The Ebola outbreak

480 posts / 0 new
Last post
cris
cris's picture
Offline
Joined: 06/14/2011
Hat Tips: 3404
Posts: 437
The Ebola outbreak

This current outbreak is extremely concerning.

i am a physician and surgeon, and I find the lack of good reporting very troubling.  I hope this forum can bring together those in our community with good information.

our friend StrongSideJedi turned me on to a great resource:

http://www.promedmail.org

If you scroll down the bar menu in the upper left hand corner of this link, you can find excellent summaries of the latest "official" information on any number of infectious disease, including Ebola.

I hope this forum burns out soon, bc the "threat" goes away.

Until that occurs, I hope that any interested member of Turdville will feel comfortable coming here to speculate and share information that they consider valuable.

Edited by admin on 11/08/2014 - 05:01
SteveW
SteveW's picture
Offline
Joined: 09/08/2011
Hat Tips: 9630
Posts: 1567
Patrick Sawyer's journey to Lagos

Thanks for starting this forum and I also hope it goes dead within the month.

I saw one report that Patrick's journey involved a stop in Ghana  and a plane change in Togo, which is missing from most reports. I have not seen how this timeline relates to his obvious illness but it seemingly increases risk.

My major concern is for the folks who clean out the toilets, I just don't see how they cannot have been exposed using standard gloves etc. Hope I'm wrong, comments?

__________________

“Don't walk behind me; I may not lead. Don't walk in front of me; I may not follow. Just walk beside me and be my friend.”
― Albert Camus

cris
cris's picture
Offline
Joined: 06/14/2011
Hat Tips: 3404
Posts: 437
Stopover

Apparently the flight stopped in Togo

http://www.usnews.com/news/world/articles/2014/07/26/nigeria-death-shows-ebola-can-spread-by-air-travel

cris
cris's picture
Offline
Joined: 06/14/2011
Hat Tips: 3404
Posts: 437
Looks like the airlines are starting to react

http://www.cbc.ca/news/world/ebola-outbreak-west-african-airline-suspends-flights-amid-widespread-fear-1.2721049

i suppose it is better late than never.

regardless, very concerning.

cris
cris's picture
Offline
Joined: 06/14/2011
Hat Tips: 3404
Posts: 437
Another physician dies

It appeared he was recovering 

http://www.huffingtonpost.com/2014/07/29/ebola-doctor-dead-sheik-umar-khan_n_5630878.html

Lamenting Laverne
Lamenting Laverne's picture
Offline
Joined: 05/24/2012
Hat Tips: 4189
Posts: 600
Can I join too?

Saywer:

​I have read via comments (so take with a grain of salt as I was reminded the hard way earlier) that he had a stop-over in Ghana (taxi, hotel, night bar?) and that he changed planes in Togo. It was said that 50 passengers were allowed to continue their journeys, but another 100 from different flight were not stopped at all.

http://www.dailymail.co.uk/news/article-2709180/Ebola-victim-sparked-fears-global-outbreak-American-Father-died-incurable-virus-Nigeria-taking-international-flight-going-visit-children-Minnesota.html#ixzz38rUfqzHO

http://www.freerepublic.com/focus/news/3186006/posts?page=48

http://mic.com/articles/95214/the-deadliest-ebola-outbreak-in-history-just-took-a-terrifying-turn

http://qz.com/241241/why-ebola-reaching-the-nigerian-capital-is-a-whole-new-level-of-scary/

Germany accepted to care for sick doctor, but if speculation is correct, it was Dr. Khan, who have now died, so that was too late. Of note is that the Germans intended to keep him behind three airlocks, so that it would be safe also in case it had become airborne. How they would do a safe transport, I do not know.

http://www.telegraph.co.uk/news/worldnews/europe/germany/10998367/Ebola-Germany-accepts-infected-patient-for-treatment.html

Another group recalls doctor home because of too high risk. They said they would call for townhall later with newest info.

http://wallowa.com/news/state_regional/medical-teams-international-flies-doctor-home-because-of-ebola-risk/article_f7eadbea-6611-5043-886b-e76c0cd7778a.html

An online fact sheet - with several references to risk of transmission by aerosol droplets: 

http://www.msdsonline.com/resources/msds-resources/free-safety-data-sheet-index/ebola-virus.aspx

Dr. Brantly: (has been reported to be very meticulous (different text), that he followed protocol and that the source of his infection is not found yet, which suggests that he did not have a known accident.

http://www.nbcdfw.com/news/local/North-Texas-Doctor-Fighting-Ebola-Asks-For-Prayers--268954061.html

Another doctor from same charity under self imposed quarantine after flying home to Canada from West Africa. He should have waited and finished the quarantine in Africa before boarding a plane, but we will see if he does indeed fall ill.

http://www.zerohedge.com/news/2014-07-29/canadian-doctor-quarantines-himself-over-ebola-fears-after-returning-liberia

Strongsidejedi
Strongsidejedi's picture
Offline
Joined: 06/14/2011
Hat Tips: 11801
Posts: 2281
Situational Awareness - Map from 7.20.2014

cris
cris's picture
Offline
Joined: 06/14/2011
Hat Tips: 3404
Posts: 437
07.29.14 update from promedmail.org

Long, but lots of good verifiable information:

Published Date: 2014-07-29 21:49:28
Subject: PRO/AH/EDR> Ebola virus disease - West Africa (106): Nigeria, Liberia, Sierra Leone, Guinea 
Archive Number: 20140729.2644117
EBOLA VIRUS DISEASE - WEST AFRICA (106): NIGERIA, LIBERIA, SIERRA LEONE, 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

In this posting:
[1] MSF update
[2] Nigeria: precautions
[3] Nigeria, Liberia: precautions
[4] Liberia
[5] USA: low risk (CDC)

******
[1] MSF update
Date: Mon 28 Jul 2014
Source: Doctors Without Borders/Medecins Sans Frontieres (MSF) [edited]
http://www.doctorswithoutborders.org/article/battling-ebola-outbreak-west-africa

Battling the Ebola Virus Disease Outbreak in West Africa
--------------------------------------------------------
As the Ebola virus disease [EVD] outbreak continues to spread, with 1093 cases and 660 deaths [now 1201 cases and 672 deaths as of 23 Jul 2014 -- see WHO update in ProMED-mail archive 20140727.2638658] reported across west Africa, Doctors Without Borders/Medecins Sans Frontieres (MSF) is stepping up its response in the most affected areas. While the number of cases in Guinea has declined significantly, in neighboring Sierra Leone and Liberia more and more people are being infected with the virus. With resources already stretched, health authorities and international organizations are struggling to bring the outbreak under control.

Sierra Leone
------------
In Sierra Leone -- now the epicenter of the epidemic, with 454 cases recorded so far [now 525 cases and 224 deaths as of 23 Jul 2014 -- see WHO update in ProMED-mail archive 20140727.2638658] -- MSF is rapidly scaling up its response, with 22 international and 250 Sierra Leonean staff currently working in the country. In Kailahun, in the east of the country, the team is running a 64-bed EVD treatment center. Since the facility opened on 24 Jun 2014, 131 suspected, probable, and confirmed patients have been admitted for treatment. So far, 12 patients have recovered and returned home to their families. An MSF psychologist is providing support and counseling to patients and their families, as well as to other MSF staff members.

MSF is also supporting the Sierra Leonean Ministry of Health and Sanitation (MoHS) at 2 referral sites in the villages of Koindu and Buedu in Kailahun district, where people with symptoms of EVD are isolated before being transferred by ambulance to MSF's center in town. In the past 3 weeks, MSF has trained more than 200 community health workers to deliver essential health messages to people in their villages about how to protect themselves against EVD and what action to take if someone shows any signs or symptoms of the disease.

MSF will now focus its efforts on halting the spread of the disease in the area straddling the Sierra Leone, Guinea, and Liberia borders, where the population is very mobile and people continue to transmit the disease to different villages. The team will scale up its health promotion and outreach activities in the villages in this area, and reinforce the alert system so that any new suspected cases can be identified promptly and transferred in MSF's ambulance to Kailahun for treatment.

[In Sierra Leone, the doctor who led the fight against EVD, Sheik Umar Khan, has died of the disease. Government officials hailed Dr Khan, 39, as a "national hero". The government disclosed last week [22 Jul 2014] that he was being treated for Ebola and had been quarantined (http://frontpageafricaonline.com/index.php/news/2492-roberts-intl-airport-puts-ebola-preventive-measures-in-place). - Mod.JW]

Guinea
------
In Guinea, the situation has stabilized in some areas and MSF has closed its EVD treatment center in Telimele, in the west of the country, after no new cases were reported for 21 days. During 7 weeks, 21 people with the disease were admitted to the center, with an astonishing 75 percent of patients making a recovery. Without medical care, as few as 10 percent of patients could be expected to survive.

In the capital, Conakry, MSF is reducing its activities as far fewer cases are appearing. Currently the Donka treatment center has just one patient who is now recovering and should be able to leave the hospital by next week. MSF is planning to hand over responsibility for the center to the Guinean Ministry of Health by the end of July [2014]. Of the 59 confirmed EVD patients admitted to the center since 25 Mar 2014, 63 percent recovered and were able to return home. However, cured patients continue to face stigma from their communities and even some of MSF's Guinean staff prefer not to reveal where they are working, for fear of being ostracized by their families.

[Photo of MSF EVD treatment centre in Conakry: http://www.msf.ca/sites/canada/files/ebola_clinic_in_conakry_eng.jpg. - Mod.JW]

In Gueckedou, in the southeast -- the original epicenter of the epidemic -- the number of patients in MSF's center has declined significantly, with currently just 2 patients admitted. It is very unlikely, however, that this reflects an end to the outbreak; instead it suggests that infected people may be hiding in their communities rather than coming for treatment. There continues to be significant fear surrounding EVD amongst local communities and MSF teams have been prevented from visiting 4 villages due to hostility. MSF is working with local authorities and elders to try to ensure safe access to these areas in order to obtain a clearer picture of whether people are still being infected and dying of the virus. Since the beginning of the outbreak, MSF has treated 150 patients in its center in Gueckedou. The recovery rate in the Gueckedou centre has been lower than in Telimele or Conakry, as people have been delaying coming for treatment.

Liberia
-------
In Liberia, the situation is deteriorating rapidly, with cases of EVD now confirmed in 7 counties, including in the capital, Monrovia. There are critical gaps in all aspects of the response, and urgent efforts are needed to scale up, particularly in terms of contact tracing, organizing safe burials, and establishing a functioning alert system. Already stretched beyond capacity in Guinea and Sierra Leone, MSF is able to provide only limited technical support to the Liberian Ministry of Health. MSF has set up an EVD treatment center in Foya, in Lofa county in northern Liberia, where cases have been increasing since the end of May [2014]. After the initial set up, MSF handed over the management of the center to nongovernmental organization Samaritan's Purse on 8 Jul 2014.

There are currently 6 patients admitted to the center and MSF experts continue to provide technical support and training to the staff there. The team will now shift its efforts to Voinjama, also in Lofa county, where there are reports of people dying of EVD in their villages before being able to reach medical assistance. The MSF team will set up a referral unit for the Ministry of Health so that people suspected to have EVD can be isolated and then transferred to the treatment center in Foya.

In Monrovia, an MSF emergency team -- comprising an emergency coordinator, medical coordinator, one doctor, 2 epidemiologists, and 2 water and sanitation specialists -- is constructing a new tented treatment center with capacity for 40-60 beds. It was scheduled to open on 27 Jul 2014 and will also be run by Samaritan's Purse. Previously, the MSF team had already set up and handed over to the Ministry a 15 bed treatment unit at Monrovia's JFK hospital Health in April 2014. However, the unit has since been closed and all patients are currently cared for at ELWA [Eternal Love Winning Africa] hospital in Paynesville until the new center is open at the same site. Currently there are 14 patients admitted to this center. The MSF team is also supporting the Ministry of Health in the overall coordination of the EVD response and providing technical and medical guidance.

[Source includes a video interview with an Ebola survivor, in French with English subtitles.]

--
Communicated by:
ProMED-mail Rapporteur Mary Marshall

******
[2] Nigeria: precautions
Date: Sun 27 Jul 2014
Source: The Guardian News [edited]
http://www.ngrguardiannews.com/lead-story/172675-who-govt-shut-down-hospital-over-ebola-virus

[Excerpts]
Lagos hospital shut down
------------------------
As part of measures to prevent the spread of Ebola virus disease (EVD), the World Health Organisation (WHO) and the Federal Government have shut down the hospital, First Consultants Medical Centre Limited, Ikoyi Road, Obalende, Lagos, where the 1st victim died.

They have also begun testing of all passengers on the same flight with the 1st EVD virus victim in Nigeria who died on Friday [25 Jul 2014] in a Lagos hospital. It is feared that all the more than 200 passengers on board were exposed to the deadly virus and may continue to spread the disease if they are not quarantined.

[Byline: Chukwuma Muanya]

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

[What test is being used? Unless a person on the plane had skin contact with the victim, or with surfaces he touched, they were not exposed to infection -- see WHO instructions to airlines/airports in comment in ProMED-mail archive 20140728.2640090. And what about the passengers who changed planes in Lagos and went elsewhere in Nigeria or the world? - Mod.JW]

******
[3] Nigeria, Liberia: precautions
Date: Tue 29 Jul 2014 
Source: BBC News [edited]
http://www.bbc.co.uk/news/world-africa-28550906

A major West African airline has stopped flying to Liberia and Sierra Leone amid growing concern about the spread of the deadly Ebola virus. Asky said it took the decision to keep "its passengers and staff safe during this unsettling time". The number of people killed by the virus in West Africa has now reached 672, according to new UN figures. Asky is the 2nd airline, after Nigeria's largest airline, Arik Air, to ban flights to Liberia and Sierra Leone. It had not halted flights to Guinea, but passengers departing from there would be "screened for signs of the virus", Asky said.

Last week, Nigeria, Africa's most populous country, reported its 1st case -- that of Liberian finance ministry official Patrick Sawyer who flew to the main city, Lagos, in an Asky flight.

Liberia has deployed police officers at the international airport in the capital, Monrovia, to ensure passengers are screened for symptoms of Ebola. "So if you have a flight and you are not complying with the rules, we will not allow you to board."

Liberia has also suspended all football activities in an effort to control the spread of Ebola. "Football being a contact sport -- people are sweating -- they do contact each other, and that could result in contracting the disease," the president of its football association, Musa Hassan Bility, told the BBC. "It also has to do with the fans because whenever there is a game, a lot of people come together and we want to discourage gathering at this point," he said. [This is overabundance of caution: people who are infectious have nasty symptoms and don't feel like playing football or going to a game. - Mod.JW]

The BBC's Jonathan Paye Layleh in Monrovia says that public awareness campaigns around Ebola have been stepped up in the city. Many people are worried about the outbreak, and fewer people are going to restaurants and entertainment centres, he says.

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

******
[4] Liberia
Date: Mon 28 Jul 2014
Source: Associated Press (AP) [edited]
http://bigstory.ap.org/article/new-fears-about-ebola-spread-after-plane-scare

No one knows for sure just how many people Patrick Sawyer came into contact with the day he boarded a flight in Liberia, had a stopover in Ghana, changed planes in Togo, and then arrived in Nigeria, where authorities say he died days later from Ebola virus disease [EVD]. Now health workers are scrambling to trace those who may have been exposed to Sawyer across West Africa, including flight attendants and fellow passengers.

Health experts say it is unlikely he could have infected others with the virus. Still, unsettling questions remain: How could a man whose sister recently died from EVD manage to board a plane leaving the country? [Is it proposed that all passengers be asked if they had a recent death in the family? And supposing they had, do the authorities expect a straight answer if the result is that the passenger is denied boarding? - Mod.JW]

Worse: Could EVD become the latest disease to be spread by international air travel? Sawyer's death on Friday [25 Jul 2014] has led to tighter screening of airline passengers in West Africa, where an unprecedented outbreak that emerged in March [2014] has killed more than 670 people in Guinea, Sierra Leone and Liberia. But some health authorities expressed little confidence in such precautions. "The best thing would be if people did not travel when they were sick, but the problem is people won't say when they're sick. They will lie in order to travel, so it is doubtful travel recommendations would have a big impact," said Dr. David Heymann, professor of infectious diseases at the London School of Hygiene and Tropical Medicine. "The important thing is for countries to be prepared when they get patients infected with EVD, that they are isolated, family members are told what to do and health workers take the right steps."

[It was reported that the victim had no symptoms when he boarded in Liberia -- see Ebola virus disease - West Africa (101): Nigeria ex Liberia, WHO, Sierra Leone 20140726.2636095. - Mod.JW]

The World Health Organization is awaiting laboratory confirmation after Nigerian health authorities said Sawyer tested positive for ebolavirus, WHO spokesman Gregory Hartl said. [Confirmation came from a competent Nigerian lab. - Mod.JW]

The WHO has not recommended any travel restrictions since the outbreak came to light. "We would have to consider any travel recommendations very carefully, but the best way to stop this outbreak is to put the necessary measures in place at the source of infection," Hartl said. Closing borders "might help, but it won't be exhaustive or foolproof."

The risk of travelers contracting EVD is considered low because it requires direct contact with bodily fluids or secretions such as urine, blood, sweat or saliva, experts say. EVD can't be spread like flu through casual contact or breathing in the same air. Patients are contagious only once the disease has progressed to the point they show symptoms, according to the WHO. The most vulnerable are health care workers and relatives who come in much closer contact with the sick.

Still, witnesses say Sawyer, a 40-year-old Finance Ministry employee en route to a conference in Nigeria, was vomiting and had diarrhea aboard at least one of his flights with some 50 other passengers aboard. Ebolavirus can be contracted from traces of feces or vomit, experts say. Sawyer was immediately quarantined upon arrival in Lagos -- a city of 21 million people -- and Nigerian authorities say his fellow travelers were advised of EVD's symptoms and then were allowed to leave. The incubation period can be as long as 21 days, meaning anyone infected may not fall ill for several weeks. Health officials rely on "contact tracing" -- locating anyone who may have been exposed, and then anyone who may have come into contact with that person. That may prove impossible, given that other passengers journeyed on to dozens of other cities.

International travel has made the spread of disease via airplanes almost routine. Outbreaks of measles, polio and cholera have been traced back to countries thousands of miles away. Even EVD previously traveled the globe this way: During an outbreak in Ivory Coast [Cote d'Ivoire] in the 1990s, the virus infected a veterinarian [who had examined dead chimpanzees in the forest and] who traveled to Switzerland, where the disease was snuffed out upon arrival and she ultimately survived, experts say. Now 2 American aid workers in Liberia have tested positive for the virus and are being treated there. US health officials said Monday [28 Jul 2014] that the risk of the deadly germ spreading to the United States is remote.

The mere prospect of EVD in Africa's most populous nation has Nigerians on edge. In Nigeria's capital, Abuja, a 35-year-old male entrepreneur, said he is particularly concerned about taking the bus, which is the only affordable way to travel. "It's actually making me very nervous. If I had my own car, I would be safer," he said. "The doctors are on strike, and that means they are not prepared for it. For now I'm trying to be very careful." It's an unprecedented public health scenario: Since 1976, when the virus was 1st discovered, EVD outbreaks were limited to remote corners of [Sudan] Congo and Uganda, far from urban centers, and stayed within the borders of a single country. This time, cases 1st emerged in Guinea, and before long hundreds of others were stricken in Liberia and Sierra Leone.

Those are some of the poorest countries in the world, with few doctors and nurses to treat sick patients let alone determine who is well enough to travel. In Sawyer's case, it appears nothing was done to question him until he fell sick on his 2nd flight with Asky Airlines. An airline spokesman would not comment on what precautions were being taken in the aftermath of Sawyer's journey. Liberian Assistant Health Minister Tolbert Nyenswah told AP last week that there had been no screening at Liberia's Monrovia airport. That changed quickly over the weekend, when President Ellen Johnson Sirleaf said a new policy on inspecting and testing all outgoing and incoming passengers will be strictly observed. She also announced that some borders were being closed and communities with large numbers of EVD cases would be quarantined.

International travelers departing from the capitals of Sierra Leone and Guinea are also being checked for signs of fever, airport officials said. Buckets of chlorine are also on hand at Sierra Leone's airport in Freetown for disinfection, authorities said. Still, detecting Ebola in departing passengers might be tricky, since its initial symptoms are similar to many other diseases, including malaria and typhoid fever. "It will be very difficult now to contain this outbreak because it's spread," Heymann said. "The chance to stop it quickly was months ago before it crossed borders ... but this can still be stopped if there is good hospital infection control, contact tracing and collaboration between countries."

Nigerian authorities so far have identified 59 people who came into contact with Sawyer and have tested 20, said Lagos State Health Commissioner Jide Idris. Among them were officials from ECOWAS [Economic Community of West African States], airline employees, health workers and the Nigerian ambassador to Liberia, he said. He said there have been no new cases of the disease.

[Byline: Maria Cheng, London; with Jonathan Paye-Layleh, Monrovia, Liberia; Clarence Roy-Macaulay, Freetown, Sierra Leone; Erick Kaglan, Lome, Togo; Heather Murdock, Abuja, Nigeria]

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

[I thank <gadanya@neo.tamu.edu> who sent in a similar story by Facebook news feed link from the Daily Trust, a general interest newspaper situated in Nigeria's capital, Abuja. - Mod.JW]

******
[5] USA: low risk (CDC)
Date: Mon 28 Jul 2014
Source: Emergency Medicine [edited]
http://www.emed-journal.com/articles/clinical-news/article/cdc-ebola-poses-very-low-risk-to-us-health-care-workers/fd0fededc548b9531862106fbceeeb1e.html

From a CDC Briefing
CDC: Ebola poses very low risk to US health care workers
--------------------------------------------------------
Standard barrier nursing protocols that have been in place in the USA since recognition of HIV will be adequate to protect health care workers in the unlikely event that patients who contracted the ebolavirus in Africa present to a US emergency department or physician's office, officials from the Centers for Disease Control and Prevention [CDC] said during a 28 Jul 2014 press briefing.

Since March 2014, 672 people have died during the ongoing Ebola virus disease [EVD] outbreak in Western Africa, according to Dr. Steve Monroe, director of the CDC Division of High-Consequence Pathogens and Pathology. 2 [US] health care workers, both in Monrovia, Liberia, have presented with EVD. One is symptomatic and in isolation; the other has fever but no other symptoms. Transmission of the virus to health care workers seems to have occurred via needle stick or contact with infected bodily fluids, according to Dr. Monroe.

In 2008, 2 cases of Marburg virus infection occurred in Western Europe. Marburgvirus is a hemorrhagic fever virus that is a close cousin to ebolavirus, Dr. Monroe noted. Both patients were managed by way of standard barrier nursing precautions already in place, and those precautions were sufficient to protect physicians and nurses involved in their care. "If a case [of EVD] were to show up in the USA, I'm confident that we are already doing what needs to be done to prevent virus transmission to health care workers," he said.

The disease cannot be spread by asymptomatic people, according to Dr. Monroe. And if a symptomatic person travels on an airplane, it is unlikely that fellow travelers will be exposed to infected bodily secretions, he added. One case of an EVD patient traveling by air has been noted. The man flew from Liberia to Lagos, Nigeria, where he died. The countries involved in the outbreak have stepped up efforts to screen for fever and other signs of the disease those travelers who seek to leave their countries. Only 50 percent of infected people present with hemorrhage; others present with the vague symptoms of fever, headache, muscle aches, and vomiting.

[Byline: Sally Koch Kubetin]

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

[There was another case in 1996 when an EVD-infected doctor flew from Gabon to South Africa. None of the passengers or other contacts caught it from him, except his hospital nurse, who died; he recovered. See ProMED-mail archive WER Contents, 29 Nov 1996 19961129.1990.

CDC emphasizes that EVD cannot be spread by people with no symptoms, and only half of the victims show external bleeding. Recommendations publicized in EVD-affected countries should take these facts into account, and not prohibit contact between people with no symptoms.

In Liberia, the Roberts International Airport, the nation's only international airport, says it is putting in place measures to help prevent the spread of the virus. As of Monday [28 Jul 2014], all people without business at the airport, including family members and well-wishers, will not be allowed to enter the premises of the airport (http://frontpageafricaonline.com/index.php/news/2492-roberts-intl-airport-puts-ebola-preventive-measures-in-place).

A new WHO update dated 27 Jul 2014, at http://who.int/csr/don/2014_07_27_ebola/en, does not provide any new case or death figures beyond 23 Jul 2014, already posted on ProMED on 25 Jul 2014, but adds a report on the Nigeria case, without giving any final confirmation that it was EVD (but a knowledgeable source informs ProMED that there is no reason to doubt the diagnosis by the Nigerian lab).

Read the story of the 2 UK and Brazilian doctors who arrived on the same day in Sierra Leone, deployed through the Global Outbreak Alert and Response Network (GOARN), a WHO-based network of experts and institutions that can assist with the international response to disease outbreaks, at http://who.int/features/2014/challenges-ebola-outbreak/en. - Mod.JW]
See Also
Ebola virus disease - West Africa (105): Guinea, Nigeria, Liberia, Sierra Leone 20140728.2640090
Ebola virus disease - West Africa (104): WHO, Nigeria, Togo alert, Sierra Leone 20140727.2638658
Ebola virus disease - West Africa (103): Liberia, Sierra Leone 20140727.2637578
Ebola virus disease - West Africa (102): Nigeria, Sierra Leone, drugs & vaccine 20140726.2636858
Ebola virus disease - West Africa (101): Nigeria ex Liberia, WHO, Sierra Leone 20140726.2636095
Ebola virus disease - West Africa (100): Cote d'Ivoire,Tanzania, Nigeria alerts 20140724.2633437
Ebola virus disease - West Africa (99): WHO, Sierra Leone, Liberia 20140724.2632442
Ebola virus disease - West Africa (98): Nigeria susp, alert 20140724.2632831
Ebola virus disease - West Africa (97): Sierra Leone, Liberia, tests 20140723.2630441
Ebola virus disease - West Africa (96): Liberia, Sierra Leone 20140723.2628773
Ebola virus disease - West Africa (95): FAO alert, Sierra Leone 20140722.2626215
Ebola virus disease - Congo DR: susp 20140721.2624831
Ebola virus disease - West Africa (94): Sierra Leone 20140720.2623966
Ebola virus disease - West Africa (93): Sierra Leone, WHO underfunded 20140719.2622727
Ebola virus disease - West Africa (92): Sierra Leone, drugs, EU disease ctr. 20140718.2620802
Ebola virus disease - West Africa (91): WHO, Guinea,Sierra Leone,Liberia, border 20140717.2618525
Ebola virus disease - West Africa (90): Sierra Leone, Ghana meeting, historical 20140716.2615640
Ebola virus disease - West Africa (89): WHO update, Sierra Leone, Liberia, risk 20140715.2613043
Ebola virus disease - West Africa (88): WHO, Liberia, prevention, challenges 20140713.2607118
Ebola virus disease - West Africa (87): Liberia, Sierra Leone, MSF, drugs, vaccine 20140712.2605570
Ebola virus disease - West Africa (86): WHO, UNSC, ECOWAS, Guinea, Liberia 20140711.2603448
Ebola virus disease - West Africa (85): Guinea, Liberia, region 20140710.2601330
Ebola virus disease - West Africa (84): WHO update 20140708.2596192
Ebola virus disease - West Africa (83): Ghana susp, Guinea, S. Leone, Liberia 20140708.2593018
Ebola virus disease - West Africa (82): Guinea, prevention, Tanzania, UK 20140706.2591433
Ebola virus disease - West Africa (81): Guinea, Sierra Leone, Liberia, overseas 20140705.2589463
Ebola virus disease - West Africa (80): WHO update, meeting 20140704.2587114
Ebola virus disease - West Africa (79): Guinea, Nigeria prevention, drug testing 20140703.2586162
Ebola virus disease - West Africa (78): Guinea, Sierra Leone, Liberia 20140702.2583396
Ebola virus disease - West Africa (77): WHO, meeting, Sierra Leone, Liberia 20140701.2579682
Ebola virus disease - West Africa (74): CDC summary 20140626.2566502
Ebola virus disease - West Africa (73): WHO update, Sierra Leone 20140625.2566397
Ebola virus disease - West Africa (72): WHO update 20140624.2562337
Ebola virus disease - West Africa (71): Guinea, Sierra Leone, Nigeria serology 20140622.2558446
Ebola virus disease - West Africa (70): Sierra Leone, Liberia, travel advice 20140621.2556770
Ebola virus disease - West Africa (69): Guinea, Sierra Leone, region 20140621.2555351
Ebola virus disease - West Africa (68): Liberia, One Health approach 20140619.2553035
Ebola virus disease - West Africa (67): WHO update, Liberia, Sierra Leone 20140618.2550323

cris
cris's picture
Offline
Joined: 06/14/2011
Hat Tips: 3404
Posts: 437
07.29.14 update from promedmail.org

Double post deleted

cris
cris's picture
Offline
Joined: 06/14/2011
Hat Tips: 3404
Posts: 437
Excellent article

Excellent comprehensive article (which btw has buried within it exciting news of  a recently reported advance in an HIV vaccine):

http://www.ngrguardiannews.com/lead-story/172675-who-govt-shut-down-hospital-over-ebola-virus

Key extended excerpt:

    It is feared that all the over 200 passengers on board are exposed to the deadly virus and may continue to spread the disease if they are not quarantined.  

 First Consultants Medical Centre Limited in a statement yesterday by the Chief Consultant/Medical Director, Dr. B. N. Ohiaeri, and the Senior Consultant Physician and Endocrinologist, Dr. A. S. Adadevoh, said: “In keeping with WHO guidelines, the hospital is shut down briefly as full decontamination exercise is currently in progress. The reopening of the hospital will also be in accordance with WHO guidelines.

  “In conclusion,  working with the state, federal and international agencies, we were able to identify and confirm the diagnosis of the Ebola Virus Disease.

 “We hope that by our action of preventing this gentleman from being extracted from our hospital and traveling to Calabar we have been able to prevent the spread of Ebola virus disease in Nigeria.

 “The board and management of the hospital wish to thank all our staff members for their diligence and professionalism.”   

  According to the statement, the victim, was a senior diplomat with the Economic Community of West African States (ECOWAS), from Liberia, who arrived in Nigeria to attend the ECOWAS Convention in Calabar, Cross River State.

  The hospital said working jointly with the state, federal agencies and international agencies, they were able to obtain the confirmation of Ebola virus disease (Zaire strain) from the WHO regional centre laboratory in Senegal, Redeemers University laboratory in Ogun State, and the Lagos University Teaching Hospital (LUTH), Idi Araba, and that the gentleman subsequently died on July 25, 2014, at 6:50 a.m.   

  The statement reads: “A 40-year-old gentleman came into the hospital with symptoms suggestive of malaria (fever, headache, extreme weakness) on Sunday night (20th July 2014).

  “He was fully conscious and gave us his clinical history and told us he was a senior diplomat from Liberia. Laboratory investigations confirmed malaria whilst other tests for HIV, hepatitis B and C were negative. He was admitted and treatment commenced.

  “However, due to the fact that he was not responding to treatment but rather was developing haemorrhagic symptoms we further questioned him. He denied having been in contact with any persons with Ebola virus disease at home, in any hospital or at any burial. In spite of this denial we immediately decided to do the following:

  “To conduct further tests for possible infectious haemorrhagic disease, especially Ebola virus diseases, based on the fact that he was a Liberian citizen and the recent outbreak of the disease in that country.

 “We immediately isolated/quarantined the patient, commenced barrier nursing and simultaneously contacted the Lagos State Ministry of Health and the Federal Ministry of Health to enquire where further laboratory tests could be performed as we had a high index of suspicion of a possible Ebola virus disease.

  “We refused for him to be let out of the hospital in spite of intensive pressure, as we were told that he was a senior ECOWAS official and had an important role to play at the ECOWAS convention in Calabar, Cross River State.

  “Initial test results from LUTH laboratory indicated a signal of possible Ebola virus disease, but required confirmation.

  “We then took the further step of reaching out to senior officials in the office of the Secretary of Health of the United States of America who promptly assisted us with contacts at the Centres for Disease Control (CDC) and WHO Regional Laboratory Centre in Senegal…”

  According to reports, the fact that the traveller from Liberia could board an international flight also raised new fears that other passengers could take the disease beyond Africa due to weak inspection of passengers and the fact Ebola’s symptoms are similar to other diseases.

  Officials in the country of Togo, where the sick man’s flight had a stopover, also went on high alert after learning Ebola could possibly have spread to a fifth country.

  Also, in response to the first Ebola virus disease (EVD) in Nigeria and to answer questions and have feedback from Nigerians, the Federal Ministry of Health (FMoH) has opened special email and twitter accounts, ebolainfo@health.gov.ng and @EbolaInfoFmohNg, and is also working on a Facebook account. 

Lamenting Laverne
Lamenting Laverne's picture
Offline
Joined: 05/24/2012
Hat Tips: 4189
Posts: 600
Airline Passengers

I looked to see which airlines are operating out of Monrovia, Lome, Accra and Lagos with which direct flight destinations. From what I could find, the list is long (primarily Lagos) and not encouraging at all, if it eventually turns out that the fear of 200 passengers possibly exposed is correct. In the cases I checked, there are 1-3 daily direct flights to major cities in Europe. There are also direct flights to the US and to Doha and Dubai, which are connecting hubs to Asia.

Do any of you know, if there are any protocols on when cases like this must be reported and to whom? I ask because Mr. Sawyer collapsed in Lagos Airport on the 20th July and it was not reported until the 24th July, which opened a large window with many flights departed since he became known by the hospital - and a slightly less large window (unknown when exactly) after they started to suspect Ebola.

ag1969
ag1969's picture
Offline
Joined: 05/10/2012
Hat Tips: 30821
Posts: 4894
Seven Facts You Should Know About Ebola

Stopping the Spread of Ebola: 7 Facts to Know

If Ebola becomes a problem, here are some key facts you’ll need to know to reduce your chance of getting it.

1. It seems to start in animals and meat.  No one’s for sure, but it’s thought the disease starts in bats. They can have the virus without getting sick. Then they infect other animals, who do usually get sick.

People kill the other animals and contract the virus while either preparing the meat or eating it poorly cooked. Then the virus starts spreading from person to person.

2. After exposure, Ebola can kick in early or late.  After someone is infected, the symptoms start anywhere from two to 21 days later.

3. Ebola doesn’t spread like the flu.  This is the only good thing I know about this awful disease.

Flu: You can be contagious before you get sick.
Ebola: You’re not contagious until you have symptoms.

Flu: The virus can spread through fluid droplets in the air (like from a sneeze).
Ebola: Although it’s theoretically possible for Ebola to spread this way, it doesn’t seem to.

4. Ebola is highly contagious.  You can catch it by coming in direct contact with any bodily fluids, including blood, semen, urine, saliva, vomit, or feces.

5. The symptoms make prevention more difficult.  Symptoms make it hard for caregivers not to come into contact with those bodily fluids.

There’s profuse vomiting and diarrhea. And the victim’s blood can’t clot. So you can’t stop bleeding from the smallest scrape, prick, or bruise. Sometimes people spontaneously bleed out the nose, mouth, rectum, or urethra.

6. Ebola is still contagious after symptoms stop or the victim dies.  Ebola doesn’t stop being contagious with death or recovery. Victims’ dead bodies still carry the disease, and people who recover may continue to be contagious for up to two months or more.

7. There are ways to protect yourself.  It’s essential to protect yourself at all times if you’re caring for someone who may have the disease so you don’t come into contact with the bodily fluids.

Basically, cover yourself in impermeable products from head to toe. Think goggles, mask, disposable gown, gloves, and shoe covers. If you’re using needles, use them once only and dispose of them immediately.

Also disinfect your environment. Clean any exposed furniture, walls, or floors with a disinfectant, like a chlorine bleach solution, before future use.  This may not all be possible during a long-term disaster, but do the best you can.

Essential Oils for Protection from Ebola and Other Viruses

In addition to healing, I am a huge believer in using essential oils to build up immunity  in order to prevent sickness.  I use essential oils myself and through trial and error, learn what works and what doesn’t.  I read as much as I can so that I can learn and make informed choices.

All that being said, I keep a spray bottle with Shield protective blend and witch hazel with me at all times for use as a hand and gizmo sanitizer.  I spray it everywhere, including on my phone, my keyboard, on pillows and bedding, and more.  If I feel a sniffle or a runny nose coming on, standalone Shield goes in the diffuser 24/7.

But what about protection from Ebola or other deadly viruses?  The jury is out but as far as I am concerned, staying healthy with a strong immune system can not hurt.

One thing I did do when the recent Ebola headlines hit was do some research to find studies that specifically addressed Ebola and essential oils.  I had some help but neither one of us could pull up any verified studies.  On the other hand, there have been some studies and articles linking Cinnamon and Ebola.  I like the cinnamon link since the Shield Blend I use contains Cinnamon Bark in addition to Clove, Lemon, Eucalyptus, and Rosemary.

I plan to keep searching for some credible information on the use of essential oils to mitigate Ebola, but in the meantime, any of the antiviral and antibacterial essential oils would be good to have on hand.  Some examples are Thyme, Melaleuca, Oregano, Cinnamon and, of course, Shield.

How to Make An Essential Oil Protective Spray

Here is the recipe I use to make “Shield Protective Spray”.  This spray makes a terrific hand sanitizer, room freshener, and all around disinfectant and protectant.  This is so darn simple, it is embarrassing.

Take a 2 ounce glass spray bottle and add 30 drops of Spark Naturals Shield Blend.
Top with Witch Hazel.
Shake before using.

That’s it.  Were you expecting something more difficult?

One more note.  Shield Blend is actually an ancient blend based upon a legend that has its roots in 15th century England during the time of the great plague. Grave-robber thieves developed their own blend of Clove, Cinnamon Bark, Lemon, Eucalyptus, and Rosemary to protect them while robbing the plague victims.

If you would like to try to make your own, here is a version that includes Lavender from Contributing Author Rebecca Schiffhauer at Camp Wander.

DIY Shield or Thieves/Robbers Blend with Lavender

Ingredients
45 drops clove essential oil
35 drops lemon essential oil
25 drops eucalyptus essential oil
20 drops cinnamon essential oil
15 drops lavender essential oil
10 drops rosemary essential oil

Instructions
Combine the all essential oils and store in a dark 15 ml glass bottle

The Final Word

I am sure you will agree that when it comes to a dread disease, Ebola is horrific.  Will it become a global pandemic?  Will we be exposed?  That is anyone’s guess.  The best we can do is to limit our exposure to others and to be prepared for physical isolation.  This is one of the few instances were moving to a bug out location or to a friend or relative’s home in the boonies would be a wise idea.  For any type of pandemic, voluntary isolation is a good thing.

In closing, I would like to thank James for allowing me to share his work.  For more information, visit his website at the Survival Doctor and his most recent article, 12 Things You Must Know About Ebola.

http://www.backdoorsurvival.com/seven-facts-about-ebola/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+BackdoorSurvival+%28Backdoor+Survival%29

cris
cris's picture
Offline
Joined: 06/14/2011
Hat Tips: 3404
Posts: 437
Nigerian health officials now tracking 30,000 contacts

Tracking 30,000 possible contacts of the American citizen who died of Ebola after flying to Lagos.

http://www.voanews.com/content/nigeria-tracking-30000-people-at-risk-of-contracting-ebola/1967845.html

Something  tells me that will be hard to do with a high degree of certainty.  This is a tacit admission that he was highly contagious and came in contact with a lot of people.

From the article:

"We've been making contacts. We now have information about the manifest. We have information about who and who were around. So, as I'm talking, our teams are in the facility, where they've trained the staff, and then they (are) now asking questions about those that were closely in contact with the patient," said Professor Omilabu.

'We're actually looking at contacting over 30,000 people in this very scenario. Because any and everybody that has contacted this person is going to be treated as a suspect," said Yewande Adeshina, a public health adviser.

Lamenting Laverne
Lamenting Laverne's picture
Offline
Joined: 05/24/2012
Hat Tips: 4189
Posts: 600
Hong Kong

https://hk.news.yahoo.com/%E5%A5%AA%E5%91%BD%E4%BC%8A%E6%B3%A2%E6%8B%89%E6%81%90%E6%AE%BA%E5%9F%8B%E8%BA%AB-220018100.html

A woman has been isolated after returning from Kenya with symptoms that appear to be similar to Ebola. HK Health Authority has received 45 inquiries about Ebola. 

Strongsidejedi
Strongsidejedi's picture
Offline
Joined: 06/14/2011
Hat Tips: 11801
Posts: 2281
@cris tracking Ebola contacts

@Cris - Tracking ebola contacts would be very challenging.

After reading ag1969's posting above, there appears some confusion regarding how the virus is being transmitted.  The comments above regarding transmissability are likely to be wrong.  The behavior of this epidemic suggests that this strain of Ebola is communicable via body fluids.  It also suggests to me that blood, perspiration, human waste, and any body fluid is a possible mode of transmission.

The prior assumptions on how the virus is behaving may be incorrect because so many are continuing to become infected.  As the virus infects thousands of people, the virus is subject to mutation.

I noted that US relief agencies are withdrawing from the zone, which is the appropriate answer (unfortunately).  The reason is that it becomes impossible to screen passengers on aircraft.  You are left with imposing a quarantine on people from particular countries.

But, people can go from the quarantined nation to one or more other nations and then can come to the Americas.

If Ebola shows up in Central America, South America, or Asia; then we will have a really big problem.

cris
cris's picture
Offline
Joined: 06/14/2011
Hat Tips: 3404
Posts: 437
Very interesting first hand account

http://phertzler.wordpress.com/2014/07/30/ebola-in-west-africa-too-close-home/

cris
cris's picture
Offline
Joined: 06/14/2011
Hat Tips: 3404
Posts: 437
Latest WHO update

WHO update:

http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4236-ebola-virus-disease-west-africa-29-july-2014.html

Key excerpt:

Between 24 and 27 July 2014, a total of 122 new cases (suspect, probable, and laboratory-confirmed cases) as well as 57 deaths were reported from Liberia, Sierra Leone, Guinea and Nigeria.

The surge in the number of new EVD cases especially in Liberia, Sierra Leone and Guinea calls for concentrated efforts by all to address the identified problems such as health facility transmission and effective contact tracing.

ag1969
ag1969's picture
Offline
Joined: 05/10/2012
Hat Tips: 30821
Posts: 4894
Ebola - What You're Not Being Told StromCloudsGathering

Strongsidejedi
Strongsidejedi's picture
Offline
Joined: 06/14/2011
Hat Tips: 11801
Posts: 2281
@ag1969

EBOLA is NOT an "airborne virus".

The video you posted is from someone speculating without medical training and without any experience in infectious disease.

I would like to urge you to stop posting speculation.  The situation is significant enough without idiots making up things for youtube hits.

Strongsidejedi
Strongsidejedi's picture
Offline
Joined: 06/14/2011
Hat Tips: 11801
Posts: 2281
@cris on "contact tracing"

Cris,

That "contact tracing" will be extremely difficult in western african nations where people are traveling internationally.

One thing is for sure, we're not getting straightforward epidemiology data from the nations involved.

They can't mount a public health response due to cultural issues and the lack of infrastructure.

This causes me to doubt the data and consider that the "tip of the iceberg" is being reported.

There may be many more people who are undiagnosed carriers or perhaps even symptomatic with disease and die without ever being diagnosed.  There could be an unrecognized vector that is harboring unrecognized source.

A good example is the presence of influenza in avian species in Asia where the virus mutates in the birds and then infects the humans in close contact.

There must be a similar process in animals or perhaps primates with respect to Ebola in African nations.

cris
cris's picture
Offline
Joined: 06/14/2011
Hat Tips: 3404
Posts: 437
Interesting graph in link

@ssj - I completely agree.  The reported data is almost certainly just the tip of the iceberg.

check out the graph of cases in the link below:

http://www.samaritanspurse.org/article/samaritans-purse-doctor-serving-in-liberia-west-africa-tests-positive-for-ebola/?utm_source=SPFacebook&utm_medium=social&utm_campaign=m_Y000-SOCM_SocialMedia&utm_content=7-31

starting to look pretty parabolic.  And as you point out, these are merely the known cases.

Comment viewing options

Select your preferred way to display the comments and click "Save settings" to activate your changes.
Topic locked
Syndicate contentComments for "The Ebola outbreak"