Ebola Outbreak in West Africa

Update
23 July 2014
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21 July 2014
What is Ebola virus ?

Is a member of the virus family Filoviridae, including:

Marburgvirus single virus species
Marburgvirus

Ebolavirus 5 viruses
Ebola (Zaire)
Sudan
Bundibugyo
Tai Forest
Reston*

*has caused disease in nonhuman primates, but not in humans
What is Ebola virus disease?
Incubation period: 8-10 days (rarely from 221 days)
Abrupt onset
Fever, headache, chills, weakness, and body aches
GI symptoms common: vomiting, diarrhea, abdominal pain
Hemorrhagic symptoms in ~ 45% of cases
Mild: bruising, nose bleed, etc.
Severe: bloodily stools, multi-organ shock
Less commonly seen: rash (trunk, shoulders), red eyes,
sore throat, cough, hiccups

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Ebolavirus ecology
Main features of Ebola Virus Disease
outbreaks
Spillover events are generally rare
Hunting, exposure to dead wildlife or preparation of bush
meat for consumption
Most outbreaks associated with waves of
person to person transmission
Direct contact with sick person or their body fluids
Nosocomial transmission in resource poor clinics and hospitals
(limited PPE; reuse of needles)
Care givers in the home
Funeral practices
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Distribution of previous EVD Outbreaks
Majority of outbreaks
are due to Ebola virus
(species Zaire ebolavirus)

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745
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Country Town Cases Deaths Ebolavirus Year
Dem. Rep. of Congo Yambuku 318 280 Ebola virus 1976
South Sudan Nzara 284 151 Sudan virus 1976
Dem. Rep. of Congo Tandala 1 1 Ebola virus 1977
South Sudan Nzara 34 22 Sudan virus 1979
Gabon Mekouka 52 31 Ebola virus 1994
Ivory Coast Tai Forest 1 0 Ta Forest virus 1994
Dem. Rep. of Congo Kikwit 315 250 Ebola virus 1995
Gabon Mayibout 37 21 Ebola virus 1996
Gabon Booue 60 45 Ebola virus 1996
South Africa Johannesburg 2 1 Ebola virus 1996
Uganda Gulu 425 224 Ebola virus 2000
Gabon Libreville 65 53 Ebola virus 2001
Republic of Congo Not specified 57 43 Ebola virus 2001
Republic of Congo Mbomo 143 128 Ebola virus 2002
Republic of Congo Mbomo 35 29 Ebola virus 2003
South Sudan Yambio 17 7 Ebola virus 2004
Dem. Rep. of Congo Luebo 264 187 Ebola virus 2007
Uganda Bundibugyo 149 37 Bundibugyo virus 2007
Dem. Rep. of Congo Luebo 32 15 Ebola virus 2008
Uganda Luwero District 1 1 Sudan virus 2011
Uganda Kibaale District 11* 4* Sudan virus 2012
Dem. Rep. of Congo Isiro Health Zone 36* 13* Bundibugyo virus 2012
Uganda Luwero District 6* 3* Sudan virus 2012
Guinea, Sierra Leone,
Liberia
multiple 745* ? Ebola virus 2014
*Reflects confirmed
cases only
Efforts to stop VHF outbreak
Find active cases in clinics/hospitals and communities
Get cases into isolation ward to provide care, prevent transmission and
protect health care workers
Real time virus diagnostics (field lab or regional lab)
difficult to clinically identify Ebola virus disease cases
Find contacts and follow for 21 days
If contact becomes febrile into treatment center; test; isolate if positive
Risk reduction messages to community and health centers
Avoid close contact with sick people; report suspect VHF cases
Dont eat bush meat; avoid contact with bats

Current EVD Outbreak
in West Africa

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Ebola Response Update for 16 July 2014
Total
1048 cumulative
cases
(632 deaths)
745 confirmed
cases
(422 deaths)

Total reported cases of EVD, as of 17 July 2014
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Guinea
410 cumulative cases (310 deaths)
301 confirmed cases (203 deaths).
Sierra Leone
442 cumulative cases (206 deaths)
368 confirmed cases (165 deaths).
Liberia
196 cumulative cases (116 deaths)
76 confirmed cases (54 deaths).

http://www.cdc.gov/vhf/ebola/outbreaks/guinea/index.html
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Distribution of
EVD cases
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Epidemiology
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Date of Situation Report
Cumulative Confirmed Cases by Date
in Guinea, Liberia, & Sierra Leone
Guinea
Liberia
Sierra Leone
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Guinea Case Chronology
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Epidemiology
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Ebola Response Update for 16 July 2014
Representatives from: Cote dIvoire, DRC, Gambia, Ghana,
Guinea Bissau, Liberia, Mali, Nigeria, Senegal, Sierra Leone,
and Uganda; WHO; CDC; NGOs
Output: Strategy for Accelerated Response to Ebola
Outbreak in West Africa
Identified issues with reaching recalcitrant villages
Need for enhanced case identification & contact tracing
Regional Ebola Response Centre (Conakry, Guinea) activated
16 July
WHO Special Ministerial Meeting, Accra, Ghana 2-3 July
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http://www.who.int/features/2014/emergency-response-ebola/en/
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Ebola Response Update for 16 July 2014
Improved case finding, contact identification and follow up in
each country
Improved database management (Epi Info VHF module utilization)
to facilitate objective 1.
Improved health messaging in the affected rural areas,
particularly targeting uncooperative communities
Improved coordination with WHO, MSF, Country MOHs and other
USG partners
Approach:
Strong surge needed. Target of 50 epidemiology and health
communications staff and EISO/FETP deployed to affected area
in next 30 days

30 day objective for Ebola Response EOC activation
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Ebola Response Update for 16 July 2014
Level 2: Alert, Practice enhanced precautions
CDC recommends that travelers avoid contact with blood
and body fluids of infected people to protect themselves.

http://wwwnc.cdc.gov/travel/notices
Guinea: http://wwwnc.cdc.gov/travel/notices/alert/ebola-guinea
Liberia: http://wwwnc.cdc.gov/travel/notices/alert/ebola-liberia
Sierra Leone: http://wwwnc.cdc.gov/travel/notices/alert/ebola-sierra-leone

Information for Travelers
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Ebolavirus webpage: http://www.cdc.gov/vhf/ebola/index.html

Outbreak webpage:
http://www.cdc.gov/vhf/ebola/outbreaks/guinea/index.html
Map: http://www.cdc.gov/vhf/ebola/resources/distribution-map-guinea-
outbreak.html
Ecology poster: http://www.cdc.gov/vhf/ebola/resources/virus-ecology.html
Radio messages (10 languages):
http://www.cdc.gov/vhf/ebola/outbreaks/guinea/radio-spots.html
Print materials: coming soon
Resources
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