Headlines - Ebola Virus Disease Outbreak in West Africa, March 2014

Health authorities in the Republic of Guinea (Guinea Conakry) confirmed on March 21, 2014, the existence of an Ebola virus outbreak within their national territory. As of April 1, the provisional tally stood at 122 suspected cases of viral hemorrhagic fever (VHF) in the Republic of Guinea, including 80 deaths (case fatality rate of 65%). In total, 24 cases have been biologically confirmed by the National Reference Center (CNR) for VHF (Inserm-Institut Pasteur, Lyon), the Institut Pasteur in Dakar, and the Bernhard-Nocht Institute in Hamburg. The risk of an imported case of Ebola VHF, contracted during this outbreak, occurring in France is very low but cannot be completely ruled out. In this context, on March 25, the Directorate General for Health issued a MARS message to the Regional Health Agencies (ARS) and healthcare facilities, including a case definition established by the InVS, and indicating, on the one hand, that suspected cases must be reported to the ARS by the physicians treating these patients, and, secondly, to consult the healthcare facility’s designated infectious disease specialist for the evaluation and management of patients. As of March 28, the case definition established the risk zone as comprising Sierra Leone, Guinea, and Liberia, following consultation with the CNR FHV and due to the difficulty of defining a precise geographical boundary in the context of an evolving epidemic. A suspected case is defined as any person presenting, within 21 days of returning from the risk area, with a fever of 38.5°C or higher. Suspected cases of FHV are notifiable in France, and clinical suspicion is the sole criterion for reporting.Any report received by an ARS triggers a supplementary investigation at the regional level, coordinated by the CIRE, to gather the information necessary to classify the case. At the same time, the reporting hospital physician, in consultation with their referring infectious disease specialist, will conduct a clinical evaluation, considering all differential diagnoses. A case of Ebola virus infection is biologically confirmed by RT-PCR at the CNR for FHV, the only facility authorized to handle and store Class 4 agents such as the Ebola virus. Sending samples requires prior contact with the CNR.