On December 3, 2014 World Health Organization reported that the Ebola outbreak in Spain has been declared over but incidents may be increasing in Sierra Leone and probably in Guinea while it is stable to possibly declining in Liberia.
A Global Ebola Response and Monitoring Map is published at
Country by Country Reports
EVD refers to Ebola Viral Disease
77 confirmed new cases were reported during the week ending 30 November, compared with 148 cases in the week before.
Although this is apparently a stable situation with average new cases being about the same for 6 weeks or so, that isn’t the case, the outbreak is dying down in some regions but increasing in others so there is a potential for new outbreaks.
“The previous 3 weeks saw a large number of new cases in the eastern districts of N’Zerekore (6 new confirmed cases in the week to 30 November; 29 cases in the previous week), Macenta (15 new confirmed cases; 26 in the previous week), and Kankan (7 new confirmed cases; 7 in the previous week). The persistent transmission in Kankan, and the surrounding areas of Kerouane, Kouroussa and Kissidougo (figure 4), is of particular concern, because the local populations are likely to seek treatment in the north, and in neighbouring Mali in particular, rather than at existing facilities in the nearby south-eastern districts of Gueckedou (1 new confirmed cases in the week to 30 November) and Macenta.”
“The first case imported to Mali travelled from a city in the northern district of Siguiri, which borders Mali, and where there has been persistent transmission since early November (2 new confirmed cases this week; between 1 and 3 cases for the past 7 weeks). The lack of established EVD treatment and isolation facilities in this northern, Sahelian zone of the country, combined with a higher than usual degree of resistance among local communities to safe burial practices, make this area vulnerable to an increase in cases. “
“In the centre of the country, the district of Faranah, which borders the north Sierra Leonean district of Koinadugu, has reported an average of 8 cases per week for each of the past 4 weeks. In the west of the country, the capital, Conakry, reported 14 new confirmed cases in the week to 30 November (figure 1). Together with the neighbouring district of Coyah (15 new confirmed cases in the week to 30 November), Conakry has now reported an increase in the number of new cases during each of the past 2 weeks. Although 10 districts are yet to report a case of EVD, there has been a geographical expansion in transmission: as at 1 October, 9 districts had reported an infection during the past 7 days; as at 1 December 14 districts had reported an infection during the past 7 days).”
New case numbers have stabilized over 5 weeks but it had been declining from mid-September to mid-October so stability is not actually a good indication.
In the capital district (around Monrovia) there were 34 confirmed cases, accounting for 79% of all confirmed cases reported nationally in the week to 28 November. “Bomi (2 confirmed cases), Grand Bassa (4 confirmed cases), Grand Cape Mount (2 confirmed cases, compared with 21 the previous week), and Margibi (1 confirmed case) are the only other districts to report a case during the same period. The district of Lofa, in the north of the country and on the border with Guinea and Sierra Leone, reported no cases for the fifth consecutive week.”
EVD (Ebola) transmission is out of control with 537 new confirmed cases reported in the week to 30 November, more than all other regions combined. There were only 385 cases the previous week.
Freetown and surrounding areas are still the hardest hit.
Only the south is exempt, with “Bo (23 cases), Bombali (66 cases), Kambia (14 cases), Kono (15 cases), Koinadugu (6 cases), Moyamba (3 cases), Port Loko (94 cases), Tonkolili (40 cases), and Western Rural Area (72 cases).” High numbers of new confirmed cases. All but Moyamba had an increase in new cases compared with the previous week, although the trend is not accelerating.”
The bottom line is that the cumulative fatality rate is now running 73% overall but those hospitalized fair better with only a 60% fatality rate.
WHO Ebola update as of December 3, 17,145 confirmed ases, 6070 deaths
Since the bodies are highly infectious and burial customs in the region of West Africa often involved direct contact of the families with the deceased, safe burial is an essential in controlling the spread of Ebola.
“As at 23 November, 221 trained safe burial teams were operational: 50 teams in Guinea, 77 teams in Liberia, and 94 teams in Sierra Leone. Both Guinea and Sierra Leone now have more than 80% of planned trained safe burial teams in place, whilst Liberia has 77% of teams in place. However, based on the current number of reported deaths in each country, capacity exists to safely bury far in excess of 100% of reported EVD-related deaths. By contrast with the distribution of capacity to isolate and treat patients, the geographic distribution of safe burial teams is far more even across the three intense-transmission countries, though some more remote areas may still be under served.”
“During the week to 23 November there were 118 safe and dignified burials in Guinea, 73 in Liberia, and 372 in Sierra Leone. The International Federation of Red Cross and Red Crescent Societies (IFRC) is currently the only organization involved in safe burials across all three of the intense-transmission countries. The non-governmental organization Global Communities operates in Liberia, and Concern Worldwide operates in Liberia and Sierra Leone. Data on the number of safe burials to have taken place only includes burials done by IFRC and Global Communities. “