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Ebola - Guinea, Liberia, Sierra Leone und Mali

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Ebola - Guinea, Liberia, Sierra Leone und Mali

Beitragvon Alexander » 22.03.2014 22:18

Vor einigen Tagen wurde von Menschen berichtet, die einer unbekannten Virenerkrankung zum Opfer gefallen waren. Mittlerweile konnte man den Erreger identifizieren: Ebola

Guinea confirms Ebola virus to blame for deadly epidemic

Guinea on Saturday confirmed that the deadly Ebola virus is to blame for a highly contagious epidemic that has so far killed 59 people in the West African nation. mehr...

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Ebola - Guinea verbietet Fledermaus-Delikatessen

Beitragvon Birgitt » 25.03.2014 22:23

Guinea has banned the sale and consumption of bats to prevent the spread of the deadly Ebola virus, its health minister has said. Bats, a local delicacy, appeared to be the "main agents" for the Ebola outbreak in the south, Rene Lamah said. Sixty-two people have now been killed by the virus in Guinea, with suspected cases reported in neighbouring Liberia and Sierra Leone ... Mr Lamah announced the ban on the sale and consumption of bats during a tour of Forest Region, the epicentre of the epidemic, reports the BBC's Alhassan Sillah from the capital, Conakry. People who eat the animals often boil them into a sort of spicy pepper soup, our correspondent says. The soup is sold in village stores where people gather to drink alcohol. Other ways of preparing the bats to eat include drying them over a fire.

Guinea Ebola outbreak: Bat-eating banned to curb virus
25.03.2014 - BBC

Fledermaus-Suppe ... sicher sehr lecker ... würg ... :roll:

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Re: Ebola-Fieber in Guinea

Beitragvon Alexander » 26.03.2014 17:57

Wie Ursula schon an anderer Stelle geschrieben hat schliesst Mauretanien die Grenze zum Senegal aufgrund der ungewöhnlich nördlichen Ebolaausbreitung

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Re: Ebola-Fieber in Guinea

Beitragvon Alexander » 26.03.2014 18:00

Hier noch ein Bericht über den Ebolaausbruch:

IRIN hat geschrieben:Curbing West Africa's Ebola outbreak

DAKAR, 26 March 2014 (IRIN) - As health authorities and aid groups work to contain the spread of Ebola in Guinea which has killed 59 people and infected scores of others since January, suspected cases have emerged in neighbouring Liberia, prompting calls for a regional response.

Haemorrhagic fever symptoms first appeared in Guinea's southern forested region. Eighty-six people have so far been infected. Authorities are urging restriction of movement and observance of hygiene to prevent further infections.

The cases have mainly been reported in the four southern districts of Guéckédou, Macenta, Nzérékoré and Kissidougou near the border with Sierra Leone and Liberia. Médecins Sans Frontières (MSF) has dispatched some 33 tons of medicines and equipment to Guinea to help curtail the epidemic which is infecting 1-3 people a day.

"It's happening along the border, so what we've been doing now is to start a collaboration between these neighbouring countries," said Francis Kasolo, director of the World Health Organization's (WHO) Disease Prevention and Control Unit in Africa. "Conferences are being held between these three countries to ensure that whenever there is a suspected case it can be identified quickly and appropriate response can be taken."

In Guinea's Guéckédou area, district health chief Moussa Kolié said: "We have begun training nurses to help contain as much as possible the spread of new cases." Funeral gatherings and unnecessary hospital visits were being discouraged, he said.

MSF has deployed medical teams to Guinea's affected areas, where the organization is setting up isolation centres and people thought to have been in contact with those infected are traced and also quarantined.

"This is the only way to try and contain the spread," Reinaldo Ortuno, a doctor with MSF, told IRIN.

Ortuno pointed out that the failure of the epidemiology surveillance system explains the high number of cases registered so far.

Sakoba Kéïta, head of Guinea's Health Ministry disease prevention unit, called for the observance of basic hygiene and avoiding eating meat the origin of which is unknown.

"We are calling on those who attended funerals of those who died of this disease to present themselves for identification and wash all their items with chlorine solution. and ensure they get medical observation for at least three weeks to one month," Kéïta said.

Ebola is transmitted to humans through contact with blood, body fluids or organs of infected animals. Infections have been reported in Africa following the handling of chimpanzees, gorillas, fruit bats, or antelopes and porcupines in tropical forests, according to WHO.

Liberia

Liberia's Health Ministry confirmed that five people have died of suspected Ebola haemorrhagic fever in the north of the country. The four women and one child are said to have come from Guinea to seek treatment in Foya in Liberia's northern Lofa County. Chief Medical Officer Bernice Dahn said a medical team had been sent to the area.

"The team is already investigating the situation, tracing contacts, collecting blood samples and sensitizing local health authorities on the disease," Dahn told reporters.

However, the deaths have yet to be confirmed as being due to Ebola. "We need to confirm these cases to know what we are dealing with," said Peter Clement, WHO's acting country director.

"The key message is that . we shouldn't panic because it can be prevented. All of us should be responsible. It can be contained. We are working hand-in-hand with the Ministry of Health to be able to mobilize the necessary support," Clement said.

Liberia's Health Minister Walter Gwenigale said market traders who cross to Guinean markets should avoid venturing into the affected districts of Guinea. "If you are living along the border and you really do not have any reason to go into towns where this disease is reported, you do not have to go there," he said.

Guinea's public health system [ http://www.irinnews.org/report/99537/gu ... s-outbreak ] is weak and has been reliant on donor funding which was suspended due to political instability, affecting public services.

"The government does not even have a laboratory to quickly verify the nature of this [Ebola] disease. This is why the death toll is high," said Conakry resident Fodé Camara

In Liberia, the health sector has yet to fully recover from the devastation of the country's civil war. "Most of the hospitals, clinics and equipment were destroyed during the years of civil conflict. The strengthening of the health sector faced financial problems. The country heavily relied on the international community for health infrastructure and aid," said health worker Martha Paye.

"This disease has really caught us off-guard"

Authorities in Guinea and Liberia have urged citizens not to panic, but many are scared of contracting Ebola, which has emerged in West Africa for the first time.

"This disease has really caught us off-guard. People are now avoiding each other in the town. There are no more greetings. Panic is overshadowing hospitality. Bodies can't be washed [before burial], but that is alright because prevention is better than cure," said Guéckédou resident Atanasse Tinkiano.

Guinea's government spokesman Damantang Albert Camara said health and public awareness measures were being taken and "I think that if all these measures are respected, the worst can be avoided."

"I am deeply worried," said Liberian journalist Jallah Grayfield. "What is mostly disturbing is that the disease has no cure."

This report online: http://www.irinnews.org/report.aspx?reportID=99840


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Re: Ebola-Fieber in Guinea

Beitragvon Alexander » 29.03.2014 16:26

Ebola hat nun die Hauptstadt von Guinea erreicht. Das dürfte ein Novum für das Land sein.

Ebola virus reaches Guinea's capital Conakry

Four cases of infection by the deadly Ebola virus have been confirmed in Conakry, Guinea's Health Minister Remy Lamah said, marking the first confirmed spread of the disease from rural areas to West African state's capital.

The minister said on Thursday that the virus appeared to have been transmitted by an old man who showed symptoms of haemorrhagic fever after visiting Dinguiraye in central Guinea, far from the identified outbreaks of Ebola in the remote southeast. mehr...

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Re: Ebola-Fieber in Guinea

Beitragvon marylin » 31.03.2014 09:02

Das auswärtige Amt siehts nicht sooo dramatisch.
http://www.auswaertiges-amt.de/sid_4F16 ... 4bodyText1
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Re: Ebola-Fieber in Guinea

Beitragvon Alexander » 31.03.2014 18:23

marylin hat geschrieben:Das auswärtige Amt siehts nicht sooo dramatisch.
http://www.auswaertiges-amt.de/sid_4F16 ... 4bodyText1


Dann hast du vermutlich nicht die ganze Meldung des Auswärtigen Amts gelesen:

Das Auswärtige Amt rät von Reisen in die betreffende Region d.h. Waldguinea und dessen Grenzgebiete zu Liberia und Sierra Leone zum jetzigen Zeitpunkt dringend ab.


Und hier noch MSF:

Ebola-Epidemie weitet sich aus

Die Ebola-Epidemie in Guinea hat die Hauptstadt Conakry erreicht. Acht Fälle sind dort bestätigt. Die Krankheit ist inzwischen in mehreren Städten des Landes aufgetreten. Eine solche Verbreitung hat Ärzte ohne Grenzen bisher noch nicht erlebt. mehr...

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Re: Ebola-Fieber in Guinea

Beitragvon marylin » 01.04.2014 10:15

Wies halt so ist mit den Links- was drinsteht verändert sich.
MIR macht das schnelle Ausbreiten schon Angst- aber so Erregerle kämpfen halt auch ums Überleben.
Dann hoffen wir mal, daß der Tierschutz der Bekämpfung keinen Strich durch die Rechnung macht.
Werden eigentlich die Flugpassagiere hier untersucht, aus den betroffenen Gebieten?
Immerhin gibts ja in München z.B. eine große guinesische Gesellschaft die regelmässig nach Hause fliegt.
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Re: Ebola-Fieber in Guinea

Beitragvon Achim Vogt » 01.04.2014 17:10

Kein Anzeichen für Entspannung:

Westafrika: Mediziner können Ebola-Epidemie nicht stoppen
(SPIEGEL Online, 1. April 2014)

Viele Grüße
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Re: Ebola-Fieber in Guinea

Beitragvon marylin » 01.04.2014 18:07

Schon irre- Ob Landgrenzen zumachen was hilft? Warum verstärkt EU nicht die Gesundheitsüberwachung der Afrikarückkehrer an den Flughäfen?
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Re: Ebola-Fieber in Guinea

Beitragvon Achim Vogt » 01.04.2014 19:01

Hallo Marylin,

vermutlich hilft es nicht viel, weil die Grenzen in Afrika zu durchlässig sind. Und zwischen Mauretanien und dem Senegal sind die beiden Hauptübergänge nicht geschlossen. Andererseits ist verständlich, dass die Staaten der Region alles versuchen, sich zu schützen, weil das Virus sich - anders als im infrastrukturell desolaten Kongo - schnell weiterzuverbreiten scheint, zumindest innerhalb Guineas, aber ja offenbar auch schon nach Liberia.

Die Gesundheitsüberwachung der EU für Afrikarückkehrer hat damit aber nichts zu tun - und hier stellt sich dann auch die Frage der Verhältnismäßigkeit.

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Re: Ebola-Fieber in Guinea

Beitragvon Götz Krieger » 04.04.2014 12:19

Ebola-Epidemie: Verdachtsfälle nun auch in Mali

In Westafrika breitet sich die Seuche Ebola immer weiter aus. Nach Guinea und Liberia ist nun wohl auch Mali betroffen. In dem Land werden drei Verdachtsfälle untersucht.

Bamako - Die westafrikanische Ebola-Epidemie könnte jetzt auch Mali erreicht haben. Es gebe drei Verdachtsfälle, zitierte der französische Sender RFI am Freitag die malischen Gesundheitsbehörden. Die Patienten seien zuvor an der Grenze zwischen Mali und Guinea unterwegs gewesen. In dem Nachbarland war die Seuche vor wenigen Wochen ausgebrochen.

In Guinea sind bereits über 80 Menschen an einer Ebola-Infektion gestorben, mehr als hundert Verdachtsfälle wurden registriert. Auch in Liberia gibt es bereits mehrere Tote und Verdachtsfälle. Die in Mali Erkrankten hätten Symptome wie starkes Erbrechen und Durchfall, jedoch müssten die Laborergebnisse abgewartet werden, um Gewissheit zu haben....
http://www.spiegel.de/wissenschaft/medi ... 62530.html

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Re: Ebola-Fieber in Guinea, Liberia und Mali

Beitragvon Alexander » 04.04.2014 16:05

Auch wenn sich Ebola derzeit in Ländern ausbreitet, in denen der Virus noch nicht aufgetreten ist, besteht kein Grund zur Panik, solange Quarantänemaßnahmen eingehalten werden. Vor ein paar Tagen floh eine erkrankte Frau in Liberia aus dem Krankenhaus, was eigentlich nicht passieren sollte.

Ebola wird vor allem durch Hautkontakt und beim "Austausch" von Körperflüssigkeiten übertragen. Hauptansteckungsherd ist das sog. Bush Meat. Tiere wie die Fledermaus stehen in Afrika auf der Speisekarte. Die Tiere erkranken nicht selbst an dem Virus, übertragen sie allerdings.

Ebola kann weder therapiert werden noch kann man sich dagegen impfen. Ebola ist eine Krankheit, die zwar immer wieder ausbricht und Tote verursacht. Der angesteckte Personenkreis ist aber in der Regel überschaubar. Entsprechend klein ist der Mark für pharmazeutische Unternehmen und man investiert kaum Geld, um Ebola wirklich zu erforschen und in letzter Konsequenz ein Gegenmittel zu entwickeln.

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Re: Ebola-Fieber in Guinea, Liberia und Mali

Beitragvon Alexander » 04.04.2014 16:12

Wer sich für Ebola interessiert kann auf der WHO Twitterseite #AskEbola Fragen stellen und Informationen einholen.

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Ebola-Fieber in Westafrika

Beitragvon Birgitt » 07.04.2014 18:55

EBOLA VIRUS DISEASE - WEST AFRICA (09)
**************************************
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] West Africa situation
[2] Guinea attack
[3] Guinea, economic impacts
[4] Liberia
[5] Liberia, economic impacts
[6] Sierra Leone official response
[7] Ghana, suspected
[8] Senegal
[9] Questions of virus origin


******
[1] West Africa situation
Date: Fri 5 Apr 2014
Source: WHO [edited]
http://www.afro.who.int/en/clusters-a-p ... -2014.html

As at 4 Apr 2014, the Ministry of Health of Guinea has reported a cumulative total of 143 clinically compatible cases of Ebola virus disease (EVD), of which 54 are laboratory confirmed by PCR. The total number includes 86 deaths (CFR 60 per cent). New cases have been reported from Conakry, Guekedou and Macenta; 23 patients are currently in isolation units. The date of onset of the most recent laboratory confirmed case is 3 Apr [2014].

The current number of clinical and confirmed cases and deaths by place of report is Conakry (18 cases, including 5 deaths), Guekedou (85 cases/59 deaths), Macenta (27 cases/14 deaths), Kissidougou (9 cases/5 deaths), and Dabola and Djingaraye combined (4 cases/3 deaths). Of the 18 clinical cases in Conakry 6 have been laboratory confirmed for EVD. There has been no increase in the number of affected health care workers (HCW) from the 14 reported previously, including 8 deaths; 11 of the affected HCWs are laboratory confirmed cases. Of the 86 deaths overall 16 are laboratory confirmed, 65 are classified as probable cases and 5 as suspected cases.

Case investigation and contact tracing are continuing, with 623 contacts requiring medical follow-up; this includes 74 new contacts identified on 3 Apr [2014] while 49 have been released from observation as they have remained well after the maximum incubation period for EVD of 21 days following the last exposure to a case.

Laboratory support for the investigation is being provided by Institut Pasteur Dakar, Senegal, and the mobile laboratory in Guekedou. Reference laboratory functions have been provided by Institut Pasteur Lyon, France, the Bernhard-Nocht Institute of Tropical Medicine Hamburg, Germany, and the Centre International de Recherche en Infectiologie (CIRI) laboratory in Lyon, France.

WHO, in collaboration with technical partners in the Global Outbreak Alert and Response Network (GOARN) has deployed field laboratory support, and experts in anthropology, epidemiology, logistics, clinical case management and infection prevention and control and outbreak coordination to support the response in Guinea.

The Ministry of Health and Social Welfare (MOHSW) of Liberia has reported 18 suspected and 2 confirmed cases of EBV, including 7 deaths, since 24 Mar [2014] (CFR 31 per cent); 7 patients are currently in an isolation unit while 2 suspected cases have been discharged. On 4 Apr [2014], 4 new clinically compatible cases were reported. One of the suspected cases is in a health care worker. Both of the laboratory confirmed cases, sisters from Lofa County, have died. The suspected cases include a hunter treated at a hospital in Tapita, Nimba County, who died shortly after presenting to the health facility and a 3 year old boy with a clinically compatible illness who had travelled from Guinea. The deceased hunter gave no history of contact with known cases in Liberia or Guinea and his exposure is being investigated to exclude transmission from an animal source (bush meat). The laboratory results for both of these suspected cases are pending. The MOHSW has placed 46 contacts under medical observation, including those of the 2nd confirmed case who travelled from Foyah, Lofa Country, to Monrovia, Montserrado Country, and then to Firestone in Margibi County. A total of 21 clinical samples have been sent to Conakry, Guinea, for laboratory testing. Counties of concern for EVD in Liberia include Lofa, Bong, Nimba, Margibi and Montserrado.

In response, Liberia has been scaling up activities to prevent the further spread of EVD. The National Task Force is conducting daily coordination meetings with response partners. WHO continues to provide technical expertise to the MOHSW, including public communications, providing a high level briefing on EVD prevention and control to the joint session of both houses of parliament and mobilising experts in epidemiology and infection prevention and control. The WHO Country Office in Liberia is working closely with the MOHSW to carry out needs assessments in areas such as procurement and the supply chain for critical materials and equipment need in the response to the outbreak. WHO is also working with the health information systems team at the MOHSW to further develop templates for case-based data collection and to track technical assistance. Additional deployments of regional experts, and partners in GOARN, are planned to support coordination activities, infection prevention and control, risk communications and social mobilisation. At the request of the MOHSW and WHO, the Metabiota Laboratory in Kenema, Sierra Leone, will install Real-Time Zaire ebolavirus-specific PCR, a pan-filo PCR, Lassa virus PCR, yellow fever and Marburg virus PCRs among other assays. This technology is being transferred from its laboratory in Kenema, Sierra Leone. Metabiota will also provide training to laboratory staff in Liberia.

Medical supplies and equipment have been provided by WHO, UNHCR, MSF, Save the Children and other partners, including personal protective equipment for health care facilities. In 5 countries, 7 isolation units have been established. Medecins Sans Frontières (MSF) is conducting training for health care workers in the affected counties on case management, including on setting up isolation facilities. An additional 60 HCWs have been trained in Margibi County. Community education and social mobilisation activities have been strongly supported by the media and telecommunications sectors in Liberia. Local government officials, community and religious leaders and traditional healers have been approached to support the MOHSW in prevention and control activities; however, additional resources are needed to expand surveillance and health promotion and social mobilisation activities to schools, religious gatherings, market places and work places. Plans are also underway to mobilise the public through house-to-house visits.

The Ministry of Health of Mali has notified WHO of 4 patients suspected to have a viral haemorrhagic fever who presented for health care in Sibiribougou, Koulikoro Region of Mali; 2 of the suspected cases had travelled from Guinea. The patients were placed in isolation pending epidemiological investigations and laboratory testing. Contact tracing is underway. Clinical samples have been sent to the Centers for Disease Control and Prevention (CDC), Atlanta, United States, for testing. Epidemiological surveillance is being enhanced on the ground and Rapid Response Teams are being mobilised to identify and treat suspected cases should others present. An isolation unit has been prepared in Bamako and units are also being installed in other locations. Information hotlines are being made available to the public.

There has been no change in the situation in Sierra Leone following the deaths of 2 probable cases of EVD in one family who died in Guinea and their bodies repatriated to Sierra Leone. The office of the Chief Medical Officer (CMO) is coordinating all operations involving suspected cases of Ebola as well as the follow-up investigations. [All cases were negative by laboratory test. See the report below. Mod TY]. Enhanced surveillance and public education activities are continuing. Senior officials from the Ministry of Health and Sanitation (MOHS) have visited border crossings between Sierra Leone and Guinea to sensitise border authorities about current prevention and response plans and public health medical officers are visiting border communities to support social mobilisation activities. Metabiota Laboratory in Kenema working under the MOHS and with the WHO Country Office in Sierra Leone, has established a full suite of ebolavirus-specific assays and differential diagnostics for other important viral haemorrhagic fevers that are locally endemic. The full range of assays is described in the section of this report for Metabiota activities in Liberia.

As this is a rapidly changing situation, the number of reported cases and deaths, contacts under medical observation and the number of laboratory results are subject to daily changes due to consolidation of case, contact and laboratory data, enhanced surveillance and contact tracing activities and ongoing laboratory investigations.

WHO does not recommend that any travel or trade restrictions be applied to Guinea, Liberia, Sierra Leone or Mali based on the current information available for this event. 


--
Communicated by:
ProMED-mail Rapporteur Mary Marshall

[The outbreak is having social repercussions in Guinea. A 6 Apr 2014 report from 10 News (http://www.wtsp.com/story/news/health/2 ... a/7379153/) indicates that "people are so afraid, one man said, they've stopped shaking hands. An Air France flight from Guinea to Paris was quarantined on Friday after a passenger was sick in the bathroom. No one was infected with Ebola [virus]". - Mod. TY]

******
[2] Guinea attack
Date: Sun 4 Apr 2014
Source: Reuters [summ. & edited]
http://mobile.reuters.com/article/idUSL ... 4?irpc=932

A crowd angry about an Ebola outbreak that has killed 86 people across Guinea attacked a center where victims were being held in isolation, prompting an international aid group to temporarily evacuate its team, officials said Saturday [5 Apr 2014].

The violence took place in the southern town of Macenta, where at least 14 people have died since the outbreak emerged last month. The mob, who descended upon the clinic, accused Doctors Without Borders health workers of bringing Ebola to Guinea, where there had never previously been any cases.

--
Communicated by:
ProMED-mail from Google Alerts
<promed@promedmail.org>

[This situation underscores the need for timely public education in order to avoid panic by an uninformed public. It also illustrates the need for public trust in their health care system.

A HealthMap/ProMED-mail map showing the location of Guinea can be accessed at http://healthmap.org/promed/p/45. - Mod. TY]

******
[3] Guinea, economic impacts
Date: Sat 4 Apr 2014
Source: Reuters [summ. & edited]
http://mobile.reuters.com/article/idUSL ... 4?irpc=932>

Foreign mining companies have locked down operations and pulled out some international staff in mineral-rich Guinea. French health authorities have also put doctors and hospitals on alert in case people travelling to and from countries in the region pick up the disease.

Conakry's luxury five-star Palm Camayenne Hotel, popular among businessmen and politicians, is running at less than a third of occupancy, according to a receptionist.

Flight data told a similar story. A return Brussels Airlines flight between the Belgian capital and Conakry on Thursday had just 55 people arriving and 200 leaving, an airline employee said.

Regional airline Gambia Bird delayed the start of a route to Conakry due to begin last weekend while Senegal has closed its border with Guinea because of the outbreak.

--
Communicated by:
Ryan McGinnis
<ryan@bigstormpicture.com>

[ProMED thanks Ryan McGinnis for sending in this report. - Mod. TY]

******
[4] Liberia
Date: 4 Apr 2014
Source: Business Standard [edited]
http://www.business-standard.com/articl ... 202_1.html

The deadly Ebola virus has claimed 2 more lives in Liberia, Minister of Health and Social Welfare Walter Gwenigale said Thursday [4 Apr 2014], taking the death toll to 7 in the West African nation.

Gwenigale told a regular press conference in Morovia, the country's capital city, that the 2 people included a woman who got infected as a result of taking care of her sister who contracted the virus in Lofa county. The woman died Wednesday night [3 Apr 2014], Xinhua reported.

The minister told reporters that after contracting the virus, the woman travelled from Lofa to Chicken-soup Factory in Gardnersville and was later taken to Firestone by the taxi driver where she later died and that her child who is currently sick is being quarantined.

Gwenigale said the other one of the 2 newly deceased is a 25-year-old man who died at the Tapita Hospital in Nimba county few minutes after he was taken there for treatment.

He said though his death is not proven to be Ebola [EVD] from standard laboratory test, the ministry concluded that he died of the deadly virus having considered the different signs and symptoms that go along with the virus and observed that they were exactly the same that affected him before he died.

He said Ebola [EVD] is real and is present in Liberia and that no one Liberian should take it as a joking matter.

Ebola virus is considered one of the most aggressive viruses known to date in part because of its rapidity to kill, which can be within one week from exposure or 3-4 days from the 1st symptoms become apparent. This leaves very little time for any treatment to act and save a sick individual.

--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@ppromedmail.org>

[In a separate 6 Apr 2014 statement cited in Sky News (http://www.skynews.com.au/world/article.aspx?id=964879), Liberian President Ellen Johnson Sirleaf appealed to her countrymen not to panic over the Ebola outbreak. She said "We do not believe that one needs to do anything more than take precaution, follow the instructions and advice of the Ministry of Health team. She dismissed the recent recommendation by the senate to close the border with neighboring Guinea, the origin of the Ebola outbreak that has spread to several countries in the region. "This is not a thing for politicians," the president said.

Although response to an outbreak is not the responsibility of politicians, support for a public health system that can deal with outbreaks depends on political support.

A HealthMap/ProMED-mail map showing the location of Liberia can be accessed at http://healthmap.org/promed/p/54. - Mod. TY]


******
[5] Liberia, economic impacts
Date: Sun 6 Apr 2014
Source: AFK Insider [edited]
http://afkinsider.com/50296/ebola-epide ... y-liberia/

The deadly Ebola epidemic reported to have entered the Liberian territory after the outbreak in Guinea that has killed more than 80 persons in that neighboring country is causing panic among many Liberians with market women dealing in Bush meat otherwise known as dry meat, complaining that they are losing customers because of a government announcement warning people to stay off the local cuisine for a while.

Scientists say Ebola [virus] is transmitted to humans through several means with monkeys, gorillas, chimpanzees and other animals serving as carriers of the deadly virus and Liberia's Health Minister, Dr. Walter Gwenigale, on Monday [31 Mar 2014] issued a warning to Liberians to desist from eating bush meat for now, cautioning County Superintendents to take the lead in working in their respective counties to advise the citizens from consuming bush meat.

The bush meat business is a big market in Liberia and serves as a major source of income for a whole group of people ranging from hunters to marketers who purchase directly from the hunters to sellers on the local market, onward to restaurants and other food centers before reaching a vast consuming public.

Liberia is one of the countries in the West African sub region with vast natural rain forest which has been used for hunting for centuries. In the southeastern Grand Gedeh, River Gee, Grand Kru and other counties hunting is an occupation for many. Monkey, one of the animals listed as a carrier of Ebola is a favorite bush meat for many Liberians, an age-old food, and convincing people to stay away from a food they have been consuming for years is proving difficult.

--
Communicated by:
ProMED-mail from Google Alerts
<promed@promedmail.org>

[The sale of bush meat in Africa is controversial in conservation circles because of the adverse impacts it can have on wildlife populations, especially the great apes that are also susceptible to Ebola virus infection and suffer mortality. Now, a public health dimension has been added to that debate. - Mod. TY]

******
[6] Sierra Leone official response
Date: 4 Apr 2014
From: Metabiota Inc., on Behalf of the Ministry of Health and Sanitation <jpgonzalez@metabiota.com> [edited]

As of today, 4 Apr 2014, there are NO laboratory confirmed cases of Ebola virus in Sierra Leone. The Ministry of Health & Sanitation [MOHS] is closely collaborating with the World Health Organization and Metabiota to provide rapid diagnostics and case investigations by MOHS personnel.

In order to effectively manage this emergency The MOHS has established National Outbreak Response task force and the following actions have been taken in response to the potential for spread of the epidemic:

- The office of the Chief Medical Officer (CMO) is coordinating all operations involving suspected cases of Ebola as well as the follow-up investigation.
- Active surveillance of suspected cases meeting the WHO case definition for either Ebola or Lassa fever is ongoing and on an as-needed basis.
- National Taskforce biweekly meetings are being held, bringing together all senior officials of national and international health institutions to provide them with relevant information in real time.
- The MOHS, the UN, foreign governments, NGOs and other National and International stakeholders are currently positioning support funds and other resources to aid in sensitization, distribution of PPE and care guidelines, educational campaigns by radio and television, and other support.
- The MOHS has established a central reporting "hotline" for the reporting of suspected VHF cases.
- Radio and television "jingles" have been developed in local languages to sensitize the community to this disease.
- Daily press conferences are being held by the MOHS to inform the public and prevent panic initiated by the spread of rumors.

Metabiota Inc., working under the MOHS and with the WHO Country Office, had previously installed Zaire Ebola-specific PCR, which was used to screen the 1st cases reported to PROMED. The laboratory team has installed and are currently running a full suite of Ebola specific and differential diagnostics, including: WHO recommended Zaire Ebola-specific RT-PCR, Zaire Ebola-specific antigen and IgM capture ELISAs, pan-filovirus RT-PCR, as well as published PCR assays for the detection of Lassa fever, yellow fever and other confounding, locally endemic pathogens. WHO, Metabiota, and other partners are providing the recommended full personal protection equipment (PPE) for health workers exposed to suspected cases.

On 30 Mar 2014, the MOHS of Sierra Leone has carried out 4 epidemiological investigations with multidisciplinary field teams to investigate suspected cases reported by local health centers. Over 15 suspected cases (contact with confirmed from a suspected infected patient from Guinea) have been investigated by the field team, at which time blood samples were collected, tested negative by RT-PCR for all existing known 5 Ebola virus species. Samples from 2 patients from Guinea, collected by the Guinean authorities (border proximity of the investigation field teams) were also referenced to the Kenema laboratory and were found to negative for Ebola, Marburg, Yellow Fever and Lassa fever by RT-PCR.

Since that time, 2 additional suspected cases from Sierra Leone were tested and found to be Negative.

The MOHS National Task Force, working with Metabiota and other partners, is continuing to actively conduct surveillance for Ebola virus, as well as Lassa fever, and the Kenema Government Hospital has been designated as the central treatment facility for anyone suspected of contracting Ebola fever. This facility of KGH specializes in the treatment and management of viral hemorrhagic fever. A specialized infectious disease ambulance previously provided by Metabiota for the transport of acutely ill Lassa fever patients is being used to transport suspected cases and every precaution made to protect both health care workers and local populations from the risk of spread of the diseases.

Just-in-time, hands-on clinical management training for district healthcare workers, including how to set up local isolation wards will be conducted in the next week. Additional training and VHF sensitization will also be provided to National level and District level surveillance officers, as well as border checkpoint health surveillance workers. Each training event will be used as a distribution opportunity for up to date materials, as well as the recommended PPE and instructions on its use. The training of trainers for clinical personnel is being managed by Dr. Sheik Humarr Khan, Chief Physician of the Lassa fever ward at the Kenema Government Hospital, and Dr. Jean-Paul Gonzalez, Metabiota Senior Scientist and physician, according to the WHO manual on the control of viral hemorrhagic fevers.

Communicated by
Metabiota Inc., on Behalf of the Ministry of Health and Sanitation
Sierra Leone
<jpgonzalez@metabiota.com>

[It is good to learn that the suspected cases are negative for Ebola virus infection. Sierra Leone with its Metabiota and WHO collaborators is very well prepared should cases appear in that country. This outstanding organization and preparedness for response could serve as a good model for the rest of West Africa. ProMED thanks Metabiota and the Sierra Leone MOHS for this communication. Receipt of this kind of 1st hand information from the field is extremely valuable.

A HealthMap/ProMED-mail map showing the location of Sierra Leone can be accessed at http://healthmap.org/promed/p/46. - Mod. TY]

******
[7] Ghana, suspected
Date: Sun 6 Apr 2014
Source: Radio XYZ [edited]
http://edition.radioxyzonline.com/pages ... /18998.stm

XYZ News can report that blood sample from a 12-year-old girl has been sent to the Noguchi Memorial Institute for tests to confirm if Ghana has recorded its 1st case of Ebola [virus infection].
 


The 12-year-old girl was first admitted at the paediatric unit of the Komfo Anokye Teaching Hospital in Kumasi with symptoms of fever and bleeding.
 
Doctors have met over the patient and taken emergency steps to ensure she is quarantined.
 
The results of the test will be known in a couple of days.

The deadly haemorrhagic disease has already killed dozens of people in neighbouring Guinea. Cases have also been reported in Liberia and lately Mali.
 
Over 70 people have died so far in Guinea alone since the outbreak begun a little over a month ago.

There is no known cure or vaccine for the haemorrhagic fever.
 
It is spread by close personal contact with people who are infected and kills between 25 per cent and 90 per cent of victims.
 


Symptoms include internal and external bleeding, diarrhoea and vomiting.

--
Communicated by:
ProMED-mail from Google Alerts
<promed@promedmail.org>

[One hopes that the tests results are negative. ProMED will appreciate receiving followup news about this case.

A HealthMap/ProMED-mail map showing the location of Ghana can be accessed at http://healthmap.org/promed/p/53. - Mod. TY]


******
[8] Senegal, reaction
Date: Thu 3 Apr 2014
Source: Xinhua News [edited]

On Wednesday [2 Apr 2014], the chief of Kolda region closed the weekly Diaobe market that is attended by people from countries such as Gambia, Guinea, Guinea Bissau and Senegal.

--
Communicated by:
ProMED-mail from Google Alerts
<promed@promedmail.org">http://news.xinhuanet.com/english/africa/2014-03/31/c_133227868.htm

Senegal's government over the weekend decided to close its border with Guinea to prevent the spread of Ebola virus prevalent in the latter, Senegal's interior ministry said.

As part of the preventive measures, the statement added, the border posts in Senegal's southern region of Kolda and Kedougou in the southeast will be closed until further notice. "Governors in the concerned areas have taken appropriate measures to ensure full execution of the decision," the statement concluded.

On Wednesday [2 Apr 2014], the chief of Kolda region closed the weekly Diaobe market that is attended by people from countries such as Gambia, Guinea, Guinea Bissau and Senegal.

--
Communicated by:
ProMED-mail from Google Alerts
<promed@promedmail.org

[Closure of the border seems to be a drastic measure, given that the WHO does not recommend any travel restrictions due to the outbreak. Intensification of surveillance at the border for febrile individuals, coupled with education of the public and issuance of alerts for the medical community does seem prudent at this time.

A HealthMap/ProMED-mail map showing the location of Senegal can be accessed at http://healthmap.org/promed/p/48. - Mod. TY]

******
[9] Question of virus origin
Date: Thu 4 Apr 2014
Source: Relief Web [in French, trans. Corr. SB, edited]
http://reliefweb.int/report/guinea/l-pi ... -cialistes>

The ongoing epidemic in West Africa, of haemorrhagic fever, in part due to Ebola virus is, causing concern to experts interviewed by AFP.[Agence France Press]

This epidemic "is serious because it is still, a priori , not controlled and because there the patients are dispersed, said the French physician, Sylvain Baize , who heads the National Reference Centre (CNR) for viral hemorrhagic fevers based in Lyon.[France]

"I am very concerned because no-one has any idea how the virus came to the region and the size of the of the infected area is unclear, said Thomas Geisbert , specialist in hemorrhagic fevers at the Medical Branch of the University of Texas ( UTMB ) .

Several countries in West Africa were mobilized Friday [April 4th] against the outbreak of hemorraghic fever that has killed more than 80 people in Guinea , a little more than half due to Ebola [virus infections], while suspected cases were reported in neighboring countries , Liberia, Sierra Leone [Proven negative] and more recently in Mali .

The suspected case of a deceased hunter in Liberia who had no contact with other cases of this haemorrhagic fever "poses questions ," said Dr Baize, on Friday [4 Apr 2014]. If this case is confirmed and if it turns out that this man had no prior contact with other patients , this could be a sign that Ebola virus has "massive circulation in forest through the bats and there may be an ongoing epidemic in progress", said Dr Baize.

As with many other viruses, bats are " very probably" the natural reservoir of Ebola virus : the animals " are not affected by the virus , but are able to transmit it. The most likely hypothesis is that the epidemic (in West Africa ) is related to virus introduction via bats but that remains to be seen "commented Dr. Baize , adding , however, that other assumptions are "possible".

--
Communicated by:
ProMED-mail Rapporteur Mary Marshall

[Only prospective field studies will establish which species of wildlife are the reservoirs of Ebola virus in nature. Mod. TY]
Birgitt
Moderator
 
Beiträge: 22993
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Ebola-Fieber in Westafrika

Beitragvon Birgitt » 08.04.2014 17:04

EBOLA VIRUS DISEASE - WEST AFRICA (10)
**************************************
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, additional information
[2] Ghana NOT
[3] Guinea
[4] Liberia


******
[1] Sierra Leone, additional information
Source: Sierra Leone Ministry of Health and Sanitation [edited]
<contehy@gmail.com>

As of today, 6 Apr 2014, there are NO laboratory confirmed cases of Ebola virus in Sierra Leone (SL).

On 23 Mar 2014, samples from 2 suspected Ebola hemorrhagic fever (EHF) patients from Guinea collected by the Guinean authorities were referenced to the Ministry of Health & Sanitation (MOHS, Sierra Leone) investigation field team and subsequently referred to the Kenema Government Hospital reference laboratory. All were found to be negative for Ebola, Lassa fever, Marburg, and yellow fever [viruses] by real-time reverse transcriptase polymerase chain reaction [RT-PCR].

On 25 Mar 2014, an MOHS multidisciplinary field team carried out epidemiological investigations to examine reports on the death of a suspected case (one of 2 previous reported to ProMED-mail). The patient had expired and was buried prior to the arrival of the investigation team. In total, 15 close case contacts were identified, sampled and tested negative by RT-PCR for all existing known 5 Ebola virus species.

On 3 and 4 Apr [2014], disease surveillance officers and district medical officers investigated one suspected case from Bombali and 2 suspected cases from Bombali and Kambia. These 3 cases were sampled and were negative for Ebola virus by conventional and real-time RT-PCR. Additional testing protocols are ongoing to test for other viral pathogens.

In order to effectively manage this emergency, the SL MOHS established a National Outbreak Response Taskforce, and the following actions have been undertaken in response to the potential for spread of the epidemic:

- the office of the chief medical officer (CMO) is coordinating all operations involving suspected cases of Ebola as well as the follow-up investigation;
- active surveillance of suspected cases meeting the WHO case definition for either Ebola or Lassa fever is ongoing and on an as-needed basis;
- national taskforce biweekly meetings are being held, bringing together all senior officials of national and international health institutions to provide them with relevant information in real time;
- the MOHS, the UN, foreign governments, NGOs and other national and international stakeholders are currently positioning support funds and other resources to aid in sensitization, distribution of PPE and care guidelines, educational campaigns by radio and television, and other support;
- the MOHS has established a central reporting "hotline" for the reporting of suspected viral hemorrhagic fever (VHF);
- radio and television "jingles" have been developed in local languages to sensitize the community to this disease;
- daily press conferences are being held by the MOHS to inform the public and prevent panic initiated by the spread of rumors;
- just in time, barrier care and isolation ward training is being conducted using the train-the-trainer method at the Kenema Government Hospital VHF Ward, where the WHO manual for the management of VHF in the African Setting will be distributed, along with local materials needed to construct makeshift isolation wards;
- a locally produced educational skit aimed at Ebola prevention and sensitization is under way and will be distributed via national television and through NGO networks;
- standardized data collection forms for surveillance, VHF notification, and VHF clinical care were adapted for local use and are being distributed at in-country training sessions to appropriate parties;
- the WHO standardized Ebola case definition is currently being distributed to all healthcare facilities;
- locally adapted public health prevention campaign posters are in the final stages of development and will be distributed nationwide;

As part of an existing collaboration between the SL MOHS, Metabiota and the USAMRIID Diagnostics Systems Division, the Kenema Government Hospital reference laboratory had previously installed a Zaire Ebola-specific PCR, which was used to screen the 1st contact cases from Sierra Leone reported to ProMED.

The MOHS/WHO/Metabiota response team has installed and is currently running a full suite of Ebola-specific and differential diagnostics, including the WHO recommended Ebola Zaire-specific RT-PCR, Ebola Zaire-specific antigen and IgM capture ELISAs, a pan-filovirus RT-PCR, as well as published PCR assays for the detection of Lassa fever, yellow fever and other confounding locally endemic pathogens.

The MOHS and other partners are providing the recommended full personal protection equipment (PPE) for health workers exposed to suspected cases.

The MOHS National Task Force is continuing to actively conduct surveillance for Ebola virus, as well as Lassa fever, which is hyperendemic in eastern Sierra Leone, and the Kenema Government Hospital Viral Hemorrhagic Fever Ward has been designated as the central receiving and treatment facility for anyone suspected of contracting either Ebola or Lassa fever [virus infections]. This facility is highly specialized in the treatment and management of viral hemorrhagic fevers. A specialized barrier-care, infectious disease ambulance provided by Metabiota to transport acute Lassa fever patients is also being used to transport suspected cases, and every precaution is being made to protect both health care workers and local populations from the risk of spread of the disease.

Metabiota Inc., working under the direct supervision of the SL MOHS and the WHO Country Office (http://www.afro.who.int/en/clusters-a-p ... -2014.html) is being supported by a US government inter-agency response effort, including the DTRA Cooperative Biological Engagement Program, the US National Institute of Allergy and Infectious Diseases Integrated Research Facility, the US Army Medical Research Institute of Infectious Diseases, the US DoD Critical Reagents Program, and other US and international partners.

Just-in-time, hands-on clinical management training for district healthcare workers, including how to set up local isolation wards, will be conducted in the next week. Additional training and VHF sensitization will also be provided to National level and District level surveillance officers as well as border checkpoint health surveillance workers. Each training event will be used as a distribution opportunity for up to date materials, as well as the recommended PPE and instructions on its use. The training of trainers for clinical personnel is being managed by Dr Sheik Humarr Khan, chief physician of the Lassa fever ward at the Kenema Government Hospital, and Dr Jean-Paul Gonzalez, Metabiota senior scientist and physician, according to the WHO manual on the control of viral hemorrhagic fevers.

--
communicated by:
Yayah A Conteh
Principal Health Partners Coordination Officer
West African Health Organisation (WAHO) Liaison Officer
Ministry of Health and Sanitation
Youyi Building, 5th Floor (East Wing)
Brookfields, Freetown,
Sierra Leone
<contehy@gmail.com>

[This complete summary of the Sierra Leone's MOHS planning and training again illustrates their outstanding organization and preparedness for response should Ebola virus disease be detected in that country. ProMED-mail thanks Dr Yayah A Conteh for providing this report.

A HealthMap/ProMED-mail map showing the location of Sierra Leone can be accessed at http://healthmap.org/promed/p/46. - Mod.TY]

******
[2] Ghana NOT
Date: Mon 7 Apr 2014
Source: Joyonline [edited]
http://www.myjoyonline.com/news/2014/Ap ... gative.php


The test result of blood samples collected from a 12 year old suspected to have been killed by the deadly Ebola [virus] disease has proven negative. The Noguchi Memorial Institute took the samples to test following the girl's death at the Komfo Anokye Teaching Hospital in Kumasi at the weekend.

Suggestions the girl might have died of Ebola [virus infection] was a matter of concern to Ghana's health officials and members of the public. The virus has already claimed more than 80 lives in Guinea alone. It has also killed more than 5 people in Liberia.

Though controversy surrounding the girl's death has been dealt with now, the Health Ministry is leaving nothing to chance. Minister of health Sherry Ayittey, who confirmed the test result at a press conference in Accra on Monday [7 Apr 2014], said 66 quarantine centres would be set up, especially at health facilities across the country.

The ministry is also looking at having similar facilities at the nation's border entries, wild game, or forest reserves. A taskforce is already in place to monitor a possible occurrence of the disease.

--
communicated by:
ProMED-mail rapporteur Mary Marshall

[It is good news indeed that the suspected case has been proven negative for Ebola virus infection.

A HealthMap/ProMED-mail map showing the location of Ghana can be accessed at http://healthmap.org/promed/p/53. - Mod.TY]

******
[3] Guinea
Date: Fri 4 Apr 2014
Source: Global Post [edited]
http://www.globalpost.com/dispatch/news ... th-toll-95


Guinea's government raised the death toll in the Ebola epidemic raging through its southern forests and capital to 95 on Mon 31 Mar 2014. The health ministry added 9 deaths to the toll of 86 given before the weekend, saying that 52 cases had been confirmed in laboratories to be the killer tropical virus.

"Up to now, the Guinean authorities have registered 151 suspect cases and 95 deaths," the ministry's chief disease prevention officer Sakoba Keita told AFP, without specifying the locations of the new deaths.

A number of patients have been discharged from Ebola treatment centres after beating the virus. Marie-Claire Lamah, a Guinean doctor working for medical charity Medecins sans Frontieres [MSF; doctors without borders] in its treatment centre in Conakry was quoted as saying: "When the 1st patient came out from the treatment centre, I was so happy, and the whole team was cheering!"

Various studies -- including a paper published in the New England Journal of Medicine last year [2013] -- have demonstrated some immunity in survivors from the particular strain to which they were exposed, but life-long immunity has not been demonstrated. MSF said it was working with local communities to ensure that discharged patients who have beaten the virus can return home safely and that everyone understands they are no longer contagious. "We explain to the families and neighbours that the patient is now negative and doesn't present any risks to anyone; they can be kissed, touched and hugged without any risk of contagion," says MSF health promoter Ella Watson-Stryker. MSF has some 60 international staff working in Guinea and has flown in more than 40 tons of supplies to tackle the epidemic.

Ebola [virus infection] leads to haemorrhagic fever, which causes muscle pain, weakness, vomiting, diarrhoea and, in severe cases, organ failure and unstoppable bleeding. The tropical virus can be transmitted to humans from wild animals, and between humans through direct contact with another's blood, faeces or sweat. Sexual contact, or the unprotected handling of contaminated corpses, can also lead to infection.

--
communicated by:
Ryan McGinnis
<ryan@bigstormpicture.com>

[It is curious that the additional 9 fatal cases were not included in the WHO fatal case count reported on 5 Apr 2014 (see ProMED-mail archive 20140406.2385791). It will be of interest to see whether the 95 cases are cited in subsequent reports.

A HealthMap/ProMED-mail map showing the location of Guinea can be accessed at http://healthmap.org/promed/p/45. - Mod.TY]

******
[4] Liberia
Date: Mon 7 Apr 2014
Source: All Africa [edited]
http://m.allafrica.com/stories/201404071825.html/


The motorcyclist who drove the last victim of the deadly Ebola virus in Liberia is reported to be ailing, and the Ministry of Health and Social Welfare wants the public to help find him before he spreads it on to others.

Health minister Dr Walter Gwenigale made the disclosure last Friday shortly after the World Health Organization (WHO) presented a consignment of protective gear to Liberia to aid health workers in the fight against the killer virus.

"The motorcycle driver who drove that sick woman to Firestone -- and the woman has already died -- that motorcycle driver is sick," the minister said. "They called us last night; we sent people to go and find him, but when we got there, they said that the mother had taken him somewhere. Now we are looking for him because whoever gets in contact with that young man including the mother now, is in trouble. So you have to help us to get the word around that whoever has that young man somewhere, please turn him over to us so we can take care of him."

The yet-to-be-identified deceased woman contracted the virus from Foyah Lofa County. The latest woman to die from the Ebola virus at Firestone contracted Ebola while caring for her sister who died of Ebola in Foya, Lofa County. The woman had been at Firestone under observation in isolation. Prior to that, she left the Foya area late on the night of 29 Mar 2014 and travelled via taxi to Monrovia to see her husband. Five other people were in the taxi with her, including the driver. The woman then took a motorcycle to a nearby clinic, where she was seen and released.

In addition, authorities are said to be on the lookout for at least 40 people who may or may not have crossed paths with the deceased woman. Until her death, the woman and her family were being quarantined in their home until they could be moved to an appropriate facility. Although the Health Ministry has been monitoring those who came in contact with the woman, including the taxi driver, the failure of authorities to find the motorcyclist could hamper attempts by health authorities to stop the deadly virus in its tracks.

--
communicated by:
Ryan McGinnis
<ryan@bigstormpicture.com>

[This story illustrates the difficulty in tracing contacts in a highly mobile population. One hopes that the other 40 individuals were not exposed. It would be unusual if the motorcyclist who transported the patient to the hospital or 40 others in casual contact with the infected person became infected during, before, or after the ride. Transmission occurs when people are exposed to blood or other bodily fluids, or are in physical contact with acutely ill or deceased individuals.

ProMED-mail thanks Ryan McGinnis for sending in this report.

A HealthMap/ProMED-mail map showing the location of Liberia can be accessed at http://healthmap.org/promed/p/54. - Mod.TY]
Birgitt
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Ebola in Westafrika - MSF warnen vor schwerer Epidemie

Beitragvon Birgitt » 08.04.2014 19:38

Es gibt keine Behandlung und kein Medikament: Im westafrikanischen Guinea sind bereits fast 100 Menschen an Ebola gestorben. Inzwischen hat das Virus die Hauptstadt Conakry erreicht. Im Nachbarland Liberia wurden zehn Todesopfer gemeldet. Auch weitere Staaten in Westafrika melden Verdachtsfälle. "Ärzte ohne Grenzen" spricht von einer Epidemie nie gekannten Ausmaßes ... Nun sei es ein Wettlauf gegen die Zeit, um Schlimmeres zu verhindern - eine weitere Verbreitung der gefährlichsten Krankheit der Welt in Westafrika.

Westafrika in Angst vor Ebola
08.04.2014 - tagesschau

Gruß
Birgitt
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Ebola-Fieber in Guinea

Beitragvon Birgitt » 09.04.2014 20:40

EBOLA VIRUS DISEASE - WEST AFRICA (11): GUINEA
**********************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Tue 8 Apr 2014
Source: Reuters [edited]
http://www.reuters.com/article/2014/04/ ... 9L20140408


A "challenging" outbreak of the deadly [Ebola virus disease] in West Africa is expected to take from 2-4 months to contain, the World Health Organization (WHO) said on Tuesday [8 Apr 2014]. The virus is still spreading in 3 "hotspots" of Guinee Forestiere [Forest-Guinea], a south eastern region some 900 km (560 miles) from Guinea's capital of Conakry, a city which has itself reported 20 cases to date, the United Nations agency said.

But WHO said it was not recommending any travel restrictions for Guinea, which has a total of 157 suspected and confirmed cases including 101 deaths, or for Liberia, which has 21 suspected and confirmed cases, including 10 deaths. "We fully expect to be engaged in this outbreak for the next 2 to 3 to 4 months before we are comfortable that we are through it," Dr Keija Fukuda, WHO assistant director-general, told a Geneva news briefing. "This is one of the most challenging outbreaks of ebolavirus we have ever faced," he said. It is also the first to strike West Africa, where some people have become infected from burial practices that involve direct contact with body fluids of the deceased.

WHO medical officer Stephane Hugonnet, just back from Guinea, said: "In Guinee Forestiere, the outbreak is not over, this is the epicenter. As long as it is not over there, there will be cases exported to the rest of the country."

Some 50 foreign experts have been deployed to help with infection control measures at hospitals and to trace 600 known contacts of infected patients, he said. Most new cases were linked to known transmission chains, which he said was "reassuring".

[byline: Stephanie Nebehay; editing by Gareth Jones]

--
communicated by:
Ryan McGinnis
<ryan@bigstormpicture.com>

[The numbers of cases and fatalities from Ebola virus disease continue to climb in Guinea. Before 4 Apr 2014 there were 143 suspected cases and 86 deaths, on 4 Apr 2014 there were 151 suspected cases and 95 deaths, and in this report (8 Apr 2014) there are reported 157 cases and 101 deaths. Tracing the 600 known contacts will be an enormous job, but it is essential if the outbreak is to be halted. Public education will be critical in order to obtain good collaboration and compliance with recommended practices -- something never easy in an environment of fear and rumors in a population spread over a large geographic area.

ProMED-mail thanks Ryan McGinnis for sending this report. A similar report was issued by the BBC (http://www.bbc.com/news/world-africa-26941698).

A HealthMap/ProMED-mail map showing the location of Guinea can be accessed at http://healthmap.org/promed/p/38440. Guinee forestiere (Forest-Guinea) is a forested mountainous region in the south eastern part of the country, extending into north eastern Sierra Leone. It is one of 4 natural regions of Guinea covering 23 per cent of the national territory. It includes the entire Nzerekore administrative region. A map showing the location of Forest-Guinea can be accessed at http://www.nationsonline.org/oneworld/m ... a-map2.htm. - Mod.TY]
Birgitt
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Ebola-Fieber in Westafrika

Beitragvon Birgitt » 10.04.2014 20:38

EBOLA VIRUS DISEASE - WEST AFRICA (12): WHO, MAPPING
****************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

In this update:
[1] WHO
[2] Liberia
[3] Guinea
[4] Mapping the outbreak
[5] Mapping tools


******
[1] WHO
Date: Mon 7 Apr 2014
Source: WHO Regional Office for Africa [edited]
http://www.afro.who.int/en/clusters-a-p ... -2014.html


Ebola virus disease in West Africa (7 Apr 2014) situation update
----------------------------------------------------------------
Guinea

------
A cumulative total of 151 clinically compatible cases of Ebola virus disease (EVD) including 95 deaths had officially been reported from Guinea; 65 samples were tested of which 34 tested positive for Ebola. The date of onset of the most recent laboratory confirmed case is 3 Apr 2014; 14 of the cases including 8 deaths are health workers, of which 11 are laboratory confirmed cases.

Liberia
-------
21 clinical cases of EVD, including 10 deaths, have been reported from Liberia. All 5 of the laboratory confirmed cases have died.

Sierra Leone
------------
2 probable cases of EVD were reported from Sierra Leone in one family, who died in Guinea and their bodies were repatriated to Sierra Leone.

Mali
----
4 patients suspected to have a viral haemorrhagic fever presented for health care in Sibiribougou, Koulikoro Region of Mali; 2 of the suspected cases had travelled from Guinea.

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******
[2] Liberia
Date: Tue 8 Apr 2014
Source: Premium Times, Xinhua News Agency/News Agency of Nigeria (NAN) report [edited]
http://www.premiumtimesng.com/news/1583 ... -dead.html


Ebolavirus is one of the most aggressive viruses known to date because it kills rapidly. The Liberia government on Tuesday [8 Apr 2014] in Monrovia said the number of people afflicted with the Ebola virus disease has risen to 18, of which 11 people have died.

The Liberian minister of health, Walter Gwenigale, decried the situation and warned Liberians to take the it seriously, saying it is no joke at all as the Ebola epidemic is aggressive. Mr Gwenigale said that the number of Ebola cases in the country had risen to the latest figure [18] from 14 last week.

He said 8 deaths were recorded in Foya, Lofa County, near Guinea, from where the virus entered the country. He also noted that the other 3 deaths took place in Montserrado County in the capital, Monrovia, one in Margibi County, and one in north eastern Nimba County, where a hunter was reported to have died of the disease. The minister said Ebola usually leaves little time for treatment to save a sick individual.

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[3] Guinea
Date: Wed 9 Apr 2014
Source: IDPH (Infectious Diseases and Public Health) Research Group [edited]
https://twitter.com/IDPHRGroup/status/4 ... 5566283778


IDPH has prepared a useful map showing the affected areas of Guinea as of 5 Apr 2014. See https://twitter.com/IDPHRGroup/status/4 ... 5566283778.

--
Sofian Ragab
IDPH Research Group

******
[4] Mapping the outbreak
Date: Wed 9 Apr 2014
Source: WHO Regional Office for Africa [edited]
http://www.afro.who.int/en/media-centre ... break.html


WHO and partners scale up the response to the Ebola outbreak

------------------------------------------------------------
According to the latest figures, 157 people, including 101 deaths, have been infected with the Ebola virus disease in Guinea. As of today [9 Apr 2014], 66 cases have been confirmed by laboratory analysis -- 8 patients in Guinea have so far recovered.

To strengthen contact tracing in Conakry, the World Health Organization (WHO) organized an intensive training today for a 1st group of 70 trainees. They will go into the communities to follow up on specific persons who had close contacts with patients with a confirmed Ebola infection. Training for health workers on infection control has started yesterday [8 Apr 2014] in different departments of the Donka national teaching hospital [Conakry] and will also take place in other health facilities in coming days.

Simultaneously, WHO is setting up an operation centre for alert and response within the Guinean Ministry of Health (MoH) in order to centralize the coordination of all activities linked to detection, search, transportation, hospitalisation, and burial of suspect cases. WHO clinicians continue to support Medecins Sans Frontieres (MSF) and MoH in providing clinical management at Donka isolation ward.

Spread across 6 districts of the country including Conakry, this Ebola outbreak represents a particular challenge that requires the mobilization of different resources from national and international partners to put in place the necessary response measures. WHO has more than 50 people on the ground supporting the Ministry of Health and other partners to provide clinical management of patients, contact tracing, disease surveillance, laboratory work, logistics, as well as information-sharing and social mobilization and communication.

New outbreak management software developed by the US Centers for Disease Control (CDC) is presently being updated with data from the field, and will soon be used as the primary database tool by all partners. The CDC software package Epi-Info aggregates various types of outbreak data into a single database that produces statistical and visual reports on the outbreak.

Raising awareness of the risk factors for infection and the protective measures that should be taken is the only way to stop transmission and subsequent deaths. Close unprotected physical contact with Ebola patients should be avoided and those who have died from the disease should be promptly and safely buried.

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[5] Mapping tools
Date: Wed 9 Apr 2014
Source: New Scientist [edited]
http://www.newscientist.com/article/mg2 ... 0XujWRDuH9


Mapping in a crisis: online army helps map Guinea's Ebola outbreak
------------------------------------------------------------------
Health workers responding to an Ebola outbreak in Guinea had no maps to go on, so they turned to the internet for help.

When doctors working for Medecins Sans Frontieres (MSF) arrived in the West African nation of Guinea last month [March 2014] to combat an outbreak of the deadly Ebola haemorrhagic fever, they found themselves working in an information vacuum. Accurate maps are crucial to pinpointing the source of the Ebola virus and preventing it from spreading. But the only maps in Guinea were topographic charts -- useless for understanding population distribution. Desperate for information, they enlisted an online army to help. MSF asked a digital mapping organisation called Humanitarian OpenStreetMap Team (HOT) to build them a map of Gueckedou, a city of around 250 000 people in southern Guinea, where the outbreak is concentrated.

As of 31 Mar 2014, online maps of Gueckedou were virtually non-existent, says Sylvie de Laborderie of cartONG, a mapping NGO that is working with MSF to coordinate the effort with HOT. "The map showed 2 roads maybe -- nothing, nothing." Within 12 hours of contacting the online group, Gueckedou's digital maps had exploded into life. Nearly 200 volunteers from around the world added 100 000 buildings based on satellite imagery of the area, including other nearby population centres. "It was amazing, incredible. I have no words to describe it. In less than 20 hours they mapped 3 cities," says de Laborderie.

Mathieu Soupart, who leads technical support for MSF operations, says his organisation started using the maps right away to pinpoint where infected people were coming from and work out how the virus, which had killed 95 people in Guinea when New Scientist went to press, is spreading. "Having very detailed maps with most of the buildings is very important, especially when working door to door, house by house," he says. The maps also let MSF chase down rumours of infection in surrounding hamlets, allowing them to find their way through unfamiliar terrain.

MSF now has up-to-date maps of the whole area. Workers are each given an A4 printout of a specific area to canvass door to door, surveying inhabitants and searching for signs of the disease. The pages can then be assembled into a larger map to provide the big picture.

Mikel Maron, co-founder of HOT, says the firm's work with the American Red Cross in response to typhoon Haiyan showed aid organisations the potential for digital mapping. De Laboradorie agrees. "After the typhoon in the Philippines we got very, very interested by GIS [geographic information system software] and maps in order to support their operation," she says. "The places that are among the most vulnerable to contagious disease outbreaks are also the least mapped," says Maron. "We have real potential to help decrease that vulnerability."

Information on each Ebola case is also being added to the maps built by HOT. While the new maps are available for anyone to use online via OpenStreetMaps (OSM), the case information won't be uploaded to the public OSM map of the city, due to its sensitive nature. But it will help MSF efforts to identify the outbreak's patient zero -- and hence where the Ebola outbreak originated.

The global nature of the mapping effort is stunning, says de Laborderie. "When you are going to sleep at the end of the day, another part of the world is mapping."

[byline: Hal Hodson]

--
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[The WHO/AFRO report in [1] above has a table of the Guinea cases by district, epidemiological graphs of ages and dates of onset of cases, and a map showing the connection between the cases in all 4 countries.

Mapping tools and the epidemiological software described above are crucial for rapid analysis of the huge amount of incoming data. - Mod.JW]
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Ebola in Westafrika

Beitragvon Birgitt » 11.04.2014 11:40

EBOLA VIRUS DISEASE - WEST AFRICA (13): WHO, MALI SUSPECTED, UNICEF
*******************************************************************
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http://www.promedmail.org
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In this update:
[1] WHO press briefing
[2] WHO/AFRO update
[3] UNICEF press release
[4] Comments


******
[1] WHO press briefing
Date: Tue 8 Apr 2014
Source: WHO virtual press briefing
http://www.who.int/mediacentre/multimed ... iefing/en/


Update on the Ebola virus disease outbreak in West Africa -- virtual press briefing
--------------------------------------------------------------------
8 Apr 2014 press briefing by Dr Keiji Fukuda, assistant director-general, Health Security and Environment, and Dr Stephane Hugonnet, medical officer, WHO.

[The complete transcript of the briefing is available at http://www.who.int/mediacentre/multimed ... 4.pdf?ua=1.
Audio and video (MP3) files are also online at WHO. - Mod.JW]

******
[2] WHO/AFRO update
Date: Thu 10 Apr 2014
Source: WHO Regional Office for Africa, Epidemic & Pandemic Alert and Response (EPR), Outbreak News [edited]
http://www.afro.who.int/en/clusters-a-p ... -news.html


EPR - Outbreak News: Ebola virus disease, West Africa -- situation as of 10 Apr 2014
---------------------------------------------------------------------
Guinea
------
As of [10 Apr 2014], a cumulative total of 157 clinically compatible cases, including 101 deaths have been officially reported.

Laboratory investigations continue at the Institut Pasteur (IP) Dakar laboratory in Conakry [Guinea] (65 samples tested, of which 38 are positive by PCR for ebolavirus) and at the European Union Mobile Laboratory (EMLab) team in Gueckedou [Guinea] (38 samples tested/28 positive). A total of 66 clinical cases have been laboratory confirmed (42 per cent), while 87 of the remaining clinical cases are classified as probable cases and 4 as suspected cases.

24 of the 101 deaths have been laboratory confirmed. 6 districts of Guinea have reported patients -- Conakry (20 patients, all laboratory confirmed), Gueckedou (96 cases/32 confirmed), Macenta (28 cases/12 confirmed), Kissidougou (9 cases/1 confirmed), and Dabola and Djingaraye combined (5 cases/1 confirmed). The date of onset of the most recently identified suspected clinical cases in Conakry and Gueckedou was [8 Apr 2014].

One additional healthcare worker (HCW) [case] has been reported since the [7 Apr 2014] update, bringing the total to 15 (10 laboratory confirmed and 5 probable cases). Medical observation is continuing for 488 contacts while 453 have been discharged from follow-up. No new contacts were identified on [8 Apr 2014].

Liberia
-------
As of [10 Apr 2014], the Ministry of Health and Social Welfare (MOHSW) of Liberia has reported a cumulative total of 5 laboratory confirmed cases and 20 suspected and probable cases of Ebola virus disease (EVD).

The date of onset of the most recent confirmed case is [6 Apr 2014], with 6 patients currently hospitalised. Lofa County accounts for 32 per cent of the clinical cases reported to date (4 laboratory confirmed/6 suspected cases) followed by Margibi County (27 per cent, 1 confirmed/ 5 suspected cases). Other Counties at risk include Bong (4 suspected cases) and Nimba (3 suspected cases). Montserrado and Grand Cape Mount Counties have each reported one suspected case.

At present 32 contacts remain under medical observation.

The cumulative number of 12 deaths are being attributed to EVD; Lofa (9), Nimba (1), Margibi (1), and Montserrado (1). All 5 laboratory confirmed cases have died. Laboratory confirmed deaths have occurred in Lofa County (4) and Margibi County (1).

Mali
----
As of [10 Apr 2014], the Ministry of Health (MOH) of Mali has reported a cumulative total of 9 suspected cases, one of whom has died. The most recent suspected case was an unexplained death in a female who had travelled between Siguiri Prefecture, in the Kankan Region of Guinea, and Bamako. Clinical samples were collected from all of the suspected cases to date. 2 of these patients have previously been reported as testing negative for ebolavirus infection and other viral haemorrhagic fever viruses in assays conducted by the US Centers for Disease Control and Prevention (CDC) in Atlanta. The remaining 7 samples have been dispatched to the Institut Pasteur, Dakar, for testing.

The patients who previously tested negative have been released from medical follow-up and counselling has been provided to their families. The isolation facility as the Centre National d'Appui a la lute contre les Maladie (CNAM), Bamako, designed for the management of cases of Lassa fever, is receiving the suspected cases of EVD. Suspected cases have also been reported from Kouremale (2) and Bankoumana (1) in Koulikoro Region of Mali.

Sierra Leone
------------
Although the epidemiological situation in Sierra Leone remains unchanged, the Ministry of Health and Sanitation (MOHS) continues to lead intensive EVD preparedness activities. 7 teams, each composed of a director from the MOHS, a program officer of the Disease Prevention and Control directorate, and a program officer from the national Health Education program have been dispatched to each of districts bordering Liberia and Guinea (Kambia, Kenema, Koinadugu, Kailahun, Bombali, Pujehun, and Kono districts) to assess district preparedness with local authorities, including community-wide approaches to EVD preparedness and response and to pre-position supplies.

WHO, in collaboration with technical partners in the Global Outbreak Alert and Response Network (GOARN) has deployed field laboratory support, and continues to identify and deploy experts in anthropology, epidemiology and data management, outbreak logistics, clinical case management and infection prevention and control, social mobilisation, risk communications, and outbreak coordination to support the response in all of the affected countries. Over 50 experts have been deployed to date and response supplies, including PPE and a variety of EVD communication and education materials for local adaptation, have been dispatched to affected and neighbouring countries.

As EVD in West Africa continues to evolve, the number of reported cases and deaths, contacts under medical observation, and the number of laboratory results are subject to change due to consolidation of case, contact, and laboratory data, enhanced surveillance and contact tracing activities and ongoing laboratory investigations.

WHO does not recommend that any travel or trade restrictions be applied to Guinea, Liberia, Mali, or Sierra Leone based on the current information available for this event.

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******
[3] UNICEF press release
Date: Thu 10 Apr 2014
Source: UN Office for the Coordination of Humanitarian Affairs (OCHA), ReliefWeb, UNICEF report [summ., edited]
http://reliefweb.int/report/guinea/life ... est-africa


Life-saving information helps reduce spread of Ebola across West Africa – Guinea
----------------------------------------------------------------
Together with Ministries of Health and other partners across 7 countries in West Africa, UNICEF is using text messaging through mobile phones, radio shows, TV programmes, and door-to-door campaigns to disseminate life-saving information in an effort to contain the often-fatal Ebola virus disease.

"Most of the people in this part of the world had never heard of [_Ebolavirus_] before," said Dr Guido Borghese, UNICEF principal advisor Child Survival and Development for West and Central Africa. "In this environment, unfounded fears and rumours spread quickly and widely. More than ever, it is crucial that families have both the means and the right information to protect themselves and prevent dangerous misunderstandings."

In collaboration with partners such as the Red Cross and the World Health Organization (WHO), UNICEF is stepping up efforts to design culturally-sensitive communication strategies and raise awareness of Ebola, at the grassroots level, across the 7 at-risk or affected countries in West Africa.

In Guinea, Liberia, Sierra Leone, Cote d'Ivoire, Senegal, Mali, and Guinea-Bissau, mass and digital media and inter-personal communication activities are being carried out to prevent people contracting the ebolavirus amongst communities and health workers in mosques, churches, schools, health centres, and markets.

UNICEF is urgently appealing for USD 1.2 million for Guinea and almost USD 1.3 million for neighbouring countries including Liberia, Sierra Leone, Senegal, Guinea Bissau, and Mali, to provide disinfectant products, essential medicines, life-saving supplies, and communication support crucially needed to stop ebolavirus from spreading further across West Africa.

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[The UNICEF/ReliefWeb efforts described above are unfortunately likely to result in a rush to health centres by anyone who has a fever or been in contact with a fever case, thus overloading them -- just as they would in the USA, Europe and Asia if a case were to be suspected there. After the 1995 Aum Shinrikyo sarin attack on the Tokyo subway, thousands of people who had never been anywhere near the subway flooded hospital emergency rooms with real or imagined symptoms. - Mod.JW]

******
[4] Comments
Date: Thu 10 Apr 2014
Source: Cross-posted from <nigerianbiomedicalandlifescientists@yahoogroups.co.uk> [edited]


On Thu 10 Apr 2014, 11:39, Shamsudeen Fagbo <oloungbo@yahoo.com> wrote:

Notable points from the WHO virtual press conference on Ebola held on 8 Apr 2014:

- It reaffirms the Ebola negative result from Ghana reported earlier, something [which was] strangely questioned by some on this list. [Nigerian biomedical and life scientists Yahoo Groups]

- Dr Fukuda stresses that the outbreak, like other Ebola outbreaks, can be controlled by enhancing clinical detection and management protocols in tandem with rapid surveillance to track case contacts and prevent further transmission.

This will be the challenge in Nigeria if it ever occurs. Have our doctors and other healthcare workers been able to manage Lassa fever such that we have prevented healthcare-acquired Lassa fever as much as possible? According to the briefing, about 14 health workers have died in Conakry.

- Dr Fukuda reiterates that spreading misinformation, rumours, and other panic-engendering behaviours are an unwanted challenge to controlling the outbreak. Food for thought.

- His broad minded answer to the question on travel restriction should be of immense value.

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[What is new in Guinea is one more (avoidable) HCW case and only 488 contacts still under observation (down from 600), while 453 have been discharged from follow-up. The length of the follow-up period is not stated, but the incubation period is up to 21 days, and to be on the safe side, twice the incubation period is normally recommended, and the 1st laboratory confirmed cases were reported on 27 Mar 2014.

The comments from a Nigerian point of view are valuable. One wonders what the reaction of Ghana and other West African countries "in the firing line" are like. - Mod.JW

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/45.]
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Verdacht auf Ebola-Fieber in Marokko

Beitragvon Birgitt » 13.04.2014 12:41

EBOLA VIRUS DISEASE - WEST AFRICA (14): MOROCCO SUSPECTED, VIRUS STABILITY
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[1] Morocco, suspected
Date: 10 Apr 2014
Source: Turner Radio Network [edited]
http://www.turnerradionetwork.com/news/417-pat


Suspected Ebola outbreak hits 6th country: Morocco; one step from Europe
-----------------------------------------------------------------
The Ebola outbreak in west Africa has now expanded to a 6th country: Morocco, and is just one step away from reaching Spain and the continent of Europe. Suspected cases: 2, deaths: 0.

[There was no independent source of this report in English found by internet search. If any reader can find one, please let us know by clicking on Submit Info in the dark blue band at the top of our home page, <www.promedmail.org>. - Mod.JW

Meanwhile, this item should be read with a measure of scepticism and our posting it should not be taken as evidence of its veracity. - Mod.SH]

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******
[2]
Comment on stability of ebolaviruses from Nigerian biomedical and life scientists

Date: Tue 8 Apr 2014
Source: cross-posted from <nigerianbiomedicalandlifescientists@yahoogroups.co.uk> [edited]


[Doubts have been raised in internet discussions about whether the serological tests being used to detect ebolavirus infections in this outbreak are valid for the virus currently circulating in West Africa. - Mod.JW]

On the Nigerian biomedical and life scientists Yahoo Groups list, Shamsudeen Fagbo <oloungbo@yahoo.com> wrote:

Scientists, including those from France and the USA, working for years on Ebola have documented that the viruses involved in past outbreaks -- spatially and temporally diverse -- are very stable.

In the absence of novel unpublished work [that is] contrary to the references below, we should stick to the evidence we know and not escalate panic. A diagnostic approach of the CDC during the Ugandan outbreak depended mainly on serology to delineate the epidemiological picture and control the outbreak. Molecular tools are sexy but have limitations in real life outbreak situations. It cannot give you answers about infections in post-viremic, convalescent individuals. Understanding the scenario demands reviewing the detailed case and exposure history of the patients -- which is where the skills, or absence thereof, of clinicians come into question.

References
----------
1. Leroy EM, Baize S, Volchkov VE, et al. Human asymptomatic Ebola infection and strong inflammatory response. Lancet. 2000; 355(9222): 2210-5. Available at http://www.thelancet.com/journals/lance ... 40-6736(00)02405-3/fulltext.

Background
----------
[Ebolavirus] is one of the most virulent pathogens, killing a very high proportion of patients within 5-7 days. 2 outbreaks of fulminating haemorrhagic fever occurred in northern Gabon in 1996, with a 70 per cent case fatality rate. During both outbreaks we identified some individuals in direct contact with sick patients who never developed symptoms. We aimed to determine whether these individuals were indeed infected with Ebolavirus, and how they maintained asymptomatic status.

Findings
--------
11 of 24 asymptomatic individuals developed both IgM and IgG responses to Ebola antigens, indicating viral infection. Western-blot analysis showed that IgG responses were directed to nucleoprotein and viral protein of 40 kDa. The glycoprotein and viral protein of 24 kDa genes showed no nucleotide differences between symptomatic and asymptomatic individuals. Asymptomatic individuals had a strong inflammatory response characterised by high circulating concentrations of cytokines and chemokines.

Interpretation
--------------
This study showed that asymptomatic, replicative Ebola infection can and does occur in human beings. The lack of genetic differences between symptomatic and asymptomatic individuals suggest that asymptomatic Ebola infection did not result from viral mutations. Elucidation of the factors related to the genesis of the strong inflammatory response occurring early during the infectious process in these asymptomatic individuals could increase our understanding of the disease. PMID: 10881895

--
2. Rodriguez LL, De Roo A, Guimard Y, et al: Persistence and genetic stability of Ebola virus during the outbreak in Kikwit, Democratic Republic of the Congo, 1995. J Infect Dis. 1999 Feb; 179 Suppl 1:S170-6; available at http://jid.oxfordjournals.org/content/1 ... /S170.long.

Abstract
--------
Ebola virus persistence was examined in body fluids from 12 convalescent patients by virus isolation and reverse transcription-polymerase chain reaction (RT-PCR) during the 1995 Ebola hemorrhagic fever outbreak in Kikwit, Democratic Republic of the Congo. Virus RNA could be detected for up to 33 days in vaginal, rectal, and conjunctival swabs of 1 patient and up to 101 days in the seminal fluid of 4 patients. Infectious virus was detected in 1 seminal fluid sample obtained 82 days after disease onset. Sequence analysis of an RT-PCR fragment of the most variable region of the glycoprotein gene amplified from 9 patients revealed no nucleotide changes. The patient samples were selected so that they would include some from a suspected line of transmission with at least 3 human-to-human passages, some from 5 survivors and 4 deceased patients, and 2 from patients who provided multiple samples through convalescence. There was no evidence of different virus variants cocirculating during the outbreak or of genetic variation accumulating during human-to-human passage or during prolonged persistence in individual patients. PMID: 9988181

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[We remain in suspense about whether the ebolavirus has crossed the Mali border.

The references in Shamsudeen's comment above are useful reminders that we do not have to search now for a new, different ebolavirus strain, and that existing ebolavirus reagents are still reliable. - Mod.JW]
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Bisher KEIN Ebola-Fieber in Ghana, Marokko und Portugal

Beitragvon Birgitt » 13.04.2014 12:42

EBOLA VIRUS DISEASE - WEST AFRICA (15): MOROCCO, GHANA, PORTUGAL ALL NOT
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[1] Morocco NOT
Date: Thu 10 Apr 2014
Source: The Moroccan Times [edited]
http://moroccantimes.com/2014/04/concer ... to-morocco


Moroccan media outlets Goud.ma and Aljarida24.com prompted concerns over a probable outbreak of the West African ebolavirus in Morocco. As a matter of fact, the sources alleged that the Moroccan authorities may have sent some West Saharan natives directly from Airport Mohammed V in Casablanca to the Moulay Youssef hospital after suspecting their contamination with the virus.

The Moroccan authorities denied this right away.

Mr Abdelghani Drhimeur, Ministry of Health's spokesman, said that "no infection case with the ebolavirus has been detected, whether within Morocco or in any of its airports," as relayed by aufaitmaroc.ma.

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[2] Ghana NOT
Date: Fri 11 Apr 2014
Source: Channels Television [edited]
http://www.channelstv.com/home/2014/04/ ... emiologist


Reports from the Noguchi Memorial Institute of Medical Research in the University of Ghana showed that there are no cases of ebolavirus in Ghana, a Nigerian epidemiologist has said.

A state epidemiologist with the Lagos State Ministry of Health, Dr Ismail Abdus-Salam, told Channels Television on Friday [11 Apr 2014] that he spoke with a colleague at the institute and he confirmed that the suspected case of ebolavirus disease in the Ashanti region of Ghana was not Ebola. "I spoke with a colleague at the Noguchi Memorial Institute of Medical Research, in the University of Ghana on Thursday morning [10 Apr 2014] and he said the test conducted on the suspected infected person was negative for Ebola and other typical viral haemorrhagic fevers."

Ghana's health authorities had announced the 1st suspected case of the deadly ebolavirus disease at the country's 2nd biggest hospital, Komfo Anokye Teaching Hospital (KATH), in Kumasi. The deputy director of public health in the Ashanti region, Dr Joseph Oduro, said on Sunday evening [6 Apr 2014] that the case resulted in the death of a 12 year old girl. Oduro said the victim, who was admitted to the paediatric unit of the Teaching Hospital with symptoms of fever and bleeding, died, and during a postmortem it was detected she had internal bleeding.

He said the development was alarming since neighbouring countries like Guinea and Liberia had recorded cases of the viral infection. Blood samples of the victim were sent to the Medical Research Institute in Accra for testing. According to Dr Ismail Abdus-Salam's statement, the result of the test was negative. He, however, advised that proper port surveillance should be embarked on to ensure that people with the ebolavirus would not enter into any country unnoticed.

The ebolavirus disease does not have any cure or vaccine and no specific symptoms are known. The disease has already killed dozens of people in neighbouring Guinea, with reported cases in Liberia and Mali.

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[3] Portugal NOT
Date: Thu 10 Apr 2014
Source: The Portugal News Online [edited]
http://www.theportugalnews.com/news/por ... ures/31199


Earlier this week a sigh of relief was breathed in Portugal, after a Portuguese national who had recently travelled to Liberia and who was suspected of having contracted Ebola, tested negative for the virus.

While laboratory analyses have quashed concerns that he may have contracted the ebolavirus and brought it back to Portugal, Portuguese immigration and health authorities have nonetheless guaranteed all "procedures appropriate to the situation at hand are ongoing and planned" to deal with an outbreak should it be necessary.

In response to concerns, Portugal's Directorate General of Health (DGS) issued an advisory note suggesting patients be immediately isolated "if a presumed diagnosis of Ebola virus disease is made in a patient with a clinical diagnosis and who has returned recently (within 21 days) from a region where the virus is active." A dedicated phone-line has been made available to medical professionals who come across suspected cases of Ebola.

Francisco George, head of the DGS, also reiterated this week that Portugal is prepared to deal with any eventual cases of Ebola should it be confirmed in this country, and said that all regions are instructed on how to proceed. "In less than 4 hours a citizen [of Guinea or Liberia] can be in Lisbon. It is necessary to draw up emergency measures to stop the activity of the virus from a case that may have just arrived. And we are prepared. We do have a plan for it which is activated whenever necessary." National airline TAP operates flights to Dakar (Senegal) and Bamako (Mali), both of which neighbour with Guinea. According to the BBC, Mali is controlling traffic into and out of its capital, Bamako, and its airport, and using thermal cameras to screen for people who might have fevers.

In a statement sent to The Portugal News WHO spokesperson Gregory Hartl explained: "In the history of Ebola, there has never been a case outside equatorial Africa. In the current event, all the cases are connected with a single chain or tree of transmission. Therefore, it would be highly, highly unlikely that there would be any cases arriving in Portugal. "But it is a terrible disease and until we know we have this outbreak controlled, everyone should remain vigilant." Also vulnerable to contracting the disease are health workers and international aid workers dispatched to the region to help with the outbreak.

[byline: Carrie-Marie Bratley]

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[A correspondent writes: "Morocco is not part of West Africa, but, through Royal Air Maroc, has made Mohamed V airport a hub through which West Africans, including Guineans and Malians, fly from Europe to their respective home countries."

ProMED-mail tries to balance posting reports of suspected cases, as an early warning, against the possibility that they may not be finally confirmed. - Mod.JW]
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Re: Ebola-Fieber in Guinea, Liberia, Sierra Leone und Mali

Beitragvon Alexander » 13.04.2014 12:59

Mittlerweile spricht man vom bisher schlimmsten Ausbruch des Ebola Virus. Nicht gemessen an den Opfern. Was diesen Ausbruch besonders gefährlich erscheinen lässt ist die Tatsache, dass es noch nie einen so flächendeckenden Ausbruch gegeben hat, der sich so weit nach Norden ausbreitet. Zum ersten Mal in der Geschichte breitet sich Ebola in einer Großstadt aus.

ebola.jpg


Ebola – der bisher schlimmste Ausbruch
Die aktuelle Ebola-Epidemie ist am 9. Februar im westafrikanischen Guinea ausgebrochen. Zwei Monate später hat sie bisher unbekannte Ausmaße erreicht. Die Weltgesundheitsorganisation ist alarmiert. Auf einer Pressekonferenz bezeichnete der zuständige Vizegeneraldirektor der WHO für Gesundheitssicherheit, der Japaner Keiji Fukuda,
diesen Ebolaausbruch als den schlimmsten bisher registrierten. Und zwar in erster Linie wegen der großflächigen Verbreitung und zweitens, weil die Krankheit erstmals in einer Großstadt auftritt, in Conakry, der Hauptstadt von Guinea. Bisher sind im zuerst betroffenen Land Guinea 157 Fälle registriert worden, von denen 101 bereits tödlich endeten.
Betroffen sind auch in Liberia mit 21 Fälle davon bisher 10 tödlich und Mali mit bisher 9 Verdachtsfällen. mehr...

Grüsse
Alexander
Du hast keine ausreichende Berechtigung, um die Dateianhänge dieses Beitrags anzusehen.
The one who follows the crowd will usually go no further than the crowd. Those who walk alone are likely to find themselves in places no one has ever been before.

... follow us on facebook - das Wüstenschiff auf Facebook
>>> Firmen, die Wüstenschiff-Aktionen in Afrika unterstützen
Alexander
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KEIN Ebola-Fieber in Sierra Leone und Mali

Beitragvon Birgitt » 13.04.2014 17:19

EBOLA VIRUS DISEASE - WEST AFRICA (16): SIERRA LEONE AND MALI NOT, ECONOMY
**************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

In this posting:
[1] Sierra Leone NOT, Mali NOT
[2] Economic impact
[3] Gambia: flights banned
[4] HealthMap: Ebola updates and an interview
[5] Survivors: immunity and transmission


******
[1] Sierra Leone NOT, Mali NOT
Date: Sat 12 Apr 2014
Source: Euronews [in French, trans. & summ. Mod.JW, edited]
http://fr.euronews.com/2014/04/12/ebola ... -de-guinee


The suspect cases in Mali and Sierra Leone have tested negative.

Temperature detectors have been installed at Guinea's international airport that will show a body temperature above 38 deg C (100.4 deg F).

--
communicated by:
ProMED-mail
<promed@promedmail.org>

[What will Guinea do with passengers who have temperatures above 38 deg C (100.4 deg F)? Quarantine them for 21 days or put them back on the plane? The 2nd alternative would be resisted by aircrew and other passengers. - Mod.JW]

******
[2] Economic impact
Date: Sat 12 Apr 2014
Source: Crofsblogs, Bloomberg News report (11 Apr 2014) [edited]
http://crofsblogs.typepad.com/h5n1/2014 ... inues.html


Ebola: the economic impact continues
------------------------------------
"At least 80 per cent of our reservations have been canceled," Ibrahima Capi Camara, general manager of the 217-room Grand Hotel de L'Independence in the heart of Conakry, said on 8 Apr 2014. "Clients are scared to come because of Ebola."

Measures such as closing borders and restricting travel "don't make sense," according to WHO, which says avoiding close contact with patients will help contain the spread of the disease. That hasn't stopped Senegal from shutting a border or Ivory Coast from barring buses from Liberia and Guinea. Rio de Janeiro-based Vale SA (VALE5), the world's biggest iron-ore producer, sent foreign workers in Guinea back to their homes last week [6-11 Apr 2014?].

"The extreme fear it provokes in populations means that local and regional businesses are already seeing disruption to operations," Charles Laurie, head of Africa research at risk consultant Maplecroft in Bath, England, said in an email. "Regional trade is at risk of grinding to a halt." The disease will curb economic growth in Liberia by slowing cross-border commerce, reducing customs revenue, and investment, finance minister Amara Konneh said in an interview yesterday [11 Apr 2014]. Gross domestic product will expand [only] 6.8 per cent this year, slower than the 8.7 per cent last year [2013], he said.

Mohamed Cherif Abdallah, head of the Organized Group of Businessmen in Conakry, said the outbreak is hurting the economy. "Guinean business owners are losing money because of this," he said by phone yesterday [10 Apr 2014]. "The disease has halted economic activity in the country's interior, and many foreigners are reluctant to come now." The Guinean region and towns of Gueckedou and Macenta where [Ebolavirus] was first detected last month [March 2014] produces most of the fruit and vegetables sold in the capital. "People claim that our bananas contain ebolavirus because they come from Gueckedou," a market vendor in Conakry, said in an interview. "For the past 2 weeks, I've had to throw all my bananas away. Business is dwindling."

--
communicated by:
ProMED-mail
<promed@promedmail.org>

*******
[3] Gambia: flights banned
Date: Sat 12 Apr 2014
Source: Freedom Newspaper, Gambia [edited]
http://www.freedomnewspaper.com/Homepag ... fault.aspx


Gambia's dictator Yahya Jammeh has ordered the banning of all flights coming from Guinea Conakry, Sierra Leone, and Liberia from landing at the Banjul International airport with immediate effect, the Freedom Newspaper can reveal. The decision followed the outbreak of Ebola virus disease in the West African region. He said the decision to ban flights coming from the above-named countries was in line with Gambia's efforts to prevent its citizens from getting infected with the dreadful Ebola pandemic. Hundreds of passengers have been stranded across the West African region, following Jammeh's latest decree to ban airlines from landing in The Gambia.

Health Ministry officials and Banjul Aviation staff have confirmed the story. According to sources, many travelers have been compelled to travel by land through other countries as The Gambia Civil Aviation Management said they have been instructed by Jammeh to turn down flights coming from Guinea, Sierra Leone, and Liberia.

"The approach taken by Jammeh is wrong, says an official of the Ministry of Health. "We can fight Ebola without banning incoming flights." Even the minister of health is not happy with the decision. The airport is going to lose a lot of revenue in coming days and weeks because of Jammeh's decision," he warned.

In Liberia, it is reported that many passengers travelling to The Gambia have been stranded. One of the passengers told the Freedom Newspaper that he had to cancel his air ticket reservation because of Jammeh's decision to ban incoming flights.

--
communicated by:
ProMED-mail
<promed@promedmail.org>

*******
[4] HealthMap: Ebola updates and an interview
Date: Fri 11 Apr 2014
Source: HealthMap, The Disease Daily [edited]
http://www.healthmap.org/site/diseaseda ... view-41114


Dr Thomas Yuill [TY], a moderator for ProMED-mail and professor emeritus in the Department of Pathobiological Sciences at the University of Wisconsin-Madison spoke with me about the challenges that exist with the current [Ebolavirus] outbreak. Dr Yuill has a joint PhD in wildlife ecology and in veterinary science with a specialization in virology. He has worked throughout the world in the field of zoonoses.

AH: Are you aware of any challenges specific to the current outbreak?

TY: The thing that is most challenging about this outbreak is not only that it is in West Africa, where the virus had not previously been seen, but that it is in many different places including Guinea and Liberia, with suspect cases previously identified in Sierra Leone in people that had traveled from Guinea.

Another challenge that exists is catching up with contacts, as the population is spread out and highly mobile. In addition, some of the regions in Guinea did not have reliable maps available, however maps have since been provided so that health authorities are better able to find houses in these hot spot areas and may now begin going house-to-house to identify any missed cases and potential contacts. Tracking and identifying contacts to specific locations is a tremendous task for officials to complete.

Lastly, there is a lot of fear among locals, which is not surprising given the nature of the disease and the high case fatality rate.

AH: Do you think we will continue to see more cases as part of this outbreak, and what can health officials do at this point to stop the disease from continuing to spread?

TY: Authorities will be able to halt the current outbreak with good case finding and contact tracing practices. It is likely that more cases will be seen however, and getting this outbreak halted will not be easy and will take some time.

AH: Could you tell me more about why the reservoir for [ebolavirus] has not yet been confirmed?

TY: If [ebolavirus] is not highly prevalent in wildlife populations it will take an enormous effort, including costly field studies to track it down. If you are not in the right place at the right time one may not find it.

AH: Do you have any insight about the consumption of bushmeat in these countries, as that is a risk for disease transmission?

TY: The consumption of bushmeat is a well-established practice in many parts of Africa and it constitutes a significant amount of protein for many people as well as a source of income. The ban on bushmeat that has been placed by several countries will likely be extremely difficult to enforce.

AH: Any final thoughts on the ongoing Ebola outbreak?

TY: I think for all of us this has been a major wake-up call. These things can and do happen by surprise and then the challenge is to be ready for them when they occur to be able to respond quickly because the virus isn't going to wait for us to get organized.

Bushmeat safe to eat
--------------------
Officials in Guinea, Sierra Leone, and Liberia have banned the sale of bushmeat in local markets in an effort to stop the spread of [ebolavirus]. Reuters reports that some specialists remain skeptical about the ban's effectiveness as many depend on bushmeat for protein and income. Further, some are not convinced that smoked or cooked bushmeat is a significant source of [ebolavirus] infection. In late March [2014], Reuters spoke with a virologist and hemorrhagic fever specialist, Bob Swanepoel, who stressed that filoviruses are transmitted by infected animals and "fresh carcasses" rather than cooked or smoked meat. -

[byline: Amy L Sonricker Hansen]

--
communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[Bob Swanepoel's advice that cooked or smoked bushmeat is safe to eat is correct. But one ProMED-mail moderator has seen a passenger arriving from Africa with blood leaking from fresh bushmeat in his baggage. - Mod.JW]

*******
[5] Survivors: immunity and transmission
Date: Fri 11 Apr 2014
Source: National Public Radio (NPR), USA [summ., edited]
http://nipr.fm/post/how-patient-can-recover-ebola


How a person can recover from [Ebola virus disease]
---------------------------------------------------
Marie-Christine Ferir, Brussels-based emergency coordinator for Medecins sans Frontieres [MSF; doctors without borders], says a person's blood may be free of Ebola, but the virus can persist in semen for 2-3 months after recovery. (That's because antibodies produced in the bloodstream don't reach the testicles.) Since Ebolavirus can be transmitted through sexual contact, male survivors are sent home with condoms and instructed to use them for the next 3 months if they engage in intercourse. The virus can also linger in breast milk, so mothers are told to wean any child who had been breastfeeding.

Ebola survivors do not have to worry about contracting the disease again, says Pierre Rollin, deputy director of the viral special pathogens branch of CDC, who has traveled to the site of previous Ebola epidemics over the past 20 years. "When they start to test negative, they're going to remain negative for the rest of their lives."

Mental health is another matter. Health care workers often check on patients in their homes to see how they are faring after the trauma of suffering through Ebola -- and perhaps losing family members to the disease as well. They must also deal with the stigma associated with having had the virus. Health workers teach the community that the Ebola survivor cannot infect them. "They will do a lot of things, especially holding hands with [the patients], to publicly demonstrate that they're not afraid of these people," says Knust. Adds Ferir: "[In the past] we would bring the patient into the middle of the village, and we would give a big kiss to the patient to show that it's OK, no problem."

[byline: Ofeibea Quist-Arcton]

--
communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/45.]
Birgitt
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Ebola-Fieber in Westafrika

Beitragvon Birgitt » 16.04.2014 11:38

EBOLA VIRUS DISEASE - WEST AFRICA (17): LIBERIA, SIERRA LEONE, MEDECINS SANS FRONTIERES, EUROPEAN UNION
*******************************************************************************************************
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 hunter case negative, no bat contact
[2] Sierra Leone - no new cases
[3] West Africa - WHO/AFRO update 14 Apr 2014
[4] EU increases immediate health assistance
[5] MSF challenges in Guinea
[6] Uganda Ebola manual
[7] West Africa


******
1] Liberia hunter case negative, no bat contact
Date: 14 Apr 2014
Source: Richard Nisbett <rnisbett@tubmanu.edu.lr> [summarized by Mod.JW, edited]


Dr Nesbit has 25 years experience in Liberia and states that nobody traps bats in Liberia; they are hunted with bow and arrow; they are not worth using firearms to kill them. The unfortunate hunter's traps were probably snares for small antelope like duikers.

In any case, the hunter died and tested negative for ebolavirus.

(He says this information is still not entirely confirmed).

--
Richard Nisbett
<rnisbett@tubmanu.edu.lr>

******
[2] Sierra Leone - no new cases
Date: 13 Apr 2014
Source: Ebola Update from Sierra Leone, official [edited]


As for 13 Apr 2014, there has been no laboratory confirmed case of Ebola in Sierra Leone (since 19 Mar 2014): the Metabiota Laboratory team in Kenema have received and tested 27 samples collected from 11 suspected acute hemorrhagic fever cases and 16 potential contacts. All (27) tested negative for Ebola fever.

All samples (27) were tested for ebolavirus (Ebola virus Zaire species) using 2 different real-time PCR protocols. IgM and IgG ELISA assays for Ebola virus have been set up and will be used efficiently for the follow-up of the contacts of Ebola suspected cases. Complementary tests including antigen capture (kindly provided and in partnership with USAMRIID) will also be set up in the coming days.

Viral Hemorrhagic fever, VHF
---------------------------
During the present period (Ebola outbreak in Guinea), all samples collected from acute suspected VHF cases and addressed to the Lassa Ward (Dr. Kahn) at the Kenema Government Hospital (KGH) are to be tested for Lassa virus as well as ebolavirus and, in accordance with the clinical picture, for other viruses potentially responsible for hemorrhagic fevers in the sub-region, including: Marburg virus, Rift Valley Fever virus, Yellow Fever virus, Dengue [4 types?]. Also, in agreement with the clinical picture and in a differential diagnosis approach, samples can/will eventually be tested for other emerging viruses including: West Nile virus and chikungunya among others.

All acute 27 samples tested also negative for several other pathogens including Lassa, Marburg, West Nile, among others potentially prevalent in the region.

The KGH Lassa Fever team and their partners, including Tulane University and Metabiota have been engaged with central MoHS since the announcement of an Ebola outbreak in Guinea. Specialist Physician Dr. Sheik Humarr Khan has been integrally involved in the national task force, providing technical expertise on case management, biosafety, surveillance and response and training. The KGH outreach team led by Lansana Kanneh and Dr. Lina Moses of Tulane University were among the 1st to respond to reports of suspicious deaths in Kailahun and Kono Districts and were primary investigators, providing logistical support, with the team that identified the 2 probable Ebola cases that were repatriated to Kono District. This team was led by District Medical Officer Dr. Francis Jayah and included District Surveillance Officers and staff of Metabiota.

More than 40 medical staff including Medical Officers, nurses, midwives, surveillance officers and laboratory staff are currently at the KGH Lassa Laboratory to participate in the Training of Trainers (TOT) organized by the Ministry and its partners (Metabiota and Tulane University) on Preparedness and Response to Ebola fever.

--
Communicated by:
Sidie Yahya Tunis
Director of Information and Communication
Ministry of Health and Sanitation
Sierra Leone
<tunisys12@gmail.com>

******
[3] West Africa - WHO/AFRO update 14 Apr 2014
Date: 14 Apr 2014
Source: WHO/AFRO
http://www.afro.who.int/en/clusters-a-p ... -2014.html


Ebola virus disease, West Africa (Situation as of [14 Apr 2014])
----------------
Guinea

As of [14 Apr 2014], the Ministry of Health of Guinea has reported a cumulative total of 168 clinically compatible cases of Ebola virus disease (EVD), including 108 deaths.

The detailed situation report is available as at [11 Apr 2014], describing 159 clinically compatible cases of Ebola virus disease (EVD), including 106 deaths. Laboratory investigations continue at the Institut Pasteur (IP) Dakar laboratory in Conakry (66 samples tested, of which 39 are positive by PCR for ebolavirus) and at the European Union Mobile Laboratory (EMLab) team in Guekedou (55 samples tested/36 positive). A total of 71 clinical cases have been laboratory confirmed (45 percent), while 34 of the remaining clinical cases are classified as probable cases and 54 as suspected cases. Forty-two of the 106 deaths (40 percent) have been laboratory confirmed. Some cases have had repeat testing carried out.

Six districts of Guinea have reported patients - Conakry (31 patients, 22 laboratory confirmed), Guekedou (95 cases/35 confirmed), Macenta (21 cases/12 confirmed), Kissidougou (6 cases/1 confirmed), Dabola (5 cases/1 confirmed) and Djingaraye (1 suspected case). The date of onset of the most recently identified suspected clinical cases in Conakry and Guekedou was [10 Apr 2014]. One additional health care worker (HCW) has been reported, bringing the total to 16 (11 laboratory confirmed and 5 probable cases).

Eleven patients were still hospitalised on [10 Apr 2014] while 37 have been discharged from care. A total 941 contacts have been identified since the beginning of the outbreak. Medical observation is continuing for 396 contacts while 545 have been discharged from follow-up.

Doctors at the Donka Hospital isolation facility in Conakry are investigating a cluster of cases who had funeral contact with a relative who died on [1 Apr 2014] with suspected malaria. Two contacts of this patient were admitted on [12 Apr 2014] and tested positive. One doctor, an internal medicine physician who tested positive on a post mortem sample, had cared for this patient and is also linked to this chain of transmission. He developed an illness with features of EVD but without signs of bleeding. Hospital-based surveillance and triage procedures and infection prevention and control are being strengthened as a result of this cluster. Community sensitization promoting safe burial practices in the community continue.

The distribution of cases and deaths reported today has changed as a result of ongoing data review against the surveillance case definitions in use and the receipt of laboratory results. Numbers of cases and contacts remain subject to change due to consolidation of case, contact and laboratory data, enhanced surveillance and contact tracing activities and the continuing laboratory investigations.

Liberia
As of [11 Apr 2014], the Ministry of Health and Social Welfare (MOHSW) of Liberia has reported a cumulative total of 26 clinical cases of EVD (6 laboratory confirmed, and 20 probable and suspected cases of EVD), including 13 deaths. The most recent clinical case was identified on [11 Apr 2014] while the date of admission of the most recent laboratory confirmed case is [4 Apr 2014]; 3 patients are currently hospitalised while 5 suspected cases that tested PCR negative for ebolavirus have been discharged (4 from Bong County and 1 from Nimba County).

Lofa County accounts for 38 percent of the clinical cases reported to date (4 laboratory confirmed and 6 suspected cases) followed by Margibi County (23 percent, 1 confirmed and 5 suspected cases). Other Counties at risk include Bong (5 suspected cases) and Nimba (3 suspected cases). Montserrado and Grand Cape Mount Counties have each reported one suspected case. At present 35 contacts remain under medical observation and 32 have been released from follow-up. A cumulative number of 13 deaths are being attributed to EVD; Lofa (9), Nimba (1), Margibi (2) and Montserrado (1). All 6 laboratory confirmed cases have died; this includes 3 HCW.

Mali
As of [14 Apr 2014], the Ministry of Health (MOH) of Mali reports a cumulative total of 6 suspected cases, all of whom remain under medical observation (3 in the capital city of Bamako, and 2 in Kouremale and 1 in Bankoumana in the Koulikoro Region. The results of testing on these patients at the Institut Pasteur laboratory in Dakar, Senegal, are expected shortly.

Sierra Leone
There has been no change in the epidemiological situation of EVD in Sierra Leone.

WHO does not recommend that any travel or trade restrictions be applied to Guinea, Liberia, Mali or Sierra Leone based on the current information available for this event.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[In the last WHO update (11 Apr 2014) reports were for 157 clinically compatible cases, including 101 deaths had been officially reported by Guinea as of 10 Apr 2014. This current report increases this tally by 11 clinically compatible case including 7 deaths .There is one additional confirmed case in Liberia since the last report. The above report provides some interesting epidemiologic details on the ongoing outbreak. - Mod.MPP]

******
[4] EU increases immediate health assistance
Date: 14 Apr 2014
Source: AllAfrica [edited]
http://allafrica.com/stories/201404140340.html


The European Union is stepping up its efforts to contain the spread of the Ebola outbreak in West Africa and assist those affected by the deadly virus. The commission has increased its funding for immediate health operations, experts and risk assessments to 1.1 million Euros [USD 1.5 million] and is contributing medical equipment to help accelerate diagnosis.

"Acting rapidly is crucial. We are reinforcing our support to partner organisations in Guinea and neighbouring countries to ensure urgently needed healthcare to those hit by the epidemic and to stop it from further expanding," said Kristalina Georgieva, EU Commissioner for International Cooperation, Humanitarian Aid and Crisis Response.

EU Commissioner for Development Andris Piebalgs commented: "The European Commission has been mobilising experts and equipment at short notice to provide quick help on the ground. Good coordination is key in the international response to this outbreak, and this is why we are also setting up a network of EU and African health institutes to exchange know-how in tackling this terrible disease."

Following a commitment of 500 000 Euros [USD 691 000] from last week, the Commission has increased its assistance to help the affected communities in Guinea and neighbouring countries to 1.1 million Euros. These new funds will allow Medecins Sans Frontieres to scale up the on-going interventions in the field of clinical management (such as the isolation of patients and psychosocial support), the tracing of suspected cases, and the training and supply of personal protective equipment for health workers.

Furthermore, the new funds will support the World Health Organization (WHO) in ensuring epidemiological surveillance and providing medical supplies, equipment, transport logistics and health personnel.

Three humanitarian experts from the commission have been sent to Conakry and Monrovia to monitor the situation on the ground and liaise with local authorities and partners. Moreover, on 26 Mar 2014, 6 European specialists of the European Mobile Lab project (EMLab) for dangerous infectious diseases arrived in Gueckedou, Guinea with a mobile laboratory unit. This consists of easily transportable equipment for high security virus manipulation. It will substantially enhance the available capacity for rapid analyses of samples and confirmation of Ebola cases, reducing the number of undiagnosed cases and preventing the further spread of the disease.

The EU is closely following the latest developments with its Centre for Disease Prevention and Control (ECDC). This has just issued a 2nd Rapid Risk Assessment stating that the risk for EU citizens travelling or living in the affected countries remains "low," and giving a series of recommendations on prevention.

The EMLab project is an initiative funded by the European Commission. It includes partners from Germany, Italy, France, Hungary, Switzerland, Slovenia and the United Kingdom. As part of the international response to the current Ebola outbreak in Guinea, WHO and its Global Outbreak Alert and Response Network (GOARN) requested lab experts of the EMLab project to support the Ministry of Health of Guinea in viral haemorrhagic fever diagnostics. The team of experts is composed of scientists from

- the Bernhard-Nocht-Institute for Tropical Medicine (Germany),
- the Bundeswehr Institute of Microbiology (Germany),
- the Istituto Nazionale per le Malattie Infettive L. Spallanzani (Italy) and
- the Laboratoire P4 - INSERM Jean Merieux (France).

They will be joined by 4 experts from Germany, France and Hungary on 15 Apr 2014; another team will take over 4 weeks later.

--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

*******
[5] MSF challenges in Guinea
Date: 12 Apr 2014
Source: Crofsblogs via The Independent [edited]
http://crofsblogs.typepad.com/h5n1/2014 ... -with.html


I received a message at home in Brussels about this strange disease which had broken out in Guedeckou, in southern Guinea. They thought that perhaps it was Lassa fever, but when I received a description of the patients' symptoms, it was clear to me that we were talking about ebolavirus disease. A couple of days later, I was in Guinea.

I've worked in every major outbreak of ebolavirus disease since 2000. What makes this one different is its geographical spread, which is unprecedented. There are cases in at least 6 towns in Guinea, as well as across the border in Liberia. The problem is that everybody moves around; infected people move from one village to another while they're still well enough to walk; even the dead bodies are moved from place to place. So, as an epidemiologist tracking the disease, it's like doing detective work.

The other problem is that ebolavirus has never been confirmed before in Guinea, so you can be blamed for being the messenger; you're the guy bringing the bad news that the village has been touched by Ebola. To them, it means death, so people often refuse to believe the reality.

We were tracing a patient who we finally found staying with family members in a very small village. He was an educated man, a professor. He'd become infected while caring for a colleague who had caught the disease by caring for his sick uncle; when somebody is sick in Guinea, they are always cared for by people of the same sex.

The professor realised it was probably better for him to come with us to the MSF centre, but his nephew and an elderly female relative suddenly appeared and took the sick patient off into the forest. They had no confidence in the health system and believed that people were killed in our centres, so they decided to keep their relative in the forest and cure him with leaves and herbs.

I followed them into the forest. They were very aggressive; the nephew took a big stick and was hitting the ground, but behind the aggression you could hear the pain in his voice. Eventually, we got a sample from the sick man to make a proper diagnosis. The next day, he asked us to come and collect him.

[Byline: Michael Van Herp, MSF]

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

******
[6] Uganda Ebola manual
Date: 14 Apr 2014
Source: Containing a Haemorrhagic fever epidemic: the Ebola experience in Uganda (October 2000-January 2001)
http://scholar.google.co.uk/scholar?q=C ... nuary+2001)&hl=pt-BR&as_sdt=0&as_vis=1&oi=scholart&sa=X&ei=kupLU9GDG_KtsQSgioHoAw&ved=0CCgQgQMwAA


[This is a useful manual. - Mod.JW]

--
Communicated by:
Muktar Gadanya
<gadanya@gmail.com>
via Nigerian Biomedical and Life Scientists Yahoo Groups

******
[7] West Africa
Date: 10 Apr 2014
Source: Minnesota Public Radio, The UTMB Newsroom [edited]
http://www.utmb.edu/newsroom/article9418.aspx


The death toll from the outbreak of Ebola virus in West Africa has passed 100. Health officials are working to contain the outbreak, which is reported spreading beyond Guinea to Mali, Ghana, and Liberia. It has killed more than 60 percent of those infected.

UTMB's Thomas Geisbert joined Gregory Haertl from the World Health Organization to provide his thoughts and expertise on the situation. As described by Laurie Garrett of the Council on Foreign Relations in an interview on PBS Newshour, the virus produces symptoms that are frightening to witness:

"Ebola is an RNA virus, a very small virus that attacks the endothelial linings that maintain the integrity of your blood vessels, blood veins, [and] capillaries. [Initially], little microscopic holes [open], through which bits of blood and fluids will leak, but eventually, larger and larger holes, until the individual begins to hemorrhage internally, hemorrhaging blood through tears, from the mouth, from the nose, all over the body, so that they become quite frightening to see. And individuals will get a high fever. They may get blood in their brain, which will lead to even more insane behavior, a kind of deranged look in their eyes, all of which contributes to a great deal of fear. On top of it all, the fluids contain virus, so they're highly, highly contagious to the touch."

This is the 1st epidemic of Ebola in West Africa and the worst since 2007. We talked to 2 experts on the disease [UTMB's Thomas Geisbert and WHO's Gregory Haertl] to get a handle on the threat posed by the current outbreak.

"Something's going on in the rain forest, because what these countries share is a special ecology, a special rain forest region, within which are the fruit bats that normally carry the Ebola virus harmlessly to the bat population, but can pass it on to other primates, which can be eaten by the humans, or to people, hunters, that may be in the rain forests. And it's possible that we're getting multiple introductions, or at least more than one, across the region. So if something is going on in the rain forest, that is why the bats are stressed and passing the virus, and then we will see multiple rounds of reintroduction" (Laurie Garrett on Newshour).

Is it time to panic? The answer from health workers responding to an Ebola outbreak in West Africa that began last month [March 2014] is a qualified "no." Transmission requires such close contact that the chance of a widespread epidemic is unlikely. ... Residents of the Mali capital of Bamako took to the streets in anger over reports that several people suspected of having the disease were being held in isolation in their neighborhood. Anger also flared in southern Guinea, where people attacked a health center that was treating patients with Ebola. Senegal has closed its border with Guinea. Morocco has stepped up border controls, and France is asking doctors and hospitals to be on alert for signs of the disease (USA Today).

[These interviews are on audio at the source link. - Mod.JW]

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[For comparison with the ebolavirus death toll, in 2012 Guinea reported more than 800 deaths per month (9775 for the year out of more than 280 000 cases) from malaria, see 2 graphs at bottom of page:
http://www.who.int/malaria/publications ... n.pdf?ua=1. - Mod.JW

A ProMED HealthMap for Liberia can be seen at http://healthmap.org/promed/p/54 and for Sierra Leone at http://healthmap.org/promed/p/46.]
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