Ebola epidemic--Liberia, March-October 2014

Abstract

On March 21, 2014, the Guinea Ministry of Health reported the outbreak of an illness characterized by fever, severe diarrhea, vomiting and a high fatality rate (59%), leading to the first known epidemic of Ebola virus disease (Ebola) in West Africa and the largest and longest Ebola epidemic in history. As of November 2, Liberia had reported the largest number of cases (6,525) and deaths (2,697) among the three affected countries of West Africa with ongoing transmission (Guinea, Liberia, and Sierra Leone). The response strategy in Liberia has included management of the epidemic through an incident management system (IMS) in which the activities of all partners are coordinated. Within the IMS, key strategies for epidemic control include surveillance, case investigation, laboratory confirmation, contact tracing, safe transportation of persons with suspected Ebola, isolation, infection control within the health care system, community engagement, and safe burial. This report provides a brief overview of the progression of the epidemic in Liberia and summarizes the interventions implemented.

FIGURE 1

Number of patients admitted to Ebola treatment units (ETUs), by county and week — Liberia, June 5–November 1, 2014 Abbreviation: ETU = Ebola treatment unit. * A) opening of ELWA2 ETU, B) opening of ELWA3 ETU and JFK ETU, C) opening of Bong ETU, D) safe burial teams trained and deployed in all counties, E) opening of Island Clinic ETU, F) opening of Nimba ETU, G) opening of MoD ETU. Not shown: openings of ELWA 1 ETU (April 2014), Margibi ETU (April 2014), and Lofa ETU (April 2014). ^† Margibi ETU opened in April but had no cases until August 8. No data were reported for October 1–21, 2014. ^§ Includes JFK, Island, ELWA-2, ELWA-3, and MoD ETUs.

FIGURE 2

Number of suspected and probable Ebola cases from MOHSW daily situation reports and locations of rapid response investigations,* by county, with inset showing case distribution in greater Monrovia — Liberia. October 25–November 3, 2014 Abbreviation: MOHSW = Liberian Ministry of Health and Social Welfare. * Grand Cape Mount County (Jene Wonde): 24 unexplained deaths; most recent probable or confirmed case on November 5; Grand Kru County (Parluken and Niaplapko): 21 deaths and 14 probable or confirmed cases; most recent probable or confirmed case on November 3; Grand Bassa County (John Logan Town): 17 unexplained deaths including two confirmed Ebola cases and one probable case; most recent confirmed case on October 25; Gbarpolu County (Geleyansiesu) : Six probable and 12 confirmed cases, including eight deaths, most recent confirmed case on November 6; Bomi County (Dorley-La and Gbah): Three confirmed and four probable cases, including five deaths; most recent confirmed case on November 3; Sinoe County (Government Camp): Three confirmed cases since October 31.

FIGURE 3

Number of laboratory tests performed and percent positive for Ebola, by week — Liberia, June 5–November 1, 2014.