1. Background

An outbreak of Ebola Viral Disease in Guinea was officially reported to WHO on 21st March 2014. Since, the Country Office in Ghana has been in the forefront of multiple unfolding events in Ghana. An official communication was sent to Ghana’s Minister of Health to inform her about the outbreak. Heads of bilateral and multilateral agencies and other partners were also provided with available information regarding the outbreak.

Several other activities have also been undertaken in the following areas:

Strengthening support to National Epidemic Management Committees
Update/review the Epidemic Preparedness and Response Plan
Activate alertness and enhance surveillance for viral hemorrhagic fevers
2. Current situation

As at 3 April, 2014, a total of 137 cases and 86 deaths have been reported from Guinea, with a Case Fatality Rate (CFR) of 62.7%, including three (3) new cases which resulted in two (2) deaths.

In Mali, three suspected cases have been reported among mine workers. The mine is situated close to the border with Guinea.

In Liberia, 7 suspected cases and 3 deaths have been reported.

Sierra Leone is following up on 15 contacts of suspected cases which originated from Guinea and have died.

3. Actions to date

i. Coordination

WHO participated in the first conveyed National Technical Coordinating Committee (NTCC) meeting held on 28th March 2014 attended by the Honorable Minister of Health, the Deputy Minister of Health, the MOH Chief Director, Representative of Minister of Interior, Director General of the Ghana Health Service (GHS) and several staff from agencies, institutions, ministries and partners.

Five Sub-committees (Epidemiologic Surveillance and Laboratory; Case Management; Social Mobilization, Health Education and Risk Communication; Logistics, Security and Financial resources; and Coordination) were put in place to define, plan and cost preparedness and response interventions. The Epidemic Preparedness and Response Plan currently being updated will incorporate the inputs related to Ebola from the 5 sub- committees. WHO is represented in all the 5 Sub-committees.
ii. Epidemiologic Surveillance and Laboratory

WCO has made available “WHO recommended Guidelines for Epidemic Preparedness and Response: Ebola Haemorrhagic Fever (EHF)” to guide surveillance activities.

So far, the MOH has taken the following steps to enhance surveillance:
Sent alerts were to Regions, districts and health facilities;
Shared a Fact Sheet on Ebola Surveillance to all Regional Directors of Health Services;
Conducted orientation for Port health staff. Orientation is also being planned for Environmental Health staff.
Briefed Senior Managers, including Regional Directors on the outreab and on preparedness interventions;

The Epidemiologic Surveillance and Laboratory subcommittee has outlined preparatory and response activities and drawn up a budget for the training and logistics required to enhance surveillance activities.

Noguchi Memorial Research Institute for Medical Research which has benefited from WHO training on diagnosing Emerging and Dangerous Pathogens indicated that it has capacity to perform laboratory diagnosis of the Ebola virus through PCR and shall be coordinating laboratory operations with the National Public Health Reference Laboratory.
iii. Case Management

WCO made available the following guidelines “Interim Infection Control Recommendations for Care of Patients with Suspected or Confirmed Filovirus (Ebola, Marburg) Haemorrhagic Fever” and WHO article on Ebola management for adaptation;

The case management sub-committee has defined the requirements for setting up and operationalizing isolation facilities, the needed logistics to equip them and the core team to be trained to man the isolation units

Guidelines for infection prevention and control, algorithm of patient flow in health facilities and referral, treatment protocols and standard operating procedures of the dead are being fine-tuned,

MOH is in the process of identifying potential facilities to have designated isolation units

WHO will support training on case management if the need arises.
iv. Information and Communications

WHO has shared daily updates on the Ebola Outbreak with the MOH and partners;

WHO also made available to the Social Mobilization, Health Education and Risk Communication for adaptation health education materials used in Uganda

A press release has been prepared for a joint release by WHO and the MOH

A presentation on Ebola Viral Disease is scheduled on the agenda of the upcoming National

EPI/Surveillance Review Meeting which Surveillance Officers from all 10 regions will be attending.
v. Logistics, Security and Financial resources

The Committee, which also includes WHO is working on prepositioning 1000 personal protective equipment in strategic locations in the country. Deployment of ambulances (already available in all 126 districts) is part of the preparedness activities

WHO is on standby to support the initial printing of 1000 health education posters and fact sheets on Ebola
3. Next Steps

A meeting of the NTCC is planned for today, to map out the next steps in Ghana, in view of the current situation. The meeting will review the outputs of the various working groups and chart the way forward.