Liberia Ebola SitRep no. 110

Ministry of Health and Social Welfare Sept. 2, 2014

Cases

County

National

Lofa County Lofa

Grand Bassa Grand

Bong County Bong

Bomi County Bomi

Grand Gedeh Grand County Sinoe

Nimba County Nimba

Margibi County Margibi

Gbarpolu

RiverCess County RiverCess

River Gee County Gee River

Grand Cape Mount Cape Grand Montserrado

New Case/s (Suspected) 35 0 2 0 3 0 0 0 7 22 0 1 0 0 New Case/s (Probable) 38 0 4 0 1 0 0 10 7 13 0 3 0 0 New case/s (confirmed) 3 0 0 0 2 0 0 0 0 0 1 0 0 0 Total suspected cases 366 1 83 1 21 2 3 63 126 42 17 6 0 1 Total probable cases 883 31 40 0 12 4 0 345 89 309 50 3 0 0 Total confirmed cases 590 31 24 0 13 4 0 220 30 225 41 0 1 1 Total Number of Confirmed Cases of Sierra Leonean Nationality 13 0 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 0 1 0 0 0 0 Cumulative (confirmed, probable, suspected) cases 1839 63 147 1 46 10 3 628 245 576 108 9 1 2

Cases among HCWs

County

National

Lofa County Lofa

Grand Bassa Grand

Bong County

BomiCounty

SinoeCounty

Grand Gedeh Grand

Nimba County Nimba

Margibi County Margibi

Gbarpolu

RiverCess County RiverCess

River Gee County Gee River

Grand Cape Mount Grand Montserrado County Montserrado

Newly Reported Cases in HCW on 2nd Sept. 2014 2 0 0 0 0 0 0 0 0 2 0 0 0 0 Cumulative cases among HCW 151 5 26 0 3 3 0 20 32 59 3 0 0 0 Newly Reported deaths in HCW on 2nd Sept. 2014 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Cumulative deaths among HCW 74 4 5 0 1 0 0 17 19 28 0 0 0 0

Isolation and Discharges

County

National

Lofa County Lofa

Grand Bassa Grand

Bong Bong County

BomiCounty

SinoeCounty

Grand Gedeh Grand

Nimba County Nimba

Margibi County Margibi

Gbarpolu

RiverCess County RiverCess

River Gee County Gee River

Grand Cape Mount Grand Montserrado County Montserrado

New Admission on Sept. 2, 2014 17 0 0 0 0 0 0 0 0 17 0 0 0 0 Total no. currently in Treatment Units 276 0 0 0 0 0 0 70 0 206 0 0 0 0 Total discharges on 2nd Sept. 2014 16 0 0 0 0 0 0 2 0 14 0 0 0 0 Cumulative admission/isolation 276 0 0 0 0 0 0 70 0 206 0 0 0 0

Deaths

County

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

Gbarpolu

RiverCess County RiverCess

River Gee County Gee River

Grand Cape Mount Cape Grand Montserrado County Montserrado Newly reported deaths 2nd Sept. 2014 47 0 0 0 7 1 0 5 5 29 0 0 0 0 Total death/s in confirmed cases 414 19 11 0 13 4 0 146 25 169 27 0 0 0 Total death/s in probable cases 390 15 13 0 3 2 0 140 49 133 34 0 1 0 Total death/s in suspected cases 247 0 17 0 3 3 2 34 37 135 11 5 0 0 Total death/s in confirmed, probable, suspected cases 1051 34 41 0 19 9 2 320 111 437 72 5 1 0 Case Fatality Rate (CFR) - Confirmed & Probable Cases 54.6 55 38 0 64 75 0 51 62 57 67 0 100 0

Contacts

County

National

Lofa County Lofa

Grand Bassa Grand

Bong Bong County

BomiCounty

SinoeCounty

Grand Gedeh Grand

Nimba County Nimba

Margibi County Margibi

Gbarpolu

RiverCess County RiverCess

River Gee County Gee River

Grand Cape Mount Grand Montserrado County Montserrado

Newly reported contacts on 2nd Sept. 2014 255 9 1 0 28 0 0 4 47 157 0 9 0 0

Total contacts listed 5743 131 476 0 61 30 0 760 951 2990 329 9 6 0

Currently under follow-up 3134 32 294 0 61 25 0 226 860 1478 145 9 4 0 Contacts seen on 2nd Spet. 2014 3080 32 294 0 61 25 0 226 860 1432 145 5 0 0 Contacts who completed 21 day follow-up 81 0 0 0 0 0 0 14 0 67 0 0 0 0 Contacts lost to follow-up 5 0 0 0 0 0 0 0 0 1 0 4 0 0

Laboratory

County

National

Lofa County Lofa

Grand Bassa Grand

Bong County Bong

Bomi County Bomi

Grand Gedeh Grand County Sinoe

Nimba County Nimba

Margibi County Margibi

Gbarpolu

RiverCess County RiverCess

River Gee County Gee River

Grand Cape Mount Cape Grand Montserrado County Montserrado

Specimens collected on 2nd Sept. 2014 5 0 3 0 0 0 0 0 0 0 1 1 0 0

Specimens pending for testing 16 3 3 0 0 0 0 8 0 0 1 1 0 0

Total specimens tested 29 0 0 0 0 0 0 0 0 29 0 0 0 0 Ebola Disease Outbreak (March 22-Sept. 2, 2014)

Table 3: Cumulative Ebola Disease Outbreak in (March 22 -Sept. 2, 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

Gbarpolu County Gbarpolu

RiverCess County RiverCess

River Gee County Gee River

Grand Cape Mount Cape Grand Montserrado County Montserrado

Total Case/s (Suspected) 366 1 83 1 21 2 3 63 126 42 17 6 0 1 Total Case/s (Probable) 885 31 40 0 12 4 0 347 89 309 50 3 0 0 Total case/s (confirmed) 596 31 24 0 13 4 0 224 32 225 41 0 1 1 Cumulative (confirmed, probable, suspected) cases 1847 63 147 1 46 10 3 634 247 576 108 9 1 2

Health Care Workers Cumulative cases among HCW 153 5 26 0 3 3 0 22 32 59 3 0 0 0 Cumulative deaths among HCW 76 4 5 0 1 0 0 19 19 28 0 0 0 0

Deaths Total death/s in confirmed cases 420 19 11 0 13 4 0 150 27 169 27 0 0 0 Total death/s in probable cases 392 15 13 0 3 2 0 142 49 133 34 0 1 0 Total death/s in suspected cases 250 0 17 0 3 3 2 35 38 136 11 5 0 0 Total death/s in confirmed, probable, suspected cases 1062 34 41 0 19 9 2 327 114 438 72 5 1 0 #### Cumulative CFR (March 22 - Sept. 2, 2014) 54.8 54.8 37.5 ##### 64.0 75.0 # 51.1 62.8 56.6 67.0 0.0 100.0 0.0

Case Investigation Daily Case Investigation Report September 2nd, 2014 CASE DISTRIBUTION Montserrado Lofa Bong Margibi Cape Mount Nimba Rivercess Bassa Bomi # of calls for Live Cases Received 21 # of calls for Live Cases Responded to 15 # Calls of Live Cases Pending Response 6 # of Cases Referred to Treatment Unit 0 # of Suspected Cases Responded to 5 # of Probable Cases Responded to 10 # of Cases Pending Transfer for today 7 Cumulative Cases Pending Transfer 33 # of Calls that were not a Case 2

Zone 1 (JFK HOSPITAL) 2 Zone 2 (DUPORT ROAD) 3 Zone 3 (JAMES DAVIES) 4 Zone 4 (REDEMPTION HOSPITAL) 4 Cumulative (probable, suspected) cases 13

# of Calls for bodies 8 Zone 1 (JFK HOSPITAL) 3 Zone 2 (DUPORT ROAD) 1 Zone 3 (JAMES DAVIES) 4 Zone 4 (REDEMPTION HOSPITAL) 0 # of bodies with specimen taken 2 # of Bodies that were not a case 0 # of Bodies Removed 8 # of Homes sprayed unknown # of Health Facilities sprayed unknown # of psychosocial Counseling done 15 Highlights

JFK ETU ELWA II

• Total admission- 47 (3 Health • Total admission- 44 Workers) • Total number of confirmed- 35 (4 • Total number of confirmed cases- Health Workers) 34 • Total number of new admission- 5 • New admission 2 (1 Health Worker) • No discharge • 13 discharged (11 Survivors and 2 • 1 death reported within the last 24 suspected cases with negative lab hours. results) • 3 death within the last 24 hours. (2 Health Workers) Highlights

ELWA III Critical Issues

• Total admission- 115 (3 • ELWA lll closed for the next two suspected cases) days in order to control the heavy • Total number of confirmed influx of patients and improve case- 112 • Total number of new security measures. However admission- 10 patients taken by the ambulance • 1 Discharged (1 suspected case will be considered. with negative lab results) • ELWA ll reported stock –out of • 10 deaths reported within the some essential drugs, hoods, last 24 hours. body bags, and waste bags. Highlights Lofa County • Total number of patient in Foya Case management center (FCMC)- 70

– 20 probable cases

– 50 confirm cases

• 10 New Probable cases

• Total of 5 deaths reported:

– 3 confirmed death from FCMC

– 2 community deaths (Zorzor)

• Total number of Discharge: 2 Survivors

Lab Result:

• No lab results received Highlight Montserrado County • 1432 (97%) of 1478 contacts under follow up were seen by 4 contact tracing teams. • Of the 21 calls for live cases received by dispatch, 15 (71%) were responded to. – 6 live cases are awaiting investigation while 33 cases are pending transfer to ETU. • 29 deaths reported: – 14 were from ETUs – 11 Suspected – 4 Probable • 5 suspected cases are in the holding unit at West Point. Highlight Nimba County • EVD 5 Lab. Result received – 1 Positive – 4 Negative • “Global Communities” Country Director donated 100 Body bags and 3 10kg buckets of chlorine to the County for Ebola Response • The last Ebola positive patients in the County were transferred to ETU in

Mobile lab at ELWA (CDC/NIH • 24 samples tested – 7 Negative – 17 Positive National Reference Lab at LIBR • 5 Samples tested – 2 Positive – 3 Negative MOHSW Warehouse Inventory (as of Sept 2, 2014 @ 17:30)

Current 3 month Category Product Description Unit Gap Balance Forecast WATSAN Body Bags (L) piece 4,139 6,000 1,861 WATSAN Body Bags (S) piece 18 6,000 5,982 WATSAN Chlorine Powder Kg 3,675 34,515 30,840 WATSAN Plastic Bucket w/ faucet* piece 42 500 458 Disposable PPE PPE Suit - Overall (no hood)** piece 3,031 - - Disposable PPE PPE Suit - Hooded Overall piece - 700,000 700,000 Disposable PPE Examination Gloves (S, M, L, XL) piece 118,111 1,400,000 1,281,889

Disposable PPE Face Mask (N95) piece 8,366 700,000 691,634

Reusuable PPE Goggles Piece 8,057 33,000 24,943

Reusuable PPE Heavy Duty Plastic Gloves pair 405 140,000 139,595 Reusuable PPE Rubber boot pair 152 14,500 14,348

Reusuable PPE Hand Sprayer (1.5L) piece - 700 700 Reusuable PPE Backpack Sprayer (12-16L) piece 1 200 199 Other Equipment Mattress piece 146 500 354 * These buckets were procured by case management specifically for use by case management teams **An additional 9,750 overalls are available and will be distributed once hoods arrive Items Received on September 2nd

Item Qty Unit Donor/Delivery point

Surgical reusable apron 699 Pcs Graceland International Surgical gloves 2500 Pairs Alcohol-based Hand Sanitizer 720 Btls Anti-fog spray (355ml) 150 Btls US Government Body Bags (L) 338 Pcs MAP/GEMS Kit (50 sets of PPE*) 63 Kit Country/ red rice flour 48 Bags Natural fruit juice 24 Boxes LIFA (sent to ELWA 2) Potato & Plantain flour 12 Bags • A large donation, worth ~$162,300 arrived from the Swiss Embassy. Supplies were delivered to the warehouse at NEC for storage – Sterilium, Softa-man pure, Glucose, Sodium Chloride, Exam Gloves (L & XL), Surgical Masks, Infusion Sets, Body Bags, ORS

* These kits include 50 coveralls (no hood), 50 goggles, 50 facemasks, and 50 pairs of gloves Pipeline

• PPEs are most urgently needed items right now: • PIPELINE INFORMATION: – 7,500 PPEs to arrive from WHO on Wednesday, Sept 03,2014 – 10,000 PPEs from USG will be available immediately once supplemental hoods arrive – 4,000 PPE kits estimated to arrive on Monday from CHAI, through funding from Norway • Limited information is being shared with the logistics subcommittee regarding items in the pipeline. The Logistics/Supply Chain Team urges all partners to share Ebola healthcare commodity delivery information with the team. • The logistics subcommittee has developed a new template to collect information from partners on a weekly basis to help inform overall stock status and gaps.

• This template will be circulated in the coming days and will collect information on: – Deliveries – Consumption – Pipeline

 LMIS Requisition forms have been developed for central level MoHSW Warehouse and CHSW Warehouse. Forms to be emailed by the SCMU LMIS Officer to all county Pharmacists Important Updates Regarding Requisitions

• A memo is currently being developed to outline new requirements for all requisitions.

• The signatory process has been streamlined

• However, there is little visibility of how orders are being used and/or consumed.

• Beginning about a week from now, all requisitions will require to be accompanied by a report outlining how the previous supplies were used.