EBOLA VIRUS DISEASE - WEST AFRICA (114): USA (NEW YORK CITY), SUSPECTED, MORE
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A ProMED-mail post
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ProMED-mail is a program of the
International Society for Infectious Diseases
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In this update:
[1] USA, NY city suspected
[2] International Response
[3] Superior Health Council recommendations
[4] CDC: Airborne transmission concern
[5] Other EVD news
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[1] USA, NY city suspected
Date: 4 Aug 2014
Source: CNN [edited]
http://www.cnn.com/2014/08/04/health/eb ... index.html
[A] patient at Mount Sinai Hospital in New York City was being tested after being admitted to the facility with a high fever and gastrointestinal symptoms, according to a statement from the hospital on Monday [4 Aug 2014]. He had recently traveled to a country in West Africa where Ebola virus disease [EVD] has been reported. The patient was placed in strict isolation, and doctors are working to determine the cause of his symptoms.
"(The) likelihood is pretty low" the patient has EVD, said CNN's Dr. Sanjay Gupta. About half a dozen people have recently returned from West Africa and gotten tested because of symptoms consistent with the disease. None of those cases has been confirmed as Ebola, Gupta said.
[Byline: Faith Karimi]
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Communicated by:
ProMED-mail Rapporteur Mary Marshall
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[2] International Response
Date: 1 Aug 2014
Source: Washington Post [abridged, edited]
http://www.washingtonpost.com/opinions/ ... story.html
For the past 2 months, the nongovernmental organizations providing the primary response to the Ebola virus disease [EVD] outbreak have realized that the response from regional governments and international public agencies was inadequate. Their call for additional resources, including personnel and supplies, went unaddressed. Now, ending this outbreak will require a much more extensive public health response than has been needed in the past.
In addition, some people are hiding potential cases because they fear that their loved ones will be moved to a clinic or a hospital and placed in isolation, where they will die alone. These concerns are fueled by a lack of education about how the ebolavirus is spread and the difficulty in treating it. People see that their loved ones are alive when they are taken away but are returned in body bags.
Since the 1st EVD cases were reported in March [2014] from forested areas in southeastern Guinea, the outbreak has grown steadily in terms of people infected and geography covered. The virus has infected more than 1300 people; more than 700 have died [latest WHO figures, certainly an undercount, as of 31 Jul 2014, are 1440 including 826 deaths; see ProMED archive 20140803.2656749, and many more will have died in the last 2 days. - Mod.JW]. This is nowhere near the tolls of other infectious diseases, such as HIV/AIDS, malaria, diarrheal disease and tuberculosis, which occur every day in this same region. But the ebolavirus strikes a chord of fear unlike other infectious diseases because of the quick, horrible deaths it causes [and the appallingly high case fatality rate, currently at least 57 percent. - Mod.JW].
The front-line providers of medical care for this outbreak have been dedicated and heroic, but there just aren't enough of them. Doctors Without Borders [MSF] is the primary treatment and community-intervention organization in the 3 [most] affected countries, in addition to the International Federation of Red Cross and Red Crescent Societies, public health agencies organized under the World Health Organization (WHO), and in-country health-care providers and community educators.
These groups know how to fight this disease -- they helped develop the interventions that stopped EVD outbreaks in the past -- but the nongovernmental organizations are "dangerously close to being completely tapped out," a Doctors Without Borders spokesman told me this past week. "It will be impossible to implement an effective control strategy for this outbreak due to a severe shortage of medical professionals on the ground and the geographic spread of the disease."
The U.S. Centers for Disease Control and Prevention announced Thursday [31 Jul 2014] that it will send 50 additional specialists to West Africa to help combat the outbreak, supplementing the 12 CDC professionals already there. For an outbreak involving 3 countries with about 22 million people and 165 000 square miles, that's hardly enough boots on the ground. But the CDC is just one piece of the international response; the WHO and other G-7 nations need to act, too. The WHO does not have the resources to stop this outbreak alone. With a deep respect for the sovereignty of the affected countries, the G-7 nations -- the USA, Canada, Germany, Britain, France, Italy and Japan -- must immediately mobilize and deploy hundreds of infectious-disease experts, along with medical and technical assets to map the epidemic. Hundreds more personnel will be needed to establish treatment centers and to work with local leaders and educators to help people learn how to stop virus transmission.
In addition to these outside resources, the affected countries must step up their commitment to stopping the outbreak. This past week [last week of July 2014], Ernest Bai Koroma, president of Sierra Leone, declared an EVD-related public emergency. He called on the army to quarantine EVD-stricken neighborhoods and to help conduct house-to-house searches for people who may have been exposed to the virus. Such moves acknowledge that this outbreak will not be stopped using the approaches that have worked before. But it is unclear how these efforts are being coordinated with the WHO and NGOs in Sierra Leone. And since this is a regional problem that requires every involved country to halt virus transmission, regional governmental coordination is crucial.
What happens if the response to and management of this outbreak don't shift? The fear and panic are growing each day, with new areas reporting cases and more health-care workers dying. If it continues, West Africa could become politically and economically destabilized. Already, crops are not being harvested because of unrest surrounding the outbreak. Schools in Liberia have closed, and the Peace Corps has removed 340 volunteers from the affected countries. Borders are being closed, too, which can have political and economic impacts.
This coming week's U.S.-Africa Leaders Summit in Washington [DC, 2-4 Aug 2014] must put the EVD crisis front and center. ... Other African countries must also pledge quick and effective responses if cases occur within their borders. We are at a critical point, and the response by the international community and the affected countries will determine whether this outbreak is just a chapter in the region's story or a dramatic and dangerous shift in West Africa's future.
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Communicated by:
ProMED-mail Rapporteur Mary Marshall
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[3] Superior Health Council recommendations
Date 4 Jul 2014
Source: Health Belgium [edited]
http://www.health.belgium.be/internet2P ... 511_fr.pdf
Publication of the Superior Health Council No. 9188 [Viral Hemorrhagic Fevers]: Practical recommendations to the attention of healthcare professionals and health authorities regarding the identification of and care delivered to suspected or confirmed carriers of highly contagious viruses (of the Ebola or Marburg type) in the context of an epidemic outbreak in West Africa.
[Congratulations to Belgium for having published this 52-page manual in English and French a month ago. - Mod.JW]
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[4] CDC: Airborne transmission concern
Date: 4 Aug 2014
Source: Prison Planet [edited]
http://www.prisonplanet.com/cdc-concern ... virus.html
Despite repeated assurances that the ebolavirus cannot be transmitted via airborne particles, the CDC is concerned about that very outcome and has directed airline staff to take steps to prevent the spread of "infectious material through the air."
While Ebola is highly contagious, the risk of a full blown pandemic has been downplayed by health authorities because, according to our current understanding of the virus, Ebola "is not airborne and is transmitted through contact with bodily fluids, including sweat and blood."
However, with concerns rising that the current strain of the virus, which is the worst in history and has killed 887 people, could in fact be airborne, the Centers For Disease Control has implemented steps to prevent its spread via international air travel.
A CDC advisory entitled Interim Guidance about Ebola Virus Infection for Airline Flight Crews, Cleaning Personnel, and Cargo Personnel reveals that the federal agency is concerned about airborne contamination.
The advisory urges airline staff to provide surgical masks to potential Ebola victims in order "to reduce the number of droplets expelled into the air by talking, sneezing, or coughing."
The CDC is also directing airline cleaning personnel to "not use compressed air, which might spread infectious material through the air."
[Byline: Paul Joseph Watson]
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[This is out of an abundance of caution. There is no evidence that airborne transmission has ever occurred naturally between humans -- nor between animals, nor between animals and humans -- in the open air as opposed to in the lab. Aircraft air is filtered. If ebolaviruses were commonly transmitted through the air, a much larger number of people, especially in the crowded capital cities, would have shown symptoms by now, as during a typical flu epidemic. - Mod.JW]
[US CDC and other health authorities have advised and continue to advise standard, contact, and droplet precautions for patients with Ebola virus disease. The use of a surgical mask is to reduce transmission of droplets and does not prevent "airborne" transmission such as that observed with measles. Of course in an airplane, a certain amount of improvisation is required to implement infection control measures. The CDC guidance can be found at:
http://www.cdc.gov/quarantine/air/manag ... lines.html
- Mod.LM]
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[5] Other EVD news
A passenger died in the UK after arriving from Freetown, Sierra Leone [EVD negative]
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The woman, said to be 72, became ill on the gangway [at Gatwick airport, England] after she left a Gambia Bird jet with 128 passengers on board. She died in hospital on Saturday [2 Aug 2014]. The plane was quarantined as officials desperately tried to trace everyone who had been in contact with the woman.
[A] shocked staff member said: "The woman was sweating buckets and vomiting. Paramedics arrived to try and help her. The next thing, everybody was there. ... emergency crews, airfield operations, even immigration. They closed down the jet bridge and put the aircraft into quarantine. They took everyone's details, even the guy who fuels the aircraft. It stopped at Banjul in The Gambia before landing in Gatwick at 8:15 am on Saturday [2 Aug 2014] after a 5-hour flight. Public Health England said the woman showed no symptoms during the flight. The patient was not symptomatic on the plane, and, therefore, there is no risk of EVD being passed on to either flight crew or other passengers. England has world class health care and disease control systems which are active permanently, regularly tested, and proven to be effective. If the UK does see a case of imported EVD, this will not result in an outbreak in this country."
South East Ambulance Service Communications chief Janine Compton said: "We attended Gatwick airport at 8:30 am on Saturday [2 Aug 2014] to attend an adult female patient who was seriously ill. She was taken to East Surrey Hospital in Redhill where she subsequently died."
At around 11:00 pm on Sunday [3 Aug 2014], the Department of Health said that tests for the deadly ebolavirus on the woman who died at Gatwick had proved negative
http://www.mirror.co.uk/news/uk-news/eb ... z39SyiCZNB.
[Public Health England is to be congratulated on their comprehensive response to this emergency. - Mod.JW]
Liberia hospital "forced to turn away some EVD cases"
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3 Aug 2014: The withdrawal of some international medics from Liberia following the infection of 2 US health workers with the Ebola virus has exacerbated the healthcare crisis caused by the epidemic. The overcrowded and understaffed Elwa hospital in the capital, Monrovia, where the 2 worked, has been forced to turn away some EVD cases.
[So where are they supposed to go now? - Mod.JW]
Liberia: Roadblocks, teargas
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4 Aug 2014: On Sunday morning [3 Aug 2014], as Liberians prepared for church, residents of the St. Paul's Bridge community staged roadblocks in protest of dead bodies lying in their community. "We have an Ebola body on the ground [and] up till now nobody to pick it up. We've been waiting for 4 days now and nobody to pick it up," said Mohamed Kollie, a resident of the area. "We decided to put roadblock down, and the police started shooting tear gas. We have 4 bodies lying down in St. Paul Bridge community alone, one in the Island Clinic area under the tree and the other 3 in houses around here."
Residents are visibly scared as a result of the deadly virus, and people are not reporting their sick to health centers but are instead caring for them at home
http://frontpageafricaonline.com/index. ... s-unburied.
Liberia: Burning of bodies starts
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4 Aug 2014: The Liberian Government announced Sunday [3 Aug 2014] that it has begun burning the bodies of victims of the deadly ebolavirus. "We have decided to burn the bodies," Information Minister Lewis G. Brown told the New Dawn Sunday. He said the decision to cremate the bodies of EVD victims was reached earlier on Sunday. The government's decision to cremate the bodies of victims of the tropical disease follows the increasing wave of resistance by residents of several communities to allow the burial of EVD victims in their areas. "Cremation will take place in Marshall beginning today [4 Aug 2014]," Mr. Brown said. Marshall is located in Margibi County, another county affected by the tropical disease here.
On Saturday [2 Aug 2014], dozens of residents from several communities protested against the burial of Ebola victims in their areas. The 1st burial site for over 25 bodies in the township of Johnsonville was abandoned by health workers after the land owner refused to sell the land to bury EVD victims
http://www.thenewdawnliberia.com/index. ... &Itemid=59.
UK: "Midwives refused to see me."
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4 Aug 2014: "I'm now 2/3rds of the way through my 2nd pregnancy and was due to have a routine midwife's appointment the day after my flight landed at Heathrow. The only problem was that my midwives refused to see me. They took this precaution as a result of 2 factors, my poorly toddler, who had a slight temperature, and heavy news coverage of the EVD outbreak in West Africa. They referred me instead to my GP. Their wisdom was debatable. I was travelling from Nigeria, a country in which so far only 2 people have been quarantined as a result of possible contact with the disease [now 8, with a 2nd confirmed case - Mod.JW]. And in any case, a GP's waiting room is not the best place to take a potentially deadly virus. Thank goodness I'm not infected."
[EVD education is obviously needed, not only in West Africa but also among UK's National Health Service staff. - Mod.JW]
Ebola Serum: Explaining Experimental Treatments
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2 Aug 2014: An American doctor working in West Africa and another health care worker, also American, who contracted EVD there have both received experimental treatments for the deadly viral disease, according to news reports. Nancy Writebol, a worker with the charity Samaritan's Purse, received an experimental serum, and Dr. Kent Brantly, from the same charity, received a blood transfusion from a patient who recovered from Ebola, according to NBC News. Both of the health care workers are also being flown to an isolation unit in an American hospital for treatment, according to news reports [one has already arrived; see ProMED archive 20140802.2655022. - Mod.JW]. Though there are conflicting reports, and no one is saying exactly what the experimental serum is, its likely that both of the reported methods contained antibodies to the ebolavirus, said Dr. William Schaffner, a professor of preventive medicine and infectious diseases at Vanderbilt University Medical Center in Nashville, Tennessee. Delivering antibodies to a patient could slow the virus's replication and give the immune system time to recover
http://news.yahoo.com/ebola-serum-expla ... 03260.html.
Emirates airline halts flights to Guinea
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Emirates has become the 1st major airline to halt flights to Guinea, in the west African region affected by the recent EVD outbreak. Upon announcing the stoppage of service, the airline said: "The safety of our passengers and crew is of the highest priority and will not be compromised"
http://flightclub.jalopnik.com/airlines ... 51/+travis.
Lagos Government Warns Church Not To Accept EVD Victims
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3 Aug 2014: Officials of Lagos State Ministry of Health and the Federal Government visited the General Overseer of the Synagogue Church of All Nations (SCOAN), Prophet Temitope Joshua, seeking his cooperation in ensuring Ebola victims are not brought to his church for healing
http://saharareporters.com/2014/08/03/l ... gue-church and
http://en.starafrica.com/news/liberia-s ... ebola.html.
[The church has an international congregation. - Mod.JW]
Liberia shuts land borders with neighbours over EVD
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3 Aug 2014: As a means of containing further spread of the disease, President Johnson-Sirleaf ordered the closure of the country's 3 land borders, sources said. Liberia has land borders with Sierra Leone, Liberia and Cote d'Ivoire.
[Although WHO has not yet recommended any trade or travel restrictions, countries have started taking matters into their own hands. But besides major road crossings, as in other continents, African countries have many uncontrolled cross-border footpaths along which people and goods move daily. - Mod.JW]
Russian experts arrive in West Africa
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3 Aug 2014: Specialists from Russia's Health Ministry have arrived in Africa to join the fight against the EVD outbreak in the region, a spokesman for the ministry said Sunday [3 Aug 2014]. "Russian specialists have been tasked with providing the research and methodology aid to their local counterparts as well as with conducting an epidemiological analysis of the situation and developing recommendations to ensure infectious security," Oleg Salagai said
http://en.ria.ru/russia/20140803/191668 ... Fight.html.
[The Russian embassy in Guinea has been placed in strict quarantine. - Mod.JW]
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