EBOLA VIRUS DISEASE - WEST AFRICA (117): WHO, NIGERIA, LIBERIA, DRUG, MORE
**************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this update:
[1] WHO update
[2] Nigeria: nurse dies
[3] Liberia
[4] Experimental drug
[5] Media reports
******
[1] WHO update
Date: 6 Aug 2014
Source: WHO Disease Outbreak News [edited]
http://www.afro.who.int/en/clusters-a-p ... -2014.html
As of 4 Aug 2014, the cumulative number of cases attributed to EVD in the 4 countries stands at 1711, including 932 deaths.
The distribution and classification of the cases are as follows:
- Guinea, 495 cases (351 confirmed, 133 probable, and 11 suspected), including 363 deaths;
- Liberia, 516 cases (143 confirmed, 252 probable, and 121 suspected), including 282 deaths;
- Nigeria, 9 cases (0 confirmed*, 2 probable, and 7 suspected), including 1 death; and
- Sierra Leone, 691 cases (576 confirmed, 49 probable, and 66 suspected), including 286 deaths.
*[This means that for reasons that are unclear, there has been no confirmation yet from a WHO reference laboratory of any of these cases. But I would see no reason to doubt the positive results from 2 different labs in Nigeria. - Mod.JW]
Between 2-4 Aug 2014, 108 new cases (laboratory-confirmed, probable, and suspect cases) of EVD including 45 deaths were reported from the 4 countries as follows:
- Guinea, 10 new cases including 5 deaths;
- Liberia, 48 new cases including 27 deaths;
- Nigeria, 5 new cases including 0 death [but see above. - Mod.JW];
- Sierra Leone, 45 new cases including 13 deaths.
Health sector response
--------------------
A mission briefing with representatives from Member States was held on 5 Aug 2014 at the World Health Organization (WHO). ... Among the critical issues are: cross-border infections and travelers; partners reaching the limits of their capacity and ability to respond rapidly, safely, and effectively; and concerns about the socio-economic impact of continued transmission.
The Sub-regional Ebola Operations Coordination Centre (SEOCC) in Conakry reported on 5 Aug 2014 that the following actions are underway in the 4 affected countries:
- In Guinea, new foci have emerged, and case management facilities will be needed. Exit screening is currently being tested in Conakry, in partnership with the US CDC.
- In Liberia, security issues continue to be of concern, notwithstanding the commitment of the Government. Community resistance remains high.
- In Nigeria, the Government is focused on following up the contacts from the index case. Clinical support is urgently needed, and a treatment centre is being set up for managing cases of EVD.
- In Sierra Leone, efforts are underway to map where treatment centres are most needed and getting those set up. A similar exercise is underway for laboratories.
The SEOCC is assisting countries with these and many other response measures.
On 6 Aug 2014, WHO is convening an Emergency Committee of international experts to review the outbreak and advise the Director-General, in accordance with the International Health Regulations, whether the Ebola virus disease outbreak constitutes a Public Health Emergency of International Concern (PHEIC). Experts will receive an epidemiological briefing and will determine whether the criteria for a PHEIC have been met. If the Emergency Committee agrees that this is a PHEIC, they will then advise the Director-General on temporary recommendations. A summary of the meeting will be made public, and a press briefing will be held on Friday, 8 Aug 2014.
[There is a table with the title:]
Confirmed, probable, and suspect cases and deaths from Ebola virus disease in Guinea, Liberia, Nigeria, and Sierra Leone, as of 4 Aug 2014
---------------------------
The total number of cases is subject to change due to ongoing reclassification, retrospective investigation, and availability of laboratory results. Data reported in the Disease Outbreak News are based on official information reported by Ministries of Health.
--
Communicated by:
ProMED-mail Rapporteur Mary Marshall
******
[2] Nigeria: nurse dies
Date: Wed 6 Aug 2014
Source: Guardian UK [edited]
http://www.theguardian.com/world/2014/a ... geria-dies
A nurse who treated Nigeria's 1st Ebola victim has died of the virus in Lagos as 5 new cases of the highly lethal disease were confirmed in Africa's most populous country. The nurse had helped care for PS, a 40-year-old Liberian-American civil servant who last month [July 2014] visited from Liberia, one of 3 countries in the region hit by the world's biggest epidemic. The 5 new cases are believed to be other health workers who came into contact with PS, who died within days of his arrival.
"Yesterday [5 Aug 2014], the 1st known Nigerian to die of EVD was recorded. This was one of the nurses that attended to the Liberian. The other 5 [newly confirmed] cases are being treated in an isolation ward," the Nigerian health minister, Onyebuchi Chukwu, told reporters in the capital, Abuja, on Wed 6 Aug 2014.
Officials initially downplayed the risk of exposure, saying PS had been immediately isolated when he collapsed on arrival at Lagos's bustling main airport 2 weeks ago. But on Tue 5 Aug 2014, the state health commissioner, Jide Idris, said EVD was diagnosed only after PS had been taken to hospital and had direct or indirect contact with at least 70 others. They included airline passengers, airport officials and health workers, and have all been placed under precautionary surveillance; 7 have been quarantined. Officials told reporters they were compiling a list of secondary contacts and appealed to those who believed they may be at risk to come forward. "This is a call for everyone to be vigilant, especially with regard to relating to people who are ill," Idris said.
A committee has been set up to deal with any potential escalation of the disease, although Nigerian officials admitted there was a shortage of doctors willing to work directly with confirmed cases. "Our doctors are worried about the danger it poses to their lives, and they need to be reassured," said Tope Ojo, Lagos chairman of the Nigerian Medical Association. Doctors and healthcare workers on the frontline have been the hardest hit during the outbreak, which has so far killed [932] people in Guinea, Liberia and Sierra Leone. Authorities said they were considering applying for an experimental drug used on 2 Americans to treat the doctor who headed PS's team and is now battling the virus herself.
Other preventive measures have been unveiled across Nigeria. Lagos, a melting pot of 20 million people, has broadcast information on radios and through leaflets, distributed protective clothing to health workers and set up 4 isolation wards. In the northern state of Kaduna, officials said corpses from outside the country would require special permission for burial. Two suspected ebolavirus-infected corpses in the southern states of Anambra and Akwa Ibom are believed to be victims flown in from Guinea. Authorities have sealed the morgues while samples are being tested.
[Byline: Monica Mark]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
******
[3] Liberia
Date: 6 Aug 2014
Source: Wall Street Journal USA [edited]
http://online.wsj.com/articles/spain-to ... 1407347679
Spain on Wednesday [6 Aug 2014] sent a specially equipped Airbus medical jet to Liberia to evacuate a Spanish priest infected with the ebolavirus, government health officials said. The stricken missionary, Father MP, 75 years old, is expected to be airlifted back to Madrid in "the coming hours," Mercedes Vinuesa, Spain's director general of public health, said at a news conference Wednesday afternoon [6 Aug 2014]. "It's a very complicated job," Ms. Vinuesa said. "We are focused on doing it with the best guarantees for the patient, for society and for health personnel. We are in the process of repatriation, which in a country like Liberia takes time."
The plane, an Airbus A310, departed from a Spanish Air Force base just outside Madrid around 1:00 p.m. local time Wednesday [6 Aug 2014], state television said. Father MP is one of 3 religious workers [the other 2 were African nationals] who are being quarantined at the San Jose de Monrovia Hospital in Liberia after having tested positive for EVD. In Spain, doctors and health officials were scrambling to make preparations to receive Father MP. Some medical workers' unions have expressed concern about whether Spanish hospitals are adequately prepared to handle an Ebola patient.
[Byline: Matt Moffett]
--
Communicated by:
ProMED-mail Rapporteur Mary Marshall
******
[4] Experimental drug
Date: 5 Aug 2014
Source: Reuters [edited]
http://www.reuters.com/article/2014/08/ ... 9920140805
Three of the world's leading Ebola virus disease specialists called on Tuesday [5 Aug 2014] for experimental drugs and vaccines to be offered to people in West Africa, where a vast outbreak of the deadly disease is raging in 3 countries. Noting that American aid workers who contracted the disease in Liberia were given an unapproved medicine before being evacuated back to the United States, the specialists -- including Peter Piot, who co-discovered the ebolavirus in 1976 -- said Africans affected by the same outbreak should get the same chance.
Piot, David Heymann and Jeremy Farrar, all influential infectious disease professors and respectively directors of the London School of Hygiene and Tropical Medicine, the Chatham House Center on Global Health Security, and the Wellcome Trust, said there were several antiviral drugs, monoclonal antibodies and vaccines under study for possible use against ebolaviruses. "African governments should be allowed to make informed decisions about whether or not to use these products, for example to protect and treat healthcare workers who run especially high risks of infection," they wrote in a joint statement. The World Health Organization (WHO), "the only body with the necessary international authority" to allow such experimental treatments, "must take on this greater leadership role," they said. "These dire circumstances call for a more robust international response," they added.
[More than] 900 people in Guinea, Sierra Leone and Liberia have been killed by Ebola and more than [1700] infected since the virus started spreading in Guinea in February 2014. Nigeria said on Tuesday [5 Aug 2014] it had 8 suspected cases linked to a confirmed fatal case in a man who traveled to Lagos from Liberia [recently]. Saudi Arabia's health ministry said it was testing a suspected case in a man returning from Sierra Leone.
Two American aid workers who fell sick with EVD in Liberia saw their conditions improve by varying degrees in Liberia after they received an experimental drug called ZMapp, developed by San Diego-based private biotech firm Mapp Biopharmaceutical. Piot, Farrar and Heymann questioned why Africans were not being given the same chance. If the deadly virus was raging though wealthy countries, they said, medical agencies "would begin discussions with companies and labs developing these products and then make rapid decisions about which of them might be appropriate for compassionate use."
"Experimental treatments shouldn't be rolled out generally without prior safety testing," they said in their statement, issued in London late on Tuesday [5 Aug 2014]. "But in the face of the critical challenge in West Africa, the WHO and Western medical agencies should be helping countries weigh the risks and benefits of limited deployment of the best (drug and vaccine) candidates to those in the greatest need, while continuously monitoring safety and efficacy." A spokesman for the Geneva-based WHO told Reuters the United Nations health agency "would not recommend any drug that has not gone through the normal process of licensing and clinical trials." Treating patients with experimental drugs that have not been tested in humans to determine safety and efficacy is highly unusual.
Biotech firm Mapp and its commercial partner Leaf Biopharmaceutical said the ZMapp drug was only identified as a potential treatment candidate in January 2014 and that, as a result, very little of it was currently available. The Food and Drug Administration, the regulatory body for medicines in the U.S., said on Friday [1 Aug 2014] it "stands ready" to work with companies and investigators working with Ebola patients "in dire need of treatment."
[Byline: Kate Kelland, Tom Miles]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[The product is grown in tobacco plants, which are not very fast growing, so there is very little available currently. - Mod.JW]
******
[5] Media reports
Ebola Interactive Map Shows Virus Spread
---------------------------------
5 Aug 2014: A Harvard University School of Medicine computational epidemiologist, John Brownstein, has created an online Ebola virus disease map that tracks how the outbreak spread over time.
[ProMED is proud to be a partner of HealthMap/Boston Children's Hospital. - Mod.JW] https://abcnews.go.com/Health/ebola-int ... d=24853012.
Saudi Arabia, suspected case
-------------------------
The Saudi man who was suspected of being infected with the ebolavirus died on Wed [6 Aug 2014] in Jeddah, the Ministry of Health (MOH) said, after showing symptoms of viral hemorrhagic fever. The MOH has submitted samples from the patient to an international reference laboratory in the USA as recommended by the World Health Organization (WHO). Additional samples are being sent to an accredited laboratory in Germany.
http://www.arabnews.com/news/featured/612411
Pilgrimage visa ban
---------------------
4 Aug 2014: Saudi health ministry: No hajj and umrah visas for 3 African nations, http://english.alarabiya.net/en/News/mi ... tions.html.
British Airways flights to and from Liberia and Sierra Leone suspended
----------------------------------
5 Aug 2014: British Airways has temporarily suspended flights to and from Liberia and Sierra Leone until 31 Aug 2014 due to the deteriorating public health situation in both countries. "The safety of our customers, crew and ground teams is always our top priority, and we will keep the routes under constant review in the coming weeks."
http://www.britishairways.com/travel/fl ... faqid=5072
Britons self quarantined
-------------------------
5 Aug 2014: Several Britons across the UK are quarantined. Doctors say the individuals are "voluntarily" confined at home after returning from an EVD infected country in West Africa.
http://www.telegraph.co.uk/health/healt ... -home.html
Philippines: healthcare workers negative so far
---------------------------------
6 Aug 2014: A recent ProMED post ( 20140805.2663054) reported symptoms of EVD in 7 healthcare workers who had been in Sierra Leone and then arrived back in the Philippines. The news media 1st reported that these 7 healthcare workers had returned to the Philippines on 1 Aug 2014. A news release from the Department of Health the same day (http://www.gov.ph/2014/08/01/doh-philip ... ebola-free) reported that the Philippines remained free of Ebola. News reports later on 1 Aug 2014 misinterpreted the DOH statement as indicating that the healthcare workers had already been tested for EVD. This does not seem to be the case. The most recent accurate information, from the Philippine Star cites a press conference by Health Secretary Enrique Ona. The 7 healthcare workers are asymptomatic and are being monitored daily for symptoms during a 30-day period. They remain outpatients, and isolation units at the hospital are ready in case they exhibit any symptoms. http://www.philstar.com/headlines/2014/ ... ealthy-doh [From: Mimi Emig, MD]
Brazil: suspected cases negative
--------------------------------
5 Aug 2014: The same ProMED post ( 20140805.2663054) carried a report about a suspected case that arrived in Guarulhos airport, Sao Paulo. It has been ruled out based on clinical and epidemiological findings from South Africa, with a definitive diagnosis of urinary tract infection and the patient taken to Emilio Ribas (the referral hospital at Sao Paulo city) on 1 Aug 2014 and discharged on 2 Aug 2014. There was another "suspected" case on 5 Aug 2014. The final diagnosis was _P. falciparum_ malaria. [From: Rodrigo Angerami MD, Mod.ProMED-PORT]
Nigeria: PS was sick on boarding
-------------------------------
6 Aug 2014: Images from a Closed Circuit Television (CCTV) monitored here at the James Spriggs Payne's Airport have shown how the late PS was terribly ill before boarding the Nigeria bond flight. From the recording, it appears he knew he had been infected by the deadly tropical disease. His behavior, among other passengers waiting at the boarding gate, was strange. His face bore a sad countenance like someone who was troubled as he sat alone avoiding body contacts with everyone who came close by him. The video footage also shows the late PS lying flat on his stomach on the floor in the corridor of the airport, a sign of someone in excruciating pain.
http://www.thenewdawnliberia.com/index. ... &Itemid=59
Nigeria: search for 27 secondary contacts
-----------------
6 Aug 2014: The Lagos State Government has commenced an intensive search for 27 secondary contacts who might have had contacts with doctors, nurses and health workers who attended to the late Liberian-American PS, at a Lagos private hospital.
http://www.punchng.com/news/ebola-lagos ... -contacts/?
Senegalese dies in Guinea
----------------------------
5 Aug 2014: Senegal's 1st victim of the ebolavirus, a tailor by trade, was based in Guinea. The victim was buried yesterday [4 Aug 2014] in Conakry.
http://www.ndarinfo.com/Ibrahima-NIANG- ... a9953.html [in French, followed by an English translation. Did friends/relatives/contacts travel to Senegal after being exposed to the virus? - ProMED-mail Rapporteur Mary Marshall]
[A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/54.]
Ebola in Westafrika
Moderator: Moderatoren
-
Birgitt
- Moderator
- Beiträge: 35240
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Ebola - Liberia ruft Notstand aus für 90 Tage
Liberia ruft Notstand ausDie liberianische Präsidentin Ellen Johnson Sirleaf hat wegen der anhaltenden Ebola-Epidemie den Notstand in ihrem Land ausgerufen. Er gilt für 90 Tage. In einer Erklärung sagte sie, die Republik sei "in Gefahr". In der Folge könnten einige Bürgerrechte eingeschränkt werden. Zuvor hatte sie bereits erlassen, dass Ebola-Tote nicht mehr bestattet, sondern eingeäschert werden sollen. Denn viele Infizierte haben kein Vertrauen in die Krankenhäuser. Die Menschen sterben zu Hause, viele Leichen bleiben unentdeckt - und stecken noch mehr Menschen an.
07.08.2014 - tagesschau
Gruß
Birgitt
-
Alexander
- Administrator
- Beiträge: 24253
- Registriert: Sa 30. Jul 2005, 19:12
- Wohnort: Dubai/Vereinigte Arabische Emirate
- Kontaktdaten:
Re: Ebola - Guinea, Liberia, Sierra Leone, Nigeria
Die WHO versucht zu klären, was das noch nicht zugelassene Mittel wirklich kann und welche ethischen Bedenken es gibt ein nicht getestetes Mittel an Patienten zu verabreichen. Obama hat sich gegen den Einsatz des Mittels ausgesprochen.
Ebola: Was kann das nicht zugelassene Mittel?
Genf - Den beiden Ebola-Patienten aus den USA geht es besser. Doch liegt das wirklich an ZMapp? Die WHO will den eventuellen Einsatz des bislang nicht zugelassenen Mittels prüfen. US-Präsident Obama ist dagegen. mehr...
Grüsse
Alexander
Ebola: Was kann das nicht zugelassene Mittel?
Genf - Den beiden Ebola-Patienten aus den USA geht es besser. Doch liegt das wirklich an ZMapp? Die WHO will den eventuellen Einsatz des bislang nicht zugelassenen Mittels prüfen. US-Präsident Obama ist dagegen. mehr...
Grüsse
Alexander
The one who follows the crowd will usually go no further than the crowd. Those who walk alone are likely to find themselves in places no one has ever been before.
· · · Wüstenschiff-Veranstaltungsübersicht 2026 —> Alle Reise-Events auf einen Blick - Check it out !!!
· · · · · Werde Wüstenschiff-Werbepartner —> Firmen, die Wüstenschiff-Aktionen in Afrika unterstützen
· · · · · · · Geschlossene Gruppen —> Die neue Wüstenschiff-Funktion
· · · Wüstenschiff-Veranstaltungsübersicht 2026 —> Alle Reise-Events auf einen Blick - Check it out !!!
· · · · · Werde Wüstenschiff-Werbepartner —> Firmen, die Wüstenschiff-Aktionen in Afrika unterstützen
· · · · · · · Geschlossene Gruppen —> Die neue Wüstenschiff-Funktion
-
Birgitt
- Moderator
- Beiträge: 35240
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Ebola-Fieber in Westafrika
EBOLA VIRUS DISEASE - WEST AFRICA (118): LIBERIA, SIERRA LEONE, CDC, DRUGS, MORE
********************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this update:
[1] Liberia, Sierra Leone
[2] CDC guidance
[3] New drug
[4] New drugs, more
[5] Media reports
******
[1] Liberia, Sierra Leone
Date: 7 Aug 2014
Source: BBC News [edited]
http://www.bbc.com/news/world-28684561
Liberian President Ellen Johnson Sirleaf has declared a state of emergency as the country grapples with an outbreak of the deadly Ebola virus disease [EVD].
Announcing a 90-day state of emergency, President Sirleaf said the government and people of Liberia required "extraordinary measures for the very survival of our state and for the protection of the lives of our people."
Speaking on national television, she said some civil liberties might have to be suspended. Already, reports are reaching Monrovia [the capital] that a military blockade is stopping people from western regions of Grand Cape Mount and Bomi, where EVD is prevalent, from entering the capital. These counties largely rely on Monrovia for their goods, and the blockade means that the cities of Robertsport and Tubmanburg are now cut off.
One Tubmanburg resident phoned into a radio show to complain that rice, the national staple, was already in short supply in the market. The head of the National Health Workers Association said that while the state of emergency was necessary, people should have been given time to prepare. Fear has prompted hospital workers to abandon clinics, meaning many are now shut. President Sirleaf said this meant many diseases prevalent during the rainy season [starting now], such as malaria and typhoid, are going untreated and may lead to unnecessary and preventable deaths.
Security forces in Sierra Leone have now imposed a complete blockade of Kenema and Kailahun districts in eastern Sierra Leone [just across the Liberian border], only allowing access for essential services.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[A map of the 3 countries showing the affected districts on each side of the Sierra Leone-Liberia border (in need of updating) is at:
http://hot.openstreetmap.org/sites/defa ... -ebola.png. - Mod.JW]
******
[2] CDC guidance
Date: 5 Aug 2014
Source: CIDRAP News [edited]
http://www.cidrap.umn.edu/news-perspect ... rol-issues
Officials said medical workers should consult with the CDC before returning to the USA. CDC officials avoided questions about how the 2 American health workers were infected and what treatments they were receiving, due to patient privacy policies.
A transcript of today's [5 Aug 2014] Clinician Outreach and Communication Activity (COCA) call will be posted soon on the COCA section of the CDC's website http://emergency.cdc.gov/coca/calls/index.asp.
See also:
1 Aug 2014: CDC Ebola infection control recommendations for hospitals, http://www.cdc.gov/vhf/ebola/hcp/infect ... tions.html;
5 Aug 2014: CDC What U.S. Hospitals Need to Know to Prepare for Ebola Virus Disease, http://emergency.cdc.gov/coca/calls/201 ... 080514.asp.
--
Communicated by:
ProMED-mail Rapporteur Mary Marshall
******
[3] New drug
Date: 5 Aug 2014
Source: Science Media Centre [edited]
http://www.sciencemediacentre.org/exper ... -for-ebola
Prof. Tom Solomon, Director of the NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, and Director of the Institute of Infection and Global Health, University of Liverpool, U.K. said:
Q1. What new treatments are being tried for Ebola virus disease?
A1. "Although there are no proven antivirus treatments for EVD, an experimental drug has been used in 2 American health care workers who became infected, with apparently encouraging results in one of them. The drug called ZMapp consists of humanized monoclonal antibodies against the virus, developed by San Diego Mapp Biopharmaceutical Inc, in collaboration with LeafBio and Defyrus Inc. It uses some of the most sophisticated techniques for drug development that we have."
Q2. How was the experimental drug developed?
A2. "The new treatment incorporates some neat scientific tricks which bring together human, mouse, and plant biology systems. Monoclonal antibodies are made by infecting a mouse with ebolavirus and then isolating the immune cells (the clonal cells) which produce specific antibody proteins against the virus. Although they are effective at neutralizing the virus, these antibodies have to be modified, or "humanized," so they are similar to human antibodies, and can thus work with the human immune system. These changes are made by altering the genes which produce the antibody proteins. The genes are injected into a tobacco plant, _Nicotiana_, which then produces large amounts of the antibody protein. The Zmapp treatment consists of 3 different monoclonal antibodies against ebolavirus proteins. So far, it has proved effective when used to treat experimentally infected monkeys. Normally, further drug development for humans would take years, with carefully controlled clinical trials. However, in emergency situations like this, when the death rate from a disease is especially high, drugs can be used on a compassionate basis, without the full set of data to support their use."
"The 1st EVD patient to receive ZMapp appeared to make a dramatic recovery within an hour, whereas in the 2nd recipient, there were no immediate effects. Such dramatic recoveries are unusual for any drug treatments, making some scientists cautious about how to interpret these findings. Full controlled clinical trials will be needed."
--
Communicated by:
ProMED-mail Rapporteur Mary Marshall
******
[4] New drugs, more
Date: 4 Aug 2014
Source: Business Insider [edited]
http://www.businessinsider.com/zmapp-se ... z39k4g1c3y
Both of the EVD-infected U.S. citizens in Liberia received a rare dose of what news reports called a "secret serum" to treat the virus before being transported to Emory University Hospital in Atlanta, USA according to a CNN report. And while some people do fight off the disease on their own, in the case of the 2 Americans, that experimental serum may have saved their lives.
As KB and missionary NW waited in a Liberian hospital, someone from the U.S. National Institutes of Health reached out to Samaritan's Purse, one of the 2 North Carolina-based Christian relief groups the 2 were working with, and offered to have vials of an experimental drug called ZMapp sent to Liberia, according to CNN's unnamed source.
Although the Food and Drug Administration does allow experimental drugs to occasionally be distributed in life-threatening circumstances without approval under the expanded access or "compassionate use" conditions, it's not yet clear whether that approval was granted in this case or not. A spokesperson for the FDA told Business Insider that federal law and FDA regulations prohibit them from commenting on specific products, as that information is considered confidential.
An Emergency Treatment
------------------
However, it was approved, 3 frozen vials of ZMapp, a drug being developed by Mapp Biopharmaceutical, were flown to Liberia and arrived the morning of Thu 31 Jul 2014. The serum needed 8-10 hours to thaw. KB, who had been sick for 9 days already, reportedly had asked that NW receive the 1st dose, as he was younger and thought he had a better chance of surviving [It's unclear from the CNN story why the doses apparently were not all ready at the same time]. But his condition worsened as the 1st dose thawed, and CNN reports that he told his doctors, "I am going to die."
He asked for the 1st dose and had it given to him through an IV. According to CNN's source, within an hour, he was able to breathe better and a rash on his body started to fade. The next day he was able to shower without help before boarding the air ambulance that flew him to Atlanta, USA.
NW reportedly didn't respond as well to the 1st treatment she received and had to be given the 3rd vial of serum. Her 2nd treatment seemed to improve her condition, according to CNN and stabilized her enough that she is expected to fly to the USA on Tue 5 Aug 2014 [which she did].
The ZMapp serum itself is what is known as a "monoclonal antibody." These substances are created by infecting an animal with the disease in question. Then, scientists harvest and use the antibodies that the animals' immune systems create to fight the virus. In this case, the antibodies were harvested from ebolavirus-infected mice.
Studies have tested various other blends of similar therapies against ebolavirus-infected monkeys before, with some efficacy, but only when the therapy is given within 48 hours of infection. As Hamblin cautions, "very little is known about the safety and effectiveness of this treatment, so little that outside of extreme circumstances like this, it would not be legal to use."
This EVD outbreak -- the worst in history -- has already killed [932] people. But promising news of an experimental serum doesn't mean that a treatment is close. Developing a cure for a virus is complicated, and developing a treatment for Ebola has proven particularly difficult. In this case, since health officials can't comment on a specific treatment or on the patients involved for privacy reasons, we don't know the exact status of KB and NW or how that status has been affected by the serum that they reportedly received.
Before this emergency use, ZMapp had only been tested in a small number of monkeys. The company reported that all 4 monkeys who received the treatment within 24 hours of being infected survived. Half of another group of 4 monkeys who were treated within 48 hours survived. KB and NW had been sick much longer than that before being treated, and treatments that work in animals -- especially such a small number of animals -- routinely fail to work in human trials.
Standard "treatment" for EVD usually involves trying to keep patients hydrated and alive long enough to give the immune system a chance to battle the virus. And while that approach may sound unpromising, this outbreak has had a fatality rate of about 60 percent so far, not close to the 90 percent that's often reported. That 60 percent number could still rise, but survival cannot necessarily be attributed to an experimental treatment. While EVD is highly fatal, some people do survive without any extraordinary interventions.
ZMapp is not even far enough along to have entered the clinical trial phase, but it may have been chosen in this case instead of the promising experimental drug Tekmira, because an ongoing Tekmira trial was just halted by the FDA. That doesn't mean that all research on Tekmira is over, however. The ongoing trial was halted because healthy patients showed a problematic immune response.
But the FDA could still approve a new trial of the drug in sick patients, as the risk-benefit equation would be changed. A potential benefit of surviving a disease that kills 60-90 percent of patients could outweigh the risks of many potentially problematic side effects [It was not side effects that stopped the trial, but lack of an adequate immune response in all test humans. - Mod.JW]. CNN also reported that on 30 Jul 2014, the military approved additional funding for Mapp Biopharmaceutical because of their promising results so far.
If either ZMapp or Tekmira prove to be effective, testing, approving, and then producing a drug will still take time, even if the process is fast-tracked. At this point, the best hope for stopping this outbreak is not curing it but containing it. Even though the virus can only be transmitted by close contact, and thus it can be contained, health officials have been completely unable to do so in West Africa due to a combination of factors including poor healthcare infrastructure, distrust of authorities, traditional burial practices, and fear of healthcare providers.
At the present rate, World Health Organization chief Margaret Chan describes the consequences of not being able to stop the disease's spread as "catastrophic."
[Byline: Kevin Loria]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
******
[5] Media reports
CDC issues highest-level alert for Ebola virus disease
-----------------------------
6 Aug 2014: The U.S. Centers for Disease Control and Prevention has issued its highest-level alert for a response to the EVD crisis in West Africa. "Ops Center moved to Level 1 response given the extension to Nigeria and potential to affect many lives," CDC chief Tom Frieden said Wed [6 Aug 2014] on Twitter. Level 1 means that increased staff and resources will be devoted to the outbreak, officials said. It is the 1st time the agency has invoked its highest level alert since 2009, over [the H1N1] flu outbreak.
http://www.usatoday.com/story/news/worl ... l/13663973
NY City Patient In Isolation Does Not Have EVD
----------------------------------
6 Aug 2014: The man was placed into "strict isolation" within 7 minutes of his arrival and was undergoing various tests to determine the cause of the symptoms, the hospital said. "We would like to report that the Centers for Disease Control and Prevention have determined that the patient kept in isolation since Mon 4 Aug 2014 at The Mount Sinai Hospital has tested negative for Ebola virus disease (EVD)," the hospital said in a statement.
http://newyork.cbslocal.com/2014/08/06/ ... -wednesday
Sierra Leone border check video
-----------------------
6 Aug 2014: [A revealing video of conditions at a border checkpoint between Sierra Leone and Liberia before the military blockade. - Mod.JW]
http://outfront.blogs.cnn.com/2014/08/0 ... checkpoint
Singapore: additional precautions
----------------------------
7 Aug 2014: Despite the low risk of spread to Singapore, all hospitals, clinics and doctors have been alerted to stay vigilant against possible suspect cases. Our public hospitals also have in place appropriate infection control measures. Suspect cases are triaged at emergency departments and, as a precaution, isolated from other patients to minimise any risk of transmission. Measures are already in place to carry out contact tracing and to quarantine all close contacts if there is a case in Singapore.
More information on Ebola virus disease is available at http://www.moh.gov.sg/content/moh_web/h ... ease-.html, or members of the public may call MOH's hotline at 1800-2254122.
http://www.moh.gov.sg/content/moh_web/h ... ebola.html
Nigeria to Screen Outbound Travellers
--------------------------------
7 Aug 2014: As part of efforts to ensure that the spread of the deadly Ebola virus disease is contained, the Federal Government has announced that it would commence screening of all outbound travellers from Nigeria's shores. Travellers who show symptoms would be prevented from travelling, and, where they are non-Nigerians, they would only be allowed out if their countries have the capacity for a properly supervised evacuation and treatment, as was demonstrated by the USA recently.
http://www.thisdaylive.com/articles/ebo ... ers/185637
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[ProMED wishes to credit Kunihiko Iizura and Mary Marshall for sending in several of the above reports.
The more we learn about the "serum" used to treat the 2 EVD-infected Americans, the less likely it seems that it is any good, but it is just about the only hope we have at this time, as the vaccine is a long way off.
Although the drug saved 4/4 monkeys when used within 24 hours of infection, it only saved 2/4 at 48 hours, and the Americans were treated days later than that. Then the doctor started recovering, probably too quickly to have been due to its effect, and the nurse so slowly that she needed a 2nd dose. So maybe their recovery is just due to excellent medical care and had nothing to do with the ZMapp serum. That leaves us with the Tekmira drug, which reportedly has not had a satisfactory immune response in clinical trials.
However, sooner or later, a dose is going to be given too late, or to a particularly vulnerable patient, who will die, and the death will be taken to show that the drug is useless, or worse, blamed on the drug itself, the way the anti-HIV drugs were blamed for producing AIDS in South Africa by the then President [not Mandela]. - Mod.JW]
[Hence the need for clinical trials of potential therapies. The ongoing occurrence of cases would allow for prospective, randomized, blinded trials of therapeutics that could definitively answer the question of their benefits (or harms).
ProMED adds its voice to the urgent calls for such trials to be conducted, ideally, under the auspices of international organizations. - Mod.LM
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/46.]
********************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this update:
[1] Liberia, Sierra Leone
[2] CDC guidance
[3] New drug
[4] New drugs, more
[5] Media reports
******
[1] Liberia, Sierra Leone
Date: 7 Aug 2014
Source: BBC News [edited]
http://www.bbc.com/news/world-28684561
Liberian President Ellen Johnson Sirleaf has declared a state of emergency as the country grapples with an outbreak of the deadly Ebola virus disease [EVD].
Announcing a 90-day state of emergency, President Sirleaf said the government and people of Liberia required "extraordinary measures for the very survival of our state and for the protection of the lives of our people."
Speaking on national television, she said some civil liberties might have to be suspended. Already, reports are reaching Monrovia [the capital] that a military blockade is stopping people from western regions of Grand Cape Mount and Bomi, where EVD is prevalent, from entering the capital. These counties largely rely on Monrovia for their goods, and the blockade means that the cities of Robertsport and Tubmanburg are now cut off.
One Tubmanburg resident phoned into a radio show to complain that rice, the national staple, was already in short supply in the market. The head of the National Health Workers Association said that while the state of emergency was necessary, people should have been given time to prepare. Fear has prompted hospital workers to abandon clinics, meaning many are now shut. President Sirleaf said this meant many diseases prevalent during the rainy season [starting now], such as malaria and typhoid, are going untreated and may lead to unnecessary and preventable deaths.
Security forces in Sierra Leone have now imposed a complete blockade of Kenema and Kailahun districts in eastern Sierra Leone [just across the Liberian border], only allowing access for essential services.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[A map of the 3 countries showing the affected districts on each side of the Sierra Leone-Liberia border (in need of updating) is at:
http://hot.openstreetmap.org/sites/defa ... -ebola.png. - Mod.JW]
******
[2] CDC guidance
Date: 5 Aug 2014
Source: CIDRAP News [edited]
http://www.cidrap.umn.edu/news-perspect ... rol-issues
Officials said medical workers should consult with the CDC before returning to the USA. CDC officials avoided questions about how the 2 American health workers were infected and what treatments they were receiving, due to patient privacy policies.
A transcript of today's [5 Aug 2014] Clinician Outreach and Communication Activity (COCA) call will be posted soon on the COCA section of the CDC's website http://emergency.cdc.gov/coca/calls/index.asp.
See also:
1 Aug 2014: CDC Ebola infection control recommendations for hospitals, http://www.cdc.gov/vhf/ebola/hcp/infect ... tions.html;
5 Aug 2014: CDC What U.S. Hospitals Need to Know to Prepare for Ebola Virus Disease, http://emergency.cdc.gov/coca/calls/201 ... 080514.asp.
--
Communicated by:
ProMED-mail Rapporteur Mary Marshall
******
[3] New drug
Date: 5 Aug 2014
Source: Science Media Centre [edited]
http://www.sciencemediacentre.org/exper ... -for-ebola
Prof. Tom Solomon, Director of the NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, and Director of the Institute of Infection and Global Health, University of Liverpool, U.K. said:
Q1. What new treatments are being tried for Ebola virus disease?
A1. "Although there are no proven antivirus treatments for EVD, an experimental drug has been used in 2 American health care workers who became infected, with apparently encouraging results in one of them. The drug called ZMapp consists of humanized monoclonal antibodies against the virus, developed by San Diego Mapp Biopharmaceutical Inc, in collaboration with LeafBio and Defyrus Inc. It uses some of the most sophisticated techniques for drug development that we have."
Q2. How was the experimental drug developed?
A2. "The new treatment incorporates some neat scientific tricks which bring together human, mouse, and plant biology systems. Monoclonal antibodies are made by infecting a mouse with ebolavirus and then isolating the immune cells (the clonal cells) which produce specific antibody proteins against the virus. Although they are effective at neutralizing the virus, these antibodies have to be modified, or "humanized," so they are similar to human antibodies, and can thus work with the human immune system. These changes are made by altering the genes which produce the antibody proteins. The genes are injected into a tobacco plant, _Nicotiana_, which then produces large amounts of the antibody protein. The Zmapp treatment consists of 3 different monoclonal antibodies against ebolavirus proteins. So far, it has proved effective when used to treat experimentally infected monkeys. Normally, further drug development for humans would take years, with carefully controlled clinical trials. However, in emergency situations like this, when the death rate from a disease is especially high, drugs can be used on a compassionate basis, without the full set of data to support their use."
"The 1st EVD patient to receive ZMapp appeared to make a dramatic recovery within an hour, whereas in the 2nd recipient, there were no immediate effects. Such dramatic recoveries are unusual for any drug treatments, making some scientists cautious about how to interpret these findings. Full controlled clinical trials will be needed."
--
Communicated by:
ProMED-mail Rapporteur Mary Marshall
******
[4] New drugs, more
Date: 4 Aug 2014
Source: Business Insider [edited]
http://www.businessinsider.com/zmapp-se ... z39k4g1c3y
Both of the EVD-infected U.S. citizens in Liberia received a rare dose of what news reports called a "secret serum" to treat the virus before being transported to Emory University Hospital in Atlanta, USA according to a CNN report. And while some people do fight off the disease on their own, in the case of the 2 Americans, that experimental serum may have saved their lives.
As KB and missionary NW waited in a Liberian hospital, someone from the U.S. National Institutes of Health reached out to Samaritan's Purse, one of the 2 North Carolina-based Christian relief groups the 2 were working with, and offered to have vials of an experimental drug called ZMapp sent to Liberia, according to CNN's unnamed source.
Although the Food and Drug Administration does allow experimental drugs to occasionally be distributed in life-threatening circumstances without approval under the expanded access or "compassionate use" conditions, it's not yet clear whether that approval was granted in this case or not. A spokesperson for the FDA told Business Insider that federal law and FDA regulations prohibit them from commenting on specific products, as that information is considered confidential.
An Emergency Treatment
------------------
However, it was approved, 3 frozen vials of ZMapp, a drug being developed by Mapp Biopharmaceutical, were flown to Liberia and arrived the morning of Thu 31 Jul 2014. The serum needed 8-10 hours to thaw. KB, who had been sick for 9 days already, reportedly had asked that NW receive the 1st dose, as he was younger and thought he had a better chance of surviving [It's unclear from the CNN story why the doses apparently were not all ready at the same time]. But his condition worsened as the 1st dose thawed, and CNN reports that he told his doctors, "I am going to die."
He asked for the 1st dose and had it given to him through an IV. According to CNN's source, within an hour, he was able to breathe better and a rash on his body started to fade. The next day he was able to shower without help before boarding the air ambulance that flew him to Atlanta, USA.
NW reportedly didn't respond as well to the 1st treatment she received and had to be given the 3rd vial of serum. Her 2nd treatment seemed to improve her condition, according to CNN and stabilized her enough that she is expected to fly to the USA on Tue 5 Aug 2014 [which she did].
The ZMapp serum itself is what is known as a "monoclonal antibody." These substances are created by infecting an animal with the disease in question. Then, scientists harvest and use the antibodies that the animals' immune systems create to fight the virus. In this case, the antibodies were harvested from ebolavirus-infected mice.
Studies have tested various other blends of similar therapies against ebolavirus-infected monkeys before, with some efficacy, but only when the therapy is given within 48 hours of infection. As Hamblin cautions, "very little is known about the safety and effectiveness of this treatment, so little that outside of extreme circumstances like this, it would not be legal to use."
This EVD outbreak -- the worst in history -- has already killed [932] people. But promising news of an experimental serum doesn't mean that a treatment is close. Developing a cure for a virus is complicated, and developing a treatment for Ebola has proven particularly difficult. In this case, since health officials can't comment on a specific treatment or on the patients involved for privacy reasons, we don't know the exact status of KB and NW or how that status has been affected by the serum that they reportedly received.
Before this emergency use, ZMapp had only been tested in a small number of monkeys. The company reported that all 4 monkeys who received the treatment within 24 hours of being infected survived. Half of another group of 4 monkeys who were treated within 48 hours survived. KB and NW had been sick much longer than that before being treated, and treatments that work in animals -- especially such a small number of animals -- routinely fail to work in human trials.
Standard "treatment" for EVD usually involves trying to keep patients hydrated and alive long enough to give the immune system a chance to battle the virus. And while that approach may sound unpromising, this outbreak has had a fatality rate of about 60 percent so far, not close to the 90 percent that's often reported. That 60 percent number could still rise, but survival cannot necessarily be attributed to an experimental treatment. While EVD is highly fatal, some people do survive without any extraordinary interventions.
ZMapp is not even far enough along to have entered the clinical trial phase, but it may have been chosen in this case instead of the promising experimental drug Tekmira, because an ongoing Tekmira trial was just halted by the FDA. That doesn't mean that all research on Tekmira is over, however. The ongoing trial was halted because healthy patients showed a problematic immune response.
But the FDA could still approve a new trial of the drug in sick patients, as the risk-benefit equation would be changed. A potential benefit of surviving a disease that kills 60-90 percent of patients could outweigh the risks of many potentially problematic side effects [It was not side effects that stopped the trial, but lack of an adequate immune response in all test humans. - Mod.JW]. CNN also reported that on 30 Jul 2014, the military approved additional funding for Mapp Biopharmaceutical because of their promising results so far.
If either ZMapp or Tekmira prove to be effective, testing, approving, and then producing a drug will still take time, even if the process is fast-tracked. At this point, the best hope for stopping this outbreak is not curing it but containing it. Even though the virus can only be transmitted by close contact, and thus it can be contained, health officials have been completely unable to do so in West Africa due to a combination of factors including poor healthcare infrastructure, distrust of authorities, traditional burial practices, and fear of healthcare providers.
At the present rate, World Health Organization chief Margaret Chan describes the consequences of not being able to stop the disease's spread as "catastrophic."
[Byline: Kevin Loria]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
******
[5] Media reports
CDC issues highest-level alert for Ebola virus disease
-----------------------------
6 Aug 2014: The U.S. Centers for Disease Control and Prevention has issued its highest-level alert for a response to the EVD crisis in West Africa. "Ops Center moved to Level 1 response given the extension to Nigeria and potential to affect many lives," CDC chief Tom Frieden said Wed [6 Aug 2014] on Twitter. Level 1 means that increased staff and resources will be devoted to the outbreak, officials said. It is the 1st time the agency has invoked its highest level alert since 2009, over [the H1N1] flu outbreak.
http://www.usatoday.com/story/news/worl ... l/13663973
NY City Patient In Isolation Does Not Have EVD
----------------------------------
6 Aug 2014: The man was placed into "strict isolation" within 7 minutes of his arrival and was undergoing various tests to determine the cause of the symptoms, the hospital said. "We would like to report that the Centers for Disease Control and Prevention have determined that the patient kept in isolation since Mon 4 Aug 2014 at The Mount Sinai Hospital has tested negative for Ebola virus disease (EVD)," the hospital said in a statement.
http://newyork.cbslocal.com/2014/08/06/ ... -wednesday
Sierra Leone border check video
-----------------------
6 Aug 2014: [A revealing video of conditions at a border checkpoint between Sierra Leone and Liberia before the military blockade. - Mod.JW]
http://outfront.blogs.cnn.com/2014/08/0 ... checkpoint
Singapore: additional precautions
----------------------------
7 Aug 2014: Despite the low risk of spread to Singapore, all hospitals, clinics and doctors have been alerted to stay vigilant against possible suspect cases. Our public hospitals also have in place appropriate infection control measures. Suspect cases are triaged at emergency departments and, as a precaution, isolated from other patients to minimise any risk of transmission. Measures are already in place to carry out contact tracing and to quarantine all close contacts if there is a case in Singapore.
More information on Ebola virus disease is available at http://www.moh.gov.sg/content/moh_web/h ... ease-.html, or members of the public may call MOH's hotline at 1800-2254122.
http://www.moh.gov.sg/content/moh_web/h ... ebola.html
Nigeria to Screen Outbound Travellers
--------------------------------
7 Aug 2014: As part of efforts to ensure that the spread of the deadly Ebola virus disease is contained, the Federal Government has announced that it would commence screening of all outbound travellers from Nigeria's shores. Travellers who show symptoms would be prevented from travelling, and, where they are non-Nigerians, they would only be allowed out if their countries have the capacity for a properly supervised evacuation and treatment, as was demonstrated by the USA recently.
http://www.thisdaylive.com/articles/ebo ... ers/185637
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[ProMED wishes to credit Kunihiko Iizura and Mary Marshall for sending in several of the above reports.
The more we learn about the "serum" used to treat the 2 EVD-infected Americans, the less likely it seems that it is any good, but it is just about the only hope we have at this time, as the vaccine is a long way off.
Although the drug saved 4/4 monkeys when used within 24 hours of infection, it only saved 2/4 at 48 hours, and the Americans were treated days later than that. Then the doctor started recovering, probably too quickly to have been due to its effect, and the nurse so slowly that she needed a 2nd dose. So maybe their recovery is just due to excellent medical care and had nothing to do with the ZMapp serum. That leaves us with the Tekmira drug, which reportedly has not had a satisfactory immune response in clinical trials.
However, sooner or later, a dose is going to be given too late, or to a particularly vulnerable patient, who will die, and the death will be taken to show that the drug is useless, or worse, blamed on the drug itself, the way the anti-HIV drugs were blamed for producing AIDS in South Africa by the then President [not Mandela]. - Mod.JW]
[Hence the need for clinical trials of potential therapies. The ongoing occurrence of cases would allow for prospective, randomized, blinded trials of therapeutics that could definitively answer the question of their benefits (or harms).
ProMED adds its voice to the urgent calls for such trials to be conducted, ideally, under the auspices of international organizations. - Mod.LM
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/46.]
-
Birgitt
- Moderator
- Beiträge: 35240
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Ebola - WHO ruft internationalen Gesundheits-Notstand aus
EBOLA VIRUS DISEASE - WEST AFRICA (119): WHO -- INTERNATIONAL EMERGENCY
***********************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: 8 Aug 2014
Source: WHO [edited]
http://who.int/mediacentre/news/stateme ... 0140808/en
WHO Statement on the Meeting of the International Health Regulations Emergency Committee Regarding the 2014 Ebola Outbreak in West Africa
-----------------------------------------
[excerpts]
After discussion and deliberation on the information provided, the Committee advised that:
- the Ebola [virus disease] outbreak in West Africa constitutes an 'extraordinary event' and a public health risk to other States;
- the possible consequences of further international spread are particularly serious in view of the virulence of the virus, the intensive community and health facility transmission patterns, and the weak health systems in the currently affected and most at-risk countries.
- a coordinated international response is deemed essential to stop and reverse the international spread of Ebola [virus disease, EVD].
***It was the unanimous view of the Committee that the conditions for a Public Health Emergency of International Concern (PHEIC) have been met.***[Emphasis added]
This is currently the largest EVD outbreak ever recorded. In response to the outbreak, a number of unaffected countries have made a range of travel related advice or recommendations. In light of States Parties' presentations and subsequent Committee discussions, several challenges were noted for the affected countries:
- their health systems are fragile with significant deficits in human, financial and material resources, resulting in compromised ability to mount an adequate EVD outbreak control response; inexperience in dealing with EVD outbreaks; misperceptions of the disease, including how the disease is transmitted, are common and continue to be a major challenge in some communities;
- high mobility of populations and several instances of cross-border movement of travellers with infection;
- several generations of transmission have occurred in the 3 capital cities of Conakry (Guinea); Monrovia (Liberia); and Freetown (Sierra Leone); and
- a high number of infections have been identified among health-care workers, highlighting inadequate infection control practices in many facilities.
The Committee provided the following advice to the Director-General for her consideration to address the EVD outbreak in accordance with IHR (2005).
States with EVD transmission
------------------------------
- The Head of State should declare a national emergency; ...
- Health Ministers and other health leaders should assume a prominent leadership role...
- States should activate their national disaster/emergency management mechanisms...
- States should ensure that there is a large-scale and sustained effort to fully engage the community - through local, religious and traditional leaders and healers...
- It is essential that a strong supply pipeline be established to ensure that sufficient medical commodities, especially personal protective equipment (PPE), are available...
- In areas of intense transmission ... extraordinary supplemental measures such as quarantine should be used as considered necessary.
- States should ensure health care workers receive: adequate (pay, PPE)...
- States should ensure that: treatment centres and reliable diagnostic laboratories are situated as closely as possible to areas of transmission; ...
- States should conduct exit screening of all persons at international airports, seaports and major land crossings...
- There should be no international travel of Ebola contacts or cases, unless the travel is part of an appropriate medical evacuation.
To minimize the risk of international spread of EVD:
- Confirmed cases should immediately be isolated and treated...
- Contacts ... should be monitored daily, with restricted national travel...
- Probable and suspect cases should immediately be isolated and their travel should be restricted...
- States should ensure funerals and burials are conducted by well-trained personnel... cross-border movement of the human remains of deceased suspect, probable or confirmed EVD cases should be prohibited unless authorized...
- States should ensure that appropriate medical care is available for the crews and staff of airlines operating in the country...
- States with EVD transmission should consider postponing mass gatherings until EVD transmission is interrupted.
States with a potential or confirmed EVD Case, and unaffected States with land borders with affected States
---------------------
- Unaffected States with land borders adjoining States with EVD transmission should urgently establish surveillance...
- Any State newly detecting a suspect or confirmed EVD case or contact, or clusters of unexplained deaths due to febrile illness, should treat this as a health emergency...
- If EVD transmission is confirmed to be occurring in the State, the full recommendations for States with EVD Transmission should be implemented...
- There should be ***no general ban*** [emphasis added] on international travel or trade...
- States should provide travelers to EVD-affected and at-risk areas with relevant information on risks, measures to minimize those risks, and advice for managing a potential exposure.
- States should be prepared to detect, investigate, and manage EVD cases...
- The general public should be provided with accurate and relevant information on the EVD outbreak and measures to reduce the risk of exposure.
- States should be prepared to facilitate the evacuation and repatriation of nationals (e.g. health workers) who have been exposed to EVD.
The Committee emphasized the importance of continued support by WHO and other national and international partners towards the effective implementation and monitoring of these recommendations.
The Director-General endorsed the Committee's advice and issued them as Temporary Recommendations under IHR (2005) to reduce the international spread of EVD, effective 8 Aug 2014. The Director-General thanked the Committee Members and Advisors for their advice and requested their reassessment of this situation within 3 months.
[Note that in spite of WHO's statement that there should be no general ban on international travel or trade, several states and airlines are implementing unilateral bans on both, which will severely affect the economies of the EVD-infected West African countries and compound their misery. - Mod.JW]
***********************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: 8 Aug 2014
Source: WHO [edited]
http://who.int/mediacentre/news/stateme ... 0140808/en
WHO Statement on the Meeting of the International Health Regulations Emergency Committee Regarding the 2014 Ebola Outbreak in West Africa
-----------------------------------------
[excerpts]
After discussion and deliberation on the information provided, the Committee advised that:
- the Ebola [virus disease] outbreak in West Africa constitutes an 'extraordinary event' and a public health risk to other States;
- the possible consequences of further international spread are particularly serious in view of the virulence of the virus, the intensive community and health facility transmission patterns, and the weak health systems in the currently affected and most at-risk countries.
- a coordinated international response is deemed essential to stop and reverse the international spread of Ebola [virus disease, EVD].
***It was the unanimous view of the Committee that the conditions for a Public Health Emergency of International Concern (PHEIC) have been met.***[Emphasis added]
This is currently the largest EVD outbreak ever recorded. In response to the outbreak, a number of unaffected countries have made a range of travel related advice or recommendations. In light of States Parties' presentations and subsequent Committee discussions, several challenges were noted for the affected countries:
- their health systems are fragile with significant deficits in human, financial and material resources, resulting in compromised ability to mount an adequate EVD outbreak control response; inexperience in dealing with EVD outbreaks; misperceptions of the disease, including how the disease is transmitted, are common and continue to be a major challenge in some communities;
- high mobility of populations and several instances of cross-border movement of travellers with infection;
- several generations of transmission have occurred in the 3 capital cities of Conakry (Guinea); Monrovia (Liberia); and Freetown (Sierra Leone); and
- a high number of infections have been identified among health-care workers, highlighting inadequate infection control practices in many facilities.
The Committee provided the following advice to the Director-General for her consideration to address the EVD outbreak in accordance with IHR (2005).
States with EVD transmission
------------------------------
- The Head of State should declare a national emergency; ...
- Health Ministers and other health leaders should assume a prominent leadership role...
- States should activate their national disaster/emergency management mechanisms...
- States should ensure that there is a large-scale and sustained effort to fully engage the community - through local, religious and traditional leaders and healers...
- It is essential that a strong supply pipeline be established to ensure that sufficient medical commodities, especially personal protective equipment (PPE), are available...
- In areas of intense transmission ... extraordinary supplemental measures such as quarantine should be used as considered necessary.
- States should ensure health care workers receive: adequate (pay, PPE)...
- States should ensure that: treatment centres and reliable diagnostic laboratories are situated as closely as possible to areas of transmission; ...
- States should conduct exit screening of all persons at international airports, seaports and major land crossings...
- There should be no international travel of Ebola contacts or cases, unless the travel is part of an appropriate medical evacuation.
To minimize the risk of international spread of EVD:
- Confirmed cases should immediately be isolated and treated...
- Contacts ... should be monitored daily, with restricted national travel...
- Probable and suspect cases should immediately be isolated and their travel should be restricted...
- States should ensure funerals and burials are conducted by well-trained personnel... cross-border movement of the human remains of deceased suspect, probable or confirmed EVD cases should be prohibited unless authorized...
- States should ensure that appropriate medical care is available for the crews and staff of airlines operating in the country...
- States with EVD transmission should consider postponing mass gatherings until EVD transmission is interrupted.
States with a potential or confirmed EVD Case, and unaffected States with land borders with affected States
---------------------
- Unaffected States with land borders adjoining States with EVD transmission should urgently establish surveillance...
- Any State newly detecting a suspect or confirmed EVD case or contact, or clusters of unexplained deaths due to febrile illness, should treat this as a health emergency...
- If EVD transmission is confirmed to be occurring in the State, the full recommendations for States with EVD Transmission should be implemented...
- There should be ***no general ban*** [emphasis added] on international travel or trade...
- States should provide travelers to EVD-affected and at-risk areas with relevant information on risks, measures to minimize those risks, and advice for managing a potential exposure.
- States should be prepared to detect, investigate, and manage EVD cases...
- The general public should be provided with accurate and relevant information on the EVD outbreak and measures to reduce the risk of exposure.
- States should be prepared to facilitate the evacuation and repatriation of nationals (e.g. health workers) who have been exposed to EVD.
The Committee emphasized the importance of continued support by WHO and other national and international partners towards the effective implementation and monitoring of these recommendations.
The Director-General endorsed the Committee's advice and issued them as Temporary Recommendations under IHR (2005) to reduce the international spread of EVD, effective 8 Aug 2014. The Director-General thanked the Committee Members and Advisors for their advice and requested their reassessment of this situation within 3 months.
[Note that in spite of WHO's statement that there should be no general ban on international travel or trade, several states and airlines are implementing unilateral bans on both, which will severely affect the economies of the EVD-infected West African countries and compound their misery. - Mod.JW]
-
Birgitt
- Moderator
- Beiträge: 35240
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Ebola-Fieber in Westafrika
EBOLA VIRUS DISEASE - WEST AFRICA (120): MSF, SIERRA LEONE, DRUG, PAHO, AID
***************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this update:
[1] MSF: response to WHO
[2] Sierra Leone: Kenema hospital
[3] New drug release
[4] PAHO manual for the Americas
[5] International aid
[6] Media reports
******
[1] MSF: response to WHO
Date: 8 Aug 2014
Source: MSF [edited]
http://www.msf.org.uk/article/ebola-off ... nary-event
In response [to the WHO statement on Ebola], Dr Bart Janssens, Medecins Sans Frontieres/Doctors Without Borders (MSF) Director of Operations said:
"Declaring Ebola virus disease an international public health emergency shows how seriously WHO is taking the current outbreak, but statements won't save lives. Now, we need this statement to translate into immediate action on the ground. For weeks, MSF has been repeating that a massive medical, epidemiological and public health response is desperately needed to saves lives and reverse the course of the epidemic. Lives are being lost because the response is too slow."
"Countries possessing necessary capacities must immediately dispatch available infectious disease experts and disaster relief assets to the region. It is clear the epidemic will not be contained without a massive deployment on the ground from these states. In concrete terms, all of the following need to be radically scaled up: medical care, training of health staff, infection control, contact tracing, epidemiological surveillance, alert and referral systems, community mobilisation and education."
"MSF currently has 66 international and 610 national staff responding to the crisis in the 3 affected countries. All of our Ebola experts are mobilised; we simply cannot do more."
MSF emergency teams are continuing their efforts to fight the EVD epidemic in West Africa. The disease has claimed 932 lives, according to the WHO, since the outbreak began in March 2014.
Over recent weeks, MSF teams have seen a worrying surge in the epidemic, with the number of cases increasing dramatically in Sierra Leone and Liberia and the disease spreading to many more villages and towns. MSF urges the WHO, health authorities and other organisations to scale up their response.
--
Communicated by:
ProMED-mail Rapporteur Mary Marshall
******
[2] Sierra Leone: Kenema hospital
Date: 8 Aug 2014
Source: New York Times [edited]
http://www.nytimes.com/2014/08/08/world ... html?&_r=1
At the government hospital in Kenema, Sierra Leone, health care workers struggle to contain the Ebola virus disease epidemic, which has killed almost 1000 people across West Africa. So many patients, nurses and health workers have died in the government hospital that many people in this city, a center of the world's worst EVD epidemic, see it as a death trap. Now, the wards are empty in the principal institution fighting the disease. EVD stalks the city, claiming lives every day, but patients have fled the hospital's long, narrow buildings, which sit silent and echoing in the fading light. Few people are taking any chances by coming here. "Don't touch the walls!" a Western medical technician yelled out. "Totally infected."
Some Ebola patients still die at the hospital, perhaps 4 per day, in the tent-like temporary isolation ward at the back of the muddy grounds. But just as many, if not more, are dying in the city and neighboring villages, greatly increasing the risk of spreading the disease and undermining international efforts to halt the epidemic. "People don't die here now," said the deputy chief of the hospital's burying team, Albert J. Mattia, exasperated after a long day of EVD burials. "They are dying in the community, 5, 6 a day." Mr. Mattia was particularly disturbed that many of the bodies his team were putting in the ground had come from outside the hospital, thwarting attempts to isolate patients and prevent them from passing the disease to others. "It's very, very dangerous, very hazardous; it is contributing to the EVD dead," he said as his 2 deputies nodded glumly in agreement. "You go to the wards, there are no patients."
Containing the virus in Kenema -- one of the nation's largest cities and a gateway to an area of the country where the disease is rampant -- is critical to taming the epidemic's deadly advance across parts of West Africa. More than 930 people, including over 280 here in Sierra Leone, have died since the outbreak was 1st identified across the border in Guinea in March [2014]. Since then, Sierra Leone has been hit with more cases of the disease than any other nation -- 691 out of 1711 at last count -- and the hospital in Kenema quickly became a focal point in the effort to grapple with the epidemic when the government set up a treatment center here for cases in the region.
International health officials have concentrated intensively on the hospital in the last several days, training healthcare workers, preparing a more secure isolation ward, establishing the rigorous separation of zones -- low risk, high risk -- that characterize the tightly sealed Doctors Without Borders [MSF] EVD facilities elsewhere in stricken West Africa. But it is a tough struggle, and the recent history of the hospital looms. More than 20 health care workers at the hospital have died trying to battle the disease over the last several months, including nurses, support staff and the country's leading doctor.
[Byline: Adam Nossiteraug]
--
Communicated by:
ProMED-mail Rapporteur Mary Marshall
[See more at source URL. - Mod.JW]
******
[3] New drug release
Date: 8 Aug 2014
Source: Bio Tuesdays [edited]
http://biotuesdays.com/2014/08/08/fda-e ... nical-hold
The FDA has verbally confirmed that it has modified a full clinical hold on Tekmira Pharmaceuticals' (NASDAQ:TKMR; TSX:TKM) TKM-Ebola Investigational New Drug [IND] application to a partial clinical hold.
"We view this news as extremely positive, as this paves the way for TKM-Ebola to potentially be used in the treatment of individuals currently infected with the ebolavirus," writes David Novak, an analyst with Clarus Securities. He said TKM-Ebola is presently the most clinically advanced therapeutic in development, "being the only one to have entered formal, regulated human safety testing." In addition, Tekmira has developed a scalable cGMP manufacturing process, which enables the company to produce sufficient quantities of therapeutic compounds for human use, unlike other preclinical alternatives. "We remain confident that Tekmira is actively pursuing discussions with the FDA to advance a special emergency protocol for use of TKM-Ebola in infected humans and expect further details in the short term," he added.
[Byline: Jennifer Poland]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
******
[4] PAHO manual for the Americas
Date: 6 Aug 2014
Source: PAHO [edited]
http://www.paho.org/hq/index.php?option ... 99&lang=en
"Ebola virus disease (EVD), implications of introduction in the Americas"
---------------------------------------
[This is a comprehensive manual directed to countries in the Americas; Spanish version at:
http://www.paho.org/hq/index.php?option ... 99&lang=es. - Mod.JW]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
******
[5] International aid
World Bank: USD 200 million
----------------------------
5 Aug 2014: In a huge step to tackle the problem of EVD, the World Bank has said that it will provide up to USD 200 million to the West African nations.
http://daily.bhaskar.com/article/WOR-20 ... 7-NOR.html
China: USD 4.86 million
--------------------------
7 Aug 2014: China will provide 30 million yuan [USD 4.86 million] in humanitarian assistance supplies for countries hit by the ebolavirus, such as Liberia, Sierra Leone and Guinea, announced the Ministry of Commerce of China on Thu 7 Aug 2014.
This is the 2nd batch of material assistance offered by China to the countries of West Africa. The 1st batch of medical equipment for prevention and treatment of the virus, worth around one million yuan [USD 162 000] arrived in the country in May [2014]. Moreover, China also sent medical teams to these countries to help in the treatment of infected people. The ebolavirus outbreak continues expanding, especially in Liberia, Sierra Leone and Guinea. The United Nations and the World Health Organization requested international assistance to fight against the epidemic.
http://www.vermelho.org.br/noticia/247181-9 [in Portuguese]
OFID USD 500 000
------------------
4 Aug 2014: The OPEC Fund for International Development (OFID) has approved an emergency assistance grant of USD 500 000 to support the activities of the World Health Organization (WHO) in stopping the spread of EVD.
http://en.starafrica.com/news/ofid-appr ... frica.html
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
******
[6] Media reports
Nigeria: 2 more cases
----------------------
8 Aug 2014: The federal government on Fri 8 Aug 2014 has said that 2 new cases of Ebola virus disease infection have been confirmed in Lagos. This brings to 7 the number of new cases of EVD in Lagos and a 2nd death from the virus. Also, the federal government warned against bathing with salt water being circulated via SMSs [texts] and the social media as a cure for EVD, saying it will prosecute individuals who spread such false information. Vanguard gathered that 139 people are under surveillance in Africa's most populous country as panic over the spread of the diseases heightens.
http://www.vanguardngr.com/2014/08/ebol ... med-lagos/?
Nigeria: salt therapy dangerous
--------------------------
8 Aug 2014: At least 2 persons have been feared killed and 20 others hospitalised in various hospitals in Plateau State after consuming excessive quantities of salt and bitter kola [see http://news.bbc.co.uk/1/hi/health/411030.stm] to prevent Ebolavirus disease (EVD). The 2, according to a source in Shendam who spoke with our reporter on the phone, were rushed to the hospital by their family members after they suddenly collapsed in the morning, having consumed too much salt overnight. They later died of high blood pressure in the hospital. According to medical personnel in the hospitals where the other patients are currently taking treatment in Jos, some developed ulcers, while others had severe diarrhea, having consumed table salt in excess.
http://www.thisdaylive.com/articles/ebo ... um=twitter
Liberia: USA Evacuates Embassy Employees, Families
--------------------------------
8 Aug 2014 (CNN): The USA ordered relatives of its embassy employees to leave Liberia as the African nation struggles to contain the Ebola epidemic.
http://theconservativetreehouse.com/201 ... ll-now-932
[A State Department statement said U.S. staff would remain on active duty at the embassy, and additional staff were being sent to help the government tackle the outbreak of the deadly virus. Do they mean dependent nationals as well? - Mod.JW]
Liberians "harassed" in Nigeria
------------------------------
7 Aug 2014: The Liberian Government has appealed to Nigerian authorities to protect Liberian citizens in the country from "stereotyping and harassment'' in the wake of the Ebola virus disease outbreak in West Africa.
http://www.vanguardngr.com/2014/08/ebol ... 8a2qp.dpuf
WHO recommends Guinea-Bissau to strengthen border surveillance
---------------------------------------
8 Aug 2014: The World Health Organization (WHO) today [8 Aug 2014] recommended to Guinea-Bissau strengthening the surveillance of borders with Guinea, a country where there have already been 367 deaths caused by EVD. "At this time, the WHO in Geneva has not received any information on cases registered in Guinea-Bissau," said Tarik Jasarevic Lusa at the organization based in Geneva.
http://www.rtp.pt/noticias/index.php?ar ... &visual=49
Benin: Nigerian Man suspected
-------------------------------
A hospital in the country has announced that they are treating a Nigerian man who they fear has contracted Ebola disease, Benin Republic Health Minister Dorothee Gazard said.
http://www.date360.net/profiles/blogs/n ... t=#date360
Togo: False alarms (official)
----------------------
8 Aug 2014: [Re. text and cell phone messages spreading false rumors - Mod.JW]
http://www.radiogameli.com/index.php/en ... l-officiel [in French]
Protecting Ships' Crews During Ebola Virus Disease Outbreak
-----------------------------
7 Aug 2014: Global maritime organizations have issued health guidance on the risks posed to ships' crews calling in countries affected by the Ebola virus disease.
http://www.marinelink.com/news/protecti ... 74465.aspx
Greece: testing potential EVD case
------------------------
8 Aug 2014: Greece said on Friday [8 Aug 2014] it was running tests on a man suspected of carrying the ebolavirus. The Greek man, an architect who had recently travelled to Nigeria, was undergoing tests at an Athens hospital, a health ministry spokesman said. "It is likely that the man checked himself in," he said, declining to give further details on the patient or the case. The ministry had earlier identified the patient as Nigerian.
http://www.vanguardngr.com/2014/08/gree ... TYywq.dpuf
ECDC: Information resources and latest news about Ebola virus disease
---------------------------------------
The European Centre for Disease Prevention and Control (ECDC) Stockholm, Sweden has a health topic page dedicated to providing comprehensive information about the Ebola virus disease (EVD) outbreak in West Africa. The page links to public health advice and the ECDC risk assessment on EVD. The Centre has published information to travellers, available in 22 European Union languages, as well as epidemiological updates.
Citation style for this article: Eurosurveillance editorial team. Information resources and latest news about Ebola virus disease available from ECDC. Euro Surveill. 2014;19(31):pii=20871. Available online: http://www.eurosurveillance.org/ViewArt ... leId=20871.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[Let us hope and pray that the massive international aid will translate into more "boots on the ground" and that there will be less of the paranoid reaction on the internet on the theme of: "They chose to go out there -- so let them stay there -- we don't want them back home again." - Mod.JW
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/46.]
***************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this update:
[1] MSF: response to WHO
[2] Sierra Leone: Kenema hospital
[3] New drug release
[4] PAHO manual for the Americas
[5] International aid
[6] Media reports
******
[1] MSF: response to WHO
Date: 8 Aug 2014
Source: MSF [edited]
http://www.msf.org.uk/article/ebola-off ... nary-event
In response [to the WHO statement on Ebola], Dr Bart Janssens, Medecins Sans Frontieres/Doctors Without Borders (MSF) Director of Operations said:
"Declaring Ebola virus disease an international public health emergency shows how seriously WHO is taking the current outbreak, but statements won't save lives. Now, we need this statement to translate into immediate action on the ground. For weeks, MSF has been repeating that a massive medical, epidemiological and public health response is desperately needed to saves lives and reverse the course of the epidemic. Lives are being lost because the response is too slow."
"Countries possessing necessary capacities must immediately dispatch available infectious disease experts and disaster relief assets to the region. It is clear the epidemic will not be contained without a massive deployment on the ground from these states. In concrete terms, all of the following need to be radically scaled up: medical care, training of health staff, infection control, contact tracing, epidemiological surveillance, alert and referral systems, community mobilisation and education."
"MSF currently has 66 international and 610 national staff responding to the crisis in the 3 affected countries. All of our Ebola experts are mobilised; we simply cannot do more."
MSF emergency teams are continuing their efforts to fight the EVD epidemic in West Africa. The disease has claimed 932 lives, according to the WHO, since the outbreak began in March 2014.
Over recent weeks, MSF teams have seen a worrying surge in the epidemic, with the number of cases increasing dramatically in Sierra Leone and Liberia and the disease spreading to many more villages and towns. MSF urges the WHO, health authorities and other organisations to scale up their response.
--
Communicated by:
ProMED-mail Rapporteur Mary Marshall
******
[2] Sierra Leone: Kenema hospital
Date: 8 Aug 2014
Source: New York Times [edited]
http://www.nytimes.com/2014/08/08/world ... html?&_r=1
At the government hospital in Kenema, Sierra Leone, health care workers struggle to contain the Ebola virus disease epidemic, which has killed almost 1000 people across West Africa. So many patients, nurses and health workers have died in the government hospital that many people in this city, a center of the world's worst EVD epidemic, see it as a death trap. Now, the wards are empty in the principal institution fighting the disease. EVD stalks the city, claiming lives every day, but patients have fled the hospital's long, narrow buildings, which sit silent and echoing in the fading light. Few people are taking any chances by coming here. "Don't touch the walls!" a Western medical technician yelled out. "Totally infected."
Some Ebola patients still die at the hospital, perhaps 4 per day, in the tent-like temporary isolation ward at the back of the muddy grounds. But just as many, if not more, are dying in the city and neighboring villages, greatly increasing the risk of spreading the disease and undermining international efforts to halt the epidemic. "People don't die here now," said the deputy chief of the hospital's burying team, Albert J. Mattia, exasperated after a long day of EVD burials. "They are dying in the community, 5, 6 a day." Mr. Mattia was particularly disturbed that many of the bodies his team were putting in the ground had come from outside the hospital, thwarting attempts to isolate patients and prevent them from passing the disease to others. "It's very, very dangerous, very hazardous; it is contributing to the EVD dead," he said as his 2 deputies nodded glumly in agreement. "You go to the wards, there are no patients."
Containing the virus in Kenema -- one of the nation's largest cities and a gateway to an area of the country where the disease is rampant -- is critical to taming the epidemic's deadly advance across parts of West Africa. More than 930 people, including over 280 here in Sierra Leone, have died since the outbreak was 1st identified across the border in Guinea in March [2014]. Since then, Sierra Leone has been hit with more cases of the disease than any other nation -- 691 out of 1711 at last count -- and the hospital in Kenema quickly became a focal point in the effort to grapple with the epidemic when the government set up a treatment center here for cases in the region.
International health officials have concentrated intensively on the hospital in the last several days, training healthcare workers, preparing a more secure isolation ward, establishing the rigorous separation of zones -- low risk, high risk -- that characterize the tightly sealed Doctors Without Borders [MSF] EVD facilities elsewhere in stricken West Africa. But it is a tough struggle, and the recent history of the hospital looms. More than 20 health care workers at the hospital have died trying to battle the disease over the last several months, including nurses, support staff and the country's leading doctor.
[Byline: Adam Nossiteraug]
--
Communicated by:
ProMED-mail Rapporteur Mary Marshall
[See more at source URL. - Mod.JW]
******
[3] New drug release
Date: 8 Aug 2014
Source: Bio Tuesdays [edited]
http://biotuesdays.com/2014/08/08/fda-e ... nical-hold
The FDA has verbally confirmed that it has modified a full clinical hold on Tekmira Pharmaceuticals' (NASDAQ:TKMR; TSX:TKM) TKM-Ebola Investigational New Drug [IND] application to a partial clinical hold.
"We view this news as extremely positive, as this paves the way for TKM-Ebola to potentially be used in the treatment of individuals currently infected with the ebolavirus," writes David Novak, an analyst with Clarus Securities. He said TKM-Ebola is presently the most clinically advanced therapeutic in development, "being the only one to have entered formal, regulated human safety testing." In addition, Tekmira has developed a scalable cGMP manufacturing process, which enables the company to produce sufficient quantities of therapeutic compounds for human use, unlike other preclinical alternatives. "We remain confident that Tekmira is actively pursuing discussions with the FDA to advance a special emergency protocol for use of TKM-Ebola in infected humans and expect further details in the short term," he added.
[Byline: Jennifer Poland]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
******
[4] PAHO manual for the Americas
Date: 6 Aug 2014
Source: PAHO [edited]
http://www.paho.org/hq/index.php?option ... 99&lang=en
"Ebola virus disease (EVD), implications of introduction in the Americas"
---------------------------------------
[This is a comprehensive manual directed to countries in the Americas; Spanish version at:
http://www.paho.org/hq/index.php?option ... 99&lang=es. - Mod.JW]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
******
[5] International aid
World Bank: USD 200 million
----------------------------
5 Aug 2014: In a huge step to tackle the problem of EVD, the World Bank has said that it will provide up to USD 200 million to the West African nations.
http://daily.bhaskar.com/article/WOR-20 ... 7-NOR.html
China: USD 4.86 million
--------------------------
7 Aug 2014: China will provide 30 million yuan [USD 4.86 million] in humanitarian assistance supplies for countries hit by the ebolavirus, such as Liberia, Sierra Leone and Guinea, announced the Ministry of Commerce of China on Thu 7 Aug 2014.
This is the 2nd batch of material assistance offered by China to the countries of West Africa. The 1st batch of medical equipment for prevention and treatment of the virus, worth around one million yuan [USD 162 000] arrived in the country in May [2014]. Moreover, China also sent medical teams to these countries to help in the treatment of infected people. The ebolavirus outbreak continues expanding, especially in Liberia, Sierra Leone and Guinea. The United Nations and the World Health Organization requested international assistance to fight against the epidemic.
http://www.vermelho.org.br/noticia/247181-9 [in Portuguese]
OFID USD 500 000
------------------
4 Aug 2014: The OPEC Fund for International Development (OFID) has approved an emergency assistance grant of USD 500 000 to support the activities of the World Health Organization (WHO) in stopping the spread of EVD.
http://en.starafrica.com/news/ofid-appr ... frica.html
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
******
[6] Media reports
Nigeria: 2 more cases
----------------------
8 Aug 2014: The federal government on Fri 8 Aug 2014 has said that 2 new cases of Ebola virus disease infection have been confirmed in Lagos. This brings to 7 the number of new cases of EVD in Lagos and a 2nd death from the virus. Also, the federal government warned against bathing with salt water being circulated via SMSs [texts] and the social media as a cure for EVD, saying it will prosecute individuals who spread such false information. Vanguard gathered that 139 people are under surveillance in Africa's most populous country as panic over the spread of the diseases heightens.
http://www.vanguardngr.com/2014/08/ebol ... med-lagos/?
Nigeria: salt therapy dangerous
--------------------------
8 Aug 2014: At least 2 persons have been feared killed and 20 others hospitalised in various hospitals in Plateau State after consuming excessive quantities of salt and bitter kola [see http://news.bbc.co.uk/1/hi/health/411030.stm] to prevent Ebolavirus disease (EVD). The 2, according to a source in Shendam who spoke with our reporter on the phone, were rushed to the hospital by their family members after they suddenly collapsed in the morning, having consumed too much salt overnight. They later died of high blood pressure in the hospital. According to medical personnel in the hospitals where the other patients are currently taking treatment in Jos, some developed ulcers, while others had severe diarrhea, having consumed table salt in excess.
http://www.thisdaylive.com/articles/ebo ... um=twitter
Liberia: USA Evacuates Embassy Employees, Families
--------------------------------
8 Aug 2014 (CNN): The USA ordered relatives of its embassy employees to leave Liberia as the African nation struggles to contain the Ebola epidemic.
http://theconservativetreehouse.com/201 ... ll-now-932
[A State Department statement said U.S. staff would remain on active duty at the embassy, and additional staff were being sent to help the government tackle the outbreak of the deadly virus. Do they mean dependent nationals as well? - Mod.JW]
Liberians "harassed" in Nigeria
------------------------------
7 Aug 2014: The Liberian Government has appealed to Nigerian authorities to protect Liberian citizens in the country from "stereotyping and harassment'' in the wake of the Ebola virus disease outbreak in West Africa.
http://www.vanguardngr.com/2014/08/ebol ... 8a2qp.dpuf
WHO recommends Guinea-Bissau to strengthen border surveillance
---------------------------------------
8 Aug 2014: The World Health Organization (WHO) today [8 Aug 2014] recommended to Guinea-Bissau strengthening the surveillance of borders with Guinea, a country where there have already been 367 deaths caused by EVD. "At this time, the WHO in Geneva has not received any information on cases registered in Guinea-Bissau," said Tarik Jasarevic Lusa at the organization based in Geneva.
http://www.rtp.pt/noticias/index.php?ar ... &visual=49
Benin: Nigerian Man suspected
-------------------------------
A hospital in the country has announced that they are treating a Nigerian man who they fear has contracted Ebola disease, Benin Republic Health Minister Dorothee Gazard said.
http://www.date360.net/profiles/blogs/n ... t=#date360
Togo: False alarms (official)
----------------------
8 Aug 2014: [Re. text and cell phone messages spreading false rumors - Mod.JW]
http://www.radiogameli.com/index.php/en ... l-officiel [in French]
Protecting Ships' Crews During Ebola Virus Disease Outbreak
-----------------------------
7 Aug 2014: Global maritime organizations have issued health guidance on the risks posed to ships' crews calling in countries affected by the Ebola virus disease.
http://www.marinelink.com/news/protecti ... 74465.aspx
Greece: testing potential EVD case
------------------------
8 Aug 2014: Greece said on Friday [8 Aug 2014] it was running tests on a man suspected of carrying the ebolavirus. The Greek man, an architect who had recently travelled to Nigeria, was undergoing tests at an Athens hospital, a health ministry spokesman said. "It is likely that the man checked himself in," he said, declining to give further details on the patient or the case. The ministry had earlier identified the patient as Nigerian.
http://www.vanguardngr.com/2014/08/gree ... TYywq.dpuf
ECDC: Information resources and latest news about Ebola virus disease
---------------------------------------
The European Centre for Disease Prevention and Control (ECDC) Stockholm, Sweden has a health topic page dedicated to providing comprehensive information about the Ebola virus disease (EVD) outbreak in West Africa. The page links to public health advice and the ECDC risk assessment on EVD. The Centre has published information to travellers, available in 22 European Union languages, as well as epidemiological updates.
Citation style for this article: Eurosurveillance editorial team. Information resources and latest news about Ebola virus disease available from ECDC. Euro Surveill. 2014;19(31):pii=20871. Available online: http://www.eurosurveillance.org/ViewArt ... leId=20871.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[Let us hope and pray that the massive international aid will translate into more "boots on the ground" and that there will be less of the paranoid reaction on the internet on the theme of: "They chose to go out there -- so let them stay there -- we don't want them back home again." - Mod.JW
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/46.]
-
Birgitt
- Moderator
- Beiträge: 35240
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Ebola-Fieber in Westafrika
EBOLA VIRUS DISEASE - WEST AFRICA (121): WHO, NIGERIA EMERGENCY, MORE
*********************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this posting:
[1] WHO update
[2] Nigeria: state of emergency
[3] Media reports
******
[1] WHO update
Date: Fri 8 Aug 2014
Source: WHO Global Alert and Response (GAR) Disease Outbreak News (DONs) [summ., edited]
http://www.who.int/csr/don/2014_08_08_ebola/en
Ebola virus disease update -- West Africa
-----------------------------------------
As of 6 Aug 2014, the cumulative number of cases attributed to EVD in the 4 countries stands at 1779, including 961 deaths.
The distribution and classification of the cases are as follows:
- Guinea, 495 cases (355 confirmed, 133 probable, and 7 suspected), including 367 deaths;
- Liberia, 554 cases (148 confirmed, 274 probable, and 132 suspected), including 294 deaths;
- Nigeria, 13 cases (0 confirmed, 7 probable, and 6 suspected), including 2 deaths;
- Sierra Leone, 717 cases (631 confirmed, 38 probable, and 48 suspected), including 298 deaths.
[As far as Nigeria is concerned, they have confirmed several of their cases in their own labs, but apparently they can't convince any courier to take the specimens abroad to an international reference laboratory. - Mod.JW]
Between 5-6 Aug 2014, 68 new cases (laboratory-confirmed, probable, and suspect cases) of EVD [including] 29 deaths were reported from the 4 countries as follows:
- Guinea, 0 new cases and 4 deaths;
- Liberia, 38 new cases and 12 deaths;
- Nigeria, 4 new cases and 1 death;
- Sierra Leone, 26 new cases and 12 deaths.
On Mon 11 Aug 2014, WHO will convene a panel of medical ethics experts to begin looking at the use of experimental treatments in the ongoing EVD outbreak in West Africa. At this time, there are no registered medicines or vaccines against this deadly virus; several experimental options are currently under development, though. The recent treatment of 2 health workers from US faith-based aid organizations has raised questions about whether medicines that have never been tested or shown to be safe in humans should be used in outbreak situations. In the case of EVD, supplies are extremely limited, which then raises questions about who should receive it, if it's used.
[A table showing confirmed, probable, and suspect cases and deaths from Ebola virus disease in Guinea, Liberia, Nigeria, and Sierra Leone as of 6 Aug 2014 is available at the source URL above.]
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.
[The paragraph concerning travel and trade is conspicuously absent. - Mod.JW]
--
Communicated by:
ProMED-mail Rapporteur Mary Marshall
******
[2] Nigeria: state of emergency
Date: Sat 9 Aug 2014
Source: BBC News [summ., edited]
http://www.bbc.co.uk/news/world-africa-28715939
Nigerian President Goodluck Jonathan has declared the outbreak of Ebola "a national emergency" and approved more than USD 11m (GBP 6.5 m) to help contain it...
[STOP PRESS -- go to source URL for details - ProMED-mail]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
******
[3] Media reports
Uganda: false alarm
-------------------
8 Aug 2014: Uganda said Friday (8 Aug 2014) a man put in isolation with fever had tested negative for the deadly tropical disease Ebola. "The results came in and it is not a case," said health ministry spokeswoman Rukia Nakamatte. The patient was stopped as he arrived in Uganda's main Entebbe airport showing signs of fever, after arriving from neighbouring South Sudan, where no cases of the Ebola virus have been reported...
http://www.channelnewsasia.com/news/wor ... 04206.html
[The Uganda Virus Research Institute hosts a US CDC lab. - Mod.JW]
Ethiopia, Kenya boost anti-Ebola measures
------------------------------------------
3 Aug 2014: Kenya and Ethiopia, home to some of Africa's largest transport hubs, said Thursday [7 Aug 2014] they had boosted measures to combat possible EVD cases arriving in their countries... Ethiopia's national carrier is a major airline connecting countries across Africa, as well as flying to the Americas, Europe, Asia, and the Middle East...
http://www.tadias.com/08/03/2014/ethiop ... a-measures
Ghana: flights normal
---------------------
2 Aug 2014: "The Ghana Civil Aviation Authority's [GCAA] attention has been drawn to an online publication on the above subject on Sat 2 Aug 2014 [Ebola: Ghana bans all flight form Nigeria, others] and we wish to state emphatically that the publication is erroneous and misleading. GCAA, as the sole regulator of the air transport industry and provider of air navigation service in the country, has not banned any airline from Nigeria and other African countries from operating to Ghana because of suspicion that the flights might be carrying passengers with the Ebola virus. We can confirm that flight operations to and from Nigeria and other African countries are normal without any interruption. The Ghana Civil Aviation Authority wishes to assure passengers and the general public that it is working with all stakeholders to ensure that the Kotoka International Airport and all other airports in the country remain safe and secure."
http://www.gcaa.com.gh/extweb/index.php ... ss-release
Malawi: report officially denied
--------------------------------
8 Aug 2014: The Minister of Health has dismissed rumours hovering around in the social media that Ebola has been registered in Malawi. On Wednesday [6 Aug 2014], news was all over Facebook pages that Malawi has registered the 1st Ebola case with the patient being admitted to ABC Clinic in Lilongwe. Chief of Health Services in the Ministry of Health, Dr Charles Mwansambo, dismissed the rumours on Wednesday [6 Aug 2014] in Lilongwe during a press briefing. In his speech, Mwansambo said this is just a mere speculation and he further called for people to treat the matter with caution and seriousness as Ebola is not just an ordinary disease.
http://www.faceofmalawi.com/2014/08/min ... whwAo.dpuf
India: suspected contact being followed up
------------------------------------------
8 Aug 2014: Health officials are keeping a close watch on a Delhi resident who arrived from Ghana on a flight in which a passenger tested positive for the deadly ebolavirus ravaging west Africa. The man's 2 housemates are also under surveillance. The Dwarka resident ... is being monitored since 21 Jul 2014, 2 days after he reached the Capital, but has not shown any symptoms of the highly contagious haemorrhagic fever. "We were alerted by the WHO about him being exposed to the disease. His co-passenger on the flight had tested positive for EVD. Our surveillance units tracked him down and also examined people living with him," a health ministry official said. The man flew from the Ghanaian capital Accra to Addis Ababa in Ethiopia and then to Delhi. No EVD cases have been reported from Ghana or Ethiopia, so far. "Since none of them have shown any symptoms so far, we didn't get them tested. We have asked them to watch out for any symptoms," said the official.
http://www.hindustantimes.com/india-new ... 49391.aspx
[This is a very confused report, especially in the light of the headline in the source article at the URL above. - Mod.JW]
India: returning from Liberia
-----------------------------
8 Aug 2014: The situation in Liberia, where ebolavirus has claimed many lives, is grim. Gentle nods of the heads have replaced handshakes. Many people wash their hands once in 15 minutes. About 1000 Indians work in Liberia. Many are planning to return home by next week. Wilfred D'Souza, from Surathkal, who works for a Singapore-based timber company, is flying home from Monrovia on Monday night [11 Aug 2014]. "The situation is more than scary. All hospitals have closed since they are getting only EVD patients and none of the medical staff wants to treat them. People are queuing up at medical shops. Paracetamol formulations are being sold 10 times their price," he says.
http://timesofindia.indiatimes.com/worl ... 637550.cms
India: 24-hour EVD helpline
---------------------------
8 Aug 2014: The 24-hour 'Emergency Operation Centre' will be functional from [9 Aug 2014] and its numbers are 011-23061469, 3205 and 1302, the ministry said.
http://www.firstpost.com/india/24-hour- ... 56515.html
[I just called the 1st number on 9 Aug 2014 and got a very quick reply. They say they are getting lots of calls. - Mod.JW]
Asia: precautions
-----------------
8 Aug 2014: China, there were no reports of EVD cases but hospitals have been told to report any suspected cases.
India, which has nearly 45 000 citizens living and working in the 4 affected countries, said it would screen travelers passing through, or starting journeys there, when they returned. "The surveillance system would be geared up to track these travelers for 4 weeks and detect them early, in case they develop symptoms," Health Minister Harsh Vardhan told parliament on Wed [6 Aug 2014].
Japan is ready to send suspected EVD victims to special isolation hospitals, Chief Cabinet Secretary Yoshihide Suga told a news conference.
In Australia authorities said they had not taken extra steps but airports were on alert for sick travelers, saying the risk of the disease reaching the country was "very low".
Officials in Singapore said the city state, praised for its tough measures against the SARS outbreak that claimed 33 lives in 2003, also faced only a low threat from the Ebola virus. "Measures are already in place to carry out contact tracing and quarantine all close contacts if there is a case," the health ministry said.
In Thailand, health official Opart said 21 travelers would stay under observation for the entire incubation period, which can last up to 21 days. "Even though Ebola is only a small risk to Thailand we are not taking any chances," he said.
http://www.reuters.com/article/2014/08/ ... TZ20140808
South Korea: precautions
------------------------
4 Aug 2014: South Korea bars Nigerians from university conference. Duksung Women's University withdraws invitation to delegates, volunteers cancel trip to West Africa.
http://www.theguardian.com/society/2014 ... conference
Malaysia: no ban on pilgrimage to Mecca
---------------------------------------
8 Aug 2014: Muslims [in Malaysia] can still make their annual pilgrimage to Mecca despite the death of a suspected EVD patient in Saudi Arabia, minister Datuk Seri Jamil Khir Baharom confirmed today [8 Aug 2014]. When asked if the country's arrangements for the Haj or the Muslim pilgrimage would be affected, the minister in charge of Islamic affairs said: "No". Jamil Khir also dispelled fears over the possibility of Malaysians catching the Ebola virus in Saudi Arabia, saying the authorities there are already well-prepared to deal with and prevent the spread of the disease.
http://www.themalaymailonline.com/malay ... DRPU0.dpuf
[So far Malaysia has not reported a suspected case of EVD. But let us hope screening for symptoms in pilgrims is effective both on departure from West African countries and on arrival in Saudi Arabia. Are all nationals of the 4 affected West African countries being denied pilgrim visas, or are those who live abroad exempt from the ban? - Mod.JW]
Canada: suspected case
----------------------
8 Aug 2014: Doctors in a Toronto-area hospital are treating a man who was admitted Friday [8 Aug 2014] with EVD-like symptoms. The man, who recently returned from Nigeria, arrived at the emergency department of Brampton Civic Hospital with a fever and flu-like symptoms. His blood sample will likely go to Winnipeg to be tested at the National Microbiology Laboratory. Dr Eileen de Villa, the assistant medical officer of health for Peel Region, cautioned that there has been no diagnosis yet.
http://news.nationalpost.com/2014/08/08 ... ederated=1
[ProMED-mail thanks Jean-Martin Lapointe <jmlapointe808@gmail.com> for contributing this report. - Mod.JW]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[It is encouraging to see many countries instituting precautions. - Mod.JW]
*********************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this posting:
[1] WHO update
[2] Nigeria: state of emergency
[3] Media reports
******
[1] WHO update
Date: Fri 8 Aug 2014
Source: WHO Global Alert and Response (GAR) Disease Outbreak News (DONs) [summ., edited]
http://www.who.int/csr/don/2014_08_08_ebola/en
Ebola virus disease update -- West Africa
-----------------------------------------
As of 6 Aug 2014, the cumulative number of cases attributed to EVD in the 4 countries stands at 1779, including 961 deaths.
The distribution and classification of the cases are as follows:
- Guinea, 495 cases (355 confirmed, 133 probable, and 7 suspected), including 367 deaths;
- Liberia, 554 cases (148 confirmed, 274 probable, and 132 suspected), including 294 deaths;
- Nigeria, 13 cases (0 confirmed, 7 probable, and 6 suspected), including 2 deaths;
- Sierra Leone, 717 cases (631 confirmed, 38 probable, and 48 suspected), including 298 deaths.
[As far as Nigeria is concerned, they have confirmed several of their cases in their own labs, but apparently they can't convince any courier to take the specimens abroad to an international reference laboratory. - Mod.JW]
Between 5-6 Aug 2014, 68 new cases (laboratory-confirmed, probable, and suspect cases) of EVD [including] 29 deaths were reported from the 4 countries as follows:
- Guinea, 0 new cases and 4 deaths;
- Liberia, 38 new cases and 12 deaths;
- Nigeria, 4 new cases and 1 death;
- Sierra Leone, 26 new cases and 12 deaths.
On Mon 11 Aug 2014, WHO will convene a panel of medical ethics experts to begin looking at the use of experimental treatments in the ongoing EVD outbreak in West Africa. At this time, there are no registered medicines or vaccines against this deadly virus; several experimental options are currently under development, though. The recent treatment of 2 health workers from US faith-based aid organizations has raised questions about whether medicines that have never been tested or shown to be safe in humans should be used in outbreak situations. In the case of EVD, supplies are extremely limited, which then raises questions about who should receive it, if it's used.
[A table showing confirmed, probable, and suspect cases and deaths from Ebola virus disease in Guinea, Liberia, Nigeria, and Sierra Leone as of 6 Aug 2014 is available at the source URL above.]
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.
[The paragraph concerning travel and trade is conspicuously absent. - Mod.JW]
--
Communicated by:
ProMED-mail Rapporteur Mary Marshall
******
[2] Nigeria: state of emergency
Date: Sat 9 Aug 2014
Source: BBC News [summ., edited]
http://www.bbc.co.uk/news/world-africa-28715939
Nigerian President Goodluck Jonathan has declared the outbreak of Ebola "a national emergency" and approved more than USD 11m (GBP 6.5 m) to help contain it...
[STOP PRESS -- go to source URL for details - ProMED-mail]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
******
[3] Media reports
Uganda: false alarm
-------------------
8 Aug 2014: Uganda said Friday (8 Aug 2014) a man put in isolation with fever had tested negative for the deadly tropical disease Ebola. "The results came in and it is not a case," said health ministry spokeswoman Rukia Nakamatte. The patient was stopped as he arrived in Uganda's main Entebbe airport showing signs of fever, after arriving from neighbouring South Sudan, where no cases of the Ebola virus have been reported...
http://www.channelnewsasia.com/news/wor ... 04206.html
[The Uganda Virus Research Institute hosts a US CDC lab. - Mod.JW]
Ethiopia, Kenya boost anti-Ebola measures
------------------------------------------
3 Aug 2014: Kenya and Ethiopia, home to some of Africa's largest transport hubs, said Thursday [7 Aug 2014] they had boosted measures to combat possible EVD cases arriving in their countries... Ethiopia's national carrier is a major airline connecting countries across Africa, as well as flying to the Americas, Europe, Asia, and the Middle East...
http://www.tadias.com/08/03/2014/ethiop ... a-measures
Ghana: flights normal
---------------------
2 Aug 2014: "The Ghana Civil Aviation Authority's [GCAA] attention has been drawn to an online publication on the above subject on Sat 2 Aug 2014 [Ebola: Ghana bans all flight form Nigeria, others] and we wish to state emphatically that the publication is erroneous and misleading. GCAA, as the sole regulator of the air transport industry and provider of air navigation service in the country, has not banned any airline from Nigeria and other African countries from operating to Ghana because of suspicion that the flights might be carrying passengers with the Ebola virus. We can confirm that flight operations to and from Nigeria and other African countries are normal without any interruption. The Ghana Civil Aviation Authority wishes to assure passengers and the general public that it is working with all stakeholders to ensure that the Kotoka International Airport and all other airports in the country remain safe and secure."
http://www.gcaa.com.gh/extweb/index.php ... ss-release
Malawi: report officially denied
--------------------------------
8 Aug 2014: The Minister of Health has dismissed rumours hovering around in the social media that Ebola has been registered in Malawi. On Wednesday [6 Aug 2014], news was all over Facebook pages that Malawi has registered the 1st Ebola case with the patient being admitted to ABC Clinic in Lilongwe. Chief of Health Services in the Ministry of Health, Dr Charles Mwansambo, dismissed the rumours on Wednesday [6 Aug 2014] in Lilongwe during a press briefing. In his speech, Mwansambo said this is just a mere speculation and he further called for people to treat the matter with caution and seriousness as Ebola is not just an ordinary disease.
http://www.faceofmalawi.com/2014/08/min ... whwAo.dpuf
India: suspected contact being followed up
------------------------------------------
8 Aug 2014: Health officials are keeping a close watch on a Delhi resident who arrived from Ghana on a flight in which a passenger tested positive for the deadly ebolavirus ravaging west Africa. The man's 2 housemates are also under surveillance. The Dwarka resident ... is being monitored since 21 Jul 2014, 2 days after he reached the Capital, but has not shown any symptoms of the highly contagious haemorrhagic fever. "We were alerted by the WHO about him being exposed to the disease. His co-passenger on the flight had tested positive for EVD. Our surveillance units tracked him down and also examined people living with him," a health ministry official said. The man flew from the Ghanaian capital Accra to Addis Ababa in Ethiopia and then to Delhi. No EVD cases have been reported from Ghana or Ethiopia, so far. "Since none of them have shown any symptoms so far, we didn't get them tested. We have asked them to watch out for any symptoms," said the official.
http://www.hindustantimes.com/india-new ... 49391.aspx
[This is a very confused report, especially in the light of the headline in the source article at the URL above. - Mod.JW]
India: returning from Liberia
-----------------------------
8 Aug 2014: The situation in Liberia, where ebolavirus has claimed many lives, is grim. Gentle nods of the heads have replaced handshakes. Many people wash their hands once in 15 minutes. About 1000 Indians work in Liberia. Many are planning to return home by next week. Wilfred D'Souza, from Surathkal, who works for a Singapore-based timber company, is flying home from Monrovia on Monday night [11 Aug 2014]. "The situation is more than scary. All hospitals have closed since they are getting only EVD patients and none of the medical staff wants to treat them. People are queuing up at medical shops. Paracetamol formulations are being sold 10 times their price," he says.
http://timesofindia.indiatimes.com/worl ... 637550.cms
India: 24-hour EVD helpline
---------------------------
8 Aug 2014: The 24-hour 'Emergency Operation Centre' will be functional from [9 Aug 2014] and its numbers are 011-23061469, 3205 and 1302, the ministry said.
http://www.firstpost.com/india/24-hour- ... 56515.html
[I just called the 1st number on 9 Aug 2014 and got a very quick reply. They say they are getting lots of calls. - Mod.JW]
Asia: precautions
-----------------
8 Aug 2014: China, there were no reports of EVD cases but hospitals have been told to report any suspected cases.
India, which has nearly 45 000 citizens living and working in the 4 affected countries, said it would screen travelers passing through, or starting journeys there, when they returned. "The surveillance system would be geared up to track these travelers for 4 weeks and detect them early, in case they develop symptoms," Health Minister Harsh Vardhan told parliament on Wed [6 Aug 2014].
Japan is ready to send suspected EVD victims to special isolation hospitals, Chief Cabinet Secretary Yoshihide Suga told a news conference.
In Australia authorities said they had not taken extra steps but airports were on alert for sick travelers, saying the risk of the disease reaching the country was "very low".
Officials in Singapore said the city state, praised for its tough measures against the SARS outbreak that claimed 33 lives in 2003, also faced only a low threat from the Ebola virus. "Measures are already in place to carry out contact tracing and quarantine all close contacts if there is a case," the health ministry said.
In Thailand, health official Opart said 21 travelers would stay under observation for the entire incubation period, which can last up to 21 days. "Even though Ebola is only a small risk to Thailand we are not taking any chances," he said.
http://www.reuters.com/article/2014/08/ ... TZ20140808
South Korea: precautions
------------------------
4 Aug 2014: South Korea bars Nigerians from university conference. Duksung Women's University withdraws invitation to delegates, volunteers cancel trip to West Africa.
http://www.theguardian.com/society/2014 ... conference
Malaysia: no ban on pilgrimage to Mecca
---------------------------------------
8 Aug 2014: Muslims [in Malaysia] can still make their annual pilgrimage to Mecca despite the death of a suspected EVD patient in Saudi Arabia, minister Datuk Seri Jamil Khir Baharom confirmed today [8 Aug 2014]. When asked if the country's arrangements for the Haj or the Muslim pilgrimage would be affected, the minister in charge of Islamic affairs said: "No". Jamil Khir also dispelled fears over the possibility of Malaysians catching the Ebola virus in Saudi Arabia, saying the authorities there are already well-prepared to deal with and prevent the spread of the disease.
http://www.themalaymailonline.com/malay ... DRPU0.dpuf
[So far Malaysia has not reported a suspected case of EVD. But let us hope screening for symptoms in pilgrims is effective both on departure from West African countries and on arrival in Saudi Arabia. Are all nationals of the 4 affected West African countries being denied pilgrim visas, or are those who live abroad exempt from the ban? - Mod.JW]
Canada: suspected case
----------------------
8 Aug 2014: Doctors in a Toronto-area hospital are treating a man who was admitted Friday [8 Aug 2014] with EVD-like symptoms. The man, who recently returned from Nigeria, arrived at the emergency department of Brampton Civic Hospital with a fever and flu-like symptoms. His blood sample will likely go to Winnipeg to be tested at the National Microbiology Laboratory. Dr Eileen de Villa, the assistant medical officer of health for Peel Region, cautioned that there has been no diagnosis yet.
http://news.nationalpost.com/2014/08/08 ... ederated=1
[ProMED-mail thanks Jean-Martin Lapointe <jmlapointe808@gmail.com> for contributing this report. - Mod.JW]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[It is encouraging to see many countries instituting precautions. - Mod.JW]
-
Birgitt
- Moderator
- Beiträge: 35240
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Ebola-Fieber in Westafrika
EBOLA VIRUS DISEASE - WEST AFRICA (122): SIERRA LEONE LESSONS LEARNED
*********************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: 8 Aug 2014
Source: ACT Alliance via ReliefWeb [edited]
http://reliefweb.int/report/sierra-leon ... come-panic
Lessons for Africa and the world from Sierra Leone
-----------------------------------
Let me preface my comments by saying responding efficiently and effectively to an Ebola virus disease [EVD] outbreak would in all probability be a challenge for any country in the world. When the EVD outbreak occurred in Guinea, our neighboring country, early in 2014, we as a country seem to have missed the opportunity to ensure our preparedness should we have an outbreak in Sierra Leone.
When the outbreak did occur, we were not prepared for it; the necessary PPE (personal prevention equipment i.e. masks, goggles, gloves etc. were in short supply; testing centers and laboratories were not set up to handle testing for EVD).
Medical staff not trained at first
------------------------
Medical staff were not trained in proper use of the PPE; medical expertise with genuine knowledge and experience in dealing with EVD were in extremely short supply. Tracing units had to be organized and trained; burial teams had to be organized and trained. Ambulances had to be procured and or refitted to accommodate only EVD victims. The general population began to protest vigorously that regular patients and EVD patients had to go to the same facility for medical attention. This put the uninfected population at higher risk.
Only after the outbreak occurred was there mass training of medical staff in government and private hospitals, treatment centers and isolation units/wards established. The rural population in Kailahun District, the 1st "hot spot" had not been sensitized, and the government and other 1st responders did not take into account traditional customs and rites related to caring for the sick and burying the dead.
Little sensitivity in dealing with customs
--------------------------
Added to that was the fact that the behavior of the Ministry of Health, accompanied by military and police, showed little sensitivity in dealing with the population directly affected. Rumors were plentiful as to the cause and role of the government in addressing the issue. In some cases, the outbreak and response were attributed to political dynamics (the outbreak occurred in the opposition party's stronghold or heartland). There was a genuine lack of trust between those who desperately wanted to assist and those who desperately needed the assistance; this lack of trust developed into opposition and resistance dynamics that fed on and grew due to misinformation and rumors. All the above has led to this point; the ebolavirus and response has reached a crisis point.
[clip]
Interfaith dialogue
----------------
Recently, we have invited other religious bodies (Catholic mission, Pentecostal fellowship and different Muslim bodies) to address the EVD crisis from a united perspective. This has now developed into the Religious Leaders Task Force on Ebola (RLTFE) which in turn has conducted more anti-EVD trainings in more communities; they have printed stickers for vehicles and T-shirts announcing that EVD can be prevented; heads of churches and mosques speak to their congregation not only from the pulpit but on radio and television. Buckets of chlorinated water are now found at the entrance of many churches and mosques.
One challenge is the weather. It is the rainy season now, and transport to rural communities is time consuming and hazardous due to the condition of the roads. Our vehicles (4 wheel drive and motorcycles) take a regular pounding. Other challenges are the expenses for accessing resources to cover more training and sensitization at the community level, training and sensitization of religious leaders, collaborating with Ministry or Health workers (assisting them with logistical issues).
Ebola affects everyday life in Sierra Leone: lack of income
---------------------------------
In those areas that are the epicenter, movement will now restricted; this will affect trade and livelihoods of the people; people live here on a day to day economy, that is they go to the market to sell and then get money to purchase what they need that day, or they go fishing, cut firewood or charcoal, sell and buy basic household necessities. When movement is restricted, incomes and livelihoods will be affected.
The wellbeing of persons and access to medical services and health are disrupted. The EVD unit is in the Government General Hospital in Kenema. I hear from staff that patients are apprehensive about going there for treatment when EVD patients are coming to the same facility when they are sick (vomiting and diarrhea).
Back to school in September?
------------------------
Currently, schools are on holiday, but there is fear that in September they will not be open. This will retard or set back the educational process for our children. The attendant danger of teenagers when they are left unsupervised with lots of time on their hands is the nightmare of mothers. Public exams have been postponed due to the EVD outbreak, and this will affect the performance of pupils taking the exams in as much as schools have been dismissed since mid-June [2014]. The percentage of those passing the exams will decrease, and this may affect students' opportunity for future education or employment. In all probability, gains made in decreasing the school "drop-out" rate among students, especially female students, may be lost, while teenage pregnancy may increase.
Grief for the children
-------------------
Personally, I am emotionally affected; though our war was considered the most brutal during its time, my fear now of the situation is worse than it was during the war, simply because you cannot see the enemy; you cannot adequately protect yourself from it; just a handshake from a friend or relative, and you may be contacting an infected person, and your likelihood of survival is quite low. Also as a mother, I think about the number of children who will have lost their parents and, because of that, possibly their link to a good education at home and at school.
It will take time to slow progression of disease
----------------------------
During the next couple of weeks, I expect a continued increase in the number of newly confirmed cases of EVD and an increase in the number of deaths. I do expect increased resources being applied to the crisis, but it will take time to slow the progression of the disease. As a nation, we need to increase the sensitization and awareness messages that result in empowering individuals and communities to rigorously implement the full range of EVD prevention strategies leading to a decrease in the number of newly infected persons. We need to rebuild the trust between the government medical professionals and staff and the populace in rural and urban communities. We also need to ensure that the quantity and quality of the PPE used by health professionals is readily available for those who need it.
God bless all of you, and thank you for your support. Continue to pray for the front line medical staff who are protecting us to the best of their ability and for all persons engaged in attempting to prevent the spread of this virus.
[Byline: Ebun James-DeKam, General Secretary, Council of Churches in Sierra Leone (CCSL)]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[The above is a warning accompanied by very practical advice from a country that is going through an EVD nightmare.
ALL COUNTRIES at risk of importing cases -- particularly neighboring African countries -- should take note and understand what can happen if they don't prepare in advance.
A map of West African countries at greatest risk can be found at:
http://watchmen-news.com/wp-content/upl ... 10x400.png - Mod.JW
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/46.]
*********************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: 8 Aug 2014
Source: ACT Alliance via ReliefWeb [edited]
http://reliefweb.int/report/sierra-leon ... come-panic
Lessons for Africa and the world from Sierra Leone
-----------------------------------
Let me preface my comments by saying responding efficiently and effectively to an Ebola virus disease [EVD] outbreak would in all probability be a challenge for any country in the world. When the EVD outbreak occurred in Guinea, our neighboring country, early in 2014, we as a country seem to have missed the opportunity to ensure our preparedness should we have an outbreak in Sierra Leone.
When the outbreak did occur, we were not prepared for it; the necessary PPE (personal prevention equipment i.e. masks, goggles, gloves etc. were in short supply; testing centers and laboratories were not set up to handle testing for EVD).
Medical staff not trained at first
------------------------
Medical staff were not trained in proper use of the PPE; medical expertise with genuine knowledge and experience in dealing with EVD were in extremely short supply. Tracing units had to be organized and trained; burial teams had to be organized and trained. Ambulances had to be procured and or refitted to accommodate only EVD victims. The general population began to protest vigorously that regular patients and EVD patients had to go to the same facility for medical attention. This put the uninfected population at higher risk.
Only after the outbreak occurred was there mass training of medical staff in government and private hospitals, treatment centers and isolation units/wards established. The rural population in Kailahun District, the 1st "hot spot" had not been sensitized, and the government and other 1st responders did not take into account traditional customs and rites related to caring for the sick and burying the dead.
Little sensitivity in dealing with customs
--------------------------
Added to that was the fact that the behavior of the Ministry of Health, accompanied by military and police, showed little sensitivity in dealing with the population directly affected. Rumors were plentiful as to the cause and role of the government in addressing the issue. In some cases, the outbreak and response were attributed to political dynamics (the outbreak occurred in the opposition party's stronghold or heartland). There was a genuine lack of trust between those who desperately wanted to assist and those who desperately needed the assistance; this lack of trust developed into opposition and resistance dynamics that fed on and grew due to misinformation and rumors. All the above has led to this point; the ebolavirus and response has reached a crisis point.
[clip]
Interfaith dialogue
----------------
Recently, we have invited other religious bodies (Catholic mission, Pentecostal fellowship and different Muslim bodies) to address the EVD crisis from a united perspective. This has now developed into the Religious Leaders Task Force on Ebola (RLTFE) which in turn has conducted more anti-EVD trainings in more communities; they have printed stickers for vehicles and T-shirts announcing that EVD can be prevented; heads of churches and mosques speak to their congregation not only from the pulpit but on radio and television. Buckets of chlorinated water are now found at the entrance of many churches and mosques.
One challenge is the weather. It is the rainy season now, and transport to rural communities is time consuming and hazardous due to the condition of the roads. Our vehicles (4 wheel drive and motorcycles) take a regular pounding. Other challenges are the expenses for accessing resources to cover more training and sensitization at the community level, training and sensitization of religious leaders, collaborating with Ministry or Health workers (assisting them with logistical issues).
Ebola affects everyday life in Sierra Leone: lack of income
---------------------------------
In those areas that are the epicenter, movement will now restricted; this will affect trade and livelihoods of the people; people live here on a day to day economy, that is they go to the market to sell and then get money to purchase what they need that day, or they go fishing, cut firewood or charcoal, sell and buy basic household necessities. When movement is restricted, incomes and livelihoods will be affected.
The wellbeing of persons and access to medical services and health are disrupted. The EVD unit is in the Government General Hospital in Kenema. I hear from staff that patients are apprehensive about going there for treatment when EVD patients are coming to the same facility when they are sick (vomiting and diarrhea).
Back to school in September?
------------------------
Currently, schools are on holiday, but there is fear that in September they will not be open. This will retard or set back the educational process for our children. The attendant danger of teenagers when they are left unsupervised with lots of time on their hands is the nightmare of mothers. Public exams have been postponed due to the EVD outbreak, and this will affect the performance of pupils taking the exams in as much as schools have been dismissed since mid-June [2014]. The percentage of those passing the exams will decrease, and this may affect students' opportunity for future education or employment. In all probability, gains made in decreasing the school "drop-out" rate among students, especially female students, may be lost, while teenage pregnancy may increase.
Grief for the children
-------------------
Personally, I am emotionally affected; though our war was considered the most brutal during its time, my fear now of the situation is worse than it was during the war, simply because you cannot see the enemy; you cannot adequately protect yourself from it; just a handshake from a friend or relative, and you may be contacting an infected person, and your likelihood of survival is quite low. Also as a mother, I think about the number of children who will have lost their parents and, because of that, possibly their link to a good education at home and at school.
It will take time to slow progression of disease
----------------------------
During the next couple of weeks, I expect a continued increase in the number of newly confirmed cases of EVD and an increase in the number of deaths. I do expect increased resources being applied to the crisis, but it will take time to slow the progression of the disease. As a nation, we need to increase the sensitization and awareness messages that result in empowering individuals and communities to rigorously implement the full range of EVD prevention strategies leading to a decrease in the number of newly infected persons. We need to rebuild the trust between the government medical professionals and staff and the populace in rural and urban communities. We also need to ensure that the quantity and quality of the PPE used by health professionals is readily available for those who need it.
God bless all of you, and thank you for your support. Continue to pray for the front line medical staff who are protecting us to the best of their ability and for all persons engaged in attempting to prevent the spread of this virus.
[Byline: Ebun James-DeKam, General Secretary, Council of Churches in Sierra Leone (CCSL)]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[The above is a warning accompanied by very practical advice from a country that is going through an EVD nightmare.
ALL COUNTRIES at risk of importing cases -- particularly neighboring African countries -- should take note and understand what can happen if they don't prepare in advance.
A map of West African countries at greatest risk can be found at:
http://watchmen-news.com/wp-content/upl ... 10x400.png - Mod.JW
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/46.]
-
Birgitt
- Moderator
- Beiträge: 35240
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Ebola - Nigeria ruft Notstand aus
Neue Ebola-Fälle in NigeriaEinen Tag, nachdem in Nigeria der Notstand ausgerufen wurde, wächst in dem Land die Furcht vor einer Ausbreitung der Ebola-Epidemie. Die nigerianischen Behörden baten in einem im Fernsehen ausgestrahlten Appell Freiwillige um Hilfe bei der Eindämmung der Krankheit. Betroffen ist vor allem die Region um die Millionenstadt Lagos. "Wir haben zu wenig Personal", sagte der Gesundheitsbeauftragte des Bundesstaates Lagos, Jide Idris. Deshalb müssten die Behörden um die Hilfe von Freiwilligen bitten. Im Gegenzug stellte Idris Anreize für die Helfer in Aussicht, darunter eine Lebensversicherung.
09.08.2014 - tagesschau
Gruß
Birgitt
-
Birgitt
- Moderator
- Beiträge: 35240
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Ebola in Westafrika
EBOLA VIRUS DISEASE - WEST AFRICA (123): SIERRA LEONE, MORE, CDC
****************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this update:
[1] Sierra Leone: official update
[2] Media reports
[3] Australian advisory not to neglect more common illnesses
[4] CDC information
******
[1] Sierra Leone: official update
Date: 9 Aug 2014
From: Sidie Yahya Tunis <tunis@health.gov.sl> [edited]
The President of the Republic of Sierra Leone Dr Ernest Bai Koroma, on Saturday [9 Aug 2014], visited the Ebola Emergency Operations Centre (EOC) at the WHO Country Office in Sierra Leone. This is the 2nd visit of the President in 10 days. He made true his promise during his 1st visit on 31 Jul [2014] that he would be following up on the emergency response activities of the EOC.
President Koroma enquired about various response structures including the treatment centres, the laboratories, contact tracing, the emergency call centres, the current status of stocks of Personal Protective Equipment (PPE) and the training needs of the response personnel during his visit.
The President expressed strong interest in the establishment of 2 additional treatment centres in the Western Area covering the capital city [Freetown] and its suburbs and another in the north to strategically locate treatment facilities for ease of access. He mentioned that there is an ongoing negotiation by Dr Margaret Chan, the WHO Director General, for the establishment of an additional laboratory for the confirmation of cases. Currently, tests are conducted in 2 laboratories in Kailahun and Kenema, which are the 2 epicentres of the outbreak. However, the rapid spread of the disease to other parts of the country has necessitated the urgent need for additional treatment centres and laboratories to minimize the time for the laboratory confirmation of tests and transfer of confirmed cases (patients) to Kenema and Kailahun, both of which are located far away from other parts of the country.
During the briefing session, Dr Jacob Mufunda, WHO Country Representative, updated the President on progress and challenges that are being experienced by the EOC as well as by the field teams. He stated that there is currently a stockpile of 30 000 PPE that is enough for more than 2 months use. He further informed the President of plans by the Chinese government to provide additional 50 000 PPE in the coming week.
Meanwhile, Dr Bannet Ndyanabangi, UNFPA Country Representative, further informed the President of the ongoing training of 900 contact tracers to monitor people who have been exposed to the virus through infected relatives or family members or through other means. He noted that the plan is for each district to have at least 100 contact tracers.
The President visited the 24 Hour Emergency Call Centre within the EOC work station where he received briefing on the operations of the facility. There were more than 10 emergency hotline telephone operators on one of the 3 8-hourly duty rosters at the time of the visit. The President was informed of the flow chart of queries raised by callers through the toll free numbers and the relay of information to the district surveillance officers who are accountable for triggering of required interventions. There is feedback to and from the caller about the outcome of the request. The President expressed satisfaction with the operation of the call centre.
The EOC is the leading coordination centre in the Ebola outbreak response. The body meets every day to discuss the overall national interventions, progress in the response, resource and logistical needs, as well as gaps and challenges at the national level. The meetings are attended mainly by top management of the Ministry of Health, including the Minister, who chairs the meetings, and heads of local and international response partners, including the United Nations agencies, Doctors Without Borders [MSF], the Red Cross and other partners. The meetings are co-chaired by the WHO Country Representative.
--
Sidie Yahya Tunis
Director, Information Communication Technology (ICT)
Ministry of Health and Sanitation, Sierra Leone
<tunis@health.gov.sl>
******
[2] Media reports
Reuters roundup 10 Aug 2014 [edited]
-----------------------------------------
Sierra Leone: another doctor sick
---------------
Sierra Leone's Health Ministry said a senior physician had contracted the disease [Ebola] at the Connaught referral hospital in the capital, Freetown. Dr. Modupeh Cole contracted the disease "after treating a patient ... who was later proved to have the virus and died," said ministry spokesman Sidi Yahya Tunis.
Cole was taken to an EVD treatment centre in eastern Kailahun district, run by medical charity Medecins Sans Frontieres [MSF], Tunis said. He is the latest Sierra Leonean medical practitioner to contract the virus. The country's leading EVD doctor, Shek Umar Khan, died of the disease last month [July 2014], and several nurses have died.
Sierra Leone, Liberia and Nigeria: national emergencies
----------------
The disease has put a severe strain on the health systems of affected states, and governments have responded with a range of measures, including the declaration of national emergencies in Sierra Leone, Liberia and Nigeria, which confirmed 7 cases of Ebola in Lagos.
Liberia: healthcare workers
-------
President Ellen Johnson Sirleaf apologised on Sat 9 Aug 2014 for the high death toll among the country's healthcare workers who have fought an Ebola virus disease [EVD] outbreak which has killed nearly 1000 people in 3 countries. Liberia has lost at least 3 doctors to the virus and 32 health workers. She pledged up to USD 18 million for the EVD fight, part of which will be given to health workers to help with insurance and death benefits, to fund more ambulances, and to increase the number of treatment centres, [speaking to] hundreds of health workers who gathered at Monrovia's City Hall for a meeting with her government. The West African Ebola outbreak, centred on Guinea, Sierra Leone and Liberia, is the worst in history. The World Health Organization (WHO) said on Fri 8 Aug 2014 it is an international health emergency that will likely continue spreading for months.
Guinea borders to stay open
------------------
Guinea said earlier on Sat [9 Aug 2014] at a news conference attended by 4 government ministers that it had closed its borders with Sierra Leone and Liberia to halt the spread of EVD. Authorities said the decision was taken primarily to prevent infected people crossing into Guinea, where at least 367 people have died of Ebola since March 2014, and 18 others are being treated in isolation. However, state television later said the borders remained open, in an about-face that appeared to highlight the difficulties governments face in coordinating policy in the face of the fast-moving outbreak. "Guinea has not closed its borders with Sierra Leone nor with Liberia. It's rather that we have taken health measures at the border posts," the television channel said. A government source said the minister who made the original announcement had not been in possession of accurate information.
Quarantine
------------
The rigorous use of quarantine is needed to prevent its spread, as well as high standards of hygiene for anyone who might come into contact with the disease. These measures have proved hard to enforce given that EVD has spread in rural parts of some of the world's poorest countries. The task is made harder because of mistrust of health workers in areas with inadequate public health services.
Ghana: suspected case
---------------
Authorities in Ghana said they were testing samples from a man from Burkina Faso who died while being transported to hospital in the Upper East region. "He had fever and was bleeding from the nose, so we are testing him for Ebola because we don't want to take chances," Yaw Manu, medical head at Bawku Presbyterian Hospital, said by telephone. Ghana has previously conducted about 20 Ebola tests, though none has proved positive.
Benin: suspected case
----------------
Authorities in Benin also said they were testing a patient for EVD, the 2nd suspected case in the country [The 1st was a Nigerian, reported 8 Aug 2014 in ProMED Archive Number 20140808.2673098].
Zambia: travel bans
------------
Zambia said it would restrict the entry of travellers from countries affected by the virus and would ban Zambians from travelling to those countries, in one of the strictest actions by any nation outside of West Africa. Zambia's Health Ministry also advised against holding any "international events" such as conferences and other gatherings, citing concerns about controlling potential outbreaks.
Gambia: airline restrictions
---------------
Gambia's Ministry of Transport said any planes flying to the capital, Banjul, should not pick up passengers at airports in Conakry [Guinea], Freetown [Sierra Leone] or Monrovia [Liberia].
[Byline: Saliou Samb, additional reporting by Umaru Fofana in Freetown, Kwasi Kpodo in Accra, David Dolan in Johannesburg, Samuel Elijah in Cotonou, Pap Saine in Banjul, Clair MacDougall in Monrovia, Amran Abocar in Toronto and Amena Bakr in Doha; Writing by Matthew Mpoke Bigg; Editing by Janet Lawrence and Steve Orlofsky] http://uk.reuters.com/article/2014/08/1 ... ER20140810
******
Liberia: demonstration (1)
-------------------
9 Aug 2014: In central Liberia on Saturday [9 Aug 2014], riot police raced to quell a demonstration by crowds who had blocked the country's busiest highway to protest the government's delay in collecting bodies of EVD victims. Several bodies had been lying by the roadside for 2 days in the town of Weala, about 50 miles (75 km) from the capital, Monrovia, residents said.
http://www.theguardian.com/society/2014 ... ne-liberia
Liberia: demonstration (2)
-------------------
9 Aug 2014: Members of the Liberian Association of Metropolitan Atlanta (LAMA), a nonprofit representing Liberian citizens residing in Atlanta, are out in force [in front of Emory University Hospital, Atlanta, Georgia USA]. "We heard about KB and missionary NW and how they risked their lives to serve humanity and also us," says Leo Mulbah, president of LAMA. "On behalf of a very grateful nation and community, we came to say thank you to them. We don't have money to give them. We don't have anything to give them, but we can say thank you. Thanks to them, [Liberians] are getting the attention our downtrodden folks need, and for that, we tell their families we are in solidarity with them." The LAMA group has been holding frequent town hall meetings for their roughly 15 000 members to raise money to buy equipment that might help stop the spread of EVD in Liberia, where it has killed nearly 280 people and triggered a nationwide state of emergency.
https://time.com/3096148/ebola-america-liberia-emory
Nigeria: burial restrictions
--------------------
10 Aug 2014: The newspaper Leadership reported Sunday [10 Aug 2014] that Nigerians would have to bury EVD victims in the communities where they die. So far, 2 people have died in Nigeria of EVD. ... "Henceforth, dead bodies will not be allowed to be transported from one part of the country to another," Dr. Khalliru Alhassan, the 2nd in command at the Health Ministry, said on Sat 9 Aug 2014 in Kano; 7 people are known to be infected in Nigeria, 6 cases remain unconfirmed; about 70 people remain under surveillance.
http://www.dw.de/new-ebola-precautions- ... a-17844564
Senegal ex Mali: suspected case negative
------------
10 Aug 2014: [Tests came back negative from Dakar. - Mod.JW]
http://www.seneweb.com/news/Sante/chu-d ... 32504.html [in French]
Mauritania: border controls
------------------------
9 Aug 2014: [Mauritania has strengthened controls at borders with Senegal and Mali, especially at night. - Mod.JW]
http://www.lefigaro.fr/flash-actu/2014/ ... itanie.php [in French]
[Locator map of Mauritania at:
http://www.ezilon.com/maps/images/afric ... itania.gif - Mod.JW]
Ghana: suspected case ex Burkino Faso
----------------
9 Aug 2014: Ghana may now have recorded her 1st EVD case. A Burkinabe man, who had fever and bled from his nose and ears "was brought in dead," at the Bawku Presby Hospital in Ghana's Upper East region on Friday afternoon [8 Aug 2014].
http://www.modernghana.com/news/562484/ ... toms-.html
[Locator map of Burkino Faso at:
http://kcm.co.kr/bethany/c_maps/burkina-1.gif - Mod.JW]
Saudi Arabia: suspected case tests negative
-----------------
A 40-year-old who died in Jeddah after returning from Sierra Leone did not have EVD, Saudi Arabia's Health Ministry announced on Saturday [9 Aug 2014]. According to officials, samples submitted to the US Centers for Disease Control and Prevention and a laboratory in Germany have come back negative for the Ebola virus.
http://www.dw.de/new-ebola-precautions- ... a-17844564
Saudi Arabia: visas suspended
------------------
The Embassy of Saudi Arabia has suspended visas of 7200 pilgrims from 3 African countries -- Guinea, Sierra Leone and Liberia -- as a precautionary measure to prevent the spread of the disease among the pilgrims during the forthcoming Haj season [1-6 Oct 2014]. Saudi Ambassador in Guinea Amjad Bedaiwi told local media that the Kingdom has put a condition that the suspension of visas will be reviewed only after WHO issues a clear cut statement that citizens in these countries are allowed to travel for Haj. Bedaiwi said the embassy extensively discussed the issue with the Guinean government, an Islamic state, where the number of its pilgrims comes to nearly 7000 as against 400 others from both Sierra Leone and Liberia.
http://www.arabnews.com/news/saudi-arabia/612306
China (Hong Kong): suspected case
------------------------
10 Aug 2014 : [A] 31-year-old Nigerian man suspected to have the ebolavirus was admitted to a Hong Kong hospital on Sunday [10 Aug 2014], the city's Centre for Health Protection (CHP) said. The Hong Kong centre is expected to announce test results in the next few hours.
The Nigerian arrived in Hong Kong from Nigeria on Thu [7 Aug 2014] and had been staying at a guest house in Chungking Mansions in Tsim Sha Tsui, according to reports in the Chinese-language press. He was sent to hospital this morning after experiencing diarrhoea, one of the fatal disease's early symptoms, hospital sources said. ... More than 10 000 travellers arrive in Hong Kong from the 4 countries every year. All would be placed under closer health surveillance upon arrival, and leaflets would be handed out at entry points. In the event of an ebolavirus case being identified, all those in close contact with the patient would be put in quarantine and banned from departing the city under the Prevention and Control of Disease Ordinance.
http://www.eturbonews.com/48942/ebola-v ... rived-asia
[It was probably just something he ate, but HK is right to take extreme precautions; 10 000 arrivals a year from those 4 countries is an average of almost 200 a week to be screened, a feasible number. - Mod.JW]
Spain: missionaries from Liberia
-----------------------------
10 Aug 2014: In Madrid, doctors will treat the priest MP -- infected in Liberia and the 1st known EVD carrier on European soil during the current outbreak -- with the experimental drug ZMapp, Spain's Health Ministry announced on Sunday [10 Aug 2014]. Doctors have determined that the 65-year-old Spanish nun JBB who worked at the same hospital as MP in Liberia, does not have EVD. The charity that MP and JBB worked for had petitioned Spain for permission to bring in 2 African missionaries who became infected with EVD while helping treat patients at the same hospital, but Spain turned the request down. One of those 2 missionaries, a Congolese nun, died of EVD on Saturday [9 Aug 2014], the charity announced.
http://www.cbc.ca/news/canada/toronto/e ... -1.2732481
--
Communicated by
ProMED-mail & ProMED-mail Rapporteurs Mary Marshall and Kunihiko Iizuka
<promed@promedmail.org>
******
[3] Australian advisory not to neglect more common illnesses
Date: 10 Aug 2014
Source: International Business Times [edited]
http://au.ibtimes.com/articles/562184/2 ... -ePYPl_vjE
Ebola Virus Fears in Australia May Lead Doctors to Wrongly Quarantine
Patients with Fevers
---------------------------------------
Australian hospitals were warned by leading experts in infectious diseases not to become overly concerned in detecting possible cases of the Ebola virus since it affects their ability to recognise other alarming but common diseases.
Since the start of the Ebola outbreak, health professionals have been on the lookout for signs and symptoms inpatients who came from West Africa. About 1,700 people are known to beinfected and the numbers continue to rise with no available cure or vaccine. The outbreak in West Africa is largest recorded, according to reports.
New South Wales department of health has issued information on the Ebola virus to state departments and clinicians. Ebola concerns have previously prompted Australia's national health department to issue information to doctors about the deadly haemorrhagic fever.
Professor Peter Collignon of infectious diseases at the Australian National University said the national government is only right to take the necessary precautions. However, he said fears of the virus may begin to overshadow reality since there are other patients who may be dying because they were not being treated as quickly.
Australia's heightened awareness of the Ebola virus may lead to cases of people with malaria returning from Africa may be wrongfully suspected of having Ebola. The patient might be subjected to quarantine while the correct treatment is delayed since Ebola is being ruled out.
The professor explained that doctors are "only human" and can become overly afraid. They may suspect an Ebola virus case too quickly. Collignon reminded health professionals that people with fevers do not necessarily have Ebola.
He recalled the same fears in 2003 when the SARS virus outbreak affected several countries.
He said even if a patient was infected with Ebola in Australia, the training in Australian hospitals would mean the virus cannot spread very far. The Ebola virus is not easy to spread in countries with strong healthcare facilities and hygiene practices. For a person to be infected, he or she must have direct contact with the virus in secretions, blood, organs and other bodily fluids of an Ebola patient.
To contact the editor, e-mail: editor@ibtimes.com
[Byline: By Reissa Su]
--
Communicated by
ProMED-mail
<promed@promedmail.org>
[This is sound advice. The likelihood of more common and potentially rapidly lethal diseases such as malaria or bacterial meningitis in a traveler from Africa far exceeds that of an importation of hemorrhagic fever, an event which has been vanishingly rare. Fear of Ebola virus disease and reluctance to carry out routine laboratory testing from these patients is likely to adversely affect many with readily treatable and more common illnesses.
The "CNN effect" in the US, nearly continuous television coverage of the outbreak and the repatriation of two US healthcare workers, has led to strict isolation of patients who have merely transited an airport in Africa with essentially zero likelihood of EVD and even the quarantine of healthy returnees with no exposure to disease. - Mod.LM]
******
[4] CDC information
CDC: new case definition
---------------------
7 Aug 2014: Early recognition is critical for infection control. Healthcare providers should be alert for and evaluate any patients suspected of having EVD.
Person Under Investigation (PUI) [See source.]
http://www.cdc.gov/vhf/ebola/hcp/case-definition.html
CDC: Interim Guidance for Specimen Collection, Transport, Testing, and Submission for Patients with Suspected Infection with Ebola Virus Disease
------------------------------
http://www.cdc.gov/vhf/ebola/hcp/interi ... ebola.html
CDC: Sample packing instructions diagram
------------------------
http://www.vox.com/2014/8/7/5979983/dia ... in/5712456
--
Communicated by:
ProMED-mail Rapporteur Mary Marshall
****************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this update:
[1] Sierra Leone: official update
[2] Media reports
[3] Australian advisory not to neglect more common illnesses
[4] CDC information
******
[1] Sierra Leone: official update
Date: 9 Aug 2014
From: Sidie Yahya Tunis <tunis@health.gov.sl> [edited]
The President of the Republic of Sierra Leone Dr Ernest Bai Koroma, on Saturday [9 Aug 2014], visited the Ebola Emergency Operations Centre (EOC) at the WHO Country Office in Sierra Leone. This is the 2nd visit of the President in 10 days. He made true his promise during his 1st visit on 31 Jul [2014] that he would be following up on the emergency response activities of the EOC.
President Koroma enquired about various response structures including the treatment centres, the laboratories, contact tracing, the emergency call centres, the current status of stocks of Personal Protective Equipment (PPE) and the training needs of the response personnel during his visit.
The President expressed strong interest in the establishment of 2 additional treatment centres in the Western Area covering the capital city [Freetown] and its suburbs and another in the north to strategically locate treatment facilities for ease of access. He mentioned that there is an ongoing negotiation by Dr Margaret Chan, the WHO Director General, for the establishment of an additional laboratory for the confirmation of cases. Currently, tests are conducted in 2 laboratories in Kailahun and Kenema, which are the 2 epicentres of the outbreak. However, the rapid spread of the disease to other parts of the country has necessitated the urgent need for additional treatment centres and laboratories to minimize the time for the laboratory confirmation of tests and transfer of confirmed cases (patients) to Kenema and Kailahun, both of which are located far away from other parts of the country.
During the briefing session, Dr Jacob Mufunda, WHO Country Representative, updated the President on progress and challenges that are being experienced by the EOC as well as by the field teams. He stated that there is currently a stockpile of 30 000 PPE that is enough for more than 2 months use. He further informed the President of plans by the Chinese government to provide additional 50 000 PPE in the coming week.
Meanwhile, Dr Bannet Ndyanabangi, UNFPA Country Representative, further informed the President of the ongoing training of 900 contact tracers to monitor people who have been exposed to the virus through infected relatives or family members or through other means. He noted that the plan is for each district to have at least 100 contact tracers.
The President visited the 24 Hour Emergency Call Centre within the EOC work station where he received briefing on the operations of the facility. There were more than 10 emergency hotline telephone operators on one of the 3 8-hourly duty rosters at the time of the visit. The President was informed of the flow chart of queries raised by callers through the toll free numbers and the relay of information to the district surveillance officers who are accountable for triggering of required interventions. There is feedback to and from the caller about the outcome of the request. The President expressed satisfaction with the operation of the call centre.
The EOC is the leading coordination centre in the Ebola outbreak response. The body meets every day to discuss the overall national interventions, progress in the response, resource and logistical needs, as well as gaps and challenges at the national level. The meetings are attended mainly by top management of the Ministry of Health, including the Minister, who chairs the meetings, and heads of local and international response partners, including the United Nations agencies, Doctors Without Borders [MSF], the Red Cross and other partners. The meetings are co-chaired by the WHO Country Representative.
--
Sidie Yahya Tunis
Director, Information Communication Technology (ICT)
Ministry of Health and Sanitation, Sierra Leone
<tunis@health.gov.sl>
******
[2] Media reports
Reuters roundup 10 Aug 2014 [edited]
-----------------------------------------
Sierra Leone: another doctor sick
---------------
Sierra Leone's Health Ministry said a senior physician had contracted the disease [Ebola] at the Connaught referral hospital in the capital, Freetown. Dr. Modupeh Cole contracted the disease "after treating a patient ... who was later proved to have the virus and died," said ministry spokesman Sidi Yahya Tunis.
Cole was taken to an EVD treatment centre in eastern Kailahun district, run by medical charity Medecins Sans Frontieres [MSF], Tunis said. He is the latest Sierra Leonean medical practitioner to contract the virus. The country's leading EVD doctor, Shek Umar Khan, died of the disease last month [July 2014], and several nurses have died.
Sierra Leone, Liberia and Nigeria: national emergencies
----------------
The disease has put a severe strain on the health systems of affected states, and governments have responded with a range of measures, including the declaration of national emergencies in Sierra Leone, Liberia and Nigeria, which confirmed 7 cases of Ebola in Lagos.
Liberia: healthcare workers
-------
President Ellen Johnson Sirleaf apologised on Sat 9 Aug 2014 for the high death toll among the country's healthcare workers who have fought an Ebola virus disease [EVD] outbreak which has killed nearly 1000 people in 3 countries. Liberia has lost at least 3 doctors to the virus and 32 health workers. She pledged up to USD 18 million for the EVD fight, part of which will be given to health workers to help with insurance and death benefits, to fund more ambulances, and to increase the number of treatment centres, [speaking to] hundreds of health workers who gathered at Monrovia's City Hall for a meeting with her government. The West African Ebola outbreak, centred on Guinea, Sierra Leone and Liberia, is the worst in history. The World Health Organization (WHO) said on Fri 8 Aug 2014 it is an international health emergency that will likely continue spreading for months.
Guinea borders to stay open
------------------
Guinea said earlier on Sat [9 Aug 2014] at a news conference attended by 4 government ministers that it had closed its borders with Sierra Leone and Liberia to halt the spread of EVD. Authorities said the decision was taken primarily to prevent infected people crossing into Guinea, where at least 367 people have died of Ebola since March 2014, and 18 others are being treated in isolation. However, state television later said the borders remained open, in an about-face that appeared to highlight the difficulties governments face in coordinating policy in the face of the fast-moving outbreak. "Guinea has not closed its borders with Sierra Leone nor with Liberia. It's rather that we have taken health measures at the border posts," the television channel said. A government source said the minister who made the original announcement had not been in possession of accurate information.
Quarantine
------------
The rigorous use of quarantine is needed to prevent its spread, as well as high standards of hygiene for anyone who might come into contact with the disease. These measures have proved hard to enforce given that EVD has spread in rural parts of some of the world's poorest countries. The task is made harder because of mistrust of health workers in areas with inadequate public health services.
Ghana: suspected case
---------------
Authorities in Ghana said they were testing samples from a man from Burkina Faso who died while being transported to hospital in the Upper East region. "He had fever and was bleeding from the nose, so we are testing him for Ebola because we don't want to take chances," Yaw Manu, medical head at Bawku Presbyterian Hospital, said by telephone. Ghana has previously conducted about 20 Ebola tests, though none has proved positive.
Benin: suspected case
----------------
Authorities in Benin also said they were testing a patient for EVD, the 2nd suspected case in the country [The 1st was a Nigerian, reported 8 Aug 2014 in ProMED Archive Number 20140808.2673098].
Zambia: travel bans
------------
Zambia said it would restrict the entry of travellers from countries affected by the virus and would ban Zambians from travelling to those countries, in one of the strictest actions by any nation outside of West Africa. Zambia's Health Ministry also advised against holding any "international events" such as conferences and other gatherings, citing concerns about controlling potential outbreaks.
Gambia: airline restrictions
---------------
Gambia's Ministry of Transport said any planes flying to the capital, Banjul, should not pick up passengers at airports in Conakry [Guinea], Freetown [Sierra Leone] or Monrovia [Liberia].
[Byline: Saliou Samb, additional reporting by Umaru Fofana in Freetown, Kwasi Kpodo in Accra, David Dolan in Johannesburg, Samuel Elijah in Cotonou, Pap Saine in Banjul, Clair MacDougall in Monrovia, Amran Abocar in Toronto and Amena Bakr in Doha; Writing by Matthew Mpoke Bigg; Editing by Janet Lawrence and Steve Orlofsky] http://uk.reuters.com/article/2014/08/1 ... ER20140810
******
Liberia: demonstration (1)
-------------------
9 Aug 2014: In central Liberia on Saturday [9 Aug 2014], riot police raced to quell a demonstration by crowds who had blocked the country's busiest highway to protest the government's delay in collecting bodies of EVD victims. Several bodies had been lying by the roadside for 2 days in the town of Weala, about 50 miles (75 km) from the capital, Monrovia, residents said.
http://www.theguardian.com/society/2014 ... ne-liberia
Liberia: demonstration (2)
-------------------
9 Aug 2014: Members of the Liberian Association of Metropolitan Atlanta (LAMA), a nonprofit representing Liberian citizens residing in Atlanta, are out in force [in front of Emory University Hospital, Atlanta, Georgia USA]. "We heard about KB and missionary NW and how they risked their lives to serve humanity and also us," says Leo Mulbah, president of LAMA. "On behalf of a very grateful nation and community, we came to say thank you to them. We don't have money to give them. We don't have anything to give them, but we can say thank you. Thanks to them, [Liberians] are getting the attention our downtrodden folks need, and for that, we tell their families we are in solidarity with them." The LAMA group has been holding frequent town hall meetings for their roughly 15 000 members to raise money to buy equipment that might help stop the spread of EVD in Liberia, where it has killed nearly 280 people and triggered a nationwide state of emergency.
https://time.com/3096148/ebola-america-liberia-emory
Nigeria: burial restrictions
--------------------
10 Aug 2014: The newspaper Leadership reported Sunday [10 Aug 2014] that Nigerians would have to bury EVD victims in the communities where they die. So far, 2 people have died in Nigeria of EVD. ... "Henceforth, dead bodies will not be allowed to be transported from one part of the country to another," Dr. Khalliru Alhassan, the 2nd in command at the Health Ministry, said on Sat 9 Aug 2014 in Kano; 7 people are known to be infected in Nigeria, 6 cases remain unconfirmed; about 70 people remain under surveillance.
http://www.dw.de/new-ebola-precautions- ... a-17844564
Senegal ex Mali: suspected case negative
------------
10 Aug 2014: [Tests came back negative from Dakar. - Mod.JW]
http://www.seneweb.com/news/Sante/chu-d ... 32504.html [in French]
Mauritania: border controls
------------------------
9 Aug 2014: [Mauritania has strengthened controls at borders with Senegal and Mali, especially at night. - Mod.JW]
http://www.lefigaro.fr/flash-actu/2014/ ... itanie.php [in French]
[Locator map of Mauritania at:
http://www.ezilon.com/maps/images/afric ... itania.gif - Mod.JW]
Ghana: suspected case ex Burkino Faso
----------------
9 Aug 2014: Ghana may now have recorded her 1st EVD case. A Burkinabe man, who had fever and bled from his nose and ears "was brought in dead," at the Bawku Presby Hospital in Ghana's Upper East region on Friday afternoon [8 Aug 2014].
http://www.modernghana.com/news/562484/ ... toms-.html
[Locator map of Burkino Faso at:
http://kcm.co.kr/bethany/c_maps/burkina-1.gif - Mod.JW]
Saudi Arabia: suspected case tests negative
-----------------
A 40-year-old who died in Jeddah after returning from Sierra Leone did not have EVD, Saudi Arabia's Health Ministry announced on Saturday [9 Aug 2014]. According to officials, samples submitted to the US Centers for Disease Control and Prevention and a laboratory in Germany have come back negative for the Ebola virus.
http://www.dw.de/new-ebola-precautions- ... a-17844564
Saudi Arabia: visas suspended
------------------
The Embassy of Saudi Arabia has suspended visas of 7200 pilgrims from 3 African countries -- Guinea, Sierra Leone and Liberia -- as a precautionary measure to prevent the spread of the disease among the pilgrims during the forthcoming Haj season [1-6 Oct 2014]. Saudi Ambassador in Guinea Amjad Bedaiwi told local media that the Kingdom has put a condition that the suspension of visas will be reviewed only after WHO issues a clear cut statement that citizens in these countries are allowed to travel for Haj. Bedaiwi said the embassy extensively discussed the issue with the Guinean government, an Islamic state, where the number of its pilgrims comes to nearly 7000 as against 400 others from both Sierra Leone and Liberia.
http://www.arabnews.com/news/saudi-arabia/612306
China (Hong Kong): suspected case
------------------------
10 Aug 2014 : [A] 31-year-old Nigerian man suspected to have the ebolavirus was admitted to a Hong Kong hospital on Sunday [10 Aug 2014], the city's Centre for Health Protection (CHP) said. The Hong Kong centre is expected to announce test results in the next few hours.
The Nigerian arrived in Hong Kong from Nigeria on Thu [7 Aug 2014] and had been staying at a guest house in Chungking Mansions in Tsim Sha Tsui, according to reports in the Chinese-language press. He was sent to hospital this morning after experiencing diarrhoea, one of the fatal disease's early symptoms, hospital sources said. ... More than 10 000 travellers arrive in Hong Kong from the 4 countries every year. All would be placed under closer health surveillance upon arrival, and leaflets would be handed out at entry points. In the event of an ebolavirus case being identified, all those in close contact with the patient would be put in quarantine and banned from departing the city under the Prevention and Control of Disease Ordinance.
http://www.eturbonews.com/48942/ebola-v ... rived-asia
[It was probably just something he ate, but HK is right to take extreme precautions; 10 000 arrivals a year from those 4 countries is an average of almost 200 a week to be screened, a feasible number. - Mod.JW]
Spain: missionaries from Liberia
-----------------------------
10 Aug 2014: In Madrid, doctors will treat the priest MP -- infected in Liberia and the 1st known EVD carrier on European soil during the current outbreak -- with the experimental drug ZMapp, Spain's Health Ministry announced on Sunday [10 Aug 2014]. Doctors have determined that the 65-year-old Spanish nun JBB who worked at the same hospital as MP in Liberia, does not have EVD. The charity that MP and JBB worked for had petitioned Spain for permission to bring in 2 African missionaries who became infected with EVD while helping treat patients at the same hospital, but Spain turned the request down. One of those 2 missionaries, a Congolese nun, died of EVD on Saturday [9 Aug 2014], the charity announced.
http://www.cbc.ca/news/canada/toronto/e ... -1.2732481
--
Communicated by
ProMED-mail & ProMED-mail Rapporteurs Mary Marshall and Kunihiko Iizuka
<promed@promedmail.org>
******
[3] Australian advisory not to neglect more common illnesses
Date: 10 Aug 2014
Source: International Business Times [edited]
http://au.ibtimes.com/articles/562184/2 ... -ePYPl_vjE
Ebola Virus Fears in Australia May Lead Doctors to Wrongly Quarantine
Patients with Fevers
---------------------------------------
Australian hospitals were warned by leading experts in infectious diseases not to become overly concerned in detecting possible cases of the Ebola virus since it affects their ability to recognise other alarming but common diseases.
Since the start of the Ebola outbreak, health professionals have been on the lookout for signs and symptoms inpatients who came from West Africa. About 1,700 people are known to beinfected and the numbers continue to rise with no available cure or vaccine. The outbreak in West Africa is largest recorded, according to reports.
New South Wales department of health has issued information on the Ebola virus to state departments and clinicians. Ebola concerns have previously prompted Australia's national health department to issue information to doctors about the deadly haemorrhagic fever.
Professor Peter Collignon of infectious diseases at the Australian National University said the national government is only right to take the necessary precautions. However, he said fears of the virus may begin to overshadow reality since there are other patients who may be dying because they were not being treated as quickly.
Australia's heightened awareness of the Ebola virus may lead to cases of people with malaria returning from Africa may be wrongfully suspected of having Ebola. The patient might be subjected to quarantine while the correct treatment is delayed since Ebola is being ruled out.
The professor explained that doctors are "only human" and can become overly afraid. They may suspect an Ebola virus case too quickly. Collignon reminded health professionals that people with fevers do not necessarily have Ebola.
He recalled the same fears in 2003 when the SARS virus outbreak affected several countries.
He said even if a patient was infected with Ebola in Australia, the training in Australian hospitals would mean the virus cannot spread very far. The Ebola virus is not easy to spread in countries with strong healthcare facilities and hygiene practices. For a person to be infected, he or she must have direct contact with the virus in secretions, blood, organs and other bodily fluids of an Ebola patient.
To contact the editor, e-mail: editor@ibtimes.com
[Byline: By Reissa Su]
--
Communicated by
ProMED-mail
<promed@promedmail.org>
[This is sound advice. The likelihood of more common and potentially rapidly lethal diseases such as malaria or bacterial meningitis in a traveler from Africa far exceeds that of an importation of hemorrhagic fever, an event which has been vanishingly rare. Fear of Ebola virus disease and reluctance to carry out routine laboratory testing from these patients is likely to adversely affect many with readily treatable and more common illnesses.
The "CNN effect" in the US, nearly continuous television coverage of the outbreak and the repatriation of two US healthcare workers, has led to strict isolation of patients who have merely transited an airport in Africa with essentially zero likelihood of EVD and even the quarantine of healthy returnees with no exposure to disease. - Mod.LM]
******
[4] CDC information
CDC: new case definition
---------------------
7 Aug 2014: Early recognition is critical for infection control. Healthcare providers should be alert for and evaluate any patients suspected of having EVD.
Person Under Investigation (PUI) [See source.]
http://www.cdc.gov/vhf/ebola/hcp/case-definition.html
CDC: Interim Guidance for Specimen Collection, Transport, Testing, and Submission for Patients with Suspected Infection with Ebola Virus Disease
------------------------------
http://www.cdc.gov/vhf/ebola/hcp/interi ... ebola.html
CDC: Sample packing instructions diagram
------------------------
http://www.vox.com/2014/8/7/5979983/dia ... in/5712456
--
Communicated by:
ProMED-mail Rapporteur Mary Marshall
-
Birgitt
- Moderator
- Beiträge: 35240
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Ebola in Westafrika
Ebola-Verdacht bei deutschem MedizinstudentenEin Deutscher hat sich möglicherweise mit dem tödlichen Ebola-Virus infiziert: Nach einem Aufenthalt in Liberia bekam der Medizinstudent Fieber, jetzt liegt er auf einer Isolierstation in Ruanda [...] Es seien Proben entnommen und an ein Labor geschickt worden. Ein Testergebnis soll binnen 48 Stunden vorliegen.
11.08.2014 - Spiegel
Gruß
Birgitt
-
Alexander
- Administrator
- Beiträge: 24253
- Registriert: Sa 30. Jul 2005, 19:12
- Wohnort: Dubai/Vereinigte Arabische Emirate
- Kontaktdaten:
Re: Ebola - Guinea, Liberia, Sierra Leone, Nigeria
Nachdem zwei Ebolapatienten in den USA erfolgreich mit dem neuen Serum behandelt wurden, stellen die Amerikaner nun das Serum den Liberianern zu Verfügung. Die Liberianer hatten die Amerikaner um Lieferung des Medikaments gebeten.
Unterdessen dürfen keine Flugzeuge aus den Ebolagebieten in der Elfenbeinküste landen. Nigeria denkt über die Schliessung aller Grenzen nach.
Grüsse
Alexander
Unterdessen dürfen keine Flugzeuge aus den Ebolagebieten in der Elfenbeinküste landen. Nigeria denkt über die Schliessung aller Grenzen nach.
Grüsse
Alexander
The one who follows the crowd will usually go no further than the crowd. Those who walk alone are likely to find themselves in places no one has ever been before.
· · · Wüstenschiff-Veranstaltungsübersicht 2026 —> Alle Reise-Events auf einen Blick - Check it out !!!
· · · · · Werde Wüstenschiff-Werbepartner —> Firmen, die Wüstenschiff-Aktionen in Afrika unterstützen
· · · · · · · Geschlossene Gruppen —> Die neue Wüstenschiff-Funktion
· · · Wüstenschiff-Veranstaltungsübersicht 2026 —> Alle Reise-Events auf einen Blick - Check it out !!!
· · · · · Werde Wüstenschiff-Werbepartner —> Firmen, die Wüstenschiff-Aktionen in Afrika unterstützen
· · · · · · · Geschlossene Gruppen —> Die neue Wüstenschiff-Funktion
-
Götz Krieger
- Beiträge: 569
- Registriert: Do 10. Jan 2008, 22:16
- Wohnort: Hillesheim/Eifel
- Kontaktdaten:
Re: Ebola - Guinea, Liberia, Sierra Leone, Nigeria
Epidemie in Westafrika: Spanischer Geistlicher an Ebola gestorben
Sie haben ihn in sein Heimatland geholt, aber die Ärzte konnten ihn nicht mehr retten: Ein spanischer Geistlicher ist in einer Klinik in Madrid an Ebola gestorben. Der 75-Jährige hatte sich in Liberia mit dem Virus infiziert.
Madrid - Der spanische Geistliche Miguel Pajares ist in einer Klinik in Madrid an Ebola gestorben. Der 75-Jährige hatte sich bei einem Aufenthalt in Liberia infiziert, als er den Direktor eines Krankenhauses in Monrovia gepflegt hatte. Auch dieser war später an Ebola gestorben.
Der Missionar ist der erste Ebola-Patient der aktuellen Epidemie, der in die EU ausgeflogen wurde. Nachdem ein Test seine Infektion bestätigt hatte, forderten Zehntausende Spanier in einer Internetpetition, ihn sofort in sein Heimatland zurückzubringen....
http://www.spiegel.de/gesundheit/diagno ... 85647.html
Gruß
Götz
Sie haben ihn in sein Heimatland geholt, aber die Ärzte konnten ihn nicht mehr retten: Ein spanischer Geistlicher ist in einer Klinik in Madrid an Ebola gestorben. Der 75-Jährige hatte sich in Liberia mit dem Virus infiziert.
Madrid - Der spanische Geistliche Miguel Pajares ist in einer Klinik in Madrid an Ebola gestorben. Der 75-Jährige hatte sich bei einem Aufenthalt in Liberia infiziert, als er den Direktor eines Krankenhauses in Monrovia gepflegt hatte. Auch dieser war später an Ebola gestorben.
Der Missionar ist der erste Ebola-Patient der aktuellen Epidemie, der in die EU ausgeflogen wurde. Nachdem ein Test seine Infektion bestätigt hatte, forderten Zehntausende Spanier in einer Internetpetition, ihn sofort in sein Heimatland zurückzubringen....
http://www.spiegel.de/gesundheit/diagno ... 85647.html
Gruß
Götz
-
Birgitt
- Moderator
- Beiträge: 35240
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Ebola-Fieber in Westafrika
EBOLA VIRUS DISEASE - WEST AFRICA (124): WHO DRUG STATEMENT
***********************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Tue 12 Aug 2014
Source: WHO Media centre [edited]
http://who.int/mediacentre/news/stateme ... summary/en
[A panel of experts was convened by WHO to consider and assess the ethical implications for clinical decision-making of the potential use of unregistered interventions. They reached consensus that, in the circumstances of this outbreak, it is ethical to offer unproven interventions with as of yet unknown efficacy and adverse effects, as potential treatment or prevention.]
Ethical considerations for use of unregistered interventions for Ebola viral disease (EVD)
----------------------------------------------------------------------
Summary of the panel discussion
WHO statement
-------------
West Africa is experiencing the largest, most severe, and most complex outbreak of Ebola virus disease in history. Ebola outbreaks can be contained using available interventions like early detection and isolation, contact tracing and monitoring, and adherence to rigorous procedures of infection control. However, a specific treatment or vaccine would be a potent asset to counter the virus.
Over the past decade, research efforts have been invested into developing drugs and vaccines for Ebola virus disease. Some of these have shown promising results in the laboratory, but they have not yet been evaluated for safety and efficacy in human beings. The large number of people affected by the 2014 west Africa outbreak, and the high case-fatality rate, have prompted calls to use investigational medical interventions to try to save the lives of patients and to curb the epidemic.
Therefore, on 11 Aug 2014, WHO convened a consultation to consider and assess the ethical implications for clinical decision-making of the potential use of unregistered interventions.
In the particular circumstances of this outbreak, and provided certain conditions are met, the panel reached consensus that it is ethical to offer unproven interventions with as yet unknown efficacy and adverse effects, as potential treatment or prevention.
Ethical criteria must guide the provision of such interventions. These include transparency about all aspects of care, informed consent, freedom of choice, confidentiality, respect for the person, preservation of dignity, and involvement of the community.
In order to understand the safety and efficacy of these interventions, the group advised that, if and when they are used to treat patients, there is a moral obligation to collect and share all data generated, including from treatments provided for 'compassionate use' (access to an unapproved drug outside of a clinical trial).
The group explored how the use of these interventions can be evaluated scientifically to ensure timely and accurate information about the safety and efficacy of these investigational interventions. There was unanimous agreement that there is a moral duty to also evaluate these interventions (for treatment or prevention) in the best possible clinical trials under the circumstances in order to definitively prove their safety and efficacy or provide evidence to stop their utilization. Ongoing evaluation should guide future interventions.
In addition to this advice, the panel identified areas that need more detailed analysis and discussion, such as:
- ethical ways to gather data while striving to provide optimal care under the prevailing circumstances;
- ethical criteria to prioritize the use of unregistered experimental therapies and vaccines;
- ethical criteria for achieving fair distribution in communities and among countries, in the face of a growing number of possible new interventions, none of which is likely to meet demand in the short term.
A report of the meeting proceedings will be available to the public by 17 Aug 2014.
[A list of participants is available at the source URL above.]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[Since ZMapp is produced in greenhouses in genetically modified tobacco plants, it will take months to produce significant quantities to satisfy demand. On the other hand, TKM-Ebola is a drug (NOT a vaccine) of which the production can be ramped up quickly. - Mod.JW]
[TKM-Ebola does not stimulate immunity in hosts infected with ebolavirus. It is small interfering RNA (siRNA), that is, messenger RNA in the form of a lipid nanoparticle that is designed to silence certain critical ebolavirus genes. In a study published in Lancet, in an animal model of early ebolavirus infection, TKM-Ebola was found to protect infected non-human primates (http://www.thelancet.com/journals/lance ... 1/abstract). ZMapp and TKM-Ebola have unknown benefits and adverse effects in humans. - Mod.ML
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/8854.]
***********************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Tue 12 Aug 2014
Source: WHO Media centre [edited]
http://who.int/mediacentre/news/stateme ... summary/en
[A panel of experts was convened by WHO to consider and assess the ethical implications for clinical decision-making of the potential use of unregistered interventions. They reached consensus that, in the circumstances of this outbreak, it is ethical to offer unproven interventions with as of yet unknown efficacy and adverse effects, as potential treatment or prevention.]
Ethical considerations for use of unregistered interventions for Ebola viral disease (EVD)
----------------------------------------------------------------------
Summary of the panel discussion
WHO statement
-------------
West Africa is experiencing the largest, most severe, and most complex outbreak of Ebola virus disease in history. Ebola outbreaks can be contained using available interventions like early detection and isolation, contact tracing and monitoring, and adherence to rigorous procedures of infection control. However, a specific treatment or vaccine would be a potent asset to counter the virus.
Over the past decade, research efforts have been invested into developing drugs and vaccines for Ebola virus disease. Some of these have shown promising results in the laboratory, but they have not yet been evaluated for safety and efficacy in human beings. The large number of people affected by the 2014 west Africa outbreak, and the high case-fatality rate, have prompted calls to use investigational medical interventions to try to save the lives of patients and to curb the epidemic.
Therefore, on 11 Aug 2014, WHO convened a consultation to consider and assess the ethical implications for clinical decision-making of the potential use of unregistered interventions.
In the particular circumstances of this outbreak, and provided certain conditions are met, the panel reached consensus that it is ethical to offer unproven interventions with as yet unknown efficacy and adverse effects, as potential treatment or prevention.
Ethical criteria must guide the provision of such interventions. These include transparency about all aspects of care, informed consent, freedom of choice, confidentiality, respect for the person, preservation of dignity, and involvement of the community.
In order to understand the safety and efficacy of these interventions, the group advised that, if and when they are used to treat patients, there is a moral obligation to collect and share all data generated, including from treatments provided for 'compassionate use' (access to an unapproved drug outside of a clinical trial).
The group explored how the use of these interventions can be evaluated scientifically to ensure timely and accurate information about the safety and efficacy of these investigational interventions. There was unanimous agreement that there is a moral duty to also evaluate these interventions (for treatment or prevention) in the best possible clinical trials under the circumstances in order to definitively prove their safety and efficacy or provide evidence to stop their utilization. Ongoing evaluation should guide future interventions.
In addition to this advice, the panel identified areas that need more detailed analysis and discussion, such as:
- ethical ways to gather data while striving to provide optimal care under the prevailing circumstances;
- ethical criteria to prioritize the use of unregistered experimental therapies and vaccines;
- ethical criteria for achieving fair distribution in communities and among countries, in the face of a growing number of possible new interventions, none of which is likely to meet demand in the short term.
A report of the meeting proceedings will be available to the public by 17 Aug 2014.
[A list of participants is available at the source URL above.]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[Since ZMapp is produced in greenhouses in genetically modified tobacco plants, it will take months to produce significant quantities to satisfy demand. On the other hand, TKM-Ebola is a drug (NOT a vaccine) of which the production can be ramped up quickly. - Mod.JW]
[TKM-Ebola does not stimulate immunity in hosts infected with ebolavirus. It is small interfering RNA (siRNA), that is, messenger RNA in the form of a lipid nanoparticle that is designed to silence certain critical ebolavirus genes. In a study published in Lancet, in an animal model of early ebolavirus infection, TKM-Ebola was found to protect infected non-human primates (http://www.thelancet.com/journals/lance ... 1/abstract). ZMapp and TKM-Ebola have unknown benefits and adverse effects in humans. - Mod.ML
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/8854.]
-
Birgitt
- Moderator
- Beiträge: 35240
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Ebola-Fieber in Westafrika
EBOLA VIRUS DISEASE - WEST AFRICA (125): WHO, NIGERIA, USA FEAR, CDC, MORE
**************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this update:
[1] WHO update
[2] Nigeria: 10th case
[3] Sierra Leone: official
[4] USA: Ebola virus disease paranoia
[5] CDC & US DOD: useful information
[6] Media reports (1)
[7] Media reports (2)
******
[1] WHO update
Date: Mon 11 Aug 2014
Source: WHO Disease Outbreak News [edited]
http://www.afro.who.int/en/clusters-a-p ... -2014.html
Ebola virus disease update -- West Africa
--------------------------
Between 7-9 Aug 2014, 69 new cases (laboratory-confirmed, probable, and suspect cases) of EVD and 52 deaths were reported from the 4 countries as follows: Guinea, 11 new cases and 6 deaths; Liberia, 45 new cases and 29 deaths; Nigeria, 0 new cases and 0 deaths; and Sierra Leone, 13 new cases and 17 deaths.
[The table in the source gives confirmed, probable, and suspect cases and deaths from Ebola virus disease in Guinea, Liberia, Nigeria, and Sierra Leone, as of 9 Aug 2014, and shows Total Cases 1848, Deaths 1013. On 10 Aug 2014, Nigeria reported one more death; see [2] below. - Mod.JW]
The recent treatment of 2 health workers, who were infected with EVD, with an experimental medicine has raised important questions about whether medicines or treatments that have never been tested or shown to be safe in humans should be used in this outbreak. Currently, quantities of the medicine are limited, which also raises questions about who should receive the treatment.
On 11 Aug 2014, WHO convened a panel of medical ethicists, scientific experts, and lay people from the affected countries to assess the role of experimental therapies in the Ebola outbreak response; 2 issues were considered:
1) Is it ethical to use unregistered interventions with unknown adverse effects for possible treatment or prophylaxis? If it is, what criteria and conditions need to be satisfied before they can be used?
2) If it is ethical to use these unregistered interventions in the current circumstances, then what criteria should guide the choice of an intervention and who should receive priority for treatment or prevention?
[The findings of this panel have been posted on WHO's website http://www.who.int on Tue 12 Aug 2014 -- see Summary on ProMED archive nnnnnnnn COPY-ED PLEASE ADD]
The total number of cases is subject to change due to ongoing reclassification, retrospective investigation, and availability of laboratory results. Data reported in the Disease Outbreak News are based on official information reported by the Ministries of Health.
--
Communicated by:
ProMED-mail Rapporteur Marianne Hopp
******
[2] Sierra Leone: official
Date: Tue 12 Aug 2014
From: Emergency Operations Center (EOC), Ministry of Health and Sanitation, Sierra Leone
Via ProMED Submit Info tab on <www.promedmail.org> [edited]
Ebola Virus Disease, Sierra Leone: Press Release
---------------------------
Ebola outbreak update: As of today, 12 Aug 2014, we have a total of 184 patients who have survived Ebola Virus Disease and were subsequently discharged. The total number of new confirmed cases is 21: Kailahun 2, Kenema 15; Bombali 1; Port Loko 2 and Tonkolili 1.
The total number of cumulative number of deaths is 259 and cumulative number of confirmed cases is 703 with Kailahun 378, Kenema 250; Kono 1; Kambia 1; Bombali 7; Tonkolili 2; Port Loko 22; Pujehun 3; Bo 22; Moyamba 4; Bonthe 1; Western Area Urban [Freetown] 11; Western Area Rural 1. As of today, Koinadugu district is the only district that has not registered confirmed cases of EVD in Sierra Leone
The cumulative number of probable cases is 38 and probable deaths 34, while the total cumulative number of suspected cases is 39 and suspected deaths is 5.
The World Health Organization has approved the use of the unregistered intervention for EVD in the 3 Ebola affected Mano River Union Countries of Guinea, Liberia and Sierra Leone. Meanwhile, the Government of Sierra Leone through the Emergency Operations Center has written a formal letter to the Director General of the WHO to request the drugs and to ascertain the number of doses available to the country.
The Indian Mercantile Association has donated 500 bucket sets with attached taps and basins to the Ministry of Health and Sanitation as their contribution towards the fight against the Ebola Virus Disease, meanwhile World Vision Sierra Leone also donated 300 million Leones [nearly USD68 000] to the Ministry of Health and Sanitation on behalf of World Vision International as their contribution in the war against the Ebola Virus Disease. World Vision also informed the Ministry of Health and Sanitation that it is in the process of procuring protective gear to be supplied to frontline health workers in health facilities across the country.
Ebola Viral Disease Situation Report: Ministry of Health and Sanitation, Sierra Leone
For more information please contact: District Health Management Team at District level
National level - Directorate of Disease Prevention and Control
<dpcsurveillance@gmail.com>
Mobile:- +23276913000
--
Sidie Yahya Tunis
Director, Information Communication Technology (ICT)
Ministry of Health and Sanitation, Sierra Leone
*******
[3] Nigeria: 10th case
Date: Mon 11 Aug 2014
Source: Agence France-Presse in Lagos [edited]
Nigeria has confirmed a new case of EVD in the financial capital, Lagos, bringing the total number of people in the country with the virus to 10.
The health minister, Onyebuchi Chukwu, said the latest confirmed case was a female nurse who came into contact with a Liberian-American man, PS, who died of EVD in a Lagos hospital on 25 Jul 2014. Another nurse who had contact with him died last week, while 7 other people have been confirmed to have the virus in the city, he added.
The 10th case actually was one of the nurses who also had primary contact with the index case. When he [PS] got ill, we then brought her into isolation," the minister told a news conference in Abuja. "We just tested her over the weekend. So, that's what made it 10. So, between Friday and today [8-11 Aug 2014], we had one additional case. That brings it to 10, and the 10 include the index case." Chukwu said the nurse was undergoing treatment and her husband was under surveillance.
The World Health Organisation (WHO) said on Friday [8 Aug 2014] there were 13 probable and suspected cases of Ebola, including 2 deaths, in Nigeria. The minister did not comment on the discrepancy in the figures.
http://www.afp.com/en/node/2716310
[11 Aug 2014: Lagos State Governor Babatunde Fashola reported today [11 Aug 2014] that all the 8 people currently infected with the deadly Ebola virus disease (EVD) are in stable condition and responding to treatment.
http://thenewsnigeria.com.ng/2014/08/11 ... ys-fashola
Officials are now monitoring 177 people for symptoms of the disease.
http://www.voanews.com/content/nurse-is ... 09916.html
--
Communicated by
ProMED-mail Rapporteur Mary Marshall
******
[4] USA: Ebola virus disease paranoia
Date: Sun 10 Aug 2014
Source: Avian Flu Diary [edited]
http://afludiary.blogspot.co.uk/2014/08 ... -hole.html
[At the end of a long debunking of YouTube videos forecasting the end of the world with the eruption of the Yellowstone "supervolcano" in the USA is the following comment]:
[M]any of those [EVD videos] on the paranoid end of the scale were receiving extensive views, some as many as 10 000 a day. ... These are the same internet scare tactics that have been successfully used by some activists to demonize childhood and flu vaccines. For their core audiences, their messages strongly resonate, and their impact shouldn't be underestimated. It is against this background of distrust that any public health campaign against future disease outbreaks must be waged. For every CDC statement rationally explaining why EVD is unlikely to spread efficiently in the Western world, there are a hundred videos screaming "cover up." ... The bad news is that 35 percent of those polled still ranked [CDC] as "only fair" or "poor," leaving more than a little confidence gap.
Just as fear, distrust, and superstition have greatly interfered in the identification, isolation, and treatment of EVD cases in West Africa, one has to seriously wonder just how much differently things would play out in [the USA] should EVD, MERS, or avian flu ever seriously threaten. Here's hoping we never find out.
[Byline: Michael Coston]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
******
[5] CDC & US DOD: useful information
Date: Sun 10 Aug 2014
Source: CDC [edited]
http://www.cdc.gov/vhf/ebola
10 Aug 2014: Ebola Virus Disease Information for Clinicians in U.S. Healthcare Settings
8 Aug 2014: West Africa Outbreak Infographic Adobe PDF file [PDF - 1 page]
8 Aug 2014: Outbreak Update
8 Aug 2014: Stopping the Ebola Outbreak Infographic Adobe PDF file [PDF - 2 pages]
7 Aug 2014: Updated Case Definition for Ebola Virus Disease (EVD)
7 Aug 2014: Interim Guidance for Monitoring and Movement of Persons with Ebola Virus Disease Exposure
1 Aug 2014: Guidelines for Evaluation of US Patients Suspected of Having Ebola Virus Disease [This is an official CDC HEALTH ADVISORY
http://emergency.cdc.gov/han/han00364.asp]
[The 2 infographics in color poster form are especially clear and concise. - Mod.JW]
Instruction booklet, Ebola Zaire (EZ1) rRT-PCR (TaqMan(R)) Assay
--------------------------------
On ABI 7500 Fast Dx, LightCycler, and JBAIDS, Version 1.0, 5 Aug 2014. For Use Under an Emergency Use Authorization (EUA) Only; Manufactured by the Naval Medical Research Center for The U. (EUA); Only Manufactured by the Naval Medical Research Center for the U.S. Department of Defense http://www.fda.gov/downloads/MedicalDev ... 408334.pdf
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
******
[6] Media reports (1)
Canada: suspect case negative
--------------------------------
Today [10 Aug 2014], Eric Hoskins, Minister of Health and Long-Term Care, issued the following statement on a patient testing negative for Ebola virus disease in Ontario: "I can now confirm a recent case that underwent testing at the National Microbiology Laboratory in Winnipeg was found to test negative for Ebola virus disease."
http://news.ontario.ca/mohltc/en/2014/0 ... ntari.html
China
------
The National Health and Family Planning Commission (NHFPC) will send health experts to the 3 West African countries affected by Ebola. Media sources report that 3 teams will be sent to Guinea, Liberia and Sierra Leone with medical supplies and to assist in the prevention and control of EVD. They will also help train local health care workers and assist the Chinese embassy officials in distributing medical supplies.
[11 Aug 2014: 8 Chinese medical workers are currently quarantined in Ebola-hit Sierra Leone [Twitter by @AFP - Mod.JW]
Cote d'Ivoire travel ban
-------------------------
Ivory Coast has not reported any cases of Ebola, and government spokesman Bruno Kone said they want to keep it that way. The government said in addition to the ban on flights, authorities at the Abidjan airport will be screening all arriving passengers for fever, using infrared thermometers. Ivory Coast's defense minister said in recent days that border authorities have already repatriated "nearly 100 people" who have tried to cross illegally from Guinea or Liberia. The Ivory Coast government said it continues to train health workers and will be holding a simulation drill later this week for 1st responders.
https://mail.google.com/mail/u/0/#searc ... a3ecdf8ac5
Cyprus prepared
------------------
10 Aug 2014: Health Ministry: Cyprus has taken all measures against Ebola virus disease. Furthermore, instructions have been given to ports and airports on how to recognise symptoms and deal with such cases. Cyprus has fully complied with World Health Organisation (WHO) recommendations concerning the ebolavirus, and its action plan to address the disease is ready to be activated if necessary. ... Regarding the Turkish occupied areas of the Republic, the Ministry of Health says there appears to be no danger from travellers, who are mainly Turkish Cypriots crossing the ceasefire line, and that no suspicious cases of disease have emerged. Furthermore, the Ministry of Health is in close contact with the Ministry of Foreign Affairs regarding measures that must be taken on both sides, and the government's action plan has been conveyed to the Turkish Cypriot side.
http://famagusta-gazette.com/health-min ... 792-69.htm
Guinea-Bissau closes border
------------------------
12 Aug 2014: Guinea-Bissau closes border with Guinea because of Ebola virus disease. Government will also create special treatment centers at various strategic points of the country. "Hundreds of people cross the border every day coming from Guinea and, therefore, we must take effective precautions before it is too late," Prime Minister Domingos Simoes Pereira said at a news conference.
http://noticias.r7.com/saude/guine-biss ... a-12082014 [in Portuguese]
Malawi, screening, quarantine
---------------------
In Malawi, health authorities said the government was taking measures to prevent the spread of the Ebola virus into the country, including airport screenings of international passengers. ... Charles Mwansambo, director of health services in the Ministry of Health, told journalists in Lilongwe that the government was screening international passengers at the airports and had set up quarantine centers at Kamuzu International Airport in the capital, Lilongwe, and Chileka Airport, in the commercial capital of Blantyre.
https://mail.google.com/mail/u/0/#searc ... a3ecdf8ac5
Romania: suspected case
----------------------
9 Aug 2014: A man suspected of being infected with ebolavirus was transferred Sunday [10 Aug 2014] to the National Institute "Matei Bals," Bucharest and brought into Ploiesti. He recently returned from Nigeria, the [4th] African country which has been given a national alarm about an outbreak of EVD. The man worked for several months in the West African state.
http://www.curierulnational.ro/Evenimen ... in+Nigeria [in Romanian, machine trans.]
http://www.tricities.com/news/national/ ... b2370.html
Rwanda: suspected case improving
----------------------------
Following Sunday's report [10 Aug 2014] of a patient who was identified in Rwanda with EVD-like symptoms, the ministry of health has announced that the patient's condition is improving. The patient, a European medical student who has recently been in West Africa, was put in isolation while at King Faisal hospital with malaria when he developed EVD-like symptoms. He is currently in the isolation facility in Kanombe while doctors wait for the results of medical tests to determine whether the man is actually infected with the hemorrhagic fever. On Monday [11 Aug 2014], however, Minisante [Ministry of Health] reported that the patient's temperature had significantly gone down and that he is recovering well from the malaria and other symptoms.
http://focus.rw/wp/2014/08/ebola-suspec ... -minisante
[Severe malaria can progress to blackwater fever; the red to brownish color of urine in blackwater fever is due to hemoglobin in the urine (hemoglobinuria) as a result of severe intravascular hemolysis. The red to brownish color of urine due to hemoglobinuria can be misinterpreted as blood in the urine (hematuria). - Mod.ML]
South Africa: thermal scanners
---------------
10 Aug 2014: South Africa announced on Thu [7 Aug 2014] that it was in the process of outfitting airports with thermal scanners to detect feverish passengers. In many ways, it's a repeat of 2009, when airports around the world brought in thermal scanners to look for passengers who were presenting with fever and suspected bird flu.
http://www.theminorityreportblog.com/20 ... -for-ebola
Turkey
---------
12 Aug 2014: Suspected EVD case at Istanbul airport. Mother and son are put under medical supervision after the woman developed a fever and vomiting on the journey to Istanbul. "Since they are coming from an EVD-affected country, Nigeria, the Health Ministry is taking every possibility into account," the statement said.
http://www.aa.com.tr/en/rss/372427--sus ... ul-airport
EVD Drug Supply Is Exhausted After Doses Sent to Africa
--------------------------------------------------
11 Aug 2014: The EVD drug given to 2 Americans and a Spanish priest has been sent to a West African country that requested it, and the supply of the medicine is now exhausted, its manufacturer said. Mapp Biopharmaceutical Inc., based in San Diego, said it was told by U.S. health officials that the countries, including Nigeria and Liberia, had requested the drug, called ZMapp. The company said it has complied with every request for the drug that was authorized by legal and regulatory authorities. It said it provided the drug at no cost. ... The additional patients allocated the drug include medical doctors in 2 West African countries as well as the Americans and the Spanish priest.
http://www.businessweek.com/news/2014-0 ... -to-africa
[In fact for 2 doctors in Liberia. - Mod.JW]
Ebola virus disease & world economy
--------------------------------
9 Aug 2014: Caterpillar has evacuated a handful of employees from Liberia. Canadian Overseas Petroleum Ltd. has suspended a drilling project. British Airways has canceled flights to the region. ExxonMobil and Chevron are waiting to see whether health officials can contain the danger. ... http://www.tricities.com/news/national/ ... b2370.html
Twitter Analytics Project HealthMap Outperforming WHO in EVD Tracking
--------------------------------------
10 Aug 2014: HealthMap, a collaborative data analytics project launched in 2006 between Harvard Medical School and Boston Children's Hospital, has been quietly tracking the recent EVD outbreak in Western Africa with notable accuracy, beating the World Health Organization's own tracking efforts by 2 weeks in some instances. HealthMap aggregates information from a variety of online sources to plot real-time disease outbreaks. Currently, the platform analyzes data from the World Health Organization, Google News, and GeoSentinel, a global disease tracking platform that tracks major geography changes in diseases carried through travelers, foreign visitors, and immigrants. The analytics project also got a new source of feeder-data this February [2014] when Twitter announced that the HealthMap project had been selected as a Twitter Data Grant recipient, which gives the 45 epidemiologists working on the project access to the "fire hose" of unfiltered data generated from Twitter's 500 million daily tweets. ...
http://histalkmobile.com/twitter-analyt ... a-tracking
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
*******
[7] Media reports (2)
Date: Mon 11 Aug 2014
Source: International SOS [edited]
https://www.internationalsos.com/ebola/ ... age_id=ENG
Suspected imported cases
--------------------
Many locations are testing people who have travelled to countries with EVD and return with a fever and other symptoms. So far, none of these have proven to be EVD. International SOS is monitoring these closely.
Bangladesh: Media sources have reported that an alert has been issued in the country as a response to the EVD situation in West Africa. Officials plan to enhance monitoring for 90 days at the airports in Dhaka, Chittagong and Sylhet and at the seaport at Chhittagong. A medical facility has been identified for isolation and treatment of suspected EVD patients in the outskirts of Dhaka.
Benin: 7 August 2 cases, one in Cotonou, who travelled from Nigeria and the other in Porto-Novo - tests sent to Senegal.
China (Hong Kong): A traveller arriving from Lagos, Nigeria on 9 August, has tested negative for EVD on 10 August.
Germany: A traveller from Sierra Leone who was quarantined has tested negative for Ebola.
Ghana: 4 suspected cases reported, in isolation at Nsawam Government hospital in the Eastern region. Test results from all 4 suspected cases are negative. Ghanian Ministry of Health has issued a red alert in the country over EVD. Health officials have urged citizens to avoid using public swimming pools, practise and maintain strict hygiene.
[When I worked for the New York State Health Dept., I personally observed that after a child vomited in a public swimming pool it was closed, emptied and cleaned before refilling. - Mod.JW]
India: 9 August A traveller from Guinea, kept under observation at a government hospital in Chennai, found healthy. Officials will monitor his health.
Iran: The Ministry of Health has issued a travel warning for its citizens against travelling to EVD affected countries.
Liberia: News sources are reporting that the Liberian army has put a 3rd province, Lofa county, under quarantine. According to the President Ellen Johnson Sirleaf "we want to protect areas that have not been yet affected." Boma and Grand Cape Mount counties, the most northern affected counties, were quarantined earlier.
Mexico: 7 August The Ministry of Health advises that there are NO EVD cases, and news reports of a suspected case are false.
Nigeria: News sources have reported that officials have banned the transport of corpses within the country. Other sources mention that wildlife hunting and other recreational activities have also been banned [in some areas]. They have also reported another case in Lagos, a nurse who was involved in caring for the 1st case [the man from Liberia].
Romania: A traveller who returned to the country from Nigeria on 25 July [2014] is in isolation at a hospital in Bucharest. The man's wife and son have placed themselves under voluntary quarantine at home but do not have any symptoms. Results are awaited.
Saudi Arabia: One suspected case detected 5 August, proved to be negative on 9 August. Over 7000 visa requests for Hajj from Guinea, Sierra Leone and Liberia have been turned down in a bid to contain EVD spread, as per media sources. Saudi embassy officials are awaiting communication from the WHO on the pilgrims from affected countries travelling for Hajj.
Senegal: A traveller from Liberia, hospitalised in Dakar 9 August, tested negative for EVD on 10 August.
Spain: 12 Aug 2014: "Spanish priest Miguel Pajares, who was infected with ebolavirus, has died from the virus, hospital in Madrid says." -- CNN <www.cnn.com>.
[It is not clear whether the serum actually did the 2 Americans any good. One patient started recovering within an hour, too soon to be true, and the other showed no effect - see ProMED archive 20140807.2669718, and was given a 2nd dose. - Mod.JW]
Sudan: Authorities have started implementing precautionary measures at Khartoum airport for passengers arriving from EVD affected countries. New sources report that health care workers have been placed at border areas and have initiated awareness campaigns by distributing health materials.
USA: Missionaries returning home to North Carolina after working with infected cases of EVD in West Africa will be placed under quarantine. Media source reported that the cases will be quarantined for 3 weeks from the last exposure to an infected case. This is been done out of an abundance of caution. Currently, the 2 positive cases of Ebola under treatment in the country are from North Carolina based aid groups.
Zimbabwe: Unverified sources are reporting that all travellers arriving at the Harare International Airport from the EVD affected countries are being monitored, probably for a 21-day period.
--
Communicated by
ProMED-mail
<www.promedmail.org>
[WHO has also posted on its website: Barriers to rapid containment of the Ebola outbreak: Overview - 11 Aug 2014 http://www.who.int/csr/disease/ebola/ov ... st-2014/en - Mod.JW
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/8854.]
**************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this update:
[1] WHO update
[2] Nigeria: 10th case
[3] Sierra Leone: official
[4] USA: Ebola virus disease paranoia
[5] CDC & US DOD: useful information
[6] Media reports (1)
[7] Media reports (2)
******
[1] WHO update
Date: Mon 11 Aug 2014
Source: WHO Disease Outbreak News [edited]
http://www.afro.who.int/en/clusters-a-p ... -2014.html
Ebola virus disease update -- West Africa
--------------------------
Between 7-9 Aug 2014, 69 new cases (laboratory-confirmed, probable, and suspect cases) of EVD and 52 deaths were reported from the 4 countries as follows: Guinea, 11 new cases and 6 deaths; Liberia, 45 new cases and 29 deaths; Nigeria, 0 new cases and 0 deaths; and Sierra Leone, 13 new cases and 17 deaths.
[The table in the source gives confirmed, probable, and suspect cases and deaths from Ebola virus disease in Guinea, Liberia, Nigeria, and Sierra Leone, as of 9 Aug 2014, and shows Total Cases 1848, Deaths 1013. On 10 Aug 2014, Nigeria reported one more death; see [2] below. - Mod.JW]
The recent treatment of 2 health workers, who were infected with EVD, with an experimental medicine has raised important questions about whether medicines or treatments that have never been tested or shown to be safe in humans should be used in this outbreak. Currently, quantities of the medicine are limited, which also raises questions about who should receive the treatment.
On 11 Aug 2014, WHO convened a panel of medical ethicists, scientific experts, and lay people from the affected countries to assess the role of experimental therapies in the Ebola outbreak response; 2 issues were considered:
1) Is it ethical to use unregistered interventions with unknown adverse effects for possible treatment or prophylaxis? If it is, what criteria and conditions need to be satisfied before they can be used?
2) If it is ethical to use these unregistered interventions in the current circumstances, then what criteria should guide the choice of an intervention and who should receive priority for treatment or prevention?
[The findings of this panel have been posted on WHO's website http://www.who.int on Tue 12 Aug 2014 -- see Summary on ProMED archive nnnnnnnn COPY-ED PLEASE ADD]
The total number of cases is subject to change due to ongoing reclassification, retrospective investigation, and availability of laboratory results. Data reported in the Disease Outbreak News are based on official information reported by the Ministries of Health.
--
Communicated by:
ProMED-mail Rapporteur Marianne Hopp
******
[2] Sierra Leone: official
Date: Tue 12 Aug 2014
From: Emergency Operations Center (EOC), Ministry of Health and Sanitation, Sierra Leone
Via ProMED Submit Info tab on <www.promedmail.org> [edited]
Ebola Virus Disease, Sierra Leone: Press Release
---------------------------
Ebola outbreak update: As of today, 12 Aug 2014, we have a total of 184 patients who have survived Ebola Virus Disease and were subsequently discharged. The total number of new confirmed cases is 21: Kailahun 2, Kenema 15; Bombali 1; Port Loko 2 and Tonkolili 1.
The total number of cumulative number of deaths is 259 and cumulative number of confirmed cases is 703 with Kailahun 378, Kenema 250; Kono 1; Kambia 1; Bombali 7; Tonkolili 2; Port Loko 22; Pujehun 3; Bo 22; Moyamba 4; Bonthe 1; Western Area Urban [Freetown] 11; Western Area Rural 1. As of today, Koinadugu district is the only district that has not registered confirmed cases of EVD in Sierra Leone
The cumulative number of probable cases is 38 and probable deaths 34, while the total cumulative number of suspected cases is 39 and suspected deaths is 5.
The World Health Organization has approved the use of the unregistered intervention for EVD in the 3 Ebola affected Mano River Union Countries of Guinea, Liberia and Sierra Leone. Meanwhile, the Government of Sierra Leone through the Emergency Operations Center has written a formal letter to the Director General of the WHO to request the drugs and to ascertain the number of doses available to the country.
The Indian Mercantile Association has donated 500 bucket sets with attached taps and basins to the Ministry of Health and Sanitation as their contribution towards the fight against the Ebola Virus Disease, meanwhile World Vision Sierra Leone also donated 300 million Leones [nearly USD68 000] to the Ministry of Health and Sanitation on behalf of World Vision International as their contribution in the war against the Ebola Virus Disease. World Vision also informed the Ministry of Health and Sanitation that it is in the process of procuring protective gear to be supplied to frontline health workers in health facilities across the country.
Ebola Viral Disease Situation Report: Ministry of Health and Sanitation, Sierra Leone
For more information please contact: District Health Management Team at District level
National level - Directorate of Disease Prevention and Control
<dpcsurveillance@gmail.com>
Mobile:- +23276913000
--
Sidie Yahya Tunis
Director, Information Communication Technology (ICT)
Ministry of Health and Sanitation, Sierra Leone
*******
[3] Nigeria: 10th case
Date: Mon 11 Aug 2014
Source: Agence France-Presse in Lagos [edited]
Nigeria has confirmed a new case of EVD in the financial capital, Lagos, bringing the total number of people in the country with the virus to 10.
The health minister, Onyebuchi Chukwu, said the latest confirmed case was a female nurse who came into contact with a Liberian-American man, PS, who died of EVD in a Lagos hospital on 25 Jul 2014. Another nurse who had contact with him died last week, while 7 other people have been confirmed to have the virus in the city, he added.
The 10th case actually was one of the nurses who also had primary contact with the index case. When he [PS] got ill, we then brought her into isolation," the minister told a news conference in Abuja. "We just tested her over the weekend. So, that's what made it 10. So, between Friday and today [8-11 Aug 2014], we had one additional case. That brings it to 10, and the 10 include the index case." Chukwu said the nurse was undergoing treatment and her husband was under surveillance.
The World Health Organisation (WHO) said on Friday [8 Aug 2014] there were 13 probable and suspected cases of Ebola, including 2 deaths, in Nigeria. The minister did not comment on the discrepancy in the figures.
http://www.afp.com/en/node/2716310
[11 Aug 2014: Lagos State Governor Babatunde Fashola reported today [11 Aug 2014] that all the 8 people currently infected with the deadly Ebola virus disease (EVD) are in stable condition and responding to treatment.
http://thenewsnigeria.com.ng/2014/08/11 ... ys-fashola
Officials are now monitoring 177 people for symptoms of the disease.
http://www.voanews.com/content/nurse-is ... 09916.html
--
Communicated by
ProMED-mail Rapporteur Mary Marshall
******
[4] USA: Ebola virus disease paranoia
Date: Sun 10 Aug 2014
Source: Avian Flu Diary [edited]
http://afludiary.blogspot.co.uk/2014/08 ... -hole.html
[At the end of a long debunking of YouTube videos forecasting the end of the world with the eruption of the Yellowstone "supervolcano" in the USA is the following comment]:
[M]any of those [EVD videos] on the paranoid end of the scale were receiving extensive views, some as many as 10 000 a day. ... These are the same internet scare tactics that have been successfully used by some activists to demonize childhood and flu vaccines. For their core audiences, their messages strongly resonate, and their impact shouldn't be underestimated. It is against this background of distrust that any public health campaign against future disease outbreaks must be waged. For every CDC statement rationally explaining why EVD is unlikely to spread efficiently in the Western world, there are a hundred videos screaming "cover up." ... The bad news is that 35 percent of those polled still ranked [CDC] as "only fair" or "poor," leaving more than a little confidence gap.
Just as fear, distrust, and superstition have greatly interfered in the identification, isolation, and treatment of EVD cases in West Africa, one has to seriously wonder just how much differently things would play out in [the USA] should EVD, MERS, or avian flu ever seriously threaten. Here's hoping we never find out.
[Byline: Michael Coston]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
******
[5] CDC & US DOD: useful information
Date: Sun 10 Aug 2014
Source: CDC [edited]
http://www.cdc.gov/vhf/ebola
10 Aug 2014: Ebola Virus Disease Information for Clinicians in U.S. Healthcare Settings
8 Aug 2014: West Africa Outbreak Infographic Adobe PDF file [PDF - 1 page]
8 Aug 2014: Outbreak Update
8 Aug 2014: Stopping the Ebola Outbreak Infographic Adobe PDF file [PDF - 2 pages]
7 Aug 2014: Updated Case Definition for Ebola Virus Disease (EVD)
7 Aug 2014: Interim Guidance for Monitoring and Movement of Persons with Ebola Virus Disease Exposure
1 Aug 2014: Guidelines for Evaluation of US Patients Suspected of Having Ebola Virus Disease [This is an official CDC HEALTH ADVISORY
http://emergency.cdc.gov/han/han00364.asp]
[The 2 infographics in color poster form are especially clear and concise. - Mod.JW]
Instruction booklet, Ebola Zaire (EZ1) rRT-PCR (TaqMan(R)) Assay
--------------------------------
On ABI 7500 Fast Dx, LightCycler, and JBAIDS, Version 1.0, 5 Aug 2014. For Use Under an Emergency Use Authorization (EUA) Only; Manufactured by the Naval Medical Research Center for The U. (EUA); Only Manufactured by the Naval Medical Research Center for the U.S. Department of Defense http://www.fda.gov/downloads/MedicalDev ... 408334.pdf
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
******
[6] Media reports (1)
Canada: suspect case negative
--------------------------------
Today [10 Aug 2014], Eric Hoskins, Minister of Health and Long-Term Care, issued the following statement on a patient testing negative for Ebola virus disease in Ontario: "I can now confirm a recent case that underwent testing at the National Microbiology Laboratory in Winnipeg was found to test negative for Ebola virus disease."
http://news.ontario.ca/mohltc/en/2014/0 ... ntari.html
China
------
The National Health and Family Planning Commission (NHFPC) will send health experts to the 3 West African countries affected by Ebola. Media sources report that 3 teams will be sent to Guinea, Liberia and Sierra Leone with medical supplies and to assist in the prevention and control of EVD. They will also help train local health care workers and assist the Chinese embassy officials in distributing medical supplies.
[11 Aug 2014: 8 Chinese medical workers are currently quarantined in Ebola-hit Sierra Leone [Twitter by @AFP - Mod.JW]
Cote d'Ivoire travel ban
-------------------------
Ivory Coast has not reported any cases of Ebola, and government spokesman Bruno Kone said they want to keep it that way. The government said in addition to the ban on flights, authorities at the Abidjan airport will be screening all arriving passengers for fever, using infrared thermometers. Ivory Coast's defense minister said in recent days that border authorities have already repatriated "nearly 100 people" who have tried to cross illegally from Guinea or Liberia. The Ivory Coast government said it continues to train health workers and will be holding a simulation drill later this week for 1st responders.
https://mail.google.com/mail/u/0/#searc ... a3ecdf8ac5
Cyprus prepared
------------------
10 Aug 2014: Health Ministry: Cyprus has taken all measures against Ebola virus disease. Furthermore, instructions have been given to ports and airports on how to recognise symptoms and deal with such cases. Cyprus has fully complied with World Health Organisation (WHO) recommendations concerning the ebolavirus, and its action plan to address the disease is ready to be activated if necessary. ... Regarding the Turkish occupied areas of the Republic, the Ministry of Health says there appears to be no danger from travellers, who are mainly Turkish Cypriots crossing the ceasefire line, and that no suspicious cases of disease have emerged. Furthermore, the Ministry of Health is in close contact with the Ministry of Foreign Affairs regarding measures that must be taken on both sides, and the government's action plan has been conveyed to the Turkish Cypriot side.
http://famagusta-gazette.com/health-min ... 792-69.htm
Guinea-Bissau closes border
------------------------
12 Aug 2014: Guinea-Bissau closes border with Guinea because of Ebola virus disease. Government will also create special treatment centers at various strategic points of the country. "Hundreds of people cross the border every day coming from Guinea and, therefore, we must take effective precautions before it is too late," Prime Minister Domingos Simoes Pereira said at a news conference.
http://noticias.r7.com/saude/guine-biss ... a-12082014 [in Portuguese]
Malawi, screening, quarantine
---------------------
In Malawi, health authorities said the government was taking measures to prevent the spread of the Ebola virus into the country, including airport screenings of international passengers. ... Charles Mwansambo, director of health services in the Ministry of Health, told journalists in Lilongwe that the government was screening international passengers at the airports and had set up quarantine centers at Kamuzu International Airport in the capital, Lilongwe, and Chileka Airport, in the commercial capital of Blantyre.
https://mail.google.com/mail/u/0/#searc ... a3ecdf8ac5
Romania: suspected case
----------------------
9 Aug 2014: A man suspected of being infected with ebolavirus was transferred Sunday [10 Aug 2014] to the National Institute "Matei Bals," Bucharest and brought into Ploiesti. He recently returned from Nigeria, the [4th] African country which has been given a national alarm about an outbreak of EVD. The man worked for several months in the West African state.
http://www.curierulnational.ro/Evenimen ... in+Nigeria [in Romanian, machine trans.]
http://www.tricities.com/news/national/ ... b2370.html
Rwanda: suspected case improving
----------------------------
Following Sunday's report [10 Aug 2014] of a patient who was identified in Rwanda with EVD-like symptoms, the ministry of health has announced that the patient's condition is improving. The patient, a European medical student who has recently been in West Africa, was put in isolation while at King Faisal hospital with malaria when he developed EVD-like symptoms. He is currently in the isolation facility in Kanombe while doctors wait for the results of medical tests to determine whether the man is actually infected with the hemorrhagic fever. On Monday [11 Aug 2014], however, Minisante [Ministry of Health] reported that the patient's temperature had significantly gone down and that he is recovering well from the malaria and other symptoms.
http://focus.rw/wp/2014/08/ebola-suspec ... -minisante
[Severe malaria can progress to blackwater fever; the red to brownish color of urine in blackwater fever is due to hemoglobin in the urine (hemoglobinuria) as a result of severe intravascular hemolysis. The red to brownish color of urine due to hemoglobinuria can be misinterpreted as blood in the urine (hematuria). - Mod.ML]
South Africa: thermal scanners
---------------
10 Aug 2014: South Africa announced on Thu [7 Aug 2014] that it was in the process of outfitting airports with thermal scanners to detect feverish passengers. In many ways, it's a repeat of 2009, when airports around the world brought in thermal scanners to look for passengers who were presenting with fever and suspected bird flu.
http://www.theminorityreportblog.com/20 ... -for-ebola
Turkey
---------
12 Aug 2014: Suspected EVD case at Istanbul airport. Mother and son are put under medical supervision after the woman developed a fever and vomiting on the journey to Istanbul. "Since they are coming from an EVD-affected country, Nigeria, the Health Ministry is taking every possibility into account," the statement said.
http://www.aa.com.tr/en/rss/372427--sus ... ul-airport
EVD Drug Supply Is Exhausted After Doses Sent to Africa
--------------------------------------------------
11 Aug 2014: The EVD drug given to 2 Americans and a Spanish priest has been sent to a West African country that requested it, and the supply of the medicine is now exhausted, its manufacturer said. Mapp Biopharmaceutical Inc., based in San Diego, said it was told by U.S. health officials that the countries, including Nigeria and Liberia, had requested the drug, called ZMapp. The company said it has complied with every request for the drug that was authorized by legal and regulatory authorities. It said it provided the drug at no cost. ... The additional patients allocated the drug include medical doctors in 2 West African countries as well as the Americans and the Spanish priest.
http://www.businessweek.com/news/2014-0 ... -to-africa
[In fact for 2 doctors in Liberia. - Mod.JW]
Ebola virus disease & world economy
--------------------------------
9 Aug 2014: Caterpillar has evacuated a handful of employees from Liberia. Canadian Overseas Petroleum Ltd. has suspended a drilling project. British Airways has canceled flights to the region. ExxonMobil and Chevron are waiting to see whether health officials can contain the danger. ... http://www.tricities.com/news/national/ ... b2370.html
Twitter Analytics Project HealthMap Outperforming WHO in EVD Tracking
--------------------------------------
10 Aug 2014: HealthMap, a collaborative data analytics project launched in 2006 between Harvard Medical School and Boston Children's Hospital, has been quietly tracking the recent EVD outbreak in Western Africa with notable accuracy, beating the World Health Organization's own tracking efforts by 2 weeks in some instances. HealthMap aggregates information from a variety of online sources to plot real-time disease outbreaks. Currently, the platform analyzes data from the World Health Organization, Google News, and GeoSentinel, a global disease tracking platform that tracks major geography changes in diseases carried through travelers, foreign visitors, and immigrants. The analytics project also got a new source of feeder-data this February [2014] when Twitter announced that the HealthMap project had been selected as a Twitter Data Grant recipient, which gives the 45 epidemiologists working on the project access to the "fire hose" of unfiltered data generated from Twitter's 500 million daily tweets. ...
http://histalkmobile.com/twitter-analyt ... a-tracking
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
*******
[7] Media reports (2)
Date: Mon 11 Aug 2014
Source: International SOS [edited]
https://www.internationalsos.com/ebola/ ... age_id=ENG
Suspected imported cases
--------------------
Many locations are testing people who have travelled to countries with EVD and return with a fever and other symptoms. So far, none of these have proven to be EVD. International SOS is monitoring these closely.
Bangladesh: Media sources have reported that an alert has been issued in the country as a response to the EVD situation in West Africa. Officials plan to enhance monitoring for 90 days at the airports in Dhaka, Chittagong and Sylhet and at the seaport at Chhittagong. A medical facility has been identified for isolation and treatment of suspected EVD patients in the outskirts of Dhaka.
Benin: 7 August 2 cases, one in Cotonou, who travelled from Nigeria and the other in Porto-Novo - tests sent to Senegal.
China (Hong Kong): A traveller arriving from Lagos, Nigeria on 9 August, has tested negative for EVD on 10 August.
Germany: A traveller from Sierra Leone who was quarantined has tested negative for Ebola.
Ghana: 4 suspected cases reported, in isolation at Nsawam Government hospital in the Eastern region. Test results from all 4 suspected cases are negative. Ghanian Ministry of Health has issued a red alert in the country over EVD. Health officials have urged citizens to avoid using public swimming pools, practise and maintain strict hygiene.
[When I worked for the New York State Health Dept., I personally observed that after a child vomited in a public swimming pool it was closed, emptied and cleaned before refilling. - Mod.JW]
India: 9 August A traveller from Guinea, kept under observation at a government hospital in Chennai, found healthy. Officials will monitor his health.
Iran: The Ministry of Health has issued a travel warning for its citizens against travelling to EVD affected countries.
Liberia: News sources are reporting that the Liberian army has put a 3rd province, Lofa county, under quarantine. According to the President Ellen Johnson Sirleaf "we want to protect areas that have not been yet affected." Boma and Grand Cape Mount counties, the most northern affected counties, were quarantined earlier.
Mexico: 7 August The Ministry of Health advises that there are NO EVD cases, and news reports of a suspected case are false.
Nigeria: News sources have reported that officials have banned the transport of corpses within the country. Other sources mention that wildlife hunting and other recreational activities have also been banned [in some areas]. They have also reported another case in Lagos, a nurse who was involved in caring for the 1st case [the man from Liberia].
Romania: A traveller who returned to the country from Nigeria on 25 July [2014] is in isolation at a hospital in Bucharest. The man's wife and son have placed themselves under voluntary quarantine at home but do not have any symptoms. Results are awaited.
Saudi Arabia: One suspected case detected 5 August, proved to be negative on 9 August. Over 7000 visa requests for Hajj from Guinea, Sierra Leone and Liberia have been turned down in a bid to contain EVD spread, as per media sources. Saudi embassy officials are awaiting communication from the WHO on the pilgrims from affected countries travelling for Hajj.
Senegal: A traveller from Liberia, hospitalised in Dakar 9 August, tested negative for EVD on 10 August.
Spain: 12 Aug 2014: "Spanish priest Miguel Pajares, who was infected with ebolavirus, has died from the virus, hospital in Madrid says." -- CNN <www.cnn.com>.
[It is not clear whether the serum actually did the 2 Americans any good. One patient started recovering within an hour, too soon to be true, and the other showed no effect - see ProMED archive 20140807.2669718, and was given a 2nd dose. - Mod.JW]
Sudan: Authorities have started implementing precautionary measures at Khartoum airport for passengers arriving from EVD affected countries. New sources report that health care workers have been placed at border areas and have initiated awareness campaigns by distributing health materials.
USA: Missionaries returning home to North Carolina after working with infected cases of EVD in West Africa will be placed under quarantine. Media source reported that the cases will be quarantined for 3 weeks from the last exposure to an infected case. This is been done out of an abundance of caution. Currently, the 2 positive cases of Ebola under treatment in the country are from North Carolina based aid groups.
Zimbabwe: Unverified sources are reporting that all travellers arriving at the Harare International Airport from the EVD affected countries are being monitored, probably for a 21-day period.
--
Communicated by
ProMED-mail
<www.promedmail.org>
[WHO has also posted on its website: Barriers to rapid containment of the Ebola outbreak: Overview - 11 Aug 2014 http://www.who.int/csr/disease/ebola/ov ... st-2014/en - Mod.JW
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/8854.]
