Cluster of Ebola Virus Disease, Bong and Montserrado Counties, Liberia - Volume 21, Number 7—July 2015 - Emerging Infectious Disease journal - CDC

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Cluster of Ebola Virus Disease, Bong and Montserrado Counties, Liberia - Volume 21, Number 7—July 2015 - Emerging Infectious Disease journal - CDC

Volume 21, Number 7—July 2015

Dispatch

Cluster of Ebola Virus Disease, Bong and Montserrado Counties, Liberia

On This Page

• The Investigation
• Conclusions
• Suggested Citation

Figures

• Figure

Tables

• Table

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Tolbert G. Nyenswah, Mosaka Fallah, Geoffrey M. Calvert, Stanley Duwor, E. Dutch Hamilton, Vishwesh Mokashi, Sampson Arzoaquoi, Emmanuel Dweh, Ryan Burbach, Diane Dlouhy, John E. Oeltmann, and Patrick K. Moonan 

Author affiliations: Ministry of Health and Social Welfare, Monrovia, Liberia (T.G. Nyenswah, M. Fallah, S. Duwor); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (G.M. Calvert, D. Dlouhy, J.E. Oeltmann, P.K. Moonan); United Nations International Children’s Emergency Fund, Monrovia (E.D. Hamilton);United States Navy, Silver Spring, Maryland, USA (V. Mokashi); Ministry of Health and Social Welfare–Bong County, Suokoko, Liberia (S. Arzoaquoi, E. Dweh); International Medical Corps, Los Angeles, California, USA (R. Burbach)

Suggested citation for this article

Abstract

Lack of trust in government-supported services after the death of a health care worker with symptoms of Ebola resulted in ongoing Ebola transmission in 2 Liberia counties. Ebola transmission was facilitated by attempts to avoid cremation of the deceased patient and delays in identifying and monitoring contacts.

Reports of what has become the largest and longest epidemic of Ebola virus disease (EVD) began in March 2014 in West Africa (1). To interrupt Ebola transmission, health care authorities must promptly isolate and treat persons with EVD and identify and monitor exposed persons before symptoms develop (2). Effective contact tracing can limit the number of new cases; however, a single missed contact can result in many new cases (3). Gaps in contact tracing have been reported as challenges for infectious diseases such as sexually transmitted infections and tuberculosis (4–6). Because contact tracing requires patients to reveal names of persons with whom they have had contact and whom they may have exposed to illness, public health officials must quickly establish trust with sick persons and those at risk for disease (3,7).

We describe a cluster of EVD cases involving transmission across 2 jurisdictions in Liberia. Data for this report were derived from interviews, case reporting forms, treatment records, and laboratory results. This EVD cluster highlights the challenges associated with public health measures to interrupt transmission of Ebola.

Mr. Nyenswah is the Head Minister of Health for the Ministry of Health and Social Welfare, Monrovia, Liberia. He has led the Ebola response in Liberia since 2014.

Acknowledgment

We thank David Bell, Jacqueline Gindler, Olga Henao, Moses Kerkula-Jeuronlon, James Lange, Heather Lorenzen, Mutaawe Arthur Lubogo, Philip McKay, Sam Sampson, health care providers at the Bong County Ebola Treatment Unit, and the US Navy Mobile Laboratory (LCDR Micheal Gregory, LT James Regeimbal Jr., HM1 Yusupha Kah) stationed in Bong County.

References

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8. Centers for Disease Control and Prevention. Rapid response to Ebola outbreaks in remote Areas—Liberia, August–December, 2014. MMWR Morb Mortal Wkly Rep. 2015;64:188–92.
9. National Public Radio. ‘Ebola must go!’ —and so must prejudice against survivors. December 9, 2014[cited 2014 Dec 9].http://www.npr.org/blogs/goatsandsoda/2014/12/09/369382711/-ebola-must-go-and-so-must-prejudice-against-survivors

Figure

• Figure. Timeline (A) and transmission diagram (B) of Ebola virus disease cluster, Bong and Montserrado Counties, Liberia, November–December 2014.

Table

• Table. Characteristics of family members in Ebola cluster, Bong and Montserrado Counties, Liberia, November–December 2014

Suggested citation for this article: Nyenswah TG, Fallah M, Calvert GM, Duwor S, Hamilton ED, Mokashi V et al. Cluster of Ebola virus disease, Bong and Montserrado Counties, Liberia. Emerg Infect Dis. 2015 July [date cited]. http://dx.doi.org/10.3201/eid2107.150511

DOI: 10.3201/eid2107.150511