Epidemiological update: Outbreak of Ebola haemorrhagic fever in Guinea, 27 March 2014

Epidemiological update

​An outbreak of Ebola haemorrhagic fever in Guinea, West Africa, with onset in early February 2014 is rapidly evolving. The first cases were reported from the Forested Region of south-eastern Guinea. ECDC published a Rapid Risk Assessment of the outbreak on 23 March at which time 80 cases including 59 deaths (CFR: 74%) had been reported.

Background

An outbreak of Ebola haemorrhagic fever in Guinea, West Africa, with onset in early February 2014 is rapidly evolving. The first cases were reported from the Forested Region of south-eastern Guinea. ECDC published a Rapid Risk Assessment of the outbreak on 23 March at which time 80 cases including 59 deaths (CFR: 74%) had been reported. To date, fifteen cases have tested positive for Ebola virus by PCR. Gene sequencing has demonstrated 98% homology with the Zaire Ebola virus last reported from an outbreak in 2009 in Kasai-Occidental Province of the Democratic Republic of Congo. The case fatality ratios in previously reported outbreaks caused by the Zaire Ebola virus have been high.

Update

On 27 March, fifteen new cases were reported to WHO, of which five were reported from Conakry, eight from Guéckédou district and two from Macenta district. Of the five cases reported from Conakry, four have been laboratory-confirmed and are isolated in a hospital while the fifth fatal case could not be tested. Investigations are underway to identify the source and route of transmission of these patients, record their travel histories before arrival in Conakry and determine their period of infectivity for the purpose of contact tracing. The five cases in Conakry are unlikely to have been infected in the capital. According to a media report quoting the Minister of Health in Guinea, the primary case in the Conakry cluster is an elderly man who developed haemorrhagic fever after visiting Dinguiraye in central Guinea and subsequently died. Four of the man’s brothers who attended his funeral in the central town of Dabola later developed symptoms and tested positive for Ebola on their return to Conakry. The four patients have been placed in an isolation ward in Donka hospital. The elderly man's family has been quarantined.

In summary, as of 27 March, 103 cases (15 laboratory-confirmed and 88 suspected) including 66 deaths (CFR: 64%) have been reported from three districts in south-eastern Guinea, Guéckédou, Macenta and Kissidougou, and from the capital, Conakry. Four of the fatal cases were healthcare workers. All age groups have been affected but most of the cases are adults aged 15-59 years.

As of 27 March, Liberia has reported eight suspected cases, including six deaths, and Sierra Leone has reported six suspected cases, including five deaths. All cases reported from Sierra Leone and Liberia had travel history to the affected districts in Guinea.Investigations and response activities are ongoing in Guinea, and isolation facilities have been set up in Guéckédou district. WHO and the Global Outbreak Alert and Response Network (GOARN) have deployed experts to support the operational response. Supplies and logistics required for supportive management of patients and all aspects of outbreak control are being mobilised.