Notes from The Field: Ebola Virus Disease Cluster — Northern Sierra Leone, January 2016

Alpren, Charles; Sloan, Michelle L.; Boegler, Karen A.; Martin, Daniel W.; Ervin, Elizabeth; Washburn, Faith; Rickert, Regan; Singh, Tushar; Redd, John T.; Bangalie, Andrew; Bass, Micah; Bennett, Sarah; Boateng, Isaac; Campbell, Deanna; Cassell, Cynthia H.; Cotton, Matt; Duffy, Nadezhda; Goodfellow, Ian; Hersey, Sara; Jackson, Eddie; Jah, Umaru; Jimissa, Augustine S.; Kamara, Ansumana S.; Kamara, Fatmata; Kellam, Paul; Levine, Rebecca; Meredith, Luke; Miller, Leigh Ann; Moody-Geissler, Stephanie; Musoke, Rachel; Naidoo, Dhamari; Ndyahikayo, John; Njie, Gibril J.; Phan, My; Rambaut, Andrew; Sesay, Foday

doi:10.15585/mmwr.mm6526a4

Cited by 14 publications

(16 citation statements)

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“…These measures focus on the early detection of cases and the comprehensive follow-up of contacts [11]. Efforts to find missing and unknown contacts are critical, but they were often hampered by a widespread distrust of health authorities in communities [12, 13]. Flaws were identified during the investigation of the last EVD cases detected in Conakry during the tail of the epidemic.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Lessons learned by surveillance during the tail-end of the Ebola outbreak in Guinea, June-October 2015: a case series

Keïta¹,

Conté

Diallo³

et al. 2017

BMC Infect Dis

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BackgroundBy the end of the 2013–2016 West African Ebola Virus Disease (EVD) outbreaks, a total of 3814 cases (probable and confirmed) and 2544 deaths were reported in Guinea. Clearly, surveillance activities aiming at stopping human-to-human transmission have been the breakthrough of EVD outbreak management, but their application has been at times easier said than done. This article presents five confirmed or probable EVD cases that arose in Conakry towards the end of the Guinea epidemic, which demonstrate flaws in surveillance and follow-up.Case presentationFor case 1, safe burial requirements were not followed. For cases 1 and 2, negative Polymerase Chain Reaction (PCR) results were interpreted as no infection. For the first case, the sample may have not been taken properly while for the second the disease was possibly at its early stage. Case 3 was stopped at a border health checkpoint and despite her high temperature she was allowed to continue the bus journey. For case 4, an oral swab sample was supposedly taken after death but could not be found for retrospective testing. Despite characteristic symptomatology, case 5 was not identified as a suspect case for as long as 3 weeks.ConclusionIn epidemic contexts, health systems must be able to track all samples of suspect cases and deaths, regardless of their laboratory results. Social mobilization in communities and training in health care facilities must be strengthened at the tail of an outbreak, to avoid the natural slackening of disease surveillance, in particular for long-lasting and deadly epidemics.

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Section: Discussionmentioning

confidence: 99%

“…This is of great importance considering the risks of EVD flare-ups [13–17]. These strategies include health care-based and (whenever possible) community-based supervised surveillance, training of medical staff for detection of suspect cases and training for an appropriate and timely use of rapid diagnostic tests [18].…”

Section: Discussionmentioning

confidence: 99%

Lessons learned by surveillance during the tail-end of the Ebola outbreak in Guinea, June-October 2015: a case series

Keïta¹,

Conté

Diallo³

et al. 2017

BMC Infect Dis

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“…The agency’s abilities were immediately tested by the recognition of an EVD case, likely related to transmission from an EVD survivor, on January 14, 2016 ( 12 ). The Ministry of Health and Sanitation stood up its emergency response structure and led a complex control effort that required coordination across 5 districts ( 13 ). The response led to identification of 131 contacts and implementation of enhanced community surveillance in 1 district for 2 months after the end of contact monitoring.…”

Section: Emergency Responsementioning

confidence: 99%

Ebola Response Impact on Public Health Programs, West Africa, 2014–2017

Marston¹,

Dokubo²,

Steelandt³

et al. 2017

Emerg. Infect. Dis.

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Events such as the 2014–2015 West Africa epidemic of Ebola virus disease highlight the importance of the capacity to detect and respond to public health threats. We describe capacity-building efforts during and after the Ebola epidemic in Liberia, Sierra Leone, and Guinea and public health progress that was made as a result of the Ebola response in 4 key areas: emergency response, laboratory capacity, surveillance, and workforce development. We further highlight ways in which capacity-building efforts such as those used in West Africa can be accelerated after a public health crisis to improve preparedness for future events.

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“…The 117 system continues to be used to help detect possible Ebola flare-ups, including those that may be linked to viral persistence in male Ebola survivors. 9 In this paper, we describe the 117 system, analyse numbers of death-alert and live-alert calls by region from 1 September 2014 to 31 December 2016, and compare call trends with daily numbers of confirmed Ebola cases from published WHO situation reports. We discuss strengths and limitations of the system and its potential long-term role in efforts to improve death reporting and enhance International Health Regulations implementation in Sierra Leone, and thereby enhance global health security.…”

Section: Bmj Global Healthmentioning

confidence: 99%

The 117 call alert system in Sierra Leone: from rapid Ebola notification to routine death reporting

Alpren¹,

Jalloh

Kaiser³

et al. 2017

BMJ Glob Health

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A toll-free, nationwide phone alert system was established for rapid notification and response during the 2014–2015 Ebola epidemic in Sierra Leone. The system remained in place after the end of the epidemic under a policy of mandatory reporting and Ebola testing for all deaths, and, from June 2016, testing only in case of suspected Ebola. We describe the design, implementation and changes in the system; analyse calling trends during and after the Ebola epidemic; and discuss strengths and limitations of the system and its potential role in efforts to improve death reporting in Sierra Leone. Numbers of calls to report deaths of any cause (death alerts) and persons suspected of having Ebola (live alerts) were analysed by province and district and compared with numbers of Ebola cases reported by the WHO. Nearly 350 000 complete, non-prank calls were made to 117 between September 2014 and December 2016. The maximum number of daily death and live alerts was 9344 (October 2014) and 3031 (December 2014), respectively. Call volumes decreased as Ebola incidence declined and continued to decrease in the post-Ebola period. A national social mobilisation strategy was especially targeted to influential religious leaders, traditional healers and women’s groups. The existing infrastructure and experience with the system offer an opportunity to consider long-term use as a death reporting tool for civil registration and mortality surveillance, including rapid detection and control of public health threats. A routine social mobilisation component should be considered to increase usage.

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Notes from The Field: Ebola Virus Disease Cluster — Northern Sierra Leone, January 2016

Cited by 14 publications

References 1 publication

Lessons learned by surveillance during the tail-end of the Ebola outbreak in Guinea, June-October 2015: a case series

Lessons learned by surveillance during the tail-end of the Ebola outbreak in Guinea, June-October 2015: a case series

Ebola Response Impact on Public Health Programs, West Africa, 2014–2017

The 117 call alert system in Sierra Leone: from rapid Ebola notification to routine death reporting

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