EBOLA VIRUS DISEASE - WEST AFRICA (77): WHO UPDATE, MEETING, SIERRA LEONE, LIBERIA
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A ProMED-mail post
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International Society for Infectious Diseases
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In this update:
[1] WHO update
[2] Emergency sub-regional Ministerial meeting
[3] Sierra Leone: survivors
[4] Liberia: update
[5] Liberia: churches
[6] Liberia: burials
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[1] WHO update
Date: Tue 1 Jul 2014
Source: WHO Global Alert and Response (GAR), Disease Outbreak News [edited]
http://www.who.int/csr/don/2014_07_01_ebola/en
Ebola virus disease, West Africa -- update
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Based on epidemiological analysis conducted by WHO, 3 major factors are contributing to patterns of transmission, which are currently responsible for the continuous propagation of Ebola virus disease (EVD) in the sub-region. These factors include:
- transmission of EVD in rural communities, facilitated by strong cultural practices and traditional beliefs;
- transmission of EVD in densely populated peri-urban areas of Conakry in Guinea and Monrovia in Liberia; and
- cross-border transmission of EVD along the border areas of Guinea, Liberia, and Sierra Leone, where commercial and social activities continue along the border areas of these countries.
Health sector response
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Containment of this outbreak requires a strong response in the countries and especially along their shared border areas. As one of the response elements, WHO is organizing a high-level meeting for the Ministers of Health in the sub-region scheduled for 2-3 July 2014 in Accra, Ghana. The meeting will bring together Ministers of Health and the Directors of disease prevention and control from 11 African countries (Cote d'Ivoire, the Democratic Republic of the Congo, Gambia, Ghana, Guinea, Guinea-Bissau, Liberia, Mali, Senegal, Sierra Leone, and Uganda), as well as partners, Ebola survivors, representatives of airlines and mining companies, and the donor communities. The objective of the meeting is to analyse the situation, identify gaps, develop operational response plans, and to ensure increased political commitment and enhanced cross-border collaboration for EVD response activities among the countries in the sub-region.
WHO and technical partners in the Global Outbreak Alert and Response Network (GOARN), including the EU Mobile Laboratory consortium, the IFRC, and national societies, Institut Pasteur Dakar, Institut Pasteur Lyon, Institut Pasteur Paris, Bernard Nocht Institute in Hamburg, Medecins Sans Frontieres/Doctors without Borders, Public Health Agency of Canada, Public Health England, and US CDC, together with UN agencies, DFID, EU, ECHO, and other partners are providing the necessary technical expertise and support to the Ministries of Health to stop community and health facility transmission of the virus.
WHO is closely supporting the Ministries of Health through the deployment of additional experts in various specialties, providing field logistics support, and personal protective equipment and medical supplies. These experts are drawn from WHO offices, GOARN partners, specialised networks, especially in the region, and include:
- field epidemiologists, who are working with the countries in surveillance and monitoring of the outbreak;
- laboratory experts who are providing mobile field laboratories in early confirmation of EVD cases;
- clinical management experts who are deployed to health facilities and are treating affected patients;
- infection control and prevention experts who are helping countries in their ongoing efforts to stop transmission of the virus in the community and health-care facilities;
- logisticians who are ensuring the operational response platform, and dispatching essential equipment and needed materials; and
- social mobilization and risk communications teams who are helping public health officials to develop and deliver appropriate messages about how to report, handle, and treat Ebola cases.
WHO does not recommend any travel or trade restrictions be applied to Guinea, Liberia, or Sierra Leone based on the current information available for this event.
Disease update
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New cases and deaths attributable to Ebola virus disease (EVD) continue to be reported by the Ministries of Health in the 3 West African countries of Guinea, Liberia, and Sierra Leone. Between 25-30 June 2014, 22 new cases of EVD, including 14 deaths, were reported from the three countries, as follows: Guinea, 3 new cases and 5 deaths; Liberia, 8 new cases with 7 deaths; and Sierra Leone 11 new cases and 2 deaths. These numbers include laboratory-confirmed, probable, and suspect cases and deaths of EVD.
As of 30 Jun 2014, the cumulative number of cases attributed to EVD in the 3 countries stands at 759, including 467 deaths. The distribution and classification of the cases are as follows:
- Guinea, 413 cases (293 confirmed, 88 probable, and 32 suspected) and 303 deaths (193 confirmed, 82 probable, and 28 suspected);
- Liberia, 107 cases (52 confirmed, 21 probable, and 34 suspected) and 65 deaths (33 confirmed, 17 probable, and 15 suspected); and
- Sierra Leone, 239 cases (199 confirmed, 31 probable, and 9 suspected) and 99 deaths (65 confirmed, 29 probable, and 5 suspected).
Confirmed, probable, and suspect cases and deaths from Ebola virus disease in Guinea, Liberia, and Sierra Leone, as of 30 Jun 2014
New* / Confirmed / Probable / Suspect / Totals by country
Guinea
Cases / 3 / 293 / 88 / 32 / 413
Deaths / 5 / 193 / 82 / 28 / 303
Liberia
Cases / 8 / 52 / 21 / 34 / 107
Deaths / 7 / 33 / 17 / 15 / 65
Sierra / Leone
Cases / 11 / 199 / 31 / 9 / 239
Deaths / 2 / 65 / 29 / 5 / 99
Totals
Cases / 22 / 544 / 140 / 75 / 759
Deaths / 14 / 291 / 128 / 48 / 467
*New cases were reported between 25-29 Jun 2014
The total number of cases is subject to change due to reclassification, retrospective investigation, consolidation of cases and laboratory data, and enhanced surveillance. Data reported in the Disease Outbreak News are based on best available information reported by Ministries of Health.
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Communicated by:
ProMED-mail Rapporteur Marianne Hopp
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[2] Emergency sub-regional Ministerial meeting
Date: Wed 25 Jun 2014
Source: WHO/AFRO [edited]
http://www.afro.who.int/en/media-centre ... frica.html
WHO calls emergency sub-regional Ministerial meeting in Accra, Ghana to tackle the on-going ebolavirus [outbreak] in West Africa
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In an effort to interrupt further spread of the ebolavirus in the shortest possible time, the World Health Organization is convening a special meeting of Ministers of Health of 11 countries and partners involved in the Ebola virus disease (EVD) outbreak response in Accra, Ghana from 2-3 Jul 2014 to discuss the best way of tackling the crisis collectively as well as develop a comprehensive inter country operational response plan.
WHAT: Press conference and sub-regional ministerial meeting to address solutions for ending the EVD outbreak that has been spreading in Guinea, Liberia and Sierra Leone since [it was 1st reported in] March 2014.
WHEN: Press Conference will be held on Thu 3 Jul 2014, 1730-1830
In addition, 2 sessions of the meeting will be open to the media: Wed 2 Jul 2014, 0900-1000 and Thu 3 Jul 2014, 1400-1700. These sessions will focus on the situation, risk assessment, testimonials from EVD survivors, a summary of technical discussions and a declaration of the operational plan.
WHO: Ministers of Health from: Cote d'Ivoire, DR Congo, Gambia, Ghana, Guinea, Guinea Bissau, Liberia, Mali, Senegal, Sierra Leone and Uganda. Partners involved in the outbreak, extractive industry from the affected countries, UN Agencies, CDC, DFID [UK Department for International Development], EU, ECHO [Humanitarian Aid and Civil Protection department of the European Commission], Institute Pasteur, IFRC [International Federation of Red Cross and Red Crescent Societies], MSF, USAID, and WAHO [West African Health Organsation].
WHERE: La Palm Golden Beach Hotel, Accra, Ghana
WHY: The emergence of Ebola virus disease outbreak in West Africa threatens regional and global public health security. The World Health Organization has so far provided technical assistance through the deployment of over 150 multidisciplinary experts involved in a range of outbreak response activities such as surveillance, communication and social mobilization, infection control, logistics, data management.
Despite this, there has been significant increase in the number of daily reported cases and deaths from EVD as well as newly affected districts over the last 3 weeks. As of 23 Jun 2014, the total cumulative number of cases reported was 635 out of which 399 died [759 now including 467 deaths -- see [1] above]. This makes the ongoing EVD outbreak the largest [ever] in terms of the number of cases and deaths as well as geographical spread.
Decisions taken at this meeting will be critical in addressing the current and future outbreaks.
Space is limited. For more information or to RSVP, please contact Donda Hansen, Tel 00 472 413 9244 Email <
hansend@who.int>
Collins Boakye-Agyemang, Tel 00 472 413 9420 Email <
boakyeagyemangc@who.int>
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[3] Sierra Leone: survivors
Date: Mon 30 Jun 2014
Source: WHO/AFRO [summ., edited]
http://www.afro.who.int/en/sierra-leone ... leone.html
More patients discharged from the Ebola treatment centres
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On 30 Jun 2014, 4 patients were discharged from the EVD treatment centres bringing the number of discharged patients to 23...
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[4] Liberia: update
Date: Mon 30 Jun 2014
Source: UN Office for the Coordination of Humanitarian Affairs (OCHA), ReliefWeb, UNICEF report [edited]
http://reliefweb.int/report/liberia/uni ... -june-2014
UNICEF-Liberia Ebola virus disease: situation report 30
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Key points
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As of 29 Jun 2014, 2 new confirmed EVD cases have been reported. With these changes, the total number of suspected, probable, and confirmed cases reported for outbreak no 2 now stands at 90.
A total of 43 confirmed cases, including 26 from Lofa County, 1 from Margibi County, and 16 from Montserrado County are reported. A total of 9 cases among health care workers is reported including 5 deaths.
The total number of EVD-related deaths for outbreak no 2 in confirmed, probable, and suspected cases now stands at 49 with 27 in Lofa County, 2 in Margibi County, and 20 in Montserrado County [Monrovia & environs); 26 deaths are among the confirmed cases. Foya, Lofa County, and New Kru Town [NW suburb of Monrovia], Montserrado County, remain the epicentres of this Ebola outbreak.
President Ellen Johnson Sirleaf, made a national address on Saturday [28 Jun 2014] on the EVD emergency and response as part of on-going efforts to raise awareness and combat denial.
UNICEF continues to scale up support for the response. The Health and WASH Units of the Child Survival Section provided 10 drums (45 kg each) of chlorine; 100 cartons of soap; 500 digital thermometers; 100 insecticide treated nets; 50 pairs of rain suits, boots, gloves, nose masks, and rubber hats; and 30 sets of overalls this weekend [28-29 Jun 2014]. The Communication Section continues to actively support the social mobilization sub-committee to engage local leaders, and is facilitating a visit from SKY News Team from South Africa to document the Ebola outbreak.
UNICEF's estimated funding requirement for EVD-related Communications for Development (C4D), Health and Water, Sanitation and Hygiene (WASH) interventions stands at approximately USD 1.59 million. The current funding gap has increased to USD 1.27 million.
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[5] Liberia: churches
Date: Fri 27 Jun 2014
Source: AllAfrica, Heritage (Monrovia) report [edited]
http://allafrica.com/stories/201406270789.html
Churches are not hospitals for curing Ebola -- Chief Medical Officer warns
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Liberia's Chief Medical Officer, Dr Bernice Dahn, has warned churches in the country that are sheltering people infected with the ebolavirus to desist immediately. Dr Dahn pointed out that people infected with the virus are being kept indoors by churches on the grounds that patients can be healed through prayer. According to her, since the outbreak of the virus, many churches have considered the epidemic to be more spiritual rather than medical.
Dr Dahn made these comments on Thu 26 Jun 2014 when the Ministry of Health and Social Welfare received some medical equipment for Ebola virus disease (EVD) response from the Government of the USA through the United States Agency for International Development (USAID) and the World Health Organization (WHO). Some of the donated items include: 13 cartons of 50 disposable full flu shields, 22 cartons of personal protection equipment, 36 cartons of respiratory masks, 27 cartons of powder-free examination gloves, 7 pairs of heavy duty gloves, and 100 digital thermometers. The equipment donated is said to be worth in the range of USD 30 000. Speaking briefly, the Mission Director of USAID-Liberia, Mr John Mark Winfield, said the donation is intended to help Liberia in its response to EVD. For his part, the Country Representative of WHO, Dr Nester Ndayiminje, lauded the United States government for its kind gesture. "We are very pleased to receive this. We want to say a very [big] thank you to the US government for this gesture. It is important that everybody puts hands together for the response of Ebola," he stated.
Speaking further, Dr Dahn disclosed that 3 persons suspected of having EVD in the Borough of New Kru Town died in a church where they had gone for prayer. But she fell short of stating the name of the church in which the patients died.
She pointed out that the situation is deteriorating due to the refusal of Liberians to accept the existence of the disease. "We must stop keeping people suspected of Ebola in our churches on the grounds that we can heal them [there]. We are begging our pastors. The churches are not hospitals. We need to take a stance to prevent the rapid spread of the disease," she added.
[Byline: Emmanuel Weedee-Conway]
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Communicated by:
ProMED-mail Rapporteur Mary Marshall
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[6] Liberia: burials
Date: Mon 30 Jun 2014
Source: AllAfrica, FrontPageAfrica (Monrovia) report [edited]
http://allafrica.com/stories/201406301362.html
Getting rid of EVD dead bodies a daunting task for Liberia
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"We need to find a special place to bury these corpses, if not, the bodies will keep piling up on us. If we don't bury them, they will begin to decompose and then that will be trouble for all of us." -- a member of the burial team who spoke to FrontPageAfrica on condition of anonymity.
On Sat 27 Jun 2014, 4 bodies of victims who died as a result of the deadly Ebola virus disease were buried but not without a hassle. 3 of the bodies were near decay, as a burial team with one of the corpses was chased out of the Banjol community in lower Virginia in Montserrado County as they prepared to bury.
The family is put outside and men in white plastic suits covered from head to toe deals with the corpse laid out on a stretcher, spraying it with high concentration of chlorine before lifting it into a white ambulance owned by the Montserrado County Health team. The vehicles are then sprayed and sealed and as the men spray themselves and get ready to pull off the suits beginning with the gloves a nurse yells:
"No, don't do that, don't take it off. You have to walk through our decontamination process. We have to make sure you are decontaminated and safe before you can take the suits off." The 3-man burial team listens and heeds the advice of the health practitioner and they emerge later with their clothes on, leaving the protective gear behind, and the car leaves with the corpse with the hope that the family has already secured a burial ground.
"We are finding it very difficult to bury these people who die from Ebola. The community people when they see us in these white suits, they think we are ghosts; the other day they chased some of our other friends and they had to bring the other body, they took to bury back to JFK [Medical Centre]," said a member of the burial team who spoke to FrontPageAfrica on condition of anonymity.
The head of the team seems very enthusiastic about his job and for him it is a duty to country, he said he and his boys cannot expose themselves to communities because of fear of reprisals. But he said they have a duty to get the consent of the family members of the dead Ebola victims before burying them, adding that some family members are not coming up to identify the bodies of their dead relatives because of some psychological fear. "We give them maximum 24 hours to come forward and identify their relatives and then we work with them and get their consent to bury; we have to do it to avoid problems," said the head of the burial team. When we get these people, it is important that we locate the families based on the locations they were brought in from, and if no one comes forward, then we are given go-ahead by the ministry to bury. But the hospital keeps the bodies in a secured location and decontaminates them, so it is no problem."
The Assistant Minister for Curative Services at the health ministry Mr Tolbert Nyenswah said the ministry is aware of these difficulties posed to the burial teams and is doing all it can to alleviate it. "We met with the Montserrado County Superintendent and we are going to secure a place to bury people who die as a result of the disease," he said.
Margibi becomes new county of infection
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Margibi County joins Montserrado and Lofa counties becoming the newest affected county as one death is reported there. Speaking to FrontPageAfrica on Saturday [28 Jun 2014] Minister Nyenswah said the number of deaths and confirmed cases has increased. "On the 25 Jun 2014 if you can recall, the cases were 35, it increased to 38. The confirmed, probable and suspected cases were 61 on the 25 June, it has increased to 70," he said.
"The probable confirmed and suspected cases in Lofa are 49, Margibi 3, Montserrado 18. The total number of people currently in the treatment unit are 33; total number of deaths on [25 Jun 2014] was 37, now it stands at 46; 25 in Lofa, 1 in Margibi, 20 in Montserrado. The new cases are coming from Lofa, Margibi, and Montserrado."
The minister said Liberia has a testing center where specimens from the affected areas are taken for testing. "We have one Ebola testing center in the country; that's the only specialized lab we have in the country," he said.
Deaths at JFK, Catholic Hospitals
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At the John F Kennedy Medical Center, Liberia's biggest referral hospital, the Cholera Unit at the facility has been turned into a center for Ebola and was seen busy all day on Wednesday [25 Jun 2014] with patients being brought in. The ELWA and the St Joseph Catholic Hospital are the latest recipients of EVD cases, both reporting deaths. FrontPageAfrica has also learned that another patient succumbed to EVD Saturday at the Catholic Hospital. Authorities at the ministry of health told FrontPageAfrica last week that the disease is a national emergency and the government is taking it with a high degree of seriousness.
"The EVD situation is critical. We are concerned; the reason it's critical is that we are confirming lot of cases, including health workers; so we're concerned right now that we are not seeing a downward trend of this disease yet," said Nyenswah. "Every health worker needs to take universal precautions on dealing with the situation so that we don't get more health workers being infected" [he said].
Denial hampers awareness
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Though the ministry of health has made several announcements about the disease and created radio messages about the prevention of the disease, educating the general public seems to be slow. Many continue to doubt that the disease actually exists.
[Byline: Wade CL Williams]
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[The WHO sub-regional meeting is a welcome development, and will hopefully enhance inter-country cooperation.
The Sierra Leone Ministry of Health & Sanitation has a Facebook page at
https://www.facebook.com/pages/Ministry ... 4805403702
A photo of the EU Mobile lab in Guinea can be seen at
http://ec.europa.eu/echo/images/photos/ ... 140411.jpg. - Mod.JW
A HealthMap/ProMED-mail map can be accessed at:
http://healthmap.org/promed/p/46,
http://healthmap.org/promed/p/54,
http://healthmap.org/promed/p/45.]
