Sierra Leone: Ebola Situation Report - 1 April 2015

SUMMARY

• A total of 82 new confirmed cases of Ebola virus disease (EVD) were reported in the week to 29 March, a slight increase compared with 79 cases the previous week. Case incidence in Guinea increased to 57, compared with 45 the previous week. This offset a fourth consecutive weekly fall in case incidence in Sierra Leone, which reported 25 confirmed cases. Liberia reported no confirmed cases over the same period.
  
• In addition to an increase in case incidence in Guinea, the geographic area of transmission also increased. A total of 7 Guinean prefectures reported at least one confirmed case in the week to 29 March, compared with 3 the previous week. Two of the 7 prefectures that reported a new confirmed case, Fria and Siguiri, did so for the first time in over 50 days. Siguiri, which borders Mali, is the first prefecture outside the western area of Guinea to report a confirmed case for over 30 days.
  
• In Sierra Leone, cases were reported from 5 northern and western districts around and including the capital Freetown, which reported 10 new confirmed cases. The neighbouring districts of Bombali (1 case), Kambia (5 cases), Port Loko (6 cases) and Western Rural (3 cases) also reported cases.
  
• Response indicators for Guinea present a mixed picture. Of 35 confirmed deaths from EVD in the week to 29 March, 15 (43%) were identified post-mortem in the community, compared with 10 of 37 (27%) the previous week. This increase may be attributable to improved access to communities in Forecariah prefecture. The proportion of confirmed cases that arose among registered contacts increased from 38% in the week to 15 March to 53% in week to 22 March. A total of 20 unsafe burials were reported in the week to 29 March, compared with 26 the previous week.
  -A 45-day state of health emergency has been declared in the Guinean prefectures of Forecariah, Coyah, Dubreka, Boffa, and Kindia. The capital, Conakry, will also be subject to emergency measures, which include the restriction of movement in areas of transmission, the temporary closure and quarantine of private hospitals and clinics where EVD cases have been detected, and limitation of burial participation to close relatives only. All corpses will be tested for EVD during the 45-day emergency period.
  
• The last confirmed case in Liberia passed away on 27 March. Investigations are ongoing to establish the origin of infection. A total of 185 contacts associated with the case are being monitored twice a day. Heightened vigilance is being maintained throughout the country. In the week to 29 March, 278 laboratory samples were tested for EVD, with no confirmed cases.
  
• In the week to 29 March, 67% of confirmed cases in Sierra Leone came from registered contacts, compared with 84% the previous week. There was one report of an unsafe burial over the same period. The proportion of confirmed deaths from EVD that were identified in the community increased slightly, from 7 of 56 (13%) in the previous week to 8 of 52 (15%) in the week to 29 March. Heightened surveillance is being maintained: over 100 suspected cases were reported in the week to 29 March, compared with 57 the previous week. The majority of suspected cases (52) were reported during the final 2 days of the 3-day stay-at-home.
  
• There were 8 new health worker infections in the week to 29 March: 7 in Guinea, and 1 in Sierra Leone. This brings the total number of health worker infections reported across the three most-affected countries since the start of the outbreak to 861, with 495 deaths.