altEbola situation assessment, 25 November 2014 -Mali’s Ministry of Health has confirmed an additional 2 new cases of Ebola virus disease. The first, confirmed on 22 November, occurred in the 23-year-old fiancée of the 25-year-old nurse who attended the Grand Imam from Guinea (the index case in this outbreak) and died of Ebola on 11 November.

The young woman developed symptoms on 19 November and, on 20 November, was hospitalized in isolation at Bamako’s Ebola treatment centre, a new facility which opened last week.

Because of her association with the nurse, most of her close contacts were already under surveillance. Her case was detected early in the disease course. Her quick isolation has further reduced opportunities for community exposures.

The second new case is part of a family of previously confirmed and deceased patients. The 27-year-old man lost his mother and half-brother to Ebola.

He developed symptoms on 19 November and was admitted for treatment at the new facility on 24 November. Laboratory confirmation was received the same day.

The identification of patient contacts for daily monitoring has reportedly reached 99%. Based on experiences in Senegal and Nigeria, this achievement could augur well for rapid containment of Mali’s outbreak.

Collaboration with health officials in Guinea
To date, all 7 cases in this second wave of infections can be linked to contact with an Imam who developed symptoms on 17 October in his native village of Kourémalé, Guinea, and arrived in Bamako on 25 October for treatment at the Pasteur Clinic.

His case has been classified as a Guinea case as he developed symptoms there. After his death on 27 October, his body was returned to Kourémalé for a funeral the following day that attracted a large number of mourners.

These events ignited additional chains of transmission in Guinea, including several deaths, which are currently under investigation by WHO epidemiologists. Most of these patients had symptom onset in early to mid-November, indicating ongoing chains of transmission.

With WHO support, staff from Mali’s Ministry of Health will be meeting with health officials from Guinea to discuss cross-border measures for coordinating control efforts and reducing the likelihood that additional cases will be imported from Guinea into Mali.

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