Faranah Guinea



Keywords: contact tracing, ebola, ebola virus disease, epidemic control, guinea, viruses
Description: The largest recorded Ebola virus disease epidemic began in March 2014; as of July 2015, it continued in 3 principally affected countries: Guinea, Liberia, and Sierra Leone. Control efforts include contact tracing to expedite identification of the virus in suspect case-patients. We examined contact tracing activities during September 20–December 31, 2014, in 2 prefectures of Guinea using national and local data about case-patients and their contacts. Results show less than one third of case-patients (28.3% and 31.1%) were registered as contacts before case identification; approximately two thirds (61.1% and 67.7%) had no registered contacts. Time to isolation of suspected case-patients was not immediate (median 5 and 3 days for Kindia and Faranah, respectively), and secondary attack rates varied by relationships of persons who had contact with the source case-patient and the type of case-patient to which a contact was exposed. More complete contact tracing efforts are needed to augment control of this epidemic.

Contact Tracing Activities during the Ebola Virus Disease Epidemic in Kindia and Faranah, Guinea, 2014

The largest recorded Ebola virus disease epidemic began in March 2014; as of July 2015, it continued in 3 principally affected countries: Guinea, Liberia, and Sierra Leone. Control efforts include contact tracing to expedite identification of the virus in suspect case-patients. We examined contact tracing activities during September 20–December 31, 2014, in 2 prefectures of Guinea using national and local data about case-patients and their contacts. Results show less than one third of case-patients (28.3% and 31.1%) were registered as contacts before case identification; approximately two thirds (61.1% and 67.7%) had no registered contacts. Time to isolation of suspected case-patients was not immediate (median 5 and 3 days for Kindia and Faranah, respectively), and secondary attack rates varied by relationships of persons who had contact with the source case-patient and the type of case-patient to which a contact was exposed. More complete contact tracing efforts are needed to augment control of this epidemic.

During March 23, 2014–July 8, 2015, Guinea reported 3,748 Ebola virus disease (EVD) cases and 2,499 EVD-related deaths (1 ), as part of what is the largest reported EVD epidemic to date (2 ). Thorough case identification and contact tracing are necessary to end this epidemic (3 ). Contact tracing involves locating all persons who have been exposed to someone infected with Ebola virus (case-patients) or their body fluids and monitoring them daily for EVD symptoms during the 3 weeks after the last exposure (4 ). This tracing permits immediate identification and isolation of symptomatic contacts (suspected case-patients). Incomplete contact tracing and delayed time to isolation of suspected case-patients may result in transmission of EVD to others in the community, perpetuating the epidemic.

EVD cases in Guinea are categorized into 1 of 3 case definitions modified from World Health Organization recommendations: 1) suspected case (in a living person with fever and > 3 of these symptoms: headache, anorexia, lethargy, aching muscles or joints, difficulty breathing, vomiting, diarrhea, stomach pain, difficulty swallowing, hiccups; or with fever and a history of contact with a person with hemorrhagic fever or a dead or sick animal; or with unexplained bleeding); 2) probable case (in a deceased person who otherwise met the suspect case definition and has an epidemiologic link to a confirmed or probable case); or 3) confirmed case (suspected or probable case that also has laboratory confirmation) (5 ). Cases are reported by using a standardized case reporting form, data from which are submitted to the national viral hemorrhagic fever (VHF) case database.

Cases from the 2 prefectures were identified and cross-referenced between the national VHF case database and the prefecture case database. Demographic information (sex, age) and case classification (confirmed, probable) were abstracted. Because this investigation was part of a public health response and considered to be nonresearch, it was not subject to US Centers for Disease Control and Prevention Institutional Review Board review.

To identify and register contacts of persons infected with EVD, prefecture public health officials and ETU staff interviewed case-patients, their families, and community members and documented resulting information on standardized contact registration forms (6 ). A contact is defined as someone at risk for infection with EVD because he or she has slept in the same household as a confirmed or probable EVD case-patient, had direct physical contact with the case-patient during that person’s illness, had direct physical contact with the body of a case-patient at a funeral or during burial preparation, touched the body fluids of a case-patient during illness, touched the case-patient’s clothes or linens, or is an infant breastfed by the case-patient (6 ). Demographic data of contacts (name, age, sex, relationship to the presumed source case-patient, and prefecture and subprefecture of residence) and daily follow-up data (presence or absence of symptoms) were obtained through use of standardized contact tracing forms (6 ), which populated a prefecture contact database.

We performed demographic descriptive analyses using nonduplicated contact data; the individual person was the unit of analysis. We performed other nondemographic descriptive analyses using contact event data; the contact event was the unit of analysis because a single contact may have had contact with several case-patients, resulting in several contact events per person. The case and contact databases may show differing numbers of source cases because contacts in a prefecture might have contacted source case-patients in another prefecture and data quality issues could exist. The date of isolation was the date a suspected case-patient was transported to an ETU. We created the following definitions: time to isolation (days) was calculated by subtracting the date of first symptom onset from the date of isolation; family/household member was anyone related by blood or marriage or who lived in the same household as the case-patient or was described as being a caregiver, excluding health care workers; safe burial was a burial with placement of the body in an impermeable bag and interment by a team wearing personal protective equipment (7 ). Secondary attack rate was calculated as the proportion of new cases among contact events × 100 (8 ). Because variables had nonparametric distributions, medians were analyzed. Relative risks were used to quantify the risk for becoming a secondary case-patient after exposure to a case-patient by relationship status or a case-patient by epidemiologic case classification. We used χ 2 tests to measure associations between categorical variables; specifically, to compare attack rates among family members and non–family members and among contacts to confirmed versus probable cases. A p value of ≤0.05 was considered statistically significant. Epidemiologic weeks were in accordance with those designated by in-country situation reports.




Photogallery Faranah Guinea:



Faranah, Guinea
Countries: Guinea on Pinterest | Baby sleep, African Women and History
An Australian Drilling in Africa [Images] | Mining Australia

Uzi, Faranah, Guinea
Fode, Faranah, Guinea
Faranah in Guinea: general information, weather, map, photo and video

Senegal Photos
The World's most recently posted photos of faranah - Flickr Hive Mind
Sayo Comedian, Faranah, Guinea

Birchir Thread #60 - Page 28 - Arofanatics Fish Talk Forums
Faranah Iron Ore Property (573 km²) - Guinea Iron Ore Limited (GIO ...
Images from Guinea | Chi Sharpe

Afrique - Guinée Française - Conakry - Concours agricole - Groupes ...
the Spear: Fadouba Oularé
Senegal Photos

d8901c88a205f22d650f6a7067000441.jpg - Washington Times
Bichir Thread #59 - Page 30 - Arofanatics Fish Talk Forums
Sayo Rasta, Faranah, Guinea

Week #2 in Guinea, West Africa — Dave Kobrenski
Faranah - Places | Facebook
Faranah Iron Ore Property (573 km²) - Guinea Iron Ore Limited (GIO ...