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ReliefWeb - Updates on Sierra Leone

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    Source: Médecins Sans Frontières
    Country: Guinea, Liberia, Sierra Leone

    14 January, 2016. As Liberia today celebrates 42 days without any new Ebola infections - effectively marking the end of the Ebola outbreak in West Africa, the international medical humanitarian organisation Médecins Sans Frontières/Doctors Without Borders (MSF) calls on the global health community to draw on lessons learnt in order to be better prepared for future similar outbreaks. MSF is also continuing its Ebola activities in Liberia, Sierra Leone and Guinea through running support clinics for Ebola survivors. “Today is a day of celebration and relief that this outbreak is finally over,” says Joanne Liu, MSF’s International President. “We must all learn from this experience to improve how we respond to future epidemics and to neglected diseases. This Ebola response was not limited by lack of international means but by a lack of political will to rapidly deploy assistance to help communities. The needs of patients and affected communities must remain at the heart of any response and outweigh political interests."

    ”We should congratulate all the people who tirelessly contributed to putting an end to this devastating and unprecedented epidemic, while we should also remember the many health professionals who tragically lost their lives on the Ebola frontline,” added Brice de le Vingne, MSF’s Director of Operations. “This devastating epidemic hit nearly 40 years after the first discovery of Ebola in 1976, yet the lack of research and development on Ebola meant that even today after the medical trials and at the end of the epidemic, there is no effective treatment. Also, there is a need to get licensure for a new vaccine that has been developed.” From the very beginning of the epidemic, MSF responded in the worst affected countries – Guinea, Liberia and Sierra Leone - through setting up Ebola treatment centres as well as providing services such as psychological support, health promotion activities, surveillance and contact tracing. At its peak, MSF employed nearly 4,000 national staff and over 325 international staff to combat the epidemic across the three countries. MSF admitted a total of 10,376 patients to its Ebola treatment centres, of which 5,226 turned out to be confirmed Ebola cases. In total, the organisation has spent over 96 million euros on tackling the epidemic. With such an unpredictable disease, it is crucial that vigilance and the capacity to respond to new cases will be maintained in the region as well as a well-functioning surveillance and rapid response system. Ebola survivors are particularly vulnerable, and they face continuing health challenges such as joint pain, chronic fatigue, and hearing- and vision problems. They also suffer from stigmatisation in their communities and need specific and tailored care. MSF has invested in setting up Ebola survivor clinics in Liberia, Sierra Leone and Guinea, providing a comprehensive care package, including medical, psychosocial care and protection against stigma.

    “Throughout the epidemic, I witnessed how communities were ripped apart,” says Hilde de Clerck, MSF epidemiologist, who worked in Liberia, Guinea and Sierra Leone. “Initially, the response from the global health community was really paralysed by fear. It was a horrible experience being left on our own and constantly running behind the wave of the epidemic. But it was very empowering to see how extremely dedicated all the national staff were, and fortunately other international actors eventually got involved. For the next epidemic, the world should stand ready to intervene much faster and more efficiently.”

    ENDS

    NOTES TO EDITOR MSF responded to the Ebola epidemic in the three worst affected countries – Guinea, Sierra Leone and Liberia – and also responded to the cases in Nigeria, Senegal and Mali, as well as a separate epidemic in Democratic Republic of Congo in 2014. MSF now continues to provide health care to Ebola survivors and to local populations through the development of new activities. Two Ebola clinics in Sierra Leone and one in Liberia already offer medical and psychological services to the survivors, and a clinic has also been opened in Guinea. Already weak public health systems have been seriously damaged by the epidemic so MSF has also decided to invest efforts in their recovery. New projects on maternal and child health should open soon in different towns of Sierra Leone (Kabala, Magburaka, Kenema), and a new paediatric hospital has already opened in Monrovia (Liberia). MSF continues to run an HIV project in Conakry, Guinea, in collaboration with the health authorities.


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    Source: European Commission Humanitarian Aid Office
    Country: Guinea, Liberia, Sierra Leone

    14/01/2016

    The World Health Organization (WHO) has declared that the Ebola transmissions in West Africa have come to an end for the moment, as Liberia marks today 42 days without new Ebola cases – an important landmark that neighbouring Guinea and Sierra Leone crossed last November and December.

    The largest Ebola epidemic on record has taken a tragic toll on life, with 11 300 deaths out of 28 600 cases since its declaration in March 2014, according to WHO.

    On the occasion, EU Ebola Coordinator and Commissioner for Humanitarian Aid and Crisis Management Christos Stylianides made the following statement:

    "_This day one year ago, the end of the Ebola epidemic may have seemed unimaginable. But thanks to the effort of health workers, ordinary people, and governments in the three affected countries, combined with an unprecedented international response, the fight against the disease has been won. I want to pay tribute to all those involved for months to bring the cases to Zero, an achievement to celebrate._

    From the outset the European Union has been at the forefront of the international response to the Ebola epidemic. We have sent medical supplies, laboratories and epidemiologists. We put in place an EU medical evacuation facility for all international health workers in the region. We provided funding for the great work done by non-governmental organisations and the United Nations to treat the victims of Ebola and deal with its consequences.

    Overall, together with its Member States, the EU has mobilised close to €2 billion in humanitarian aid, technical expertise, longer-term development assistance, and research into vaccines and treatments. We are now shifting our response from emergency to development, keeping a particular focus on the needs of survivors.

    Despite today's declaration that the Ebola outbreak in West Africa is over, there must be no place for complacency. The risk of re-infection is much greater than we thought, as Liberia’s various relapses since May 2015 have shown.

    There are also lessons to be learnt. The international system needs to fix the failures which became all too apparent in the inadequacy of the response to the disease in the early months of 2014. In this regard, the European Union is setting up a European Medical Corps through which medical teams and equipment from our Member States can be deployed swiftly to deal with future health emergencies. There will be more crises like this one. We need to be better prepared.

    It is also more important than ever to help the three countries rebuild and strengthen their health systems and to invest in effective and resilient alert and response mechanisms. These are essential requirements to prevent any future outbreak from spreading. The EU’s commitment to support the affected countries remains firm. We will stand by Liberia, Sierra Leone and Guinea for as long as it takes".

    Background

    The EU, together with its Member States, has made available close to €2 billion in financial aid to help contain and recover from the outbreak of Ebola virus disease in West Africa.

    The European Commission has coordinated EU support and provided countries affected by the Ebola outbreak with humanitarian aid, technical expertise, longer-term development assistance, investment in research for a vaccine and evacuation means for international humanitarian workers. In addition, activation of the EU Civil Protection Mechanism has enabled the rapid, coordinated deployment of emergency supplies and experts offered by the Member States.

    The EU Commission is now increasingly focusing on long-term recovery: financing programs for health care, agriculture, infrastructure, education, sanitation, macro-economic stability and transport.


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    Source: UN News Service
    Country: Guinea, Liberia, Sierra Leone

    13 janvier 2016 – A l'occasion d'une réunion de l'Assemblée générale des Nations Unies sur l'épidémie d'Ebola en Afrique de l'Ouest, le Secrétaire général de l'ONU, Ban Ki-moon, s'est félicité des efforts collectifs qui ont permis de mettre fin à la transmission du virus Ebola dans la région.

    « Pour la première fois depuis que l'épidémie a débuté, la région est sur le point d'être déclarée exempte de la transmission d'Ebola », a souligné M. Ban dans un discours devant les Etats membres.

    En effet, la Sierra Leone a déclaré la fin de la transmission le 7 novembre 2015, la Guinée l'a fait le 29 décembre 2015 et le Libéria devrait annoncer jeudi la fin de l'épidémie.

    « Cela veut dire que demain, 14 janvier, toutes les chaînes connues de transmission auront été stoppées en Afrique de l'Ouest », a déclaré M. Ban.

    Le Président de l'Assemblée générale, Mogens Lykketoft, a rappelé de son côté que l'épidémie avait commencé en décembre 2013 quand un petit garçon nommé Emile, de la ville de Guéckédou, en Guinée, est tombé malade et est mort deux jours plus tard.

    Deux ans après, l'épidémie d'Ebola a affecté plus de 28.600 personnes, principalement en Guinée, au Libéria et en Sierra Leone et a causé la mort d'au moins 11.300 personnes.

    Ban Ki-moon a cependant rappelé que l'Afrique de l'Ouest était aujourd'hui confrontée à des défis significatifs, malgré la fin de l'épidémie.

    « Nous pouvons anticiper la réapparition d'Ebola au cours de l'année à venir. L'expérience du Libéria, qui a combattu deux retours du virus, a montré la résilience et la capacité des pays affectés à réactiver les mécanismes de réponse d'urgence et à contenir le virus », a-t-il ajouté. « Mais nous espérons aussi que la possibilité et la fréquence de ces réapparitions du virus diminueront au fil du temps ».

    M. Ban a rappelé qu'à l'avenir, les gouvernements des pays affectés auront besoin de ressources pour aider les communautés à prévenir l'infection, à détecter les cas potentiels et à réagir rapidement et de manière efficace.

    « Plus de 10.000 personnes en Afrique de l'Ouest ont survécu à l'infection d'Ebola. Elles auront besoin d'un soutien complet pour leur santé et leur bien-être. Nous devons nous assurer qu'on prenne soin des survivants, des veuves, des orphelins et des autres personnes vulnérables », a-t-il dit.

    Le chef de l'ONU a souligné qu'il n'oublierait jamais sa visite dans la région en décembre 2014 et qu'il avait été profondément ému par ses rencontres avec les « héros » fournissant des soins et luttant contre la stigmatisation.

    « La fin de la transmission d'Ebola en Afrique de l'Ouest est un exemple de ce que nous pouvons réaliser quand le multilatéralisme fonctionne comme il le devrait, faisant travailler ensemble la communauté internationale avec les gouvernements nationaux pour prendre soin de leurs populations », a-t-il conclu.


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    Source: UN Secretary-General
    Country: Guinea, Liberia, Sierra Leone

    New York, 14 January 2016

    The Secretary-General welcomes the announcement by the World Health Organization on 14 January marking the end of Ebola transmission in Liberia. For the first time since this devastating outbreak began, all known chains of transmission of Ebola in West Africa have been stopped and no new cases have been reported since the end of November.

    The Secretary-General commends the national authorities of the affected countries for their leadership and determination, and the local communities whose ownership and engagement have been instrumental in tackling this outbreak. He acknowledges the vital role played by the health workers and burial teams in the Ebola response. The Secretary-General expresses his gratitude to the many regional and international partners who have supported the response.

    The Secretary-General notes that the three affected countries will need to maintain intensive surveillance in order to detect and respond to any new flare-ups of Ebola. The Secretary-General calls upon the international community to continue supporting the affected countries in order that they have the capacity to rapidly respond to any future flare-ups and to provide comprehensive support to all survivors.

    The United Nations will stand firm with Guinea, Liberia, Sierra Leone, and the entire region, as they move ahead along the path towards social and economic recovery.


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    Source: UN Secretary-General
    Country: Guinea, Liberia, Sierra Leone

    Le Secrétaire général salue l'annonce faite par l'Organisation mondiale de la santé le 14 janvier de la fin de la transmission du virus Ebola au Libéria. Pour la première fois depuis que cette flambée dévastatrice a commencé, toutes les chaînes de transmission connues du virus Ebola en Afrique de l'Ouest ont été rompues et aucun nouveau cas n'a été signalé depuis la fin novembre.

    Le Secrétaire général félicite les autorités nationales des pays touchés pour leur leadership et leur détermination, ainsi que les communautés locales dont l’implication et l'engagement ont été déterminants pour lutter contre cette flambée de maladie à virus Ebola. Il reconnaît aussi le rôle vital joué par les personnels de la santé et les équipes funéraires dans cette lutte, et exprime sa gratitude aux nombreux partenaires régionaux et internationaux qui l’ont soutenue.

    Le Secrétaire général note que les trois pays touchés devront maintenir une surveillance intensive dans le but de détecter et de répondre à de possibles nouvelles flambées de virus Ebola. Le Secrétaire général appelle la communauté internationale à continuer de soutenir les pays touchés, afin qu'ils aient la capacité de réagir rapidement à toute future réapparition du virus et de fournir un soutien complet à tous les survivants.

    Les Nations Unies resteront fermement engagées auprès de la Guinée, du Libéria, de la Sierra Leone et de toute la région sur la voie du redressement économique et social.


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    Source: European Commission Humanitarian Aid Office
    Country: Liberia, Sierra Leone

    It is time for post-Ebola recovery in GuineaSierra Leone and Liberia – all three countries have now been declared as Ebola-free. However surveillance is still in place and challenges remain. The virus can re-emerge at any time and care and support for survivors is still very much needed. With EU funding, Welthungerhilfe and Action Against Hunger are helping people whose livelihoods were compromised by the epidemic to get back on their feet. 

    Eddie David talks fondly about his grandmother. She sold smoked fish and from the profits she was able to clothe and feed the two of them, as well as pay the fees for Eddie to go to school.

    That was two years ago.

    Eddie was with his grandmother when she got sick, he took care of her until her illness became critical and the community called the ambulance. A few days later, Eddie started to feel unwell and he was taken to an 'Ebola treatment unit'.

    When he returned to his community, after being certified free from Ebola, his neighbours were afraid to come close to him. They knew his grandmother had died from Ebola and as a survivor, they thought it was dangerous to be near him. It became so bad he was embarrassed to leave the house because of how people would treat him.

    During this time Eddie struggled to get by. His grandmother was a kind lady so, even after she died, once in a while people would leave food at her door for Eddie. But that wasn’t enough.

    With funding from the European Commission’s Humanitarian Aid and Civil Protection department, Welthungerhilfe has been working with Action Against Hunger across Sierra Leone and Liberia to help families affected by Ebola recover the ability to feed themselves.

    These families have all had their lives turned up-side-down by Ebola. Some people lost all their possessions when their items were burnt in an attempt to stop the virus spreading. Households suspected of being infected with Ebola were quarantined – one woman and her family were quarantined three different times, 63 days in total!

    With so many deaths from Ebola, some families have been left without a source of income following the death of the breadwinner who supported the household financially. There are also families who have increased in number as people took in children who lost their parents due to the virus.

    When we started our project in May 2015, people told us that times were hard; with savings spent and businesses gone, feeding their families was a daily struggle. To cope, they were reducing the number of meals they ate a day, or limiting the portion sizes for adults so children could eat more.

    To address families’ immediate food concerns, in Liberia, Welthungerhilfe and Action Against Hunger gave 1 050 people in Bomi and Monsterrado counties 50 US dollars (around €46) every month for six months, through mobile money. Mobile money is a system with which people receive and manage money through their mobile phone.

    Action Against Hunger is also supporting 450 people who lost their business during the Ebola crisis. Not only are we helping people financially but we are also giving people a chance to talk about the impact of Ebola and the changes to their lives through individual and group psycho-social interventions. These efforts are all part of the national recovery strategy to help families return to some sort of normalcy following the catastrophic effects of Ebola.

    Eddie heard about the project through Alfred, one of Welthungerhilfe’s community mobilisers. Being part of this project has got him back on his feet.

    “This money has put me back in school, and I am eating very well – everyday! Unlike before, I used to stay hungry always, thinking of where to get food to eat”.

    The financial boost we have given families has prevented them from borrowing, begging or selling their belongings just to get by. It has stopped them from making difficult decisions on how to spend the little money they had. When we talk to communities now, we hear that their situation has greatly improved, people can not only buy enough food now but they are able to send their children to school and pay their rent. They are also saving and investing or re-investing in business and trade as a way to meet their daily needs as well as looking to the future.

    Eddie has managed to save some of the money and with it he wants to buy tools and seeds. As an agriculture student, he plans to use the knowledge from his studies to start a backyard garden to grow vegetables which he will then sell to support himself through the rest of his degree.


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    Source: UN Children's Fund
    Country: Guinea, Liberia, Sierra Leone

    CONAKRY/MONROVIA/FREETOWN/DAKAR, 14 January 2016– Nearly 23,000 children who lost one or both parents or their primary caregivers to Ebola in Guinea, Liberia and Sierra Leone will continue to need care and support, UNICEF said as it welcomed the declaration that there are no more cases of the disease in West Africa.

    Today’s declaration that Liberia is free of Ebola transmissions, having completed a 42-day period without a case of the disease, follows Guinea’s declaration in December and Sierra Leone’s in November. The country now enters a three month period of heightened surveillance.

    “To have contained this epidemic is an achievement, but we can’t forget the terrible toll Ebola has taken on these countries,” said Manuel Fontaine, UNICEF’s Regional Director for West and Central Africa. “Many people continue to suffer, particularly those children whose lives have been left even more vulnerable by the virus.”

    The vast majority of the children whose parents or caregivers died of Ebola have been taken in by immediate or extended family or community members, and it is critical to continue supporting them beyond the emergency phase through cash grants, school support, clothing and food during the transition and to sustain new family care arrangements.

    Of the 28,637 people infected by Ebola in the more than two years since the outbreak started, 4,767 were children. A total of 11,315 people lost their lives to the virus – 3,508 of them children, representing more than one in four deaths.

    In addition, over 1,260 children who have survived the disease across the three countries are facing challenges that are both medical and social as many struggle to be accepted back into their communities.

    “Ebola has been a terrifying experience for children,” said Fontaine. “We owe it to them and to all the people of Guinea, Liberia and Sierra Leone to continue to support them as they recover from the devastating effects this disease has had on their lives,” he added.

    UNICEF’s support to vulnerable children across the three countries aims to reinforce systems for child protection. This means ensuring that national authorities are able to provide a range of protection services including psychosocial support, family tracing and reunification, interim or alternative care, and state and community-based networks to prevent and respond to abuse and violence against children, who are more at risk.

    In addition to child protection support, UNICEF will continue to support campaigns to maintain vigilance and awareness as well as rapid response teams that conduct active surveillance, social mobilization and early isolation and provide basic services, such as health, nutrition and water, hygiene and sanitation services.

    UNICEF is appealing for $15 million to fund Ebola emergency interventions in Guinea, Liberia and Sierra Leone for January-March 2016. This figure does not cover post-Ebola recovery work – only immediate needs.

    /###

    Broadcast quality photos and videos are available here: http://uni.cf/1xZAb39

    Note to the editor: The new photo essay ‘My Ebola’ tells the story of 21 people – in their own words – whose lives have been affected by Ebola in Liberia, Guinea and Sierra Leone:

    https://medium.com/@UNICEF/97be6dd6a8a0

    About UNICEF

    UNICEF promotes the rights and wellbeing of every child, in everything we do. Together with our partners, we work in 190 countries and territories to translate that commitment into practical action, focusing special effort on reaching the most vulnerable and excluded children, to the benefit of all children, everywhere.

    For more information about UNICEF and its work for children visit www.unicef.org

    Follow UNICEF on Twitter and Facebook.

    For more information please contact;
    John James, UNICEF Sierra Leone, jjames@unicef.org, Tel: + 232 76 102 401
    Rukshan Ratnam, UNICEF Liberia, rratnam@unicef.org; Tel: + (231) 770 257110
    Timothy La Rose, UNICEF Guinea, tlarose@unicef.org; Tel: (+224) 622 350 251
    Thierry Delvigne-Jean, UNICEF West and Central Africa, tdelvignejean@unicef.org; Tel: +221 33 869 5862


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    Source: World Health Organization
    Country: Guinea, Liberia, Sierra Leone

    14 JANVIER 2016 | LIBÉRIA - L’Organisation mondiale de la Santé (OMS) a déclaré aujourd’hui la fin de la flambée de maladie à virus Ebola la plus récente au Libéria, précisant qu’il a été mis fin à toutes les chaînes de transmission connues en Afrique de l’Ouest. Mais l’Organisation déclare également que son travail n’est pas terminé, des résurgences étant attendues, et que des systèmes de surveillance et d’intervention solides seront déterminants au cours des mois à venir.

    Le Libéria a été déclaré exempt de transmission du virus Ebola une première fois en mai 2015, mais le virus a été réintroduit deux fois depuis, la dernière flambée ayant eu lieu en novembre. L’annonce d’aujourd’hui est faite 42 jours (soit deux cycles d’incubation du virus de 21 jours) après la réalisation de deux tests négatifs pour la maladie chez le dernier patient confirmé au Libéria.

    Aucun cas depuis 42 jours dans les 3 pays affectés

    «L’OMS félicite le gouvernement et le peuple libériens de l’efficacité de leur action face à cette réémergence récente du virus Ebola», a déclaré le Dr Alex Gasasira, Représentant de l’OMS au Libéria. «La fin rapide de cette flambée témoigne concrètement de la capacité accrue du gouvernement à gérer les flambées épidémiques. L’OMS continuera à apporter son soutien au Libéria dans ses efforts pour prévenir, détecter et gérer les cas suspects.»

    C’est aujourd’hui la première fois depuis le début de l’épidémie il y a deux ans que les trois pays les plus touchés – la Guinée, le Libéria et la Sierra Leone – n’ont notifié aucun cas pendant au moins 42 jours. La Sierra Leone a été déclarée exempte de transmission le 7 novembre 2015 et la Guinée le 29 décembre.

    Pour le Dr Margaret Chan, Directeur général de l’OMS, «détecter et interrompre toutes les chaînes de transmission a été une réalisation monumentale. Il y avait tant à faire et tant a été accompli par les autorités nationales, des agents de santé héroïques, la société civile, des organisations internationales et locales, et de généreux partenaires. Mais notre travail n’est pas terminé et la vigilance reste de mise pour prévenir de nouvelles flambées.»

    Un risque élevé d’autres petites flambées

    L’Organisation mondiale de la Santé avertit que le risque d’autres petites flambées, telles que celle qui s’est produite récemment au Libéria, reste très élevé dans les trois pays. À ce jour, 10 résurgences de ce type, qui n’étaient pas rattachées à la flambée initiale, vraisemblablement dues à la persistance du virus chez des hommes survivants même après la guérison, ont été enregistrées. Les données montrent que le virus disparaît relativement rapidement chez les survivants, mais qu’il peut subsister dans le sperme d’un petit nombre d’hommes jusqu’à un an et, dans de rares cas, être transmis aux partenaires intimes.

    «Nous sommes à un moment critique de l’épidémie d’Ebola alors que nous passons de la prise en charge des cas et des patients à la prise en charge du risque résiduel de nouvelles infections», déclare le Dr Bruce Aylward, Représentant spécial de l’OMS pour la riposte à Ebola. «Le risque de réintroduction de l’infection diminue à mesure que le virus disparaît progressivement de la population des survivants, mais nous prévoyons cependant de nouvelles résurgences et devons nous y préparer. Un effort massif est en cours pour faire en sorte que des capacités de prévention, de surveillance et d’action solides soient en place dans les trois pays d’ici fin mars.»

    L’OMS et ses partenaires travaillent avec les gouvernements de la Guinée, du Libéria et de la Sierra Leone pour aider à faire en sorte que les survivants aient accès aux soins médicaux et psychosociaux et au dépistage du virus persistant, ainsi qu’à des conseils et à une éducation pour les aider à se réinsérer dans la vie familiale et communautaire, en minimisant le risque de stigmatisation et de transmission du virus Ebola.

    L’épidémie d’Ebola a fait plus de 11 300 morts et plus de 28 500 personnes ont été infectées. La maladie a dévasté des familles, des communautés et les systèmes sanitaires et économiques des 3 pays.

    Pour plus d’informations, merci de prendre contact avec:

    Gregory Härtl
    Responsable de communication, OMS
    £ Téléphone: +41 22 791 44 58
    Portable: +41 79 203 67 15
    Courriel: hartlg@who.int

    Tarik Jašarević
    Chargé de communication, OMS
    Téléphone: +41 22 791 5099
    Portable: +41 793 676 214
    Courriel: jasarevict@who.int


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    Source: Médecins Sans Frontières
    Country: Guinea, Liberia, Sierra Leone

    Global overview

    • Liberia: The last patient was declared negative on 4 December. The countdown has started again and should be over 14 January.

    • Guinea: Guinea was declared free of Ebola on 28 December. MSF has now opened an Ebola clinic for survivors. Since March 2014 (start of the epidemic), MSF teams treated 10,376 patients in West Africa including 3,804 patients in Guinea. The authorities reported that 110 health workers died from the virus in the country.

    • Sierra Leone: The country has been declared free of EVD transmission on 7 November. MSF played a key leading role in treating people who suffered from Ebola and continue to provide medical and psychosocial services to some of the country’s 4,051 Ebola survivors in Freetown and Tonkolili district. New projects on maternal and child health should open soon in different towns of the country (Kabala, Magburaka, Kenema). MSF will also maintain an emergency response capacity through a small team.

    MSF Staff on ground

    At its peak, MSF employed nearly 4,000 national staff and over 325 expatriate staff to combat the epidemic across the three countries.

    Overview

    Today should be a day of celebration and relief, but the world also needs to learn its lessons from this epidemic.

    We must all learn from this experience to improve how we respond to future epidemics and to neglected diseases. This Ebola response was not limited by lack of international means but by a lack of political will to rapidly deploy assistance to help communities. The needs of patients and affected communities must remain at the heart of any response and outweigh political interests.

    This devastating epidemic hit nearly 40 years after the first discovery of Ebola in 1976, yet the lack of research and development on Ebola meant that even today after the medical trials and at the end of the epidemic, there is no effective treatment.

    This has been an unprecedented epidemic with an unprecedented response

    From the very beginning of the epidemic, MSF responded in the worst affected countries – Guinea, Liberia and Sierra Leone - through setting up Ebola Management Centres and providing services such as psychological support, health promotion, surveillance and contact tracing. At its peak, MSF employed nearly 4,000 national staff and over 325 international staff to combat the epidemic across the three countries. MSF admitted a total of 10,376 patients to its Ebola Management Centres, of which 5,226 turned out to be confirmed Ebola cases. In total, the organization has spent over 96 million Euros on tackling the epidemic.

    The lessons learned:

    We have learned a lot from the past outbreak, which should allow us to provide an improved response during a future outbreak. Below are a few key points:
    • There is now a new, promising vaccine, that can help us slow the expansion of an epidemic, and also protect medical staff working with Ebola patients.
    • We now have an independent way of testing for Ebola, which organisations like MSF can operate ourselves.
    • We are now able to do better medical follow up of the patients, which enables better supportive care.

    But there is still a lot of room for progress. Most importantly, there still is no treatment for this deadly disease, and a lot remains unknown about the virus and the disease.

    Steps need to be taken to better prepare the world for a future outbreak

    A lot of data has been gathered during this outbreak, and a lot of it remains to be analysed. This analysis will be of vital importance in order to learn as much as possible about the disease before a next outbreak occurs.

    We now have a promising vaccine for Ebola, but it is yet to be approved for regular administration. In order for it to be useful during a next outbreak, we must make sure that it will be accessible to those in need.

    There’s no treatment for Ebola yet, but there are a few promising developments in the pipeline. In order to test these products, preparations of clinical studies of the most promising treatment products should be prepared before the next outbreak, in order to lose as little time as possible.

    A sustained and well-functioning surveillance and rapid response system is essential in order to maintain zero cases of Ebola across West Africa and also to respond to cases of other diseases with epidemic potential including measles and cholera which have previously broken out in the region.

    Finally, already weak public health systems have been seriously damaged by the epidemic and their recovery must be sufficiently funded and resourced.

    MSF will continue its work on Ebola

    Even though the epidemic is over, MSF’s work on Ebola is not over. Ebola survivors are a particularly vulnerable group, who face continuing health challenges such as joint pain, chronic fatigue, and hearing and vision problems. They also suffer from stigmatisation in their communities and need specific and tailored care. MSF has invested in setting up five Ebola survivor clinics in Liberia, Sierra Leone and Guinea, providing a comprehensive care package, including medical, psychosocial care and protection against stigma.

    Re-emergence of cases is very rare:

    Evidence gathered during this epidemic shows that the virus can stay in some parts of survivors’ bodies for as long as 9 months, or longer. In Sierra Leone and Liberia, there have been some cases of transmission of the disease by survivors, as well as what seems to be relapse of the disease. But these episodes are extremely rare. Only ten cases of re-emergence have been identified out of a total of 15,000 survivors. However, it is important to maintain adequate surveillance systems in order to identify and treat such cases and avoid further transmission.

    Operational highlights

    MSF’s Ebola response started in March 2014 and had included activities in the three most affected countries of Guinea, Liberia, and Sierra Leone as well as Nigeria, Mali and DRC.

    Since the beginning of the epidemic:
    • 10,376 patients admitted to MSF Ebola Management Centres
    • 5,226 patients confirmed with Ebola
    • 2,478 patients recovered from Ebola in our centres

    Highlights per country

    Guinea

    Guinea was declared free of Ebola on 28 December. The Nongo Ebola Management Centre has been passed to the authorities but an MSF structure for Ebola survivors remains within the same compound.

    Since March 2014 (start of the epidemic), MSF teams treated 10,376 patients in West Africa including 3,804 patients in Guinea. The authorities reported that 110 health workers died from the virus in the country.

    Liberia

    According to WHO, the last cluster of cases is now understood to have been a result of the re-emergence of Ebola virus that had persisted in a previously infected individual. But the outbreak should be over 14 January.

    The Liberian national health system, which was already among the weakest in the world, has been decimated by the outbreak – nearly 200 Liberian healthcare workers died from Ebola according to official statistics, which represents 8% of all health workers in the country. MSF is focusing activities on supporting the recovery of health facilities. For instance before the epidemic, there were 220 inpatient paediatric beds in Monrovia. In April 2015, when MSF opened its paediatric hospital, all paediatric wards had closed. At the end of 2015, 122 inpatient beds were available, including 40 in the MSF hospital. But this is clearly not enough for a city of 1.4 million inhabitants, with an estimated 17% of them being children under 5 years old.

    Monrovia – paediatric hospital and survivors clinic

    In Monrovia, MSF is running a 74-bed paediatric hospital, the Bardnsesville Junction Hospital (BJH), including a 10-beds neonatal intensive care unit, aiming to contribute to restoring the provision of emergency and secondary healthcare for children in the aftermath of the Ebola outbreak. From January to end of November 2015, more than 3,100 consultations took place in the emergency room of the hospital, and 1,900 children were admitted in the inpatient ward. One third of these admissions were due to malaria.

    MSF also runs a clinic for Ebola survivors in the premises of the hospital. Former patients have to face stigma and discrimination while accessing care, as well as social and economic problems (loss of work, loss of housing, etc.). MSF provides general outpatient consultations, and addresses mental health needs to a group of more than 500 identified former Ebola patients, which are estimated to be half of all survivors in Montserrado county. Teams have been providing consultations also to patients who are not identified as survivors, because of the lack of certificates of cure or discharge from Ebola Management Centres. Compared to identified survivors, their access to medical and social assistance has therefore been even poorer. Common complaints are joint pains and ophthalmic issues. For the latter, MSF guarantees referral to external specialists. About 400 survivors have been seen since April 2015, 168 are actively followed. 23 patients are under psychiatric treatment and 35 patients are currently followed for eye problems.

    Sierra Leone

    The outbreak was declared over on 7 November. MSF is now focusing activities on survivor health care and surveillance in Western Area (Freetown) and Tonkolili (Magburaka). There are also plans to begin non-Ebola health activities in several districts of the country as many components of the health system need to be strengthened.

    Magburaka – Survivor clinic

    MSF is running a survivor health clinic in Magburaka town as well as a mobile clinic in the surrounding villages in Tonkolili and Bombali districts. By the end of December the team had provided support to 146 survivors for medical and mental health needs. The team as well did a two week mobile clinic to Kailahun facilitating eye exams and providing medical screening. 153 survivors were seen.

    Freetown – Survivor clinic

    MSF has been running a survivor clinic in Freetown since February 2015 providing primary healthcare and mental health support, with around 150 patients attending up to now.

    Koinadugu and Tonkolili Districts – Maternal and Child Health

    MSF is currently working to incorporate survivor health care in the national facilities in Tonkolili District. On 04 January, the team began clinical care in the maternity and paediatric wards of Magburaka Government Hospital. The program will expand to provide basic emergency obstetrics and newborn care to primary level of care.

    In Kabala hospital, in Koinadugu district, MSF is preparing to open a new project with the aim of increasing access to free secondary level maternal, neonatal and paediatric care while ensuring free health care to Ebola survivors in the district and effective response to outbreaks and emergencies in the area.


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    Source: UN News Service
    Country: Guinea, Liberia, Sierra Leone

    13 janvier 2016 – A l'occasion d'une réunion de l'Assemblée générale des Nations Unies sur l'épidémie d'Ebola en Afrique de l'Ouest, le Secrétaire général de l'ONU, Ban Ki-moon, s'est félicité des efforts collectifs qui ont permis de mettre fin à la transmission du virus Ebola dans la région.

    « Pour la première fois depuis que l'épidémie a débuté, la région est sur le point d'être déclarée exempte de la transmission d'Ebola », a souligné M. Ban dans un discours devant les Etats membres.

    En effet, la Sierra Leone a déclaré la fin de la transmission le 7 novembre 2015, la Guinée l'a fait le 29 décembre 2015 et le Libéria devrait annoncer jeudi la fin de l'épidémie.

    « Cela veut dire que demain, 14 janvier, toutes les chaînes connues de transmission auront été stoppées en Afrique de l'Ouest », a déclaré M. Ban.

    Le Président de l'Assemblée générale, Mogens Lykketoft, a rappelé de son côté que l'épidémie avait commencé en décembre 2013 quand un petit garçon nommé Emile, de la ville de Guéckédou, en Guinée, est tombé malade et est mort deux jours plus tard.

    Deux ans après, l'épidémie d'Ebola a affecté plus de 28.600 personnes, principalement en Guinée, au Libéria et en Sierra Leone et a causé la mort d'au moins 11.300 personnes.

    Ban Ki-moon a cependant rappelé que l'Afrique de l'Ouest était aujourd'hui confrontée à des défis significatifs, malgré la fin de l'épidémie.

    « Nous pouvons anticiper la réapparition d'Ebola au cours de l'année à venir. L'expérience du Libéria, qui a combattu deux retours du virus, a montré la résilience et la capacité des pays affectés à réactiver les mécanismes de réponse d'urgence et à contenir le virus », a-t-il ajouté. « Mais nous espérons aussi que la possibilité et la fréquence de ces réapparitions du virus diminueront au fil du temps ».

    M. Ban a rappelé qu'à l'avenir, les gouvernements des pays affectés auront besoin de ressources pour aider les communautés à prévenir l'infection, à détecter les cas potentiels et à réagir rapidement et de manière efficace.

    « Plus de 10.000 personnes en Afrique de l'Ouest ont survécu à l'infection d'Ebola. Elles auront besoin d'un soutien complet pour leur santé et leur bien-être. Nous devons nous assurer qu'on prenne soin des survivants, des veuves, des orphelins et des autres personnes vulnérables », a-t-il dit.

    Le chef de l'ONU a souligné qu'il n'oublierait jamais sa visite dans la région en décembre 2014 et qu'il avait été profondément ému par ses rencontres avec les « héros » fournissant des soins et luttant contre la stigmatisation.

    « La fin de la transmission d'Ebola en Afrique de l'Ouest est un exemple de ce que nous pouvons réaliser quand le multilatéralisme fonctionne comme il le devrait, faisant travailler ensemble la communauté internationale avec les gouvernements nationaux pour prendre soin de leurs populations », a-t-il conclu.


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    Source: Agence France-Presse
    Country: Guinea, Liberia, Sierra Leone

    Freetown, Sierra Leone | AFP | Friday 1/15/2016 - 03:44 GMT

    by Zoom Dosso

    A woman in Sierra Leone is thought to have died from Ebola, officials said Thursday, just hours after the World Health Organization (WHO) declared an end to an epidemic of the disease.

    The female student was taken ill in the northern village of Bamoi Luma near the Guinean border and died soon after, with an initial swab testing positive for Ebola, a senior health ministry official told AFP.

    "Complete findings will be made known to the public by tomorrow (Friday)," he said, adding that further tests were under way.

    Earlier Thursday the WHO said a two-year Ebola epidemic that killed more than 11,000 people and triggered a global health alert was over, with Liberia the last country to get the all-clear.

    The deadliest outbreak in the history of the feared tropical virus wrecked the economies and health systems of the three worst-hit west African nations after it emerged in southern Guinea in December 2013.

    At its peak, it devastated Guinea, Liberia and Sierra Leone, with bodies piling up in the streets and overwhelmed hospitals recording hundreds of new cases a week.

    Rick Brennan, the World Health Organization's chief of emergency risk management, hailed the milestone but told reporters in Geneva that "the job is still not done", pointing out that there had already been 10 small flare-ups because of the persistance of the virus in survivors.

    UN chief Ban Ki-moon also warned the region can expect sporadic cases in the coming year but added "we also expect the potential and frequency of those flare-ups to decrease over time".

    • No celebration -

    Liberia, the country worst hit by the outbreak with 4,800 deaths, discharged its last two patients from hospital -- the father and younger brother of a 15-year-old victim -- on December 3, 2015.

    Africa's oldest republic was the last country still afflicted by the outbreak that infected almost 29,000 people and claimed 11,315 lives, according to official data.

    The real toll is suspected to be much higher, with many Ebola deaths believed to have gone unreported.

    After the last patient is declared in the clear, a 42-day countdown -- twice the incubation period of the virus -- begins before the country is proclaimed Ebola-free.

    Ebola causes severe fever and muscle pain, weakness, vomiting and diarrhoea. In many cases it shuts down organs and causes unstoppable internal bleeding. Patients often succumb within days.

    From a Guinean infant who was the first victim, the epidemic quickly spread into neighbouring Liberia and Sierra Leone, notching up more deaths than all other Ebola outbreaks combined.

    Liberia was first to be declared free of human-to-human Ebola transmission in May, only to see the virus resurface six weeks later.

    It was officially credited with beating the epidemic for a second time in September before another small cluster of cases emerged.

    Reaction to Thursday's announcement was muted in the capital Monrovia, where locals have become accustomed to good news on Ebola being followed by setbacks, and there was no official programme of celebration.

    • Economic ruin -

    The WHO came under fire for its sluggish response to the epidemic, which local healthcare systems were woefully under-equipped to handle. Over 500 healthcare workers died in three west African countries at the height of the outbreak.

    Brennan acknowledged the WHO's initial inertia but said the organisation had "done a lot of soul-searching", pointing to a "major reform" it is undergoing.

    While Cuba sent doctors, Western governments offered little until foreign aid workers started falling ill and returning home for treatment, sparking fears of a global pandemic.

    The concerns inched higher when three cases of infections came to light outside Africa -- two in the United States and one in Spain.

    The US, Britain and other countries eventually rallied to the cause, sending thousands of troops and medics to Africa in 2014 and developing a number of promising potential vaccines and treatments.

    But the economic ravages of the epidemic are still being felt.

    The World Bank estimates the economic damage of the outbreak, which devastated the mining, agriculture and tourism industries in Liberia, Sierra Leone and Guinea, at $2.2 billion over 2014-15.

    WHO director Margaret Chan described the next three months as "the most critical," as foreign medical groups shut down operations in west Africa and national health ministries take over.

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    © 1994-2016 Agence France-Presse


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    Source: European Commission Humanitarian Aid Office
    Country: Guinea, Liberia, Sierra Leone

    14 January marks the end of the 42nd day Ebola case-free period in Liberia, which implies that Liberia is now officially Ebola-free again.

    • As Sierra Leone and Guinea have already recently been declared Ebola-free, this means that the West Africa Ebola epidemic is now technically over. However, each country will embark on a 90 day period of heightened vigilance whereby, for example, the safe burial and testing of suspicious cases will continue.

    • Each country is also developing a programme to follow up survivors and establish a robust surveillance and response system.

    ECHO will continue to monitor these developments on the ground.


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    Source: International Crisis Group
    Country: Guinea, Liberia, Sierra Leone

    By EJ Hogendoorn

    Today the Ebola epidemic in West Africa has formally ended.

    At its height in mid-2014, there were concerns social order in Guinea, Liberia and Sierra Leone could collapse. International mobilisation, notably after the UN Security Council declared the epidemic "a threat to peace and security" on 18 September, brought an extensive intervention and steady progress in reducing the virus' spread.

    Now the focus has turned to preventing the re-emergence of Ebola or a similarly virulent disease. Most of the effort is understandably on better disease surveillance and strengthening the region's weak health systems, but missing is a focus on the governance challenges that allowed the initial Ebola outbreak to spread unchecked for months.

    Lack of trust in the state, its institutions and leaders was a major reason people did not heed warnings and advice on how to respond. Nor was the international community beyond reproach. It prevaricated, and mostly ignored early and clear warnings until the threat was perceived as global. Unless these lessons are learned, the next regional health crisis will be as needlessly costly and disruptive.

    As Crisis Group noted in its report The Politics behind the Ebola Crisis, 28 October 2015, the virus initially spread unchecked not only because of the weakness of epidemiological monitoring and inadequate health system capacity and response, but also because people were sceptical of what their governments were saying or asking them to do.

    Lack of trust in government intentions, whether in the form of political opportunism or corruption, was based on experience. In its initial phase, many West Africans thought Ebola was a ploy to generate more aid funding or reinforce the position of ruling elites. And when Ebola proved real enough, political machinations and manipulation needlessly hindered the early response.

    Initially, information was not shared, and warnings were not disseminated widely enough. Countries hesitated to declare an emergency for fear of creating panic and scaring away business. Once they did so, their governments relied on the security services - their most capable institutions - but the early curfews and quarantines exacerbated tensions and alienated people whose cooperation was necessary to contain the epidemic.

    Officials in capitals also initially ignored local authorities, who were sometimes more familiar with traditional customs and accepted by their communities (with the exception of Guinée Forestière, where appointed local authorities were no more familiar with local customs or trusted than the national government).

    It was only after the second wave of Ebola cases threatened the very stability of the affected countries that authorities took concerted action (with the help of NGOs, international agencies on the ground and donors), starting with the engagement of community leaders.

    Particularly in Liberia, they slowly learned what did not work and how to better communicate appropriate precautions and necessary cultural changes, eg, handling of deceased relatives, that finally helped bring the epidemic under control.

    The international reaction was equally problematic and rightly criticised as dysfunctional and inadequate by many observers. Early warnings were largely ignored until cases began cropping up in the U.S.

    The World Health Organization (WHO), which had stalled for far too long on declaring an international health emergency, then proved incapable of mounting an effective response. The Security Council was forced to create a new body to scale up and coordinate operations - with variable results - the UN Mission for Ebola Emergency Response (UNMEER).

    Divorcing political consideration from the response to public health crises should be a priority. It requires transparency from governments, opposition groups and international organisations. As a first step, West Africa's still fragile states need to learn from and allay fears over actions taken against Ebola, as well as account for the use of Ebola-related resources. The movement toward greater regional cooperation, with regards to both transmissible disease and other transnational threats, is at least one positive development emerging from the crisis. Sustained international support is likewise necessary in the recovery process. Donors and implementers must also learn from their own failings during the Ebola response. The epidemic might not have been preventable; it certainly was controllable in the early stages. Avoiding a repetition requires addressing the errors of the past.

    EJ Hogendoorn is Crisis Group's Deputy Africa Program Director.


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    Source: Voice of America
    Country: Guinea, Liberia, Sierra Leone

    by Carol Pearson

    It's been more than two years since a young boy contracted the first suspected case of Ebola in the forests of Guinea.

    Thursday, the World Health Organization declared that the Ebola outbreak in Liberia was over. This essentially ends an outbreak that claimed more than 11,000 lives and sickened more than 28,000 people in three West African countries.

    Guinea, Sierra Leone and Liberia have had no cases for at least 42 days.

    Liberians received the news with mixed emotions

    Hannah Banwon, a nurse who lost 13 members of her family to the disease, said it started with her sister-in-law. Then, her sister started bleeding.

    "I told them that it was the sign of Ebola," Banwon said, "but they didn't really believe me, and because of that many of the family died."

    "At that time we didn't have enough equipment to help," she said.

    And that was the crux of the problem: not enough hospital beds, too many hospitals with no running water or electricity, too few laboratories to diagnose the disease, too few people to trace the contacts of the sick so they could stop the progression of the disease, too slow a response from the international community, and weak public health systems.

    In its announcement, the World Health Organization warned that there will be flare-ups of Ebola in West Africa, but not another massive outbreak.

    More work needed

    Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, said the world is better prepared now than it was two years ago, "but not nearly as prepared as we need to be.”

    “We need to build systems around the world to find things when they first emerge,” he said, “to stop them rapidly and to prevent them whenever that's possible."

    The CDC sent doctors, epidemiologists, communications specialists and other staff to West Africa to teach people how to stay safe, convince them that Ebola is real and very deadly, and help with contact tracing so the disease could be stopped.

    Dr. Anthony Fauci, who oversees infectious disease research at the National Institutes of Health, agreed that poor health care systems enabled Ebola to sweep through West Africa with such ferocity.

    While it's important to build sustainable health care capacity in low- and middle-income countries, he said, "the countries themselves need to realize that that is an important priority for them, and they need to put the resources in."

    A lot has been learned about treating Ebola, Fauci said.

    "In the beginning, we heard that it was 90 percent fatal to have Ebola," he said. "Then we found out that when you provide the appropriate care, you can bring that down to 20, 30 percent, sometimes."

    When patients were given enough fluids and the symptoms of the disease were addressed, their survival rates improved significantly, even though there is no treatment specifically for the disease itself.

    ‘Durable’ answers key

    Scientists learned things, too, about the value of maintaining strict scientific standards when it comes to experimental treatments.

    "We've learned that when you have an outbreak, even though you need to deliver care in the best possible way, that when you do research, you’ve got to do it in a scientifically sound, transparent way, so that when you get an answer, it's a durable answer," Fauci said, because otherwise, "you may wind up at the end of the epidemic not really knowing what works and what doesn't work, which unfortunately, was the case with some of the medications and therapies that were distributed" during the epidemic.

    It became abundantly apparent during the outbreak that the World Health Organization was not up to the task of organizing and mobilizing a response to the Ebola outbreak, according to many experts, including Frieden.

    "We need a WHO where technical competence rules,” he said, “and where the human resources are fit to what's needed to run programs, to give technical advice, to coordinate among partners."

    The WHO has acknowledged its shortcomings and has made recommendations for change.

    ‘Not about profit alone’

    Large pharmaceutical companies like Merck — or MSD, as it is known outside the U.S. — also want to be involved, according to Dr. Julie Gerberding, the president of Merck.

    Gerberding told a conference in Washington that the "Industry steps up because we want to," and that "pharmaceutical companies are not about profit alone."

    But beyond that, she stressed that the large pharmaceutical companies can develop and produce vaccines and treatments on the kind of scale that's needed. Merck was instrumental in producing the highly successful Ebola vaccine that was used in Guinea.

    But the valuable lessons learned during the Ebola epidemic won't matter if they aren't taken to heart. Nigeria stopped Ebola from spreading in Lagos, a city of 21 million, because of the infrastructure in place to test and isolate Ebola patients. If Ebola had spread through Lagos, the epidemic might not be over.

    "I fear that the world will forget how close we got to a total global catastrophe with Ebola, and how much worse it could have been," Frieden said, adding, "That's why it's so important that we implement effective programs rapidly, get other countries around the world to do more to strengthen those core detection and response capacities, and that we have sustained funding" for programs to protect people from global health threats posed by infectious diseases.

    Funding is critical.

    Lawrence Gostin, a professor of global health law at Georgetown University, told VOA, "We have to keep our foot on the pedal ... because the next time we may not be so fortunate as to have something we can contain. We might have a novel influenza that will literally sweep the world and cause millions of deaths in its wake, and we can't allow that to happen."


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    Source: Agence France-Presse
    Country: Guinea, Liberia, Sierra Leone

    Freetown, Sierra Leone | AFP | vendredi 15/01/2016 - 17:02 GMT

    par Rod MAC JOHNSON

    Un nouveau cas d'Ebola a été confirmé vendredi en Sierra Leone, faisant ressurgir des craintes d'un retour de l'épidémie, au lendemain de la déclaration par l'Organisation mondiale de la Santé (OMS) de l'arrêt de "toutes les chaînes connues de transmission" de la maladie en Afrique de l'Ouest.

    Il s'agit d'une étudiante de 22 ans, Marie Jalloh, décédée le 12 janvier à Magburaka, dans le nord du pays, a indiqué vendredi à l'AFP le docteur Augustine Junisa, un responsable médical de cette ville.

    Un premier prélèvement a été testé positif au virus jeudi. Un nouveau test a confirmé vendredi la présence du virus par l'OMS, qui a salué la "réponse rapide" des autorités sierra-léonaises.

    "Une équipe conjointe de responsables locaux, de l'OMS et de ses partenaires est en train d'enquêter sur l'origine de ce cas, d'identifier les contacts (personnes susceptibles d'avoir été en contact avec la victime, NDLR) et engager les mesures de contrôle pour prévenir la propagation", a affirmé l'OMS dans une note aux médias.

    Marie Jalloh était tombée malade la semaine dernière lors de ses vacances dans le village de Baomoi Luma. Elle a été transportée par voie terrestre par ses proches à Magburaka où elle est morte.

    Selon un haut responsable au ministère de la Santé, elle vivait habituellement à Lunsar, une autre ville du nord de la Sierra Leone.

    Ces développements surviennent alors que le président sierra-léonais, Ernest Bai Koroma séjourne en Namibie de jeudi à samedi pour un sommet de l'Union africaine sur la réforme du Conseil de sécurité de l'ONU.

    A Freetown, le porte-parole du Bureau de la Sécurité nationale (ONS), Langoba Kelly, a voulu rassurer sur les mesures prises pour circonscrire la propagation du virus. Apparu en Afrique de l'Ouest fin 2013 en Guinée, il s'est ensuite étendu au Liberia et à la Sierra Leone, trois pays limitrophes qui ont été les plus touchés par l'épidémie.

    La cellule de crise a été réactivée, des équipes d'enquêtes de voisinage sont déployées dans les villes de Makeni (nord) et Magburaka, a affirmé M. Kelly.

    "Notre niveau de préparation demeure élevé car nous n'avons pas démantelé toutes les structures que nous avions utilisées pour lutter contre le virus", a-t-il expliqué, invitant la population au calme et à continuer d'appliquer les mesures d'hygiène et de prévention.

    • "rétablir le lavage des mains" - Le professeur Ian Mackay, de l'université de Queensland, en Australie, s'est inquiété notamment d'une réduction des bonnes pratiques, comme le lavage des mains, dans un entretien à la BBC vendredi.

    "Cela semble avoir baissé quelque peu. L'OMS évoquait juste hier (jeudi) que le lavage des mains était négligé et qu'il fallait le rétablir pour aider à lutter contre le retour (d'Ebola) et d'autres infections", a souligné le virologiste.

    Ce nouveau cas confirmé marque un recul dans la lutte contre Ebola après l'annonce officielle de l'arrêt de "toutes les chaînes connues de transmission" de l'épidémie au Liberia et dans l'ensemble de la région.

    Cette déclaration de l'OMS avait été accueillie avec soulagement mais aussi prudence par les pays touchés et la communauté internationale. Moins de 24 heures plus tard, la joie contenue s'est muée en désappointement.

    En deux ans, l'épidémie a gagné dix pays, dont l'Espagne et les Etats-Unis, provoquant officiellement plus de 11.300 morts sur plus de 28.600 cas recensés, à plus de 99% en Guinée, au Liberia et en Sierra Leone.

    Ce bilan, sous-évalué de l'aveu même de l'OMS, est sept fois supérieur en nombre de morts à celui cumulé de toutes les épidémies d'Ebola depuis l'identification du virus en 1976.

    La Sierra Leone était sortie de l'épidémie le 7 novembre, puis la Guinée le 29 décembre. Il ne restait plus que le Liberia, qui avait atteint jeudi son 42e jour - deux fois la durée maximale d'incubation du virus - sans nouveau cas depuis le second test négatif sur le dernier patient, d'après l'OMS.

    A Magburaka, la mauvaise nouvelle a plongé les habitants dans la consternation, selon l'agriculteur Allieu Kamara, joint par téléphone depuis Freetown. Même s'il est "vraiment inquiet", il espère "que la présence massive de différents acteurs clés va redonner confiance" à tous.

    L'OMS a mis en garde contre le "risque permanent de nouvelles flambées durant 2016 en raison de la persistance du virus chez les survivants", dans leurs liquides corporels, notamment le sperme où il peut rester jusqu'à neuf mois, voire un an.

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    © 1994-2016 Agence France-Presse


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    Source: International Federation of Red Cross And Red Crescent Societies
    Country: Guinea, Liberia, Sierra Leone

    Executive Summary

    More than scale makes West Africa’s Ebola epidemic momentous, although that in itself has tested the world’s response to the limit, and asked questions of how we respond to insurgent infections in the future.

    The geographical spread in Guinea, Liberia and Sierra Leone has brought enormous challenges. Urban and rural, from hotspots in the slums of capital cities to others in remote countrysides, it has even caused concern that sudden surges might be missed or rapid response capacity might simply be insufficient.

    The numbers are truly horrific: over 11,200 deaths and more than 27,600 cases by mid-July 2015. Overall the situation was improving, but concerted efforts were still required to get to zero cases and stay there. Even after Liberia was declared Ebola free, new cases occurred there. In Guinea and Sierra Leone, cases were down significantly from those recorded at the end of 2014, but in the week to July 5, Guinea reported 18 cases and Sierra Leone, nine. Weekly case incidence in the region had stalled at between 20 and 30 for six consecutive weeks and cases continued to arise from unknown sources of infection, or were detected only after post-mortem testing.

    So the threat to the region continued. As humanitarians firmed up recovery plans, they were aware that response was still needed. The danger of fresh outbreaks, and even re-emergence in areas cleared of the virus, meant response and recovery operations might have to run side by side.

    Alongside scale, the epidemic’s unpredictability has challenged operations: it has done the most unexpected things. When it was thought the disease would wane, it would simply flare up again. And it has never been so urban.

    An epidemic that assumes the proportions it has is of a different order to disasters commonly dealt with. Normally, disaster response starts in the worst situation and plans to work through an improving one. The worst comes first. The Ebola epidemic was the other way round – getting much worse over an extended period before it got better.

    Conventional disaster response mechanisms were inadequate as a consequence.
    With a common disaster, there may be early warning, and on Day One in any case, responders will be there, meeting first needs, assessing the damage, preparing a further plan of action. Day Two will be better, Day Three better still, and so we go on, from relief to recovery, to building back better.
    Ebola was a moving target, travelling fast in uncharted ways, and it turned the graph on its head. What was needed was public health emergency response within disaster management systems. Paradigms needed to be re-examined. It could be that a modified disaster approach should be developed for future epidemics, building on Red Cross and Red Crescent experience with SARS, cholera, meningitis, MERS,
    H1N1 and measles. Ebola is not going to go away, and the international community needs to ask if the response to epidemics can be strengthened.

    A prerequisite the West Africa outbreak has underlined is the early detection, diagnosis and isolation of the virus. Surveillance and contact tracing have formed one of five pillars on which our response has stood, along with community engagement, safe and dignified burials and disinfection, psychosocial support, and case management and treatment. Teams of Red Cross volunteers have traced and monitored tens of thousands of people.

    Community engagement has been central to much of the response. While information passed on to communities helps to keep them safe, and the virus contained, structured feedback from them helps guide decision making. The West African epidemic has underlined that we must embed such dialogue into response operations.

    It cannot come as an afterthought, a post-response intervention.

    The bottom line is, you cannot simply treat your way out of a public health emergency on this scale, and we will not be able to do so during future outbreaks.

    Effective community engagement would have been impossible without Red Cross volunteers. Since the start of the epidemic, more than 10,000 of them now with the Red Cross Society of Guinea, The Liberia National Red Cross Society, and the Sierra Leone Red Cross Society, have been trained specifically for Ebola. In all, the three societies have double that number on the ground.

    Some have laid their lives on the line – a few have died as a consequence – many have faced stigma and discrimination from people who think that because of their work the volunteers themselves may be infected.

    Nonetheless, by the beginning of August 2015, along with Red Cross staff, and with support from over 30 Red Cross and Red Crescent partner societies from around the world, they had reached 7 million people through social mobilization and beneficiary communication programmes. They had helped to safely bury 34,448 bodies, see 1,341 people admitted to Red Cross Ebola treatment centres, provide 339,000 people with psychosocial support, and trace and monitor more than 97,000 thought to have had contact with infected people.

    Alasan Senghore, the IFRC’s Director of Africa zone, pointed out that when the epidemic is over, and the recovery work is done, those volunteers will remain, within their communities. No other organization has such a resource and harnessing it is key to ensuring Ebola-affected communities are more resilient and built back stronger.

    Our volunteers can be deployed, not only against Ebola, but against other diseases that trouble the region as well, and in immunization campaigns, and the scale-up of established community-based health programmes that are well placed to meet gaps in basic health services. But when the incentives that come with a large-scale response such as this one are gone, and people return to regular occupations and dayto-day struggles, we must ensure this volunteer base continues to stay engaged and is there when communities need it.


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    Source: International Federation of Red Cross And Red Crescent Societies
    Country: Guinea, Liberia, Sierra Leone

    Geneva, 14 January 2016 – The International Federation of Red Cross and Red Crescent Societies (IFRC) has welcomed today’s announcement of the end of Ebola virus transmission in Liberia, and the effective end of the Ebola outbreak in West Africa.

    Elhadj As Sy, Secretary General of the IFRC said the role of local Red Cross volunteers and affected communities themselves in bringing the outbreak to an end could not be underestimated:

    “Today’s announcement is a testament to the dedication, courage and strength of communities across West Africa, and to the many local and international actors that have supported them over the past 22 months,” said Mr Sy.

    Since the outbreak was first announced in early 2014, more than 10,000 Red Cross volunteers have been trained on the Ebola response, with many risking their lives on the frontline. Importantly, Red Cross teams assumed responsibility for providing safe and dignified burials for those who died, a dangerous intervention that was crucial in bringing the outbreak under control.

    “Our volunteers were often the difference between life and death,” said Mr Sy. “Now that the outbreak is over, they can play a critical role in strengthening community resilience; in helping their communities prepare for future challenges.”

    The IFRC has also renewed its call for increased investment in early warning and response mechanisms.

    “Unfortunately, the threat has not passed, and our focus now must be on strengthening the capacity within these three countries to effectively identify and respond to future outbreaks,” said Alasan Senghore, the IFRC’s Regional Director for Africa. “We also need to keep our commitment to communities. Ebola illustrated the weakness of health systems in this region. Let’s not wait for another reminder.”

    The Ebola outbreak ended in Sierra Leone in November, followed by Guinea in December. Today, the World Health Organization officially declared the end of Ebola virus transmission in Liberia. The National Red Cross Societies of these three countries were among the first organizations to respond in March 2014 when the first Ebola cases were identified and confirmed.

    Red Cross recovery planning in the three affected countries includes Community Event-Based Surveillance which involves training community health monitors to detect and isolate cases before new outbreaks can be triggered.

    “Early detection increases the chances of warding off an outbreak of any kind,” added Senghore. “We were all caught off guard by the intensity of the Ebola epidemic. Our recovery activities will help ensure this does not happen again.”

    IFRC supported emergency operations in GuineaLiberia, and Sierra Leonehave targeted 23 million people. These operations will now focus on meeting the longer-term needs of communities. To date, 62 per cent of the 214 million Swiss francs needed for these operations has been received.

    The International Federation of Red Cross and Red Crescent Societies (IFRC) is the world’s largest volunteer-based humanitarian network, reaching 150 million people each year through its 190 member National Societies. Together, IFRC acts before, during and after disasters and health emergencies to meet the needs and improve the lives of vulnerable people. It does so with impartiality as to nationality, race, gender, religious beliefs, class and political opinions. For more information, please visit www.ifrc.org. You can also connect with us on FacebookTwitterYouTube and Flickr.

    For further information, please contact:

    In Liberia:

    • Mirva Helenius, Communications delegate, IFRC

    Mobile: +231 770 472 409, E-mail: mirva.helenius@ifrc.org

    In Addis Ababa:

    • Katherine Mueller, Communications manager, IFRC Africa

    Mobile : +251 930 03 3413 E-mail: katherine.mueller@ifrc.org

    In Geneva:

    • Benoit Carpentier, Team leader, public communications, IFRC

    Mobile : +41 792 132 413, E-mail: benoit.carpentier@ifrc.org


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    Source: Agence France-Presse
    Country: Guinea, Liberia, Sierra Leone

    Freetown, Sierra Leone | Thursday 1/14/2016 - 09:27 GMT

    by Rod Mac Johnson

    Tropical disease experts in Sierra Leone scrambled Friday to investigate a new suspected death from Ebola announced just hours after west Africa celebrated halting the spread of the deadly virus.

    A 22-year-old female student was taken ill near the Guinean border and died three days ago, with an initial swab testing positive for Ebola, health officials said.

    "The victim was taken ill when she was on holidays in Bamoi Luma and was taken to Magburaka, where her relatives took her to the government hospital for medical attention," district medical officer Augustine Junisa told reporters.

    "Three days later she died at home and her death was reported to the hospital officials and an initial swab test was taken which proved positive" on Thursday.

    Junisa said further tests would be carried out on Friday and appealed to the public in the area to remain calm.

    The WHO had said Thursday a two-year Ebola epidemic that killed more than 11,000 people and triggered a global health alert was over, with Liberia the last country to get the all-clear.

    Residents in the Magburaka, a town of around 40,000 people and the capital of the Tonkolili district, expressed their shock and distress over the announcement.

    'Really worried'

    "It was not expected and came at a time when we had thought that the virus is nowhere within our land," groundnut farmer Allieu Kamara told AFP.

    "We are really worried that death has resulted from the case but we are hopeful that the huge presence of the various key players will bring back confidence to all of us."

    The deadliest outbreak in the history of the feared tropical virus wrecked the economies and health systems of the three worst-hit west African nations after it emerged in southern Guinea in December 2013.

    Sierra Leone was declared free of Ebola transmission on November 7 last year and Guinea on December 29.

    At its peak, it devastated Guinea, Liberia and Sierra Leone, with bodies piling up in the streets and overwhelmed hospitals recording hundreds of new cases a week.

    Rick Brennan, the World Health Organization's chief of emergency risk management, hailed the milestone but told reporters in Geneva that "the job is still not done", pointing out that there had already been 10 small flare-ups because of the persistance of the virus in survivors.

    UN chief Ban Ki-moon also warned the region can expect sporadic cases in the coming year but added "we also expect the potential and frequency of those flare-ups to decrease over time".

    Muted reaction

    Liberia, the country worst hit by the outbreak with 4,800 deaths, discharged its last two patients from hospital -- the father and younger brother of a 15-year-old victim -- on December 3, 2015.

    Africa's oldest republic was the last country still afflicted by the outbreak that infected almost 29,000 people and claimed 11,315 lives, according to official data.

    The real toll is suspected to be much higher, with many Ebola deaths believed to have gone unreported.

    After the last patient is declared in the clear, a 42-day countdown -- twice the incubation period of the virus -- begins before the country is proclaimed Ebola-free.

    Ebola causes severe fever and muscle pain, weakness, vomiting and diarrhoea. In many cases it shuts down organs and causes unstoppable internal bleeding. Patients often succumb within days.

    From a Guinean infant who was the first victim, the epidemic quickly spread into neighbouring Liberia and Sierra Leone, notching up more deaths than all other Ebola outbreaks combined.

    Liberia was first to be declared free of human-to-human Ebola transmission in May, only to see the virus resurface six weeks later.

    It was officially credited with beating the epidemic for a second time in September before another small cluster of cases emerged.

    Reaction to Thursday's announcement was muted in the capital Monrovia, where locals have become accustomed to good news on Ebola being followed by setbacks, and there was no official programme of celebration.

    rmj/ft/ach


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    Source: World Health Organization
    Country: Guinea, Liberia, Sierra Leone

    15 January 2016—A new case of Ebola has been confirmed in Sierra Leone, reflecting the ongoing risk of new flare-ups of the virus in affected countries.

    The Sierra Leone government acted rapidly to respond to this new case. Through the country’s new emergency operations centre, a joint team of local authorities, WHO and partners are investigating the origin of the case, identifying contacts and initiating control measures to prevent further transmission.

    The World Health Organization stressed in a statement yesterday (14 January), that Guinea, Liberia and Sierra Leone remain at high risk of additional small outbreaks of Ebola in the coming months due to the virus persisting in survivors after recovery.

    “We are now at a critical period in the Ebola epidemic as we move from managing cases and patients to managing the residual risk of new infections,” said Dr Bruce Aylward, WHO’s Special Representative for the Ebola Response, yesterday. “We still anticipate more flare-ups and must be prepared for them.”

    Sierra Leone is still in a 90-day period of enhanced surveillance following the declaration on 7 November 2015 of the end of Ebola transmission in the country. This period is designed to ensure no hidden chains of transmission have been missed and to detect any new flare-ups of the disease.


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    Source: World Health Organization
    Country: Guinea, Liberia, Sierra Leone

    Déclaration de l'OMS
    15 janvier 2016

    Un nouveau cas de maladie à virus Ebola a été confirmé en Sierra Leone, témoignant de la persistance du risque de résurgence du virus dans les pays affectés.

    Le gouvernement de Sierra Leone a agi rapidement face à ce nouveau cas. Par l’intermédiaire du nouveau centre national des opérations d’urgence, une équipe conjointe, composée des autorités locales, de l’OMS et des partenaires, enquête sur l’origine du cas, recherche les contacts et met en place des mesures de lutte pour éviter toute nouvelle transmission.

    Dans son communiqué de presse du 14 janvier, l’Organisation mondiale de la Santé a souligné qu’il y avait toujours un risque de nouvelles petites flambées d’Ebola dans les mois à venir en Guinée, au Libéria et en Sierra Leone à cause de la persistance du virus chez les survivants après la guérison.

    «Nous sommes à un moment critique de l’épidémie d’Ebola alors que nous passons de la prise en charge des cas et des patients à la prise en charge du risque résiduel de nouvelles infections», a déclaré hier le Dr Bruce Aylward, Représentant spécial de l’OMS pour la riposte à Ebola. « Nous prévoyons de nouvelles résurgences et nous devons nous y préparer.»

    La Sierra Leone se trouve encore dans la période de surveillance renforcée, d’une durée de 90 jours, après la déclaration de la fin de la transmission du virus Ebola dans le pays, le 7 novembre 2015. Cette période a été définie pour s’assurer qu’aucune chaîne de transmission n’est passée inaperçue et pour détecter toute nouvelle résurgence de la maladie.


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