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EBOLA VIRUS DISEASE - WEST AFRICA (212): MALI, GUINEA-BISSAU REOPENS, LIBERIA
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In this update:
[1] Mali: UN mission scraps clinic contract
[2] Guinea-Bissau reopens borders with Ebola-stricken Guinea
[3] Liberia: Chinese team lands to fight Ebola
[4] Liberia: Firestone control strategy
[5] West Africa: US CDC MMWR Early Release articles

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[1] Mali: UN mission scraps clinic contract
Date: Sun 16 Nov 2014
Source: Reuters [edited]
http://www.reuters.com/article/2014/11/ ... C120141116


The United Nations mission in Mali has canceled plans to renew a contract with a private clinic providing care to its peacekeepers after a case of Ebola was missed and spread from there... The UN mission in Mali, whose peacekeepers are helping to protect the nation against Islamist rebels, reversed on Sat [15 Nov 2014] a decision taken earlier in the week to renew the contract with the Pasteur Clinic in Bamako to care for sick or injured troops. A UN spokesman said the decision was taken "due to prevailing circumstances," but gave no further details.

[byline: David Lewis]

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["The United Nations Multidimensional Integrated Stabilization Mission in Mali (MINUSMA) was established by Security Council resolution 2100 of 25 Apr 2013. Under the terms of the resolution, the mission would support the political process and carry out a number of security-related stabilization tasks, with a focus on major population centres and lines of communication, protecting civilians, human rights monitoring, the creation of conditions for the provision of humanitarian assistance and the return of displaced persons, the extension of State authority and the preparation of free, inclusive and peaceful elections." http://www.un.org/en/peacekeeping/missi ... ound.shtml. - Mod.JW]

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[2] Guinea-Bissau reopens borders with Ebola-stricken Guinea
Date: 15 Nov 2014
Source: StarAfrica (APA) [edited]
http://en.starafrica.com/news/gbissau-r ... uinea.html


Guinea Bissau's general director of prevention and health promotion Nicholas Almeida announced on Sat [15 Nov 2014] the reopening of borders with Ebola-hit Guinea to facilitate trade between the 2 countries.

"We will continue to reinforce the preventive measures against the deadly Ebola virus," Mr Almeida said, pointing out that the emergency plan would be still in force despite the lack of means to fully put it in place. Guinea Bissau is currently unable to afford an epidemiological monitoring, he said, recalling a summit which brought together heads of states and governments from the Economic Community of West African States (ECOWAS), which recommended the reopening of the borders. The health expert said that some 40 entry points have been identified as requiring great attention.

"Screening units are set up in the hospital Simoes Mendes in Bissau and across the region," Almeida said, while pointing to the already launched emergency plans, including radio sensitization campaigns and training sessions for health workers.

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[3] Liberia: Chinese team lands to fight Ebola
Date: 16 Nov 2014
Source: Aljazeera [edited]
http://www.aljazeera.com/news/africa/20 ... 77918.html


About 160 Chinese health workers have arrived in Liberia, where they are due to staff a new USD 41 million Ebola clinic that, unlike most other foreign interventions, is being built and fully run by Chinese personnel.

China, Africa's biggest trade partner, had come under fire for the level of its response to the Ebola crisis. But it said this week it would send a team comprising 1000 personnel to help fight an outbreak that has killed over 5000 people in West Africa. "Up to now in Liberia, China is the only country providing not only the construction of an ETU (Ebola treatment unit), but also the running and operation and the staffing of an ETU," Zhang Yue, the Chinese ambassador to Liberia, told the Reuters news agency.

Yue said the new team in Liberia included a mix of doctors, nurses, technicians and engineers. "They experienced SARS (severe acute respiratory syndrome). They are very knowledgeable in this area," he said, referring to the contagious illness that was 1st identified in China in 2002 and killed several hundred people across the world. On arrival, the Chinese health workers had their temperatures taken and were made to wash their hands, a ritual adopted across the region as part of efforts to stem the disease. Yue said the establishment of the clinic in Liberia brought China's contribution to the anti-Ebola effort in the country to USD 122 million.

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[4] Liberia: Firestone control strategy
Date: 15 Nov 2014
Source: Healio [edited]
http://www.healio.com/infectious-diseas ... rnalsearch


Various unique and robust Ebola control measures implemented by a Liberian rubber tree plantation restricted the spread of the disease within that community, according to a recent MMWR. The success of this program may serve as a model for containing the disease in other areas of Liberia, CDC researchers wrote. In the report, the Centers for Disease Control and Prevention detailed the response efforts made at Firestone Liberia, a rubber tree plantation company affiliated with Bridgestone Americas.

After the report of the 1st diagnosed Ebola case at the plantation in March 2014, the company implemented a management strategy using the company's existing organizational structure. The response plan included case identification and management services, as well as re-assimilation of recuperating patients into the community. This "survivor reintegration program" included community education about the survivor's disease- and contagion-free status and also featured a ceremony attended by local officials, clergy and Firestone staff. Ongoing community meetings and radio updates were used to provide important information about Ebola risks, prevention and social mobilization within the community.

Control efforts also included offering voluntary quarantine to high-risk, asymptomatic individuals who were in contact with Ebola patients for up to 21 days after exposure. Quarantine facilities offered education, personal protective equipment, sanitary supplies and meals. All patient contacts who developed Ebola were among the voluntary quarantines. In addition, personal protective and waste disposal equipment were given to family members of individuals with suspected Ebola infection.

Between August 2014 and 23 Sep 2014, 71 Ebola cases were reported in 39 families within Firestone's catchment area; 57 of these were confirmed cases; 53 patients died, and 39 of these were confirmed cases (68 percent mortality rate among confirmed cases). There were 27 deaths in the Ebola treatment unit, 6 in the main hospital, and 6 in the community. Since Firestone introduced its Ebola response program, 18 disease survivors have been discharged from the Ebola treatment unit and reintroduced into the community. According to the CDC report, the success of Firestone's response strategy hinged on community cooperation and the support of company leadership.

"An important result of Firestone's response is the success with which community members identified suspected Ebola cases, agreed to voluntary quarantine in dedicated facilities, and minimized stigmatization of Ebola survivors," the researchers wrote. "The education, social mobilization, and reintegration programs, as well as the visibility of supervisors and leaders in the community likely contributed to these successes."

[ref: Erik J Reaves, et al. Control of Ebola virus disease -- Firestone District, Liberia, 2014. MMWR 2014; 63(42): 959-965;
http://www.cdc.gov/mmwr/pdf/wk/mm6342.pdf.]

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[5] West Africa: US CDC MMWR Early Release articles
Date: 14 Nov 2014
Sources: see below:


1. Evidence for a decrease in transmission of Ebola Virus -- Lofa County, Liberia, 8 Jun-1 Nov 2014
http://www.cdc.gov/mmwr/preview/mmwrhtm ... 3e1114a1_w
2. Evidence for declining numbers of Ebola cases -- Montserrado County, Liberia, June-October 2014
http://www.cdc.gov/mmwr/preview/mmwrhtm ... 3e1114a2_w
3. Ebola virus disease cases among health care workers not working in Ebola Treatment Units -- Liberia, June-August 2014
http://www.cdc.gov/mmwr/preview/mmwrhtm ... 3e1114a3_w
4. Ebola epidemic -- Liberia, March-October 2014
http://www.cdc.gov/mmwr/preview/mmwrhtm ... 3e1114a4_w

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EBOLA VIRUS DISEASE - WEST AFRICA (213): SIERRA LEONE, BENIN FALSE ALARM, MALI
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In this update:
[1] Sierra Leone: 7th doctor dies of Ebola
[2] Benin: Ebola discounted as cause of death of health workers
[3] Mali: 577 contacts being traced
[4] Mali: Questions over Ebola response

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[1] Sierra Leone: 7th doctor dies of Ebola
Date: 18 Nov 2014
Source: Philly News (AP) [edited]
http://www.philly.com/philly/news/natio ... 2b0e0.html


A top health official says a 7th doctor in Sierra Leone has died of Ebola. Dr. Moses Kargbo, who had been a retired medical officer in the Ministry of Health, died on Tue [16 Nov 2014] at the Hastings Ebola Treatment Center east of the capital, Freetown, where he had been receiving treatment. He had been volunteering to help fight the spread of the virus at a government hospital in the central Tonkolili district... - more

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[2] Benin: Ebola discounted as cause of death of health workers
Date: 18 Nov 2014
Source: RFI [in French, machine trans. edited]
http://www.rfi.fr/afrique/20141118-beni ... d-gamatie-


Questions and concern are evident in Benin after the deaths of several people in Tanguieta hospital, located in the northwest of the country. These deaths occurred in less than one month in health personnel.

Ebola tests are negative, and the Minister of Health held a press conference on Mon [17 Nov 2014] to reassure the public. Last week, the Ministry of Health was informed of the deaths of 3 members of the St John of God Hospital Tanguieta. Among them were 2 nurses in neonatology. On Fri [14 Nov 2014], a pediatrician died in Porto-Novo, where he had been transferred. The samples were sent to Lagos, Nigeria.

Ebola is not involved in these deaths, explained Dorothee Kinde Gazard, the Minister of Health: "I say and I repeat that these tests came back negative, so we have no case of Ebola virus in our country. We do not intend to hide anything if it is a serious illness that kills the staff."

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[3] Mali: 577 contacts being traced
Date: 18 Nov 2014
Source: Iafrica (AFP) [edited]
http://news.iafrica.com/worldnews/971453.html


Mali said on Monday [17 Nov 2014] it had placed nearly 600 people who may have been exposed to Ebola under surveillance as the country battles to contain the spread of the deadly tropical virus. The West African nation has been scrambling to prevent a minor outbreak turning into a major crisis after the deaths of a Guinean imam and the Malian nurse who treated him in the capital Bamako. A friend who had visited the imam in the Pasteur clinic also died of probable Ebola, while a doctor at the clinic who contracted the disease was undergoing treatment. A 2-year-old child died of Ebola in an unconnected case in the western town of Kayes in October [2014].

President Ibrahim Boubacar Keita, on a visit to the imam's home village of Kouremale on the Mali-Guinea border, urged locals to take all precautions in "the war" against Ebola. "I ask you to redouble your vigilance. We will not close the border, but don't let anyone enter Mali without having washed their hands or taken their temperature," the president told frontier medical workers...

Health Minister Ousmane Kone, who accompanied the president on the trip, said "577 people were under daily observation," up from Sunday's [16 Nov 2014] figure of 442 people who were being monitored for Ebola symptoms. A government official said on Fri [14 Nov 2014] that 2 people who died after exposure to the imam's body were "highly suspected" of having contracted the virus. They are not confirmed cases, however, and have not been counted among the official statistics.

Samba Sow, of the Ebola emergency operations centre, said on Sun [16 Nov 2014] that the western town of Kayes had not reported any new cases in the last 3 weeks and was now considered Ebola-free.

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[Washed hands and non-febrile temperatures unfortunately do not guarantee a person is free of the virus, and as we have seen in the case of the Sierra Leonean doctor who died on Monday [17 Nov 2014], even a negative blood test early in the course of infection does not either. But what other measures are feasible other than trying to block as much cross-border traffic as possible, with inevitable repercussions on the supply of food, fuel and other essentials? - Mod.JW]

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[4] Mali: Questions over Ebola response
Date: 18 Nov 2014
Source: IRIN [edited]
http://www.irinnews.org/report/100853/q ... a-response


The failure of a top Malian hospital to detect probable cases of Ebola has raised questions about whether the country's health system is sufficiently prepared to tackle the disease...

In Kayes, where a 2-year-old girl tested positive for Ebola on 23 Oct [2014], the hospital was caught off-guard. Only 2 of its 160 workers had received training on how to detect and treat Ebola patients and how to protect themselves while doing so, said hospital director Toumani Konare. "The staff had the right protective gear, but they didn't know how to use it," he told IRIN.

Before the current outbreak in Mali, the World Health Organization (WHO) had categorized the country as at-risk, due to its long border and strong economic ties with Guinea, where the epidemic began. It was targeted as a country to receive technical assistance, including training on infection prevention, epidemiological surveillance and contact tracing. Sow said preparations started in April [2014]. However, those preparations were focused mostly on the 805 km border that Mali shares with Guinea.

The government started to send a few health workers to check travellers for fever and other signs of the virus among the chaos of trucks, buses, bush taxis and motorbikes at border checkpoints. The Ministry of Health says the Kouremale border checkpoint, where an imam who died of Ebola in Mali on 27 Oct [2014] had entered from Guinea, checks more than 1000 people and 150 vehicles per day...

Ibrahima Soce-Fall, the World Health Organization (WHO) representative in Mali, said the country has the capacity to tackle the disease. "You can't say Mali wasn't prepared; people were trained," Fall told IRIN, although he did not specify how many. The Malian authorities are working with international partners, among them WHO, the US Centers for Disease Control, UNICEF, the International Committee of the Red Cross and Red Crescent Societies, NGO Alima, and Croix Rouge Mali to trace, isolate and monitor over 400 contacts [now nearly 600, see [3] above] of those who have died. Several WHO epidemiologists will soon join CNAM's rapid response team of doctors, nurses, social workers and laboratory technicians.

Oumar Ouologuem, a communications officer with the Ministry of Health, said the government is planning an isolation and treatment centre in Siby, 50 km southwest of the capital. "When we started making plans for a centre in town, the neighbours objected," said Ouologuem. "That's why we decided to find a location outside the capital." The authorities say the site will open if they have more cases but could not give a precise date.

Medecins Sans Frontieres (MSF) has set up 2 treatment centres, one in Bamako and one in Kayes. For the moment, its treatment centre in Bamako is the only one there. Natalia Torrent, the Ebola response coordinator in Mali for MSF-Spain, told IRIN they have 6 beds for suspected cases and 6 for confirmed cases, adding: "We are working on enlarging the site and giving technical advice on how to set up the CNAM treatment centre."

In one area, at least, Mali's health system seems to be already up to speed. Mali's national laboratory, SEREFO, on one of the hills overlooking Bamako, boasts a level-3 biosafety laboratory, equipped by the US National Institutes of Health (NIH), to handle the diagnosis of tuberculosis, HIV and Ebola. SEREFO director Ousmane Koita said their lab can get Ebola test results within a few hours. Even so, if the number of suspected cases continues to rise, it will have a hard time keeping up.

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EBOLA VIRUS DISEASE - WEST AFRICA (214): WHO, SIERRA LEONE, LIBERIA
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In this update:
[1] WHO Situation report 19 Nov 2014
[2] Sierra Leone: Cuban doctor tests positive, evacuated to Switzerland
[3] Liberia gaining, Sierra Leone losing
[4] Liberia: One in 2 workers now jobless

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[1] WHO Situation report 19 Nov 2014
Date: 19 Nov 2014
Source: WHO Situation report 19 Nov 2014 [excerpted, edited]
http://www.who.int/csr/disease/ebola/si ... m=20141119


Summary
A total of 15 145 confirmed, probable, and suspected cases of Ebola virus disease (EVD) have been reported in 6 affected countries (Guinea, Liberia, Mali, Sierra Leone, Spain and the United States of America) and 2 previously affected countries (Nigeria and Senegal) up to the end of 16 Nov [2014]. There have been 5420 reported deaths. Cases and deaths continue to be under-reported in this outbreak.

In the 3 countries with widespread and intense transmission, reported case incidence is no longer increasing nationally in Guinea and Liberia but is still increasing in Sierra Leone. The outbreaks in Guinea and Liberia now appear to be driven by intense transmission in several key districts, whereas transmission is intense throughout the north and west of Sierra Leone. The number of new cases is highest in N'Zerekore in Guinea [the 2nd largest city in Guinea by population, after the capital Conakry and the largest city in the Guinee Forestiere region of south-eastern Guinea. - Mod.JW]; Montserrado in Liberia [the county where the capital, Monrovia, is located. - Mod.JW]; and in the western and northern areas of Sierra Leone, particularly the capital, Freetown, and nearby Port Loko. Lofa in Liberia, and Kenema and Kailahun in Sierra Leone have now reported no or a very low number of new cases for several weeks.

In Mali, there have been 6 reported confirmed and probable cases and 5 deaths. The most recent cases have occurred in the Malian capital Bamako and are not related to the country's 1st EVD-positive patient, who died on 24 Oct 2014. All identified contacts connected with this initial case have now completed 21-day follow-up.

The response to the EVD outbreak continues to evolve in the 3 most affected countries. Over 1000 beds are now operational in 18 Ebola Treatment Centres. As this number increases, so does the capacity to isolate patients and prevent further transmission of the disease. The capacity to conduct burials in a safe and dignified manner of patients who have died from EVD is a crucial part of halting EVD transmission. More than 4800 safe and dignified burials have taken place since the outbreak began. Accurate, timely laboratory diagnosis of EVD cases is also an integral part of the response. Samples from all 53 EVD-affected districts of the 3 most-affected countries can be transported to a laboratory for testing within 24 hours of sample collection... - more

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[Transported to a laboratory for testing within 24 hours of sample collection presumably means results will be transmitted by telephone within 48 hours, so that suspected cases with negative tests will not have to be kept in hospital longer than that, taking up bed space. This is a considerable advance, 1st reported in last week's WHO sitrep. - Mod.JW]

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[2] Sierra Leone: Cuban doctor tests positive, evacuated to Switzerland
Date: 19 Nov 2014
Source: Reuters [edited]
http://www.reuters.com/article/2014/11/ ... 8820141119


A Cuban doctor treating Ebola patients in Sierra Leone has tested positive for the disease and was being sent to Geneva for treatment, officials said, the 1st Cuban known to have contracted the potentially deadly hemorrhagic fever.

The doctor ... is one of 165 Cuban doctors and nurses treating Ebola patients in Sierra Leone. They have been there since early October [2014].

They are part of a Cuban team of 256 medical professionals sent to West Africa to treat patients in the worst Ebola outbreak on record that has killed more than 5000 people.

[Byline: Daniel Trotta]

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[3] Liberia gaining, Sierra Leone losing
Date: 18 Nov 2014
Source: IB Times [edited]
http://www.ibtimes.com/ebola-deadly-out ... ew-1725305


Ebola continues to ravage West Africa, killing hundreds of people per week and showing no signs of slowing down in Sierra Leone, where new cases continue to emerge. At the same time, Liberia has seen its rate of infection and death toll slow markedly in recent weeks, turning the nation that was not long ago the epicenter of the Ebola epidemic into an emerging symbol of tenuous hope. The most recent Ebola statistics out of Liberia suggest that the outbreak, the deadliest in the history of the virus, can be stopped. But they also raise the question of just what the country has done differently than Sierra Leone, which shows no similar signs of progress.

As of 12 Nov 2014, Sierra Leone had seen 5368 reported cases of Ebola, while Liberia had experienced 6822 and Guinea 1878, according to the World Health Organization. But the situation is most critical in Sierra Leone, the only one of the 3 countries where cases are "still increasing," according to the Centers for Disease Control and Prevention [US CDC].

The 1st week of November [2014] saw 435 new Ebola cases in Sierra Leone, and about 24 percent of cases there since the outbreak began were reported in the 3 weeks preceding 7 Nov 2014, the WHO said earlier this month [November 2014], according to USA Today.

Meanwhile, Liberia has seen a major falloff in new Ebola cases, with only about 50 emerging per day, versus 500 per day at its peak, the Daily Beast reported on Mon [17 Nov 2014]. Liberian President Ellen Johnson Sirleaf issued a statement Thu [13 Nov 2013] announcing the end of the official state of emergency in her country, signaling her confidence in the gains that have been made there.

The recent success in Liberia arose from a synergy of factors and circumstances, including the amount of money and professionals that have poured into the country and the efforts of the nation's government and populace to slow its spread. The U.S. military also has thousands of troops on the ground in Liberia, where it is building a series of hospitals and treatment centers to aid in the fight against the epidemic.

"I'm cautiously optimistic about the declining case numbers in Liberia, which attests to the fact that U.S. efforts to augment local capacity are starting to pay dividends. Ebola treatment units, training of healthcare workers, and more rapid testing all likely are playing a role in Liberia's improving situation," Amesh Adalja, a senior associate at the University of Pittsburgh Medical Center's Center for Health Security, said. In contrast, failed anti-Ebola efforts in Sierra Leone have left the country more susceptible to the disease and allowed it to spread more quickly and efficiently. The country lacks resources, funding and people to roll out an effective, comprehensive and expensive relief apparatus.

"Liberia seems to have enough beds for patients, while Sierra Leone does not," John Lyon, CEO of World Hope International, a nonprofit relief and development organization, said. "In addition to the lack of beds, it is the lack of clean water and ambulances that are also negatively impacting Ebola cases in Sierra Leone." No county in the nation remains untouched by Ebola, and the Sierra Leonian government and aid groups have had less success instituting best containment practices there than in Liberia, according to Adalja. "There have been reports of healthcare worker strikes in Sierra Leone as well as some reluctance of people to present for treatment that may be compounding Sierra Leone's situation," he said... - more

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[4] Liberia: One in 2 workers now jobless
Date: 19 Nov 2014
Source: BBC News [edited]
http://www.bbc.co.uk/news/world-africa-30119043


Nearly half of all Liberians who were employed when the Ebola outbreak began are no longer working, a survey by the World Bank has found. It said many workers have been told to stay at home or have lost their jobs, while markets have been forced to shut. Earlier, a World Bank economist said the Ebola outbreak was expected to cost the region about USD 3-4 billion (GBP1.9-2.5 billion)... - more

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EBOLA VIRUS DISEASE - WEST AFRICA (215): MALI MORE CASES, WHO, SIERRA LEONE
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In this update:
[1] Mali: new case linked to dead nurse
[2] WHO: sitrep as of end of 18 Nov 2014
[3] Sierra Leone: more UK volunteers
[4] Sierra Leone: with schools closed, forced marriages on the rise

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[1] Mali: new case linked to dead nurse
Date: Sat 22 Nov 2014
Source: Reuters [edited]
http://www.reuters.com/article/2014/11/ ... EI20141122


Mali records new Ebola case, linked to dead nurse
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Mali has recorded a new case of Ebola in the capital Bamako, after the friend of a nurse who died of the hemorrhagic fever earlier this month [November 2014] tested positive for the disease, health and medical officials said on Saturday [22 Nov 2015]. The nurse contracted the disease after treating an imam from neighboring Guinea, who died after being incorrectly diagnosed with kidney problems. This allowed Ebola to spread to 5 other people in the West African nation's 2nd outbreak.... 2 Malian medical officials, who asked not to be named, confirmed the relationship between the new case and the deceased nurse.... -- more

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[2] WHO: sitrep as of end of 18 Nov 2014
Date: Fri 21 Nov 2014
Source: WHO [excerpted, edited]
http://who.int/csr/disease/ebola/situation-reports/en


Ebola response roadmap -- Situation report update [as of end of 18 Nov 2014]
----------------------------------------------------------------------------
Summary
-------
A total of 15 351 confirmed, probable, and suspected cases of Ebola virus disease (EVD) have been reported in 6 affected countries (Guinea, Liberia, Mali, Sierra Leone, Spain, and the United States of America) and 2 previously affected countries (Nigeria, Senegal) up to the end of 18 Nov 2014. There have been 5459 reported deaths.

[This is more than 100 new cases a day and 39 more deaths in only 2 days since the previous sitrep. - Mod.JW]

Following the WHO Ebola Response Roadmap structure [1], country reports fall into 2 categories:
1) those with widespread and intense transmission (Guinea, Liberia, and Sierra Leone); and
2) those with or that have had an initial case or cases, or with localized transmission (Mali, Nigeria, Senegal, Spain, and the United States of America).

A separate, unrelated outbreak of EVD in the Democratic Republic of the Congo has now been declared over.

1. Countries with Widespread and Intense Transmission
A total of 15 319 confirmed, probable, and suspected cases of EVD and 5444 deaths have been reported up to the end of the 18 Nov [2014] by the Ministries of Health of Guinea and Sierra Leone, and 17 Nov [2014] by the Ministry of Health of Liberia (table 1).

A total of 588 health-care workers (HCWs) are known to have been infected with EVD: 94 in Guinea; 341 in Liberia; 2 in Mali; 11 in Nigeria; 136 in Sierra Leone; 1 in Spain; and 3 in the United States of America (2 [of the latter] were infected in the USA and 1 in Guinea). A total of 337 HCWs have died.

Table 1: Confirmed, probable, and suspected cases in Guinea, Liberia, and Sierra Leone

[Go to URL above for Table.]

Table footnote: Data are based on official information reported by the Ministries of Health of Guinea and Sierra Leone up to the end of 18 Nov [2014], and the Ministry of Health of Liberia up to the end of 17 Nov [2014]. These numbers are subject to change due to ongoing reclassification, retrospective investigation and availability of laboratory results.

... -- more

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[3] Sierra Leone: more UK volunteers
Date: Sat 22 Nov 2014
Source: Daily Mail [edited]
http://www.dailymail.co.uk/news/article ... ssion.html


1st group of NHS volunteers fly out from Heathrow to tackle Ebola crisis in Sierra Leone
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NHS [National Health Service] staff join the fight against Ebola: 30 GPs [general practitioners], nurses and psychiatrists fly to Sierra Leone in 1st wave of volunteers deployed by the government. More than 1000 NHS staff have volunteered to travel to fight Ebola. The 1st group of 30 doctors and nurses will fly out later today [22 Nov 2014]. The British team will undergo a final week's training in Sierra Leone. Already, 1000 British personnel are in the field building new clinics.... -- more

[Byline: Darren Boyle]

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[5 NHS workers from Scotland are part of a UK team of medical volunteers heading to Sierra Leone to help in the fight against Ebola, and an intensive care registrar at Ysbyty Gwynedd in Bangor [Wales, UK], will join them (BBC). - Mod.JW]

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[4] Sierra Leone: with schools closed, forced marriages on the rise
Date: Fri 21 Nov 2014
Source: Plan International [edited]
http://plan-international.org/about-pla ... e-of-ebola


Forced marriages on the rise in the time of Ebola
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My name is Christiana. I am 17 years old. I live in a small village in the Moyamba District in southern Sierra Leone. I lost my father when I was a baby and my mother is a petty trader. I have experienced issues affecting girls' rights to education because I was forced into marriage. I want to be a voice to tackle forced marriage in Sierra Leone and the world....

In my school, Plan Sierra Leone established a girls' club under the Girl Power Project. I was selected by my peers to be their president because of my goal to be an advocate for girls' education and against early marriage, teenage pregnancy and female genital mutilation.

Before the Ebola outbreak, we were having meetings as a group, doing peer education and visiting homes to promote girls' education and discourage early marriage which was prevalent in our community. I have often said: "If you plant a tree and allow it to grow, then expect a fresh fruit from it." Now it is impossible to meet as a group because schools are closed.... -- more

[Byline: Christiana, Plan International youth blogger]

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[This is a very well-written, detailed account of the plight of schoolgirls with no school to attend in an Ebola-afflicted country. - Mod.JW]

EBOLA VIRUS DISEASE - WEST AFRICA (216): MALI, SIERRA LEONE, WEST AFRICA, LIBERIA
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In this update:
[1] Mali: confirms 8th case
[2] Sierra Leone: Italian doctor repatriated
[3] West Africa: MSF Ebola crisis update
[4] West Africa: Germany sends motorbikes
[5] Liberia: a new focus on tracking down rural Ebola cases
[6] Liberia: Ebola response hampered by infighting

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[1] Mali: confirms 8th case
Date: 24 Nov 2014
Source: Associated Press [edited]
http://abcnews.go.com/Health/wireStory/ ... e-27145797


Mali has confirmed a new case of Ebola, bringing to 8 the number of people who have fallen ill with the deadly disease in the West African country. A government statement issued Monday night [24 Nov 2014] said the patient had been placed in a treatment center. All of Mali's Ebola cases can be traced back to a 70-year-old imam who was brought to the country from Guinea, where the epidemic 1st began; 6 of Mali's 8 Ebola patients have died. The government said Sat [22 Nov 2014] that another patient who tested positive was also receiving treatment and had been isolated. Officials are monitoring 271 people in a bid to contain the disease... - more

--
Communicated by:
ProMED Rapporteur Kunihiko Iizuka

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[2] Sierra Leone: Italian doctor repatriated
Date: 24 Nov 2014
Source: Reuters [edited]
http://www.reuters.com/article/2014/11/ ... VA20141124


An Italian doctor who contracted Ebola while working in Sierra Leone is being flown to Italy, the Health Ministry in Rome said on Mon [24 Nov 2014]. The ministry said the doctor, who had been working for the humanitarian group Emergency, was in a stable condition and was eating and drinking on his own. He is expected to arrive on Monday night and will be treated in the Lazzaro Spallanzani infectious diseases institute in Rome, the ministry said.

[Byline: Antonella Cinelli]

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******
[3] West Africa: MSF Ebola crisis update
Date: Fri 21 Nov 2014
Source: MSF [edited]
http://www.msf.org/article/ebola-crisis ... ember-2014


Since the Ebola outbreak in West Africa was officially declared on 22 Mar 2014 in Guinea, it has claimed [a reported] 5420 lives in the region. The outbreak is the largest ever and is currently affecting 4 countries in West Africa: Guinea, Liberia, Sierra Leone and Mali. One person in Spain and 3 people in the USA have recovered; one person in the USA has died. Outbreaks in Nigeria and Senegal have been declared over. A separate outbreak in DRC has also ended.

Following announcements made in the last weeks, deployment of international aid is slowly rolling out in the 3 main countries affected: Sierra Leone, Liberia and Guinea. However, there is little indication that current efforts to increase capacity to isolate and take care of suspected and confirmed Ebola cases will address needs sufficiently.

Last week, MSF and 3 research institutions announced that clinical trials for 3 different treatments would be carried out at MSF sites in West Africa:

1) The French National Institute of Health and Medical Research (INSERM) will lead a trial for the antiviral drug favipiravir at an MSF facility in Gueckedou, Guinea;

2) The Antwerp Institute of Tropical Medicine (ITM) will lead a trial of convalescent whole blood and plasma therapy at the MSF Donka Ebola centre in Conakry, Guinea; and

3) The University of Oxford will lead, on behalf of the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC), a Wellcome Trust-funded trial of the antiviral drug brincidofovir at a site yet to be determined.

The United Nations Mission for Ebola Emergency Response (UNMEER) has been set up and will be based in Ghana to pursue 5 strategic priorities:
- stop the spread of the disease;
- treat the infected;
- ensure essential services;
- preserve stability; and
- prevent the spread of the disease to countries currently unaffected.

MSF teams in West Africa are still seeing critical gaps in all aspects of the response, including
- medical care,
- training of health staff,
- infection control,
- contact tracing,
- epidemiological surveillance,
- alert and referral systems,
- community education, and
- mobilisation [Don't they mean ambulances and transport? - Mod.JW].

MSF has been responding to the outbreak since March 2014 and currently has more than 3400 staff working in Guinea, Liberia, Sierra Leone and Mali, treating an increasing number of patients. Since the response began, 24 MSF staff members have fallen ill with Ebola, 11 of whom have recovered. The vast majority of these infections were found to have occurred in the community [i.e. not in Ebola hospitals or treatment units. - Mod.JW]... - more

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Communicated by:
ProMED-mail
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& Roger Feldman <promedrf@gmail.com>

[24 MSF staff (3 international plus 21 local out of 3400) have suffered a 54 percent CFR (case fatality rate, all local). They deserve another Nobel Peace Prize (previously awarded them to them in 1999). - Mod.JW]

******
[4] West Africa: Germany sends motorbikes
Date: 21 Nov 2014
Source: Reliefweb (AFP) [edited]
http://reliefweb.int/report/liberia/ger ... la-testing


The specially adapted fleet of bikes will be able to rush test samples to laboratories from remote areas, where patients can often wait 9 days or more for results. The UN's World Food Programme (WFP) said the motorbikes should cut transport delays to a day. Experts say faster test results could help slow the spread of the epidemic, which has so far claimed more than 5400 lives, according to the UN. "The samples coming from 53 districts in the 3 worst-affected countries -- Sierra Leone, Guinea and Liberia -- will be able to be taken to the closest laboratory in less than 24 hours," said WFP spokeswoman Elisabeth Byrs.

The announcement comes as a new airlift by the agency, the 5th since September [2014], landed in the Liberian capital Monrovia carrying water kits and generators. The WFP estimates that 1.7 million people in the 3 countries are threatened by hunger, 200 000 of them directly because of the Ebola outbreak.

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******
[5] Liberia: New focus on tracking down rural Ebola cases
Date: Fri 21 Nov 2014
Source: NPR [edited]



The Centers for Disease Control is trying out a system of rapid response teams for isolated rural areas. About 2 hours outside of the Liberian capital Monrovia, just down the coast on the Atlantic Ocean, near a town called Buchanan, is basically a series of tents that are the size of a house, which serve as Ebola Treatment Units (ETU), places where people can be isolated and treated who are confirmed to have the disease. But many health experts are asking whether building these Ebola Treatment Units is the best use of medical resources now in the fight against Ebola.

This is because the characteristics of the Ebola epidemic are really undergoing significant changes in Liberia. When the epidemic 1st started in Guinea and then crossed over the borders into rural Liberia, ill people started going to the capital, Monrovia, to get care. That's when there really was an explosion of cases in Monrovia. So at that time, around September 2014, health officials saw the need for treatment centers outside the main city, treatment centers in the outlying counties, so people did not need to come to the capital.

But what's happening now is people, and families are leaving the capital and going all the way back into really remote areas from which they came when they're sick. And so local hotspots occurred all over the country in very remote areas, far away even from any treatment centers.

So what a lot of experts are saying now is that there is a need to respond to this with Rapid Response Teams -- people who can get out into very remote areas to find people who are sick, or people who have been in contact with people who are sick -- and decide what to do, there, at the very local level. What began as a medical problem has now developed, in addition, into a social problem and even a political problem.

In these very remote areas, there is a major problem getting just the simplest health information message out to the populace. "Rapid" really means teaching the sort of basic public health and preventive measures that had been easier to deal with in Monrovia, with posters and public service announcements or messages on a cell phone.

The community, helped by the Rapid Response Team, might decide to just isolate the ill people there in the village and work with the community to agree who should be quarantined and treated right there in the village. They might involve a nearby village with an existing clinic, already a part of the Liberian health system. The plan might include building an isolation tent next to an existing clinic and allowing care for ill patients there. Or they might find patients and families well enough to get all the way to an existing ETU.

The ETUs are best in certain circumstances. So locations for ETUs and how best to handle rural cases are best made on a case-by-case basis. The sooner you get someone into treatment, the better chances they have of survival, because treatment is primarily hydration and medicine to take down fever... - more

[Byline: Kelly McEvers]

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******
[6] Liberia: Ebola response hampered by infighting
Date: Wed 19 Nov 2014
Source: NY Times [edited]
http://www.nytimes.com/2014/11/20/world ... .html?_r=1.


The global response to the Ebola virus outbreak in Liberia is being hampered by poor coordination and serious disagreements between Liberian officials and the donors and health agencies fighting the epidemic, according to minutes of top-level meetings and interviews with participants.

Even now, 3 months after donors began pouring resources into Liberia, many confirmed cases still go unreported, countries refuse to change plans to erect field hospitals in the wrong places, families cannot find out whether their relatives in treatment are alive or dead, health workers sent to take temperatures sometimes lack thermometers, and bodies have been cremated because a larger cemetery was not yet open.

The detailed accounts of high-level meetings, the most recent from Mon 17 Nov 2014, lifted the veil on the messy and contentious process of running the sprawling response to Liberia's epidemic, one that now involves more than 100 government agencies, charities and donors from around the world.

Despite these problems, with help from donors, Liberia, one of the 3 most afflicted West African countries and the one with the highest death toll, has seen new cases drop to about 20 a day from about 100 a day 2 months ago. Experts attribute that to fearful Liberians touching one another less, more safe burials of bodies, and distribution of protective gear to health care workers. But they also warn that cases are now holding steady and could explode again... - more

[Byline: Donald G. McNeil Jr.]

--
Communicated by:
ProMED-mail
<promed@promedmail.org>
& Roger Feldman <promedrf@gmail.com>

[For HealthMap interactive maps, see:
Mali: http://healthmap.org/promed/p/50;
Sierra Leone: http://healthmap.org/promed/p/46;
Liberia: http://healthmap.org/promed/p/54. - Mod.JW]

EBOLA VIRUS DISEASE - WEST AFRICA (217): SIERRA LEONE, MORE AID, WHO, CDC, CONGO
********************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

In this update:
[1] Sierra Leone: 9th doctor infected with Ebola
[2] WHO Ebola response roadmap -- Situation report
[3] West Africa: Kenya to send 300 health workers to fight Ebola
[4] Why Congo conquered Ebola
[5] CDC guidelines for gauging risk of Ebola transmission & patient management
[6] Sierra Leone: ASEOWA takes charge of ETC
[7] West Africa: EU Offloads Anti-Ebola Cargo
[8] Sierra Leone: burial workers strike

******
[1] Sierra Leone: 9th doctor infected with Ebola
Date: 26 Nov 2014
Source: AP [edited]
http://hosted2.ap.org/APDEFAULT/bbd8255 ... 660f6dc6ce


An official says a 9th Sierra Leonean doctor has been infected with Ebola, underscoring the devastating toll the disease is taking on health care workers. Abass Kamara, a Health Ministry spokesman, said that a top military doctor tested positive for Ebola on Wed [26 Nov 2014]. He was working at the Hastings Ebola treatment center in the east end of the capital [Monrovia]... more

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******
[2] WHO Ebola response roadmap -- Situation report
Date: 26 Nov 2014
Source: WHO [excerpted, edited]
http://who.int/csr/disease/ebola/situation-reports/en


A total of 15 935 confirmed, probable, and suspected cases of Ebola virus disease (EVD) have been reported in 6 affected countries (Guinea, Liberia, Mali, Sierra Leone, Spain and the United States of America) and 2 previously affected countries (Nigeria and Senegal) up to the end of 23 Nov [2014]. There have been 5689 reported deaths.

Cases and deaths continue to be under-reported in this outbreak. Reported case incidence is stable in Guinea (148 confirmed cases reported in the week to 23 Nov 2014), stable or declining in Liberia (67 new confirmed cases in the week to 23 Nov 2014), and may still be rising in Sierra Leone (385 new confirmed cases in the week to 23 Nov 2014).

The total number of cases reported in Sierra Leone since the outbreak began will soon eclipse the number reported from Liberia. The case fatality rate [CFR] across the 3 most-affected countries in patients with a recorded definitive outcome is approximately 60 percent; 3 health-care workers were reported infected with EVD in Guinea in the week to 23 Nov 2014.

Response activities continue to intensify in line with the UNMEER aim to isolate 70 percent of EVD cases and safely bury 70 percent of EVD-related deaths by 1 Dec 2014. Guinea isolates over 70 percent of all reported cases of EVD, and has more than 80 percent of required safe burial teams. Progress on isolation and safe burials has apparently been slower in parts of Liberia and Sierra Leone, although uncertainties in data preclude firm conclusions. At a national level, both countries are apparently unable to isolate 70 percent of patients, although data on isolation is up to 3 weeks out of date.

Every EVD-affected district in the 3 intense-transmission countries has access to a laboratory for case confirmation within 24 hours of sample collection. All 3 countries report that more than 80 percent of registered contacts associated with known cases of EVD are traced, though the low mean number of contacts registered per case suggests that contact tracing is still a challenge in areas of intense transmission... - more

--
Communicated by:
ProMED-mail
<promed@promedmail.org>
& Ryan McGinnis <ryan@bigstormpicture.com>

[There follow detailed tables, maps & graphs. Isolation of 70 percent of identified patients is thought to be enough to stop the epidemic. - Mod.JW]

******
[3] West Africa: Kenya to send 300 health workers to fight Ebola
Date: 24 Nov 2014
Source: World Bulletin [edited]
http://www.worldbulletin.net/news/14915 ... ight-ebola


Kenya will send 300 health workers to West Africa to help fight the deadly Ebola virus, which killed thousands in the region, a Kenyan official has said.

"Kenya will soon be sending over 300 health workers to the West African countries affected by the Ebola epidemic," James Macharia, Cabinet Secretary for Health, said during the opening of the African Medical and Research Foundation (AMREF) on Mon [24 Nov 2014] ... - more

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******
[4] Why Congo conquered Ebola
Date: 24 Nov 2014
Source: NBC News [edited]
http://www.nbcnews.com/storyline/ebola- ... la-n253911


Two outbreaks, 2 entirely different outcomes. The World Health Organization has declared an outbreak of Ebola over in the Democratic Republic of Congo after just 66 cases and 49 deaths. It lasted 3 months. Yet the epidemic in Liberia, Sierra Leone and Guinea has been going on for 9 months, with more than 15 000 cases, 5000 deaths and no end in sight.

What's the difference? Experts say experience matters; it was the 7th outbreak in the former Zaire. But equally important is the fact that the village where it started was extremely remote, and the country has a rudimentary system of healthcare workers who know to look out for Ebola... - more

[Byline: Maggie Fox]

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******
[5] CDC guidelines for gauging risk of Ebola transmission & patient management
Date: 25 Nov 2014
Source: CDC [edited]
http://www.cdc.gov/vhf/ebola/hcp/intern ... -risk.html


(1) For Community and Healthcare Settings in West Africa: Determining Risk of Ebola Transmission
---------------------------------------
Since the discovery of Ebola virus, there have been Ebola infections among healthcare workers in almost every outbreak. Protecting healthcare workers from Ebola infection and improving infection control are critical elements to provide reliable health care and stop the epidemic... - more

***
For General Healthcare Settings in West Africa: Managing Ebola Patients, Their Families, and the Community Safely and Compassionately
---------------------------------------
Date: 25 Nov 2014
Source: CDC [edited]
http://www.cdc.gov/vhf/ebola/hcp/intern ... ately.html


(2) Management of Suspected Ebola Patients in General Healthcare Settings (Non-Ebola Treatment Units)
----------------------------------------
- Safely isolate and manage patients with suspected Ebola cases.
- Alert public health authorities about a suspected Ebola case.
- Educate family and the community about what they can do to stay healthy.
- All patients coming to the healthcare facility must be assessed for Ebola based on the screening flowchart.
- Any patient suspected of having Ebola should be immediately directed to the isolation area. Proper public health authorities should be immediately notified.
- Any patient suspected of having Ebola needs to be isolated while waiting for the ambulance to pick them up. If more than one patient is isolated in your facility, keep them at least one meter apart... - more

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[Note that CDC has gone back to using the term "suspect" without re-defining it. - Mod.JW

******
[6] Sierra Leone: ASEOWA takes charge of ETC
Date: 24 Nov 2014
Source: Union Africaine [edited]
http://www.au.int/fr/content/aseowa-tak ... erra-leone


The African Union Support to the Ebola Outbreak in West Africa, ASEOWA, in Sierra Leone has received the go-ahead for the management of the newly completed Ebola Treatment Centre (ETC) in Magbenteh, Bombali District of Sierra Leone. The coordination of the ETC will be in partnership with the Ministry of Health of Sierra Leone. President Ernest Bai Koroma, while commissioning the treatment centre on Sun 16 Nov 2014, commended the efforts of the African Union in providing medical personnel in fighting against the Ebola virus disease.

The Magbenteh treatment centre, with a bed space capacity of 100 was scheduled to receive its 1st 6 Ebola patients on Mon 24 Nov 2014. The treatment centre is expected to ease the backlog of sick patients at the Arab, Paramedic, Government and Kamakwe holding centres in Bombali District, where Ebola patients were held pending their transfer to Kailahun, a neighboring district, for treatment... - more

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******
[7] West Africa: EU Offloads Anti-Ebola Cargo
Date: 25 Nov 2014
Source: New Dawn [edited]
http://allafrica.com/stories/201411250921.html


The Dutch government and 8 other European Union member states have presented a [sea-borne] cargo of anti-Ebola materials valued at 3.6 million Euros [USD 4.5 million], including 2 fully-equipped ambulances, a laboratory, jumper delivery beds [sic: can't discover what they are, probably obstetric - Mod.JW], body beds, protective suits, goggles, respiratory masks, and rubber boots, among others...

The Netherlands envoy told President Sirleaf that upon discharging the ship, it was returning to Europe to pick up a 2nd cargo of anti-Ebola items for the 3 countries to be back in Monrovia around the Christmas season... - more

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******
[8] Sierra Leone: burial workers strike
Date: Tue 25 Nov 2014
Source: BBC edited [edited]
http://www.bbc.co.uk/news/world-africa-30191938


Burial workers in the Sierra Leonean city of Kenema have dumped bodies in public in protest at non-payment of allowances for October and November 2014 handling of Ebola victims.

The workers, who went on strike over the issue, left 15 bodies abandoned at the city's main hospital. One body was reportedly left by the office of the hospital manager and 2 others by the hospital entrance. The bodies have now been taken away, but the workers have refused to end their strike. It has been reported that the striking workers have now been sacked. There has been no public comment by the hospital's management or the Sierra Leonean health ministry.

The burial workers' industrial action came 2 weeks after health workers went on strike for similar reasons at a clinic near Bo, the only facility in southern Sierra Leone treating Ebola victims... more

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& Roger Feldman <promedrf@gmail.com>

[A later report said they were not sacked for striking but for disrespecting the bodies of the dead. - Mod.JW

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/46.]

EBOLA VIRUS DISEASE - WEST AFRICA (218): LIBERIA CLINICS, SEMEN TRANSMISSION, SIERRA LEONE
******************************************************************************************
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: Chinese-built Ebola center dedicated
[3] Liberia: US DoD/IOM Ebola Treatment Units
[4] Liberia: Monrovia Medical Unit opened
[5] Liberia: sexual transmission reported
[6] Sierra Leone: 8 day wait for test result in health care unit
[7] Sierra Leone: 100 Nigerian medics for Ebola war

******
[1] Liberia: Chinese-built Ebola center dedicated
Date: Tue 25 Nov 2014
Source: ABC News [edited]
http://abcnews.go.com/International/wir ... a-27162074


Chinese-built Ebola center dedicated in Liberia
-----------------------------------------------
China, one of the 1st countries to send aid to battle Ebola in West Africa, ramped up the assistance significantly Tue 25 Nov 2014 by opening a 100-bed treatment center in Liberia. Liberian President Ellen Johnson Sirleaf toured the Ebola treatment center, calling it "1st-class." "We want to commend China for this exceptional response," Sirleaf said.

The facility, which is air-conditioned and has digital document keeping instead of paper, will start accepting patients next week, Chinese Embassy officials said. The giant white building was built in the parking lot of a stadium, outside Monrovia, Liberia's capital. Soldiers from USA, which has also sent troops and is building treatment units in Liberia, were present at the ceremony.

China is Africa's largest trading partner and has especially close ties with Liberia, where many Chinese firms won contracts for post-war reconstruction projects. It has pledged USD 81 million in aid to West Africa, including the money for the treatment center, to stem the Ebola outbreak and has also sent at least 200 medical staff and promised more.

[Byline: Jonathan Paye-Layleh & Clarence Roy-Macaulay]

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******
[3] Liberia: US DoD/IOM Ebola Treatment Units
Date: Tue 25 Nov 2014
Source: International Organization for Migration [edited]
http://www.iom.int/cms/en/sites/iom/hom ... -hots.html


Fighting Ebola in Liberian "hotspots"
-------------------------------------
On Fri 21 Nov 2014, Buchanan's 1st Ebola Treatment Unit (ETU), constructed by the US Department of Defence [DoD], was opened, to be run by IOM [International Organization for Migration] international, with local staff currently being trained by WHO and Liberia's Ministry of Health and Social Welfare. The ETU is equipped to receive and treat up to 50 patients and will likely begin receiving transfers and suspected cases in the 1st week of December 2014. Training includes educating communities about the importance of seeking early treatment at an ETU.

The Buchanan ETU is one of 3 facilities planned for Bomi, Grand Bassa and Grand Cape Mount counties. The 1st was opened in mid November 2014 in Tubmanburg in Bomi county. A team of 22 foreign medical workers and 138 national staff are running that unit. The 3rd ETU will open shortly in Sinje, Grand Cape Mount country, with the capacity to serve up to 50 patients. All 3 ETUs have all been built by the US Department of Defense, with the support of the Armed Forces of Liberia (AFL).... -- more

[Byline: Sandra Tumwesigye]

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******
[4] Liberia: Monrovia Medical Unit opened
Date: Sat 22 Nov 2014
Source: US Department of State blog [edited]
http://blogs.state.gov/stories/2014/11/ ... inst-ebola


Monrovia Medical Unit is aiding healthcare workers in the fight against Ebola
-----------------------------------------------------------------------------
The United States has been engaged with the Ebola outbreak since the 1st cases were reported in March 2014 -- and on Wed 5 Nov 2014, opened the Monrovia Medical Unit, to provide care to healthcare workers who become infected with Ebola while treating patients.

Liberian President Ellen Johnson Sirleaf was present to mark the inauguration of the Monrovia Medical Unit (MMU), a 25-bed field hospital located in Margibi County, Liberia. The MMU is currently [22 Nov 2014] treating 3 Liberian health care workers.

The MMU was constructed by the US Department of Defense and [is] staffed by the men and women of the U.S. Public Health Service. [In response to the Ebola outbreak], the U.S. government has deployed more than 2500 personnel to West Africa, making this the largest-ever U.S. government response to a global health crisis.

[Byline: Deborah R. Malac]

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******
[5] Liberia: sexual transmission reported
Date: Thu 27 Nov 2014
Source: AllAfrica, Liberian Observer report [edited]
http://allafrica.com/stories/201411271023.html


Liberia: Ebola doctor alarmed over male survivors infecting partners
--------------------------------------------------------------------
Dr. Atai Omurutu, head doctor at the Island Clinic Ebola treatment unit, has raised an alarm over the disturbing incidents of male Ebola survivors infecting their partners and putting entire families at risk. Dr. Omurutu said wives of male survivors are being admitted to the facility because they have contracted the disease from their partners. She appealed to the Ministry of Health for condoms to be given to male survivors in order to stop this mode of transmission of the Ebola virus.

She disclosed this new wave of infection to President Ellen Johnson Sirleaf when the President toured the Island Clinic ETU and the Alpha OAU ETU in Tweh Farm and Virginia, respectively. Dr. Omurutu, a Ugandan doctor, stated that once a man survives Ebola, he still has the virus in his semen for up to 3 months, therefore it is extremely important that male survivors abstain from sex during that period or use a condom to avoid infecting their partner.

[Byline: Alaskai Moore Johnson]

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******
[6] Sierra Leone: 8 day wait for test result in health care unit
Date: Tue 25 Nov 2014
Source: Telegraph [edited]
http://www.telegraph.co.uk/news/worldne ... ative.html


Sierra Leone: 8 days in a health care unit before tests proves negative
After the long wait for an Ebola test, a patient is told he can go home
-----------------------------------------------------------------------
A wonderful thing happened today. I was able to give a patient in our unit the news that he tested negative for Ebola and was free to go home. He leapt out of bed and danced for joy, praised the Lord and us -- and even, mortifyingly, bowed to our PPE-clad feet. Throughout the unit, we could hear him singing and I know I'm not the only one who got a bit weepy. As a qualified doctor in 2006, and then a paediatrician studying for a PhD in infectious diseases at the UCL Institute of Child Health, a month ago I volunteered to work in Freetown with the UK's King's Sierra Leone Partnership and am working at the Connaught Hospital Ebola Isolation Unit.

When a patient attends a health care unit, they are immediately screened for symptoms of Ebola -- fever plus abdominal pain, vomiting, headache and so on. The symptoms are non-specific and [they can also result from] anything from malaria to flu. If there is any suspicion of Ebola, they are admitted to an Isolation Unit -- beds permitting -- to be tested for the Ebola virus. And there they are kept until the results are available. This is intended to be within 24 hours.

The implications of delayed laboratory results are that those who turn out to be negative may be in beds next to positive patients with profuse diarrhoea, vomiting and even bleeding. The potential risk of infection is considerable. Patients are separated from each other by a wall of plastic sheeting; chlorine is used to decontaminate our gloved hands in between tending each patient; they are told to not leave their bed. [Even delayed, the news today was welcome.]

[Byline: Dr Felicity Fitzgerald]

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******
[7] Sierra Leone: 100 Nigerian medics for Ebola war
Date: Tue 25 Nov 2014
Source: Awoko [edited]
http://awoko.org/2014/11/25/sierra-leon ... -nig-envoy


Sierra Leone: 100 Nigerian medics for Ebola war
-----------------------------------------------
The Nigerian Envoy over the weekend disclosed that 100 Nigerian medics will be arriving in Sierra Leone the 1st week December [2014], under the auspices of the African Union, to help boost the fight against the deadly Ebola virus. Nigerian High Commissioner to Sierra Leone, Gladys Modupeola Aquist-Adebiyi made this disclosure during a one-day visit at the Magbenteh Ebola Treatment centre in Makeni, manned by the African Union medical team.... -- more

[Byline: Mariam Bah]

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Deutschland wieder mal nur viel bla, bla? Ärzte ohne Grenzen äußern scharfe Kritik an der deutschen Bundesregierung.

Regierung hat Versprechen nicht eingelöst

Zu spät, zu unkoordiniert – die Organisation „Ärzte ohne Grenzen“ beklagt in der F.A.S. Deutschlands Rolle in den westafrikanischen Ebola-Krisengebieten. Eigene medizinische Hilfe wurde bislang nicht geleistet.

Deutschland hat in den westafrikanischen Ländern, die von Ebola betroffen sind, bislang keine eigene medizinische Hilfe leisten können. Trotz zahlreicher Versprechen und erheblicher Finanzzusagen wird keines der zahlreichen Zentren zur Behandlung Ebola-Kranker bislang in deutscher Regie betrieben. mehr...

Grüsse
Alexander

Es ist recht still geworden um Ebola in den letzten Wochen.

Ende November hat die WHO publiziert, dass es bereits 7'000 Tote und 16'000 Infektionen gäbe...
...um ein paar Tage später zu revidieren und von 6'000 Toten dafür 17'000 Infektionen zu schreiben.

Es hätte sich m einen *Zählfehler* in Sierra Leone gehandelt. Soviel zur Möglichkeit (oder Fähgkeit) der WHO die eigenen Zahlen zu verifizieren.

Fakt ist , dass sich bisher die ganzen Panikankündigungen vom drohenden Weltuntergang nicht bewahrheitet haben und Ebola mit ganz wneigen Ausnahmen auf die Länder Sierra Leone, Liberia und Guinea beschränkt geblieben ist. Das hat bestimmt auch viel mit den eingeleiteten Gegenmassnahmen in diesen Ländern zu tun - aber meiner Meinung auch ganz einfach damit, dass Ebola eben nicht ganz so einfach "weitergegeben" werden kann, wie zum Beispiel eine Grippe und doch ganz bestimmte Bedingungen braucht um sich weiterzu verbreiten.

Ebola-Epidemie: Regierung riegelt Norden von Sierra Leone ab

Im Kampf gegen die Ebola-Epidemie ergreift die Regierung Sierra Leones drastische Maßnahmen: Der Norden des Landes soll fünf Tage lang vollständig abgeschottet werden. Zugleich sehen Mediziner Anzeichen für eine Verbesserung der Lage. mehr...

Grüsse
Alexander

Vor einem Jahr wurde der erste Ebolafall in Westafrika gemeldet und die Seuche breitete sich sehr schnell aus. Ein Horrorszenario wurde prognostiziert, das zum Glück nicht eintrat. Der Ausbruch und seine Folgen werden jetzt anscheinend realistischer eingeschätzt. Trotzdem: vorbei ist die Seuche noch lange nicht.

Ein Jahr Ebola: Noch lange nicht vorbei

Die internationale Alarmstimmung ist abgeklungen. Die Seuche aber nicht. In Sierra Leone herrscht immer noch Ausnahmezustand.

Vor einem Jahr, am 28. Dezember 2013, starb in dem Urwalddorf Meliandou in Guinea der zweijährige Émile Ouamouno an schwarzem Durchfall und hohem Fieber. Als dies Monate später als der erste Ebola-Todesfall Westafrikas bestätigt wurde, hatte er bereits eine grenzüberschreitende Epidemie in Gang gesetzt. Es dauerte bis zum Sommer, dass die Weltöffentlichkeit davon Notiz nahm. Die große Aufregung im September und Oktober, als über die zu geringe deutsche Hilfe gestritten wurde und sich Tausende Freiwillige zum Hilfseinsatz in Westafrika meldeten, hat sich aber längst wieder gelegt. Es ist still geworden um Ebola. mehr...

Grüsse
Alexander

Mali erklärte in den letzten Tagen die Ebolaepidemie für beendet. Seit 42 Tagen gibt es keine neuen Krankheitsfälle. Für eine Entwarnung ist es allerdings noch zu früh. In Guinea breitet sich der Virus immer noch aus.

Ebola in Mali offiziell besiegt

Grüsse
Alexander

Ebola ist noch nicht vollständig besiegt, die Entwicklungen sehen aber positiv aus.
In Liberia gibt es "nur" noch fünf Ebolafälle. Von diesen guten Nachrichten hätte man wohl früher lesen können, wäre die internationale Hilfe nicht so zögerlich angelaufen.

Ende der Ebola-Epidemie in Sicht

Experten hoffen, dass die Seuche bis Mitte des Jahres ausgerottet sein könnte. Grund für die positive Wende soll die massiv angelaufene Hilfe aus dem Ausland sein. mehr...

Grüsse
Alexander

In den letzten Wochen zeichnete sich ein guter Trend in den Ebola Ländern ab. Es gab keine Neuinfizierten mehr. Seit zwei Wochen scheint Ebola sich aber wieder auszubreiten.


Ebola-Virus verbreitet sich wieder stärker

Es schien, als hätten die Helfer in Westafrika die Ebola-Epidemie in den Griff bekommen. Nun aber nehmen Neuinfektionen die zweite Woche in Folge zu. Der Negativtrend kommt zu denkbar schlechter Zeit. mehr...

Die US Armee beendet ihren Einsatz in den Ebolagebieten. Auch die Deutsche Bundeswehr möchte am März Personal abziehen. Zu früh?

US-Armee beendet Ebola-Einsatz in Westafrika

Die US-Regierung holt fast alle 1300 Soldaten aus dem Einsatz gegen die Ebola-Seuche in Westafrika zurück. Hoffnungen auf Abschwächung der Epidemie haben indes einen Rückschlag erlitten. mehr...

Grüsse
Alexander

Zugegeben, seit die Seuche in Nigeria durch war habe ich mich nicht mehr gross damit beschäftigt. Jetzt bringt der Spiegel die Meldung, auf die man so lange gewartet hat:

"Monrovia - Der Countdown läuft, die Hoffnungen sind groß: Wenn in Liberia in den nächsten 30 Tagen kein neuer Ebola-Fall bestätigt wird, gilt das Land offiziell als frei von Ebola. Denn dann ist es insgesamt 42 Tage her, dass kein infizierter Patient mehr gemeldet wurde."