Transcript update on cases

Ebola Virus Disease,
West Africa outbreak 2014
An update on cases
02/02/2015
To update slides with most recent figures,
please follow links and instructions provided in
the notes section of the relevant slides
Background – Ebola Virus Disease
• First discovered in 1976; two
simultaneous human outbreaks
– South Sudan
– Northern Zaire
(now Democratic Republic of the Congo)
– Latter in village near Ebola river,
from which disease takes its name
• 1976-2012: Several outbreaks
in African regions
Ebola outbreaks, 1976-2014
How does EVD outbreak 2014
compare with past outbreaks?
www.nytimes.com
EVD Outbreak 2014 – Key events
18 Mar: Guinea announces outbreak
20 Mar: Lab tests confirm Ebola
23 Mar: WHO notified of outbreak in Guinea
25 Mar: First WHO report released
31 Mar: Liberia reports confirmed case
06-Dec: Death of index case
2 year old, Meliandou village,
Guéckédou, Guinea.
Followed by deaths of his
mother, sister, grandmother
All retrospectively identified
01 Apr:
MSF warns outbreak
unprecedented
Dec 2013
Jan 2014
Feb 2014
Mar 2014
Apr 2014
EVD Outbreak 2014 – Key events
17 Jun: EVD cases now in
Liberian capital, Monrovia
12 May: EVD cases in
Guinean capital, Conakry
May 2014
25 Jul: Nigeria
reports first
EVD case
Jun 2014
Jul 2014
08 Aug: WHO declares PHEIC
12 Aug: Deaths >1,000
(WHO)
21 Aug: Two medically
evacuated cases in US,
successfully treated with
experimental therapy ZMapp
29 Aug: Senegal reports first
EVD case
Aug 2014
EVD Outbreak 2014 – Key events
06 Oct: First EVD case in Europe (nurse in
Spain)
08 Oct: Death of first US EVD case
12 Oct: Nurse tests positive in US
(2o case)
15 Oct: 2nd nurse tests positive in US
17 Oct: Outbreak declared over in Senegal
20 Oct: Outbreak declared over in Nigeria
23 Oct: First EVD case in Mali
28 Sept: First
EVD case in US
Sept 2014
02 Dec: Outbreak
declared over in Spain
29 Dec: First EVD case
diagnosed in UK
(Scottish nurse)
12 Nov: Three more
cases in Mali; no links
to first case
Oct 2014
Nov 2014
18 Jan : Outbreak
declared over Mali
Dec 2014
Jan 2015
How EVD outbreak has grown since
March 2014
Source: http://www.telegraph.co.uk/
Ebola Outbreak 2014 in West Africa
Affected countries
• Widespread transmission
– Sierra Leone
– Liberia
– Guinea
• Outbreak declared over
– Nigeria
– Senegal
– Mali
Number of EVD cases and deaths, 2014/2015
WHO update 28 January 2015
2917
1910
Guinea
Liberia
3686
Sierra Leone
Mali
8622
10518
3199
Widespread
and intense
transmission
8
6
Nigeria*
20
8
Cases
Senegal*
1
0
Deaths
Spain
1
0
UK
1
0
USA
4
1
Total
8810
22092
*Outbreaks declared over, Senegal (17 Oct) and Nigeria (20 Oct)
Cases of EVD by country, 2014/2015
WHO Update 28 January 2015
Country
Cases*
Deaths*
Guinea
2917
1910
Liberia
8622
3686
10518
3199
8
6
Nigeria
20
8
Senegal
1
0
Spain
1
0
United Kingdom
1
0
United States
4
1
22092
8810
Sierra Leone
Mali
Total
*Confirmed, probable or suspected but not repatriations
Geographical distribution of new cases and total cases in
Guinea, Liberia, and Sierra Leone
WHO Update 28 January 2015
FIGURE 3. Number of new cases of Ebola virus disease reported —
Guinea, Liberia, and Sierra Leone, November 9–30, 2014
Clinically compatible cases Guinea, Liberia and
Sierra Leone as of 25 Jan 2015
Source: Public Health England, 30 Jan 2015
Cases in Guinea, Liberia and Sierra Leone,
2014/2015
WHO update 28 January 2015
9000
7968
8000
Number of cases
7000
6000
5000
Confirmed
4000
3000
3138
0
Suspected
2569
2263
1864
2000
1000
Probable
3620
332
287
16
Guinea
Liberia
Sierra Leone
Number of new confirmed cases per report week,
21 September 2014 – 25 January 2015
Graphs from Public Health England EVD Epidemiological Update 30 January 2015
Case fatality rate, EVD outbreak 2014
WHO (10 Dec 2014):
• Case fatality rate 71%
Sierra Leone*:
• 74% CFR overall
• 57% CFR < 21 years
• 94% CFR >45 years
• Positive correlation between
viral load and risk of death
*Clinical illness and outcomes in patients with Ebola in Sierra Leone,
Schieffelin et al, NEJM, 29 Oct 2014
Clinical illness in first 106 patients with EVD,
Sierra Leone, May-June 2014 (n=106)
Schieffelin et al, NEJM, 29 Oct 2014
EVD cases and deaths in healthcare workers
WHO Update 28 January 2015
Country
Cases
Deaths
Guinea
162
Liberia
371
Sierra Leone
283
Mali
Nigeria
2
11
Spain
1
United Kingdom*
1
United States†
3
Total
*Case infected in Sierra Leone
†Two cases infected in US, one in Guinea
834
488
Non-repatriated cases of EVD outside of
West Africa, as of 28 January 2015 (n=6)
Date of
diagnosis
Country of
diagnosis
Country of
infection
Type
HCW Status
30 Sep 2014
USA
Liberia
Imported
No
Died
06 Oct 2014
Spain
Spain
Local
transmission
Yes
EVD free
11 Oct 2014
USA
USA
Local
transmission
Yes
EVD free
15 Oct 2014
USA
USA
Local
transmission
Yes
EVD free
23 Oct 2014
USA
Guinea
Imported
Yes
EVD free
29 Dec 2014
UK
Sierra Leone
Imported
Yes
EVD free
Medical evacuations and repatriations
from West Africa, as of 28 January 2015
• 32 individuals evacuated or repatriated (includes confirmed
cases or those with an Ebola exposure)
• 13 confirmed EVD cases
evacuated to Europe:
➢
Germany 3
➢ Spain 3
➢ France 2
➢ UK 1
➢ Norway 1
➢ Italy 1
➢ Netherlands 1
➢ Switzerland 1
Countries involved in the management of
EVD cases
www.wikipedia.com
Ongoing updates on the EVD situation available
at:
http://www.who.int/csr/disease/ebola/situati
on-reports/en/