Ebola Situation Report

1 SUMMARY  In recent weeks, the decline in case incidence and the contraction of the geographic area affected by Ebola virus disease (EVD) transmission that was apparent throughout April and early May has stalled. In total, 31 confirmed cases of EVD were reported in the week ending 7 June: 16 cases in Guinea and 15 in Sierra Leone. This is the second consecutive weekly increase in case incidence, and the highest weekly total number of cases reported from Sierra Leone since late March. In addition, cases were reported from a widening geographical area in Guinea and Sierra Leone, and the continued occurrence of cases that arise from unknown sources of infection highlights the challenges still faced in finding and eliminating every chain of transmission.  A total of 16 cases were reported from 5 western prefectures of Guinea in the week to 7 June. Half of all cases were reported from the south western prefecture of Forecariah, which borders Sierra Leone. In the north west of the country, on the border with Guinea-Bissau, a case was reported from the prefecture of Boke for the fourth consecutive week. The capital, Conakry, reported 2 cases, as did the neighbouring coastal prefecture of Dubreka, with the remaining 3 cases reported from the inland prefecture of Kindia, which borders the Sierra Leonean district of Bombali. Conakry and Kindia had previously not reported a case for over 40 days.  A total of 5 of the 16 cases reported from Guinea arose from unknown sources of infection, including all 3 cases reported from Kindia. Investigations are ongoing to trace the origin of those cases. In addition, 3 cases in Guinea, including 1 of those from Kindia, were identified after post-mortem testing of community deaths. As at 7 June, there were 1693 contacts being monitored across 8 prefectures in Guinea.  Sierra Leone reported a total of 15 confirmed cases from 2 districts in the week to 7 June. Similar to the previous week, most cases (7) were reported from quarantined homes in a small area of Kaffu Bullom chiefdom in the district of Port Loko. However, a cluster of 3 cases was also reported from the Bureh Kasseh Ma chiefdom of the same district. The cases are not thought to be directly linked to Kaffu Bullom, but rather to a chain of transmission in the neighbouring district of Kambia. After reporting its first case in more than 2 weeks the previous week, 5 cases were reported from 2 chiefdoms in Kambia during the week ending 7 June.  The Western Urban Area of Sierra Leone, which includes the capital Freetown, reported no cases for the first time since August 2014. However, there were still 195 contacts under follow-up in the district as at 7 June, and a total of 392 contacts nationally in 3 districts (Kambia and Port Loko are the other 2 districts).  Efforts are ongoing to augment the ability of contact tracing and case-investigation teams to engage effectively with affected communities in Guinea and Sierra Leone. In Guinea, 19 unsafe burials were reported during the week to 7 June. Although no unsafe burials have been reported for many weeks in Sierra Leone, investigations into recent cases in Kambia have found clear evidence that they are still taking place in some areas. Improved communication with local communities is essential to understand and address any concerns that prevent cases and deaths from being reported, and chains of transmission from being detected.  All contacts associated with the case confirmed in Italy on 12 May have now completed the 21-day follow-up period.  The last health worker infections in Guinea and Sierra Leone were reported on 6 April and 14 May, respectively. There have been a total of 869 confirmed health worker infections reported from Guinea, Liberia, and Sierra Leone since the start of the outbreak, with 507 reported deaths. EBOLA SITUATION REPOR