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Recurrence of Ebola transmission in Liberia

Ebola situation assessment
3 July 2015

On 9 May 2015, Liberia marked an important milestone in the management of their Ebola outbreak. On that day, the country was declared free of Ebola transmission because no new cases had been identified for 42 days after the safe burial of the last person confirmed to have been infected with Ebola virus disease.

Although transmission of the virus had ceased, Liberia remained at high risk of a recurrence of Ebola due to ongoing transmission in neighbouring Guinea and Sierra Leone. For this reason Liberia then entered a 90-day period of vigilance involving testing anyone with features of Ebola virus disease and testing post-mortem swabs for Ebola virus.

On Monday, 29 June 2015, midway through that 90 day period, a post-mortem swab taken from a seventeen-year-old male who died on June 28 from a febrile illness managed as malaria tested positive for Ebola virus disease. In accordance with standard practice for the current period of heightened vigilance throughout Liberia, a Safe and Dignified Burial team buried the young man’s body safely on the same day that he died. That team also took the swab that later tested positive for Ebola virus.

Every week, Liberia has been testing hundreds of such swabs and blood samples taken from anyone with symptoms that may be caused by Ebola virus disease. When this first sample proved positive, the Liberian ‘incident management system’ immediately activated a team to carry out a detailed investigation in the area, and began tracing people who had been in contact with the young man while he was symptomatic.

The investigation revealed that close to 200 people had been in contact with the young man while he had symptoms of Ebola and these people are now being closely monitored. Two of those people have developed symptoms and have tested positive for Ebola virus. Both of these people are being treated in an Ebola treatment centre that had been kept at the ready as part of the 90-day heightened vigilance period.

People in the community where the young man died - Nedowein, Margibi - are now very involved in ensuring that all people, who have been in contact with others infected with Ebola, do not leave the area and are monitored closely. Where households are quarantined, food and supplies - such as bedding and tents to ease household crowding - are being provided by UN agencies, including UNICEF and the World Food Programme.

The United Nations system and nongovernmental organizations are supporting the Government with necessary supplies such as protective equipment, alcohol-based hand sprays, temperature monitors, and staff already based in Liberia. WHO is sending additional experts in epidemiology and social mobilization to ensure the community is fully involved in identifying contacts and preventing any further disease spread.

The Government has informed the people of Liberia about what is happening, and has reminded them of the key steps needed to keep themselves and their communities safe.