Epidemiological Situation

The public health emergency of international concern regarding the Ebola outbreak in West Africa was declared over by the World Health Organization on March 29, 2016. Efforts to strengthen surveillance and public health security systems are continuing in Guinea, Sierra Leone, and Liberia to prevent new outbreaks of Ebola virus disease.

This was the largest Ebola virus disease (EVD) outbreak. It was declared in 2014 in the three most affected West African countries—Guinea, Sierra Leone, and Liberia—and ended with more than 280,000 reported cases, including 11,310 deaths. In Mali, a limited chain of transmission was reported in October 2014. Local transmission of the Ebola virus to healthcare workers was reported for the first time outside the African continent, in Spain (1) and the United States (2).

Even in the absence of a large-scale transmission chain, we can expect limited transmission outbreaks to emerge in the coming months due to the persistence of the virus in its environmental reservoir, the large number of survivors (more than 10,000), and reactivation or sexual transmission resulting from possible viral shedding in semen long after recovery. These outbreaks should be rapidly detected and controlled due to the strengthening of national control and surveillance measures.

The risk of imported EVD cases in France has once again become very low, comparable to the risk across sub-Saharan Africa prior to the 2014 West African epidemic. As with other viral hemorrhagic fevers, outside the context of a major epidemic, surveillance of Ebola virus disease now once again relies on the mandatory reporting of “African viral hemorrhagic fevers.” It is therefore the responsibility of every physician or laboratory technician to immediately notify the physician at the regional health agency of any suspected case in a person returning from equatorial regions of Africa or who has been in contact with a person suspected of having Ebola virus disease.

Santé publique France’s Response to the Ebola Outbreak in West Africa

Santé publique France (formerly InVS) has closely monitored the progression of this outbreak since the first cases appeared in Guinea and has issued regular epidemiological updates.

Since the start of the outbreak, France has mobilized to provide, alongside its partners, an appropriate response to this situation. In addition to implementing enhanced surveillance and measures to limit the transmission of the virus should a case be confirmed on French territory, Santé publique France has also contributed to the French response to the Ebola outbreak by sending epidemiologists to the affected countries, helping to train local teams, and strengthening public health networks.

Deployment of epidemiologists

The French Institute for Public Health Surveillance contributed to the international response aimed at eradicating the Ebola epidemic. As early as October 2014, epidemiologists from the institute were deployed in the field. These deployments are carried out either through the French interministerial response or through the international mobilization coordinated by the Global Outbreak Alert and Response Network (GOARN), a technical collaboration mechanism of the World Health Organization.
Support from InVS epidemiologists has focused on French-speaking West African countries, specifically Mali and Guinea. Since January 2015, the InVS’s contribution to the global response under the auspices of GOARN has been ongoing and consists of ensuring the presence of at least two InVS epidemiologists in Guinea for missions lasting 4 to 5 weeks. These volunteer epidemiologists are selected based on their specific expertise in Ebola virus disease and/or their prior field experience in epidemic control. They have contributed their expertise in epidemiological investigation and surveillance. This presence was maintained until the eradication of Ebola virus disease in Guinea.

View the timeline of our volunteers

Training Support

The Project to Support the Establishment of Eight Regional Multipurpose Epidemic Alert and Response Teams (PREPARE) is a project co-financed by the European Union and France that aims to train teams of 24 people per region in Guinea to form “anti-epidemic task forces.” It is part of the broader effort to combat epidemics in general, and the Ebola virus epidemic in particular.
Under the supervision of the Ministry of Foreign Affairs and International Development (MAEDI), the French partners involved are Expertise France, the Bioforce Institute, and the French Civil Protection Agency.

PREPARE has two components:

• strengthening the skills of team personnel;

• supporting the deployment and operations of the teams.

The project is being carried out in two phases:

An initial phase of training and deployment of local teams, from March to July 2015. In this context, the InVS contributed to the epidemiological training of multidisciplinary teams (doctors, biologists, community health workers, etc.). This two-day epidemiology training course covers, through theoretical lectures and case studies, epidemiological surveillance, early detection and warning systems, investigation—particularly active case finding—and contact tracing in the context of Ebola virus disease.
The second phase, from August 2015 to June 2016, focuses on strengthening training and providing operational support for these teams. As part of this effort, the InVS will establish a remote mentorship system, with senior InVS epidemiologists serving as advisors to Guinean regional epidemiologists. Two on-site sessions will be organized to review the teams’ performance and provide in-depth training to regional epidemiologists.

Strengthening Networks

The RIPOST project is a French initiative led by Expertise France and developed within the framework of the Ebola Task Force. Its objective is to strengthen the capacities of French-speaking West African countries in the areas of epidemiological surveillance, health monitoring and early warning, operational research, and training. To achieve this, it aims to facilitate networking among organizations responsible for public health expertise to enable better information sharing and, ultimately, to assist health authorities in decision-making.
The French Institute for Public Health Surveillance is part of the project’s Steering Committee, alongside the French Development Agency (AFD), the Center for Epidemiology and Public Health of the Armed Forces (CESPA), and the Pasteur Institutes Network, among others. It is involved in exploratory field missions.

The RIPOST project’s activities are carried out in collaboration with the World Health Organization’s Regional Office for Africa (WHO AFRO), the West African Health Organization (WAHO), and the Centers for Disease Control and Prevention (CDC, Atlanta).