Widespread under-reporting and a lack of reliable data continues to place strain on efforts to provide detailed information regarding the 2014 Ebola outbreak. It has claimed at least 4493 lives according to the latest official report from the World Health Organization. Senegal and Nigeria are nearing the 42 day mark after which the outbreaks in those regions will be declared over if no new infections are reported. It is noteworthy that information released earlier this week indicated that the 21 day incubation upper limit was relevant to 95% of cases with 5% of cases occurring beyond the 21 day limit.
Guinea, Sierra Leone and Liberia continue to deteriorate with very little slowdown in sight. Case counts in most districts continue to increase despite the claims of under-reporting. Liberia which has been accused of attempting to hide Ebola cases after a recent ban on foreign media has reported 4249 cases in total. The total case count for the West African cluster has increased to 8973. The death tolls continue to exceed the number of confirmed cases particularly in Sierra Leone which, according to the report, is showing rampant spread of the virus.
The case count in Spain has remained constant with a single case reported while the official count for the USA has grown to 2. The US count excludes the third case which was announced earlier today. The United Nations has urged high risk countries to bolster their readiness in expectation of further global spread. The UN also warned that if the outbreak cannot be contained by the end of November the situation could be “unprecedented”.
The unrelated outbreak in the Democratic Republic of Congo remains stable with all contacts clear of symptoms after their 21 day follow-up suggesting that the outbreak in the Congo has been successfully contained.
WHO Situation Report – 15 October 2014
The World Health Organization has published it’s Roadmap Update which now includes data from Spain. The official case count now totals 8470 including the initial outbreaks in Nigeria, Senegal, Spain, the United States of America as well as the unrelated outbreak in the Democratic Republic of Congo. 4076 deaths have been reported across all regions. WHO noted serious concerns about the quality of data provided in recent reports from the so called “hot zone” countries earlier this week. Based on current data the growth of the outbreak is no longer exponential if the data is accurate.
The World Health Organization has been particularly active this week raising several concerns about the global impact of Ebola. East Asia is considered to be at risk according to WHO. The large trade and transport hubs in the region are of particular concern. The first transmission of Ebola in Spain raised additional alarm bells and resulted in announcements that further cases in Europe would be inevitable.
Liberia remains of particular concern. A report from the Health Ministry today showed no new cases raising concerns around the ability of the country to collect data on the outbreak. Journalists and Media have been banned from being near Ebola treatment centers or making contact with Ebola patients without explicit permission from the Health Ministry. Speculation about the situation in Liberia has been fierce and generally concerning.
Guinea has seen a significant increase in the number of patients particularly in Conakry where Donka Ebola management center has been severely stretched by a large intake of patients. The center is now well over its 60 bed capacity after admitting at least 22 patients on the 6th of October.
WHO Road-map 10/10/2014
The latest Situation Report has been released by the World Health Organization with data reported up until the 4th of October 2014 for Liberia and 5th of October for Sierra Leone and Guinea. Liberia reports 77 more deaths than confirmed cases while Sierra Leone reports 86 more deaths than confirmed cases. Reporting continues to suffer as the situation worsens in the 3 hardest hit countries. The official case total for the West African outbreak has increased to 8011 with 3857 deaths reported.
The report has a general worrying sentiment with all three regions described as deteriorating. Liberia is noted for extreme difficulties in acquiring data and the concern of widespread under reporting of cases is echoed in the report. Media reports from Liberia have been spotty after the Government allegedly began interfering with the media. Reports from individuals on the ground indicate a growing concern at the status of general infrastructure and facilities in Liberia.
The report includes data on beds available per country and the current capacity. Liberia reports 21% coverage suggesting that at least 2300 Ebola patients are without proper treatment facilities in the country. Media reports indicate that Sierra Leone is facing a strike among burial teams resulting in slow removal of bodies which will certainly impact the situation further. The situation in Senegal, Nigeria and the Democratic Republic of Congo remains stable.
USA still lists one case but the data has not yet been updated to indicate the passing of America’s first Ebola patient. Data from Spain is not included in the report and will likely be contained in a report later this week. Minimal data is reported regarding the number of contacts for the US however it is reported by the Media as between 80 and 100 with at least 10 considered high risk. Spain has admitted 5 cases for testing and at least 30 contacts are being monitored.
WHO Ebola Update 8 October 2014
Sierra Leone has released its latest official situation report compiled by the Ministry of Health. The report is released independently of the World Health Organization’s Roadmap updates. The report includes data recorded until the 4th of October 2014. The 358 new cases and 265 deaths reported during the lockdown still seem to be omitted from official data and reports.
The official CFR nationally is reported at 28.1% based on confirmed cases which excludes deaths that occur outside of medical facilities. 678 of the 831 deaths listed are confirmed as resulting from Ebola out of a total of 2727 cases which have been reported since the 23rd of May 2014. A sharp increase for the 4th of October is attributed to a large set of test results which arrived from a Chinese laboratory.
The New York Times reported earlier that critical medical supplies have been stuck in Freetown’s port awaiting customs clearance from the local Government. It seems that a matter of covering the shipping costs is at the heart of the delay. It is worrying given the urgency of need for supplies to help combat the outbreak that such delays would exist.
Contact tracing in Sierra Leone continues according to the report with 7734 contacts having made it past the 21 day incubation period without exhibiting symptoms and 8239 contacts currently being monitored by the Health Ministry. 37 contacts seen in the last 24 hours are reportedly ill but not yet confirmed as suspected cases of Ebola. Only 27 contacts were not interviewed in the 24 hours leading up to the report.
Sierra Leone Situation Report – 5 October 2014
The World Health Organization has released its Roadmap update which now includes the United States of America. The total number of Ebola cases has risen to 7470 with 3431 death reported. 70 cases and 43 deaths are reported in the Democratic Republic of Congo which is counted separately as an unrelated outbreak of EVD. The data contained in the report is taken from official Health Ministries in affected countries as of the 30th of September 2014.
Nigeria and Senegal have both completed their 21 day follow up time frames for known contacts giving further credit to their claims that Ebola has been contained in their countries. The USA is listed with 1 case as confirmed by the CDC on the 30th of September. Total contact numbers for the United States are not available from the report as investigations are ongoing.
Healthcare workers are still at significant risk with the total number of deaths at 218. The high incidence of transmission from patient to HCWs is concerning given the already challenging ratio of patients to caregivers in the so called hot-zone which includes Guinea, Sierra Leone and Liberia. Data from the three hardest hit countries continues to deteriorate with glaring inconsistencies. Overwhelmed infrastructure is cited as a contributor to data discrepancies in some instances. The most notable anomaly is Liberia’s report indicating 3 more deaths than confirmed cases which is attributed to insufficient capacity for testing in laboratories.
Additionally the situation in Liberia appears to be worsening rapidly despite foreign assistance. More than 100 beds have been made available in the last week and all have been filled. The strange data reporting indicates severe strain on official Health Services in the country and recent restrictions placed on the press by the Liberian Government also raise concern.
3 October WHO Roadmap Update