GENEVA, Switzerland – The International Health Regulations (2005) Emergency Committee regarding Ebola virus disease (EVD) in West Africa met for a ninth time on 29 March. On the basis of the Committee’s advice and her own assessment of the situation, the WHO Director-General declared the end of the Public Health Emergency of International Concern regarding the Ebola virus disease outbreak in West Africa. The Committee noted that since its last meeting Guinea, Liberia, and Sierra Leone have all met the criteria for confirming interruption of their original chains of Ebola virus transmission. The Committee also noted that, although new clusters of EVD cases continue to occur as expected, including a recent and ongoing cluster in Guinea, all clusters to date have been detected and responded to rapidly.
Guinea was declared free of Ebola transmission linked directly to the original outbreak on 29 December 2015. On 17 March 2016 a cluster of 2 confirmed and 3 probable cases of Ebola virus disease was reported from the prefecture of N’Zerekore in south-eastern Guinea. Three further confirmed cases were reported on 21, 26, and 28 March, respectively. All confirmed cases had symptom onset in the sub-prefecture of Koropara. Cases reported on 21 and 26 March were high-risk contacts of the initial case-cluster; the contact status of the case confirmed on 28 March has not yet been reported. All 5 confirmed cases are epidemiologically linked to a chain of 3 probable cases in the subprefecture of Koropara: two females in their late 30s, and one male in his late 50s. All 3 probable cases died between 27 February and 15 March, and were not buried safely. Investigations have determined that the first probable case (a female in her late 30s) had symptom onset on or around 15 February 2016. The source of her infection is being investigated. Viral sequencing data indicate that virus present in the blood of one of the confirmed cases is closely related to virus that circulated in south-eastern Guinea in November 2014. 1033 contacts linked to the cluster have been identified so far, 171 of whom are considered to be high risk. All but 10 contacts have been traced. Response efforts have been reinforced by the redeployment of over 30 epidemiologists from western prefectures including the capital, Conakry. In addition, four villages are subject to cerclage measures, whereby individuals must report for regular check-ups and are not permitted to leave the immediate area of the village. Vaccination teams began vaccination of contacts and contacts of contacts on 22 March. Additional cases are likely because of the large number of contacts. One suspect case (reported 30 March) is currently under observation in an Ebola treatment center.
Not including individuals who have been tested as part of ongoing viral persistence studies, over 350 male survivors in Liberia have used semen screening and counselling services. In addition, over 2600 survivors in Sierra Leone have accessed a general health assessment and eye exam.
To manage the residual risks of Ebola reintroduction or re-emergence, WHO has supported the implementation of enhanced surveillance systems in Guinea, Liberia, and Sierra Leone to alert authorities to cases of febrile illness or death that may be related to EVD. In the week to 27 March, 1512 alerts were reported in Guinea from all of the country’s 34 prefectures. Over the same period, 9 operational laboratories in Guinea tested a total of 434 new and repeat samples from 19 of the country’s 34 prefectures. In Liberia, 861 alerts were reported from all of the country’s 15 counties. The country’s 5 operational laboratories tested 730 new and repeat samples for Ebola virus over the same period. In Sierra Leone 1220 alerts were reported from the country’s 14 districts in the week to 20 March. 911 new and repeat samples were tested for Ebola virus by the country’s 7 operational laboratories in the week to 27 March.