Ebola virus epidemic in Sierra Leone

Further information: Ebola virus epidemic in West Africa

Sierra Leone in green

As of 2014, an epidemic of the Ebola virus disease (EVD) is ongoing in the West African country of Sierra Leone.

Ebola virus is not endemic to Sierra Leone or to the West Africa region and this epidemic represents the first time the virus has been discovered there.

Epidemiology

Sierra Leone and its immediate neighbours: a coloured map showing the reported spread of Ebola in Guinea, Liberia, and Sierra Leone as of 26 September 2014.

Spring 2014: Early cases

As of the 31 March there were suspected but not confirmed cases in Sierra Leone

The epidemic is thought to have started when 14 people returned from a funeral of a traditional healer, who had been trying to cure others with Ebola in Guinea. The first person reported infected was a tribal healer. She had treated an infected person(s) and died on 26 May. According to tribal tradition, her body was washed for burial and this appears to have led to infections in women from neighboring towns. On 27 May 2014 it was reported 5 people died from Ebola virus.

The species of the Ebola virus appears to be the Zaire ebolavirus.

Summer 2014: Continued growth, Khan dies

In Early June Sierra Leone shut its borders with Guinea and Libera, and also closed its schools, cinemas, and nightlife places.

On 29 July, well-known physician Sheik Umar Khan, Sierra Leone's only expert on hemorrhagic fever, died after contacting Ebola at his clinic in Kenema. Khan had long worked with Lassa fever, a disease that kills over 5,000 a year in Africa. He had expanded his clinic to accept Ebola patients. Sierra Leone's President, Ernest Bai Koroma, celebrated Khan as a "national hero".

On July 30, it declared a state of emergency and deployed troops to quarantine hot spots.

In August, awareness campaigns in Freetown, Sierra Leone's capital, were delivered over the radio and through loudspeakers. Also in August, Sierra Leone passed a law that subjected anyone hiding someone believed to be infected to two years in jail. At the time the law was enacted, a top parliamentarian was critical of failures by neighboring countries to stop the outbreak.

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  Kailahun District
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  Kenema District

September 2014: Exponential growth, quarantines

Port Loko District, Bombali District, and Moyamba District were added to the quarantine on September 25, 2014

In an attempt to control the disease, Sierra Leone imposed a three-day lockdown on its population from 19 to 21 September. During this period 28,500 trained community workers and volunteers went door-to-door providing information on how to prevent infection, as well as setting up community Ebola surveillance teams. The campaign was called the Ouse to Ouse Tak in Krio language. There was concern the 72 hour lock-down could backfire.

WHO estimated on 21 September that Sierra Leone's capacity to treat EVD cases falls short by the equivalent of 532 beds. Experts pushed for a greater response at this time noting that it may destroy Sierra Leone and Liberia. At this time it was estimated that if it spreads through both Liberia and Sierra Leone up to 5 million could be killed. (the population of Liberia about 4.3 million and S. Leone about 6.1 million)

On Monday 22 September, Stephen Gaojia said that the three day lock down has obtained its objective and will not be extended. Eighty percent of targeted households were reached in the operation. A total of around 150 new cases have been uncovered, but the exact figures will only be known on Thursday as the health ministry is still awaiting reports from remote locations.

On Wednesday 24 September, President Ernest Bai Koroma added three more districts under "isolation," in an effort to contain the spread. The districts include Port Loko, Bombali, and Moyamba. In the capital, Freetown, all homes with identified cases will be quarantined. This brings the total areas under isolation to 5, including the outbreak "hot spots" Kenema and Kailahun which are already in isolation. Only deliveries and essential services will be allowed in and out. A sharp rise in cases in these areas were also noted by WHO.

As of late September about 2 million people are in areas of restricted travel, which include Kailahun, Kenema, Bombali, Tonkolili, and Port Loko Districts.

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  Bombali District
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  Moyamba District
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  Port Loko District

The number of cases seemed to be doubling every 20 days, which lead to the estimate that by January 2015 the number of cases in Liberia and Sierra Leone could grow to 1.4 million. After January 2015 if that level of growth continued the number of cases could grow to 100 million by June 2015, 1 billion (1000 million) by August 2015, and to the rest of population before 2016. For comparison there is about 1 billion people in all of Africa.

On 25 September there was 1940 cases and 587 deaths officially, however, many acknowledged under reporting and there was an increasing number of cases in Freetown (the capital of Sierra Leone).

Healthcare capacity

On 26 August, the WHO shut down one of two laboratories after a health worker became infected. The laboratory was situated in the Kailahun district, one of the worst-affected areas. It was thought by some that this move would disrupt efforts to increase the global response to the outbreak of the disease in the district. "It's a temporary measure to take care of the welfare of our remaining workers," WHO spokesperson Christy Feig announced. He did not specify how long the closure would last, but said they would return after an assessment of the situation by the WHO. The medical worker, one of the first WHO staff infected by the Ebola Virus, was treated at a hospital in Kenema and then evacuated to Germany.

As the Ebola epidemic grew it damaged the health care infrastructure, leading to increased deaths from other health issues including malaria, dysentery, and pnumenia because they were not be treated. Sierra Leone lost three of its top doctors by the end of August, because they died from Ebola. A fourth doctor became ill with Ebola in September and died that month.

By 23 September 2014 about 61 health workers had died out of 91 known to have been infected with ebola in Sierra Leone.

WHO estimated on 21 September that Sierra Leone's capacity to treat EVD cases falls short by the equivalent of 532 beds.

Evacuations

On 24 August. William Pooley, a British nurse, was evacuated from Sierra Leone. He was released on September the 3rd, 2014.

On 21 September 2014 Spain evacuated a Catholic priest who had contracted Ebola while working in Sierra Leone with Hospital Order of San Juan de Dios. By 25 September 2014 the priest passed away in Madrid, Spain.

A doctor from Senegal contracted Ebola while working in Sierra Leone, and was evacuated to Germany at the end of August 2014. In late September, a doctor working for an International Aid organization in Sierra Leone, was evacuated to Switzerland after potentially being exposed. He later tested negative for the disease.

In late September 2014, an American doctor working in Sierra Leone was evacuated to Maryland, USA after being exposed to Ebola. Althouth they were exposed they may not develop the virus.

See also

• Ebola virus epidemic in West Africa
• Ebola virus epidemic in Guinea
• Ebola virus epidemic in Liberia
• Ebola virus disease
• Health in Sierra Leone