It was humid, muddy and raining when WHO staff approached a compound in heavily populated New Kru Town, outside Monrovia, Liberia to look for people who have had contact with people infected with Ebola. A WHO technical adviser from Rwanda, sent in to help the zone coordinator, spoke to a woman who had cared for an Ebola patient. She understood the need to be monitored for the disease, but another man with whom the team talked denied knowing anyone with Ebola and refused further contact with the team.
As new cases of Ebola virus disease continue to be reported by the Ministries of Health in Guinea, Liberia, and Sierra Leone, WHO’s response is accelerating in vital areas crucial to control the outbreak.
People in close contact with Ebola patients
One of the most important of these areas is contact tracing, or finding persons who have been in close contact with persons infected with Ebola, monitoring them to see if they have become infected, and providing them with education and support.
The response by WHO and its partners to stop transmission of the Ebola virus is accelerating by scaling up effective outbreak control measures and preventing its further spread, as urged by Health Ministers from 11 West African countries in a new strategy approved in July. Health authorities are concerned because Ebola continues to be transmitted in communities and in health-care settings, and it has appeared in cities as well as rural and border areas.
The 3 affected countries (Guinea, Liberia, and Sierra Leone) have reported some 930 cases of Ebola, with about 580 deaths, and new cases continue to be reported. The disease, which causes severe haemorrhaging and can kill up to 90% of those infected, is spread by direct contact with the blood and body fluids of infected animals or people.
WHO, the Global Alert and Response Network (GOARN), and its partners are providing guidance and support and have deployed teams of experts to West African countries, including epidemiologists to work with the countries in surveillance and monitoring of the outbreak and laboratory experts to support mobile field laboratories for early confirmation of Ebola cases. Also deployed are clinical management experts to help health-care facilities treat affected patients, infection and prevention control experts to help the countries stop community and health-care facility transmission of the virus, and logisticians to dispatch needed equipment and materials.
Delivering appropriate messages
In addition, social mobilization and risk communications teams are working in the 3 countries to help health officials deliver appropriate messages about how to report, handle, and treat Ebola cases.
One example of these accelerated activities has been contact tracing in Monrovia and in New Kru Town, Montserrado county, Liberia, where 107 community volunteers are working as tracers, in teams with 33 supervisors and a coordinator, to look for persons who may have come into contact with infected persons.
WHO Technical Adviser Dr Andre Rusanganwa and zone coordinator for Ebola surveillance Emmanuel Lassana joined the contact tracers visiting areas in Monrovia to look for individuals who have come in contact with patients positive for Ebola virus infection. In New Kru Town, individuals who were in contact with patients were identified and given support based on the awareness they may have been exposed and must be monitored.