Epidemiological and Surveillance Response to Ebola Virus Disease Outbreak in Lofa County, Liberia (March-September, 2014); Lessons Learned

Abstract

Ebola Virus Disease (EVD) outbreak was confirmed in Liberia on March 31st 2014. A response comprising of diverse expertise was mobilized and deployed to the country to contain transmission of Ebola and give relief to a people already impoverished from protracted civil war. This paper describes the epidemiological and surveillance response to the EVD outbreak in Lofa County in Liberia from March to September 2014. Five of the 6 districts of Lofa were affected. The most affected districts were Voinjama/Guardu Gbondi and Foya. By 26th September, 2014, a total of 619 cases, including 19.4% probable cases, 20.3% suspected cases and 44.2% confirmed cases were recorded by the Ebola Emergency Response Team (EERT) of Lofa County. Adults (20-50 years) were the most affected. Overall fatality rate was 53.3%. Twenty two (22) cases were reported among the Health Care Workers with a fatality rate of 81.8%. Seventy eight percent (78%) of the contacts successfully completed 21 days follow-up while 134 (6.15%) that developed signs and symptoms of EVD were referred to the ETU in Foya. The contributions of the weak health systems as well as socio-cultural factors in fueling the epidemic are highlighted. Importantly, the lessons learnt including the positive impact of multi-sectorial and multidisciplinary and coordinated response led by the government and community. Again, given that the spread of infectious disease can be considered a security threat every effort has to put in place to strengthen the health systems in developing countries including the International Health Regulation (IHR)’s core capacities. Key words: Ebola virus disease, outbreak, epidemiology and surveillance, socio-cultural factors, health system, West Africa.

Enhancing Ebola Virus Disease Surveillance and Prevention in Counties Without Confirmed Cases in Rural Liberia: Experiences from Sinoe County During the Flare-up in Monrovia, April to June, 2016

“…This finding may have been affected by community engagement activities, awareness and mentoring of the health workers, and improved availability of clinicians in the facilities during the flare-up. Similar findings were reported in Lofa County, Liberia, during the original outbreak in 2014, when more community deaths were reported to the health authorities to be investigated for EVD after community sensitization and acceptance 28 . The reasons for reduction of live alerts were not clear from our study, and the same may have occurred owing to the increased attention focused on the death alerts during the flare-up, considering that the reporting and investigation of live alerts was already high in the county before the flare-up.…”

Infection Rates and Risk Factors for Infection Among Health Workers During Ebola and Marburg Virus Outbreaks: A Systematic Review

“…Among the 5 major categories identified, “insufficient/incorrect use of personal protective equipment [PPE]” was the most frequently cited exposure risk. In many situations, deficiencies in PPE use arose from the lack of availability of appropriate equipment and/or the lack of training in PPE use during patient care, patient transport, and cleaning and environmental disinfection activities [ 5 , 6 , 9–11 , 18 , 22 , 24–26 , 28 , 32 , 36 , 38–40 , 42 , 43 , 50–54 , 56 , 58 , 61–65 , 69–74 , 78–80 , 85 , 86 ]. Less commonly, HWs were observed to engage in behavior such as rubbing the eyes [ 52 ], smoking [ 9 , 39 ], and using a mobile telephone [ 39 ], thus risking exposure to mucus membranes.…”

Integrating Non-clinical Data with EHRs

“…In the 2014 Ebola Virus Disease outbreak, self-reporting and close contact reporting was essential to create accurate disease outbreak maps [24]. The emergence of wearables is pushing both EHR manufacturers to develop frameworks that integrate data from wearable devices, and third party companies to provide cloud storage and integration of data from different wearables for greater analytic power.…”