Location/Time: Guinea, West Africa – reporting lag (11/8/2015);
Disease: Ebola Virus Disease (EVD)
Recap/Hazard Description: A transmission chain in Forecariah, Guinea continues to lead to new cases, and contacts from this chain are being traced in Forecariah and Conakry. Tanah, Guinea is also under surveillance due to cases in the past two months. In the past month, the W.H.O. has reported 7 new cases of EVD in Guinea, while declaring Sierra Leone transmission free. Guinea remains the only country in West Africa with an ongoing outbreak of EVD. However, indications of inadequate surveillance, community disregard for proper preventative measures, and the proximity of Forecariah to the Sierra Leone border mean that the region is not all clear from an EVD threat.
Relevance: The EVD outbreak in West Africa remains an outbreak of international concern. The CDC is continuing to funnel travelers from Guinea and Sierra Leone through 1 of 5 airports in the US with enhanced security measures. EVD continues to transmit over 18 months after initial infection, indicating a failure to garner local support and provide adequate surveillance measures. Regional and international transmission is still a potential threat. Recent reporting also suggests that EVD can survive in the body for months after infection, and can be transmitted sexually in people carrying the virus. It is unclear to what extent, if any, transmission from survivors occurs, and therefore creates uncertainty in the context of a country being declared “Ebola free”.
Current vs. Forecast: The current case count is low. Incidence in the region in the past 14 weeks has been below 5 cases/week. At this point, elimination of the disease is contingent on the ability of public health response teams to garner local support and conduct adequate surveillance of cases and case contacts.
Guidance: With Liberia and Sierra Leone declared virus-free, travel to Monrovia and Freetown is cleared, while Conakry and Guinea still pose a risk, albeit small, for international travel. Awareness if/when traveling in the region is highly advised.
Final observation: EVD transmission remains an outbreak of international concern due to its highly fatal and disruptive nature. Guinea is the only country in West Africa with ongoing disease transmission. Forecariah is a current hotspot of disease activity – close to Conakry and the border with Sierra Leone. Critical to eliminating the spread of disease will be garnering community support for EVD awareness and preventative measures, and scaling surveillance to trace all contacts of known transmission chains.