD) in three West African countries which are also part of the Mano River Union (MRU): Sierra Leone, Guinea and Liberia. The fourth member, Cote d’Ivoire, is Ebola-free at the moment. WHO seems to realize that EVD can only be seriously contained by concerted efforts in all three countries which should be sharing information, strategies and tactics.
People move freely through numerous crossing points among the four MRU countries of Sierra Leone, Guinea, Liberia and Cote d’Ivoire frequently without any contact with immigration authorities.
According to WHO, cases and deaths attributable to Ebola virus disease (EVD) outbreak continue to be reported from new (Telimele and Boffa) and some affected districts (Conakry and Macenta) that did not report cases for more than 42 days. Since the last update of Disease Outbreak News of 28 May 2014, 10 new cases and 7 new deaths have been reported. The current evolving epidemiological situation could be partly explained by persistent community resistance in some communities in Gueckedou, Macenta, and Conakry.
Resistance to health care workers in the fight against Ebola has been reported in Sierra Leone too where the relatives of an Ebola victim actually chased away with stones health workers that arrived to take her away to hospital. The said patient has since passed away, according to reports.
As of the 28th of May 2014, a cumulative total of 291 clinical cases of EVD, including 193 deaths have been reported in Guinea. WHO says the classification of these cases and deaths are as follows: confirmed, 172 cases and 108 deaths; probable, 71 cases and 62 deaths; and suspected, 48 cases and 23 deaths. The breakdown of cases and deaths by affected areas is as follows: Conakry, 53 cases and 27 deaths; Gueckedou, 179 cases and 133 deaths; Macenta, 40 cases and 23 deaths; Kissidougou, 7 cases and 5 deaths; Dabola, 4 cases and 4 deaths, Djinguiraye, 1 case and 1 death; and Boffa, 4 cases and 0 deaths.
The total number of cases in isolation is 13 (9 in Gueckedou, 3 in Telimele, and 1 in Conakry). The number of contacts under follow-up is 493 (275 in Gueckedou, 125 in Macenta, and 93 in Telimele).
Ebola seems to be spreading into other districts from Kailahun district where the first case appeared a couple of weeks ago. The WHO update says as of the 29th of May 2014, 34 new cases (7 confirmed, 3 probable, and 24 suspected) and one suspected death were reported from five districts. This brings the cumulative total number of clinical cases of EVD to 50 (14 confirmed, 3 probable, and 36 suspected) including 6 deaths (2 confirmed, 3 probable and 1 suspected). The geographical distribution of these cases and deaths are as follows: Kailahun (37 cases and 6 deaths), Kenema (1 case and 0 death), Koinadugu (1 case and 0 death), Bo (1 case and 0 death), Moyamba and (1 case and 0 death).
The Ebola outbreak in Liberia seems less severe in Liberia compared to Guinea and Sierra Leone. According to WHO since the 29th of May 2014, one new suspected case who died in Foya district was reported in Liberia. The body was transported to and buried in Sierra Leone. The case is being investigated by both Liberia and Sierra Leone.
The number of cases remains subject to change due to reclassification, retrospective investigation, consolidation of cases and laboratory data, and enhanced surveillance.
Community resistance, inadequate treatment facilities and insufficient human resources in certain affected areas are among challenges currently faced by the three countries in responding to the EVD outbreak.
WHO and its partners have deployed experts to both Sierra Leone and Guinea to support and build capacity of national personnel to mount an effective EVD outbreak response including coordination, disease outbreak investigation, risk assessment, establishment of treatment facilities, case management, infection prevention and control in the newly affected districts, and social mobilization targeting the resistant communities.
In Sierra Leone, WHO and its partners have established a treatment centre in Koindu and are also coordinating the laboratory testing of samples from Kailahun district, Sierra Leone to be tested in Gueckedou, Guinea.
WHO says it does not "recommend that any travel or trade restrictions be applied to Guinea, Liberia, or Sierra Leone based on the current information available for this event."