Guinea's most recent Ebola patient—a baby girl thought to be the outbreak's youngest—was discharged from the hospital over the weekend, while no new cases were reported in Liberia's recent cluster, though a few details are emerging about the investigation.
The baby girl had tested negative for a second time on Nov 16, which started Guinea's 42-day countdown toward Ebola-free status. However, at that time health officials said she would continue to receive specialized medical care before she returned home.
Sierra Leone was declared free of Ebola transmission on Nov 7, and Liberia's Ebola-free status ended on Nov 19 when tests confirmed Ebola in a 15-year-old boy, part of a family cluster of illnesses.
Baby received experimental antivirals, intensive monitoring
She was born on Oct 27 in a Doctors Without Borders (MSF) treatment center in Conakry to a 25-year-old woman who died from her infection. The mother and baby were part of a four-person family cluster in Guinea's Forecariah district that had links to the country's last known transmission chain.
Laurence Sailly, who heads MSF's emergency team in Guinea, told Reuters that staff and family members are celebrating the girl's release. She said the baby—named Nubia after an MSF nurse—received antivirals after having convulsions earlier in her illness course. She said the baby received two experimental antivirals: ZMapp, developed by Mapp Biopharmaceuticals, and GS-5734, developed by Gilead Sciences.
A monitoring system to track the baby's breathing and temperature helped minimize staff entries to the high-risk area, though they entered the area regularly for bottle feedings and diaper changes, according to the Reuters report. About 20 staff members provided around-the-clock care.
Liberia Ebola cluster developments
The number of patients in Liberia's recent family cluster remained at three, as new details emerged about the investigation into the source of the virus and the vaccine response to the new cases, according to Liberian media reports.
The family's mother was reportedly the first to feel ill, after she was hospitalized and given a blood transfusion after delivering a baby at home, AllAfrica news reported on Nov 27.
According to earlier reports, the mother tested positive for high levels of Ebola antibodies, which hinted at an earlier infection. The report last week from UNICEF also said the 2-month-old baby's antibodies were elevated, which it said could have come from the mother and not a recent infection.
Family members told AllAfrica that the woman's husband and their 15-year-old son, who died from his illness, started having symptoms days after the woman was released from a hospital in Paynesville, a suburb of Monrovia.
Ebola infections have been confirmed in the 40-year-old father and an 8-year-old son. Other family members are being monitored in an Ebola treatment center.
The three illnesses have raised questions about the source of the virus, which could be linked to persistent virus in a survivor, a reintroduction, or undetected transmission. However, a World Health Organization official said undetected transmission was unlikely, given how far Liberia was into its enhanced surveillance period. He said disease flares such as the one in Liberia are inevitable but rare, and reinforce the need for close surveillance and quick response in the outbreak region.
Meanwhile, more details emerged in a separate AllAfrica report about vaccination response to the outbreak. A Nov 26 report said Liberia's Partnership on Ebola Vaccines in Liberia (PREVAIL) has secured 1,700 doses of vaccine for health workers at three facilities: the Eternal Love Winning Africa (ELWA 2) Ebola treatment center, Duport Health Center, and John F. Kennedy Medical Center.
It said the health workers at those locations are among those managing the country's latest illness cluster.
The vaccine is VSV-EBOV, developed by Canadian researchers and licensed by NewLink Genetics and Merck, according to the report. It was shown to be highly effective in a ring vaccination trial in Guinea, and the study has also been extended to Sierra Leone.
Nov 29 Reuters story
Nov 17 CIDRAP News story "Guinea begins countdown to end of Ebola transmission"
Nov 27 AllAfrica report
Nov 26 AllAfrica report