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Ebola kicked out from Kailahun, Sierra Leone


30 December 2014 - Kailahun district in eastern Sierra Leone was one of the country’s first hotspots in the Ebola outbreak, at its peak reporting more than 80 new cases per week in late June 2014.

Today, the district has managed to beat the disease and has reported no new cases for several weeks.

Kailahun district borders the area of Guinea where the first cases of Ebola were confirmed at the end of March 2014. The risk of infectious diseases spreading across the border has always been high, as communities are culturally connected and there is a lot of free movement between the two countries. In spite of efforts to prevent it, the disease was carried across the border and, on 25 May, Sierra Leone notified WHO of its first confirmed case. Three days later, Kailahun district already had 7 confirmed cases. The virus then spread so fast that local health capacities in Kailahun were quickly overwhelmed and needed urgent assistance.

Escalating situation

14700531867 00d4f89733 zBy mid-July, the situation had escalated. “The disease was ahead of us, we did not know where transmission chains were,” says Dr Yoti, a WHO team leader who has a long track record of working on many other haemorrhagic fever outbreaks.

The response structure, however, started to take shape as more chiefdom leaders joined the fight. “Initially only 4 out of 14 chiefdom leaders were part of the District Ebola Taskforce. We went to see all the others to convince them to join the fight,” recalls Dr Yoti. “We also included the head of the interreligious council so mosques and churches would also spread the appropriate messages.”

Turning the tide against Ebola

By the beginning of August, the number of confirmed cases started to level off and the majority of new cases were coming from registered contacts.

“What was really important is that we started to know where transmission chains were located and we were able to link cases to one another,” says Dr Yoti.

ebola site kailahun310In just weeks, the number of new cases started to fall -- from 80 reported cases in the last week of June to just 10 new infections in the second week of August. And from September to November, the progress was sustained. “From being hunted by the virus at the beginning, we started to hunt it down, cutting each transmission chain we found,” says Dr Yoti.

The last confirmed case was reported on 12 December . Today in Kailahun, the only patients in the treatment centre have come from other districts.

The Kailahun approach has since been successfully applied to the neighbouring district of Kenema, also heavily affected by the Ebola outbreak.

Fighting ebola in Kailahun. Photo: European COmmission, DG ECHO“There were good interpersonal relationships between all the players including the District Medical Health Teams, WHO, MSF, Save the Children, World Vision, UNFPA and, importantly, the local nongovernmental organizations,” says Dr Victoria Mukasa, WHO Infection Prevention and Control specialist, who spent more than 2 months in the district.

Dr James Squire, District Medical Officer in Kailahun, who was heading the response from the beginning, singles out key interventions: "The 2 most important things that helped to overcome the outbreak were the early establishment of response structures that we did with assistance of WHO and full involvement of community leaders."

“The decrease of cases in Kailahun is very good news, but it does not mean the epidemic is over – outreach and contact tracing activities play a major role at this stage and all actors involved should continue to monitor the situation very closely.”

UNRIC's related links:

UNRIC library backgrounder on Ebola
Article: Ebola, a global social crisis

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