Use of Peripheral Health Units in Low-Transmission Ebola Virus Disease Surveillance

Surveillance strategies for Ebola Virus Disease (EVD) in Sierra Leone use a centralized "live alert" system to refer suspect cases from the community to specialized Ebola treatment centers. As EVD case burden declined in Port Loko District, Sierra Leone so did the number of reported alerts. Because EVD presents similarly to malaria, the number of alerts should remain consistent with malaria prevalence in malaria-endemic areas, irrespective of the reduction in true EVD cases. A community-based EVD surveillance system with improved symptom recording and follow-up of malaria-confirmed patients at PHUs was implemented in order to strengthen the sensitivity of EVD reporting.