CDC Grant: Enhancing Ebola Detection and Response in Guinea through Community-Based Surveillance and Safe Burial Practices

While WHO has recently suggested an additional 90 days of heightened surveillance, there is very limited information about the duration of viral persistence in survivors and thus the duration of heightened risk in a country that has experienced a major epidemic. Thus, the capacity for testing must be maintained for the foreseeable future and it is essential that that capacity be transferred from partner organizations to persons with long term responsibility for managing health risks in the community.
The US Centers for Disease Control and Prevention (CDC), has taken steps to respond to the rapidly changing EVD outbreak situation in West Africa. Hundreds of CDC staff members have provided logistics, staffing, communication, analytics, management, and other support functions for the response. CDC has established a Country Office in the region to assist with response and recovery efforts, including surveillance, contact tracing, data management, laboratory testing, and health education. In order to ensure rapid recognition of future cases and to ensure that any future flare ups of the EVD outbreak are rapidly controlled CDC must work with partners on the ground to strengthen the active surveillance conducted by community volunteers, community health workers (CHWs) and health facilities in the field, and assist the local governments with the needed epidemiologic technical assistance as needed to ensure that suspect cases are tested, contacts are identified and monitored, , and appropriate Infection Control and Prevention (IPC) activities occur within the local community level to prevent and control transmission. Rapid diagnostic tests offer the most practical way to test corpses. These tests have been newly developed in the context of the epidemic. While the performance characteristics are favorable, there is not widespread expertise with the use and interpretation of these tests and their effective use requires that they be used safely (for example with appropriate infection control precautions) and that they be linked with safe burials.
The testing and safe burials are two of the most important interventions for breaking the chain of transmission of Ebola. At this time, community-based surveillance programs are in early development in Guinea and the notification rate of community deaths is less than 50% in potential flare-up areas.