EBOLA VIRUS DISEASE - WEST AFRICA (188): INTERNATIONAL CASES, LIBERIA, CLINICAL
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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 Ebola situation assessment - 6 October 2014
[2] Norwegian aid worker contracts Ebola, Sierra Leone
[3] French nurse & Senegalese leave hospitals in Europe
[4] Liberia: US military hospital construction delay
[5] Liberia: burials without benefit of PPE
[6] Clinical information about viral haemorrhagic fevers
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[1] WHO Ebola situation assessment - 6 October 2014
Date: 6 Oct 2014
Source: WHO [edited]
http://who.int/mediacentre/news/ebola/0 ... er-2014/en
What we know about transmission of the Ebola virus among humans
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The Ebola virus is transmitted among humans through close and direct physical contact with infected bodily fluids, the most infectious being blood, faeces and vomit.
The Ebola virus has also been detected in breast milk, urine and semen. In a convalescent male, the virus can persist in semen for at least 70 days; one study suggests persistence for more than 90 days.
Saliva and tears may also carry some risk. However, the studies implicating these additional bodily fluids were extremely limited in sample size and the science is inconclusive. In studies of saliva, the virus was found most frequently in patients at a severe stage of illness. The whole live virus has never been isolated from sweat.
The Ebola virus can also be transmitted indirectly, by contact with previously contaminated surfaces and objects. The risk of transmission from these surfaces is low and can be reduced even further by appropriate cleaning and disinfection procedures.
Not an airborne virus
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Ebola virus disease is not an airborne infection. Airborne spread among humans implies inhalation of an infectious dose of virus from a suspended cloud of small dried droplets.
This mode of transmission has not been observed during extensive studies of the Ebola virus over several decades.
Common sense and observation tell us that spread of the virus via coughing or sneezing is rare, if it happens at all. Epidemiological data emerging from the outbreak are not consistent with the pattern of spread seen with airborne viruses, like those that cause measles and chickenpox, or the airborne bacterium that causes tuberculosis.
Theoretically, wet and bigger droplets from a heavily infected individual, who has respiratory symptoms caused by other conditions or who vomits violently, could transmit the virus -- over a short distance -- to another nearby person. This could happen when virus-laden heavy droplets are directly propelled, by coughing or sneezing (which does not mean airborne transmission) onto the mucus membranes or skin with cuts or abrasions of another person.
WHO is not aware of any studies that actually document this mode of transmission [in humans]. On the contrary, good quality studies from previous Ebola outbreaks show that all cases were infected by direct close contact with symptomatic patients.
No evidence that viral diseases change their mode of transmission
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Moreover, scientists are unaware of any virus that has dramatically changed its mode of transmission. For example, the H5N1 avian influenza virus, which has caused sporadic human cases since 1997, is now endemic in chickens and ducks in large parts of Asia. That virus has probably circulated through many billions of birds for at least two decades. Its mode of transmission remains basically unchanged.
Speculation that Ebola virus disease might mutate into a form that could easily spread among humans through the air is just that: speculation, unsubstantiated by any evidence.
This kind of speculation is unfounded but understandable as health officials race to catch up with this fast-moving and rapidly evolving outbreak.
To stop this outbreak, more needs to be done to implement - on a much larger scale - well-known protective and preventive measures. Abundant evidence has documented their effectiveness.
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[Note: This ebolavirus is NOT transmitted through the air the way that flu & measles are -- otherwise there would already be thousands of cases in the capitals of the 3 countries. - Mod.JW]
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[2] Norwegian aid worker contracts Ebola, Sierra Leone
Date: 6 Oct 2014
Source: Wall St Journal [edited]
< http://online.wsj.com/articles/norwegia ... 1412609567>
A Norwegian aid worker at Doctors Without Borders [MSF] in Sierra Leone has contracted Ebola, the organization said on Mon [6 Oct 2014], and health authorities in Norway are preparing to treat the patient. "We can unfortunately confirm that one of our Norwegian field workers has tested positive for Ebola," said Anne Cecilie Kaltenborn, the secretary-general of Doctors Without Borders Norway, at an Oslo news conference. The aid worker was identified by Norwegian media as a woman working in Bo, Sierra Leone's second-biggest city...
The affected Norwegian field worker would be isolated and treated in Oslo. She had been isolated on Sun [5 Oct 2014] after contracting a fever, and a lab test confirmed that she had Ebola.
[Byline: Kjetil Malkenes Hovland]
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[This is only the 2nd MSF international HCW to catch EVD in 40 years of hundreds of MSF internationals responding to multiple Ebola outbreaks in Africa. - Mod.JW]
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[3] French nurse & Senegalese leave hospitals in Europe
Date: 6 Oct 2014
Source: The HealthSite [edited]
http://www.thehealthsite.com/news/ebola ... ug-avigan/
The French nurse, who was diagnosed with Ebola virus disease while engaging in healthcare work in Monrovia, Liberia's capital, and was repatriated to France for treatment, has been confirmed to have recovered from the disease by Doctors Without Borders [MSF}. The medical charity, which has shouldered a large part of the response to the West African outbreak, said Saturday [4 Oct 2014] that it received confirmation from the French Health Ministry that the woman had survived the disease. She was evacuated from Liberia and cared for at a hospital near Paris.
The University Medical Center Hamburg-Eppendorf in Germany also said Sat [4 Oct 2014] that a Senegalese scientist who was infected with Ebola in Sierra Leone has recovered and been discharged. [He was a WHO consultant epidemiologist. -Mod.JW]
ANSM [Agence Nationale de Securite du Medicament et des Produits de Sante] stated that a treatment combining Avigan [Favipiravir] and another experimental drug started on 19 Sep 2014. The [French] patient is taking Avigan as of 25 Sep 2014. Fujifilm and Toyama Chemical will continue to work together with relevant pharmaceutical authorities, international organizations and infectious disease specialists to explore the potential of leveraging Avigan for patients with the Ebola virus disease.... - more
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[4] Liberia: US military hospital construction delay
Date: 6 Oct 2014
Source: ABC News [edited]
http://abcnews.go.com/International/wir ... c-25989874
US military to put up tent at Liberia Ebola clinic
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Poor infrastructure, difficulties with equipment and torrential rains have slowed work for the U.S. military's initial response to the deadly Ebola outbreak in West Africa, but it is now ready to start erecting the main tent for a field hospital in Liberia.
Lt. Col. Jason Brown, who was at the site near the airport in the capital Monrovia, said work is supposed to begin Monday afternoon [6 Oct 2014] on the main structure of the 25-bed clinic that will treat healthcare workers infected with Ebola. It should be ready to accept patients at the end of the month, according to spokesman Chuck Prichard at the U.S. military's Africa Command.
"Every time it rains it slows things down," said Brown, noting that construction for the field hospital was supposed to begin Monday [6 Oct 2014] morning and has been pushed to the afternoon. Military teams have also been slowed by equipment that's broken down -- including the steering on a road grader -- or mix-ups in the delivery of supplies... - more
[Byline: DiLorenzo]
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[They were hoping to put up 100-bed hospitals at the rate of one a week, but didnit count on the rain and the poor condition of local equipment. - Mod.JW]
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[5] Liberia: burials without benefit of PPE
Date: 5 Oct 2014
Source: Daily Observer [edited]
http://www.liberianobserver.com/news/%E ... ong-county
"Traditional Man" buries 21 suspected Ebola victims in Bong county
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On the one hand they are told not to touch Ebola bodies, but on the other people don't show up to bury them for days. [A 62 year old male], of the Kpelle tribe has disclosed that he has buried 21 suspected Ebola bodies in the village of Balakerthela, one of the quarantined communities in Bong County. He said he carried out this dangerous feat "without the recommended personal protective equipment (PPE) being used by health workers to conduct the burial of Ebola suspected bodies."
Balakerthela is located in the Konoyea Clan in Salala District and it is one of the communities hardest hit by Ebola deaths which forced the County Health Team (CHT) to quarantine the area last August [2014].
Speaking through an interpreter last weekend in Balakerthela, [this man] said he decided to bury the suspected Ebola bodies because the Burial Team failed to act quickly to bury the bodies. "Sometimes there are about 3-4 dead bodies in the village in a day's time and the corpses would remain in the village for 3 days awaiting the arrival of the burial team. At the same time the Health Team is telling us that the longer you keep the dead bodies, the faster the disease will spread", [he] exclaimed...
[This is only true if people touch the bodies - it does not spread through the air. - Mod.JW]
When cross-examined about what precisely he used to conduct the burial in the absence of the standard personal protective equipment (PPE), the old man told how he applied traditional herbs on the corpses and also rubbed these herbs on himself and his colleagues before carrying out the interments. These herbs when used on a dead body, will prevent it from smelling horrible for a week, he disclosed.
"The townspeople only help with the digging of the grave but we are the ones to place the bodies in the graves" the old man remarked, pounding his chest with his right hand. He informed this reporter that he has been in the business for the past 30 years but was swift to acknowledge that one of his helpers ... died just a week ago. But [he] said he was not exactly sure as to whether his colleague died from the deadly Ebola virus...
"If the old man were not immune to the virus, why did [only] his colleague who has been helping him to carry on the burials fall prey to the virus?" a social worker asked. A health practitioner argued that [this man] cannot be resistant to the virus when [the man] has not previously suffered and survived from the Ebola virus disease, adding that the old man is being protected by supernatural powers.
It was also established by the Daily Observer that some residents of Balakerthela have left the village for sanctuary in other satellite villages for fear of contracting Ebola... - more
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[Perhaps there is such a thing as subclinical or very mild infection, leading to solid immunity. If only a BL-4 lab had the time to test the effect of those herbs on this ebolavirus -- if they could really protect hands, they could be used in places where gloves have not yet arrived, which appears to be a chronic problem. But I am speculating about protection; I am NOT recommending herbal remedies in the place of standard EVD treatment. - Mod.JW]
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[6] Clinical information about viral haemorrhagic fevers
Date: 6 Oct 2014
From: Dr Joost Butenop <butenop@medbox.org>
Dear ProMED members!
The latest clinical information about the epidemiology, diagnosis and treatment of viral haemorrhagic fevers, published in the well-known medical textbook 'Manson's Tropical Diseases', has been made freely available by the publisher! It is available at the Ebola Toolbox of the innovative online-library Medbox: http://www.medbox.org/ebola-toolbox/vir ... rs/preview?
You can find over 300 Ebola-related documents there, including national guidelines and SOPs [standard operating procedures], or IEC [Information, Education, Communication] material. The site is currently being revamped to optimise user-friendliness.
The chapter is aimed at doctors around the world treating patients with all types of viral haemorrhagic fevers. These include Ebola, Marburg fever, Lassa fever, Lujo haemorrhagic fever, South American haemorrhagic fevers and Bunyavirus diseases including Rift Valley fever and Crimean-Congo haemorrhagic fever.
Reproduced from: Farrar J et al. Manson's Tropical Diseases. 23rd edn. Elsevier; 2014. Chapter 16: Blumberg L et al. Viral Haemorrhagic Fevers. pp. 171-94. © 2014, with permission from Elsevier. ISBN 978-0-7020-5102-9
Thanks to the Wellcome Trust, who facilitated this!
Best regards
Joost
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Dr Joost Butenop MD, MPH
Founder, Project Coordinator,
Medbox - the aid library: Tools to simplify your life!
Medbox is hosted by:
Medical Mission Institute - The Advisory Group for International Health
Hermann Schell Str.7
97074 Würzburg
Germany
<butenop@medbox.org>
<www.medbox.org>
<www.medmissio.de>
[The HealthMap/ProMED map of Liberia can be found at: http://healthmap.org/promed/p/54
The HealthMap/ProMED map of Sierra Leone can be found at: http://healthmap.org/promed/p/46. - Mod.MPP]
Ebola in Westafrika
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EBOLA VIRUS DISEASE - WEST AFRICA (189): SIERRA LEONE, LIBERIA, OIE
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A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
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In this update:
STOP PRESS: Liberian case in Texas has died (CNN)
[1] Sierra Leone: medical supplies blocked at docks for 2 months
[2] Liberia: home disinfection kits for Monrovia
[3] Liberia: journalists need written permission for Ebola interviews
[4] Liberia: US military will have 7 Ebola testing labs throughout country
[5] Liberia: cremation brings problems
[6] Liberia: anti-corruption program
[7] Sex after Ebola
[8] OIE experts review current knowledge on Ebola reservoir
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STOP PRESS: Liberian case in Texas has died (CNN)
[Heard by me on TV at 11:30 8 Oct 2014. More to follow in next update. - Mod.JW]
[1] Sierra Leone: medical supplies blocked at docks for 2 months
Date: Sun 5 Oct 2014
Source: The New York Times [edited]
http://www.nytimes.com/2014/10/06/world ... .html?_r=0
It has been sitting idly on the docks for nearly 2 months: a shipping container packed with protective gowns, gloves, stretchers, mattresses, and other medical supplies needed to help fight Sierra Leone's exploding Ebola epidemic. There are 100 bags and boxes of hospital linens, 100 cases of protective suits, 80 cases of face masks, and other items -- in all, more than USD 140 000 worth of medical equipment locked inside a dented container at the port since 9 Aug 2014. Hundreds of people have died of Ebola in Sierra Leone since then, and health workers have endured grave shortages of lifesaving supplies, putting them at even greater risk in a country reeling from the virus.
"We are still just hoping (!!!) -- which sounds like begging -- that this container should be cleared," one government official wrote in a frantic email to his superiors, weeks after the container arrived. In many ways, the delay reflects what some in the growing ranks of international officials pouring into this nation to fight Ebola describe as a chaotic, disorganized government response to the epidemic.
Many health care workers in Sierra Leone have died of Ebola. "It's a mess," said one foreign official working alongside the Sierra Leone government agency set up to deal with the crisis. The official, who spoke on condition of anonymity to maintain vital relations with the government, said that nobody appeared to be in charge at the agency, known as the "emergency operations center," and that different factions made decisions independently. "It's the only body responsible," the official said. "What is it doing?"
In the case of the shipping container, the desperately needed supplies seem to have been caught, at least in part, in a trap that is common the world over: politics, money, and power. The supplies were donated by individuals and institutions in the United States, according to Chernoh Alpha Bah, who organized the shipment. But Mr Bah wears another hat, as well. He is an opposition politician from President Ernest Bai Koroma's hometown, Makeni -- a place that clearly showed the government's inability to contain Ebola.
Mr Bah said he thought the equipment would be welcomed by the struggling authorities, and he said he expected the shipping fee of USD 6500 would be a small detail for Sierra Leone. According to the official, the government has already received well over USD 40 million in cash from international donors to fight Ebola. The shipping company, as a good-will gesture in a moment of crisis, had agreed to send the goods without being paid first, Mr Bah said. But no more. 3 other containers of similar value await shipment from the United States, he said, halted by the government's long refusal to pay... -- more
[Byline: Adam Nossiter]
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[2] Liberia: home disinfection kits for Monrovia
Date: Thu 2 Oct 2014
Source: UN Office for the Coordination of Humanitarian Affairs (OCHA), ReliefWeb, Medecins Sans Frontieres (MSF) report [edited]
http://reliefweb.int/report/liberia/ebo ... y-monrovia
Teams from Doctors Without Borders/Medecins Sans Frontieres (MSF) have begun distributing more than 50 000 family protection and home disinfection kits in Monrovia, Liberia, as part of the organization's Ebola response. The kits are designed to give people some protection should a family member become ill and also allow them to disinfect their homes, reducing the chance that others in the household could become infected.
"We know these kits are not the solution to the Ebola crisis in Monrovia," said Anna Halford, coordinator for the distribution. "But the scale of the epidemic, and the inadequacy of the response so far, means that we are forced to take unprecedented and imperfect measures.
"In order to get the epidemic under control, all infected people must be able to have a bed in a treatment center, but until the facilities that have been promised materialize, this will be impossible. In the meantime, these kits offer people some protection from an infected family member until they can get the medical care they need in an Ebola management center."
The kits, which are distributed in 2 buckets, contain chlorine, soap, gloves, a gown, plastic bags, a spray bottle, and masks. The kits also contain health promotion messages and instructions for their safe use. MSF started the distribution by giving the kits to people who were turned away from MSF's treatment center when it was full, to contacts of patients at the center, to those working at the center, and to those living nearby.
"Our kits are not designed to allow people to care for an Ebola patient in their homes," said Laurence Sailly, MSF head of mission in Monrovia. "To do this safely, people need intensive training and support, but it will allow people to protect themselves from a sick family member for a short time until they can be admitted to a treatment center."... -- more
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[The kits are "not designed to allow people to care for an Ebola patient in their homes" but "will allow people to protect themselves from a sick family member for a short time until they can be admitted to a treatment center" -- after many more are built and staffed. But since that will take much more than a week, people will inevitably end up caring for Ebola patients in their homes. - Mod.JW]
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[3] Liberia: journalists need written permission for Ebola interviews
Date: Mon 6 Oct 2014
Source: Voice of America [edited]
http://www.voanews.com/content/liberia- ... 73713.html
The Ministry of Health and Social Welfare has released a new media order requiring journalists wanting to photograph, conduct interviews, or do video recordings at an Ebola health care facility to first get written permission from the health ministry.
Assistant Health Minister and head of the Ebola incident management team Tolbert Nyenswah told journalists the new media access policy aims to protect the privacy of patients and healthcare workers as well as the health and safety of Liberian and international journalists... -- more
[Byline James Butty]
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[I wonder how many days it takes to get an answer from an already overstretched ministry? - Mod.JW]
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[4] Liberia: US military will have 7 Ebola testing labs throughout country
Date: Tue 7 Oct 2014
Source: Stars and Stripes [edited]
http://www.stripes.com/news/dod-to-set- ... a-1.307144
The US Defense Department [DOD] will operate 7 mobile testing labs in Liberia to fight the spread of Ebola, the head of US Africa Command said Tue [7 Oct 2014] at the Pentagon. Hundreds of DOD personnel are in Liberia laying the groundwork for a US military mission to fight the outbreak that the World Health Organization estimates has killed more than 3400 people. Thousands of US soldiers are scheduled to arrive this month [October 2014] to build treatment centers and oversee logistics. The humanitarian mission is likely to cost about USD 750 million over the coming 6 months, Gen. David Rodriguez said.
Defense officials have repeatedly said troops have no contact with disease sufferers, but Rodriguez said Tue [7 Oct 2014] that a few military infectious disease specialists would be working with contaminated blood samples in the mobile labs. "This is not just medical guys trained to do this [particular task], this is what they do for a living," he said. One such lab has been operational in Liberia for years, while 2 more were recently deployed. DOD now is working to send 4 more labs, he said -- each operated by 3 or 4 technicians -- needed because Ebola symptoms can mimic other tropical diseases, such as malaria. "The testing really focuses on whom you need to treat and whom you don't need to treat, because malaria shows a similar problem with the symptoms," he said.
Making sure US personnel don't catch Ebola is priority no. 1, Rodriguez said. "By providing pre-deployment training, adhering to strict medical protocols while deployed, and carrying out carefully planned reintegration measures based on risk and exposure, I am confident that we can ensure our service members' safety, and the safety of their families and the American people," he said.
While deployed, troops will use safety clothing and equipment and wash constantly to prevent the virus spreading. They'll also be checked for symptoms throughout the day, Rodriguez promised. Should anyone come down with the virus, they'll be evacuated to the United States for treatment on a specially equipped medical transport plane.
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[Photo of US military field hot lab in action:
http://www.defense.gov/dodcmsshare/home ... xD-001.jpg
(US Army Africa photo by US Navy Chief Petty Officer Jerrold Diederich)
US Navy Lt Jose Garcia inactivates the Ebola virus in each specimen in a process that renders the virus safe for further analysis at a Naval Medical Research Center mobile laboratory at Bushrod Island, Liberia, 6 Oct 2014. The center sent 2 mobile testing labs to Liberia to support Operation United Assistance. Each 2-person lab is capable of testing up to 80 samples per day. - Mod.JW]
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[5] Liberia: cremation brings problems
Date: Tue 7 Oct 2014
Source: Time [edited]
http://time.com/3478238/ebola-liberia-b ... ion-burned
Overwhelmed by the increasing number of dead, and faced with community fears that the buried bodies may also transmit the disease -- which, if interred properly, they won't -- Liberia's government declared in August [2014] that all those who died of Ebola should be cremated.
With international help and advice, the government established a Dead Body Management program to pick up Ebola's victims and dispose of them safely. But testing for Ebola is difficult and time consuming. What little testing resources do exist are reserved for the living, says assistant health minister, Tolbert Nyenswah. With hospitals closed and doctors overwhelmed, it is almost impossible to prove that the cause of death is anything but the deadly virus. "These days, if someone dies, it's Ebola," says [a coffin-maker]. "There is no testing, no questions. Just Ebola, and they take the body away. No one has time for coffins." He hasn't sold a coffin in 2 months, ever since the Liberian government declared, in an effort to tackle the Ebola crisis, that all of the country's dead should be burned and not buried.
The government directive, while logical from an epidemiological aspect, has taken a toll on a society already traumatized by Ebola's sweep. It denies communities a final farewell, and has led to standoffs with the Dead Body Management teams who must pick up the dead even as the living insist that the cause of death was measles, or stroke, or malaria -- anything but Ebola. "We take every body, and burn it," says Nelson Sayon, who works on one of the teams. Dealing with the living is one of the most difficult aspects of his job, he says, because he knows how important grieving can be. "No one gets their body back, not even the ashes, so there is nothing physical left to mourn."
Monrovia's mass cremations, which take place in a rural area far in the outskirts of town, happen at night, to minimize the impact on neighboring communities. For a while the bodies were simply burned in a pile; now they are placed in incinerators donated by an international NGO. There are so many that it can sometimes take all night, says Sayon.
In a country where distrust between the people and the government runs deep, the mass cremations have caused a deeper rift, says Kenneth Martu, a community organizer from the Westpoint area of Monrovia. "In west Africa we don't cremate bodies at all. So when the government takes away our bodies, and can't even tell us if they died of Ebola or not, it breeds resentment." Liberians, he points out, are no strangers to mass casualties: 2 civil wars, from 1989 to 1996 and 1999 to 2003, saw nearly half a million die. "Even with mass graves, people can bring flowers. They know where to find the dead. But here we don't even know where the ashes are." [It seems insensitive not to identify the burial places of the ashes. - Mod.JW]
There are exceptions to the cremation directive. If a family can get a signed death certificate from the Ministry of Health stating that the cause of death was not Ebola, they can take the body to a funeral parlor for embalming and eventual burial. There are even dispensations for those who do die of Ebola; under certain circumstances the dead can be buried in a cemetery, if the Dead Body Management team conducts the preliminary steps of laying the body 6 feet [2 m] deep and soaking the next 4 feet [1.2 m] of earth with chlorine solution. But those dispensations are impossible to get without connections. One recent Saturday, a funeral cortege down one of Monrovia's main thoroughfares drew questioning comments and glares of resentment from bystanders. "Haven't seen that in a while," exclaimed one woman. "Must be related to a minister," muttered a man... -- more
[Byline: Aryn Baker]
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[6] Liberia: anti-corruption program
Date: Tue 7 Oct 2014
Source: AllAfrica, Heritage (Monrovia) report [edited]
http://allafrica.com/stories/201410071860.html
In an effort to ensure transparency, accountability and integrity in the management of Ebola resources, the Liberia Anti-Corruption Commission (LACC) has embarked on a program to monitor and make sure that adequate internal controls and systems are instituted in the administration of said resources.
The LACC has therefore requested the National Ebola Taskforce to furnish the list of all monetary contributions and payments made to the National Ebola Trust Fund, along with information of all other related resources. Additionally, the Commission has entreated the National Ebola Taskforce to provide a full list of all administrators of Ebola resources.
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7 Oct 2014: (Heritage) The Government of Liberia (GoL) through the Ministry of Finance and Development Planning (MFDP) has commenced the process for the selection and appointment of an independent "Fiduciary Agent" to assist the government with the financial management of the Ebola Trust Fund. An MFDP release says the decision to contract an independent financial management firm was intended to uphold government's commitment to full transparency and accountability as announced recently by Liberia's Minister of Finance and Development Planning, Amara M Konneh.
According to Minister Konneh, the firm selected to provide the fiduciary service would manage the fund and supervise accounting related services, under the direction of the Minister of Finance and Development Planning, under the multi-donor governance structure. The release says it would be required to set up a sound financial management system to accurately record and report on all funds received and disbursed from the Trust Fund and providing regular fund management report.
The Firm would also provide oversight of all procurement functions to ensure compliance with established guidelines of the government as well as those of development partners ... The GoL in response to the Ebola Virus epidemic established the Ebola Trust Fund (ETF) at the Central of Bank of Liberia (CBL) in a bid to attract resources from the government, private citizens and international donors. The Fund was created with an initial USD 5 million injection through a loan facility from the Central Bank of Liberia. To date, the fund has raised over USD 10 million, with more donations expected from foreign partners and friendly governments in coming weeks. Recently, the Liberian government announced it needed USD 375 million to effectively fund its National Ebola Response and Restoration of Basic Health Services strategy.
http://allafrica.com/stories/201410071869.html
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[7] Sex after Ebola
Date: Tue 7 Oct 2014
Source: Reuters [edited]
https://uk.news.yahoo.com/male-ebola-su ... ml#wuBlTys
Sex could keep the Ebola epidemic alive even after the World Health Organization (WHO) declares an area free of the disease, one of the discoverers of the deadly virus said on Tue [7 Oct 2014].
The WHO is hoping to announce later this week that Nigeria and Senegal are free of Ebola after 42 days with no infections -- the standard period for declaring an outbreak over, twice the maximum 21-day incubation period of the virus. However, it appears the disease can last much longer in semen.
"In a convalescent male, the virus can persist in semen for at least 70 days; one study suggests persistence for more than 90 days," the WHO said in an information note on Mon [6 Oct 2014] [see item [1] WHO Ebola situation assessment - 6 Oct 2014 in ProMED-mail posting Ebola virus disease - West Africa (188): international cases, Liberia, clinical 20141007.2837773 - Mod.JW]
"Certainly, the advice has to be for survivors to use a condom, to not have unprotected sex, for 90 days," said Peter Piot, a professor at the London School of Hygiene and Tropical Medicine and a discoverer of Ebola in 1976. "If we would apply the rule for double the time, that would be 180 days -- 6 months. I think it (90 days) is probably a compromise, for practicality," he told a news conference in Geneva.
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[It didn't keep Ebola going in the Congo after the original outbreak in 1976, or after the Kikwit outbreak in 1995, or after any other outbreak in the Congo or Uganda between 1976 and now.
Reference
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Rowe AK, Bertolli J, Khan AS, et al: Clinical, virologic, and immunologic follow-up of convalescent Ebola hemorrhagic fever patients and their household contacts, Kikwit, Democratic Republic of the Congo. J Infect Dis. 1999; 179 Suppl 1: S28-35; available at http://jid.oxfordjournals.org/content/1 ... 1/S28.full
"Evidence of Ebola virus was detected by reverse transcription -- polymerase chain reaction in semen specimens up to 91 days after disease onset; however, these and all other non-blood body fluids tested negative by virus isolation. Among 81 initially antibody negative HHCs [household contacts] , none became antibody positive."
Also note:
"Blood specimens of 5 HHCs not identified as EHF [Ebola hemorrhagic fever; now Ebola virus disease] patients were initially antibody positive. No direct evidence of convalescent-to-HHC transmission of EHF was found, although the semen of convalescents may be infectious. The existence of initially antibody-positive HHCs suggests that mild cases of Ebola virus infection occurred and that the full extent of the EHF epidemic was probably underestimated."
- Mod.JW]
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[8] OIE experts review current knowledge on Ebola reservoir
Date: Mon 6 Oct 2014
Source: OIE (World Organisation for Animal Health) press releases [edited]
http://www.oie.int/en/for-the-media/pre ... us-disease
The World Organisation for Animal Health (OIE) has issued a technical information sheet on Ebola virus disease outlining epidemiological observations and scientific knowledge of the disease including the animal reservoir.
The OIE technical information sheet on Ebola virus disease has been prepared and reviewed by internationally regarded scientific experts, including experts from OIE global Reference Centres and Working Group on wildlife, and was subsequently endorsed by the OIE Scientific Commission on Animal Diseases.
Ebola virus disease (EVD), also known as Ebola haemorrhagic fever is a severe contagious disease affecting humans and non-human primates, such as gorillas, chimpanzees and some other monkeys. It mainly occurs in the Central and West African regions and can be transmitted to humans from an infected animal or human. Hence, Ebola virus disease is a zoonosis and poses significant threats to public health by causing hemorrhagic fever outbreaks in humans with a high case fatality rate. At present, there is no licensed therapeutic or vaccine for humans. Experimental drugs and vaccines are being developed.
The virus was reported again in humans at the beginning of 2014 in Guinea and then Liberia. It has since then spread to Sierra Leone and most recently to Nigeria to become the largest Ebola outbreak in history and the 1st in West Africa. In August 2014, the WHO declared the outbreak as an international health emergency. An unrelated outbreak was also reported in Democratic Republic of Congo (DRC).
Although the strain causing the current outbreak has resulted in an unprecedented number of fatalities, the initial source of the virus remains unclear. However it is likely that the initial introduction to the human population was from a wild animal source to a single person. The disease is now being transmitted between humans and there is no evidence that animals continue to play a role in spreading the virus.
Field studies and epidemiological surveys demonstrate that the natural reservoir hosts for this virus may be fruit bats, without showing clinical signs. These results still need to be further investigated.
Ebola is most likely initially transmitted from animals such as bats and non-human primates to humans through hunting and collection of sick or dead wild animals and handling or consumption of uncooked bush meat. In rural areas fruit bats are a popular source of forest meat for humans and are prepared by hand to be dried, smoked, and/or cooked. Infection could also be transmitted to humans by handling or consumption of forest fruits contaminated with bat saliva or faeces in affected areas.
Therefore the OIE is in full accordance with World Health Organization (WHO) recommendations to avoid contact with wild animals, including bats, monkeys, and rodents, in affected areas.
The OIE encourages the national Veterinary Services of the countries affected to remain vigilant and develop their involvement towards wildlife. In collaboration with OIE experts, it will continue to work and regularly update guidance to its Members and the public on this disease.
Related links:
WHO fact sheet on Ebola virus
http://www.who.int/mediacentre/factsheets/fs103/en
Link to OIE Information Sheet
http://www.oie.int/fileadmin/Home/fr/Me ... _Final.pdf
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In this update:
STOP PRESS: Liberian case in Texas has died (CNN)
[1] Sierra Leone: medical supplies blocked at docks for 2 months
[2] Liberia: home disinfection kits for Monrovia
[3] Liberia: journalists need written permission for Ebola interviews
[4] Liberia: US military will have 7 Ebola testing labs throughout country
[5] Liberia: cremation brings problems
[6] Liberia: anti-corruption program
[7] Sex after Ebola
[8] OIE experts review current knowledge on Ebola reservoir
******
STOP PRESS: Liberian case in Texas has died (CNN)
[Heard by me on TV at 11:30 8 Oct 2014. More to follow in next update. - Mod.JW]
[1] Sierra Leone: medical supplies blocked at docks for 2 months
Date: Sun 5 Oct 2014
Source: The New York Times [edited]
http://www.nytimes.com/2014/10/06/world ... .html?_r=0
It has been sitting idly on the docks for nearly 2 months: a shipping container packed with protective gowns, gloves, stretchers, mattresses, and other medical supplies needed to help fight Sierra Leone's exploding Ebola epidemic. There are 100 bags and boxes of hospital linens, 100 cases of protective suits, 80 cases of face masks, and other items -- in all, more than USD 140 000 worth of medical equipment locked inside a dented container at the port since 9 Aug 2014. Hundreds of people have died of Ebola in Sierra Leone since then, and health workers have endured grave shortages of lifesaving supplies, putting them at even greater risk in a country reeling from the virus.
"We are still just hoping (!!!) -- which sounds like begging -- that this container should be cleared," one government official wrote in a frantic email to his superiors, weeks after the container arrived. In many ways, the delay reflects what some in the growing ranks of international officials pouring into this nation to fight Ebola describe as a chaotic, disorganized government response to the epidemic.
Many health care workers in Sierra Leone have died of Ebola. "It's a mess," said one foreign official working alongside the Sierra Leone government agency set up to deal with the crisis. The official, who spoke on condition of anonymity to maintain vital relations with the government, said that nobody appeared to be in charge at the agency, known as the "emergency operations center," and that different factions made decisions independently. "It's the only body responsible," the official said. "What is it doing?"
In the case of the shipping container, the desperately needed supplies seem to have been caught, at least in part, in a trap that is common the world over: politics, money, and power. The supplies were donated by individuals and institutions in the United States, according to Chernoh Alpha Bah, who organized the shipment. But Mr Bah wears another hat, as well. He is an opposition politician from President Ernest Bai Koroma's hometown, Makeni -- a place that clearly showed the government's inability to contain Ebola.
Mr Bah said he thought the equipment would be welcomed by the struggling authorities, and he said he expected the shipping fee of USD 6500 would be a small detail for Sierra Leone. According to the official, the government has already received well over USD 40 million in cash from international donors to fight Ebola. The shipping company, as a good-will gesture in a moment of crisis, had agreed to send the goods without being paid first, Mr Bah said. But no more. 3 other containers of similar value await shipment from the United States, he said, halted by the government's long refusal to pay... -- more
[Byline: Adam Nossiter]
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[2] Liberia: home disinfection kits for Monrovia
Date: Thu 2 Oct 2014
Source: UN Office for the Coordination of Humanitarian Affairs (OCHA), ReliefWeb, Medecins Sans Frontieres (MSF) report [edited]
http://reliefweb.int/report/liberia/ebo ... y-monrovia
Teams from Doctors Without Borders/Medecins Sans Frontieres (MSF) have begun distributing more than 50 000 family protection and home disinfection kits in Monrovia, Liberia, as part of the organization's Ebola response. The kits are designed to give people some protection should a family member become ill and also allow them to disinfect their homes, reducing the chance that others in the household could become infected.
"We know these kits are not the solution to the Ebola crisis in Monrovia," said Anna Halford, coordinator for the distribution. "But the scale of the epidemic, and the inadequacy of the response so far, means that we are forced to take unprecedented and imperfect measures.
"In order to get the epidemic under control, all infected people must be able to have a bed in a treatment center, but until the facilities that have been promised materialize, this will be impossible. In the meantime, these kits offer people some protection from an infected family member until they can get the medical care they need in an Ebola management center."
The kits, which are distributed in 2 buckets, contain chlorine, soap, gloves, a gown, plastic bags, a spray bottle, and masks. The kits also contain health promotion messages and instructions for their safe use. MSF started the distribution by giving the kits to people who were turned away from MSF's treatment center when it was full, to contacts of patients at the center, to those working at the center, and to those living nearby.
"Our kits are not designed to allow people to care for an Ebola patient in their homes," said Laurence Sailly, MSF head of mission in Monrovia. "To do this safely, people need intensive training and support, but it will allow people to protect themselves from a sick family member for a short time until they can be admitted to a treatment center."... -- more
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[The kits are "not designed to allow people to care for an Ebola patient in their homes" but "will allow people to protect themselves from a sick family member for a short time until they can be admitted to a treatment center" -- after many more are built and staffed. But since that will take much more than a week, people will inevitably end up caring for Ebola patients in their homes. - Mod.JW]
******
[3] Liberia: journalists need written permission for Ebola interviews
Date: Mon 6 Oct 2014
Source: Voice of America [edited]
http://www.voanews.com/content/liberia- ... 73713.html
The Ministry of Health and Social Welfare has released a new media order requiring journalists wanting to photograph, conduct interviews, or do video recordings at an Ebola health care facility to first get written permission from the health ministry.
Assistant Health Minister and head of the Ebola incident management team Tolbert Nyenswah told journalists the new media access policy aims to protect the privacy of patients and healthcare workers as well as the health and safety of Liberian and international journalists... -- more
[Byline James Butty]
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[I wonder how many days it takes to get an answer from an already overstretched ministry? - Mod.JW]
******
[4] Liberia: US military will have 7 Ebola testing labs throughout country
Date: Tue 7 Oct 2014
Source: Stars and Stripes [edited]
http://www.stripes.com/news/dod-to-set- ... a-1.307144
The US Defense Department [DOD] will operate 7 mobile testing labs in Liberia to fight the spread of Ebola, the head of US Africa Command said Tue [7 Oct 2014] at the Pentagon. Hundreds of DOD personnel are in Liberia laying the groundwork for a US military mission to fight the outbreak that the World Health Organization estimates has killed more than 3400 people. Thousands of US soldiers are scheduled to arrive this month [October 2014] to build treatment centers and oversee logistics. The humanitarian mission is likely to cost about USD 750 million over the coming 6 months, Gen. David Rodriguez said.
Defense officials have repeatedly said troops have no contact with disease sufferers, but Rodriguez said Tue [7 Oct 2014] that a few military infectious disease specialists would be working with contaminated blood samples in the mobile labs. "This is not just medical guys trained to do this [particular task], this is what they do for a living," he said. One such lab has been operational in Liberia for years, while 2 more were recently deployed. DOD now is working to send 4 more labs, he said -- each operated by 3 or 4 technicians -- needed because Ebola symptoms can mimic other tropical diseases, such as malaria. "The testing really focuses on whom you need to treat and whom you don't need to treat, because malaria shows a similar problem with the symptoms," he said.
Making sure US personnel don't catch Ebola is priority no. 1, Rodriguez said. "By providing pre-deployment training, adhering to strict medical protocols while deployed, and carrying out carefully planned reintegration measures based on risk and exposure, I am confident that we can ensure our service members' safety, and the safety of their families and the American people," he said.
While deployed, troops will use safety clothing and equipment and wash constantly to prevent the virus spreading. They'll also be checked for symptoms throughout the day, Rodriguez promised. Should anyone come down with the virus, they'll be evacuated to the United States for treatment on a specially equipped medical transport plane.
--
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[Photo of US military field hot lab in action:
http://www.defense.gov/dodcmsshare/home ... xD-001.jpg
(US Army Africa photo by US Navy Chief Petty Officer Jerrold Diederich)
US Navy Lt Jose Garcia inactivates the Ebola virus in each specimen in a process that renders the virus safe for further analysis at a Naval Medical Research Center mobile laboratory at Bushrod Island, Liberia, 6 Oct 2014. The center sent 2 mobile testing labs to Liberia to support Operation United Assistance. Each 2-person lab is capable of testing up to 80 samples per day. - Mod.JW]
******
[5] Liberia: cremation brings problems
Date: Tue 7 Oct 2014
Source: Time [edited]
http://time.com/3478238/ebola-liberia-b ... ion-burned
Overwhelmed by the increasing number of dead, and faced with community fears that the buried bodies may also transmit the disease -- which, if interred properly, they won't -- Liberia's government declared in August [2014] that all those who died of Ebola should be cremated.
With international help and advice, the government established a Dead Body Management program to pick up Ebola's victims and dispose of them safely. But testing for Ebola is difficult and time consuming. What little testing resources do exist are reserved for the living, says assistant health minister, Tolbert Nyenswah. With hospitals closed and doctors overwhelmed, it is almost impossible to prove that the cause of death is anything but the deadly virus. "These days, if someone dies, it's Ebola," says [a coffin-maker]. "There is no testing, no questions. Just Ebola, and they take the body away. No one has time for coffins." He hasn't sold a coffin in 2 months, ever since the Liberian government declared, in an effort to tackle the Ebola crisis, that all of the country's dead should be burned and not buried.
The government directive, while logical from an epidemiological aspect, has taken a toll on a society already traumatized by Ebola's sweep. It denies communities a final farewell, and has led to standoffs with the Dead Body Management teams who must pick up the dead even as the living insist that the cause of death was measles, or stroke, or malaria -- anything but Ebola. "We take every body, and burn it," says Nelson Sayon, who works on one of the teams. Dealing with the living is one of the most difficult aspects of his job, he says, because he knows how important grieving can be. "No one gets their body back, not even the ashes, so there is nothing physical left to mourn."
Monrovia's mass cremations, which take place in a rural area far in the outskirts of town, happen at night, to minimize the impact on neighboring communities. For a while the bodies were simply burned in a pile; now they are placed in incinerators donated by an international NGO. There are so many that it can sometimes take all night, says Sayon.
In a country where distrust between the people and the government runs deep, the mass cremations have caused a deeper rift, says Kenneth Martu, a community organizer from the Westpoint area of Monrovia. "In west Africa we don't cremate bodies at all. So when the government takes away our bodies, and can't even tell us if they died of Ebola or not, it breeds resentment." Liberians, he points out, are no strangers to mass casualties: 2 civil wars, from 1989 to 1996 and 1999 to 2003, saw nearly half a million die. "Even with mass graves, people can bring flowers. They know where to find the dead. But here we don't even know where the ashes are." [It seems insensitive not to identify the burial places of the ashes. - Mod.JW]
There are exceptions to the cremation directive. If a family can get a signed death certificate from the Ministry of Health stating that the cause of death was not Ebola, they can take the body to a funeral parlor for embalming and eventual burial. There are even dispensations for those who do die of Ebola; under certain circumstances the dead can be buried in a cemetery, if the Dead Body Management team conducts the preliminary steps of laying the body 6 feet [2 m] deep and soaking the next 4 feet [1.2 m] of earth with chlorine solution. But those dispensations are impossible to get without connections. One recent Saturday, a funeral cortege down one of Monrovia's main thoroughfares drew questioning comments and glares of resentment from bystanders. "Haven't seen that in a while," exclaimed one woman. "Must be related to a minister," muttered a man... -- more
[Byline: Aryn Baker]
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[6] Liberia: anti-corruption program
Date: Tue 7 Oct 2014
Source: AllAfrica, Heritage (Monrovia) report [edited]
http://allafrica.com/stories/201410071860.html
In an effort to ensure transparency, accountability and integrity in the management of Ebola resources, the Liberia Anti-Corruption Commission (LACC) has embarked on a program to monitor and make sure that adequate internal controls and systems are instituted in the administration of said resources.
The LACC has therefore requested the National Ebola Taskforce to furnish the list of all monetary contributions and payments made to the National Ebola Trust Fund, along with information of all other related resources. Additionally, the Commission has entreated the National Ebola Taskforce to provide a full list of all administrators of Ebola resources.
--
7 Oct 2014: (Heritage) The Government of Liberia (GoL) through the Ministry of Finance and Development Planning (MFDP) has commenced the process for the selection and appointment of an independent "Fiduciary Agent" to assist the government with the financial management of the Ebola Trust Fund. An MFDP release says the decision to contract an independent financial management firm was intended to uphold government's commitment to full transparency and accountability as announced recently by Liberia's Minister of Finance and Development Planning, Amara M Konneh.
According to Minister Konneh, the firm selected to provide the fiduciary service would manage the fund and supervise accounting related services, under the direction of the Minister of Finance and Development Planning, under the multi-donor governance structure. The release says it would be required to set up a sound financial management system to accurately record and report on all funds received and disbursed from the Trust Fund and providing regular fund management report.
The Firm would also provide oversight of all procurement functions to ensure compliance with established guidelines of the government as well as those of development partners ... The GoL in response to the Ebola Virus epidemic established the Ebola Trust Fund (ETF) at the Central of Bank of Liberia (CBL) in a bid to attract resources from the government, private citizens and international donors. The Fund was created with an initial USD 5 million injection through a loan facility from the Central Bank of Liberia. To date, the fund has raised over USD 10 million, with more donations expected from foreign partners and friendly governments in coming weeks. Recently, the Liberian government announced it needed USD 375 million to effectively fund its National Ebola Response and Restoration of Basic Health Services strategy.
http://allafrica.com/stories/201410071869.html
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[7] Sex after Ebola
Date: Tue 7 Oct 2014
Source: Reuters [edited]
https://uk.news.yahoo.com/male-ebola-su ... ml#wuBlTys
Sex could keep the Ebola epidemic alive even after the World Health Organization (WHO) declares an area free of the disease, one of the discoverers of the deadly virus said on Tue [7 Oct 2014].
The WHO is hoping to announce later this week that Nigeria and Senegal are free of Ebola after 42 days with no infections -- the standard period for declaring an outbreak over, twice the maximum 21-day incubation period of the virus. However, it appears the disease can last much longer in semen.
"In a convalescent male, the virus can persist in semen for at least 70 days; one study suggests persistence for more than 90 days," the WHO said in an information note on Mon [6 Oct 2014] [see item [1] WHO Ebola situation assessment - 6 Oct 2014 in ProMED-mail posting Ebola virus disease - West Africa (188): international cases, Liberia, clinical 20141007.2837773 - Mod.JW]
"Certainly, the advice has to be for survivors to use a condom, to not have unprotected sex, for 90 days," said Peter Piot, a professor at the London School of Hygiene and Tropical Medicine and a discoverer of Ebola in 1976. "If we would apply the rule for double the time, that would be 180 days -- 6 months. I think it (90 days) is probably a compromise, for practicality," he told a news conference in Geneva.
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[It didn't keep Ebola going in the Congo after the original outbreak in 1976, or after the Kikwit outbreak in 1995, or after any other outbreak in the Congo or Uganda between 1976 and now.
Reference
---------
Rowe AK, Bertolli J, Khan AS, et al: Clinical, virologic, and immunologic follow-up of convalescent Ebola hemorrhagic fever patients and their household contacts, Kikwit, Democratic Republic of the Congo. J Infect Dis. 1999; 179 Suppl 1: S28-35; available at http://jid.oxfordjournals.org/content/1 ... 1/S28.full
"Evidence of Ebola virus was detected by reverse transcription -- polymerase chain reaction in semen specimens up to 91 days after disease onset; however, these and all other non-blood body fluids tested negative by virus isolation. Among 81 initially antibody negative HHCs [household contacts] , none became antibody positive."
Also note:
"Blood specimens of 5 HHCs not identified as EHF [Ebola hemorrhagic fever; now Ebola virus disease] patients were initially antibody positive. No direct evidence of convalescent-to-HHC transmission of EHF was found, although the semen of convalescents may be infectious. The existence of initially antibody-positive HHCs suggests that mild cases of Ebola virus infection occurred and that the full extent of the EHF epidemic was probably underestimated."
- Mod.JW]
******
[8] OIE experts review current knowledge on Ebola reservoir
Date: Mon 6 Oct 2014
Source: OIE (World Organisation for Animal Health) press releases [edited]
http://www.oie.int/en/for-the-media/pre ... us-disease
The World Organisation for Animal Health (OIE) has issued a technical information sheet on Ebola virus disease outlining epidemiological observations and scientific knowledge of the disease including the animal reservoir.
The OIE technical information sheet on Ebola virus disease has been prepared and reviewed by internationally regarded scientific experts, including experts from OIE global Reference Centres and Working Group on wildlife, and was subsequently endorsed by the OIE Scientific Commission on Animal Diseases.
Ebola virus disease (EVD), also known as Ebola haemorrhagic fever is a severe contagious disease affecting humans and non-human primates, such as gorillas, chimpanzees and some other monkeys. It mainly occurs in the Central and West African regions and can be transmitted to humans from an infected animal or human. Hence, Ebola virus disease is a zoonosis and poses significant threats to public health by causing hemorrhagic fever outbreaks in humans with a high case fatality rate. At present, there is no licensed therapeutic or vaccine for humans. Experimental drugs and vaccines are being developed.
The virus was reported again in humans at the beginning of 2014 in Guinea and then Liberia. It has since then spread to Sierra Leone and most recently to Nigeria to become the largest Ebola outbreak in history and the 1st in West Africa. In August 2014, the WHO declared the outbreak as an international health emergency. An unrelated outbreak was also reported in Democratic Republic of Congo (DRC).
Although the strain causing the current outbreak has resulted in an unprecedented number of fatalities, the initial source of the virus remains unclear. However it is likely that the initial introduction to the human population was from a wild animal source to a single person. The disease is now being transmitted between humans and there is no evidence that animals continue to play a role in spreading the virus.
Field studies and epidemiological surveys demonstrate that the natural reservoir hosts for this virus may be fruit bats, without showing clinical signs. These results still need to be further investigated.
Ebola is most likely initially transmitted from animals such as bats and non-human primates to humans through hunting and collection of sick or dead wild animals and handling or consumption of uncooked bush meat. In rural areas fruit bats are a popular source of forest meat for humans and are prepared by hand to be dried, smoked, and/or cooked. Infection could also be transmitted to humans by handling or consumption of forest fruits contaminated with bat saliva or faeces in affected areas.
Therefore the OIE is in full accordance with World Health Organization (WHO) recommendations to avoid contact with wild animals, including bats, monkeys, and rodents, in affected areas.
The OIE encourages the national Veterinary Services of the countries affected to remain vigilant and develop their involvement towards wildlife. In collaboration with OIE experts, it will continue to work and regularly update guidance to its Members and the public on this disease.
Related links:
WHO fact sheet on Ebola virus
http://www.who.int/mediacentre/factsheets/fs103/en
Link to OIE Information Sheet
http://www.oie.int/fileadmin/Home/fr/Me ... _Final.pdf
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Ebola in Westafrika
EBOLA VIRUS DISEASE - WEST AFRICA (190): LIBERIA, SIERRA LEONE, CHINA MONITORING
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In this update:
[1] Re: Comment in WHO Roadmap 8 Oct 2014
[2] Liberia: 1332 Nigerian soldiers quarantined
[3] Sierra Leone: Chinese holding center
[4] China: arrivals monitoring
*******
[1] Re: Comment in WHO Roadmap 8 Oct 2014
[ProMED Moderator Emeritus Charlie Calisher has pointed out that mortality rates are not expressed as percentages but as rates, say per 1000 or more cases per unit of time. What I actually inserted in this WHO report was a CFR or case fatality rate of 48 percent since the start of the epidemic. But in any case a CFR derived from reported numbers is pretty meaningless, given that neither all the cases nor all the deaths have been lab confirmed, because not all samples are in fit condition to be tested after a long trip to a lab, and I understand the labs have been pretty overwhelmed up to now. Many new fully staffed labs are now arriving, but they will be hard pressed to keep up with the influx of ever more cases. - Mod.JW]
******
[2] Liberia: 1332 Nigerian soldiers quarantined
Date: Fri 10 Oct 2014
Source: AllAfrica, Leadership report [edited]
http://allafrica.com/stories/201410100266.html
The Nigerian Army has revealed that about 1332 of its peace-keeping troops in Liberia have been placed under surveillance following their contact with a Sudanese who later died of the Ebola virus disease (EVD). The director of the Nigerian Army Medical Corps, Major-General Obashina Ogunbiyi stated this in Abuja yesterday [9 Oct 2014]. According to the Army medical officer, the incident followed the death of a Sudanese Muslim man who had come to the camp of the soldiers to lead them in prayer during the Eid-el Fitri celebration, but developed Ebola symptoms the following day and later died.
Ogunbuyi noted that the country remained at risk as any of the soldiers could choose to travel home anytime, saying "that is why the military had to be totally involved in the fight against the Ebola virus."
[Byline: Abiodun Oluwarotimi, Winifred Ogbebo and Victor Okeke]
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[It is difficult to imagine how over 1000 troops can have has skin contact with a single case. - Mod.JW]
******
[3] Sierra Leone: Chinese holding center
Date: Thu 9 Oct 2014
Source: Awoko [edited]
http://awoko.org/2014/10/09/sierra-leon ... well-dr-mu
The 30 man Chinese medical team working at the Jui holding center [near Freetown, Sierra Leone] started working on 1 Oct 2014 and on that day they received 6 patients. In an exclusive interview with Dr Jinsong Mu, who is the leader of the medical group, they have received 42 suspected cases -- 13 were confirmed positive and 7 died -- during the 8 days they have worked.
He explained that when the cases are received they are taken to Area 1 where all of them are kept together until the results are out. After the results are released, the confirmed cases are then moved to Area 2 where they are isolated before being transferred to the treatment center. He complained that "these confirmed cases are told strictly to stay in their room, but these people refuse and will come out of the room walking around which is not good for other patients." Dr Mu explained that after the confirmed cases are taken to the isolation ward, the team then contacts the Command Center who will then send an ambulance to collect and take them to the treatment center.
When asked how they receive patients, Dr Mu said every morning, they hold discussions with the Command Center, which calls them at 8am to know how many patients the holding center will receive. After both parties agree, the Command Center will then send the required number to them for testing.
Dr Mu said because they are working in the same compound with the lab, it is easy for them to receive the results. Most of the cases in the holding centre, he disclosed, will take a maximum of 3 days before they are sent for treatment.
The Chinese head of the medical team said they have 4 doctors and 22 nurses, and currently they have 42 patients. This works out at one doctor for at least 10 patients. He said when a doctor goes into the isolation ward, he is there for about one hour dressed in the protective suits. "I tell you, it is not easy to be in that suit for so long, as it is very inconvenient."
One problem he says they have is people just walking into the hospital without any report from community hospitals or from the central Command. This, he said, is not correct because they need to have prior knowledge of these victims. However, he said, they cannot turn them away and have to accept and check them. While there, 8 patients walked into the hospital complaining that they are infected, so they were taken into the holding center for further tests.
Dr Mu disclosed that they are now training some of their other doctors in the hope that they will be able to assist them in the fight. He also revealed plans to train local doctors if and when they have them. For now, however, they are only working with Sierra Leonean nurses.
Dr Mu said the local nurses are very hard working and he is very proud of them because they are complementing their effort in winning this battle. "I am very happy for them and Dr Alex Kanu as they are really working with us to end this fight."
During the interview, a 7th patient died Wednesday morning [8 Oct 2014] and the burial team arrived 3 hours later, headed by Mr Deen, who Dr Mu said has been very active, and doing his work well because he has collected all the dead patients from the Jui hospital.... Dr Mu said he wants to advise all Sierra Leoneans that Ebola can be cured if they go to the hospital early. He said many people have been cured because they went to the hospital on time.
He complimented the Sierra Leone military for their good job at the treatment center as he heard that 49 patients were [discharged] on Monday [6 Oct 2014]. "I hope more patients will be able to make it out alive so that it will give more confidence to others."
--
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Ryan McGinnis
http://bigstormpicture.com
*******
[4] China: arrivals monitoring
Date: 10 Oct 2015
Source: Sohu News [in Chinese, transl. DS, edited]
http://news.sohu.com/20141011/n404999657.shtml
An article in Chinese media today [10 Oct 2015] reports the case of a patient in Wuhan, a 29-year old worker, returned to China from Nigeria in mid-August [2014]. Experienced fever, muscle aches, vomiting, diarrhoea on day 2 after returning home. Went to hospital in Wuhan where Ebola was ruled out and patient was diagnosed with malaria.
--
Date: 10 Oct 2014
From: Dan Silver
<dgsilver@yahoo.com>
Here's a partial translation of an article from Chengdu, Sichuan describing monitoring of people returning from West Africa. It states that about 60 people have returned to Chengdu from countries with Ebola outbreaks since mid-August [2014]. Looking at Chengdu's ratio to China's total population, we can estimate that maybe 5800 people have returned from those countries to any part of China. For sure, this is an oversimplification (among other things, Chengdu is a major metropolis unlike the vast majority of China). But it gives some idea of how Chinese returnees from West Africa might fit into the global picture. This article also talks a little about China's policies on monitoring of returnees. [see below]
-----
Date: 10 Oct 2014
Source: Sichuan Scol.com
http://sichuan.scol.com.cn/ttxw/content ... m?node=888
Young African man from Ebola outbreak zone coming to Chengdu for PhD: 1st class is 17 days of isolation
------------------------------------------------
"I well understand." [the] 29 year old Nigerian is a new PhD student at Southwest Jiaotong University. Though he says "boring, dry" to describe these 17 days, he still expresses understanding for the isolation. It was learned yesterday that in mid August [2014], Chengdu launched health monitoring of people coming to Chengdu from countries with outbreaks. Now, more than 30 people are undergoing monitoring with a total of 70 having been through it so far ...In fact, "isolation" like [this PhD student] is called "health monitoring" in medical terms and isn't actual medical isolation. From the National Health and Family Planning Commission's "Notice Regarding Ebola Prevention & Control Program (3rd Version)" how medical monitoring for ordinary people merely visiting (returning) to China from outbreak zones, versus those who have had close contact with Ebola cases, is different requires a close look at the details.
...[of the 70] the number of foreigners is less than 10. The majority are Chinese nationals returning from countries with Ebola outbreaks, such as citizens working in West Africa."
--
Communicated by:
Dan Silver
<dgsilver@yahoo.com>
[Luckily, not a single case had been reported as imported, so far. - Mod.JW]
[A HealthMap/ProMED-mail map of Liberia can be accessed at: http://healthmap.org/promed/p/54.
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/2699.]
********************************************************************************
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] Re: Comment in WHO Roadmap 8 Oct 2014
[2] Liberia: 1332 Nigerian soldiers quarantined
[3] Sierra Leone: Chinese holding center
[4] China: arrivals monitoring
*******
[1] Re: Comment in WHO Roadmap 8 Oct 2014
[ProMED Moderator Emeritus Charlie Calisher has pointed out that mortality rates are not expressed as percentages but as rates, say per 1000 or more cases per unit of time. What I actually inserted in this WHO report was a CFR or case fatality rate of 48 percent since the start of the epidemic. But in any case a CFR derived from reported numbers is pretty meaningless, given that neither all the cases nor all the deaths have been lab confirmed, because not all samples are in fit condition to be tested after a long trip to a lab, and I understand the labs have been pretty overwhelmed up to now. Many new fully staffed labs are now arriving, but they will be hard pressed to keep up with the influx of ever more cases. - Mod.JW]
******
[2] Liberia: 1332 Nigerian soldiers quarantined
Date: Fri 10 Oct 2014
Source: AllAfrica, Leadership report [edited]
http://allafrica.com/stories/201410100266.html
The Nigerian Army has revealed that about 1332 of its peace-keeping troops in Liberia have been placed under surveillance following their contact with a Sudanese who later died of the Ebola virus disease (EVD). The director of the Nigerian Army Medical Corps, Major-General Obashina Ogunbiyi stated this in Abuja yesterday [9 Oct 2014]. According to the Army medical officer, the incident followed the death of a Sudanese Muslim man who had come to the camp of the soldiers to lead them in prayer during the Eid-el Fitri celebration, but developed Ebola symptoms the following day and later died.
Ogunbuyi noted that the country remained at risk as any of the soldiers could choose to travel home anytime, saying "that is why the military had to be totally involved in the fight against the Ebola virus."
[Byline: Abiodun Oluwarotimi, Winifred Ogbebo and Victor Okeke]
--
Communicated by:
Ryan McGinnis
http://bigstormpicture.com
[It is difficult to imagine how over 1000 troops can have has skin contact with a single case. - Mod.JW]
******
[3] Sierra Leone: Chinese holding center
Date: Thu 9 Oct 2014
Source: Awoko [edited]
http://awoko.org/2014/10/09/sierra-leon ... well-dr-mu
The 30 man Chinese medical team working at the Jui holding center [near Freetown, Sierra Leone] started working on 1 Oct 2014 and on that day they received 6 patients. In an exclusive interview with Dr Jinsong Mu, who is the leader of the medical group, they have received 42 suspected cases -- 13 were confirmed positive and 7 died -- during the 8 days they have worked.
He explained that when the cases are received they are taken to Area 1 where all of them are kept together until the results are out. After the results are released, the confirmed cases are then moved to Area 2 where they are isolated before being transferred to the treatment center. He complained that "these confirmed cases are told strictly to stay in their room, but these people refuse and will come out of the room walking around which is not good for other patients." Dr Mu explained that after the confirmed cases are taken to the isolation ward, the team then contacts the Command Center who will then send an ambulance to collect and take them to the treatment center.
When asked how they receive patients, Dr Mu said every morning, they hold discussions with the Command Center, which calls them at 8am to know how many patients the holding center will receive. After both parties agree, the Command Center will then send the required number to them for testing.
Dr Mu said because they are working in the same compound with the lab, it is easy for them to receive the results. Most of the cases in the holding centre, he disclosed, will take a maximum of 3 days before they are sent for treatment.
The Chinese head of the medical team said they have 4 doctors and 22 nurses, and currently they have 42 patients. This works out at one doctor for at least 10 patients. He said when a doctor goes into the isolation ward, he is there for about one hour dressed in the protective suits. "I tell you, it is not easy to be in that suit for so long, as it is very inconvenient."
One problem he says they have is people just walking into the hospital without any report from community hospitals or from the central Command. This, he said, is not correct because they need to have prior knowledge of these victims. However, he said, they cannot turn them away and have to accept and check them. While there, 8 patients walked into the hospital complaining that they are infected, so they were taken into the holding center for further tests.
Dr Mu disclosed that they are now training some of their other doctors in the hope that they will be able to assist them in the fight. He also revealed plans to train local doctors if and when they have them. For now, however, they are only working with Sierra Leonean nurses.
Dr Mu said the local nurses are very hard working and he is very proud of them because they are complementing their effort in winning this battle. "I am very happy for them and Dr Alex Kanu as they are really working with us to end this fight."
During the interview, a 7th patient died Wednesday morning [8 Oct 2014] and the burial team arrived 3 hours later, headed by Mr Deen, who Dr Mu said has been very active, and doing his work well because he has collected all the dead patients from the Jui hospital.... Dr Mu said he wants to advise all Sierra Leoneans that Ebola can be cured if they go to the hospital early. He said many people have been cured because they went to the hospital on time.
He complimented the Sierra Leone military for their good job at the treatment center as he heard that 49 patients were [discharged] on Monday [6 Oct 2014]. "I hope more patients will be able to make it out alive so that it will give more confidence to others."
--
Communicated by:
Ryan McGinnis
http://bigstormpicture.com
*******
[4] China: arrivals monitoring
Date: 10 Oct 2015
Source: Sohu News [in Chinese, transl. DS, edited]
http://news.sohu.com/20141011/n404999657.shtml
An article in Chinese media today [10 Oct 2015] reports the case of a patient in Wuhan, a 29-year old worker, returned to China from Nigeria in mid-August [2014]. Experienced fever, muscle aches, vomiting, diarrhoea on day 2 after returning home. Went to hospital in Wuhan where Ebola was ruled out and patient was diagnosed with malaria.
--
Date: 10 Oct 2014
From: Dan Silver
<dgsilver@yahoo.com>
Here's a partial translation of an article from Chengdu, Sichuan describing monitoring of people returning from West Africa. It states that about 60 people have returned to Chengdu from countries with Ebola outbreaks since mid-August [2014]. Looking at Chengdu's ratio to China's total population, we can estimate that maybe 5800 people have returned from those countries to any part of China. For sure, this is an oversimplification (among other things, Chengdu is a major metropolis unlike the vast majority of China). But it gives some idea of how Chinese returnees from West Africa might fit into the global picture. This article also talks a little about China's policies on monitoring of returnees. [see below]
-----
Date: 10 Oct 2014
Source: Sichuan Scol.com
http://sichuan.scol.com.cn/ttxw/content ... m?node=888
Young African man from Ebola outbreak zone coming to Chengdu for PhD: 1st class is 17 days of isolation
------------------------------------------------
"I well understand." [the] 29 year old Nigerian is a new PhD student at Southwest Jiaotong University. Though he says "boring, dry" to describe these 17 days, he still expresses understanding for the isolation. It was learned yesterday that in mid August [2014], Chengdu launched health monitoring of people coming to Chengdu from countries with outbreaks. Now, more than 30 people are undergoing monitoring with a total of 70 having been through it so far ...In fact, "isolation" like [this PhD student] is called "health monitoring" in medical terms and isn't actual medical isolation. From the National Health and Family Planning Commission's "Notice Regarding Ebola Prevention & Control Program (3rd Version)" how medical monitoring for ordinary people merely visiting (returning) to China from outbreak zones, versus those who have had close contact with Ebola cases, is different requires a close look at the details.
...[of the 70] the number of foreigners is less than 10. The majority are Chinese nationals returning from countries with Ebola outbreaks, such as citizens working in West Africa."
--
Communicated by:
Dan Silver
<dgsilver@yahoo.com>
[Luckily, not a single case had been reported as imported, so far. - Mod.JW]
[A HealthMap/ProMED-mail map of Liberia can be accessed at: http://healthmap.org/promed/p/54.
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/2699.]
-
Birgitt
- Moderator
- Beiträge: 35234
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Ebola in Westafrika
EBOLA VIRUS DISEASE - WEST AFRICA (191): LIBERIA, SIERRA LEONE, VOLUNTEERS, VACCINE TESTING
*******************************************************************************************
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: 41 UN staffers now under observation
[2] West Africa: 591 Nigerians to Join Volunteer Group to Fight Virus
[3] Liberia: U.S. Ebola hospitals are going up ... slowly
[4] Mali: Vaccine being tested
[5] Sierra Leone: Officials admit a 'defeat'
******
[1] Liberia: 41 UN staffers now under observation
Date: 11 Oct 2014
Source: O Canada [edited]
http://o.canada.com/news/ebola-41-un-st ... in-liberia
Liberia's United Nations peacekeeping mission has placed 41 staff members, including 20 military personnel, under "close medical observation" after an international member of its medical team was diagnosed with Ebola this week, the 2nd mission member to test positive for the deadly disease. "This measure is precautionary and meant to ensure no possible further transmission of the disease," the mission said in a statement Fri [10 Oct 2014]. "None of the personnel who are contacts have shown any symptoms but will be observed for the full 21-day possible incubation period."
The World Health Organization says 21 days is the maximum incubation period for Ebola, which is spread via the bodily fluids of infected people. The 41 staffers were identified as having possibly come into contact with the member of the medical team, whose name and nationality have not been disclosed.
The patient tested positive Mon [6 Oct 2014] and arrived in Germany Thu [9 Oct 2014] for treatment, the 3rd Ebola patient to be flown there. The St. Georg Hospital in Leipzig said this week the patient would be placed in a special isolation unit.
[Byline: Jonathan Paye-Layleh]
--
Communicated by:
Ebola News Digest
http://eboladigest.blogspot.com
******
[2] West Africa: 591 Nigerians to Join Volunteer Group to Fight Virus
Date: 10 Oct 2014
Source: Bella Naija [edited]
http://www.bellanaija.com/2014/10/10/eb ... erra-leone
Nigeria's success in containing the Ebola virus disease has been hugely lauded by governments all around the world. Through the formation of an international volunteer group, the country is set to impart its knowledge and techniques about battling the virus to the countries that are most affected by the deadly disease: Liberia, Guinea, and Sierra Leone. A total of 591 Nigerians have registered to join the Ebola volunteer group, which will be deployed to the aforementioned countries, The Nation reports. Minister of Health Onyebuchi Chukwu made the announcement yesterday [9 Oct 2014] while giving updates about eradication of Ebola.
Nigerian volunteers from different heath professions have been registering with us, willing to join the international force that will go to Liberia, Sierra Leone and Guinea to help out with the containment, and as of now, 591 Nigerians have already registered with us in 3 registers we opened in Lagos, Abuja, and Port Harcourt. Before we allow them to leave, certain conditions must be met; the President has to approve for them to leave Nigeria as volunteers." Secondly, they have to be given proper training on how they would avoid the disease and ensure that they don't get it. They have to be fully and properly trained according to our standards in Nigeria, which are fairly high," he said.
--
Communicated by:
Ebola News Digest
http://eboladigest.blogspot.com
[This will be a very significant contribution to the boots on the ground when they arrive. - Mod.JW]
******
[3] Liberia: U.S. Ebola hospitals are going up ... slowly
Date: 7 Oct 2014 [note date]
Source: NPR [edited]
Last month [September 2014], the United States made 2 promises to Liberia. On 8 Sep 2014, Obama pledged that the U.S. would construct a 25-bed hospital outside Monrovia, the capital, to treat health care workers. They've been bearing the brunt of the outbreak: In Liberia alone, at least 188 health workers have been infected, and 94 have died. Then, on 16 Sep 2014, Obama announced a massive response to the outbreak, involving thousands of U.S. troops on the ground to train health care workers, deliver relief supplies, and build 17 Ebola treatment centers for the general public.
At the time of the announcement, Obama stressed that time is of the essence... Yet progress on the hospitals has been slow. As NPR's Jason Beaubien reports from Liberia, a month later, workers are still spreading gravel on the construction site of the 25-bed hospital. Standing on the side are dozens of locals looking for work. Without health care workers, the hospital won't be able to open its doors.
NPR's Nurith Aizenman is in Anniston, Ala., [USA] where officers from the U.S. Public Health Services, who will run the hospital, are [going] to get trained by CDC. Right now, she tells Morning Edition's Steve Inskeep, only 8 of the 65 people needed are there. "Quite a number of [officers] are being delayed for all sorts of reasons," she says. "I'm told not all of them have passports; they have to get all the vaccinations that you need to work in West Africa, so they're not scheduled to get this training for another 2 weeks."
And this round of training is just the preliminary 3-day course. "There's more training to come," she says. At this rate, the earliest the hospital can open its doors for business is possibly around the end of October [2014], about 7 weeks after the hospital was promised. "Maybe that is a reasonable amount of time to staff up a hospital from scratch," Aizenman says, "but reasonable amounts of time are a luxury that we don't really have in this outbreak." The 17 other treatment units that Obama promised are also under construction, though Beaubien reports that the U.S. military [only] expects those to be fully operational in 60 to 90 days...
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[I suppose torrential rain and heavy equipment breakdowns are responsible for the construction delays. I would have thought that passports and visas would be expedited, and that AfriCom soldiers would have already had all the required vaccinations to permit rapid deployment in emergency (my personal opinion, not necessarily that of ProMED). Yellow fever shots have to be given 10 days before arrival to be valid. - Mod.JW]
******
[4] Mali: Vaccine being tested
Date: 11 Oct 2014
Source: The Verge [edited]
http://www.theverge.com/2014/10/11/6962 ... est-africa
Mali has no known Ebola [virus disease] cases, though it shares a border with Guinea, the nation in which the outbreak began. According to The Guardian, 3 healthcare workers there have been given the experimental vaccine to test that it has no adverse effects. It's reported that 37 more workers will receive the vaccine in the coming weeks before it can be used in Ebola-stricken nations. The efficacy of the vaccine will largely remain unknown until it is used in areas hit with the virus.
The vaccine, manufactured by GlaxoSmithKline and developed by the National Institute of Allergy and Infectious Diseases in Maryland, has been fast-tracked in hopes that it can help turn the tide in the battle against the virus. Just a couple of weeks ago, it was tested on volunteers in the US and UK. Last month [September 2014], it was successfully tested in monkeys with no ill effects. It's not unusual for a typical vaccine to take as long as a year to go through the same process.
It's said that as many as 10 000 doses of the vaccine, which uses a [common] cold virus to deliver a inactive portion of the ebolavirus to the body, could be ready by year's end [2014]. The focus, however, is on protecting doctors and other healthcare workers in the region, with hopes that a reliable vaccine could bring more health workers to the area.
[Byline: Dante D'Orazio]
--
Communicated by:
Ebola News Digest
http://eboladigest.blogspot.com
[A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/54.]
******
[5] Sierra Leone: Officials admit a 'defeat'
Date: 11 Oct 2014
Source: NY Times [edited]
http://www.nytimes.com/2014/10/11/world ... .html?_r=1
Acknowledging a major "defeat" in the fight against Ebola, international health officials battling the epidemic in Sierra Leone approved plans on Friday [10 Oct 2014] to help families tend to patients at home, recognizing that they are overwhelmed and have little chance of getting enough treatment beds in place quickly to meet the surging need.
The decision signifies a significant shift in the struggle against the rampaging disease. Officials said they would begin distributing painkillers, rehydrating solution and gloves to hundreds of Ebola-afflicted households in Sierra Leone, contending that the aid arriving here was not fast or extensive enough to keep up with an outbreak that doubles in size every month or so.
"It's basically admitting defeat," said Dr. Peter H. Kilmarx, the leader of the federal Centers for Disease Control and Prevention's [CDC] team in Sierra Leone, adding that it was "now [Sierra Leone's] national policy that we should take care of these people at home. For the clinicians, it's admitting failure, but we are responding to the need," Dr. Kilmarx said. "There are hundreds of people with Ebola that we are not able to bring into a facility."...
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[The HealthMap/ProMED map of Sierra Leone can be found 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: 41 UN staffers now under observation
[2] West Africa: 591 Nigerians to Join Volunteer Group to Fight Virus
[3] Liberia: U.S. Ebola hospitals are going up ... slowly
[4] Mali: Vaccine being tested
[5] Sierra Leone: Officials admit a 'defeat'
******
[1] Liberia: 41 UN staffers now under observation
Date: 11 Oct 2014
Source: O Canada [edited]
http://o.canada.com/news/ebola-41-un-st ... in-liberia
Liberia's United Nations peacekeeping mission has placed 41 staff members, including 20 military personnel, under "close medical observation" after an international member of its medical team was diagnosed with Ebola this week, the 2nd mission member to test positive for the deadly disease. "This measure is precautionary and meant to ensure no possible further transmission of the disease," the mission said in a statement Fri [10 Oct 2014]. "None of the personnel who are contacts have shown any symptoms but will be observed for the full 21-day possible incubation period."
The World Health Organization says 21 days is the maximum incubation period for Ebola, which is spread via the bodily fluids of infected people. The 41 staffers were identified as having possibly come into contact with the member of the medical team, whose name and nationality have not been disclosed.
The patient tested positive Mon [6 Oct 2014] and arrived in Germany Thu [9 Oct 2014] for treatment, the 3rd Ebola patient to be flown there. The St. Georg Hospital in Leipzig said this week the patient would be placed in a special isolation unit.
[Byline: Jonathan Paye-Layleh]
--
Communicated by:
Ebola News Digest
http://eboladigest.blogspot.com
******
[2] West Africa: 591 Nigerians to Join Volunteer Group to Fight Virus
Date: 10 Oct 2014
Source: Bella Naija [edited]
http://www.bellanaija.com/2014/10/10/eb ... erra-leone
Nigeria's success in containing the Ebola virus disease has been hugely lauded by governments all around the world. Through the formation of an international volunteer group, the country is set to impart its knowledge and techniques about battling the virus to the countries that are most affected by the deadly disease: Liberia, Guinea, and Sierra Leone. A total of 591 Nigerians have registered to join the Ebola volunteer group, which will be deployed to the aforementioned countries, The Nation reports. Minister of Health Onyebuchi Chukwu made the announcement yesterday [9 Oct 2014] while giving updates about eradication of Ebola.
Nigerian volunteers from different heath professions have been registering with us, willing to join the international force that will go to Liberia, Sierra Leone and Guinea to help out with the containment, and as of now, 591 Nigerians have already registered with us in 3 registers we opened in Lagos, Abuja, and Port Harcourt. Before we allow them to leave, certain conditions must be met; the President has to approve for them to leave Nigeria as volunteers." Secondly, they have to be given proper training on how they would avoid the disease and ensure that they don't get it. They have to be fully and properly trained according to our standards in Nigeria, which are fairly high," he said.
--
Communicated by:
Ebola News Digest
http://eboladigest.blogspot.com
[This will be a very significant contribution to the boots on the ground when they arrive. - Mod.JW]
******
[3] Liberia: U.S. Ebola hospitals are going up ... slowly
Date: 7 Oct 2014 [note date]
Source: NPR [edited]
Last month [September 2014], the United States made 2 promises to Liberia. On 8 Sep 2014, Obama pledged that the U.S. would construct a 25-bed hospital outside Monrovia, the capital, to treat health care workers. They've been bearing the brunt of the outbreak: In Liberia alone, at least 188 health workers have been infected, and 94 have died. Then, on 16 Sep 2014, Obama announced a massive response to the outbreak, involving thousands of U.S. troops on the ground to train health care workers, deliver relief supplies, and build 17 Ebola treatment centers for the general public.
At the time of the announcement, Obama stressed that time is of the essence... Yet progress on the hospitals has been slow. As NPR's Jason Beaubien reports from Liberia, a month later, workers are still spreading gravel on the construction site of the 25-bed hospital. Standing on the side are dozens of locals looking for work. Without health care workers, the hospital won't be able to open its doors.
NPR's Nurith Aizenman is in Anniston, Ala., [USA] where officers from the U.S. Public Health Services, who will run the hospital, are [going] to get trained by CDC. Right now, she tells Morning Edition's Steve Inskeep, only 8 of the 65 people needed are there. "Quite a number of [officers] are being delayed for all sorts of reasons," she says. "I'm told not all of them have passports; they have to get all the vaccinations that you need to work in West Africa, so they're not scheduled to get this training for another 2 weeks."
And this round of training is just the preliminary 3-day course. "There's more training to come," she says. At this rate, the earliest the hospital can open its doors for business is possibly around the end of October [2014], about 7 weeks after the hospital was promised. "Maybe that is a reasonable amount of time to staff up a hospital from scratch," Aizenman says, "but reasonable amounts of time are a luxury that we don't really have in this outbreak." The 17 other treatment units that Obama promised are also under construction, though Beaubien reports that the U.S. military [only] expects those to be fully operational in 60 to 90 days...
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[I suppose torrential rain and heavy equipment breakdowns are responsible for the construction delays. I would have thought that passports and visas would be expedited, and that AfriCom soldiers would have already had all the required vaccinations to permit rapid deployment in emergency (my personal opinion, not necessarily that of ProMED). Yellow fever shots have to be given 10 days before arrival to be valid. - Mod.JW]
******
[4] Mali: Vaccine being tested
Date: 11 Oct 2014
Source: The Verge [edited]
http://www.theverge.com/2014/10/11/6962 ... est-africa
Mali has no known Ebola [virus disease] cases, though it shares a border with Guinea, the nation in which the outbreak began. According to The Guardian, 3 healthcare workers there have been given the experimental vaccine to test that it has no adverse effects. It's reported that 37 more workers will receive the vaccine in the coming weeks before it can be used in Ebola-stricken nations. The efficacy of the vaccine will largely remain unknown until it is used in areas hit with the virus.
The vaccine, manufactured by GlaxoSmithKline and developed by the National Institute of Allergy and Infectious Diseases in Maryland, has been fast-tracked in hopes that it can help turn the tide in the battle against the virus. Just a couple of weeks ago, it was tested on volunteers in the US and UK. Last month [September 2014], it was successfully tested in monkeys with no ill effects. It's not unusual for a typical vaccine to take as long as a year to go through the same process.
It's said that as many as 10 000 doses of the vaccine, which uses a [common] cold virus to deliver a inactive portion of the ebolavirus to the body, could be ready by year's end [2014]. The focus, however, is on protecting doctors and other healthcare workers in the region, with hopes that a reliable vaccine could bring more health workers to the area.
[Byline: Dante D'Orazio]
--
Communicated by:
Ebola News Digest
http://eboladigest.blogspot.com
[A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/54.]
******
[5] Sierra Leone: Officials admit a 'defeat'
Date: 11 Oct 2014
Source: NY Times [edited]
http://www.nytimes.com/2014/10/11/world ... .html?_r=1
Acknowledging a major "defeat" in the fight against Ebola, international health officials battling the epidemic in Sierra Leone approved plans on Friday [10 Oct 2014] to help families tend to patients at home, recognizing that they are overwhelmed and have little chance of getting enough treatment beds in place quickly to meet the surging need.
The decision signifies a significant shift in the struggle against the rampaging disease. Officials said they would begin distributing painkillers, rehydrating solution and gloves to hundreds of Ebola-afflicted households in Sierra Leone, contending that the aid arriving here was not fast or extensive enough to keep up with an outbreak that doubles in size every month or so.
"It's basically admitting defeat," said Dr. Peter H. Kilmarx, the leader of the federal Centers for Disease Control and Prevention's [CDC] team in Sierra Leone, adding that it was "now [Sierra Leone's] national policy that we should take care of these people at home. For the clinicians, it's admitting failure, but we are responding to the need," Dr. Kilmarx said. "There are hundreds of people with Ebola that we are not able to bring into a facility."...
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[The HealthMap/ProMED map of Sierra Leone can be found at: http://healthmap.org/promed/p/46.]
-
Birgitt
- Moderator
- Beiträge: 35234
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Ebola in Westafrika
Epidemie weitet sich aus - WHO fürchtet Tausende neue Ebola-FälleDie Weltgesundheitsorganisation (WHO) befürchtet in den nächsten Wochen rasant steigende Zahlen von Ebola-Erkrankungen. Im Dezember könnten jede Woche bis zu 10.000 neue Infektionen hinzukommen, sollte der Kampf gegen das tödliche Virus nicht binnen zwei Monaten verstärkt werden, erklärte der stellvertretende WHO-Generaldirektor Bruce Aylward. Die Krankheit habe im Laufe einer Monatsfrist weitere Kreise und Distrikte erfasst, die Sterberate sei auf 70 Prozent gestiegen.
14.10.2014 - tagesschau
Gruß
Birgitt
-
Birgitt
- Moderator
- Beiträge: 35234
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Ebola in Westafrika - Aktuelle Infos via Whatsapp
BBC launches WhatsApp Ebola serviceThe BBC has launched an Ebola public health information service on WhatsApp, aimed at users of the service in West Africa. The service will provide audio, text message alerts and images to help people get the latest public health information to combat the spread of Ebola in the region. Content will be limited to three items a day, and the service will be in English and French.
To subscribe, send 'JOIN' via WhatsApp to +44 7702 348 651
To unsubscribe, send 'STOP' via WhatsApp to the same number.
As the biggest "chat app" in use in Africa, the platform is being used as a means of reaching people in the region directly through their mobile phones.
16.10.2014 - BBC
BBC versendet ab sofort via Whatsapp aktuelle Infos zur Ebola-Epidemie in Westafrika.
Um sich dort zu registrieren reicht es, über Whatsapp die Nachricht "JOIN" an die Nummer +44 7702 348 651 zu senden. Wenn man sich von diesem Service wieder abmelden möchte ist es ausreichend, an die angegebene Nummer den Text "STOP" zu senden.
Gruß
Birgitt
-
Birgitt
- Moderator
- Beiträge: 35234
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Ebola - Guinea, Liberia, Sierra Leone, Nigeria, Senegal
EBOLA VIRUS DISEASE - WEST AFRICA (192): WHO, SIERRA LEONE SOLDIER, MSF, NEW DRUG
*********************************************************************************
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: Ebola Response Roadmap Situation Report 15 Oct 2014
[2] WHO: Are the Ebola outbreaks in Nigeria and Senegal over?
[3] Sierra Leone: soldier positive; other contacts self-quarantined
[4] MSF reaching limit
[5] China: new drug
[6] Prevention & false alarms
******
[1] WHO: Ebola Response Roadmap Situation Report 15 Oct 2014
Date: Wed 15 Oct 2014
Source: WHO Situation report - 15 October 2014
http://apps.who.int/iris/bitstream/1066 ... 4.pdf?ua=1
Ebola Response Roadmap Situation Report 15 Oct 2014 [data as of end of 12 Oct 2014]
----------------------------------------------------------------------
A total of 8997 confirmed, probable, and suspected cases of Ebola virus disease (EVD) have been reported in 7 affected countries (Guinea, Liberia, Nigeria, Senegal, Sierra Leone, Spain, and the USA) up to the end of 12 Oct [2014]. There have been 4493 deaths.
Data for epidemiological week 41 are incomplete, with missing data for 12 Oct [2014] from Liberia. This reflects the challenging nature of data gathering in countries with widespread and intense EVD transmission. These challenges remain particularly acute in Liberia, where there continues to be a mismatch between the relatively low numbers of new cases reported through official clinical surveillance systems on one hand, and reports from laboratory staff and 1st responders of large numbers of new cases on the other. Efforts are ongoing to reconcile different sources of data, and to rapidly scale-up capacity for epidemiological data gathering throughout each country with widespread and intense transmission.
It is clear, however, that the situation in Guinea, Liberia, and Sierra Leone is deteriorating, with widespread and persistent transmission of EVD. An increase in new cases in Guinea is being driven by a spike in confirmed and suspected cases in the capital, Conakry, and the nearby district of Coyah. In Liberia, problems with data gathering make it hard to draw any firm conclusions from recent data. There is almost certainly significant under-reporting of cases from the capital Monrovia. There does appear to have been a genuine fall in the number of cases in Lofa district, but a concerted effort will be required to sustain that drop in cases and translate it into an elimination of EVD in that area. In Sierra Leone, intense transmission is still occurring in the capital Freetown and the surrounding districts.
Of the countries with localized transmission, Nigeria and Senegal are now approaching 42 days since the date of last potential contact with a probable or confirmed case. Both Spain and the United States continue to monitor potential contacts... -- more
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[This report is full of very detailed tables and graphs, but they are built on admittedly uncertain data; for example, Sierra Leone has officially reported 120 more probable deaths than probable cases, and Liberia does not provide official data breaking down its 2458 deaths into confirmed, probable, and suspected deaths. - Mod.JW]
******
[2] WHO: Are the Ebola outbreaks in Nigeria and Senegal over?
Date: Tue 14 Oct 2014
Source: WHO, News Situation assessments: Ebola virus disease [edited]
http://who.int/mediacentre/news/ebola/1 ... er-2014/en
Are the Ebola outbreaks in Nigeria and Senegal over?
----------------------------------------------------
Not quite yet.
If the active surveillance for new cases that is currently in place continues, and no new cases are detected, WHO will declare the end of the outbreak of Ebola virus disease in Senegal on Fri 17 Oct [2014]. Likewise, Nigeria is expected to have passed through the requisite 42 days, with active surveillance for new cases in place and none detected, on Mon 20 Oct [2014]... -- more
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[Fingers crossed. - Mod.JW]
******
[3] Sierra Leone: soldier positive; other contacts self-quarantined
Date: Tue 14 Oct 2014
Source: WTOP, Associated Press (AP) report [edited]
http://wtop.com/?nid=1235&sid=3721819
A Sierra Leone soldier has tested positive for Ebola but he is not a member of, and had no contact with, a battalion of peacekeepers waiting to deploy to Somalia, a government spokesman said Tue 14 Oct 2014]. Meanwhile, Liberia's transport minister said she was voluntarily isolating herself inside her home after her driver died of Ebola. The 2 situations underscore the precautions being taken to minimize the spread of the deadly disease, and the risks inherent in the movement of people.
In another example of the disease's relentless march, Doctors Without Borders [MSF] said Tue [14 Oct 2014] that 16 of its staff members have been infected with Ebola and that 9 have died [2 were internationals, both under treatment overseas. - Mod.JW] The toll highlights the high risk of caring for Ebola patients even at well-equipped and properly staffed treatment centers.
Angela Bush, Liberia's transport minister, said her last contact with her driver, who died over the weekend [11-12 Oct 2014] of the disease, was on 3 Oct 2014. She did not know he was sick with Ebola until after his death, she said. She is not showing any symptoms of the disease, but Liberia's government has asked people to keep themselves isolated for 21 days if they think they have been exposed. The country's chief medical officer put herself under quarantine about 2 weeks ago, after her office assistant died of Ebola.
Fear of Ebola's spread has already slowed the deployment of a battalion of Sierra Leone troops, who were supposed to relieve soldiers serving with an African Union [AU] mission to protect the Somali government and fight al-Shabab militants. The replacements' deployment was put on hold this summer [2014] when the Ebola outbreak in West Africa spiraled out of control. Earlier this month [October 2014], Osman Keh Kamara, Sierra Leone's ambassador to Ethiopia, where the AU has its headquarters, pleaded for the new battalion be allowed to rotate in and relieve their compatriots, saying the troops in Sierra Leone had been held in isolation for 4 months and screened for Ebola.
[Byline: Clarence Roy-Macaulay]
--
Communicated by
Ryan McGinnis
http://bigstormpicture.com
[The trouble is, a person can be incubating an ebolavirus infection without showing any symptoms, and develop them only days after travel. - Mod.JW]
******
[4] MSF reaching limit
Date: Wed 15 Oct 2014
Source: Reuters [edited]
http://reuters.com/article/idUSKCN0I428 ... 5?irpc=932
Medecins Sans Frontieres, a medical charity that has been at the forefront in the fight against Ebola in West Africa, said it was reaching its limit and urgently needed other organizations to step up the efforts against the deadly disease.
The organization currently operates 6 centers in Guinea, Sierra Leone, and Liberia, with a total of 600 beds. Its personnel on the ground have grown from about 650 at the start of August [2014] to about 3000 currently. "We have increased our capacity a lot," said Brice de le Vigne, director of operations for MSF, which is also known as Doctors Without Borders. "Now we have reached our ceiling." De le Vigne called on other actors, such as governments and international organizations, to up their game... -- more
[Byline: Robert-Jan Bartunek]
--
Communicated by
Ryan McGinnis
http://bigstormpicture.com
[I'd give MSF the Nobel Prize for Medicine. - Mod.JW]
******
[5] China: new drug
Date: Wed 15 Oct 2014
Source: Financial Times [edited]
http://www.ft.com/intl/cms/s/0/33012186 ... ab7de.html
China has sent thousands of doses of an experimental anti-Ebola drug developed by the military to Africa. The company manufacturing the drug said it plans to start human clinical trials there soon.
Sihuan Pharmaceutical, the private Chinese company that last week [week of 6 Oct 2014] purchased the rights to commercialise jk-05 from a branch of the People's Liberation Army (PLA), said it began manufacturing the drug after it was approved in August [2014] as a "special drug for military needs."
The Chinese military has already sent enough of the drug to treat 10 000 people to West Africa, according to Dr Huo Caixia, associate president of research and development for Sihuan and head of its Beijing Aohe Drug Research Institute. Sihuan, whose founders are former military doctors, is part owned by Morgan Stanley private equity funds... The drug is being developed to treat Ebola and is not a vaccine. But it also has preventive uses, according to Dr Huo. She said it had passed cell and animal tests, but not human testing... -- more
[Byline: Patti Waldmeir, Clive Cookson]
--
Communicated by:
Jonathan Ezekiel
<jezekiel@his.com>
******
[6] Prevention & false alarms
China: Guangdong designates 27 hospitals to treat Ebola patients
----------------------------------------------------------------
16 Oct 2014: (Guangzhou Daily) Guangdong Province has designated 27 hospitals including Guangdong People's Hospital and 3 case screening and detection labs including Guangdong Province CDC. It has set up clinical therapy, prevention and pathology expert groups, and established contingency plans and guidance on hospital infection prevention and control. It has coordinated with hospitals to prepare negative pressure/laminar flow beds, respirators, negative pressure ambulances, personal protective equipment, masks, and other protective items. At the border, in hospitals, areas where Africans reside, police stations, and hotels it has placed nearly 200 000 Chinese-English-French language flyers and health information.
[Byline: He Xuehua]
http://news.dayoo.com/guangzhou/201410/ ... 493193.htm [in Chinese, trans. & summ. Rappt.DS]
[This all sounds exemplary. Guangdong province is currently suffering a huge epidemic of dengue (see ProMED reports), with 3 deaths from hemorrhagic fever, which could have been confused with Ebola if not lab confirmed as dengue (see http://paper.people.com.cn/smsb/html/20 ... 484434.htm [in Chinese]. See below. - Mod.JW]
---
China: fatal hemorrhagic fever, Guangzhou
-----------------------------------------
16 Sep 2014: (Southern Metropolis Daily) A 43-year-old woman from Yuexiu District [Guangzhou] was diagnosed with DHF [dengue hemorrhagic fever or severe dengue]. When she arrived at People's Number 8 Hospital on 4 Sep 2014, her lower body had already started hemorrhaging and her liver, kidney, and heart function were seriously compromised.
http://news.sohu.com/20140916/n404347584.shtml [in Chinese, trans. & summ. Rappt.DS]
[Sounds like Ebola, doesn't it -- but presumably it was lab confirmed to be dengue. - Mod.JW]
---
China: false alarms as of October 2014
--------------------------------------
14 Oct 2014: (Jinghua) Yesterday morning [13 Oct 2014], Beijing CDC reported public health information for September [2014]. Up to now, the city has ruled out Ebola in 30 patients placed under observation... [Those] who return from Africa with temperatures reaching 37.3 deg C [99.1 deg F] can be placed under observation with tests then carried out in laboratories... Test results in all patients placed under observation for Ebola have been negative.
[Byline: Gong Mian]
http://epaper.jinghua.cn/html/2014-10/1 ... 134637.htm [in Chinese, trans. & summ. Rappt.DS]
---
China: travel history suppressed (August 2014)
----------------------------------------------
A case of malaria was reported in a Wuhan patient who had returned from a tour in Africa (Niger) [NOT Nigeria], in mid-August [2014]. He was fearful that he might have contracted Ebola and would be placed in isolation. He withheld his travel history for 5 days while being treated for cold/flu. After revealing that he was in Africa, he was tested and found to have malaria.
http://roll.sohu.com/20140911/n404222113.shtml [in Chinese, trans. & summ. Rappt.DS]
[The patient appears not to have understood that Niger and Nigeria are different countries. But if he had in fact been in Nigeria, this was a potentially dangerous suppression of travel history, both from the treatment and contact point of view.
A map showing Niger across the northern border of Nigeria can be seen at http://www.african-politics.com/wp-cont ... -niger.jpg. - Mod.JW]
---
China: 4 being monitored
------------------------
15 Oct 2014: (Nanhai Network) The Health & Family Planning Commission and the Public Security Bureau of Hainan Province are conducting health monitoring of 4 people who entered China from countries with Ebola outbreaks. 2 dedicated personnel are responsible for health monitoring. At this time, Hainan has no suspected or confirmed Ebola cases.
[Byline: Liu Mai]
http://www.hinews.cn/news/system/2014/1 ... 4821.shtml [in Chinese, trans. & summ. Rappt.DS]
[This presumably means they are having their temperatures checked twice daily. China's official threshold for triggering testing is 37.3 deg C [99.1 deg F], see above -- much lower than in the USA. - Mod.JW]
---
Sierra Leone: UK cancels resumption of direct flights
-----------------------------------------------------
13 Oct 2014: (Guardian UK) Department of Transport cites deteriorating public health for revoking Gambia Bird's licence to fly [from UK] to Ebola-hit country... -- more
http://www.theguardian.com/world/2014/o ... ambia-bird
[To quote MSF about this move: "this is very unhelpful" -- a classically British understatement. - Mod.JW]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[
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] WHO: Ebola Response Roadmap Situation Report 15 Oct 2014
[2] WHO: Are the Ebola outbreaks in Nigeria and Senegal over?
[3] Sierra Leone: soldier positive; other contacts self-quarantined
[4] MSF reaching limit
[5] China: new drug
[6] Prevention & false alarms
******
[1] WHO: Ebola Response Roadmap Situation Report 15 Oct 2014
Date: Wed 15 Oct 2014
Source: WHO Situation report - 15 October 2014
http://apps.who.int/iris/bitstream/1066 ... 4.pdf?ua=1
Ebola Response Roadmap Situation Report 15 Oct 2014 [data as of end of 12 Oct 2014]
----------------------------------------------------------------------
A total of 8997 confirmed, probable, and suspected cases of Ebola virus disease (EVD) have been reported in 7 affected countries (Guinea, Liberia, Nigeria, Senegal, Sierra Leone, Spain, and the USA) up to the end of 12 Oct [2014]. There have been 4493 deaths.
Data for epidemiological week 41 are incomplete, with missing data for 12 Oct [2014] from Liberia. This reflects the challenging nature of data gathering in countries with widespread and intense EVD transmission. These challenges remain particularly acute in Liberia, where there continues to be a mismatch between the relatively low numbers of new cases reported through official clinical surveillance systems on one hand, and reports from laboratory staff and 1st responders of large numbers of new cases on the other. Efforts are ongoing to reconcile different sources of data, and to rapidly scale-up capacity for epidemiological data gathering throughout each country with widespread and intense transmission.
It is clear, however, that the situation in Guinea, Liberia, and Sierra Leone is deteriorating, with widespread and persistent transmission of EVD. An increase in new cases in Guinea is being driven by a spike in confirmed and suspected cases in the capital, Conakry, and the nearby district of Coyah. In Liberia, problems with data gathering make it hard to draw any firm conclusions from recent data. There is almost certainly significant under-reporting of cases from the capital Monrovia. There does appear to have been a genuine fall in the number of cases in Lofa district, but a concerted effort will be required to sustain that drop in cases and translate it into an elimination of EVD in that area. In Sierra Leone, intense transmission is still occurring in the capital Freetown and the surrounding districts.
Of the countries with localized transmission, Nigeria and Senegal are now approaching 42 days since the date of last potential contact with a probable or confirmed case. Both Spain and the United States continue to monitor potential contacts... -- more
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[This report is full of very detailed tables and graphs, but they are built on admittedly uncertain data; for example, Sierra Leone has officially reported 120 more probable deaths than probable cases, and Liberia does not provide official data breaking down its 2458 deaths into confirmed, probable, and suspected deaths. - Mod.JW]
******
[2] WHO: Are the Ebola outbreaks in Nigeria and Senegal over?
Date: Tue 14 Oct 2014
Source: WHO, News Situation assessments: Ebola virus disease [edited]
http://who.int/mediacentre/news/ebola/1 ... er-2014/en
Are the Ebola outbreaks in Nigeria and Senegal over?
----------------------------------------------------
Not quite yet.
If the active surveillance for new cases that is currently in place continues, and no new cases are detected, WHO will declare the end of the outbreak of Ebola virus disease in Senegal on Fri 17 Oct [2014]. Likewise, Nigeria is expected to have passed through the requisite 42 days, with active surveillance for new cases in place and none detected, on Mon 20 Oct [2014]... -- more
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[Fingers crossed. - Mod.JW]
******
[3] Sierra Leone: soldier positive; other contacts self-quarantined
Date: Tue 14 Oct 2014
Source: WTOP, Associated Press (AP) report [edited]
http://wtop.com/?nid=1235&sid=3721819
A Sierra Leone soldier has tested positive for Ebola but he is not a member of, and had no contact with, a battalion of peacekeepers waiting to deploy to Somalia, a government spokesman said Tue 14 Oct 2014]. Meanwhile, Liberia's transport minister said she was voluntarily isolating herself inside her home after her driver died of Ebola. The 2 situations underscore the precautions being taken to minimize the spread of the deadly disease, and the risks inherent in the movement of people.
In another example of the disease's relentless march, Doctors Without Borders [MSF] said Tue [14 Oct 2014] that 16 of its staff members have been infected with Ebola and that 9 have died [2 were internationals, both under treatment overseas. - Mod.JW] The toll highlights the high risk of caring for Ebola patients even at well-equipped and properly staffed treatment centers.
Angela Bush, Liberia's transport minister, said her last contact with her driver, who died over the weekend [11-12 Oct 2014] of the disease, was on 3 Oct 2014. She did not know he was sick with Ebola until after his death, she said. She is not showing any symptoms of the disease, but Liberia's government has asked people to keep themselves isolated for 21 days if they think they have been exposed. The country's chief medical officer put herself under quarantine about 2 weeks ago, after her office assistant died of Ebola.
Fear of Ebola's spread has already slowed the deployment of a battalion of Sierra Leone troops, who were supposed to relieve soldiers serving with an African Union [AU] mission to protect the Somali government and fight al-Shabab militants. The replacements' deployment was put on hold this summer [2014] when the Ebola outbreak in West Africa spiraled out of control. Earlier this month [October 2014], Osman Keh Kamara, Sierra Leone's ambassador to Ethiopia, where the AU has its headquarters, pleaded for the new battalion be allowed to rotate in and relieve their compatriots, saying the troops in Sierra Leone had been held in isolation for 4 months and screened for Ebola.
[Byline: Clarence Roy-Macaulay]
--
Communicated by
Ryan McGinnis
http://bigstormpicture.com
[The trouble is, a person can be incubating an ebolavirus infection without showing any symptoms, and develop them only days after travel. - Mod.JW]
******
[4] MSF reaching limit
Date: Wed 15 Oct 2014
Source: Reuters [edited]
http://reuters.com/article/idUSKCN0I428 ... 5?irpc=932
Medecins Sans Frontieres, a medical charity that has been at the forefront in the fight against Ebola in West Africa, said it was reaching its limit and urgently needed other organizations to step up the efforts against the deadly disease.
The organization currently operates 6 centers in Guinea, Sierra Leone, and Liberia, with a total of 600 beds. Its personnel on the ground have grown from about 650 at the start of August [2014] to about 3000 currently. "We have increased our capacity a lot," said Brice de le Vigne, director of operations for MSF, which is also known as Doctors Without Borders. "Now we have reached our ceiling." De le Vigne called on other actors, such as governments and international organizations, to up their game... -- more
[Byline: Robert-Jan Bartunek]
--
Communicated by
Ryan McGinnis
http://bigstormpicture.com
[I'd give MSF the Nobel Prize for Medicine. - Mod.JW]
******
[5] China: new drug
Date: Wed 15 Oct 2014
Source: Financial Times [edited]
http://www.ft.com/intl/cms/s/0/33012186 ... ab7de.html
China has sent thousands of doses of an experimental anti-Ebola drug developed by the military to Africa. The company manufacturing the drug said it plans to start human clinical trials there soon.
Sihuan Pharmaceutical, the private Chinese company that last week [week of 6 Oct 2014] purchased the rights to commercialise jk-05 from a branch of the People's Liberation Army (PLA), said it began manufacturing the drug after it was approved in August [2014] as a "special drug for military needs."
The Chinese military has already sent enough of the drug to treat 10 000 people to West Africa, according to Dr Huo Caixia, associate president of research and development for Sihuan and head of its Beijing Aohe Drug Research Institute. Sihuan, whose founders are former military doctors, is part owned by Morgan Stanley private equity funds... The drug is being developed to treat Ebola and is not a vaccine. But it also has preventive uses, according to Dr Huo. She said it had passed cell and animal tests, but not human testing... -- more
[Byline: Patti Waldmeir, Clive Cookson]
--
Communicated by:
Jonathan Ezekiel
<jezekiel@his.com>
******
[6] Prevention & false alarms
China: Guangdong designates 27 hospitals to treat Ebola patients
----------------------------------------------------------------
16 Oct 2014: (Guangzhou Daily) Guangdong Province has designated 27 hospitals including Guangdong People's Hospital and 3 case screening and detection labs including Guangdong Province CDC. It has set up clinical therapy, prevention and pathology expert groups, and established contingency plans and guidance on hospital infection prevention and control. It has coordinated with hospitals to prepare negative pressure/laminar flow beds, respirators, negative pressure ambulances, personal protective equipment, masks, and other protective items. At the border, in hospitals, areas where Africans reside, police stations, and hotels it has placed nearly 200 000 Chinese-English-French language flyers and health information.
[Byline: He Xuehua]
http://news.dayoo.com/guangzhou/201410/ ... 493193.htm [in Chinese, trans. & summ. Rappt.DS]
[This all sounds exemplary. Guangdong province is currently suffering a huge epidemic of dengue (see ProMED reports), with 3 deaths from hemorrhagic fever, which could have been confused with Ebola if not lab confirmed as dengue (see http://paper.people.com.cn/smsb/html/20 ... 484434.htm [in Chinese]. See below. - Mod.JW]
---
China: fatal hemorrhagic fever, Guangzhou
-----------------------------------------
16 Sep 2014: (Southern Metropolis Daily) A 43-year-old woman from Yuexiu District [Guangzhou] was diagnosed with DHF [dengue hemorrhagic fever or severe dengue]. When she arrived at People's Number 8 Hospital on 4 Sep 2014, her lower body had already started hemorrhaging and her liver, kidney, and heart function were seriously compromised.
http://news.sohu.com/20140916/n404347584.shtml [in Chinese, trans. & summ. Rappt.DS]
[Sounds like Ebola, doesn't it -- but presumably it was lab confirmed to be dengue. - Mod.JW]
---
China: false alarms as of October 2014
--------------------------------------
14 Oct 2014: (Jinghua) Yesterday morning [13 Oct 2014], Beijing CDC reported public health information for September [2014]. Up to now, the city has ruled out Ebola in 30 patients placed under observation... [Those] who return from Africa with temperatures reaching 37.3 deg C [99.1 deg F] can be placed under observation with tests then carried out in laboratories... Test results in all patients placed under observation for Ebola have been negative.
[Byline: Gong Mian]
http://epaper.jinghua.cn/html/2014-10/1 ... 134637.htm [in Chinese, trans. & summ. Rappt.DS]
---
China: travel history suppressed (August 2014)
----------------------------------------------
A case of malaria was reported in a Wuhan patient who had returned from a tour in Africa (Niger) [NOT Nigeria], in mid-August [2014]. He was fearful that he might have contracted Ebola and would be placed in isolation. He withheld his travel history for 5 days while being treated for cold/flu. After revealing that he was in Africa, he was tested and found to have malaria.
http://roll.sohu.com/20140911/n404222113.shtml [in Chinese, trans. & summ. Rappt.DS]
[The patient appears not to have understood that Niger and Nigeria are different countries. But if he had in fact been in Nigeria, this was a potentially dangerous suppression of travel history, both from the treatment and contact point of view.
A map showing Niger across the northern border of Nigeria can be seen at http://www.african-politics.com/wp-cont ... -niger.jpg. - Mod.JW]
---
China: 4 being monitored
------------------------
15 Oct 2014: (Nanhai Network) The Health & Family Planning Commission and the Public Security Bureau of Hainan Province are conducting health monitoring of 4 people who entered China from countries with Ebola outbreaks. 2 dedicated personnel are responsible for health monitoring. At this time, Hainan has no suspected or confirmed Ebola cases.
[Byline: Liu Mai]
http://www.hinews.cn/news/system/2014/1 ... 4821.shtml [in Chinese, trans. & summ. Rappt.DS]
[This presumably means they are having their temperatures checked twice daily. China's official threshold for triggering testing is 37.3 deg C [99.1 deg F], see above -- much lower than in the USA. - Mod.JW]
---
Sierra Leone: UK cancels resumption of direct flights
-----------------------------------------------------
13 Oct 2014: (Guardian UK) Department of Transport cites deteriorating public health for revoking Gambia Bird's licence to fly [from UK] to Ebola-hit country... -- more
http://www.theguardian.com/world/2014/o ... ambia-bird
[To quote MSF about this move: "this is very unhelpful" -- a classically British understatement. - Mod.JW]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/46.]
-
Birgitt
- Moderator
- Beiträge: 35234
- Registriert: Di 2. Aug 2005, 22:52
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- Kontaktdaten:
WHO erklärt Senegal wieder für Ebola-frei
EBOLA VIRUS DISEASE - WEST AFRICA (193): SENEGAL FREE, WHO, SIERRA LEONE, NIGERIA
*********************************************************************************
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] Senegal: declared Ebola free by WHO
[2] WHO: Ebola Response Roadmap Update 17 Oct 2014 [as of 14 Oct 2014]
[3] Sierra Leone: Ebola comes to last safe district in Sierra Leone
[4] Nigeria: outbreak response
[5] Preparedness: Ivory Coast & Mali
******
[1] Senegal: declared Ebola free by WHO
Date: Fri 17 Oct 2014
Source: WHO Ebola situation assessment [edited]
http://who.int/mediacentre/news/ebola/1 ... er-2014/en
The outbreak of Ebola virus disease in Senegal is over
------------------------------------------------------
Senegal is now free of Ebola virus transmission. 42 days have now passed since the last contact of Senegal's single confirmed case of Ebola virus disease completed the requisite 21-day monitoring period, under medical supervision, developed no symptoms, and tested negative for the virus.
The response to Senegal's 1st case, confirmed on 29 Aug [2014], on the part of President Macky Sall, the Ministry of Health and Welfare, headed by Dr Awa Coll-Seck, and several other sectors of government, carries some instructive lessons for many other developing countries that are now wisely preparing to respond to an imported case. Other lessons come from staff at the WHO country office, senior epidemiologists sent to investigate and support the response, and WHO's many institutional partners in outbreak response.... -- more
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[Congratulations, Senegal! - Mod.JW]
******
[2] WHO: Ebola Response Roadmap Update 17 Oct 2014
Date: Fri 17 Oct 2014
Source: WHO: Ebola Response Roadmap [edited]
http://apps.who.int/iris/bitstream/1066 ... g.pdf?ua=1
Ebola Response Roadmap Update 17 Oct 2014 [as of 14 Oct 2014]
-------------------------------------------------------------
9216 cases up to the end of 14 Oct [2014]. There have been 4555 deaths.... The death toll includes 239 health workers.... -- more
[WHO has now placed line breaks between every word and I don't know how to remove them en bloc after copying and pasting, so please go to the source URL for clear text. - Mod.JW]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
******
[3] Sierra Leone: Ebola comes to last safe district in Sierra Leone
Date: Thu 16 Oct 2014
Source: Bellingham Herald, AP (Associated Press) report [edited]
http://www.bellinghamherald.com/welcome ... -gets.html
Ebola comes to last safe district in Sierra Leone
-------------------------------------------------
Ebola has infected 2 people in last untouched district -- Koinadugu -- of Sierra Leone, far north; 15 people have also died....
Planes can't fly to the affected countries because they are afraid they will be refused landing elsewhere, said the African Union chair Nkosazana Zuma on Thursday [16 Oct 2014] and airlines that wanted to restart service couldn't. Currently only Moroccan airlines and Brussels Air fly to all 3 countries. Sierra Leone's Finance Minister Kaifalah Marah on Thursday warned that border closures and cutting flights were "killing our economies," describing the isolation as a de facto economic embargo.... -- more
[Byline: Clarence Roy-Macaulay & Paul Schemm]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
******
[4] Nigeria: outbreak response
Date: Sat 18 Oct 2014
From: Tamsin Dew <t.dewe14@imperial.ac.uk> [edited]
A very impressive, transparent and enlightening talk was given at Imperial College London last night [17 Oct 2014] by Mrs. Sara Beysolow Nyanti, Team Lead for Management & Coordination in the National Ebola Emergency Operation Center, Nigeria; Chief of Office, UNICEF Lagos. I don't know how much of this information is in the public eye already, but Mrs. Nyanti described the Nigerian outbreak response in detail and I urge you to contact her for further information about it.
The response was co-ordinated by Ebola Emergency Operation Centres (EOC) established in Lagos and Port Harcourt and involved heads of 6 different teams (epi/surveillance, clinical management, organisation/management, etc) reporting to a single Incident Manager, Dr Faisal Shuaib from the Federal Ministry of Health/Nigerian CDC. Appointments were skills- and motivation-driven, from a variety of state and federal government bodies and technical partners (including MSF). Far-sighted governmental support, strong leadership, and solid communication and co-operation between different individuals and groups seem to have been critical.
Daily team meetings and strategy group round tables were implemented and all tasks were allocated, tracked and followed up daily. An isolation ward was purpose built under guidance from MSF [Medecins Sans Frontieres]. Danger pay and risk-based life insurance policies were implemented for all at-risk staff. A dedicated rumour line was established and all calls responded to. A social mobilisation and communication team that targeted neighbourhoods of contacts (using GIS to go house-to-house, radially) was instrumental in reducing stigma and spreading important information about the disease, as well as gathering additional leads.
Mrs. Nyanti reports the following figures:
- 899 contacts traced (only 1 lost to follow-up)
- 20 cases, 8 deaths, CFR [case fatality rate] of 40 percent
- 1289 staff in Lagos and Port Harcourt EOC, including more than 300 in epi/surveillance, more than 500 in social mobilisation/communication, more than 300 at ports of entry, more than 100 in clinical care/case management, more than 20 lab staff, and more than 20 in the management/coordination team
- no health workers involved with case management were infected.
--
Tamsin Dew
Imperial College, London (student)
UK
<t.dewe14@imperial.ac.uk>
******
[5] Preparedness: Ivory Coast & Mali
Date: Thu 16 Oct 2014
Source: Irish Times [edited]
http://www.irishtimes.com/news/world/af ... -1.1966573
WHO to test Ebola preparedness in Ivory Coast [Cote d'Ivoire] & Mali
--------------------------------------------------------------------
The World Health Organization will send experts to test the Ebola-preparedness measures in Ivory Coast and Mali, the 2 countries at greatest risk of being the next to be affected by the epidemic, WHO's health security response chief Isabelle Nuttall said this evening.... -- more
--
Communicated by:
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[At last some good news, with Senegal declared free. - Mod.JW
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/48.]
*********************************************************************************
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] Senegal: declared Ebola free by WHO
[2] WHO: Ebola Response Roadmap Update 17 Oct 2014 [as of 14 Oct 2014]
[3] Sierra Leone: Ebola comes to last safe district in Sierra Leone
[4] Nigeria: outbreak response
[5] Preparedness: Ivory Coast & Mali
******
[1] Senegal: declared Ebola free by WHO
Date: Fri 17 Oct 2014
Source: WHO Ebola situation assessment [edited]
http://who.int/mediacentre/news/ebola/1 ... er-2014/en
The outbreak of Ebola virus disease in Senegal is over
------------------------------------------------------
Senegal is now free of Ebola virus transmission. 42 days have now passed since the last contact of Senegal's single confirmed case of Ebola virus disease completed the requisite 21-day monitoring period, under medical supervision, developed no symptoms, and tested negative for the virus.
The response to Senegal's 1st case, confirmed on 29 Aug [2014], on the part of President Macky Sall, the Ministry of Health and Welfare, headed by Dr Awa Coll-Seck, and several other sectors of government, carries some instructive lessons for many other developing countries that are now wisely preparing to respond to an imported case. Other lessons come from staff at the WHO country office, senior epidemiologists sent to investigate and support the response, and WHO's many institutional partners in outbreak response.... -- more
--
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[Congratulations, Senegal! - Mod.JW]
******
[2] WHO: Ebola Response Roadmap Update 17 Oct 2014
Date: Fri 17 Oct 2014
Source: WHO: Ebola Response Roadmap [edited]
http://apps.who.int/iris/bitstream/1066 ... g.pdf?ua=1
Ebola Response Roadmap Update 17 Oct 2014 [as of 14 Oct 2014]
-------------------------------------------------------------
9216 cases up to the end of 14 Oct [2014]. There have been 4555 deaths.... The death toll includes 239 health workers.... -- more
[WHO has now placed line breaks between every word and I don't know how to remove them en bloc after copying and pasting, so please go to the source URL for clear text. - Mod.JW]
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******
[3] Sierra Leone: Ebola comes to last safe district in Sierra Leone
Date: Thu 16 Oct 2014
Source: Bellingham Herald, AP (Associated Press) report [edited]
http://www.bellinghamherald.com/welcome ... -gets.html
Ebola comes to last safe district in Sierra Leone
-------------------------------------------------
Ebola has infected 2 people in last untouched district -- Koinadugu -- of Sierra Leone, far north; 15 people have also died....
Planes can't fly to the affected countries because they are afraid they will be refused landing elsewhere, said the African Union chair Nkosazana Zuma on Thursday [16 Oct 2014] and airlines that wanted to restart service couldn't. Currently only Moroccan airlines and Brussels Air fly to all 3 countries. Sierra Leone's Finance Minister Kaifalah Marah on Thursday warned that border closures and cutting flights were "killing our economies," describing the isolation as a de facto economic embargo.... -- more
[Byline: Clarence Roy-Macaulay & Paul Schemm]
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******
[4] Nigeria: outbreak response
Date: Sat 18 Oct 2014
From: Tamsin Dew <t.dewe14@imperial.ac.uk> [edited]
A very impressive, transparent and enlightening talk was given at Imperial College London last night [17 Oct 2014] by Mrs. Sara Beysolow Nyanti, Team Lead for Management & Coordination in the National Ebola Emergency Operation Center, Nigeria; Chief of Office, UNICEF Lagos. I don't know how much of this information is in the public eye already, but Mrs. Nyanti described the Nigerian outbreak response in detail and I urge you to contact her for further information about it.
The response was co-ordinated by Ebola Emergency Operation Centres (EOC) established in Lagos and Port Harcourt and involved heads of 6 different teams (epi/surveillance, clinical management, organisation/management, etc) reporting to a single Incident Manager, Dr Faisal Shuaib from the Federal Ministry of Health/Nigerian CDC. Appointments were skills- and motivation-driven, from a variety of state and federal government bodies and technical partners (including MSF). Far-sighted governmental support, strong leadership, and solid communication and co-operation between different individuals and groups seem to have been critical.
Daily team meetings and strategy group round tables were implemented and all tasks were allocated, tracked and followed up daily. An isolation ward was purpose built under guidance from MSF [Medecins Sans Frontieres]. Danger pay and risk-based life insurance policies were implemented for all at-risk staff. A dedicated rumour line was established and all calls responded to. A social mobilisation and communication team that targeted neighbourhoods of contacts (using GIS to go house-to-house, radially) was instrumental in reducing stigma and spreading important information about the disease, as well as gathering additional leads.
Mrs. Nyanti reports the following figures:
- 899 contacts traced (only 1 lost to follow-up)
- 20 cases, 8 deaths, CFR [case fatality rate] of 40 percent
- 1289 staff in Lagos and Port Harcourt EOC, including more than 300 in epi/surveillance, more than 500 in social mobilisation/communication, more than 300 at ports of entry, more than 100 in clinical care/case management, more than 20 lab staff, and more than 20 in the management/coordination team
- no health workers involved with case management were infected.
--
Tamsin Dew
Imperial College, London (student)
UK
<t.dewe14@imperial.ac.uk>
******
[5] Preparedness: Ivory Coast & Mali
Date: Thu 16 Oct 2014
Source: Irish Times [edited]
http://www.irishtimes.com/news/world/af ... -1.1966573
WHO to test Ebola preparedness in Ivory Coast [Cote d'Ivoire] & Mali
--------------------------------------------------------------------
The World Health Organization will send experts to test the Ebola-preparedness measures in Ivory Coast and Mali, the 2 countries at greatest risk of being the next to be affected by the epidemic, WHO's health security response chief Isabelle Nuttall said this evening.... -- more
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[At last some good news, with Senegal declared free. - Mod.JW
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/48.]
-
Birgitt
- Moderator
- Beiträge: 35234
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- Wohnort: NRW / Südl. Rheinland
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Ebola in Liberia und Nigeria
Warum Liberia im Chaos versinkt ...Kein Land in Westafrika leidet mehr unter Ebola als Liberia. Mehr als 2500 Menschen sind dort bereits gestorben. Verzweifelt stemmt sich das Land gegen die Seuche, doch das Gesundheitssystem ist kollabiert. Liberia versinkt im Chaos.
19.10.2014 - tagesschau
... und Nigeria die Seuche besiegtNigerias Umgang mit Ebola ist vorbildlich: Seit dem ersten Fall wurden Kontaktpersonen isoliert und die Bevölkerung konsequent informiert. Das führte zu geringen Todeszahlen. Doch das Land hatte einen Vorteil: Es war vorbereitet.
19.10.2014 - tagesschau
Gruß
Birgitt
-
Kuno
- Beiträge: 9586
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WHO erklärt Nigeria wieder für Ebola-frei
Am 20. Oktober hat die WHO Nigeria als frei von Ebola deklariert.
-
Alexander
- Administrator
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Re: WHO erklärt Nigeria wieder für Ebola-frei
Die andere gute Nachricht ist: geheilte Ebolapatienten wurden durch ihre Antikörper immun gegen den Virus. Allerdings nur gegen diesen einen Stamm.Kuno hat geschrieben:Am 20. Oktober hat die WHO Nigeria als frei von Ebola deklariert.
Man denkt bereits darüber nach, die Immunität auszunützen und die "Ex-Infizierten" als Helfer in den Krisengebieten einzusetzen.
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.
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Ebola in Westafrika
EBOLA VIRUS DISEASE - WEST AFRICA (194): BAT IMMUNITY CLUE
**********************************************************
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: Thu 16 Oct 2014
Source: The Conversation [edited]
http://theconversation.com/bats-immunit ... eaks-32633
Bats are the natural host species for Ebola and a variety of viruses, many of which can be fatal when transmitted to humans. More than 100 viruses have been identified in bats and this number is rising each year.
African fruit bats first transmitted Ebola virus to [non-human] primates and other species through contact with bat droppings, half-eaten fruit, or bodily fluids of diseased bats. People are thought to have contracted the virus through contact with infected bats and [non-human] primates. Subsequent person-to-person transmission occurs through direct contact with infected body fluids: blood, saliva, mucus, vomit, urine, or faeces.
Interestingly, bats have the ability to harbour viruses such as Ebola and don't display clinical signs of disease. Yet once the virus infects other species, it has the potential to cause widespread death and disease. How is it that bats are resistant to a disease that kills up to 90 per cent of people it infects?
The impact of Ebola virus in people is largely the result of the activation of the immune system, rather than the virus itself. During the initial stages of infection, Ebola shuts off the immune response to the virus, resulting in rapid viral replication and a delay in the production of antibodies.
The immune system is initiated only once the virus is out of control and then results in over-activation of the immune response. Although the role of the immune system is to eliminate the virus, when it is activated at extreme levels it becomes damaging to the host -- in this case, an infected patient.
Like all haemorrhagic fevers, this results in widespread tissue damage, leading to internal and external bleeding, decreased kidney and liver function and ultimately, in many cases, death.
The Ebola outbreak in West Africa is the largest ever recorded and is continuing to accelerate. Researchers and drug companies are racing to develop treatments and vaccines targeting the Zaire ebolavirus, the strain that is causing the current outbreak.
The 1st human trial to establish the safety of the vaccine and assess the immune responses of volunteers is underway. The researchers hope that by November [2014] there will be enough data to make an informed decision about whether to deploy the vaccine in Western Africa.
So far, studies in monkeys have demonstrated that the vaccine provides protective immunity for up to 10 months.
Unlocking the bat immune system
-------------------------------
Studying how bats control viral replication may unlock alternative mechanisms for tackling Ebola as well as other new and emerging infectious diseases. Increasing antimicrobial resistance of viruses, bacteria and fungi, for instance, is becoming a global concern and we need to think creatively to find solutions.
Bats and viruses have achieved an equilibrium that allows them to co-exist. Clues from studies of bat genomes have revealed differences in genes associated with the very early immune response that could help bats respond to infections. These genes appear to be evolving at a faster rate in bats compared with other species, providing evidence that they are likely co-evolving with the viruses that bats carry.
Functional differences in the immune system may also play a role. Unlike humans and mice, which activate their immune systems only in response to an infection, bats appear to have certain components of their immune system constantly switched on. This may allow bats to control viral replication much more efficiently compared with other species.
If we can redirect the immune responses of other species to behave in a similar manner to that of bats, the high death rate associated with diseases such as Ebola could be a thing of the past.
It's tempting to look to culling as the answer to deal with bats as the natural hosts of Ebola. This suggestion was made during the spillover of Hendra virus from bats to horses in Australia. But it is not the answer; bats are an extremely successful group of mammals, making up 20 per cent of all mammalian diversity. They are critical to ecosystems, with roles in insect control and pollination.
Rather than persecuting bats, we need to unravel the secrets of the success of this group of mammals. Understanding how bats control viral replication would not only assist in developing future therapeutics but may also help predict transmission events from bats into human and animal populations.
[byline: Michelle Baker]
--
communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
[Zoonotic viruses in over 15 virus families have been identified in at least 200 bat species around the world. Bats infected with these viruses seem to show no conspicuous signs of disease and they may be persistently infected. It is clear that investigating the immune system of bats is crucial to gain a better understanding of their role as reservoirs of zoonotic pathogens. It has been suggested that bats might be able to control viral replication through innate immunity.
Related to this, it has been hypothesized that innate immunity is linked to flight activities. Flight increases body temperature, which accelerates the rate of multiple immune responses in mammals, including components of the innate and adaptive immune systems (see http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4012789/).
Undoubtedly, a better knowledge of the immune system of bats will enhance our capability to predict, prevent, control, and treat the zoonoses transmitted by them. - Mod.PMB]
**********************************************************
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: Thu 16 Oct 2014
Source: The Conversation [edited]
http://theconversation.com/bats-immunit ... eaks-32633
Bats are the natural host species for Ebola and a variety of viruses, many of which can be fatal when transmitted to humans. More than 100 viruses have been identified in bats and this number is rising each year.
African fruit bats first transmitted Ebola virus to [non-human] primates and other species through contact with bat droppings, half-eaten fruit, or bodily fluids of diseased bats. People are thought to have contracted the virus through contact with infected bats and [non-human] primates. Subsequent person-to-person transmission occurs through direct contact with infected body fluids: blood, saliva, mucus, vomit, urine, or faeces.
Interestingly, bats have the ability to harbour viruses such as Ebola and don't display clinical signs of disease. Yet once the virus infects other species, it has the potential to cause widespread death and disease. How is it that bats are resistant to a disease that kills up to 90 per cent of people it infects?
The impact of Ebola virus in people is largely the result of the activation of the immune system, rather than the virus itself. During the initial stages of infection, Ebola shuts off the immune response to the virus, resulting in rapid viral replication and a delay in the production of antibodies.
The immune system is initiated only once the virus is out of control and then results in over-activation of the immune response. Although the role of the immune system is to eliminate the virus, when it is activated at extreme levels it becomes damaging to the host -- in this case, an infected patient.
Like all haemorrhagic fevers, this results in widespread tissue damage, leading to internal and external bleeding, decreased kidney and liver function and ultimately, in many cases, death.
The Ebola outbreak in West Africa is the largest ever recorded and is continuing to accelerate. Researchers and drug companies are racing to develop treatments and vaccines targeting the Zaire ebolavirus, the strain that is causing the current outbreak.
The 1st human trial to establish the safety of the vaccine and assess the immune responses of volunteers is underway. The researchers hope that by November [2014] there will be enough data to make an informed decision about whether to deploy the vaccine in Western Africa.
So far, studies in monkeys have demonstrated that the vaccine provides protective immunity for up to 10 months.
Unlocking the bat immune system
-------------------------------
Studying how bats control viral replication may unlock alternative mechanisms for tackling Ebola as well as other new and emerging infectious diseases. Increasing antimicrobial resistance of viruses, bacteria and fungi, for instance, is becoming a global concern and we need to think creatively to find solutions.
Bats and viruses have achieved an equilibrium that allows them to co-exist. Clues from studies of bat genomes have revealed differences in genes associated with the very early immune response that could help bats respond to infections. These genes appear to be evolving at a faster rate in bats compared with other species, providing evidence that they are likely co-evolving with the viruses that bats carry.
Functional differences in the immune system may also play a role. Unlike humans and mice, which activate their immune systems only in response to an infection, bats appear to have certain components of their immune system constantly switched on. This may allow bats to control viral replication much more efficiently compared with other species.
If we can redirect the immune responses of other species to behave in a similar manner to that of bats, the high death rate associated with diseases such as Ebola could be a thing of the past.
It's tempting to look to culling as the answer to deal with bats as the natural hosts of Ebola. This suggestion was made during the spillover of Hendra virus from bats to horses in Australia. But it is not the answer; bats are an extremely successful group of mammals, making up 20 per cent of all mammalian diversity. They are critical to ecosystems, with roles in insect control and pollination.
Rather than persecuting bats, we need to unravel the secrets of the success of this group of mammals. Understanding how bats control viral replication would not only assist in developing future therapeutics but may also help predict transmission events from bats into human and animal populations.
[byline: Michelle Baker]
--
communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
[Zoonotic viruses in over 15 virus families have been identified in at least 200 bat species around the world. Bats infected with these viruses seem to show no conspicuous signs of disease and they may be persistently infected. It is clear that investigating the immune system of bats is crucial to gain a better understanding of their role as reservoirs of zoonotic pathogens. It has been suggested that bats might be able to control viral replication through innate immunity.
Related to this, it has been hypothesized that innate immunity is linked to flight activities. Flight increases body temperature, which accelerates the rate of multiple immune responses in mammals, including components of the innate and adaptive immune systems (see http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4012789/).
Undoubtedly, a better knowledge of the immune system of bats will enhance our capability to predict, prevent, control, and treat the zoonoses transmitted by them. - Mod.PMB]
-
Birgitt
- Moderator
- Beiträge: 35234
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Ebola - Guinea, Liberia und Sierra Leone
EBOLA VIRUS DISEASE - WEST AFRICA (195): LIBERIA, SIERRA LEONE, DRUG TRIALS
***************************************************************************
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: Ebola virus disease (EVD) outbreak (as of 20 Oct 2014)
[2] Sierra Leone: fresh UK deployment
[3] Drug trials planned: MSF
******
[1] Liberia: Ebola virus disease (EVD) outbreak (as of 20 Oct 2014)
Date: Mon 20 Oct 2014
Source: UN Office for the Coordination of Humanitarian Affairs
http://reliefweb.int/report/liberia/lib ... 0-oct-2014
See graphic at URL above.
--
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******
[2] Sierra Leone: fresh UK deployment
Date: Tue 21 Oct 2014
Source: BBC News [edited]
http://www.bbc.com/news/uk-29699195
Ebola crisis: British medics head to Sierra Leone
-------------------------------------------------
About 100 soldiers from the Royal Army Medical Corps are travelling to Sierra Leone as part of the UK's efforts to tackle the Ebola outbreak....
Cabinet minister Ms Greening left RAF Brize Norton in Oxfordshire on Tuesday morning [21 Oct 2014] with the medics from Catterick-based 35 Squadron, 5 Armoured Medical Regiment and the Royal Army Medical Corps. They will staff an Ebola training academy alongside some 90 personnel from 22 Field Hospital who left for Sierra Leone last week [13-19 Oct 2014]. Ms Greening will visit the academy and the site of a 92-bed treatment facility in Kerry Town, which is in the final stages of construction. She said: "Halting the disease in West Africa is the most effective way of preventing Ebola infecting people here in the UK. That is why we are providing 700 treatment beds in Sierra Leone, sending vital supplies such as chlorine and protective clothing, and training hundreds of health workers."
The UK is leading the [European] response to the disease in Sierra Leone, where it has pledged a GBP 125 million [about USD 200 million] aid package. In all, Britain is deploying 750 military personnel, including the Royal Navy's casualty ship RFA Argus. European countries have committed more than 500 million euros (GBP 400 million; USD 600 million) -- but the UK is pressing for that amount to be doubled.
Infographic (from Reuters):
- 780 British health staff volunteers helping to cope with the crisis
- 700 hospital beds supported by UK -- tripling Sierra Leone's capacity
- 750 military staff to help construct treatment centre and other facilities
- 100 beds on board medical ship RFA Argus being deployed to region
Source: health secretary's statement to Commons
--
communicated by:
ProMED-mail
<promed@promedmail.org>
******
[3] Drug trials planned: MSF
Date: 21 Oct 2014
Source: Reuters [edited]
http://www.reuters.com/article/2014/10/ ... UL20141021
MSF aims to start drug trials in Ebola clinics next month [Nov 2014]
--------------------------------------------------------------------
Bertrand Draguez, medical director of MSF [Medecins sans Frontieres] Belgium, said academics and the World Health Organization (WHO) were currently assessing which drugs to include in the tests....
Draguez said priority would be given to pharmaceuticals that are already available -- so called 'off-label' drugs that were approved for use on other diseases but that may have a beneficial effect on Ebola. "To start the trials, I hope we are talking about weeks," Draguez said. "I hope it will be around the end of November [2014]."
Turn no one down
----------------
Draguez said MSF wanted to avoid having to turn down any patient who wanted to be involved in the trials because of the lack of availability of drugs. He said that while there were good supplies of Avigan, or favipiravir, originally developed by Japan's Fujifilm to treat flu, and Chimerix's Brincidofovir, the ZMapp treatment developed by Mapp Biopharmaceutical was scarcer. A 4th treatment, TKM-Ebola, is being developed by Tekmira.
[byline: Daniel Flynn]
--
communicated by:
ProMED-mail
<promed@promedmail.org>
[HealthMaps may be seen for:
Liberia: http://healthmap.org/promed/p/54
Sierra Leone: 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: Ebola virus disease (EVD) outbreak (as of 20 Oct 2014)
[2] Sierra Leone: fresh UK deployment
[3] Drug trials planned: MSF
******
[1] Liberia: Ebola virus disease (EVD) outbreak (as of 20 Oct 2014)
Date: Mon 20 Oct 2014
Source: UN Office for the Coordination of Humanitarian Affairs
http://reliefweb.int/report/liberia/lib ... 0-oct-2014
See graphic at URL above.
--
communicated by:
ProMED-mail
<promed@promedmail.org>
******
[2] Sierra Leone: fresh UK deployment
Date: Tue 21 Oct 2014
Source: BBC News [edited]
http://www.bbc.com/news/uk-29699195
Ebola crisis: British medics head to Sierra Leone
-------------------------------------------------
About 100 soldiers from the Royal Army Medical Corps are travelling to Sierra Leone as part of the UK's efforts to tackle the Ebola outbreak....
Cabinet minister Ms Greening left RAF Brize Norton in Oxfordshire on Tuesday morning [21 Oct 2014] with the medics from Catterick-based 35 Squadron, 5 Armoured Medical Regiment and the Royal Army Medical Corps. They will staff an Ebola training academy alongside some 90 personnel from 22 Field Hospital who left for Sierra Leone last week [13-19 Oct 2014]. Ms Greening will visit the academy and the site of a 92-bed treatment facility in Kerry Town, which is in the final stages of construction. She said: "Halting the disease in West Africa is the most effective way of preventing Ebola infecting people here in the UK. That is why we are providing 700 treatment beds in Sierra Leone, sending vital supplies such as chlorine and protective clothing, and training hundreds of health workers."
The UK is leading the [European] response to the disease in Sierra Leone, where it has pledged a GBP 125 million [about USD 200 million] aid package. In all, Britain is deploying 750 military personnel, including the Royal Navy's casualty ship RFA Argus. European countries have committed more than 500 million euros (GBP 400 million; USD 600 million) -- but the UK is pressing for that amount to be doubled.
Infographic (from Reuters):
- 780 British health staff volunteers helping to cope with the crisis
- 700 hospital beds supported by UK -- tripling Sierra Leone's capacity
- 750 military staff to help construct treatment centre and other facilities
- 100 beds on board medical ship RFA Argus being deployed to region
Source: health secretary's statement to Commons
--
communicated by:
ProMED-mail
<promed@promedmail.org>
******
[3] Drug trials planned: MSF
Date: 21 Oct 2014
Source: Reuters [edited]
http://www.reuters.com/article/2014/10/ ... UL20141021
MSF aims to start drug trials in Ebola clinics next month [Nov 2014]
--------------------------------------------------------------------
Bertrand Draguez, medical director of MSF [Medecins sans Frontieres] Belgium, said academics and the World Health Organization (WHO) were currently assessing which drugs to include in the tests....
Draguez said priority would be given to pharmaceuticals that are already available -- so called 'off-label' drugs that were approved for use on other diseases but that may have a beneficial effect on Ebola. "To start the trials, I hope we are talking about weeks," Draguez said. "I hope it will be around the end of November [2014]."
Turn no one down
----------------
Draguez said MSF wanted to avoid having to turn down any patient who wanted to be involved in the trials because of the lack of availability of drugs. He said that while there were good supplies of Avigan, or favipiravir, originally developed by Japan's Fujifilm to treat flu, and Chimerix's Brincidofovir, the ZMapp treatment developed by Mapp Biopharmaceutical was scarcer. A 4th treatment, TKM-Ebola, is being developed by Tekmira.
[byline: Daniel Flynn]
--
communicated by:
ProMED-mail
<promed@promedmail.org>
[HealthMaps may be seen for:
Liberia: http://healthmap.org/promed/p/54
Sierra Leone: http://healthmap.org/promed/p/46]
-
Birgitt
- Moderator
- Beiträge: 35234
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Mali bestätigt ersten Ebola-Fall
Mali bestätigt den ersten Ebola Fall in Kayes
23.10.2014 - BBC
Gruß
Birgitt
First Ebola case in Mali confirmedThe Mali government has confirmed the first case of Ebola in the country. It said a two-year-old girl had tested positive for the haemorrhagic virus. She recently returned from the neighbouring Guinea. Speaking on state television on Thursday, Malian Health Minister Ousmane Kone said the infected girl was being treated in the western town of Kayes.
23.10.2014 - BBC
Gruß
Birgitt
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Birgitt
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- Beiträge: 35234
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Ebola - Guinea, Liberia, Sierra Leone und Mali
EBOLA VIRUS DISEASE - WEST AFRICA (196): WHO, MALI CONFIRMED CASE ex GUINEA, LIBERIA
***********************************************************************************
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 roadmap 22 Oct 2014
[2] Mali: confirmed case ex Guinea
[3] Liberia: fewer new cases
[4] WHO: extended incubation period
******
[1] WHO roadmap 22 Oct 2014
Date: 22 Oct 2014
Source: WHO Ebola Response Roadmap [edited]
http://apps.who.int/iris/bitstream/1066 ... g.pdf?ua=1
Situation Report Summary -- up to the end of 19 Oct 2014
-----------------------------------------------------------------------------
[Begins with a histogram of cases in the 3 countries.]
A total of 9936 confirmed, probable, and suspected cases of Ebola virus disease (EVD) have been reported in 5 affected countries (Guinea, Liberia, Sierra Leone, Spain, and the United States of America) and 2 previously affected countries (Nigeria and Senegal) up to the end of 19 Oct [2014]. A total of 4877 deaths have been reported.
The outbreaks of EVD in Senegal and Nigeria were declared over on 17 and 19 Oct 2014, respectively.
EVD transmission remains persistent and widespread in Guinea, Liberia, and Sierra Leone. All but one administrative district in Liberia and all administrative districts in Sierra Leone have now reported at least one confirmed or probable case of EVD since the outbreak began. Cases of EVD transmission remain lowest in Guinea, but case numbers are still very high in absolute terms. Transmission remains intense in the capital cities of the 3 most affected countries. Case numbers continue to be under-reported, especially from the Liberian capital Monrovia.
Of the countries with localized transmission, both Spain and the United States continue to monitor potential contacts. On 21 Oct [2014], the single patient with EVD in Spain tested negative for the disease for a 2nd time. Spain will be declared free of EVD 42 days after the date of the 2nd negative test unless a new case arises during that period.
On 22 Oct 2014, WHO convened the 3rd Emergency Committee on Ebola under the International Health Regulations (2005)...
Table 1: Confirmed, probable, and suspected cases in Guinea, Liberia, and Sierra Leone
Footnotes:
* For Liberia, 276 more confirmed deaths have been reported than have confirmed cases.
** For Sierra Leone, 127 more probable deaths have been reported than have probable cases.
Data are based on official information reported by Ministries of Health. These numbers are subject to change due to ongoing reclassification, retrospective investigation and availability of laboratory results...
[This table has a column for reported cases in the past 7 days [13-19 Oct 2014:
- Guinea: 109 [avg. 16/day]
- Liberia: 413 [avg. 59/day]
- Sierra Leone: 454 [avg. 65/day]
Liberia and Sierra Leone must have run out of beds by now. They look on track to reach 100/day before the new 100-bed hospitals are finished and staffed. - Mod.JW]
Figure 1: Ebola virus disease cases reported each week from Guinea and Conakry
Figure 2: Ebola virus disease cases reported each week from Liberia and Monrovia
Figure 3: Ebola virus disease cases reported each week from Sierra Leone and Freetown
Figure 4: Geographical distribution of new cases and total cases in Guinea, Liberia, and Sierra Leone
Table 2: Ebola virus disease infections in health-care workers
Table 3: Available and planned EVD bed capacity [Bed availability varies from 30-60 percent. - Mod.JW]
Figure 5: Response monitoring for Guinea, Liberia, and Sierra Leone
Table 4: Ebola virus disease cases and deaths in Spain and the United States of America
Annex 1: categories used to classify Ebola cases
Table 5: Ebola case-classification criteria
Annex 3: response monitoring legend
[NB: there is no Annex 2. - Mod.JW]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
******
[2] Mali: confirmed case ex Guinea
Date: 23 Oct 2014
Source: Reuters [edited]
http://www.reuters.com/article/2014/10/ ... KS20141023
Mali becomes 6th West African nation hit by Ebola
-------------------------------------------------------------------
Mali confirmed its 1st case of Ebola on Thu [23 Oct 2014], becoming the 6th West African country to be touched by the worst outbreak on record of the hemorrhagic fever, which has killed nearly 4900 people. Mali's Health Minister Ousmane Kone told state television that the patient in the western town of Kayes was a 2-year-old girl who had recently arrived from neighboring Guinea, where the outbreak began. "The condition of the girl, according to our services, is improving thanks to her rapid treatment," the minister told state television.
A health ministry official, who asked not to be identified, said the girl's mother died in Guinea a few weeks ago and the baby was brought by relatives to the Malian capital Bamako, where she stayed for 10 days in the Bagadadji neighborhood before heading to Kayes. A ministry statement said the girl, who came from the Guinean town of Kissidougou, was admitted at the Fousseyni Daou hospital in Kayes on Wednesday night [22 Oct 2014], where she was promptly tested for Ebola. People who came into contact with the patient in Kayes have been identified and placed under watch, the minister said, but he appealed to any person who believed they may have had contact with the girl to step forward.
[By Adama Diarra And Tiemoko Diallo]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[This is really bad news, requiring diversion of already insufficient African & international resources. - Mod.JW]
[For the HealthMap/ProMED map of Mali, see http://healthmap.org/promed/p/50. - Mod.MPP]
******
[3] Liberia: fewer new cases
Date: 21 Oct 2014
Source: AllAfrica [edited]
http://allafrica.com/stories/201410211595.html
Liberia: Ebola cases dropping from 10 to 3 daily
----------------------------------------------------------------
Cases of Ebola are said to be dropping from 10 to 3 per day at various Ebola Treatment Units in the country. For ELWA 2, it is reported that in September [2014] the Center received over 520 Ebola patients with over 142 survivals and approximately 290 deaths, and currently there are 54 patients and 41 have been confirmed at that unit, while the Island Clinic ETU received 384 patients with 103 survivors.
Doctors Jerry Brown of ELWA-2 and Atai Omoruto of the Island Clinic ETU have both admitted that the troops of patients taken at their various Centers have decreased numerically. Speaking at the Ministry of Information, Culture and Tourism regular Ebola press briefing yesterday [20 Oct 2014], Dr. Brown said the ELWA holding unit -- now converted to a treatment unit -- has been receiving between 2--3 patients in the past few weeks as compared to the past 2 months where they had to admit over 9--10 persons per day.
Dr. Omoruto, a Ugandan, also confirmed that the cases of Ebola have reduced as well but is not sure if it is the reality in the communities or people are just not reporting to the ETUs. According to Dr. Omoruto, several patients have been discharged from the Island Clinic ETU while more patients currently undergoing treatment are expected to be discharged anytime soon because they are responding to treatment.
However, in relation to the death of one of the 4 doctors who joined in the Ebola fight from its onset at the John F. Kennedy Medical Center, Dr. Omoruto described it as unfortunate and a regrettable situation.
She said Dr. Scotland's early departure [death] due to Ebola could be attributed to the walk-out protest by health workers at the Island Clinic ETU where he was being kept, treated and monitored before being transferred to Bomi County. According to Dr. Omoruto, Dr. Scotland could have survived if the health workers who were assigned at the Island Clinic didn't leave their work in protest which led the deceased to request his transfer to Dr. Logan in Tubmanburg. She said Dr. Scotland was later brought back to the Island Clinic ETU but by then his breathing system was deteriorating and his organs were all mal-functioning and there was barely anything they could do to save his life.
[By Antoinette Sendolo]
--
Communicated by:
ProMED-mail from HealthMap alerts
<promed@promedmail.org>
[This report runs directly contrary to the figures in WHO's update above -- but that report does state that Liberia's statistics are in serious disarray. - Mod.JW]
******
[4] WHO: extended incubation period
Date: 14 Oct 2014
Source: WHO [excerpted, edited]
http://www.who.int/mediacentre/news/ebo ... er-2014/en
[I missed this WHO statement when we posted the 1st paragraph and link on ProMED in Ebola virus disease - West Africa (192): 20141016.2870865, [2] WHO: Are the Ebola outbreaks in Nigeria and Senegal over?]
Here is the excerpt from WHO's link above:
Incubation period
------------------------
The period of 42 days, with active case-finding in place, is twice the maximum incubation period for Ebola virus disease and is considered by WHO as sufficient to generate confidence in a declaration that an Ebola outbreak has ended.
"Recent studies conducted in West Africa have demonstrated that 95 percent of confirmed cases have an incubation period in the range of 1-21 days; 98 percent have an incubation period that falls within the 1-42 day interval. WHO is, therefore, confident that detection of no new cases with active surveillance in place throughout this 42-day period means that an Ebola outbreak is indeed over.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[Yet contacts are being released in the USA after only 21 days. But most of the so-called contacts have not actually had any skin contact with a case. However, maybe the quarantine period for all real contacts, including those who shared an apartment with D. when he was ill, should be re-evaluated.
The article referenced by WHO is in PLoS:
http://www.newswise.com/articles/drexel ... -for-ebola. - 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 update:
[1] WHO roadmap 22 Oct 2014
[2] Mali: confirmed case ex Guinea
[3] Liberia: fewer new cases
[4] WHO: extended incubation period
******
[1] WHO roadmap 22 Oct 2014
Date: 22 Oct 2014
Source: WHO Ebola Response Roadmap [edited]
http://apps.who.int/iris/bitstream/1066 ... g.pdf?ua=1
Situation Report Summary -- up to the end of 19 Oct 2014
-----------------------------------------------------------------------------
[Begins with a histogram of cases in the 3 countries.]
A total of 9936 confirmed, probable, and suspected cases of Ebola virus disease (EVD) have been reported in 5 affected countries (Guinea, Liberia, Sierra Leone, Spain, and the United States of America) and 2 previously affected countries (Nigeria and Senegal) up to the end of 19 Oct [2014]. A total of 4877 deaths have been reported.
The outbreaks of EVD in Senegal and Nigeria were declared over on 17 and 19 Oct 2014, respectively.
EVD transmission remains persistent and widespread in Guinea, Liberia, and Sierra Leone. All but one administrative district in Liberia and all administrative districts in Sierra Leone have now reported at least one confirmed or probable case of EVD since the outbreak began. Cases of EVD transmission remain lowest in Guinea, but case numbers are still very high in absolute terms. Transmission remains intense in the capital cities of the 3 most affected countries. Case numbers continue to be under-reported, especially from the Liberian capital Monrovia.
Of the countries with localized transmission, both Spain and the United States continue to monitor potential contacts. On 21 Oct [2014], the single patient with EVD in Spain tested negative for the disease for a 2nd time. Spain will be declared free of EVD 42 days after the date of the 2nd negative test unless a new case arises during that period.
On 22 Oct 2014, WHO convened the 3rd Emergency Committee on Ebola under the International Health Regulations (2005)...
Table 1: Confirmed, probable, and suspected cases in Guinea, Liberia, and Sierra Leone
Footnotes:
* For Liberia, 276 more confirmed deaths have been reported than have confirmed cases.
** For Sierra Leone, 127 more probable deaths have been reported than have probable cases.
Data are based on official information reported by Ministries of Health. These numbers are subject to change due to ongoing reclassification, retrospective investigation and availability of laboratory results...
[This table has a column for reported cases in the past 7 days [13-19 Oct 2014:
- Guinea: 109 [avg. 16/day]
- Liberia: 413 [avg. 59/day]
- Sierra Leone: 454 [avg. 65/day]
Liberia and Sierra Leone must have run out of beds by now. They look on track to reach 100/day before the new 100-bed hospitals are finished and staffed. - Mod.JW]
Figure 1: Ebola virus disease cases reported each week from Guinea and Conakry
Figure 2: Ebola virus disease cases reported each week from Liberia and Monrovia
Figure 3: Ebola virus disease cases reported each week from Sierra Leone and Freetown
Figure 4: Geographical distribution of new cases and total cases in Guinea, Liberia, and Sierra Leone
Table 2: Ebola virus disease infections in health-care workers
Table 3: Available and planned EVD bed capacity [Bed availability varies from 30-60 percent. - Mod.JW]
Figure 5: Response monitoring for Guinea, Liberia, and Sierra Leone
Table 4: Ebola virus disease cases and deaths in Spain and the United States of America
Annex 1: categories used to classify Ebola cases
Table 5: Ebola case-classification criteria
Annex 3: response monitoring legend
[NB: there is no Annex 2. - Mod.JW]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
******
[2] Mali: confirmed case ex Guinea
Date: 23 Oct 2014
Source: Reuters [edited]
http://www.reuters.com/article/2014/10/ ... KS20141023
Mali becomes 6th West African nation hit by Ebola
-------------------------------------------------------------------
Mali confirmed its 1st case of Ebola on Thu [23 Oct 2014], becoming the 6th West African country to be touched by the worst outbreak on record of the hemorrhagic fever, which has killed nearly 4900 people. Mali's Health Minister Ousmane Kone told state television that the patient in the western town of Kayes was a 2-year-old girl who had recently arrived from neighboring Guinea, where the outbreak began. "The condition of the girl, according to our services, is improving thanks to her rapid treatment," the minister told state television.
A health ministry official, who asked not to be identified, said the girl's mother died in Guinea a few weeks ago and the baby was brought by relatives to the Malian capital Bamako, where she stayed for 10 days in the Bagadadji neighborhood before heading to Kayes. A ministry statement said the girl, who came from the Guinean town of Kissidougou, was admitted at the Fousseyni Daou hospital in Kayes on Wednesday night [22 Oct 2014], where she was promptly tested for Ebola. People who came into contact with the patient in Kayes have been identified and placed under watch, the minister said, but he appealed to any person who believed they may have had contact with the girl to step forward.
[By Adama Diarra And Tiemoko Diallo]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[This is really bad news, requiring diversion of already insufficient African & international resources. - Mod.JW]
[For the HealthMap/ProMED map of Mali, see http://healthmap.org/promed/p/50. - Mod.MPP]
******
[3] Liberia: fewer new cases
Date: 21 Oct 2014
Source: AllAfrica [edited]
http://allafrica.com/stories/201410211595.html
Liberia: Ebola cases dropping from 10 to 3 daily
----------------------------------------------------------------
Cases of Ebola are said to be dropping from 10 to 3 per day at various Ebola Treatment Units in the country. For ELWA 2, it is reported that in September [2014] the Center received over 520 Ebola patients with over 142 survivals and approximately 290 deaths, and currently there are 54 patients and 41 have been confirmed at that unit, while the Island Clinic ETU received 384 patients with 103 survivors.
Doctors Jerry Brown of ELWA-2 and Atai Omoruto of the Island Clinic ETU have both admitted that the troops of patients taken at their various Centers have decreased numerically. Speaking at the Ministry of Information, Culture and Tourism regular Ebola press briefing yesterday [20 Oct 2014], Dr. Brown said the ELWA holding unit -- now converted to a treatment unit -- has been receiving between 2--3 patients in the past few weeks as compared to the past 2 months where they had to admit over 9--10 persons per day.
Dr. Omoruto, a Ugandan, also confirmed that the cases of Ebola have reduced as well but is not sure if it is the reality in the communities or people are just not reporting to the ETUs. According to Dr. Omoruto, several patients have been discharged from the Island Clinic ETU while more patients currently undergoing treatment are expected to be discharged anytime soon because they are responding to treatment.
However, in relation to the death of one of the 4 doctors who joined in the Ebola fight from its onset at the John F. Kennedy Medical Center, Dr. Omoruto described it as unfortunate and a regrettable situation.
She said Dr. Scotland's early departure [death] due to Ebola could be attributed to the walk-out protest by health workers at the Island Clinic ETU where he was being kept, treated and monitored before being transferred to Bomi County. According to Dr. Omoruto, Dr. Scotland could have survived if the health workers who were assigned at the Island Clinic didn't leave their work in protest which led the deceased to request his transfer to Dr. Logan in Tubmanburg. She said Dr. Scotland was later brought back to the Island Clinic ETU but by then his breathing system was deteriorating and his organs were all mal-functioning and there was barely anything they could do to save his life.
[By Antoinette Sendolo]
--
Communicated by:
ProMED-mail from HealthMap alerts
<promed@promedmail.org>
[This report runs directly contrary to the figures in WHO's update above -- but that report does state that Liberia's statistics are in serious disarray. - Mod.JW]
******
[4] WHO: extended incubation period
Date: 14 Oct 2014
Source: WHO [excerpted, edited]
http://www.who.int/mediacentre/news/ebo ... er-2014/en
[I missed this WHO statement when we posted the 1st paragraph and link on ProMED in Ebola virus disease - West Africa (192): 20141016.2870865, [2] WHO: Are the Ebola outbreaks in Nigeria and Senegal over?]
Here is the excerpt from WHO's link above:
Incubation period
------------------------
The period of 42 days, with active case-finding in place, is twice the maximum incubation period for Ebola virus disease and is considered by WHO as sufficient to generate confidence in a declaration that an Ebola outbreak has ended.
"Recent studies conducted in West Africa have demonstrated that 95 percent of confirmed cases have an incubation period in the range of 1-21 days; 98 percent have an incubation period that falls within the 1-42 day interval. WHO is, therefore, confident that detection of no new cases with active surveillance in place throughout this 42-day period means that an Ebola outbreak is indeed over.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[Yet contacts are being released in the USA after only 21 days. But most of the so-called contacts have not actually had any skin contact with a case. However, maybe the quarantine period for all real contacts, including those who shared an apartment with D. when he was ill, should be re-evaluated.
The article referenced by WHO is in PLoS:
http://www.newswise.com/articles/drexel ... -for-ebola. - Mod.JW]
