Liberia Ebola SitRep no. 100

Ministry of Health and Social Welfare Aug 23, 2014

Cases

National

Lofa County Lofa

Grand Bassa Grand

Bong County Bong

Bomi County Bomi

Sinoe County Sinoe

Grand Gedeh Grand

Nimba County Nimba

Margibi County Margibi

RiverCess County RiverCess

River Gee County Gee River

Grand Cape Mount Cape Grand Montserrado

New Case/s (Suspected) 4 0 0 0 0 0 0 4 0 0 0 0 0 New Case/s (Probable) 21 1 0 0 0 0 10 7 0 3 0 0 0 New case/s (confirmed) 10 0 0 0 0 0 10 0 0 0 0 0 0 Total suspected cases 343 1 68 8 1 2 63 79 107 12 1 0 1 Total probable cases 635 24 30 1 3 0 297 47 189 44 0 0 0 Total confirmed cases 311 21 20 6 4 0 163 27 43 25 0 1 1 Total Number of Confirmed Cases of Sierra Leonean Nationality 13 0 0 0 2 0 11 0 0 0 0 0 0 Total Number of Confirmed Cases of Guinean Nationality 1 0 0 0 0 0 0 0 1 0 0 0 0 Cumulative (confirmed, probable, suspected) cases 1289 46 118 15 8 2 523 153 339 81 1 1 2 Outbreak Overview: Case Counts Reported

450 400 Confirmed Probable 350 Suspect 300 250 200 150 100 50 0

Cases among HCWs

National

Lofa County Lofa

Grand Bassa Grand

Bong County

BomiCounty

SinoeCounty

Grand Gedeh Grand

Nimba County Nimba

Margibi County Margibi

RiverCess County RiverCess

River Gee County Gee River

Grand Mount Cape Grand Montserrado County Montserrado

Newly Reported Cases in HCW on 23rd Aug 2014 3 0 0 0 0 0 1 2 0 0 0 0 0 Cumulative cases among HCW 127 5 26 3 3 0 18 29 42 1 0 0 0 Newly Reported deaths in HCW on 23rd Aug 2014 0 0 0 0 0 0 0 0 0 0 0 0 0 Cumulative deaths among HCW 65 4 5 0 0 0 15 18 23 0 0 0 0

Isolation and Discharges

National

Lofa County Lofa

Grand Bassa Grand

Bong County

BomiCounty

SinoeCounty

Grand Gedeh Grand

Nimba County Nimba

Margibi County Margibi

RiverCess County RiverCess

River Gee County Gee River

Grand Cape Mount Grand Montserrado County Montserrado

New Admission on Aug 23 2014 10 0 0 0 0 0 10 0 0 0 0 0 0 Total no. currently in Treatment Units 65 0 0 0 0 0 65 0 0 0 0 0 0 Total discharges on 23rd Aug 2014 1 0 0 0 0 0 1 0 0 0 0 0 0 Cumulative admission/isolation 65 0 0 0 0 0 65 0 0 0 0 0 0

Deaths

National

Lofa County Lofa

Grand Bassa Grand

Bong Bong County

BomiCounty

SinoeCounty

Grand Gedeh Grand

Nimba County Nimba

Margibi County Margibi

RiverCess County RiverCess

River Gee County Gee River

Grand Cape Mount Grand Montserrado County Montserrado

Newly reported deaths 23rd Aug 2014 16 1 0 0 0 0 7 4 0 4 0 0 0 Total death/s in confirmed cases 265 19 10 1 4 0 109 23 80 19 0 0 0 Total death/s in probable cases 293 10 11 1 1 0 109 32 106 22 0 1 0 Total death/s in suspected cases 154 0 13 0 2 1 34 26 71 6 1 0 0

Total death/s in confirmed, probable, suspected cases 712 29 34 2 7 1 252 81 257 47 1 1 0

Case Fatality Rate (CFR) - Confirmed & 100. Probable Cases 59.0 64.4 42.0 28.6 71.4 0.0 47.4 74.3 80.2 59.4 0.0 0 0.0 Outbreak Overview: Deaths Reported

300 Confirmed 250 Probable Suspect 200

150

100

50

0

Contacts

National

Lofa County Lofa

Grand Bassa Grand

Bong County Bong

Bomi County Bomi

Sinoe County Sinoe

Grand Gedeh Grand

Nimba County Nimba

Margibi County Margibi

RiverCess County RiverCess

River Gee County Gee River

Grand Cape Mount Cape Grand Montserrado County Montserrado

Newly reported contacts on 23rd Aug 2014 117 0 0 0 0 0 44 64 0 9 0 0 0

Total contacts listed 3208 64 396 10 31 0 647 357 1490 207 0 6 0

Currently under follow-up 1870 54 261 10 27 0 417 356 730 11 0 4 0

Contacts seen on 23rd Aug 2014 1796 54 261 0 0 0 417 356 697 11 0 0 0 Contacts who completed 21 day follow-up 22 0 0 0 0 0 21 0 1 0 0 0 0 Contacts lost to follow-up 5 0 0 0 0 0 0 1 4 0 0 0 0

Laboratory

National

Lofa County Lofa

Grand Bassa Grand

Bong County

BomiCounty

SinoeCounty

Grand Gedeh Grand

Nimba County Nimba

Margibi County Margibi

RiverCess County RiverCess

River Gee County Gee River

Grand Cape Mount Grand Montserrado County Montserrado

Specimens collected on 23rd Aug 2014 3 0 0 0 0 0 0 0 0 3 0 0 0 Specimens pending for testing 73 0 12 2 1 0 41 4 5 8 0 0 0 Total specimens tested 14 0 0 0 0 0 14 0 0 0 0 0 0 Ebola Disease Outbreak (March 22-Aug 23, 2014)

Table 3: Cumulative Ebola Disease Outbreak in (March 22 -Aug 23, 2014)

Cases

National

Lofa County Lofa

Grand Bassa Grand

Bong County Bong

Bomi County Bomi

Grand Gedeh Grand County Sinoe

Nimba County Nimba

Margibi County Margibi

RiverCess County RiverCess

River Gee County Gee River

Grand Cape Mount Cape Grand Montserrado County Montserrado Total Case/s (Suspected) 343 1 68 8 1 2 63 79 107 12 1 0 1 Total Case/s (Probable) 637 24 30 1 3 0 299 47 189 44 0 0 0 Total case/s (confirmed) 317 21 20 6 4 0 167 29 43 25 0 1 1

Cumulative (confirmed, probable, suspected) cases 1297 46 118 15 8 2 529 155 339 81 1 1 2

Health Care Workers Cumulative cases among HCW 129 5 26 3 3 0 20 29 42 1 0 0 0 Cumulative deaths among HCW 67 4 5 0 0 0 17 18 23 0 0 0 0

Deaths Total death/s in confirmed cases 271 19 10 1 4 0 113 25 80 19 0 0 0 Total death/s in probable cases 295 10 11 1 1 0 111 32 106 22 0 1 0 Total death/s in suspected cases 157 0 13 0 2 1 35 27 72 6 1 0 0 Total death/s in confirmed, probable, suspected cases 723 29 34 2 7 1 259 84 258 47 1 1 0 Cumulative CFR (March 22 - Aug 23, 2014) 59.3 64.4 42.0 28.6 71.4 ##### 48.1 75.0 80.2 59.4 ##### 100.0 0.0

Case Investigation

Daily Case investigation

Date: August 23, 2014 Montserrado Lofa Bong Margibi Cape Mount Nimba Rivercess Bassa Bomi •# of calls received 81 0 0 3 0 0 0 0 1

•# of calls responded to 36 0 0 3 0 0 0 0 0 •# of cases referred to treatment unit 5 0 0 0 1 0 0 0 1 •# of suspected Cases 16 0 0 2 1 0 0 0 0 •# of probable cases 20 0 0 1 0 0 0 0 0 •# of suspected or probable cases with specimen taken 0 0 0 0 0 0 0 0 0 •# of bodies 18 0 0 0 0 0 0 0 0 •# of bodies with specimen taken 2 0 0 0 0 0 0 0 0 •# homes sprayed 0 0 0 0 0 0 0 0 0 •# of psychosocial counseling done 36 0 0 3 0 0 0 0 0 # of cases pending transfer 13 0 0 0 0 0 0 0 0 Highlight

Case Investigation • One of the escapees from West Point showed up in Swehn Mecca District, Bomi County. He is currently at the Holding Room in Tubmanburg

Montserrado County • On August 23, 697 of 730 contacts were seen (95%) by 3 of the 4 tracing teams; data from 1 tracing team was not available at the time of reporting. • Montserrado-based investigation teams continue to investigate cases in Margibi and Cape Mount, in addition to those in Montserrado. Highlight Margibi County • This report cover only two districts in Margibi County ( and Gibi Districts). It had been difficult to received report from Firestone and Mamba – Kaba Districts • No Ambulances and pickups/jeeps to transfer cases and for case investigation respectively. • The tracers and supervisors threatened to stay out of work due to lack of information on incentive/risk allowance payment Bomi • President Ellen Johnson Sirleaf visited the Bomi County Health to acquaint herself with situation at the hospital and quarantine Unit

• The burial team today buried one (probable ebola case) in Goghen, Klay District Highlight Nimba County • 1 confirmed case died upon arrival at treatment unit in • 4 bodies (confirmed cases) buried. • 3 Specimens of probable cases collected one each from Ganta, Kpein and Bunadin • Arcelor Mittal is renovating holding center for suspected Ebola cases in Yekepa

National Reference Lab at LIBR • 47 test conducted – 11 negative – 36 positive Logistics Highlights

# OF CARS FROM # OF MOTORBIKES # OF CARS FORM MACs NO. COUNTY MOH 1. BOMI 0 5 0 2. BONG 1 10 1 3. GBARPOLU 1 2 0 4. GRAND CAPE MOUNT 1 6 1 5. GRAND BASSA 2 8 0 6. GRAND GEDEH 1 2 0 7. GRAND KRU 0 2 0 8. LOFA 1 13 1 9. MARGIBI 2 6 1 10. MARY LAND 0 2 0 11. MONTSERRADO 38 20 14 12. NIMBA 2 7 0 13. RIVERCESS 1 6 0 14. RIVER GEE 0 2 0 15. SINOE 0 2 0 TOTAL 50 93 18