December 18, 2015

HIGHLIGHTS

• No EVD cases reported in West Africa in nearly one month
• All contacts in Liberia complete 21-day monitoring period
• USAID/OFDA partners support adherence to IPC protocols in Liberia
• DART works to bolster PPE pipeline in Guinea

KEY DEVELOPMENTS

• The Government of Liberia (GoL), the USG Disaster Assistance Response Team (DART), and relief organizations continue to lead response efforts linked to mid-November cases of Ebola Virus Disease (EVD) in Liberia’s Montserrado County. All contacts linked to the EVD cases completed their 21-day monitoring period on December 10, with no contacts remaining under precautionary observation.
• A USAID/OFDA health advisor traveled to Sierra Leone during the week of November 30 to assess the ongoing EVD response transition. The advisor briefed the U.S. Ambassador to Sierra Leone and met with the DART, CDC, the UN, and USAID/OFDA partners.
• As of December 18, the governments of Guinea, Liberia, and Sierra Leone had not reported a confirmed EVD case since the week of November 15.

Liberia

All 166 primary contacts—including at least 10 health care workers and 13 community members classified as high-risk contacts—linked to the mid-November EVD cases completed their 21-day monitoring period on December 10. As part of the ongoing EVD response effort, the GoL and the U.S. National Institutes of Health had provided EVD vaccines— via the Partnership for Research on Ebola Vaccines in Liberia (PREVAIL) project—to more than 200 individuals associated with the cluster as of December 11, according to the UN World Health Organization (WHO).

USAID/OFDA partners, including the International Medical Corps (IMC), John Snow, Inc. (JSI), and MENTOR Initiative, continue to monitor staff adherence to infection prevention and control (IPC) protocols at more than 70 Montserrado health facilities considered at risk for EVD transmission related to the recent cases. Known as a ring IPC approach, the strategy ensures that health facilities likely to receive additional EVD-affected patients adhere to IPC protocols such as triage and isolation. In addition to support for monitoring, USAID/OFDA partners are providing IPC mentorship at 21 health facilities. For example, JSI is conducting daily mentorship and bolstering screening and waste management procedures at seven health facilities.

On November 30, the GoL Ministry of Health, the UN Children’s Fund (UNICEF), and other EVD response actors conducted seven social mobilization trainings in Montserrado and deployed more than 450 general community health volunteers to disseminate EVD-related messages, including general information about the virus, the importance of community monitoring and reporting, and continued adherence to EVD prevention methods such as hand washing.

On December 18, the Office of the UN High Commissioner for Refugees (UNHCR) resumed the voluntary repatriation of Ivorian refugees residing in Liberia—a UNHCR-led process that began in late 2012. The EVD outbreak and subsequent closure of the Côte d’Ivoire–Liberia border interrupted the program and forced UNHCR to suspend refugee returns in July 2014. According to UNHCR, approximately 11,000 of the 38,000 Ivorian refugees in Liberia have expressed a desire to return immediately to Côte d’Ivoire, and more than 1,000 refugees are expected to return by the end of 2015. UNHCR plans to provide transportation and reintegration support, including emergency relief commodities and livelihoods assistance, to facilitate the process.

In FY 2015, USAID/FFP provided more than $8.9 million to the UN World Food Program (WFP) to deliver food assistance to Ivorian refugees in Liberia. USAID/FFP also provided more than $3.6 million in FY 2015 to WFP to support refugee returnees and host communities in Côte d’Ivoire.

Sierra Leone

The Government of Sierra Leone (GoSL) has not reported a confirmed EVD case in approximately three months. The most recent EVD case—identified in mid-September—recovered and tested negative for EVD by September 27.

During the week of November 30, a USAID/OFDA health advisor traveled to Sierra Leone to assess the EVD response transition from emergency operations to long-term residual response capacity. During the visit, the health advisor met with representatives from the DART, CDC, international donors, the UN, and USAID/OFDA partners. The health advisor also briefed U.S. Ambassador to Sierra Leone John F. Hoover on the current situation.

On December 14, the National Ebola Response Center (NERC) presented a contingency plan for responding to potential EVD outbreaks in Sierra Leone, which maps existing isolation and treatment capacity across the country. As of midDecember, Sierra Leone’s isolation capacity at non-EVD health facilities for suspected cases included approximately 40 beds in three facilities in Western Area Region. Three EVD treatment units (ETUs), including a mobile ETU, also maintained isolation and treatment capacity for more than 100 patients. The mobile ETU, operated by the Republic of Sierra Leone Armed Forces, can deploy within four days and treat at least 36 patients, according to the NERC. In the coming weeks, the GoSL plans to develop standard operating procedures and trigger mechanisms for deploying the mobile ETU. The UN Office for Project Services also plans to provide additional isolation units at district hospitals across the country by mid-2016.

Guinea

The Government of Guinea (GoG) has not reported a confirmed EVD case in more than six weeks, with the most recent EVD-positive case—identified in late October—recovering and testing negative for EVD by November 17.

On November 27, the GoG—with support from USAID/OFDA partners UNICEF and WHO—held a workshop in the capital city of Conakry regarding how to improve access to vaccines against viral hemorrhagic fevers, including EVD. Workshop participants included scientists, public health experts, biomedical research institutions, pharmaceutical companies, and international organizations, according to the UN. The discussions assessed current research efforts, production and marketing constraints, and approval and certification procedures for vaccines in case of an epidemiological emergency.

As part of the national EVD surveillance strategy, the GoG and EVD response actors continue to test blood samples or oral swabs from recently deceased individuals who exhibited clinical symptoms compatible with EVD, including fever, fatigue, muscle pain, headaches, vomiting, and diarrhea. The GoG reported more than 1,000 community death alerts during the week of December 7—approximately 45 percent of the nearly 2,250 anticipated community deaths based on population estimates and the crude mortality rate in Guinea, according to WHO. Eight operational laboratories, including one supported by the USG, tested more than 580 specimens for EVD during the same period. 

Through consultations with the GoG, WHO, and other EVD response actors, the DART is working to resolve ongoing personal protective equipment (PPE) logistical challenges. Ensuring consistent PPE stocks at health facilities enables USAID/OFDA partners and other EVD response actors to continue IPC training for health care workers—an essential element for strengthening local capacity to respond safely to possible EVD transmission.

PUBLIC DONATION INFORMATION

• The most effective way people can assist relief efforts is by making cash contributions to humanitarian organizations that are conducting relief operations. A list of humanitarian organizations that are accepting cash donations for disaster responses around the world can be found at www.interaction.org.
• USAID encourages cash donations because they allow aid professionals to procure the exact items needed (often in the affected region); reduce the burden on scarce resources (such as transportation routes, staff time, and warehouse space); can be transferred very quickly and without transportation costs; support the economy of the disaster-stricken region; and ensure culturally, dietary, and environmentally appropriate assistance.

More information can be found at:

• The Center for International Disaster Information: www.cidi.org or +1.202.821.1999.
• Information on relief activities of the humanitarian community can be found at www.reliefweb.int.

USAID/OFDA bulletins appear on the USAID website at what-we-do/working-crises-and-conflict/responding-times-crisis/where-we-work