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Western African Ebola epidemic

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Western African Ebola epidemic
Situation map of the outbreak as of 18 June 2014
DateFebruary 2014 – Ongoing
LocationWest Africa
(Guinea, Liberia, Sierra Leone)
Casualties
 Guinea – 390 cases, 271 deaths
 Liberia – 51 cases, 34 deaths
 Sierra Leone — 158 suspected cases, 58 suspected deaths[1]
Total mortality:
467 deaths / 759 cases (62%)

An ongoing epidemic of the Ebola virus disease has spread throughout Guinea and beyond the nation's borders in West Africa. At least 759 infections and 467 deaths have been reported.[2][3] Various organizations, including the U.S. Centers for Disease Control, European Commission, and Economic Community of West African States, have donated funds and mobilized personnel to help counter the outbreak, and Médecins Sans Frontières is also working in the area.[4] This Ebola outbreak is the most severe both in the number of cases and dead.[5]

Initial outbreak in Guinea

In February 2014, the first Ebola virus outbreak registered in the region occurred in Guinea. By 23 April, the total number of suspected and confirmed cases in the Ebola Haemorrhagic Fever (EHF) outbreak had increased to 242, including 142 deaths at a case fatality rate of 58.7%.[6] Originally, the suspected cases were reported in Conakry (four cases), Guéckédougou (four), Macenta (one) and Dabola (one) prefectures. On 25 March the Ministry of Health of Guinea reported that four southeastern districts: Guekedou, Macenta, Nzerekore, and Kissidougou, were affected with an outbreak of Ebola hemorrhagic fever.[7] The following day the Pasteur Institute in Lyon, France confirmed the Ebola strain as Zaire ebolavirus.[7] However, full genetic sequencing subsequently revealed that it was a new strain of Ebolavirus.[8] One suspected case was admitted to hospital on 28 March 2014.[9] On 31 March, the US Centers for Disease Control sent a five-person team "to assist Guinea Ministry of Health (MOH) and World Health Organization (WHO) led international response to the Ebola outbreak".[7]

Conakry, Guinea

The outbreak spread to Guinea's capital Conakry,[7] a city of about two million inhabitants, and is a major concern according to Ibrahima Touré, Country Director of Plan Guinea NGO: "The poor living conditions and lack of water and sanitation in most districts of Conakry pose a serious risk that the epidemic escalates into a crisis. People do not think to wash their hands when they do not have enough water to drink."[10]

Subsequent spread

Initially Sierra Leone, Mali and Ghana identified suspected cases, but all the clinical samples on those suspected cases have tested negative for ebolavirus.[11] The overall situation with the Ebola virus infection in Guinea improved in May 2014. For several days no new alerts, cases or nosocomial transmission were reported from Liberia and from 5 out of the 6 affected prefectures in Guinea. Gueckedou was the only hotspot where community transmission and deaths were still being reported.

However, from 23 May 2014 to 27 May 2014, three previously affected districts (Guéckédou, Macenta and Conackry), four new districts (Boffa, Télimélé, Boke and Dubréka) and one new country (Sierra Leone) reported several new EVH clinical cases.[12]

Monrovia, Liberia

On 17 June 2014, it was announced that seven people in Monrovia had died of Ebola.[13]

Response

The national authorities of Guinea, Sierra Leone, and Liberia have activated their national emergency committees, prepared EHF response plans and carried out needs assessments.[9] The Economic Community of West African States (ECOWAS) issued a statement that called for the support of the international community in the fight against the epidemic: "The Board of Mediation and Security of ECOWAS appeals to the international community to provide support in the management of the Ebola epidemic in the region."[14] On 30 March 2014, during the 44th Summit of the heads of state and government of West Africa, ECOWAS disbursed USD $250,000 to deal with the outbreak.[15] Sierra Leone has instituted a temporary measure which includes reactivation of its Active Surveillance Protocol that will see all travellers into the country from either Guinea or Liberia subjected to strict screening to ascertain their state of health.[16]

Senegal’s Ministry of Interior has ordered all movements of people through the southern border with Guinea to be suspended indefinitely to prevent the spread of the disease, according to a statement published on 29 March 2014 by state agency APS.[17] Since 26 March 2014, Mauritania closed all crossings along the Senegal River, the natural border between Mauritania and Senegal, except for the Rosso and Diama points of entry. From 1 April 2014, Saudi Arabia stopped issuing visas for the Muslim pilgrimage to Mecca to those from Guinea and Liberia. Moreover, Morocco reinforced medical surveillance at the Casablanca airport, a regional hub for flights from and to West Africa.[18][19][20] Conversely, the border between Guinea and Liberia remained open; Guinea's ambassador in Monrovia noted his government's belief that efforts to fight the disease directly would be more effective than closing the border.[21]

The European Commission (EC) gave €500,000 to help contain the spread of the virus in Guinea and its neighbouring countries. The EC has also sent a health expert to Guinea to help assess the situation and liaise with the local authorities. EU Commissioner for International Cooperation, Humanitarian Aid and Crisis Response Kristalina Georgieva said: "We are deeply concerned about the spread of this virulent disease and our support will help ensure immediate health assistance to those affected by it. It's vital that we act swiftly to prevent the outbreak from spreading, particularly to neighbouring countries."[22]

A mobile laboratory, capable of performing the molecular diagnosis of viral pathogens of risk groups 3 and 4, was deployed in Guinea by the European Mobile Laboratory consortium as part of the WHO/GOARN outbreak response. Prior samples were analyzed at the Jean Mérieux BSL-4 Laboratory in Lyon.[23]

The humanitarian aid organisation Doctors Without Borders has a team of 300 staff working in Guinea, Sierra Leone and Liberia, has set up specialist centers to give medical care to affected people, and has sent over 40 tonnes of equipment and supplies.[24]

In July, the WHO convened an emergency sub-regional meeting with health ministers from 11 countries in Accra, Ghana. A press conference will be held on 3 July 2014.[25]

Complications

As of June 2014, the outbreak was described as "totally out of control" by Doctors without Borders.[26] Difficulties faced in attempting to contain the outbreak include the outbreak's multiple locations across country borders,[26] inadequate precautions taken by medical personnel,[27] funeral practices [28] and community resistance, including "freeing" suspected Ebola patients from isolation, [29] and suspicion that the disease is caused by witchcraft, or that doctors are killing patients.[30] There has also been an attack on aid workers who were in a hurry to retrieve "freed" patients and did not explain to villagers who they are.[31]

Virology

Main article: Ebola virus § Virology

Researchers performed full-length genome sequencing and phylogenetic analysis of samples from 20 patients. Results suggest that the Zaire ebolavirus (EBOV) in Guinea is a different clade than the strains from outbreaks in the Democratic Republic of Congo and Gabon.[32]

Economic effects

In addition to the loss of life, the outbreak is having an economic effect. Conakry's Palm Camayenne Hotel, which is popular among businessmen and politicians, has less than a third of occupancy rate.[33] On Brussels Airlines flights between the Brussels and Conakry, there are reduced numbers of people arriving in Conakry but more people leaving Conakry.[33] Regional airline Gambia Bird delayed the start of a route to Conakry due to Senegal closing "its border with Guinea because of the outbreak".[33]

Non-essential employees of British firm London Mining in Sierra Leone were transported out of the country in June following an outbreak of the virus. At least 50 suspected cases of Ebola with 5 deaths had been reported.[34]

Temporal evolution

Timeline of the oubreak, using data reported by Centers for Disease Control and Prevention.[7]

Temporal evolution of the West African Ebola outbreak (25-March-2014 to 2-July-2014)
Temporal evolution of the cases per day of the 2014 Ebola outbreak.
Date Total cases Total deaths Guinea cases/deaths Liberia cases/deaths Sierra Leone cases/deaths
2 July 2014 759 467 413/303 107/65 239/99
24 June 2014 599 362 390/270 51/34 158/58
17 June 2014 528 337 398/264 33/24 97/49
10 June 2014 474 252 372/236 13/9 89/7
5 June 2014 438 231 344/215 13/9 81/7
2 June 2014 354 208 291/193 13/9 50/6
27 May 2014 309 200 281/186 12/9 16/5
23 May 2014 270 181 258/174 12/9
14 May 2014 245 164 233/157 12/9
5 May 2014 243 162 231/155 12/9
30 April 2014 233 153 221/146 12/9
23 April 2014 220 143 208/136 12/9
21 April 2014 215 136 203/129 12/9
17 April 2014 209 129 197/122 12/9
10 April 2014 169 108 157/101 12/9
7 April 2014 163 102 151/95 12/7
2 April 2014 135 88 127/83 8/5
1 April 2014 130 82 122/80 8/2
31 March 2014 114 70 112/70 2/0
27 March 2014 103 66 103/66 0/0
26 March 2014 86 60 86/60 0/0
25 March 2014 86 59 86/59 0/0

See also

Wikimedia Commons has media related to 2014 West Africa Ebola outbreak.

References

  1. ^ "Outbreak of Ebola in Guinea, Liberia, and Sierra Leone". Center s for disease cpntrol and prevention. 18 June 2014.
  2. ^ "Epidemiological update: Outbreak of Ebola Virus Disease in West Africa". WHO AFRICA. 7 June 2014.
  3. ^ "WHO: Ebola death toll in West Africa reaches 467". NHK.
  4. ^ "Ebola in West Africa: "The epidemic is out of control"". msf.org.uk. 25 June 2014. Retrieved 2 July 2014.
  5. ^ "Chronology of Ebola Hemorrhagic Fever Outbreaks". Centers for Disease Control and Prevention. 24 June 2014. Retrieved 25 June 2014.
  6. ^ "Ebola outbreak in Guinea 'unprecedented' – MSF". BBC News. 31 March 2014. Retrieved 31 March 2014.
  7. ^ a b c d e "Outbreak of Ebola in Guinea and Liberia". Centers for Disease Control and Prevention.
  8. ^ "Emergence of Zaire Ebola Virus Disease in Guinea — Preliminary Report". New England Journal of Medicine. 16 April 2014. Retrieved 3 May 2014.
  9. ^ a b "Ebola Haemorrhagic Fever, Guinea (Situation as of 30 March 2014)". Afro.who.int. Retrieved 31 March 2014.
  10. ^ Diallo, Boubacar (29 March 2014). "Ebola in Guinea: the NGO Plan Guinea-feared a worsening of the epidemic ..." Africaguinee.com. Retrieved 31 March 2014.
  11. ^ "Ebola Haemorrhagic Fever, West Africa (Situation as of 16 April 2014)". Afro.who.int. Retrieved 16 April 2014.
  12. ^ WHO Update 27 April 2014%5d "Ebola Haemorrhagic Fever, West Africa (Situation as of 27 April 2014)". Afro.who.int. Retrieved 27 April 2014. {{cite web}}: Check |url= value (help)
  13. ^ "Seven die in Monrovia Ebola outbreak". BBC News. 17 June 2014. Retrieved 18 June 2014.
  14. ^ "The West Africa requires the support of the international community in the fight against Ebola". abidjan.net. 28 March 2014. Retrieved 31 March 2014.
  15. ^ "La CEDEAO décaisse 250 000 dollars pour faire face à la fièvre Ebola" (in French). abidjan.net. 30 March 2014. Retrieved 31 March 2014.
  16. ^ Cham, Kemo (1 April 2014). "Sierra Leone restricts movement across borders over Ebola fears". Africa Review. Retrieved 1 April 2014.
  17. ^ "Ebola Death Toll in Guinea Rises to 70 as Senegal Closes Border". Bloomberg News. 29 March 2014. Retrieved 31 March 2014.
  18. ^ "Fièvre Ebola : contrôle sanitaire renforcé au Maroc" (in French). Nouvelobs. 1 April 2014. Retrieved 1 April 2014.
  19. ^ "Visas refusés aux pèlerins de Guinée et du Libéria" (in French). 20min.ch. 1 April 2014. Retrieved 1 April 2014.
  20. ^ Ndiaye Moctar, Pape (29 March 2014). "The uncrossable river Senegal since last Tuesday". Sud Quotidien. Retrieved 31 March 2014.
  21. ^ Kwanue, C.Y. "Guinean Gov’t Provides Ebola Updates", Liberian Observer, 2014-04-07. Accessed 2014-04-07.
  22. ^ "Ebola in West Africa: European Union joins effort to stop spread of disease and releases €500,000 in immediate funding". Europa.eu. 19 November 2013. Retrieved 31 March 2014.
  23. ^ "Inserm and the Institut Pasteur identify a new variant of Ebola virus in Guinea". INSERM.fr. 18 April 2014. Retrieved 24 April 2014.
  24. ^ "Ebola in West Africa: "The epidemic is out of control"". msf.org.uk. 25 June 2014. Retrieved 2 July 2014.
  25. ^ "WHO calls emergency sub-regional Ministerial meeting in Accra, Ghana to tackle the on-going Ebola virus in West Africa". 2 July 2014. Retrieved 2 July 2014.
  26. ^ a b "Doctors Without Borders: West Africa's Ebola Outbreak is Totally Out of Control". CTVNews. 20 June 2014. Retrieved 21 June 2014.
  27. ^ "Liberia: Unheralded Fear - Ebola Pose Risks for Liberia Health Workers". FrontPage Africa via AllAfrica.com. 19 June 2014. Retrieved 21 June 2014. {{cite web}}: Italic or bold markup not allowed in: |publisher= (help)
  28. ^ "Growing Ebola Outbreak Threatens to Overwhelm Volunteers". Today Health. 8 June 2014. Retrieved 21 June 2014.
  29. ^ "8 ebola suspects freed by relatives in Sierra Leone". Global Post. 28 May 2014. Retrieved 21 June 2014.
  30. ^ "Ebola, snakes and witchcraft: Stopping the deadly disease in its tracks in West Africa". International Federation of Red Cross and Red Crescent Societies. 24 June 2014. Retrieved 28 June 2014.
  31. ^ "Villagers stone ebola trackers in Sierra Leone as cases rise". Chicago Tribune. 28 May 2014. Archived from the original on 2 July 2014. Retrieved 2 July 2014.
  32. ^ Baize, Sylvain; Pannetier, Delphine; Oestereich, Lisa; Rieger, Toni (16 April 2014). "Emergence of Zaire Ebola Virus Disease in Guinea — Preliminary Report". New England Journal of Medicine. doi:10.1056/NEJMoa1404505.
  33. ^ a b c Adama Diarra and Misha Hussain (4 April 2014). "Mali suspects first Ebola cases as regional death toll tops 90". Reuters. Retrieved 4 April 2014.
  34. ^ "UK employees leave Sierra Leone over Ebola threat". BBC News. 3 June 2014. Retrieved 4 June 2014.
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