VHF Outbreak Situation in the West Africa Sub-region - Partner Update August 16, 2021 - ReliefWeb

VHF Outbreak Situation
        in the
West Africa Sub-region

      Partner Update
      August 16, 2021

Presentation outline
                Health Emergencies in AFRO

         VHF Situation update in West Africa sub-region

                      Risk assessment

                      WHO actions

                       Challenges

                    Required needs

Health Emergencies in AFRO
▪ Multiple health emergencies in the region

▪ COVID-19 pandemic in all 47 countries

▪ Recurrence of VHF in the sub-region
   – Ebola 2014-2016: Liberia, Guinea, Sierra Leone, Nigeria
   – Ebola 2021: DRC, Guinea

▪ Ongoing regional strategy to improve IHR core capacities
   – Member states supported to build IHR core capacities, conducted SIMEX, AAR,
     IAR and JEE

VHF Situation in West Africa Sub-Region

▪ 14 February 2021, Guinea declared an outbreak of EVD in
  Guéckédou prefecture, in N’zérékoré region
   – 23 cases (16 confirmed cases and 7 probable) including 12 deaths
   – Outbreak was declared over 19 June 2021
   – 45 days after the official declaration of end of EVD a case of Marburg
     was notified

▪ 9 August 2021, Marburg outbreak declared in Guinea

▪ 14 August 2021, EVD outbreak declared in Cote D’Ivoire

Risk Assessment
❖ The risk is assessed by WHO as very high at national and regional levels,
  but low at global level taking into consideration porous borders and fragile
  health systems
    – Unknown size and origin of the Marburg outbreak
    – Domestic travel and potential spread of Marburg to other parts of Guinea and
      neighbouring countries (Liberia, Cote D’Ivoire, Sierra Leone)
    – Confirmed Ebola outbreak in the commercial capital city, Abidjan, with close to 5
      million people
    – Travel history of the EVD case across two countries using public transport,
      complicating the contact tracing process

❖ The complexity of the VHF outbreaks in the current context pose a risk of
  regional spread

Marburg Epidemiological Situation
            Cases                    Map of Guinea showing location of confirmed case

➢ Marburg – 1 confirmed case

            Deaths
 ➢ Marburg – 1 death

            Contacts
➢ Marburg – 173 contacts listed (1
  missing high-risk contact)

Guinea – Marburg Outbreak (Grade 2)
❖3rd August 2021 – 46 year old man died in the Temessadou village, sample
 collected and tested positive for Marburg in Guéckédou laboratory

❖5th August 2021 – sample confirmed at the NPHL in Conakry

❖9th August 2021 - the IP Dakar confirmed it was Marburg and the MOH
 officially declared the Marburg outbreak

❖Affected area: Koundou Lengo Bengou sub-prefecture, Guéckédou
 prefecture, in N’zérékoré region
❖Affected area shares close borders with Sierra Leone and Liberia.

Cote D’Ivoire – Ebola Outbreak
               Cases
                                                         Map showing the itinerary of the patient
➢ Ebola – 2 cases (1 confirmed case and 1
  suspected case)

                Deaths
 ➢ EVD – 0 death

              Contacts
➢ Ebola - 9 contacts listed so far
 (3 family members and 6 hospital staff)

    Hospitalization
 ➢Ebola - 2 (01 – confirmed case, 01 – suspected case)

Cote D’Ivoire – Ebola Outbreak                             (Grade 3)

❖Index case – 18-year-old Guinean lady travelled by road from Labé, through Nzérékoré,
 Guinea to Abidjan, Côte d'Ivoire (although land borders are closed)

❖11th August – arrived in Abidjan by a bus from Ouaninou (CIV) close to the Guinea border
 (about 70 passengers)

❖12th August - patient was symptomatic upon arrival and was admitted at a hospital in Abidjan

❖14 August 2021- case confirmed positive for EVD at IP Côte d'Ivoire and MOH declared an
 EVD outbreak

❖Preliminary sequencing result shows a close match with the 2014 – 2016 West Africa EVD
 outbreak

❖High risk neighbouring countries identified are Ghana, Burkina Faso, Mali, Liberia and Guinea

Action taken by WHO
▪ Released US$ 500,000 CFE funds to each affected country to
  initiate the response
▪ Experts deployed to support the response activities
▪ 5,000 doses of vaccine arrived in CIV with 5 vaccination
  experts to support vaccination activities
▪ 50 monoclonal antibody treatments being delivered from
  Guinea (in process)
▪ One Health team deployed for ecosystem study related to
  source of infection

Major Issues/ Challenges
▪ Several countries in West Africa are experiencing a third wave of COVID-19,
  which is stretching the national capacity to respond to multiple outbreaks.

▪ Inadequate surveillance capacity:
    – the community alert system for reporting suspect Marburg and EVD cases is low and
      there are concerns about the quality of surveillance.
    – Contact tracing capacity and surveillance at Points of Entry
    – Intensive coordinated surveillance across Guinea and Cote d’Ivoire will be needed to
      account for all contacts and to determine the source of infection

▪ Variation in level of operational readiness across countries to respond to
  potential outbreaks.

▪ Inadequate resources to support the response activities

Priority Actions & Needs
▪ Ensure effective coordination at country and regional level to respond
▪ Strengthen cross border collaboration, including collaboration with regional
  and sub regional entities, to intensify surveillance and information sharing.
▪ Follow up and support readiness activities in neighboring countries for both
  events
▪ Finalize in-depth investigation for both events to identify the source of
  infection for optimal response.
▪ Mobilize resources (financial, technical and operational) to support both
  countries. Response plans are currently being developed.

Thank You