The 6th meeting of the Emergency Committee convened by the World Health Organization regarding the Ebola virus disease (EVD) outbreak in West Africa took place by teleconference on July 2, 2015, and by electronic correspondence from July 2-6, 2015.
Presentations were made by representatives of Guinea and Sierra Leone on the current epidemiological situation in their countries, progress of the response operations, contact tracing and exit screening.
A written statement was provided by Liberia, which included information on 3 recently confirmed Ebola virus disease cases in lower Margibi County. It also outlined steps being taken to investigate the cases, determine the primary source of infection, identify and follow contacts, and isolate and manage the cases.
The Committee reviewed developments since the previous meeting of April 9, 2015. These developments include:
- Decreased numbers of cases overall
- A plateau in case incidence over the past 5 weeks
- Concentration of the outbreak primarily in Western areas of Guinea and Sierra Leone
- Identification of the 3 new cases in Liberia
The Committee noted WHO’s preparedness activities in neighboring countries and stressed the importance of reinforcing cross-border collaboration between Guinea and Guinea-Bissau.
The progress of a number of research studies was discussed briefly, specifically those involving possible prolonged persistence of virus in semen, cohorts of survivors, and clinical trials of vaccines and convalescent serum therapy.
The Committee said that interagency collaboration, especially at community level, should be improved and that operational agencies should be able to communicate with communities in the appropriate language. With respect to the critical role of national leadership, the Committee noted the meeting of the Presidents of Guinea and Sierra Leone and commended their commitments to ongoing close collaboration.
Regarding the EVD response strategy, the Committee welcomed the move to a new phase, Phase 3, in which the focus will be on a detailed understanding of every chain of transmission. Defining and interrupting all remaining chains of transmission is central to Phase 3 and will be accomplished through:
- An event-based management approach of treating each transmission chain as an “event”
- All related elements identified and managed together
- Enhanced identification and incentivizing of cases and contacts
- A response led by chiefs and owned by communities
Additional measures will be used to identify and reduce the residual risk in Ebola-free areas, including enhanced and adapted alert management; strengthened rapid response capacity at the regional and zonal levels; and improved engagement with and support for survivors. The plan for Phase 3 should be finalized rapidly and implemented expeditiously.
The Committee noted that although some improvements have been observed, inappropriate travel and transport measures continue to be implemented by numerous countries and a number of international airlines have still not resumed flights to the affected countries.
The Committee advised that the EVD outbreak continues to constitute a Public Health Emergency of International Concern and previously issued temporary recommendations should be extended.
Recommendations for the most affected countries (Guinea, Liberia, Sierra Leone) include:
- Continued exit screening in the 3 affected countries
- Detailed statistics on exit screening published monthly
- A strongly functioning alert system and contact tracing
- Avoidance of unnecessary interference with international travel and transport
- Continued international support for these countries to carry out effective exit screening
- Further strengthen cross-border collaboration and communication, particularly between Guinea and Guinea-Bissau
- Make every effort to retain and retrain health workers
- Providing social and psychosocial support to communities
- Support to persons placed in quarantine
The Committee noted with concern the recent infections of a physician and an ambulance driver, which again underscore the importance of ensuring continued rigorous application of appropriate infection prevention and control measures in both private and public health facilities.
Based on this advice and information, the Director-General declared that the 2014-2015 Ebola outbreak in these West African countries continues to constitute a Public Health Emergency of International Concern.
In addition, the Director-General reemphasized that there is no public health justification for refusing entry or quarantining travelers simply because they had been in, or are a citizen of, one of the affected countries. Any measures applied must be based on appropriate public health evidence or information about potential risks posed by the individual traveler.