Ebola Situation Report – Guinea
During the week to 18 January, 6 of 20 (30%) new confirmed and probable cases in Guinea arose among known contacts. The north Guinean prefecture that borders Mali also reported its first case.
Uganda has prioritized prevention and detection activities. It has implemented a clear communication strategy and regularly publishes publicly available situation reports.
EVD is a pandemic
EVD is a severe, often fatal disease caused by Ebola virus. The virus is a member of the filovirus family and occurs in humans and non-human primates, including fruit bats (Pteropodidae). EVD outbreaks occur mainly in remote villages in Central Africa close to tropical rainforests. The 2014-2016 outbreak in West Africa was the largest and most complex since EVD first emerged in 1976.
During this outbreak, a large number of health and humanitarian actors worked together to contain the epidemic. They developed critical response infrastructure such as a functioning EOC and standardized operating procedures and protocols for field epidemiology, laboratory investigations, case identification and management, and contact tracing.
The outbreak also brought about significant economic and social disruption. The closure of businesses and schools affected the supply of labor, and restrictions on travel impacted the movement of goods. Additionally, health care workers were exposed to high levels of fear and stress. In the United States, mandatory quarantines were imposed on healthcare workers returning from West Africa.
EVD is a public health emergency of international concern
On August 8, 33 weeks into the world’s largest and longest outbreak of EVD, WHO declared this epidemic a “Public Health Emergency of International Concern.” This designation reflects the extraordinary event, the potential impact to other Member States through international spread of the disease, and the need for a coordinated, international response.
The global health community responded to the re-emergence of EVD with unprecedented coordination and cooperation. This was made possible by the unprecedented outbreak dynamics, including the re-emergence of EVD in densely populated urban areas and the rapid expansion to neighboring countries, all of which strained existing capacity for disease detection, control, and response.
In a highly complex and dynamic outbreak, it is important for States to reevaluate their risk assessment, travel recommendations, and laboratory capacities. They should also ensure that they are prepared to support the evacuation of citizens from affected or at-risk areas. They should also make plans to facilitate the return of EVD patients and their relatives to their homes.
EVD is a threat to international peace and security
After the re-emergence of Ebola virus disease (EVD), WHO has declared the outbreak a Public Health Emergency of International Concern (PHEIC). This is the highest level of alert and calls for a coordinated response from governments, humanitarian agencies, and other stakeholders.
In addition to increasing the vigilance of all actors, WHO recommends standard precautions in health care settings. These include avoiding needle-stick injuries, safe phlebotomy, hand hygiene, rational use of personal protective equipment, and regular and rigorous environmental cleaning and decontamination.
The deteriorating security situation in DRC and a high degree of mistrust among communities towards aid workers has significantly hampered the response to the outbreak. The fear that the epidemic might spread to South Sudan has also raised concerns. In order to mitigate this risk, DRC should strengthen its border controls with neighboring countries and promote community-based monitoring of EVD cases in the region. It should also increase the capacity of its health facilities to detect and manage EVD.
EVD is a human rights crisis
As EVD spreads, its impact on people’s mental health and well-being is increasingly evident. Humanitarian agencies are struggling to manage the psychological crisis caused by EVD. The epidemic is not a result of a lack of resources, but rather, the absence of proper planning and coordination. Distrust, shortage of staff, and fear of authorities have contributed to the spread of the disease.
States with active EVD transmission should activate disaster management plans and establish emergency operation centers. They should also mobilize healthcare workers and ensure that they have adequate supplies of personal protective equipment. They should also provide clear information about EVD transmission and prevention, while ensuring that traditional healers and community leaders are involved in risk communication.
In addition, all EVD cases should be isolated and treated, while exposed individuals should be monitored daily. They should be restricted from travel within the 21-day incubation period, unless they require medical evacuation. This will help to prevent the spread of the disease, and mitigate second-order impacts.