Ebola Virus Disease. West Africa Dr Sylvie Briand. Pandemic and Epidemic Diseases department

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1 Ebola Virus Disease West Africa Dr Sylvie Briand 1

2 Haemorrhagic fever Incubation period: 2 21 days Symptoms: start with fever, intense weakness, muscle pain, headache and sore throat. Followed by vomiting, diarrhoea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding People are not contagious before they show symptoms Treatment is supportive but effective in reducing mortality: rehydration, intensive care Some potential specific treatment such as convalescent plasma and some antivirals Vaccines in development What is EVD? CFR for current outbreak: 55-60% 2

Ebola Outbreak History Since the discovery of Ebola in 1976 until December 2013: 23 outbreaks 2388 human cases and 1590 deaths As of 30 October 2014, Guinea, Liberia, and Sierra Leone have reported

3 Ebola Outbreak History Since the discovery of Ebola in 1976 until December 2013: 23 outbreaks 2388 human cases and 1590 deaths As of 30 October 2014, Guinea, Liberia, and Sierra Leone have reported 13,781 cases, including 4937 deaths Largest EVD outbreak ever recorded Country Year Number of cases Number of deaths Cote d Ivoire A few examples of previous EVD outbreaks Uganda Gabon DRC Uganda

4 Summary epidemiology in most affected countries as of 30 October 4

5 Epicurves in the most affected countries, as of 29 October 5

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8 Epidemiological situation in countries with an initial case or with localized transmission Several cases have been reported outside Guinea, Liberia and Sierra Leone: Country US 4 Spain 1 Mali 1 # of cases reported Senegal and Nigeria are Ebola-free since 17 and 20 October Unrelated outbreak in DRC: 66 cases and 19 days have passed since the last EVD case tested negative twice and was discharged 8

9 Characteristic and challenges of the current outbreak First Ebola outbreak in West Africa : lack of understanding within local communities, lack of experience among HCWs, and limited capacities for rapid response Unprecedented geographical spread global health security concern (by air or land): major 3 countries with intense transmission, including in capital cities and urban settings: Guinea, Liberia, Sierra Leone Several countries with imported cases Unrelated recent outbreak: Democratic Republic of Congo Burden on health systems: High number of health-care workers (HCWs) infected which impacts already weak health systems Specific protocols and IPC procedures for Ebola patients (isolation wards, PPE) 9

10 Pillars of WHO strategy Surveillance and contact tracing for early detection of cases Early isolation and care for patients Safe burials Laboratory diagnosis Community engagement 10

11 EBOLA in few words " Ebola is a 3-legged animal: politico- medico- social" quote from a paramount chief in Sierra Leone. "Community care is a ray of hope" " Ebola is a disease of contact. It affects the ones we love more". 11

12 Community engagement as a pillar to stop the outbreak High level of community exposure through cultural practices: Cousehold care Care preferences Customary burial procedures Misunderstanding of the disease and beliefs within communities including conspiracy theories lead to fear, panic and resistance to proposed response measures Community engagement means that communities are involved and empowered in outbreak control measures: Community monitoring and contact tracing Community Care (e.g. Community Care Centres for isolation) Safe and dignified burials 12

13 What needs to be done to fully engage communities? Better understanding of perceptions, beliefs and local practices, to address fear, misconceptions and stigma and work with the community to stop this outbreak with culturally accepted measures Development of training materials adapted to communities for community surveillance and monitoring, community care and safe and dignified burial practices Collaboration with faith based organisations and traditional healers. More engagement with teachers is needed 13

Ebola Virus disease in West Africa : challenges and lessons learned

Ebola Virus disease in West Africa : challenges and lessons learned Pr N. Shindo Dr S.C. Briand Pandemic and Epidemic Diseases Department WHO Geneva EVD outbreak in West Africa in Numbers From24 March