Disease

Ebola virus disease, West Africa – update

The evolution of the Ebola virus disease outbreak in Guinea, Sierra Leone and Liberia remains a serious concern as primary and secondary viral transmissions continue to occur in both urban and rural communities. Analyses of the current trend and the potential risk factors for the continuing spread of this epidemic have been conducted. The major factors responsible for continuous propagation of EVD outbreak in the sub-region include:

1. Some negative cultural practices and traditional beliefs, resulting into mistrust, apprehension and resistance to adopt recommended public health preventive measures. The implication of this include poor health care seeking behaviour such as hiding of EVD patients, home-based management of EVD patients, and customary treatment of dead bodies. These are very high risk practices leading to extensive exposures to Ebola virus in the community. Consequently, community deaths continue to be reported. In addition, the potential contacts to the EVD patients managed at home and exposures during customary burial procedures are not systematically identified and put under observation (very critical measures for containment of community transmission of Ebola virus). This is therefore a major factor amplifying the outbreak.

2. The extensive movement of people within and across borders has facilitated rapid spread of the infection across and within the three countries. The homogeneous community living along the border areas have common socio-cultural activities that enhance viral transmission e.g. visiting sick relatives or attending to burial ceremonies of relatives across the border. In addition, the cross border movement has complicated tracking and follow up of contacts, with several contacts loss to follow up.

3. Currently, the coverage of effective outbreak containment measures is not comprehensive. The unprecedented geographical expanse of the EVD outbreak in the three countries requires enormous and robust response capacity and structures in terms of human capital, financial, operational and logistics requirements. This is the first major EVD outbreak in West Africa and the affected countries had weak capacity and structures for epidemic preparedness and response, particularly for viral haemorrhagic fever. Lastly, the apprehension of some communities limits access to affected population with effective outbreak control measures.

Middle East respiratory syndrome coronavirus (MERS-CoV) – update

On 30 June and 1 July 2014, the National IHR Focal Point for Saudi Arabia reported an additional 3 laboratory-confirmed cases of infection with Middle East respiratory syndrome coronavirus (MERS-CoV), and a death in a previously reported case.