Ebola in Westafrika

[Birgitt]

EBOLA VIRUS DISEASE - WEST AFRICA (144): LIBERIA, NEW DRUGS, PREVENTION, MORE
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ProMED-mail is a program of the
International Society for Infectious Diseases
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In this update:
[1] Liberia: quarantine lifted
[2] New drugs
[3] Prevention & suspect cases
[4] Sierra Leone: working in a triage tent
[5] Ebolavirus: genomic studies
[6] Media reports

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[1] Liberia: quarantine lifted
Date: Sat 30 Aug 2014
Source: New York Times [edited]
http://www.nytimes.com/2014/08/30/world ... -slum.html


Liberia's government announced Friday night [29 Aug 2014] that it would lift an Ebola quarantine on a large slum here in the capital [Monrovia], 10 days after attempts to cordon off the neighborhood from the rest of the city sparked deadly clashes and fueled doubts about President Ellen Johnson Sirleaf's ability to handle the outbreak. Residents of the neighborhood, West Point, will be free to move in and out starting Saturday at 6:00 a.m., said Lewis Brown, the minister of information. The army, which had pressed for the quarantine and took the lead in enforcing it in the 1st 2 days, will be removed from West Point, leaving only the police, Mr. Brown said.

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[2] New drugs

ZMapp post-exposure antiserum

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29 Aug 2014: (BBC) The only clinical trial data on the experimental EVD [Ebola virus disease] drug ZMapp shows it is 100 percent effective in monkey studies [with 18 monkeys], even in later stages of the infection.

The researchers, publishing their data in [the journal] Nature, said it was a "very important step forward". Yet the limited supplies will not help the 20 000 people predicted to be infected during the outbreak in West Africa. And 2/7 people given the drug, have later died from EVD.... This included animals given the drug up to 5 days after infection. For the monkeys this would be a relatively late stage in the infection, around 3 days before it becomes fatal ... [more]
http://www.bbc.com/news/health-28980153

BioCryst post-exposure antiviral
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29 Aug 2014: BioCryst Pharmaceuticals, Inc. announced this morning that their small-molecule, nucleoside analogue, BCX-4430, would be entering a dose ranging efficacy study in non-human primates within the next few weeks.... So, unlike with a vaccine, BCX-4430 is being developed as a post-exposure measure for those in environments where conditions are conducive to accidental viral exposure ... [more]
http://www.forbes.com/sites/davidkroll/ ... thin-weeks
[First priority would be health workers and lab workers. - Mod.JW]

NIH/GlaxoSmithKline vaccine tests to start
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Federal researchers next week will start testing humans with an experimental vaccine to prevent the deadly ebolavirus.

The National Institutes of Health announced Thursday [28 Aug 2014] that it is launching the safety trial on a vaccine developed by the agency's National Institute of Allergy and Infectious Diseases and GlaxoSmithKline. Beginning Tuesday [2 Sep 2014], it will test 20 healthy adult volunteers to see if the virus is safe and triggers an adequate response in their immune systems.

This isn't a treatment for the disease, but a hoped-for preventative measure. Fauci said the vaccine cannot cause EVD in the volunteers being tested. He cautioned that there is no guarantee it will work: "I have been fooled enough in my many years of experience."

The US vaccine takes a single protein from the ebolavirus and pairs it with a chimpanzee cold virus to help as a delivery system. Past vaccines have the used the same protein but different delivery systems.

Usually, the 2nd stage of drug trials involve testing on larger numbers of people before it goes into final testing.

A British consortium has pledged USD 4.6 million to help speed up the vaccine tests. With some of that money, GlaxoSmithKline will be able to begin manufacturing up to 10 000 doses of the US vaccine, if the tests are successful. The 10 000 doses will be ready by the end of the year [2014] and if needed, production can be ramped up for stockpiling, GSK spokeswoman Sarah Alspach said.

Fauci doesn't expect results from this initial round of testing until the end of the year....

The major target of the vaccine, if it works, would be health care workers ... [more]
http://www.santafenewmexican.com/news/u ... 1baa6.html

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[3] Prevention & suspect cases

Guinea: riot in Nzerekore over disinfectant
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29 Aug 2014: Residents of Guinea's 2nd-biggest city have rioted after the market was sprayed with disinfectant in a bid to halt the spread of the ebolavirus.... Local traders were apparently not warned and held a protest march to the city's hospital, which was attacked. Police responded by firing tear gas and a 24-hour curfew was imposed. Local Red Cross workers had to flee to a military base.... Youssouf Traore, president of the Guinean Red Cross, said the rioters had fired guns. "A rumour, which was totally false, spread that we had sprayed the market in order to transmit the virus to locals," he said ... [more]
http://www.bbc.co.uk/news/world-africa-28984259

Nigeria: Port Harcourt
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Sister of dead EVD doctor escapes from Port Harcourt as 200 are quarantined
29 Aug 2014: SaharaReporters has learned that a sister of a Port Harcourt-based medical doctor, who recently died from the ebolavirus, fled to Abia State to avoid being quarantined with others who came into contact with the late doctor. However, one of her siblings, who is also a doctor, forced her to return to the quarantine center in Port Harcourt, the capital of Rivers State ... [more]
http://saharareporters.com/2014/08/29/s ... vers-state

Nigeria: EVD Ministry of Health Release
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29 Aug 2014: "If you visited Samstel Clinic, Rumuokoro, Port Harcourt, within the last few weeks, you are kindly urged to report to the Rivers State Health Ministry! Please search yourself and if this concerns you, please go and get tested immediately. If you were in this hospital but have left Port Harcourt, please look for where to give yourself up. Everything is being done to curb the spread. Please do your little part to help. Do not hide family members who you think might be infected." 217 people have so far been quarantined in Port Harcourt.
http://lindaikeji.blogspot.co.uk/2014/0 ... h-ask.html

Belgium
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EVD suspected cases in Belgium ex Guinea
29 Aug 2014: Guinean in quarantine in Ostend had malaria not EVD; MSF collaborator in quarantine in Brussels hospital suspected of contamination with EVD ... [more]
http://www.lesoir.be/639168/article/act ... as-suspect [in French]

Canada
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Canadian hospital staffers get EVD workshops
28 Aug 2014: (Globe & Mail) While federal public health authorities have assured Canadians that there is very little risk of an EVD outbreak, hospitals across the country are training staff and reinforcing protocols should an infected patient walk through their doors ... [more]
http://www.theglobeandmail.com/life/hea ... le20262430

Guinea-Bissau: 8 people quarantined
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28 Aug 2014: 8 people from Guinea Conakry are quarantined at the Regional Hospital of Gabu in eastern Guinea-Bissau. These individuals have entered the country secretly. EVD has not yet come to Guinea-Bissau but authorities have been taking a series of preventive measures.
http://www.portugues.rfi.fr/africa/2014 ... ine-bissau [in Portuguese]

Indonesia: hajj pilgrims
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29 Aug 2014: Around 170 000 Indonesians are set to fly to Saudi Arabia for the annual haj pilgrim in the coming weeks, but few are aware of the lurking danger of the ebolavirus, following the deaths of at least 1500 people in western Africa over the past 6 months. While Indonesia is fully geared up to handle the virus with isolation facilities established in around 100 hospitals nationwide, the country's preventive measures against the virus have been questioned. Indonesian Haj and Umrah Tour and Travel Union (Kesthuri) and Nahdlatul Ulama's Haj and the Umrah Counselors Association (Asbihu-NU) said recently that they had received no information from the health authorities on precautionary measures against the virus.... The 1st batch of Indonesia's haj pilgrims is slated to depart for Saudi Arabia on 1 Sep 2014, and will return in the 1st week of October.
http://m.thejakartapost.com/news/2014/0 ... -dark.html

USA, UK: West African student screening
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EVD in mind, US and UK colleges screen some students
29 Aug 2014: (AP) US universities count 9728 active students from Nigeria, 204 from Liberia, 169 from Sierra Leone and 95 students from Guinea, according to the USA federal government. College students from West Africa may be subject to extra health checks when they arrive to study in the USA, as administrators try to insulate campuses from the worst EVD outbreak in history.

Universities in the United Kingdom also are on alert with the expected arrival of thousands of Nigerian students there. Universities UK, which represents universities, has circulated guidance from Public Health England advising administrators on how to recognize and react to possible cases.
http://www.miamiherald.com/2014/08/29/4 ... creen.html

Zimbabwe: 21-Day Quarantine for EVD Suspects
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29 Aug 2014: (AllAfrica) People who travel to Zimbabwe from countries that have been affected by the ebolavirus will be quarantined for 21 days, while prophets who claim to cure HIV and Aids, diabetes and cancer risk being arrested for urging patients to stop taking medication, the Senate heard yesterday [28 Aug 2014].
http://allafrica.com/stories/201408290459.html

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[4] Sierra Leone: working in a triage tent
Date: 26 Aug 2014 [updated 27 Aug 2014]
Source: Stuff, New Zealand [edited]
http://www.stuff.co.nz/world/africa/608 ... erra-Leone


New Zealand Red Cross nurses fighting the EVD outbreak in Sierra Leone are unable to work inside the hospital where they are based because it is too dangerous. "21 of its medical staff have died and the staff who do turn up to work are scared, depressed and tired," health co-ordinator Sharon Mackie from Wellington, 45, said in a blog. She and mother of 4 Donna Collins, 48, from Whangarei recently arrived in Kenema, the worst-hit area of Sierra Leone. They are part of a multinational Red Cross team that opened 2 triage tents outside the Kenema Government Hospital.

"The local staff are traumatised," Mackie said. "This is a hospital that has lost most of its senior staff to ebolavirus due to poor understanding of isolation techniques." The goal of the triage tents was to help support patient flow and identification of suspected EVD cases, ensuring the hospital received the right patients at the right time, providing reassurance and confidence for local staff ... [more]

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[It is well worth reading the rest of this report for its description of working conditions around the isolation hospital. One has to admire the bravery of people who leave their families to work in the hot zone.

Interior photo of the screening tent in Kenema, Sierra Leone
https://i0.wp.com/cdn.rt.com/files/news ... ncy.si.jpg - Mod.JW]

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[5] Ebolavirus: genomic studies
Date: Fri 29 Aug 2014
Source: IFL Science [edited]
http://www.iflscience.com/health-and-me ... -published


Unfortunately, before the paper "Genomic surveillance elucidates ebolavirus origin and transmission during the 2014 outbreak" could be published online yesterday [28 Aug 2014], 5 of the 50 co-authors fell ill and died from the Ebola virus disease (EVD) raging on in West Africa.
[See first page in memoriam http://nextgenseek.com/wp-content/uploa ... moriam.jpg. - Mod.JW

In the paper, the researchers sequenced the genomes of the ebolavirus from 78 patients across the affected region, including Guinea, Liberia, Sierra Leone, and Nigeria. They identified the incredibly rapid mutation rate within the virus, which is currently changing twice as fast as ever before. They were able to determine that although the virus was originally transmitted to humans through an animal reservoir, the spread has been due to human interaction with infected individuals and not by several animals infecting humans in several locations.

The co-authors who had died from EVD all had ties to Kenema Government Hospital (KGH)'s Lassa fever ward in Sierra Leone. Since the start of the outbreak, over 24 KGH personnel have died because of the EVD. Lassa is similar to EVD in that they are both acute hemorrhagic fevers with similar symptoms, though the viruses are not related ... [more]

[Byline: Lisa Winter]

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[6] Media reports

Liberia: President sacks health minister
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27 Aug 2014: (VOA) Liberian President Ellen Johnson Sirleaf has ordered the dismissal of some junior and senior level cabinet ministers, who, in the wake of the deadly EVD outbreak left the country and have yet to return ... [more]
http://allafrica.com/stories/201408270535.html

CDC: Q&A on EVD
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29 Aug 2014: Members of the Young African Leaders Initiative (YALI) Network are focused on the EVD outbreak in West Africa and eager to learn more. More than 100 questions and comments came in from all over the region when experts at the US Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia answered questions from network members in a Facebook chat 26-28 Aug 2014. [A very short selection follows.]
https://youngafricanleaders.state.gov/cdcyalichat

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[ProMED thanks Ryan McGinnis for contributing to this post. - Mod.JW

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/8854.]

[Birgitt]

In den von Ebola betroffenen westafrikanischen Staaten liegen die Nerven zunehmend blank. In Sierra Leone trat das Personal in einem der beiden Ebola-Behandlungszentren nach dem Tod von mittlerweile fast 30 Kollegen in den Streik. Die Klinik verfüge nur über eine Krankentrage und diese sei kaputt, schilderte Abteilungsleiter Ishmael Mehemoh. Auf ihr seien sowohl Patienten als auch Leichen transportiert worden, wodurch sich das Ansteckungsrisiko erhöht habe. Krankenpfleger und Bestatter erklärten zudem, die Regierung habe ihre Wochenlöhne in Höhe von 50 Dollar nicht mehr bezahlt [...] In Nigeria nahm die Polizei aus Furcht vor der Krankheit in zwei Hotels 39 Bürger aus Sierra Leone und der Demokratischen Republik Kongo fest. Zur Begründung hieß es, die Menschen kämen aus Ländern, in denen das Virus aufgetreten sei, berichtete die Zeitung "Vanguard". Die Gäste seien unter Beobachtung gestellt worden [...] In Guinea wurden bei Zusammenstößen zwischen Demonstranten und Sicherheitskräften Dutzende Menschen verletzt, als Händler gegen eine Desinfektionskampagne auf einem Markt in N'Zerekore protestierten. Sie glaubten Gerüchten, dass dabei Menschen mit Ebola infiziert worden seien.

Proteste aus Angst vor der Ansteckung
31.08.2014 - tagesschau

Gruß
Birgitt

[Birgitt]

EBOLA VIRUS DISEASE - WEST AFRICA (145): SIERRA LEONE, CHILDREN IN DIRE NEED
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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:
[1] Sierra Leone: EVD orphans
[2] Pediatric hospital (again)

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[1] Sierra Leone: EVD orphans
Date: 19 Aug 2014
Source: Bloomberg [edited]
http://www.bloomberg.com/news/2014-08-1 ... ctims.html


Orphans whose families were killed by EVD are becoming a tragic legacy of the deadly outbreak in [3] West African nations, say relief organizations struggling to care for the children who may themselves be infected. ...

The nonprofit Catholic organization Salesian Missions was asked to provide care for the orphans by the government of Sierra Leone, and local staff are deciding today [19 Aug 2014] on a plan of action. ... Besides immediate needs such as food, the growing number of children whose families have been decimated by EVD will likely face long-term stigma and discrimination in the future as aid groups try to reintegrate them into the community, according to UNICEF, the United Nations Children's Fund.

The current epidemic, the worst on record, has strained the resources of governments and aid groups seeking to help the children, Crisafulli said. "There are already 70 in need of immediate attention," Father Jorge Crisafulli said of the orphans in Sierra Leone. "The number will increase." ...

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[2] Pediatric hospital (again)
Date: Sun 24 Aug 2014 [ProMED apologizes for the delay]
From: Daniel Lucey <daniel.lucey8@gmail.com> [edited]


[Re: Ebola virus disease - West Africa (143): Senegal, Sierra Leone pediatric crisis Archive No. 20140829.2735183]

Status report - Critical situation regarding disintegration of pediatric care during the EVD crisis in Sierra Leone:

Under normal conditions in Sierra Leone, pediatric medical care available is substandard. There is only one tertiary-level facility in the country -- Ola During Children's Hospital (ODCH) -- which is capable of providing basic inpatient pediatric care. As the hospital normally requires significant support from expatriate pediatricians, and there are only a few national pediatricians in the whole country, the available resources were already overburdened. Baseline health statistics are dismal, with an under-5 mortality in 2012 of 140 children/1000. One year ago, in August 2013, the ODCH admitted close to 1000 children, with 600 admissions due to malaria and almost 200 due to pneumonia.

Due to the massive outbreak of EVD and lack of concrete actions to control it, the ability to care for these children has been seriously compromised. This has been evidenced by a decrease in patient numbers seeking medical care due to fear of isolation and widespread fear of health care workers acquiring Ebola virus disease when caring for infected patients, whether confirmed, suspected, or unsuspected, without appropriate protective equipment and training in its use.

The most serious event was the recent and immediate closure of ODCH on 18 Aug 2014, when 127 inpatient children were abandoned by local hospital staff. This was due to a positive EVD test result in a young child admitted to the emergency department for 2 days, with close contact to other patients, parents and staff. The impact of this event was compounded by a Ministry of Health decision to immediately order a 21-day quarantine for 6 of 8 junior doctors. Even though screening was in place, due to deception by the child's father, the identification and isolation of this child was too late.

Now that there is active transmission in Freetown, with limited/incomplete contact history, the only way to identify suspected cases of Ebola in children is based on clinical symptoms. These mimic many other common pediatric illnesses, such as malaria and typhoid. Therefore, the only acceptable way to be able to reopen ODCH is to establish a 40-bed "fever" or isolation ward, requiring rapid lab turn-around time for EVD confirmation and a significant logistic and human resource commitment, neither of which are currently accessible. In addition, the lack of good-quality personal protective equipment (PPE) and adequate PPE training both for health care providers and support staff such as cleaners, counselors, technicians, water and waste management personnel, makes a safe reopening of the children's hospital virtually impossible.

Finally, a secure waste-disposal system, capable of coping with a large volume of waste for an EVD epidemic in an overcrowded, poor, urban area must be established. As long as the ODCH remains closed, thousands of children with treatable diseases, such as malaria and pneumonia, will die at home, without receiving essential treatment they require. The implications will also be severe for services such as outpatient pediatric HIV/AIDS and tuberculosis treatment, as these patients are either afraid to come to the hospital to receive their medications, or health care staff are placed at high risk without proper PPE to allow them to safely conduct consultations. These children will never be accounted for in national EVD mortality statistics. The only possible way to re-establish any form of pediatric care in Freetown requires a substantial and immediate international clinical and logistic intervention in order to support and instill confidence among national health care workers who are still willing to contribute to maintaining basic health care services and contribute to the fight against EVD.

--
Dr. Vanessa Wolfman, MD/MPH
Pediatric Care Manager/PMTCT Coordinator
Solthis-Sierra Leone

Daniel Lucey
<daniel.lucey8@gmail.com>

[I'm sure that everyone would like to see the UN, WHO and the World Bank health division address this emergency immediately.

It will take weeks to establish safe conditions for working at this hospital. Meanwhile, there are a lot of sick orphans needing treatment for non-EVD diseases.

The world should recognize the dedication of the pediatric hospital and orphanage staff putting their lives on the line while waiting for PPE supplies and a preventive vaccine to arrive from international aid. - Mod.JW

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

[Alexander]

Ein Ebola verdächtiger wurde am Wochenende im Leipziger Klinikum eingeliefert. Der Patient soll sich fünf Wochen in Ebolagebieten aufgehalten haben. Der Patient sei vor sechs Tagen mit hohem Fieber aus Liberia zurückgekehrt. Ein erster Test verlief negativ. Verdachtsfälle in Europa haben sich bisher immer als negativ herausgestellt. In einigen Fällen handelte es sich um Malaria.

Grüsse
Alexander

[Birgitt]

EBOLA VIRUS DISEASE - WEST AFRICA (146): SENEGAL, VACCINE TRIAL (UK), MORE
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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] Senegal: top priority emergency (WHO)
[2] Ebolavirus vaccine to be trialed in September 2014 in Oxford, UK
[3] Prevention & suspect cases
[4] Media reports

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[1] Senegal: top priority emergency (WHO)
Date: 30 Aug 2014
Source: WHO Epidemiology and surveillance [edited]
http://www.who.int/csr/don/don_updates/en


On 30 Aug 2014, Senegal's Ministry of Public Health and Social Affairs provided WHO with details about a case of Ebola virus disease (EVD) announced in that country on 29 Aug 2014. WHO has also received details of the emergency investigation immediately launched by the Government. Testing and confirmation of EVD were undertaken by a laboratory at the Institut Pasteur in Dakar [capital of Senegal].

The case is a 21-year-old male native of Guinea who arrived in Dakar by road on 20 Aug 2014 and stayed with relatives at a home in the outskirts of the city. On 23 Aug 2014, he sought medical care for symptoms that included fever, diarrhoea, and vomiting. He received treatment for malaria, but did not improve and left the facility. After leaving the facility, he continued to reside with his relatives. Though the investigation is in its early stages, he is not presently known to have travelled elsewhere. On 26 Aug 2014, he was referred to a specialized facility for infectious diseases, still showing the same symptoms, and was hospitalized. On 27 Aug 2014, authorities in Conakry, Guinea issued an alert informing medical services in Guinea and neighbouring countries that a person who was a close contact of a confirmed EVD patient had escaped the surveillance system. That alert prompted testing at the Dakar laboratory, launching an investigation and triggering urgent contact tracing.

Health sector response
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WHO is treating this 1st case in Senegal as a top priority emergency. Key operational personnel were dispatched to Dakar [30 Aug 2014]; others will follow. The Government of Senegal has informed WHO of the urgent need for epidemiological support, personal protective equipment, and hygiene kits. These needs will be met with the fastest possible speed.

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[2] Ebolavirus vaccine to be trialed in September 2014 in Oxford, UK
Date: 30 Aug 2014
Source: Cherwell [edited]
http://www.cherwell.org/news/town/2014/ ... -in-oxford


Oxford University's Jenner Institute, led by Professor Adrian Hill, is to begin human trials of a potential vaccine against the ebolavirus. The 1st round of trials should take place at the Oxford Vaccine Centre in Churchill Hospital in September [2014], subject to approval, and involve 60 volunteers from the Oxford area. If these prove successful, trials will be extended to volunteers in the Gambia and Mali to account for potential differences between European and West African responses.

There is no risk of volunteers becoming infected with ebolavirus themselves, as Professor Hill explains: "The vaccine takes a gene from the ebolavirus and puts in it a virus carrier. The carrier happens to be a safe version of a common cold virus."

The trials have received accelerated funding due to the current EVD epidemic, which has killed more than 1500 people at the time of writing. The Jenner Institute is working in tandem with GlaxoSmithKline and the US government's National Institute of Health. ...

[Byline: Ellen O'Neill]

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[3] Prevention & suspect cases

Nigeria: contacts
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31 Aug 2014: (PressTV) Some 160 people have been placed under medical surveillance over the deadly Ebola virus [disease] in the Nigerian city of Port Harcourt in Rivers State. "As of today [31 Aug 2014], none of them has shown symptoms of any kind. We are in touch with them constantly, and they also call us to tell us their condition," Sampson Parker, the health commissioner of Rivers State, said on Fri [29 Aug 2014]. The people who are being monitored had been in contact with a doctor who died from the virus. The Nigerian government said on Thursday [28 Aug 2014] that the doctor, Ikyke Samuel Enuemo, was the country's 6th person to die from the disease. http://www.presstv.ir/detail/2014/08/29 ... over-ebola

Spain (Malaga) ex Nigeria
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31 Aug 2014: Malaga Regional Hospital has activated its EVD protocol after the arrival at 5:30 a.m. of a 40-year-old man with symptoms of the virus. The patient, of Nigerian origin and a resident of Antequera, returned on 17 Aug 2014 from a journey to his homeland; he presented with a very high fever at the moment of his admission.

These circumstances obliged the Andalusian Health Service to activate its EVD protocol and immediately admit the patient. He is now in isolation in the infectious-cases unit of the 5th floor of Carlos Haya Hospital. He is in a room designed for his condition and is being cared for by professionals "prepared and equipped for it," according to sources in the Regional Hospital.

The patient arrived in the morning at the Carlos de Haya Regional Hospital, having come from Antequera to Malaga. Although an ambulance was ready to transport him, he used his own vehicle to make the trip to the capital. He arrived accompanied by his wife and 2 [other] children, who had no symptoms and could return home [to their holiday apartment].

The entire family recently returned from a trip to Nigeria, where, according to WHO, the virus has spread with force recently. "At the moment, this is only a suspected case, but since he has been in a danger zone recently, we feel obliged to treat the case as if he were infected with EVD," hospital sources said. http://www.laopiniondemalaga.es/malaga/ ... 03738.html [in Spanish, trans. by Crawford Kilian.
See map at http://www.antequerarural.com/images/mapa_grande.jpg. - Mod.JW]

Sweden ex West Africa
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31 Aug 2014: (ITV) A possible case of EVD is being investigated by a hospital in Sweden, local media has reported. A man who recently travelled to a "risk area" was being treated in an isolation unit at the Karolinska University Hospital in Stockholm, the reports said. They added that doctors are currently running tests on the man, who recently returned from West Africa where the disease has claimed [over] 1500 lives.
http://www.itv.com/news/story/2014-08-3 ... -in-sweden

WHO helps Gambia prevent EVD
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30 Aug 2014: (Xinhua) The World Health Organization (WHO) has equipped the Gambian Ministry of Health and Social Welfare with laboratory materials to combat the deadly EVD, Gambia's officials said on Sat [30 Aug 2014]. "We are supporting the government through its ministry to close ranks against the deadly EVD, which is spreading in West Africa," said Charles Saego Moses, a WHO country Representative in Gambia. The materials were handed over to the ministry through the ministry deputy permanent secretary Dawda Ceesay, who noted that Gambia should not be complacent despite [the fact] that no EVD case has been detected in the country. ... The ministry has increased surveillance teams at the border to ensure the health check of those going out of and coming into Gambia, Ceesay said. According to the WHO, more than 3000 people have been infected with EVD. On Fri [29 Aug 2014], Senegal, Gambia's neighboring country, confirmed its 1st case of EVD, making it the 5th West African country to be affected by the outbreak.
http://news.xinhuanet.com/english/world ... 609045.htm

[Gambia is an English-speaking country completely surrounded by French-speaking Senegal; see map: http://geology.com/world/the-gambia-map.gif. - Mod.JW]

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[4] Media reports

Economic effects, regional
-----------------
29 Aug 2014: The African Development Bank (AfDB) has assessed that the worst ever EVD outbreak has been causing enormous damage to West African economies, as foreign businessmen quit the region. ...
http://allafrica.com/stories/201408290339.html

Sierra Leone: strike averted
----------------------
31 Aug 2014: (AP) In Sierra Leone on Sunday [31 Aug 2014], officials said they had avoided a strike threatened by workers at an EVD treatment center [Kenema] in the east of the country, the region hardest hit by the outbreak. Protective equipment is being sent to the health workers and a "monthly incentive allowance" will be paid on Mon [1 Sep 2014], health ministry spokesman Sidie Yahya Tunis told The Associated Press. On Fri [29 Aug 2014], Sierra Leone President Ernest Bai Koroma replaced Health Minister Miatta Kargbo with Abu Bakarr Fofanah, a move his office described as necessary to more efficiently combat the outbreak. Kargbo was recalled to work in the president's office. http://bigstory.ap.org/article/who-sene ... -emergency

[In Kenema, 26 staff members have already died from EVD, following the death of physician Sahr Rogers. The diagnostic lab has been closed down, and some international staff have been withdrawn after safety concerns. - Mod.JW]

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[Birgitt]

EBOLA VIRUS DISEASE - WEST AFRICA (147): LIBERIA, NEW DRUG, PREVENTION
**********************************************************************
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] Ugandan doctors deployed to Liberia
[2] China: new EVD antiviral drug
[3] Prevention, suspected cases

[This is by no means a complete roundup of "all the news that's fit to print" about EVD but a selection from the avalanche of reports of what this moderator considers important from a public health point of view. - Mod.JW]

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[1] Ugandan doctors deployed to Liberia
Date: 1 Sep 2014
Source: WHO/AFRO [edited]
http://www.afro.who.int/en/liberia/pres ... beria.html


A team of Ugandan doctors and health workers are deployed by WHO to provide medical support for an Ebola treatment centre in Monrovia, Liberia. This team comes with vast experience in managing Ebola outbreaks, having faced many cases of this disease since 2000. They work shifts alongside their Liberian colleagues to provide around the clock care and to help maintain strict infection control measures. ...

[The 1st African doctor from outside West Africa to die from the current EVD pandemic was also Ugandan. Dr Samuel Muhumuza Mutooro (Dr Sam) and his wife and children had been living in Liberia for 3 years under a pre-epidemic contract; see ProMED-mail: Ebola virus disease - West Africa (78): Guinea, Sierra Leone, Liberia 20140702.2583396. - Mod.JW]

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[2] China: new EVD antiviral drug
Date: 1 Sep 2014
Source: SCMP [edited]
http://www.scmp.com/news/china/article/ ... y-use-only


China's 1st drug against EVD has obtained manufacturing approval for emergency use, a military newspaper reports. The drug, named JK-05, was developed by Professor Wang Hongquan with the Institute of Microbiological Epidemiology under the Academy of Military Medical Sciences, according to the PLA News.

"JK-05 is a micro-molecular chemical, and its pharmacological mechanism is to selectively contain the RNA polymerase of the Ebola virus to inhibit virus replication," Wang told the newspaper.

Wang's study showed JK-05 resisted the replication of Ebola cells in experiments and animal tests. The drug, after 5 years of study, has passed pre-clinical testing and the clinical safety test. However, the drug currently is strictly limited for emergency use only, Wang said.

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[3] Prevention, suspected cases

Nigeria: fatal case in Abuja
----------------------------
1 Sep 2014: (iREPORTS-NG) A suspected Ebola virus disease (EVD) patient has [died] in one of the biggest government-owned hospitals in Abuja, Asokoro General Hospital, in the nation's capital city, barely 3 weeks after another suspected patient died in a private hospital [there]. The death, which was said to have occurred last weekend [30-31 Aug 2014] has already caused serious panic in the Federal Capital Territory (FCT). In a statement released yesterday [31 Aug 2014], spokesperson of FCT Health Secretariat Badaru Salisu Yakasai said the results of the tests conducted on the deceased have yet to either confirm or refute claims that the patient died of EVD.
http://ireports-ng.com/2014/09/01/suspe ... rveillance

Sweden: negative
----------------
1 Sep 2014: (MSN News NZ) A man suspected of being infected with the deadly ebolavirus ravaging several African countries has tested negative in Sweden, local health officials say. "We analysed the tests and can say there is no sign whatsoever that the patient was suffering from EVD," a statement said. The man, a foreign national who travelled to Sweden from an EVD-affected area last week, was hospitalised on Sun [31 Aug 2014].
http://news.msn.co.nz/worldnews/8899171 ... n-official

Sudan: hemorrhagic fever case in Darfur
---------------------------------------
31 Aug 2014: (StarAfrica) The minister of health affairs for the Darfur Regional Authority, Firdos Abdel Rahman Yousif, denied reports of the deadly Ebola virus disease in El Geneina, capital of West Darfur State. The Sudan News Agency quoted the minister as saying the suspected case had come from Abeche in Chad. The patient suffered from hemorrhagic fever, began taking treatment from the health center, and was then transferred to a hospital in El Geneina, she claimed. ...
http://en.starafrica.com/news/sudan-ban ... ebola.html

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[There have not been any reports of EVD or any other hemorrhagic fever in Chad, but yellow fever (YF) needs to be excluded, because there was an outbreak of YF in 2012 in Darfur, Sudan, which also affected Chad, and 6 million people were vaccinated in Darfur in 2013; see ProMED-mail: Yellow fever - Africa (12): Sudan (Darfur) 20130302.1567578.

It is highly unlikely that EVD has arrived in the region, as I don't think there is much human through traffic all the way from Bamako in Mali, just north of the Guinean border, and the Chad-Sudan border, around 4000 km (2500 miles) further east by the trans-African highway (see map at: http://upload.wikimedia.org/wikipedia/c ... ghways.PNG), nor many air passengers from West Africa via Khartoum. If anyone has information to the contrary, ProMED-mail would be glad to receive it. - Mod.JW

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/54.]

[Birgitt]

Das Ebolavirus breitet sich in Westafrika aus. Eine Simulation zeigt jetzt, über welche Flughäfen die Seuche nach Europa gelangen könnte. Entscheidend sind die Verbindungen zwischen Afrika und den einstigen Kolonialmächten. Der Pest-Erreger brauchte einst Jahre, um einen Kontinent zu durchqueren. In der modernen Welt reisen Menschen im Flugzeug binnen eines Tages um die Erde - und dies beschleunigt die Ausbreitung von Krankheiten, wie die Lungenkrankheit Sars oder die Vogelgrippe bereits gezeigt haben. Wie stark Flugverbindungen den Verlauf von Infektionswellen beeinflussen, hatten zuletzt zwei deutsche Forscher demonstriert. Das verblüffend simple Modell von Dirk Brockmann von der Berliner Humboldt-Universität Berlin und Dirk Helbing von der ETH Zürich kann die Ausbreitung einer Seuche vorhersagen.

Computersimulation: Wie Ebola nach Europa gelangen könnte
02.09.2014 - Spiegel

Gruß
Birgitt

[Birgitt]

EBOLA VIRUS DISEASE - WEST AFRICA (148): CDC, WHO, NIGERIA, LIBERIA, MORE
*************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

In this update:
[1] CDC & WHO Press Briefings on EVD
[2] Nigeria: new case
[3] Liberia: new US doctor case, nurses strike
[4] Prevention & suspected cases
[5] Harvests threatened
[6] Central African Republic: ebolavirus found in wildlife

[This is by no means a complete roundup of "all the news that's fit to print" about EVD but a selection from the avalanche of reports of what this moderator considers important from a public health point of view. - Mod.JW]

******
[1] CDC & WHO Press Briefings on EVD
Date: 2 Sep 2014
Source: AFluDiary [edited]
http://afludiary.blogspot.co.uk/2014/09 ... ebola.html


Today [2 Sep 2014], the World Health Organization and the US Centers for Disease Control and Prevention [CDC] both held press conferences (unfortunately, at the same time) on the Ebola virus disease outbreak in West Africa. Both carried similar messages.

The EVD outbreak in West Africa is moving faster than the response currently being mounted against it. A concerted international effort is needed now to defeat this epidemic, with the implied threat that we either deal with it now in Africa, or we risk having to deal with it for years to come around the globe.

CDC director Dr Thomas Frieden painted a grim picture in his update on the Ebola outbreak in West Africa, saying that the epidemic was "spiraling out of control", but stressed there was still a "small window of opportunity" to contain it.

A transcript and audio file should be posted on the CDC Media website, hopefully later today [2 Sep 2014], with links to videos of the WHO/UN briefing.
http://www.cdc.gov/vhf/ebola/index.html ... eature_001

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[2] Nigeria: new case
Date: 2 Sep 2014
Source: Nigerian Eye [abridged, edited]
http://www.nigerianeye.com/2014/09/ebol ... -port.html


One of 3 people taken to the Ebola virus quarantine centre in Oduoha, Emohua Local Government Area of Rivers State, has tested positive for the disease. The latest case, an elderly woman, contracted the virus in Good Heart Hospital, the health facility where the doctor who treated a Nigerian ECOWAS diplomat [contact of index case Sawyer from Liberia] died last week. The 2 others -- a doctor and a pharmacist -- tested negative. Even though they had been released from the centre, another round of tests will be carried out to reconfirm their status. ...

Amidst fear of the Ebola virus disease (EVD) spreading in Nigeria, the federal government is increasing its capacity to curtail the spread of the virus, the health minister said on Mon [1 Sep 2014].

The minister of health, Onyebuchi Chukwu, revealed on Monday [1 Sep 2014] during the 2nd emergency National Council on Health meeting on the EVD outbreak in Nigeria, which was held in Abuja, that the federal ministry of health has steadily been increasing capacity to diagnose EVD.

Mr Chukwu said the virus can now be diagnosed at the following locations: NCDC Laboratory, Asokoro, Abuja; NCDC Laboratory at LUTH, Lagos; NCDC Laboratory at University College Hospital, Ibadan; Irrua Specialist Teaching Hospital Irrua, Edo State; Virology Laboratory of Redeemers University, Ogun State; the Irrua-based mobile laboratory, which has now been relocated from Enugu to Port Harcourt.

He stated that plans were at an advanced stage to enable the following laboratories: NCDC Laboratory at Aminu Kano Teaching Hospital, Kano; NCDC Laboratory at UPTH, Port Harcourt, while the federal ministry of health plans to procure additional mobile laboratories to be based in the following locations: Abakaliki, Port Harcourt, Bauchi, Jos and Sokoto. ...

The minister further revealed that Nigeria has indicated interest to participate in the clinical trials for Ebola virus disease vaccines, adding that the country has also applied for experimental drugs such as TKM-Ebola: "The Treatment Research Group (TRG) has been working hard to identify experimental drugs like Zmapp and also to make recommendations to government on further research on these drugs as well as vaccines for EVD treatment and prevention. Following the TRG's recommendation and in consultation with NAFDAC and NHREC, Nigeria has indicated interest to participate in the clinical trials for 2 candidate EVD vaccines and is considering a 3rd that may be added to the list. We have also applied for experimental drugs such as TKM-Ebola.

"The TRG has submitted a detailed profile and brief on the oral antiviral agent which the Japanese Government has offered to make available to affected countries through the WHO. We are now considering the profile and brief to enable us to reach a final decision on making it available to our patients."
http://allafrica.com/stories/2014090209 ... e=slideout

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[3] Liberia: new US doctor case, nurses strike

2 Sep 2014: (ABC News Radio) Another American doctor working for the missionary group SIM [Serving in Mission] has tested positive for Ebola in Liberia. The doctor was treating pregnant women at ELWA [Eternal Love Winning Africa] Hospital in Monrovia, Liberia, according to SIM. But he was not treating EVD patients in the hospital's separate EVD isolation facility, the group said, adding that it was unclear how he contracted the virus. ...
http://abcnewsradioonline.com/health-ne ... z3CBli2TQz


Liberia: nurses strike
----------------------
2 Sep 2014: (Reuters/AFP) Nurses on strike at Monrovia hospital are demanding protective equipment which they say has not been provided. [They are] demanding higher salaries as well as protective equipment against EVD. At the John F. Kennedy hospital in Monrovia, the nurses sought personal protective equipment, hazmat-style suits that protect against the spread of the disease, reports AFP.
http://www.ibtimes.co.uk/ebola-liberia- ... ar-1463545

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[4] Prevention & suspected cases

Nigeria
-------
Kaduna governmentt confirms there's a suspected case of Ebola at ABU.
2 Sep 2014: (PT) The Kaduna state government has confirmed that there is indeed a suspected case of Ebola virus disease in the state. ...
Premium Times had reported that a 19 year old law student at the Ahmadu Bello University was suspected to be down with the deadly Ebola virus in Kaduna and was on admission at the Ahmadu Bello University Teaching Hospital, (ABUTH). As indicated in the report, Bilyaminu Umar, spokesperson for ABUTH, confirmed the development. But no sooner than our report was published, the spokesperson to the minister, Mr Nwomeh, took to the social media to say the story was false. "The Kaduna report is totally untrue," Mr Nwomeh tweeted.

But the [Kaduna] state commissioner of health, Dr Thot Dogo, has now confirmed the development to Premium Times. Mr Dogo said in a telephone interview: "That case is a case of a student who took ill; we are just suspecting the ebolavirus. So, we have taken his blood sample for test. ... The patient is on isolation in Zaria. By tomorrow [3 Sep 2014] in the afternoon, the result will be ready from Lagos. We have already gone there after the ABUTH authorities alerted us, and our rapid response team took the blood sample. He has been at the hospital for about a week now. It's only fever. But I think he developed rashes with redness of the eyes. So, we are just taking precautions. ..."
https://www.premiumtimesng.com/news/167 ... jQoYt.dpuf

[See map of Nigeria's states, with Kaduna in yellow in the centre, at http://www.nigeriahc.org.uk/images/nigeria_map_m.gif. - Mod.JW]


St Lucia (Caribbean)
--------------
1 Sep 2014: (SNO ) Ebola medical team activated at Hewanorra International.
The Ministry of Health has activated an EVD medical team at the Hewanorra International Airport. ... Reports are that the officials at the airport were planning a protest on Sat [30 Aug 2014] since there was no medical team in place to deal with an international flight that had African nationals who could be possible EVD victims. ...
http://www.stlucianewsonline.com/ebola- ... oxQER.dpuf


Canada
------
2 Sep 2014: (St Catharines Standard) There is only a remote possibility a patient in quarantine at the Niagara Health System's St Catharines Hospital [Ontario] was infected by the deadly ebolavirus, but doctors are taking no chances. The NHS has released few details about the patient -- including the person's gender, age, city of residence or nationality -- who was placed in isolation on Mon [1 Sep 2014]. The patient went to the St Catharines emergency department with flu-like symptoms after having recently traveled from the heart of the EVD outbreak in West Africa. The NHS declined to say which West African nation the person had visited. The outbreaks are in Guinea, Liberia, Sierra Leone and Nigeria.
http://www.stcatharinesstandard.ca/2014 ... catharines

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[5] Harvests threatened
Date: 2 Sep 2014
Source: BBC [edited]
http://www.bbc.co.uk/news/world-africa-29028768
http://www.fao.org/news/story/en/item/242177/icode


Residents of the West Point slum in Monrovia, Liberia received food aid on 21 Aug 2014. The EVD outbreak is putting food harvests in West Africa "at serious risk", the UN's Food and Agriculture Organization (FAO) warns. It has raised a special alert for Liberia, Sierra Leone and Guinea, the 3 countries worst affected. Rice and maize production will be particularly affected during the coming harvest season, says the FAO. The food shortages are expected to worsen in the coming months. ...

In Monrovia, Liberia, a recently conducted rapid market assessment indicates that prices of some food items have increased rapidly, for example, in Monrovia's Redlight Market, the price of cassava went up 150 per cent within the 1st weeks of August [2014]. ...

"Even prior to the Ebola outbreak, households in some of the affected areas were spending up to 80 per cent of their incomes on food," said Vincent Martin, head of the FAO's Dakar-based Resilience Hub, which is coordinating the agency's emergency response. "These latest price spikes are effectively putting food completely out of their reach," he added.

To meet short-term food needs, the FAO has jointly approved an emergency programme with the UN's World Food Programme to deliver 65 000 tonnes of food to the estimated 1.3 million people affected by EVD over 3 months.

The depreciation of national currencies in Sierra Leone and Liberia in recent months is expected to exert further upward price pressure on imported food commodities. ...

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[6] Central African Republic: ebolavirus found in wildlife
Date: 2 Sep 2014
Source: Star Africa [machine trans. edited]
http://fr.starafrica.com/actualites/le- ... n-rca.html [in French]


"The ebolavirus is circulating in Central African wildlife, but conditions are perhaps not met for an epidemic to arise in the Central African Republic, the director of the Pasteur Institute of Bangui, Emmanuel Nakoune Yandoko, said on Mon 1 Sep 2014. "We captured animals such as rats, bats, monkeys and sibissi [giant cane rats, a national delicacy]. We sought ebolavirus, and we found it in the spleens of these animals," said Emmanuel Nakoune. ...

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[Alexander]

Resignation, angesteckte Ärzte und Helfer. Menschen, die an anderen Krankheiten leiden sterben, weil entweder kein Ärztepersonal mehr vorhanden ist oder sie komplett mit dem Kampf gegen Ebola beschäftigt sind. Die hygienischen Verhältnisse sind katastrophal. Leichen verrotten im Strassengraben. Und Ebola breitet sich weiter aus.


Ärzte ohne Grenzen: "Wir sind dabei, Kampf gegen Ebola zu verlieren"

Ebola breitet sich aus, und die Hilferufe der WHO und von Ärzte ohne Grenzen werden immer lauter. Ein weiterer US-Arzt hat sich infiziert. Für Geburten oder andere Patienten ist kein Platz. Nur Tod. mehr...

Grüsse
Alexander

[Wüstenkind]

Resignation, angesteckte Ärzte und Helfer. Menschen, die an anderen Krankheiten leiden sterben, weil entweder kein Ärztepersonal mehr vorhanden ist oder sie komplett mit dem Kampf gegen Ebola beschäftigt sind. Die hygienischen Verhältnisse sind katastrophal. Leichen verrotten im Strassengraben. Und Ebola breitet sich weiter aus.


Ärzte ohne Grenzen: "Wir sind dabei, Kampf gegen Ebola zu verlieren"

Ebola breitet sich aus, und die Hilferufe der WHO und von Ärzte ohne Grenzen werden immer lauter. Ein weiterer US-Arzt hat sich infiziert. Für Geburten oder andere Patienten ist kein Platz. Nur Tod. mehr...

Grüsse
Alexander

Furchtbar, einfach nur furchtbar. Die armen Menschen!
Das ist wie ein Szenario mit dem Hollywood immer Menschen ins Kino locken will. Nur das es nun nicht fiktiv ist, sondern real. Grausam will gar nicht daran denken, wie sich das weiter entwickeln kann.
Gegen diese Krankheit kann man wohl nichts machen. Das ist pure Ohnmacht.

[Birgitt]

Die Zahl der Ebola-Opfer im Westen Afrikas steigt - und das ausgesprochen schnell: Nach Angaben der Weltgesundheitsorganisatio (WHO) erkrankten seit Ende vergangenen Jahres mehr als 3500 Menschen an der Krankheit, mehr als 1900 von ihnen starben. Vor wenigen Tagen war noch von 1500 Todesopfern die Rede. Entsprechend alarmierend äußerte sich WHO-Direktorin Margaret Chan: "Dieser Ausbruch ist viel schneller als unsere Versuche, ihn einzudämmen", sagte sie.

1900 Tote seit Ausbruch der Epidemie
03.09.2014 - tagesschau

Gruß
Birgitt

[kro]

Gegen diese Krankheit kann man wohl nichts machen. Das ist pure Ohnmacht.

Doch, man kann einiges tun.... Zur Vermeidung weiterer Fälle in erster Linie: Aufklären, informieren, contact tracing, aber natürlich auch vernünftige Infrastruktur für Isolierung und Behandlung bereitstellen, sowie auch versuchen anderweitig Betroffenen zu helfen, die wegen den Auswirkungen von Ebola auf der Strecke bleiben.

All diese Arbeit erfordert natürlich viel Zeit und Ressourcen, die nicht jeder hat. Dafür kann man aber diejenigen unterstützen, die aktiv vorgehen und vor Ort wirklich hervorragende Arbeit leisten. Als erstes kommt dabei wohl MSF in Frage => http://www.msf.org.uk/ebola

Gruß,
Felix

[Alexander]

Das hört sich in der Theorie ganz gut an. Die Praxis sieht leider ganz anders aus. In Ländern, wo der Voodoo noch tief verwurzelt ist, wirst du es schwer mit Aufklärung und Information haben. Informationskampagnen wurden bereits durchgeführt. Das Ergebnis kennen wir.

Die von dir genannten MSF schätze ich persönlich sehr und ihr Einsatz würde einen Nobelpreis verdienen. Aber auch sie scheinen ihre Grenzen erkannt zu haben und rufen wie die WHO um Hilfe.

1900 Tote - WHO sendet Hilferuf in die Welt

Die Weltgesundheitsorganisation schlägt immer lauter Alarm: Die Zahl der Ebola-Toten ist inzwischen auf rund 1900 gestiegen, Tausende sind erkrankt. Die WHO spricht von einer "globalen Krise". mehr...

Grüsse
Alexander

[Wüstenkind]

@Felix: Ja natürlich kann man einiges machen... Also, wenn hier die Krankheit wäre (Europa), wären wir besser versorgt als die Menschen in Westafrika. Da ist eben das Problem, dass sie dort noch nicht so weit sind. Sehe das ähnlich wie Alexander...
Den Menschen fehlt leider das Vertrauen in Ärzte. Man kann nur hoffen...

[Kuno]

@Felix: Ja natürlich kann man einiges machen... Also, wenn hier die Krankheit wäre (Europa), wären wir besser versorgt als die Menschen in Westafrika. Da ist eben das Problem, dass sie dort noch nicht so weit sind. Sehe das ähnlich wie Alexander...
Den Menschen fehlt leider das Vertrauen in Ärzte. Man kann nur hoffen...

1) "Man kann einiges machen" und "man kann nur hoffen" stehen sich diametral entgegen.
2) Es ist nicht die Frage ob die Krankheit nach Europa kommt sondern nur wann sie kommt.
3) Und du wirst ueberrascht sein, wie schnell unsere Spitaeler am Anschlag sind, wenn sie sich mit einigen solchen Faellen beschaeftigen muessen.