The document summarizes the Ebola virus disease (EVD) outbreak response in Needowein, Liberia from June 29 to August 2, 2015. It provides details of the initial response including emergency meetings, contact tracing efforts, case management, and community engagement activities. It notes that the outbreak was localized to one community and identifies enabling factors such as community cooperation as well as challenges like initial data flow issues. It highlights the importance of decisions like establishing a district-level command post and strong community involvement in successfully controlling the outbreak.

1. June 29 – Aug 2 (contact follow up stopped)
Kakata Town,
CHT Conference Room
CHT
Sep 17, 2015

2. Introduction
General trend
Responses
Opportunities
Challenges
Good practices
Way forewords
Needowein Response Review Sep 17,
2015 2

3. Margibi county – is the 3rd hardly hit county in
previous outbreaks
Mamba Kaba district is located in the lower end
and have close interaction with Monrovia
Needowein town, Epi center of the outbreak is a
main corridor b/n Monrovia/Airport & Grand Bassa
Liberia was declared free of EVD for about 7 weeks
June 29,15 several calls came to M&E from MoH (5
pm)
Response start quick the same day (with a meeting)
Needowein Response Review Sep 17,
2015 3

4. Case Estimate date
of onset
age Sex Location date
tested
Lab-result ETU entry
date/date of
admission
Date of exit
from ETU
Type of
exit
On
Contact
list?
KK 10-Jun-15 24 M Needowein 01-Jul-15 Positive 01-Jul-15 20-Jul-15 Survivor N
MD 10-Jun-15 9 M Needowein 01-Jul-15
Indeterminat
e 01-Jul-15 13-Jul-15 Survivor N
OM 18-Jun-15 19 M Needowein 01-Jul-15
Indeterminat
e 01-Jul-15 15-Jul-15 Survivor N
FN 20-Jun-15 27 M Needowein 01-Jul-15 Positive 01-Jul-15 20-Jul-15 Survivor N
AM 21-Jun-15 17 M Needowein 29-Jun-15 Positive
Death, 28-
Jun-15 NA dead N
MA 06-Jul-15 40 M Needowein 07-Jul-15 Positive 08-Jul-15 ? Survivor Y
GD 06-Jul-15 13 F Needowein 07-Jul-15 Positive 07-Jul-15 ? Survivor Y
Montserrado case
KeK 01-Jul-15 28 F
Montserrad
o 12-Jul-15 Positive
Death, 12-
Jul-15 NA dead Y
• High survival rate (80% for Margibi C., 67% for Liberia)
• More case in males than Females
• Localized transmission Needowein Response Review Sep 17, 2015
4

5. Needowein Response Review Sep 17,
2015 5

6. 1
2
11
134
115
124
119
107
71
57
39
16
100
20
40
60
80
100
120
140
160
180
200
0
1
2
3
4
5
6
19-Jun-15
21-Jun-15
23-Jun-15
25-Jun-15
27-Jun-15
29-Jun-15
1-Jul-15
3-Jul-15
5-Jul-15
7-Jul-15
9-Jul-15
11-Jul-15
13-Jul-15
15-Jul-15
17-Jul-15
19-Jul-15
21-Jul-15
23-Jul-15
25-Jul-15
27-Jul-15
29-Jul-15
31-Jul-15
2-Aug-15
Contacts
Number of confirmed cases
casebydateofadmission/deathContactsfollowedup
NeedoweinResponseReviewSep17,
20156

7. Investigate, Confirm
Identify Causative agent (5 - 1st from Swab MRG-0276)
Emergency & Planning meetings
District command post
Contact tracing, ACS, Line listing & Data presentation
Cross county coordination
Daily Taskforce & evening data verification meeting (30+
days)
Early detection & Case Management ETU (CFR-20%)
Coordination, WASH, IPC,PSS, EPI Surveillance, SM, FS & Log)
Strengthen Surveillance facility & community
Reporting & Documentation
Needowein Response Review Sep 17,
2015 7

8. Emergency Response Meetings
2 Emergency meetings
held
The same day 8:30,
29th June – UT Clinic
it was a join meeting
(Central level & county
team)
On the 30th of June
Needowein Response Review Sep 17,
2015 8

9. Plan meeting was held for
2 days
Formation/reestablish of
clusters (WASH /IPC-RITE
& FS /Log, EPI-Sur, PSS, SM
Each pillar were requested
to have their own plan
Key decisions were passed
Needowein Response Review Sep 17,
2015 9

10. Re-initiate the response
team
Quick meeting
Planning meeting
Shift command post to
District
Daily coordination
meetings
Command post
management
Documentation and
reporting of events
Needowein Response Review Sep 17,
2015 10

11. Reactivate Contact
tracers, Active case
searcher
gCHVs (ACS/CT)
refreshment taring
Recruited gCHVs from
Motorbike riders
Follow up & trace
contacts twice daily
Set up data flow
Needowein Response Review Sep 17,
2015 11

12. Set daily evening Data
verification meeting
Daily field Report from
gCHVs
Early detection of cases
(2 cases turn (+) in ETU
Safe & dignified burial
continue
Swab collection
continue Funeral Home
Extended to HCF
Needowein Response Review Sep 17,
2015 12

13. 9 Trucks (648 bags of
rice were distributed for
HH
278 sack of Water
supplied
Adequate transport for
all the responses were
secured
Store management
Flit Management
Needowein Response Review Sep 17,
2015 13

14. Ring approach assessment
done to 16 HF
Specific regular risk
assessment to the 3 HF
Strengthen the IPC practice
& protocol
Harmonize RITE & CI Team
RITE –Training
IPC –SQS Training Pilot
Needowein Response Review Sep 17,
2015 14

15. Distribute Hygiene kits–County
Water & swage system in the
command centers
Construction of triage at Gates
Water tankers and maintenance
Construct temp Latrine for
community under close
observation
Swab Collection training for
HCW-66
Swab collection scale up to
HCF
Dislodging of temp. latrine,
disinfection of cars & 3 HCFs
Needowein Response Review Sep 17,
2015 15

16. 40 SS volunteers were taring
Team council family
resistance to any
investigation
Team carried out counseling
for family refuse
investigation, hide family
member
Counseling of people under
close observation sites
Supportive in all mater
related to care and support
Needowein Response Review Sep 17,
2015 16

17. Engage community at all level
Engage leaders thorough
meetings
Work with Community, youth,
women & religious leaders &
Traditional healers)
Train all the volunteer from 6
zone
Inter personal communication
House to House
Use local radio station
Needowein Response Review Sep 17,
2015 17

18. Chief, religious leaders,
formal leaders - were
committed on assisting the
process
Motorbike riders association
leaders support
Liberian Police
500 (+) volunteers were
participated
Companies - Firestone
Needowein Response Review Sep 17,
2015 18

19. Easy accessible area
Only One Community (Localized Outbreak)
Partners willing to support
Near Monsorado (Coordination between
counties)
Community cooperative and involved
Good communication
Motor Bock association with good record
system
Needowein Response Review Sep 17,
2015 19

20. Individual denial
Data flow first few days
Change of pyt rate
Rain
Getting the source of
Infection
Needowein Response Review Sep 17,
2015 20

21. Decision to bring Command post to District
Decision not use force for resistance
Data Quality (at all level, suspected case report, &
surveillance)
Community involvement at all level
(quarter leaders, workshop for 220 leaders)
Support from and coordination with Monsorado team
(more & more investigation in the field)
Higher level commitment –MoH, WHO & Partners
Pool of resources for achieving common Goal
Motorbike riders – is about best example for decision-
making / leadership (CSO have great role on this)
Needowein Response Review Sep 17,
2015 21

22. Margibi county – is the 3rd hardly hit county in
previous outbreaks
Mamba Kaba district is located in the lower end
and have close interaction with Monrovia
Needowein town, Epi center of the outbreak is a
main corridor b/n Monrovia/Airport & Grand Bassa
Liberia was declared free of EVD for about 7 weeks
June 29,15 several calls came to M&E from MoH (5
pm)
Response start quick the same day (with a meeting)
Needowein Response Review Sep 17,
2015 3