tKZZZ K KsZst d st E s d - PDF document

1 t,K͗ďŽůĂZĞƐƉŽŶƐĞZŽĂĚŵĂƉ^ŝƚƵĂƚŝŽŶZĞƉŽƌƚ Ï­  KĐƚŽďĞƌ  ϮϬϭϰ KsZs/t dŚĞƚŽƚĂůŶƵŵďĞƌŽĨƉƌŽďĂďůĞ͕ĐŽŶĨŝƌŵĞĚ ĂŶĚƐƵƐƉĞĐƚĞĚĐĂƐĞƐ;ƐĞĞŶŶĞdžÏ­ Í¿ŝŶƚŚĞĐƵƌƌĞŶƚŽƵƚďƌĞĂŬ ŽĨďŽůĂǀŝƌƵƐĚŝƐĞĂƐĞ;sÍ¿ŝŶtĞƐƚĨƌŝĐĂ ƌĞƉŽƌƚĞĚƵƉƚŽ Ï® Ï´  ^ĞƉƚĞŵďĞƌϮϬϭϰ ŝƐ  ϳϭϳϴ ͕ǁŝƚŚ ϯ ϯϯ Ï´  ĚĞĂƚŚƐ ͘ŽƵŶƚƌŝĞƐĂĨĨĞĐƚĞĚĂƌĞ'ƵŝŶĞĂ͕>ŝďĞƌŝĂ͕EŝŐĞƌŝĂ͕^ĞŶĞŐĂůĂ ŶĚ^ŝĞƌƌĂ>ĞŽŶĞ͘&ŝŐƵƌĞÏ­ ƐŚŽǁƐƚŚĞ ƚŽƚĂůŶƵŵďĞƌŽĨĐŽŶĨŝƌŵĞĚĂŶĚƉƌŽďĂďůĞĐĂƐĞƐ ŝŶƚŚĞƚŚƌĞĞŚŝŐŚ - ƚƌĂŶƐŵŝƐƐŝŽŶĐŽƵŶƚƌŝĞƐ;'ƵŝŶĞĂ͕ >ŝďĞƌŝĂ͕ĂŶĚ^ŝĞƌƌĂ>ĞŽŶĞͿ  ƌĞƉŽƌƚĞĚŝŶĞĂĐŚĞƉŝ ĚĞŵŝŽůŽŐŝĐĂůǁĞĞŬďĞƚǁĞĞŶϯϬĞĐĞŵďĞƌϮϬϭϯ;ƐƚĂƌƚ ŽĨĞƉŝĚĞŵŝŽůŽŐŝĐĂůǁĞĞŬÏ­Í¿ĂŶĚÏ® Ï´  ^ĞƉƚĞŵďĞƌϮϬϭϰ; ĞŶĚŽĨ ĞƉŝĚĞŵŝŽůŽŐŝĐĂůǁĞĞŬϯ ϵ Í¿ ͘  &ŽƌƚŚĞ ƐĞĐŽŶĚǁĞĞŬŝŶĂƌŽǁƚ ŚĞ ƚŽƚĂů ŶƵŵďĞƌ  ŽĨƌĞƉŽƌƚĞĚŶĞǁĐĂƐĞƐ ŚĂƐĨĂůůĞŶ ͘ /ƚŝƐĐůĞĂƌ͕Ś ŽǁĞǀĞƌ͕ ƚŚĂƚ sĐĂƐĞƐĂƌĞƵŶĚĞƌ - ƌĞƉŽƌƚĞĚĨƌŽŵƐĞǀĞƌĂůŬĞLJůŽĐĂƚŝŽŶƐ͘ dƌĂŶƐŵŝƐƐŝŽŶƌĞŵĂŝŶƐ  ƉĞƌƐŝƐƚĞŶƚĂŶĚ ǁŝĚĞƐƉƌĞĂĚŝŶ'ƵŝŶĞĂ͕>ŝďĞƌŝĂĂŶĚ^ŝĞƌƌĂ>ĞŽŶĞ͕ǁŝƚŚ ƐƚƌŽŶŐĞǀŝĚĞŶĐĞ ŽĨŝŶĐƌĞĂƐŝŶŐ ĐĂƐĞ ŝŶĐŝĚĞŶĐĞŝŶ ƐĞǀĞƌĂůĚŝƐƚƌŝĐƚƐ͘  dŚĞ ƌĞĂ ƌĞ  ĨĞǁƐŝŐŶƐLJĞƚƚŚĂƚƚŚĞsĞ ƉŝĚĞŵŝĐ ŝŶtĞƐƚĨƌŝĐĂŝƐ ďĞŝŶŐďƌŽƵŐŚƚƵŶĚĞƌ ĐŽŶƚƌŽů ͘ Khd>/E dŚŝƐŝƐƚŚĞ ƐŝdžƚŚ  ŝŶĂƐĞƌŝĞƐŽĨƌĞŐƵůĂƌƐŝƚƵĂƚŝŽŶƌĞƉŽƌƚƐŽŶƚŚĞďŽůĂZĞƐƉŽŶƐĞZŽĂĚŵĂƉ 1 ͘dŚĞƌĞƉŽƌƚ ĐŽŶƚĂŝŶƐĂƌĞǀŝĞǁŽĨƚŚĞĞƉŝĚĞŵŝŽůŽŐŝĐĂůƐŝƚƵĂƚŝŽŶďĂƐĞĚŽŶŽĨĨŝĐŝĂůŝŶĨŽƌŵĂƚŝŽŶƌĞƉŽƌƚĞĚďLJ ŵŝŶŝƐƚƌŝĞƐŽĨŚĞĂůƚŚ͕ĂŶĚĂŶĂƐƐĞƐƐŵĞŶƚŽĨƚŚĞƌĞƐƉŽŶƐĞŵĞĂƐƵƌĞĚĂŐĂŝŶƐƚƚŚĞĐŽƌĞZŽĂĚŵĂƉ ŝŶĚŝĐĂƚŽƌƐǁŚĞƌĞĂǀĂŝůĂďůĞ͘dŚĞĚĂƚĂĐŽŶƚĂŝŶĞĚŝŶƚŚŝƐƌĞƉŽƌ ƚĂƌĞďĂƐĞĚŽŶƚŚĞďĞƐƚŝŶĨŽƌŵĂƚŝŽŶ ĂǀĂŝůĂďůĞ͘^ƵďƐƚĂŶƚŝĂůĞĨĨŽƌƚƐĂƌĞŽŶŐŽŝŶŐƚŽŝŵƉƌŽǀĞƚŚĞĂǀĂŝůĂďŝůŝƚLJĂŶĚĂĐĐƵƌĂĐLJŽĨŝŶĨŽƌŵĂƚŝŽŶ ĂďŽƵƚďŽƚŚƚŚĞĞƉŝĚĞŵŝŽůŽŐŝĐĂůƐŝƚƵĂƚŝŽŶĂŶĚƚŚĞŝŵƉůĞŵĞŶƚĂƚŝŽŶŽĨƚŚĞƌĞƐƉŽŶƐĞ͘ &ŽůůŽǁŝŶŐƚŚĞƌŽĂĚŵĂƉƐƚƌƵĐƚƵƌĞ͕ĐŽƵŶƚ ƌLJƌĞƉŽƌƚƐĨĂůůŝŶƚŽƚŚƌĞĞĐĂƚĞŐŽƌŝĞƐ͗ ; Ï­Í¿ ƚŚŽƐĞǁŝƚŚ ǁŝĚĞƐƉƌĞĂĚĂŶĚŝŶƚĞŶƐĞƚƌĂŶƐŵŝƐƐŝŽŶ;'ƵŝŶĞĂ͕>ŝďĞƌŝĂ͕ĂŶĚ^ŝĞƌƌĂ>ĞŽŶĞͿ͖ ; ϮͿ ƚŚŽƐĞǁŝƚŚĂŶŝŶŝƚŝĂů ĐĂƐĞŽƌĐĂƐĞƐ͕ŽƌǁŝƚŚůŽĐĂůŝnjĞĚƚƌĂŶƐŵŝƐƐŝŽŶ;EŝŐĞƌŝĂ͕^ĞŶĞŐĂůͿ͖ĂŶĚ ; ϯͿ ͕  ƚŚŽƐĞĐŽƵŶƚƌŝĞƐƚŚĂƚ ŶĞŝŐŚďŽ ƵƌĂƌĞĂƐŽĨĂĐƚŝǀĞƚƌĂŶƐŵŝƐƐŝŽŶ;ĞŶŝŶ͕ƵƌŬŝŶĂ&ĂƐŽ͕ƀƚĞĚ͛/ǀŽŝƌĞ͕'ƵŝŶĞĂ - ŝƐƐĂƵ͕DĂůŝ͕ ^ĞŶĞŐĂůͿ͘ŶŽǀĞƌǀŝĞǁŽĨƚŚĞƐŝƚƵĂƚŝŽŶŝŶƚŚĞĞŵŽĐƌĂƚŝĐZĞƉƵďůŝĐŽĨƚŚĞŽŶŐŽ͕ǁŚĞƌĞ ƚŚĞƌĞŝƐ Ă ƐĞƉĂƌĂƚĞ͕ƵŶƌĞůĂƚĞĚŽƵƚďƌĞĂŬŽĨ s ͕ŝƐĂůƐŽƉƌŽǀŝĚĞĚ;ƐĞĞŶŶĞdžÏ® Ϳ͘  &ŝŐƵƌĞϭ͗ ŽŶĨŝƌŵĞĚĂŶĚƉƌŽďĂďůĞĐĂƐĞƐŽĨďŽůĂǀŝƌƵƐĚŝƐĞĂƐĞŝŶ  'ƵŝŶĞĂ͕>ŝďĞƌŝĂ͕ĂŶĚ^ŝĞƌƌĂ>ĞŽŶĞ ĂƚĂĂƌĞďĂƐĞĚŽŶŽĨĨŝĐŝĂůŝŶĨŽƌŵĂƚŝŽŶƌĞƉŽƌƚĞĚďLJDŝŶŝƐƚƌŝĞƐŽĨ,ĞĂůƚŚ͘dŚĞƐĞŶƵŵďĞƌƐĂƌĞƐƵďũĞĐƚƚŽĐŚĂŶŐĞĚƵĞƚŽ ŽŶŐŽŝŶŐƌĞĐůĂƐƐŝĨŝĐĂƚŝŽŶ͕ƌĞƚƌŽƐƉĞĐƚŝǀĞŝŶǀĞƐƚŝŐĂƚŝŽŶĂŶĚĂǀĂŝůĂďŝůŝƚLJŽĨůĂďŽƌĂƚŽƌLJƌĞƐƵůƚƐ͘ 1 &ŽƌƚŚĞďŽůĂZĞƐƉŽŶƐĞZŽĂĚŵĂƉƐĞĞ͗ ŚƚƚƉ͗ͬͬǁǁǁ͘ǁŚŽ͘ŝŶƚͬĐƐƌͬƌĞƐŽƵƌĐĞƐͬƉƵďůŝĐĂƚŝŽŶƐͬĞďŽůĂͬƌĞƐƉŽŶƐĞ - ƌŽĂĚŵĂƉͬĞŶͬ 2 1. COUNTRIES WITH WIDESPREAD AND INTENSE TRAN SMISSION The upward epidemic trend continues in Sierra Leone and most probably also in Liberia. By contrast , the situation in Guinea appears to be more stable, though it must be emphasized that in the context of an outbreak of EVD , a stable pattern of tran smission is still of grave concern , and could change quickly (figure 1 ; table 1 ) . Table 1: Probable, confirmed, and suspected cases in Guinea, Liberia, and Sierra Leone as at end 28 September 2014 Country Case definition Cases Cases in past 21 days Cases in past 21 days/total cases Deaths Guinea Confirmed 950 230 24 % 535 Probable 170 14 8 % 170 Suspected 37 23 62 % 5 All 1157 270 23 % 710 Liberia Confirmed 927 280 30 % 890 Probable 1656 687 42 % 664 Suspected 1113 672 60 % 444 All 3696 1639 44 % 1998 Sierra Leone Confirmed 2076 788 38 % 574 Probable 37 0 0 % 3 7 Suspected 191 106 56 % 11 All 2304 894 39 % 622 Total 7157 2800 39 % 3330 Data are based on official information reported by Ministries of Health. These numbers are subject to change due to ongoing reclassification, retrospective investigation and availability of laboratory results. 'h/E Reports from Guinea show a slight fall in the number of new cases reported compared with each of the past five weeks (figure 2) . This fall is largely attributable to a drop in the number of new cases reported from Macenta district , which had seen a surge in the number of new cases over the past five weeks. Figure 2: Ebola virus disease cases reported each week from Guinea and Conakry Data are based on official information reported by Ministries of Health. These numbers are subject to change due to ongoing reclassification, retrospective investigation and availability of laboratory results . 3 Transmission is persistent in Gueckedou, the region in which the outbreak originated, which has report ed between five and 20 new cases over the past 10 weeks . T here has been a slight increase in the number of new cases reported in the capital , Conakry , with 27 new confirmed cases reported this week . Beyla district , which borders ƀƚĞĚ͛/ǀŽŝƌĞ , has now reported its first confirmed case . >/Z/ dŚĞ ĐŽŶƚŝŶƵĞĚ ĨĂůůŝŶƚŚĞŶƵŵďĞƌŽĨ ƌĞƉŽƌƚĞĚ ŶĞǁĐĂƐĞƐ ƐŚŽǁŶŝŶĨŝŐƵƌĞÏ­ ŝƐůĂƌŐĞůLJĂƚƚƌŝďƵƚĂďůĞƚŽ ƚŚĞ  ƐŚĂƌƉĚƌŽƉŝŶƚŚĞŶƵŵďĞƌŽĨĐŽŶĨŝƌŵĞĚŶĞǁĐĂƐĞƐƌĞƉŽƌƚĞĚĨƌŽŵ>ŝďĞƌŝĂ  ŽǀĞƌƚŚĞƉĂƐƚƚǁŽ ǁĞĞŬƐ ͘ >ĂƐƚǁĞĞŬ  ƚŚĞƌĞǁĞƌĞŶŽŶĞǁƌĞƉŽƌƚĞĚĐŽŶĨŝƌŵĞĚĐĂƐĞƐĨƌŽŵƚŚĞĐĂƉŝƚĂů͕DŽŶƌŽǀŝĂ͕ǁŚŝĐŚŝŶ ƉƌĞǀŝŽƵƐǁĞĞŬƐŚĂ Ě  ƌĞƉ ŽƌƚĞĚĂƐƵƌŐĞŝŶĐĂƐĞƐ͘ dŚŝƐǁĞĞŬ͕ĨŝǀĞŶĞǁĐŽŶĨŝƌŵĞĚĐĂƐĞƐŚĂǀĞďĞĞŶ ƌĞƉŽƌƚĞĚŝŶDŽŶƌŽǀŝĂ͕ďƵƚƚŚĞƌĞƌĞŵĂŝŶƐĐŽŵƉĞůůŝŶŐĞǀŝĚĞŶĐĞ ŽďƚĂŝŶĞĚĨƌŽŵƌĞƐƉŽŶĚĞƌƐ ĂŶĚ ůĂďŽƌĂƚŽƌLJƐƚĂĨĨ ŝŶ ƚŚĞĐŽƵŶƚƌLJƚŚĂƚƚŚĞƌĞŝƐǁŝĚĞƐƉƌĞĂĚƵŶĚĞƌ - ƌĞƉŽƌƚŝŶŐŽĨŶĞǁĐĂƐĞƐ͕ĂŶĚƚŚĂƚƚ ŚĞ ƐŝƚƵĂƚŝŽŶŝŶ  >ŝďĞƌŝĂ ͕ĂŶĚŝŶDŽŶƌŽǀŝĂŝŶƉĂƌƚŝĐƵůĂƌ ͕ĐŽŶƚŝŶƵĞƐƚŽĚĞƚĞƌŝŽƌĂƚĞ ͘ Figure 3: Ebola virus disease cases reported each week from Liberia and Monrovia Data are based on official information reported by Ministries of Health. These numbers are subject to change due to ongoing reclassification, retrospective investigation and availability of laboratory results.   ůĂƌŐĞŶƵŵďĞƌŽĨƐƵƐƉĞĐƚĞĚŶĞǁĐĂƐĞƐ;ĂŶĚĚ ĞĂƚŚƐĂŵŽŶŐƐƵƐƉĞĐƚĞĚĐĂƐĞƐͿ ŚĂǀĞďĞĞŶ ƌĞƉŽƌƚĞĚ ĨƌŽŵ>ŝďĞƌŝĂŽǀĞƌƚŚĞƉĂƐƚǁĞĞŬ͘/ƚŝƐǀĞƌLJůŝŬĞůLJƚŚĂƚĂƐƵďƐƚĂŶƚŝĂůƉƌŽƉŽƌƚŝŽŶŽĨƚŚĞƐĞƐƵƐƉĞĐƚĞĚ ĐĂƐĞƐĂƌĞŐĞŶƵŝŶĞĐĂƐĞƐŽĨs͕ĂŶĚƚŚĂƚƚŚĞƌĞƉŽƌƚĞĚĨĂůůŝŶĐŽŶĨŝƌŵĞĚĐĂƐĞƐƌĞĨůĞĐƚƐĚĞůĂLJƐŝŶ ŵĂƚĐŚŝŶŐůĂ ďŽƌĂƚŽƌLJƌĞƐƵůƚƐǁŝƚŚĐůŝŶŝĐĂůƐƵƌǀĞŝůůĂŶĐĞĚĂƚĂ͘ĨĨŽƌƚƐĂƌĞďĞŝŶŐŵĂĚĞƚŽƵƌŐĞŶƚůLJĂĚĚƌĞƐƐ ƚŚŝƐƉƌŽďůĞŵ͕ĂŶĚŝƚŝƐůŝŬĞůLJƚŚĂƚƚŚĞĨŝŐƵƌĞƐǁŝůůďĞƌĞǀŝƐĞĚƵƉǁĂƌĚƐŝŶĚƵĞĐŽƵƌƐĞ͘ƚƚŚĞƉƌĞƐĞŶƚ ƚŝŵĞ͕ƚŚĞŶƵŵďĞƌƐŽĨƉƌŽďĂďůĞĂŶĚƐƵƐƉĞĐƚĞĚĐĂƐĞƐ͕ƚŽŐĞƚŚĞƌǁ ŝƚŚƚŚŽƐĞĐŽŶĨŝƌŵĞĚ͕ŵĂLJďĞĂŵŽƌĞ ĂĐĐƵƌĂƚĞƌĞĨůĞĐƚŝŽŶŽĨĐĂƐĞŶƵŵďĞƌƐŝŶ>ŝďĞƌŝĂ͘  dŚĞĐŽƵŶƚŝĞƐŽĨ  ŽŶŐ͕'ƌĂŶĚĂƐƐĂ͕DĂƌŐŝďŝĂŶĚ EŝŵďĂĐŽŶƚŝŶƵĞ  ƚŽ ƌĞƉŽƌƚŚŝŐŚŶƵŵďĞƌƐŽĨŶĞǁ  ĐĂƐĞƐ͘dŚĞ ƌĞ  ŚĂƐďĞĞŶůŝƚƚůĞĐŚĂŶŐĞŝŶƚŚĞ ŶƵŵďĞƌŽĨ ŶĞǁĐĂƐĞƐ ƌĞƉŽƌƚĞĚ ŝŶ>ŽĨĂ͕ ǁŚŝĐŚďŽƌĚĞƌƐ 'ƵĞĐŬĞĚŽƵŝŶ'ƵŝŶĞĂ͕  ĨŽƌ  ƚŚĞƉĂƐƚƚŚƌĞĞǁĞĞŬƐ ͕ ǁŝƚŚϯϴ ĐŽŶĨŝƌŵĞĚĂŶĚƉƌŽďĂďůĞĐĂƐĞƐƌĞƉŽƌƚĞĚƚŚŝƐǁĞĞŬ ͘  ^/ZZ>KE EĂƚŝŽŶĂůůLJ͕ƚ ŚĞƐŝƚƵĂƚŝŽŶŝŶ^ŝĞƌƌĂ>ĞŽŶĞ ĐŽŶƚŝŶƵĞƐƚŽ ĚĞƚĞƌŝŽƌĂƚ Ğ ͕ǁŝƚŚĂ Ŷ  ŝŶĐƌĞĂƐĞŝŶƚŚĞŶƵŵďĞƌŽĨ ŶĞǁĐŽŶĨŝƌŵĞĚĐĂƐĞƐƌĞƉ ŽƌƚĞĚŽǀĞƌĞĂĐŚŽĨƚŚĞƉĂƐƚƐŝdž  ǁĞĞŬƐ͘dŚĞŶĞŝŐŚďŽƵƌŝŶŐĚŝƐƚƌŝĐƚƐŽĨWŽƌƚ >ŽŬŽ͕ŽŵďĂůŝ͕ĂŶĚDŽLJĂŵďĂ ͕  ǁŚŝĐŚĂƌĞĂĚũĂĐĞŶƚƚŽ ƚŚĞĐĂƉŝƚĂů͕&ƌĞĞƚŽǁŶ͕  ŚĂǀĞŶŽǁďĞĞŶ ƋƵĂƌĂŶƚŝŶĞĚ  ĂĨƚĞƌ  ĂƐƵƌŐĞŝŶŶĞǁĐĂƐĞƐŽǀĞƌƚŚĞƉĂƐƚ ĨŽƵƌ  ǁĞĞŬƐ͘ dŽŶŬŽůŝůŝŚĂƐĂůƐŽƌĞƉŽƌƚĞĚĂƌŝƐĞŝŶ ƚŚĞŶƵŵďĞƌŽĨŶĞǁĐĂƐĞƐƚŚŝƐǁĞĞŬ͘ LJĐŽŶƚƌĂƐƚ͕  ĂǀĞƌLJůŽǁ  ŶƵŵďĞƌŽĨŶĞǁ ĐĂƐĞƐ ŚĂǀĞďĞĞŶ ƌĞƉŽƌƚĞĚĨƌŽŵ  <ĂŝůĂŚƵŶĂŶĚ<ĞŶĞŵĂ  ĨŽƌƚŚĞƉĂƐƚƚǁŽǁĞĞŬƐ͘dŚĞƐĞĂƌĞĂƐŚĂĚƉƌĞǀŝŽƵ ƐůLJƌĞƉŽƌƚĞĚ ŚŝŐŚůĞǀĞůƐŽĨƚƌĂŶƐŵŝƐƐŝŽŶ͘  & ƵƌƚŚĞƌŝŶǀĞƐƚŝŐĂƚŝŽŶǁŝůůďĞƌĞƋƵŝƌĞĚƚŽĐŽŶĨŝƌŵǁŚĞƚŚĞƌƚŚŝƐĨĂůůŝƐ ŐĞŶƵŝŶĞ ͕ŽƌĂƌĞƐƵůƚŽĨ ƵŶĚĞƌ - ƌĞƉŽƌƚŝŶŐ ͘  ƚƉƌĞƐĞŶƚ ͕  ƚŚĞůĂƚƚĞƌĂƉƉĞĂƌƐŵŽƌĞůŝŬĞůLJ͘ Figure 4: Ebola virus disease cases reported each week from Sierra Leone and Freetown 4 Data are based on official information reported by Ministries of Health. These numbers are subject to change due to ongoing reclassification, retrospective investigation and availability of laborat ory results. HEALTH - CARE WORKERS The high number of EVD infections in health - care workers ( HCWs ) continues to be a cause of great concern . 377 HCWs have now been infected with EVD as of 28 September , 216 of whom have died (table 2) . Table 2: Ebola virus disease infections in healthcare workers as of 28 September 2014 Country Case definition Cases Deaths Guinea Confirmed 59 27 Probable 8 8 Suspected 0 0 All 67 35 Liberia Confirmed 73 63 Probable 88 28 Suspected 24 4 All 185 95 Nigeria Confirmed 11 5 Probable 0 0 Suspected 0 0 All 11 5 Sierra Leone Confirmed 111 78 Probable 2 2 Suspected 1 1 All 114 81 Total 377 216 Data are based on official information reported by Ministries of Health. These numbers are subject to change due to ongoing reclassification, retrospective investigation and availability of laboratory results. GEOGRAPHICAL DISTRIBUTION AND NEWLY AFECTED DISTRICTS &ŝŐƵƌĞϱƐŚŽǁƐƚŚĞůŽĐĂƚŝŽŶŽĨĐĂƐĞƐƚŚƌŽƵŐŚŽƵƚƚŚĞĐŽƵŶƚƌŝĞƐǁŝƚŚǁŝĚĞƐƉƌĞĂĚĂŶĚŝŶƚĞŶƐĞ ƚƌĂŶƐŵŝƐƐŝŽŶ͘dŚĞĐƵŵƵůĂƚŝǀĞŶƵŵďĞƌŽĨĐĂƐĞƐƚŽĚĂƚĞŝŶĞĂĐŚĂƌĞĂŝƐƐŚŽǁŶ;ŐƌĞLJĐŝƌĐůĞƐͿ͕ƚŽŐĞƚŚĞƌ ǁŝƚŚƚŚĞŶƵŵďĞƌŽĨĐĂƐĞƐƚŚĂƚŚĂǀĞŽĐĐƵƌƌĞĚǁŝƚŚŝŶƚŚĞÏ® Ï­ĚĂLJƐ;ƌ ĞĚĐŝƌĐůĞƐͿƵƉƚŽϮϴ  ^ĞƉƚĞŵďĞƌ͘ Ten districts in which previous cases were confirmed have reported no cases during the 21 days prior to the end of 2 8 September ( nine districts in Guinea, one in Sierra Leone ). In Guinea, there has 5 been one confirmed case reported in the newly affected Beyla district , on the border with Côte Ě͛/ǀŽŝƌĞ . In Liberia, t he previously uninfected area of Grand Kru, near the border with ƀƚĞĚ͛/ǀŽŝƌĞ , has now reported six confirmed case s of EVD . Figure 5: Geographical distribution of new cases and total cases in Guinea, Liberia, and Sierra Leone Data are based on official information reported by Ministries of Health . The boundaries and names shown and the designations used on this map do not imply the exp ression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement.