Epidemiological update: Outbreak of Ebola Virus Disease in West Africa, 16 July 2014

​An outbreak of Ebola Virus Disease (EVD) with onset in December 2013 is still evolving in Guinea, Liberia and Sierra Leone. The first cases were reported from Guéckédou prefecture, a forested region of south-eastern Guinea near the border with Liberia and Sierra Leone. After a slow-down in April, new cases and deaths attributed to EVD have continued to be reported. The largest increase in cases since the previous ECDC update in 2 July was in Sierra Leone, followed by Liberia and Guinea.

From 8–12 July 2014, 85 new cases including 68 deaths were reported. As of 12 July, the cumulative number of cases and deaths was 964 and 603 respectively, making this the largest ever documented outbreak of EVD, unprecedented in the number of cases and geographical spread.

Current situation

The case count as of 12 July is displayed in the table below. The data are based on best available information reported by Ministries of Health through the World Health Organization Regional Office for Africa.   

Source: Adapted from WHO (Ebola virus disease, West Africa – update). The total number of cases is subject to change due to reclassification, retrospective investigation, consolidation of cases and laboratory data, and enhanced surveillance

While outbreaks of EVD are not new in Africa, this is the first documented outbreak in West Africa. Various patterns of transmission complicate the control of the current EVD outbreak: the affected area is vast and in parts difficult to access; there are multiple hotspots of transmission; differences in beliefs, cultural practices and traditions among the affected populations; and substantial movement of people between rural and urban areas and across national borders. Transmission occurs in rural areas, in peri-urban areas notably in capitals in Guinea (Conakry), Liberia (Monrovia), and Sierra Leone (Freetown), and in districts alongside country borders in Guinea, Sierra Leone and Liberia.

On 16 July 2014, WHO established a sub-regional outbreak coordination centre in Conakry, Guinea  to better meet the needs to control the outbreak, as a follow up action to the Emergency Ministerial meeting in Accra that was convened by WHO in Accra, Ghana, 2-3 July. The centre will act as a control and coordination platform, consolidating and harmonising the technical support to the West African countries including assisting in resource mobilisation.

WHO and international organisations are closely supporting the Ministry of Health of Guinea, Ministry of Health & Social Welfare of Liberia and Ministry of Health and Sanitation of Sierra Leone in their EVD prevention, contract tracing, health care and control related activities.

Conclusions

Despite the efforts to limit the spread, a substantial number of new cases have continued to be reported from all three affected countries since the previous ECDC Epidemiological Update of 2 July 2014 showing that the outbreak has not yet been brought under control. While the speed of transmission remains stable in Guinea, it seems to have accelerated in Liberia and Sierra Leone.

The risk of infection for travellers visiting Guinea, Liberia and Sierra Leone is considered very low. Most human infections result from direct contact with bodily fluids or secretions from an infected human, and the highest risks of infection are associated with caring for infected patients, particularly in hospital settings, unsafe medical procedures, including exposure to contaminated medical devices, such as needles and syringes and unprotected exposure to contaminated bodily fluids.

WHO does not recommend any travel or trade restrictions be applied to Guinea, Liberia, or Sierra Leone based on the current information available for this event.

ECDC continues to closely monitor the situation on the Ebola outbreak in the West Africa region. The conclusions of the assessment provided in the ECDC rapid risk assessment (RRA) on the 9 June 2014 remain valid. 

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