Ebola Situation Report

1 SUMMARY  There were 20 confirmed cases of Ebola virus disease (EVD) reported in the week to 28 June, the same as the previous week. Weekly case incidence has been between 20 and 27 cases for 5 consecutive weeks. In Guinea, 12 cases were reported from 3 prefectures: Boke, Conakry, and Forecariah. All 3 prefectures reported cases the previous week. In Sierra Leone, 8 cases were reported from the same 3 districts as the previous week: Kambia, Port Loko, and the district that includes the capital, Freetown. Challenges tracing and monitoring contacts continue to hamper efforts to end transmission, with a proportion of cases not detected until after death, increasing the risk of further transmission.  On 29 June, routine surveillance detected a confirmed case of EVD in Margibi County, Liberia—the first new confirmed case in the country since 20 March. The case is a 17-year-old male who first became ill on 21 June. After presenting at a local health facility the patient was treated for malaria and discharged. He died on 28 June and received a safe burial the same day. An oral swab taken before the burial subsequently tested positive twice for EVD. 102 contacts have been identified, although that number is expected to increase as investigations continue. At this stage the origin of infection is not known. The case reportedly had no recent history of travel, contact with visitors from affected areas, or funeral attendance.  All 3 Guinean prefectures that reported cases in the week to 28 June have reported cases for the past 4 weeks or more, although the area and nature of transmission within those prefectures continues to change. In the northern prefecture of Boke, which borders Guinea-Bissau, 9 of 10 cases were registered contacts. One of these cases is a health worker. The remaining case from Boke is from the coastal sub-prefecture of Kamsar. This case is also a health worker and has generated a substantial number of high-risk contacts. The single case reported this week from Conakry came from the Dixinn commune (municipal district) of the city, and arose from an unknown source of infection. Dixinn is the third commune of Conakry to report a case in the past 4 weeks—the others being Matam and Matoto. The remaining case was reported from the prefecture of Forecariah and was a registered contact of a previous case.  Transmission in Sierra Leone remains concentrated in several chiefdoms of Kambia and Port Loko districts, and a single neighbourhood of the capital, Freetown. Half (4) of the 8 cases reported from Sierra Leone arose in the densely populated Magazine Wharf area of Freetown, all of whom have a known link to a case reported from the area the previous week, although the origin of that case is not yet known. Both of the cases reported from the district of Kambia came from quarantined homes in the chiefdom of Tonko Limba. The remaining two cases were reported from two chiefdoms in the district of Port Loko. One of these cases, which was reported from the chiefdom of Masimera, is linked to the Magazine Wharf chain of transmission.  Ten of the 12 cases reported from Guinea and 4 of the 8 cases reported from Sierra Leone in the week to 28 June were registered contacts of previous cases. Five of the 20 cases reported were identified after postmortem testing of community deaths.  Two new health worker infections were reported from Boke, Guinea, for a second consecutive week. No new health worker infections were reported from Sierra Leone. There have been a total of 874 confirmed health worker infections reported from Guinea, Liberia, and Sierra Leone since the start of the outbreak, with 509 reported deaths. EBOLA SITUATION REPOR