EBOLA VIRUS DISEASE - WEST AFRICA (128): WHO, TOLL, LIBERIA, DRUG, MORE
***********************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this posting:
[1] WHO update
[2] WHO: toll vastly underestimated
[3] Liberia: disruption of hospital services
[4] Liberia: food shortage in quarantine
[5] Emergency food for quarantined EVD region
[6] Drug use obstacle
[7] FDA: fake drug alert
[8] Ghana: suspected death
[9] Media reports
******
[1] WHO update
Date: Fri 15 Aug 2014
Source: WHO Global Alert and Response, Disease Outbreak News [edited]
http://www.who.int/csr/don/2014_08_15_ebola/en/
Ebola virus disease update -- west Africa
-----------------------------------------
Disease update
[Table: Confirmed, probable, and suspect cases and deaths from Ebola virus disease in Guinea, Liberia, Nigeria, and Sierra Leone, as of 13 Aug 2014: Total Cases 2127; Deaths 1145]
Between 12-13 Aug 2014, a total of 152 new cases of Ebola virus disease [EVD] (laboratory-confirmed, probable, and suspect cases) as well as 76 deaths were reported from Guinea, Liberia, Nigeria and Sierra Leone.
[Nigeria announced Thu 14 Aug 2014 that another nurse had died from EVD, bringing the country's death toll to 4, as in the table above, but the ministry corrected its total number of EVD cases to 10, instead of 11 as it had reported earlier in the day (
http://townhall.com/news/world/2014/08/ ... e-n1878682). - Mod.JW]
On 13-14 Aug 2014, some airlines and social media and traditional media vehicles expressed concern that air travel to and from affected countries was a high-risk activity for the spread of EVD. To correct this misunderstanding, WHO called a press conference at the UN Palais des Nations in Geneva on 14 Aug 2014. Dr Isabelle Nuttall, speaking on behalf of WHO, said, "Air travel, even from EVD-affected countries, is low-risk for EVD transmission."
Dr Nuttall further clarified modes of transmission for EVD and emphasized that the disease is not an airborne virus, unlike influenza or tuberculosis. The infection is transmitted to others through direct contact with the bodily fluids of a sick person, such as blood, vomit, sweat, and diarrhoea. Even if an individual infected with EVD travels by plane, the likelihood of other passengers and crew coming into contact with the individual's bodily fluids is very low.
WHO does not recommend any travel or trade restrictions be applied except in cases where individuals have been confirmed or are suspected of being infected with EVD or where individuals have had contact with cases of EVD. (Contacts do not include properly-protected health-care workers and laboratory staff.) Temporary recommendations from the Emergency Committee with regard to actions to be taken by countries can be found at:
IHR Emergency Committee meeting on Ebola outbreak in west Africa
http://www.who.int/mediacentre/news/sta ... 0140808/en
The total number of cases is subject to change due to ongoing reclassification, retrospective investigation, and availability of laboratory results. Data reported in the Disease Outbreak News are based on official information reported by Ministries of Health.
--
Communicated by:
ProMED-mail Rapporteurs Marianne Hopp
and Joe Dudley
[WHO/CDC map of EVD region as of 11 Aug 2014:
http://www.bbc.com/news/world-africa-28798542. - Mod.JW]
******
[2] WHO: toll vastly underestimated
Date: Fri 15 Aug 2014
Source: Reuters [edited]
http://www.reuters.com/article/2014/08/ ... US20140815
Evidence suggests Ebola [virus disease] toll vastly underestimated: WHO
-----------------------------------------------------------------------
Staff with the World Health Organisation battling an EVD outbreak in West Africa see evidence the numbers of reported cases and deaths vastly underestimates the scale of the outbreak, the UN agency said on its website on Thursday [14 Aug 2014] ... [more]
[Byline: Saliou Samb]
--
Communicated by:
ProMED-mail
<
promed@promedmail.org>
******
[3] Liberia: disruption of hospital services
Date: Thu 14 Aug 2014
Source: Times of India [edited]
http://timesofindia.indiatimes.com/nri/ ... 209229.cms
Indian with malaria sent away from Liberian hospital, dies
----------------------------------------------------------
In Liberia, if EVD does not kill you, malaria will. For that matter, any curable disease will. Reason: the healthcare system in Liberia is so overwhelmed with EVD cases that patients with other diseases are bearing the brunt. An example is the death of Augustine Aiyadurai (fondly called Prabha), administrator of a Vellore hospital. He was in Liberia's Zorzor district since November last year [2013] ... putting into place efficient hospital systems. He died of malaria on 2 Aug 2014 due to non-availability of advanced medical care. Augustine's mother hails from Udupi [Karnataka, India].
A friend of Aiyadurai posted on Facebook: "Prabha developed fever last week and the peripheral blood smear showed malaria. The doctor in Zorzor had started him on Artemisinin and ceftriaxone. He was then sent to Monrovia, capital of Liberia, an arduous 8-hour road journey, to get better diagnostics and treatment. Unfortunately, almost all the hospitals in Liberia are closed because of the EVD epidemic.... The hospitals which are open are [only] taking EVD patients. Prabha was turned away. He did, however, have some tests which showed that he did not have EVD or Lassa fever. Prabha took the only recourse open to him: to go back to Zorzor, where he would get at least some treatment. When he got back to Zorzor, he was much worse.... He was confused and not eating. He was hydrated and looked after very well by Dr Roberts. However, after making some initial progress, he started deteriorating by the afternoon of 2 Aug 2014 and passed away by evening."
Surathkal resident Wilfred D'Souza, who left Liberia 2 weeks ago, had apprehended a situation similar to Aiyadurai's; 2 of his associates were down with malaria and typhoid. He had told TOI [Times of India] that almost all hospitals in Liberia were closed because of the EVD epidemic; those that were open took only Ebola patients and quarantined them. The situation is much the same today.
--
Communicated by:
ProMED-mail
<
promed@promedmail.org>
******
[4] Liberia: food shortage in quarantine
Date: Fri 15 Aug 2014
Source: Monrovia Inquirer [edited]
http://monroviainquirer.com/2014/08/15/ ... uarantined
No Food for Ebola Victims...West Point, Dolo Town to Be Quarantined
-----------------------------------------------------------------
Amidst positive news of the survival of persons affected by the EVD virus, latest report says victims at the ELWA Ebola Isolation Center are leaving the camp due to lack of food. Disclosing this at the National Ebola Task Force Meeting held at the Ministry of Foreign Affairs in Monrovia yesterday [14 Aug 2014], Health Minister, Walter Gwenigale, said he had received several calls from the center that the people are hungry and need food.
According to Dr. Gwenigale, based on this latest report, most of the victims are now leaving the center which is a major threat to several communities to which those leaving are going. "I'm getting calls every day of the lack of food; the people say they are hungry and I understand that there is food there but I'm getting these calls every minute," Liberia's Health Minister Gwenigale said.
In quick clarification, Assistant Health Minister for Preventive Services, Tolbert Nyenswah, said food is available at the various Isolation Camps but those who are making the calls may need special diet. Nyenswah said the victims are being provided meal 3 times daily adding that the callers are the higher-ups who may need special kind of diet ... [more]
[Byline: Morrison O. G. Sayon]
--
Communicated by:
ProMED-mail Rapporteur Mary Marshall
******
[5] Emergency food for quarantined EVD region
Date: Thu 14 Aug 2014
Source: Reuters [edited]
http://www.reuters.com/article/2014/08/ ... CW20140814
Via ProMED-IN mailing list
http://www.promedmail.org
Exclusive: Emergency food drops eyed for quarantined EVD region of West Africa
------------------------------------------------------------------------------
International agencies are looking into emergency food drops and truck convoys to reach extremely hungry people in Liberia and Sierra Leone, who are cordoned off from the outside world to halt the spread of the Ebola virus, a top World Bank official said on Thursday [14 Aug 2014]. Hunger is spreading fast as farmers die leaving crops rotting in fields. Truckers scared of the highly infectious disease halt deliveries. Shops close and major airlines have shut down routes, isolating large swathes of the countries ... [more]
[Byline: Stella Dawson]
--
Communicated by:
ProMED-mail
<
promed@promedmail.org>
******
[6] Drug use obstacle
Date: Thu 14 Aug 2014
Source: PharmaManufacturing, Bloomberg Businessweek report [edited]
http://www.pharmamanufacturing.com/indu ... ug-africa/
In addition to the ethical and supply concerns surrounding experimental EVD drugs, companies developing treatments may also face regulatory issues when attempting to bring new drugs to Africa. Tekmira Pharmaceuticals Corp., a Canada-based biopharmaceutical firm investigating an experimental treatment for Ebola, said that the "regulatory framework" to support dispensing its drug to patients in Africa "has not yet been established," given that the drug's safety and effectiveness has not been proven. Furthermore, Tekmira Chief Executive Officer Mark Murray told analysts that there is no assurance that the framework to support the new treatment -- TKM-Ebola -- in Africa will be developed.
Early stage human trials to test Tekmira's EVD therapy in healthy volunteers were put on clinical hold by the FDA in early July [2014] due to safety concerns. Last week, the FDA modified its stance to enable testing of Tekmira's drug in infected patients, although the hold on healthy volunteers is still in place, the company said.
[See also:
http://www.businessweek.com/articles/20 ... ach-aftica. - Mod.JW]
--
Communicated by:
ProMED-mail
<
promed@promedmail.org>
******
[7] FDA: fake drug alert
Date: Fri 15 Aug 2014
Source: World Pharma News [edited]
http://www.worldpharmanews.com/fda/2860 ... t-products
FDA warns consumers about fraudulent EVD treatment products
-----------------------------------------------------------
The US Food and Drug Administration [FDA] is advising consumers to be aware of products sold online claiming to prevent or treat ebolaviruses. Since the outbreak of the ebolavirus in West Africa, the FDA has seen and received consumer complaints about a variety of products claiming to either prevent the ebolavirus or treat the infection.
There are currently no FDA-approved vaccines or drugs to prevent or treat EVD. Although there are experimental EVD vaccines and treatments under development, these investigational products are in the early stages of product development, have not yet been fully tested for safety or effectiveness, and the supply is very limited. There are no approved vaccines, drugs, or investigational products specifically for EVD available for purchase on the Internet. By law, dietary supplements cannot claim to prevent or cure disease.
Individuals promoting these unapproved and fraudulent products must take immediate action to correct or remove these claims or face potential FDA action.
It is important to note that according to the Centers for Disease Control and Prevention (CDC), EVD does not pose a significant risk to the US public. Unfortunately, during outbreak situations, fraudulent products that claim to prevent, treat, or cure a disease all too often appear on the market. The FDA monitors for these fraudulent products and false claims and takes appropriate action to protect consumers.
Consumers who have seen these fraudulent products or false claims are encouraged to report them to the US FDA.
[Reporting of Counterfeit Drug Products
---------------------------------------
FDA needs your help! In order to ensure that only safe and effective drug products are available on the market, the FDA relies on the voluntary reporting of suspect counterfeit drugs from consumers, health practitioners, and other drug supply chain partners.
For Patients:
If you are a patient and believe that you may have a counterfeit drug, please contact the pharmacy where you received the medicine.
http://www.fda.gov/Drugs/DrugSafety/ucm170314.htm]
--
Communicated by:
ProMED-mail
<
promed@promedmail.org>
******
[8] Ghana: suspected death
Date: Fri 15 Aug 2014
Source: GhanaWeb [edited]
http://www.ghanaweb.com/GhanaHomePage/N ... ?ID=321271
via ProMED-IN mailing list
Suspected EVD patient dies; care givers at risk
-----------------------------------------------
Health workers at the Accra Psychiatric Hospital are praying and hoping that a suspected Ebola patient who they attended to and who died in their arms may well prove negative for the virus. If he proves otherwise, all who had contact with the man may well have to seek medical attention and with urgency.
On Tuesday evening [12 Aug 2014] Joy News learnt a patient who had previously been treated for a psychotic episode returned after the wife noticed that he was clenching his teeth. Doctors initially thought it was a drug reaction. Deputy Director of the facility Dr. Pinaman Appau was called by nurses and rushed in to see the man going unconscious and bleeding from the nose and mouth. She and the medical director came in wearing gloves and managed to put the patient on the floor to keep him from choking on his blood.
They tried to take samples of the blood but were not successful. They eventually took a sample from the blood oozing from the nose. Within 5 minutes the patient was dead. There was no protective clothing and other key protective health materials to keep the care givers safe from a possible ebolavirus infection. Dr Pinaman Appau, Deputy Director admits a lot went wrong in managing the case because none of them at the hospital had any knowledge on how to handle an EVD [case]. "Let me put on record that since this EVD scare started we have not had any formal education on how to handle a case," she admitted. She said the only protective material they had were ordinary gloves which they wore. She was candid that they had broken some principles in attending to a suspected EVD case. Even though a sample was finally taken and delivered to the Noguchi Institute for testing, Dr Pinaman again conceded, that sample may well be rejected because the right steps were not followed.
With the suspected EVD patient now dead, the only option left for a thorough scientific investigation of whether he was actually infected with ebolavirus is all the persons who had contact with him the few hours before he died. Dr Pinaman named them as the wife and uncle of the deceased, the security man, the taxi driver who helped carry the patient into the hospital premises, the nurses and other health workers who attended to him and herself and a colleague who attempted to resuscitate him. Dr Pinaman said given the discussion they had with the family of the deceased it was clear the deceased had no travel history, especially [not] to the EVD infected countries in West Africa. Dr Asiedu Bekoe, Public Health Specialist with the Ghana Health Service told Joy News every hospital must have a holding room or an isolation room. He said there must be a standby team that has a clinician, a nurse and a lab person who would ensure minimal contact with a patient.
[With no suspicious travel history, this case does not fit the definition of an EVD case. Among other possibilities, he may just have bitten his tongue off and choked to death. - Mod.JW]
--
Communicated by:
ProMED-mail Rapporteur Mary Marshall
******
[9] Media reports
[This is a selection of the many suspected cases and other information to be found recently on the internet. - Mod.JW]
Nigeria: Nurse who escaped quarantine is now back in Lagos with her husband and 20 others in strict quarantine. Number of Nigerians under quarantine is now 198 ... [more]
http://allafrica.com/stories/201408141475.html
[This nurse was earlier reported to have died in Enugu and been in contact with 20 people there who are now under quarantine in Enugu. - Mod.JW]
Nigeria: 4th death, corrected figures
-------------------------------------
Also, Nigeria announced Thursday [14 Aug 2014] that another person had died from EVD, bringing the country's death toll to 4. The Health Ministry said the person was a nurse who helped treat the country's 1st Ebola case, Liberian-American Patrick Sawyer who flew in last month [July 2014] and died. The ministry corrected its total number EVD cases to 10 instead of 11 as it had reported earlier in the day.
http://townhall.com/news/world/2014/08/ ... e-n1878682
Sierra Leone: US embassy personnel leave
----------------------------------------
The US State Department ordered families of embassy personnel to leave Sierra Leone on Thursday [14 Aug 2014] because of concerns that the crisis would make it difficult to get treatment for even routine health problems.
http://townhall.com/news/world/2014/08/ ... e-n1878682
[News included in this URL is correct in spite of its title. - Mod.JW]
Ghana: travel ban
-----------------
14 Aug 2014: Government has warned that its citizens must not travel to any of the EVD-stricken countries in Africa including Liberia, Sierra Leone or Guinea in order to avoid contracting the killer Ebola virus disease. The Minister for Foreign Affairs, Hannah Tetteh, in a travel advisory issued at a press conference in Accra, also revealed that the country has suspended all international meetings it was scheduled to host for the next 3 months as a measure to mute the danger of visiting participants who may harbour the Ebola virus from transmitting same ... [more]
http://news.peacefmonline.com/pages/hea ... 210837.php
UK (Scotland) suspected case
----------------------------
15 Aug 2014: an EVD alert has been launched in Scotland after a detainee at an immigration centre was tested for the deadly virus. The woman, believed to be in her 30s and from Sierra Leone, was taken to a hospital for tests yesterday. She was transported in a specialist ambulance from the Dungavel Detention Centre, in Lanarkshire, where she was being held, to hospital in Airdrie. The tests for the deadly virus were carried out at Monklands General Hospital. A spokesman for NHS Lanarkshire said it was "highly unlikely" that the woman would test positive for ebola.
http://www.dailyrecord.co.uk/news/scott ... re-4055946
Ireland: false alarm
--------------------
15 Aug 2014: Ebola outbreak: 'No confirmed or suspected EVD in Ireland', health officials say following reports of patient in Dublin ... [more]
http://www.independent.co.uk/news/world ... 70550.html
South Africa: false alarm
-------------------------
15 Aug 2014: On Thursday [14 Aug 2014] the Democratic Alliance (DA) incorrectly published a statement saying that a woman was admitted to the Rahima Moosa Mother and Child Hospital in Gauteng with EVD symptoms. While the pregnant woman, who came to South Africa from Guinea, tested negative for the virus, Health Minister Aaron Motsoaledi says government will alert the public if it believes EVD is in the country. Motsoaledi says the woman was placed in isolation as a precaution, while waiting for test results.
http://ewn.co.za/2014/08/15/SA-govt-tra ... bola-cases
ZMapp supply finished
---------------------
14 Aug 2014: ZMapp, the untested Ebola drug, arrived in [Liberia] late Wednesday [13 Aug 2014]. A day later, no one had yet received the treatment, which officials said would go to 3 people. The Liberian government had previously said 2 doctors would receive ZMapp, but it was unclear who else would. Information Minister Lewis Brown said Thursday [14 Aug 2014] it would probably be another health care worker. Treatment will be staggered, so doctors can observe the effects in one patient before moving on to the next. Late Thursday, he said the treatment had not yet started. These are the last known doses of ZMapp left. The San Diego-based company that developed it has said it will take months to build up even a modest supply.
http://townhall.com/news/world/2014/08/ ... e-n1878682
Interim Guidance about Ebola Infection for Airline Crews, Cleaning Personnel, and Cargo Personnel
http://www.cdc.gov/quarantine/air/manag ... lines.html
IOC bars Ebola-region athletes from some events in Youth Games
--------------------------------------------------------------
15 Aug 2014: The International Olympic Committee (IOC) said on Friday [15 Aug 2014] it was prohibiting young athletes from the EVD-affected region of West Africa from participating in certain events at the Youth Olympic Games in Nanjing, China.
http://uk.reuters.com/article/2014/08/1 ... Q320140815
Ebola computer malware
----------------------
15 Aug 2014: Ebola fear used as bait, leads to malware infection. News of the Ebola virus disease epidemic in West Africa has hit every news outlet around the globe, and cybercriminals are once again using the latest headlines to bait victims. Symantec [computer virus detection company] has observed 3 malware operations and one phishing campaign using the ebolavirus as a social engineering theme ... [more]
http://www.symantec.com/connect/blogs/e ... -infection
--
Communicated by:
ProMED-mail
<
promed@promedmail.org>
