Ebola cases ebb a bit, with Conakry, Freetown as hot spots

The number of new Ebola cases in Guinea and Sierra Leone declined a bit last week, with much of the disease activity centered in the two capital cities for the second week in a row, the World Health Organization (WHO) said in its weekly epidemiologic update today.

Tests confirmed 26 Ebola cases among the two countries, 22 in Guinea and 4 in Sierra Leone. The total is down from 30 reported the previous week, but progress against the disease has been stagnant over the past several weeks, hovering around 25 to 30 cases. Officials, however, said they saw more hopeful signs in contact tracing.

No new cases were reported in Liberia.

Overall, the total in the three countries has reached 27,705 confirmed, probable, and suspected cases, including 11,269 deaths, according to the WHO.

Urban shift in Guinea, Sierra Leone

Fifteen of last week's 26 confirmed cases came from Conakry and Freetown. Over the past few weeks the pattern has shifted away from districts in the western parts of each country to the capitals. For example, previous recent hot spots—Boke district in Guinea and Kambia in Sierra Leone—haven't reported any cases for 18 and 9 days, respectively.

Conakry's cases were all in registered contacts from two transmission chains, and two involved healthcare workers. Other parts of Guinea that reported cases were Coyah, which had its first 2 cases since April, and Forecariah district, which confirmed 7 cases, only 1 of them from an unknown source.

One of Freetown's two cases was in a healthcare worker whose illness was detected while he or she was in a voluntary quarantine facility. The city's other case-patient had advanced disease, no known address, and the source of infection isn't known. Sierra Leone's other two cases were in Port Loko and were both linked to a transmission chain involving an infected woman who died during childbirth in the middle of June.

Overall, only 2 of this week's 26 cases were from unknown transmission chains, a sign that contact tracing and case investigation continue to improve.

A total of three healthcare worker Ebola infections were reported last week, bringing the outbreak total to 879, including 510 deaths.

Monitoring 56 in Liberia

Of the 6 infections that were detected in Liberia since Jun 29, 2 patients died, 2 have been discharged from the hospital, and 2 are still in observation in an Ebola treatment center, the WHO said. As of yesterday, 56 contacts were still being monitored.

The cluster's origin is still under investigation, but recent genetic sequencing tests pointed more toward reemergence from an Ebola survivor than an importation from Guinea or Sierra Leone.

Elsewhere, Italy was declared free of the virus on Jul 20, 42 days after the country's first and only patient tested negative and was discharged from the hospital. He is a nurse who got sick in May after serving in Sierra Leone.

See also:

Jul 22 WHO situation update

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