EBOLA VIRUS DISEASE - ex AFRICA (07): EUROPE CASES, USA QUARANTINE STATIONS
***************************************************************************
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] Spain: nurse's Ebola infection blamed on substandard equipment
[2] Norway case
[3] USA: quarantine stations
[4] Where to find non-sensational Ebola coverage
******
[1] Spain: nurse's Ebola infection blamed on substandard equipment
Date: 7 Oct 2014
Source: The Guardian [edited]
http://www.theguardian.com/world/2014/o ... tive-spain
Health professionals in Madrid have blamed substandard equipment and a failure to follow protocol for the 1st case of Ebola to be contracted outside West Africa. Health authorities announced on Mon [6 Oct 2014] that a Spanish nurse at Madrid's Carlos III hospital who treated a patient repatriated from Sierra Leone had twice tested positive for Ebola.
Her husband had also been admitted to hospital and was in isolation, and a 2nd nurse from the same team that treated both repatriated Ebola victims was also being tested. In this case, the nurse contacted the authorities on Mon [6 Oct 2014] complaining of a fever. She was in isolation in the Carlos III Hospital while authorities waited for the test results, a spokesperson for the Madrid regional government said.
Staff at the hospital told El Pais that the protective suits they were given did not meet World Health Organization (WHO) standards, which specify that suits must be impermeable and include breathing apparatus. Staff also pointed to latex gloves secured with adhesive tape as an example of how the suits were not impermeable and noted that they did not have their own breathing equipment.
The nurse was part of a team attending to missionary MGV, 69, who died 4 days after being brought to Carlos III hospital on 20 Sep 2014. The same team, including the nurse, also treated missionary MP, 75, who was repatriated from Liberia in August 2014 and died 5 days later. Staff at the hospital said waste from the rooms of both patients was carried out in the same elevator used by all personnel and, in the case of the 2nd patient, the hospital was not evacuated.
The European commission said on Tue [7 Oct 2014] it had written to the Spanish health minister "to obtain some clarification" on how the nurse had become infected when all EU member states were supposed to have taken measures to prevent transmission. There is obviously a problem somewhere," the commission spokesman Frederic Vincent said.
Spanish health authorities have said that professionals treating Ebola patients in Spain always follow WHO protocols. The nurse would have entered GV's room just twice, said Antonio Alemany, from the regional government of Madrid, both times wearing protective equipment. "We don't know yet what failed," Alemany said. "We are investigating the mechanism of infection."
The nurse was in a stable condition. She had alerted the ministry of a slight fever on 30 Sep 2014 and been checked into a hospital in Alcorcon, on the outskirts of Madrid, with a high fever on Mon [6 Oct 2014]. The nurse, who is married with no children, was transferred to Carlos III hospital early on Tuesday morning [7 Oct 2014]. El Mundo reported that it was the nurse who asked to be tested for Ebola, having to insist repeatedly on being tested before it was done on Monday [6 Oct 2014].
While staff at the Alcorcon hospital were waiting for the test results, the nurse remained in a bed in the emergency room, separated only by curtains from other patients, hospital staff told El Mundo. Their version of events clashes with that of health authorities, who have said the patient was isolated from the 1st moment.
The woman was on holiday at an unknown location when she began showing symptoms. "We are drawing up a list of all the people she may have been in contact with, including with health professionals at the Alcorcon hospital," said Alemany, estimating that more than 30 people were being monitored for any sign of symptoms.
In August 2014, Spain became the 1st European country in the current, fast-spreading outbreak to evacuate patients for treatment. The decision prompted concern among health professionals, who said Spanish hospitals were not adequately equipped to handle Ebola.
[Byline: Ashifa Kassam]
--
Communicated by:
ProMED-mail Rapporteur Kunihiko Iizuka
--
Spain: contacts quarantined
-------------------------------------
7 Oct 2014: (BBC) Three other people, including the nurse's husband, have been quarantined. The nurse had twice gone into the room where Mr. GV had been treated to be directly involved in his care and to disinfect the room after his death. Both times, she was wearing protective clothing. Madrid healthcare director Antonia Alemany told reporters that according to the information available: "The nurse went into the room wearing the individual protection gear, and there's no knowledge of an accidental exposure to risk."... The hospital was reported to have had extreme protective measures in place including 2 sets of overalls, gloves and goggles.
However, health workers told El Pais newspaper that the clothing did not have level-4 biological security, which is fully waterproof and with independent breathing apparatus. Instead, it was level 2, the paper says, as photographs provided by staff indicated that the overalls did not allow for ventilation, and the gloves were made of latex and bound with adhesive tape.
Doctors are also monitoring 22 people with whom the nurse had contact at Alcorcon hospital and 30 people working at Carlos III, according to health sources quoted by Spanish newspaper El Pais. They include an ambulance crew and doctors and nurses, and all have been contacted by the health authorities.
http://www.bbc.com/news/world-europe-29516882
[The] case highlighted the dangers that health care workers face caring for Ebola patients; officials said she had changed a diaper for the priest and collected material from his room after he died. Dead Ebola victims are highly infectious, and in West Africa, their bodies are collected by workers in hazmat outfits.
[This posting from the Washington Post originally cited an AP report that said a Nigerian has been hospitalized in Spain. The AP has updated its reporting to say that the man is Spanish and had recently traveled to Nigeria. This post has been updated as well. - Mod.JW]
News of the quarantines hit Spain's stock market Tuesday [7 Oct 2014]. Spain is one of Europe's biggest tourist destinations, and stocks in tourism-related companies such as airlines and hotel chains fell on the Madrid stock exchange as investors feared the consequences of the Ebola case. Shares in International Airlines Group, formed in early 2011 by the merger of British Airways and Iberia, dropped more than 6 percent, while those of NH Hotel Group and Melia Hotels were down 4 percent. The Ibex 35 stock market index was 1.7 percent lower.
The nurse, who did not leave Madrid during her vacation, was currently being treated with drip using antibodies from previous infected patients... [presumably plasma from the 2 missionaries who died in the hospital. - Mod.JW]
http://abcnews.go.com/Health/wireStory/ ... ePage=true,
http://uk.mobile.reuters.com/article/id ... 7?irpc=932.
[Byline: Inmaculada Sanz]
--
Ryan McGinnis
http://bigstormpicture.com
******
[2] Norway case
Date: 7 Oct 2014
Source: The Local, Norway [edited]
http://m.thelocal.no//20141007/norwegia ... e-of-zmapp
The Norwegian woman infected by Ebola [ebolavirus] in Sierra Leone and currently receiving treatment in Oslo, will get the last dose of the virus treatment medicine ZMapp available in the world. The news was released by the Norwegian Medicines Agency on Tue [7 Oct 2014], according to NTB. Steinar Madsen, medical director of the Norwegian Medicines Agency, said to Dagens Medisin: "It looks like we could get the last available dose of ZMapp to Norway. The medicine is now in Canada."
According to the professional medic's magazine, the agency has given Oslo University hospital the authorisation to import Ebola medicines not approved of in Norway. Madsen said: "When there are patients with an acute need for medicine, we allow import of medicines that are not approved."
While the medicine Avigan came to Norway already on Tue [7 Oct 2014], TKM-Ebola will arrive on Wed [8 Oct 2014]. Madsen reported that ZMapp has been the most difficult to get. "It must be said it is lucky that Norway will get the last dose of ZMapp. There are no more doses in the world, and it takes a long time to produce. It is the hospital pharmacy that gets the medicine through contact networks all over the world, while the Norwegian Medicines Agency gives the necessary approval," said Madsen.
Madsen explained further the medicine will be imported to the Ebola patient only. It has been tried on only a small number of patients, and the effect of the medicine is, therefore, not fully known. Madsen said: "Of those who have taken ZMapp, the majority have survived. Another person has survived with TKM-Ebola, but the medicines are used on a small number of patients."
It has been revealed that at least 27 Norwegians are still currently working in Ebola-ridden areas and include:
- Medecins Sans Frontiers: Around 20 Norwegians take part in the Ebola effort in Liberia, Sierra Leone and Guinea.
- Red Cross: 7 Norwegian employees in areas struck by Ebola.
- NORCAP: A Norwegian health logistics worker will travel to Liberia on Fri [10 Oct 2014]. Other Norwegians are also on NORCAP's preparedness lists.
--
Ryan McGinnis
http://bigstormpicture.com
******
[3] USA: quarantine stations
Date: 6 Oct 2014
Source: Washington Post [edited]
http://www.washingtonpost.com/blogs/fed ... o-they-do/
Public health officials say Ebola is extremely unlikely to spread in the United States, but the Centers for Disease Control and Prevention is on the lookout for international travelers who might be carrying the deadly virus. The agency operates a network of 20 quarantine stations where health officers can "decide whether ill persons can enter the United States and what measures should be taken to prevent the spread of contagious diseases."
The locations of all 20 U.S. quarantine stations (Courtesy of CDC):
http://www.cdc.gov/quarantine/images/ju ... -925px.jpg.
On Sun [5 Oct 2014], one of those stations sprang to action after a passenger began vomiting on board an international flight headed from Brussels to New Jersey's Newark Liberty International Airport, according to a CNN report. Most of the 255 passengers on the flight were released to go through customs after about an hour and 35 minutes. The sick traveler was allowed to leave after the New Jersey Department of Health, in coordination with federal officials, determined that his condition was "consistent with another, minor treatable condition unrelated to Ebola."
The CDC has the authority to deny entry to the United States for ill people if they have one of 9 types of "quarantinable diseases," as defined by executive order. The agency can also admit patients to specialized hospitals for treatment. The list of quarantinable diseases, which was last updated by President Obama in July [2014], includes cholera, diphtheria, infectious tuberculosis, plague, smallpox, yellow fever, viral hemorrhagic fevers, severe acute respiratory syndromes, and new types of flu that could cause a pandemic. Ebola counts as a viral hemorrhagic fever.
CDC quarantine centers are staffed by personnel who assess the health of travelers on board landed aircraft when passengers become ill. Sick individuals can be moved to isolation rooms at the quarantine facilities, or the agency can send them for care at hospitals. To be clear, the CDC considers "quarantine" to be different from "isolation." Quarantines apply to individuals who have been exposed to diseases but feel well and need monitoring, while isolation applies to those who are actually ill...
[Byline: Josh Hicks]
--
Communicated by:
ProMED-mail
<
promed@promedmail.org>
******
[4] Where to find non-sensational Ebola coverage
Date: 4 Oct 2014
Source: US4 [edited]
http://us4.campaign-archive2.com/?u=60b ... 6ca7d6f116
We talked to medical reporter Helen Branswell of The Canadian Press about where she goes to find reliable news about Ebola.
Your Sanity Guide To Ebola
------------------------------------
"A case of #Ebola in Dallas shows the risk this virus poses the world. But the fight needs to go to the source, West Africa. #containment," tweeted Helen Branswell, the longtime medical reporter for The Canadian Press, this week. She keeps us from going completely nutso with fear every day, so we asked her where she goes for her most reliable and up-to-date info.
- The World Health Organization is crucial for up-to-date information. "I don't think anybody trusts the Ebola numbers, but the best ones that are available are the ones WHO is generating."
- "It's hard to say that one thing is more important than the other, but ProMED-mail is critical for trying to keep on top of things." It's a push service and aggregator that sends out tailored email updates several times a day with context added in by infectious disease specialists.
- The Journal of Science has "some of the best English language science writers on the planet, and they are particularly strong on infectious diseases." The full stories appear weekly in the journal, but they put things up quickly on Science Insider.
- Dr. Richard Besser was an acting director of the CDC at one time and is now Chief Health and Medical Editor at ABC News. He's currently in Monrovia, and he's a good source of informative, non-hyped Ebola coverage.
- Follow Kai Kupferschmidt, a science writer, on Twitter; he's phenomenal. It's hard to follow Ebola on Twitter right now because it's moving so fast, but this is a good place to start.
--
Communicated by:
ProMED-mail
<
promed@promedmail.org>
[ProMED thanks Helen, a good friend and contributor to our list, for her kind mention. - Mod.JW
A HealthMap/ProMED-mail map can be accessed at:
http://healthmap.org/promed/p/106.]