For the second week in a row, Ebola cases remained at zero in West Africa's outbreak region, but the threat of more cases still looms, with response workers still tracing case contacts, many of whom are in the high-risk category, the World Health Organization (WHO) said today.
The agency also acknowledged the case of a Scottish nurse who was hospitalized for late Ebola-related complications and is now said by UK officials to be in critical condition.
Guinea following 150 contacts
In its weekly update, the WHO said the outbreak region has now gone 11 straight weeks with five or fewer confirmed cases.
Guinea is still following 150 contacts in Forecariah district, including 118 who were thought to have high-risk exposure. All of the contacts are linked to a transmission chain centered in Conakry's Ratoma neighborhood. In addition, officials are still trying to locate 259 contacts in the country, most of them in Conakry and Forecariah.
Meanwhile, Sierra Leone has gone 4 consecutive weeks without a new case, the WHO said. Though all contacts in its two most recent transmission chains have completed their follow-up periods, public health workers are still trying to find two high-risk contacts—one from Bombali district and the other from Kambia district. It added that efforts to locate them will continue until 42 days have passed (two incubation periods) since the last reported case in each district.
Overall, the outbreak countries have reported 28,454 confirmed, probable, or suspected cases since the outbreak began in early 2014. The number of deaths is at 11,297.
Nurse's condition critical
Meanwhile, the condition of a Scottish nurse who is hospitalized in London with late Ebola-related complications has been downgraded from serious to critical, Royal Free Hospital said today in a statement. Pauline Cafferkey got sick with Ebola in Scotland in late December after working at a treatment center in Sierra Leone and was treated at the same hospital before she was released in late January after blood tests showed she was clear of the virus.
Today's WHO report said she was hospitalized again on Oct 6, and the hospital statement says she was first admitted to Queen Elizabeth University Hospital in Glasgow, then transferred to Royal Free Hospital on Oct 9, where she is being treated in its high-containment unit.
Little information is available on the scope of her illness or if tests show that she is infected with Ebola again. Survivors can harbor the virus in immune-protected areas of the body, and the complications from Ebola—such as joint pain and eye problems—can be debilitating.
Two days ago Scottish health officials announced that 58 close contacts had been identified and that the VSV-EBOV vaccine was offered to 40 who were thought to have had contact with the woman's body fluids. Twenty-five of them accepted the vaccine, with 15 declining or unable to receive it due to medical contraindications.
Today's WHO update on Ebola says that as of yesterday 62 close contacts have been identified for follow-up in the United Kingdom.
Oct 14 WHO situation update
Oct 14 Royal Free Hospital statement
Oct 13 CIDRAP News story "Contacts of hospitalized UK nurse got Ebola vaccine"