The first Roadmap update for October has been released by the World Health Organization. The data includes reporting up to the 28th of September 2014. The official case total for the West African outbreak has risen to 7178 with 3338 confirmed deaths and strong indications that the case rate is increasing in several districts. This report does not include data on the USA case which was confirmed on the 30th of September 2014.
Guinea and Liberia both show some signs of a slowing case rate in some districts but Sierra Leone continues to deteriorate according the to WHO. Several reports have emerged in the last weeks indicating under reporting of cases or the outright inability of the worst affected countries to maintain accurate data on the Ebola outbreak. The Roadmap report makes mention of anecdotal evidence to support the statements made by experts and media in this regard. Nigeria and Senegal continue to report stable numbers via their Health Ministries with 891 contacts under surveillance in Nigeria. The Democratic Republic of Congo has now reported 42 deaths from 70 cases in the unrelated outbreak.
The last few days have seen multiple suspected cases around the world and dozens of reports suggesting infections beyond the current official list of infected countries. The USA yesterday confirmed the first importation of the virus to America with a confirmed case in Dallas. The Namibian Government was also forced to distance itself from comments made by its own Health Minister who implied that Zimbabwe had already suffered an Ebola outbreak. Zimbabwe has reportedly quarantined more than 100 individuals in recent weeks in its efforts to prevent an outbreak in the Southern African country. To date there has been no confirmation that any cases of Ebola exist outside of the following countries: Guinea, Sierra Leone, Liberia, Senegal, Nigeria, DRC and the USA.
1 October WHO Ebola Update
Sierra Leone released an official update yesterday showing a climb in the total number of Ebola cases to 2317 for the period between the 23rd of May 2014 and the 28th of September 2014 resulting in 570 reported deaths. The case fatality rate (CFR) has been reported as 25% by the Health Ministry. Port Loko, Kenema and Bombali remain particularly hard hit reporting several new cases in recent days.
The CFR report is questionable due to the fact that Ebola typically has a very high mortality rate with several strains exhibiting mortality rates of 90%. The under-reporting appears to be as a result of the counting method applied in the country which allegedly does not include deaths occurring outside of Government facilities in the official tally. The 2014 Ebola outbreak is reported to have killed 70% of its victims so far inferring that the death toll in Sierra Leone should be closer to 1622. The report also indicates that a total of 13687 contacts have been identified over the course of the outbreak.
The Ministry of Health and Sanitation in Sierra Leone issued a further press release yesterday after receiving information that residents of Bombali, Port Loko and Koinadugu had begun celebrating the end of Ebola. The Ministry reminded residents that Ebola remained a high threat and that no cure has yet been confirmed. The citizens were told that the state of emergency prevented them from gathering in public and basic Ebola prevention guidelines were reiterated.
Earlier today the Foreign Minister of Sierra Leone met with the United Nations Secretary-General Ban Ki-moon to discuss the Ebola outbreak. Joint efforts between the UN and Sierra Leone were discussed in addition to the current impact on West African Nation.
Sierra Leone Report 124 29 September 2014
The World Health Organization has released an official update on the 2014 Ebola Virus outbreak confirming that the death toll has climbed past the 3000 mark even though Sierra Leone has failed to report data from the lockdown last weekend where at least 358 news cases and 265 bodies were discovered. Officially as of the 23 September 2014 Ebola has claimed 3083 lives in West Africa with 6553 cases being reported to date. Unofficially by adding in the estimated Sierra Leone counts the total case number is 6911 with as many as 3348 deaths. It is not possible to confirm at this stage that all 265 bodies are as a result of Ebola since many other deadly diseases are endemic to the West African Region.
The situation in Guinea continues to be reported as stable with the number of new cases reported remaining consistent, Nigeria and Senegal have not reported any new cases with Nigeria reporting 847 out of 872 contacts beyond the 21 day follow-up period. WHO has not reported further outbreaks in any new countries. Several new treatment centers have been added to the report and many of the larger centers are reported as having capacity for additional cases. Unfortunately Liberia remains unable to treat all Ebola patients and treatment centers have been forced to turn potential Ebola cases away.
26 September Case Map
Cote D’Ivoire (Ivory Coast) has announced that ports will once again be opened to affected countries allowing travel from its neighbors. Several organizations have, in recent weeks, criticized the decisions of many African countries to ban travel from the affected zones. The African Union has been particularly critical of border closures insisting that African countries allow travel but many critics still believe border closures provide an effective means of limiting the spread of the virus. Cote D’Ivoire has so far evaded infection despite being bordered by the worst hit countries and many fear that opening the borders will as a positive provide economic relief in the region but as a negative increase the risk of Ebola spreading to the nation.
WHO Roadmap Update 26 September 2014
The latest update has been released by the World Health Organization with indications that the situation in Sierra Leone and Liberia is worsening while Guinea appears stable. The total case count has increased to 6242 however the report alludes to data discrepancies from Liberia raising concerns that the total number of cases in the country could be far higher than reported by the official Health Ministry. The death toll has risen to 2909 according to the fifth Roadmap report including the death of 208 health workers in the region.
WHO reports that in areas where contact tracing is possible at least 90% of contacts are under surveillance but no indication is given as to the total number of contacts being monitored in the so called ‘hot zone’ of the 2014 Ebola outbreak. Global reports have emerged over the last week suggesting that Liberia and Sierra Leone are unable to monitor the situation sufficiently given the widespread outbreak with Sierra Leone announcing further quarantine measures today effectively isolating areas which house well over 1 million citizens. The data from the Sierra Leone lockdown which revealed more than 350 new cases has not yet been accounted for in the official figures but is expected to be ready for collation by the next reporting interval.
Senegal and Nigeria have remained stable however at least 4 Nigerian nationals have been placed in isolation across the world in the last 48 hours in order to conduct tests for the virus after they showed early symptoms. Currently Australia, India, Switzerland and Turkey have suspected Ebola cases under quarantine but to date all suspected cases outside of Africa have tested negative.
Alarming reports have emerged claiming that the bodies of Ebola victims are being disposed of in rivers and other water sources primarily in Monrovia. Although Ebola is not known to be waterborne it remains concerning and could result in the further spread of the virus. EVD victims continue to be infectious postmortem and contact risk is increased if bodies are not properly buried.
Office Who Roadmap Update 24 September 2014
The World Health Organization has released an update on the Ebola Virus outbreak which has claimed nearly 3000 lives. The total number of cases in the West African outbreak has increased to 5843 and the number of deaths has risen to 2803. The report most notably does not include recent data for Liberia which is possibly the worst hit country and data for Sierra Leone will exclude new cases discovered during the country’s lockdown since the official numbers are accurate up to the 19th of September 2014.
WHO announced yesterday that outbreaks in Nigeria and Senegal were “virtually” contained which is reflected in the official report. Senegal remains stable with a single reported case while Nigeria has decreased the case count slightly to 20. Nigeria has remained cautious opting to keep schools closed after a back and forth debate between government and education facilities with influencing factors including financial viability with income from students and pay wages being two of the main deciding factors.
The report indicates that at least 7 previously affected areas in Sierra Leone have not reported any new cases which confirms a definite turn around in the region. The integrity of the data from Sierra Leone has been questioned by critics who claim that the local Government may be under-reporting data. The total number of cases in Guinea has risen to 1008 with data reported up until the 20th of September 2014.
With some positive trends appearing in the data it is safe to assume that at least some of the intervention from the local and international community is starting to make a difference in the fight against the deadly outbreak and although a lot of questions have been raised around the integrity of the data received in this report, it is very encouraging to see Senegal and Nigeria successfully containing the spread of the virus.
WHO Roadmap Update 22 Sept 2014