ID = 191109100

Disease Place Number of Cases

show the keywords found by daniel

Document language : en

Unknown title

Published Date: 2014-09-11 14:11:28
Subject: PRO/AH/EDR> Ebola virus disease - West Africa (160): Senegal, Liberia, tests, media
Archive Number: 20140911.2766294

EBOLA VIRUS DISEASE - WEST AFRICA (160): SENEGAL, LIBERIA, TESTS, MEDIA
***********************************************************************
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] Senegal: 2 new suspected cases
[2] Liberia: 1st person report
[3] Diagnostic tests
[4] ECDC case definition for Ebola virus disease in Europe
[5] Media reports

******
[1] Senegal: 2 new suspected cases
Date: Wed 10 Sep 2014
Source: IOL (Independent Online, South Africa) [summ., edited]
http://www.iol.co.za/news/africa/senegal-tracks-ebola-patient-s-path-1.1748682#.VBGKp_m3OPN

A total of 33 people are being kept in quarantine after a 21-year-old student from neighbouring Guinea came to stay there at his uncle's house a fortnight ago. With him, he brought the deadly Ebola virus [disease]. The student is now in isolation in a Dakar hospital, his condition improving, according to the health ministry. So far, no other Ebola cases have been confirmed, but the World Health Organization said on Tue [9 Sep 2014] that 2 new suspected cases had been detected in Senegal. It provided no further details...

Those quarantined inside the house include a 2-month-old baby. People under surveillance are being tested morning and night for fever, Senegalese authorities say. It was not immediately clear if the WHO's 2 suspected cases were among this group... [They could be among the health workers who treated him initially after he denied any contact with an EVD case. If they are confirmed, Senegal faces the same scenario as Nigeria. - Mod.JW]

Doctor Mamadou Ndiaye, director of prevention in Senegal, said the student travelled by "bush taxi" -- typically, old Peugeot 504 estate cars transporting 7 passengers jammed together for hours, sweating in the heat. An initial test of the student by Senegalese doctors came out negative, a diplomat said. But a 2nd test, revealed to ministry officials in the early hours of 29 Aug 2014, was positive and health minister Seck announced it that morning. Yet even the day after the announcement, a Reuters witness at the house said there was no surveillance in place. Neighbours say a young woman slipped away under cover of darkness last week [week of 1 Sep 2014], though a police officer monitoring the site denied this.

Though his health has improved, the student still tested positive for the virus in a check up on 3 Sep 2014 and he remains in isolation. - more

[Byline: Emma Farge, Andrew Oberstadt]

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

******
[2] Liberia: 1st person report
Date: Thu 11 Sep 2014
Source: BBC News [summ., edited]
http://www.bbc.com/news/world-africa-29147797

"Flights into disaster zones are usually full of aid workers and journalists. Not this time. The plane was one of the 1st in after some 10 airlines stopped flying to Liberia because of EVD, and still it was empty...

A colleague tells me she has just lost a family member about to give birth. It was a normal pregnancy, but she was turned away by every hospital as staff were too afraid to take her in case she had EVD. She did not have the virus, but she died because of delivery complications. Her baby at least survived... [For how long? - Mod.JW]

Heavy rains lash down over the weekend -- I shudder to think of Medecins Sans Frontieres and health ministry workers and patients battling under plastic sheeting in such rains...

They tell us about a survivor in their community. He came back from the treatment centre, but despite testing negative for the virus he infected his girlfriend, who died. The semen of male Ebola survivors remains contagious for a minimum of 7 weeks after infection. The villagers ask if survivors can be isolated...

The doctor at the empty hospital we visit says they suspect any patient who comes with fever, diarrhoea, or stomach pains as having Ebola. "Guilty until proven otherwise" is the motto -- and people are sent away as medical staff do not have the facilities to cope with the virus...

One of the joys of working for Unicef is children, picking up babies, playing with them. Here we dare not touch babies; there are no handshakes, no hugs. It's simply too risky.

[What it's like on the ground there now -- well worth reading the full report. - Mod.JW]

--
Communicated by:
ProMED-mail Rapporteur Kunihiko Iizuka

******
[3] Diagnostic tests
Date: Tue 9 Sep 2014
Source: The Washington Post [summ., edited]
http://www.washingtonpost.com/national/health-science/official-us-response-to-ebola-hampered-by-lack-of-expertise-with-deadly-virus/2014/09/09/343e5cd8-385d-11e4-9c9f-ebb47272e40e_story.html

The death toll has climbed to at least 2296 in West Africa, WHO announced Tue [9 Sep 2014]. The new figure, current through Sat [6 Sep 2014], shows a staggering spike of nearly 200 new deaths recorded in one day. West Africa has 4293 total cases of confirmed, probable and suspected Ebola infections, a number that could rise as high as 20 000, WHO has warned.

More than half of the epidemic's deaths (1224) and nearly half of all cases (2046) have been in Liberia. The country has become so overwhelmed that only 31 percent of EVD cases in Liberia have been lab confirmed through blood tests, WHO said. Another 47 percent of Liberia's cases have been deemed "probable," which means they have been evaluated by a clinician, according to WHO. Probable cases also include people who had suspected cases and died and had a link to someone with a confirmed case.

Several factors account for why so many Liberian cases aren't confirmed by labs, WHO spokesman Daniel Epstein said Tue [9 Sep 2014]. Among them are the sheer volume of cases in that country, poor infrastructure, and the limited number of EVD labs and staff throughout West Africa.

[Byline: Lena H Sun. Elahe Izadi contributed to this report]

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

----
Date: Sun 7 Sep 2014
From: David Thomson <dthomson@naqia.gov.pg> [edited]

[Re: ProMED-mail Ebola virus disease - West Africa (152): region, UN, Nigeria, tests 20140906.2753389]
----------------------------------------------------------------------
Regarding "[5] Faster diagnostic test" in the post, I agree that the diagnostic system needs to be validated against the 'gold standard' and also that it may turn out to be very useful, so warrants genuine attention.

Bottom line, however, is that any new diagnostic technologies usually also require significant attention to the entire diagnostic process and system associated with them, particularly if trying to introduce them into a chronically under-resourced environment that is currently under quite extreme immediate operational stress. Under such circumstances, it is rarely easy to introduce any significant change, such as a new field rapid screening test strip/card system, let alone a more sophisticated machine-based molecular diagnostic system.

These types of diagnostic technologies can be useful in developing countries, largely because they are often 'simpler' and 'less expensive' to operationalize than some others (that is, to put into labs and to train comparatively untrained or unexposed people to use effectively, repeatably, and predictably, they are often less expensive and/or easier to maintain or replace, etc.), and because once operationalized, they may be able to produce results for the field faster, and (with a lot of luck) it may be possible to operationalize them closer to the point of service delivery.

They may not, however, always be quite as useful as superficially might appear to the uninitiated just because they use less costly or less sophisticated equipment or processes. This reality often stems from issues associated with handling of specimens during their preparation -- for example, a diagnostic system that runs in a small, simple, battery-powered bench-top device may not be as useful if a large electricity-powered Class 3 laminar flow hood or containment cabinet is the minimum needed to safely prepare specimens for testing (particularly from symptomatically suspect or confirmed patients). For molecular tests, there is usually also the need for a particularly clean specimen preparation, processing, and testing environment because cross-contamination and over-contamination can be quite significant issues -- hence their more typical application within 'clean room' laboratory environments (Class 3 or 3+ in this case) that are, themselves, usually in very short supply within developing countries.

--
Dr David Thomson
General Manager Operations
National Agriculture Quarantine & Inspection Authority (NAQIA)
Papua New Guinea
<dthomson@naqia.gov.pg>

[However, PCR tests in the (few) field labs are producing same-day results. - Mod.JW]

******
[4] ECDC case definition for Ebola virus disease in Europe
Date: Wed 10 Sep 2014
http://www.ecdc.europa.eu/en/press/news/_layouts/forms/News_DispForm.aspx?List=8db7286c-fe2d-476c-9133-18ff4cb1b568&ID=1062

A case definition (http://www.ecdc.europa.eu/en/healthtopics/ebola_marburg_fevers/EVDcasedefinition/Pages/default.aspx) for reporting cases of Ebola virus disease in the EU has been released by the European Centre of Disease Prevention and Control (ECDC). The definition aims to classify cases for epidemiological reporting and not to guide investigation or clinical management of cases.

Although developed in response to the outbreak of Ebola virus disease currently affecting West Africa, the case definition is broad enough to apply to any case of EVD.

Only confirmed cases are to be reported at the European level, although the newly published case definition does include a 'probable case' definition.

Algorithms for laboratory diagnosis (http://www.ecdc.europa.eu/en/healthtopics/ebola_marburg_fevers/algorithm-evd-diagnosis/Pages/default.aspx) of EVD and for the initial assessment and management of patients (http://www.ecdc.europa.eu/en/healthtopics/ebola_marburg_fevers/algorithm-evd-case-assessment/Pages/default.aspx) have also been released. To offer further support to healthcare professionals possibly faced with a situation where the management of patients suffering from EVD becomes necessary, the algorithms are accompanied by a directory of guidance (http://www.ecdc.europa.eu/en/healthtopics/ebola_marburg_fevers/directory-evd/Pages/default.aspx) from national institutes and other public health bodies. These guidance documents provide more detailed steps for the management of any EVD patient.

By releasing the case definition and related algorithms, ECDC works to support EU Member States in their preparedness for a quick and effective response to any situation that may potentially involve an EVD case.

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

[Unlike Europe, West Africa does not have the capacity to test its thousands of suspected and probable cases, nor are samples (especially from long-dead bodies) always obtainable in good enough condition to be tested. - Mod.JW]

******
[5] Media reports

Donation: Gates foundation
--------------------------
10 Sep 2014: The Bill & Melinda Gates Foundation today [10 Sep 2014] announced that it will commit USD 50 million to support the scale up of emergency efforts to contain the EVD outbreak in West Africa and interrupt transmission of the virus... To date, the Gates Foundation has committed more than USD 10 million of the USD 50 million to fight the Ebola outbreak, including USD 5 million to WHO for emergency operations and R&D [research & development] assessments and USD 5 million to the US Fund for UNICEF to support efforts in Liberia, Sierra Leone, and Guinea to purchase essential medical supplies, coordinate response activities, and provide at-risk communities with life-saving health information. An additional USD 2 million will also be committed immediately to the Centers for Disease Control and Prevention [CDC] to support incident management, treatment, and health care system strengthening.
http://www.gatesfoundation.org/Media-Center/Press-Releases/2014/09/Gates-Foundation-Commits-$50%20Million-to-Support-Emergency-Response-to-Ebola

--
Nigeria: school reopening concerns, airport screening
-----------------------------------------------------
11 Sep 2014: (Lindaikeji's Blog) It seems a lot of mums are against the resumption of primary and secondary schools on 22 Sep 2014... [one writes]

"I am yet to receive information about confirmed (not advised/suggested) nationwide measures that have been put in place to ensure the safety of our children from the Ebola virus [disease] upon resumption at school in 2 weeks." ...

"I ask what control measures against EVD have been put in place in ALL schools, particularly the government and state schools? I visited a private school in Abuja and before we could go in, our temperatures were taken. We should remember that even if private schools are well catered for, the children of our drivers, domestic help, and "junior staff" attend public schools...

[J]ust before boarding planes (in Lagos and Abuja), passengers (adults and children) are given a rub-down. The officials checking our bodies were wearing gloves. However, the same gloves were worn while touching a good number of people. The officials were protected, but how about the passengers being touched with the gloves that had been used to touch many others? On arrival at the Abuja airport, the temperature of every passenger was taken before entry was granted into the Federal Capital Territory. Of concern is that on departure from Abuja, this was not the case. Worse still, Lagos State that had the index case of EVD welcomed us without any precautionary measures of any kind... - more
http://lindaikeji.blogspot.co.uk/2014/09/a-concerned-nigerian-mom-on-ebola-and.html

[There appears to be a need for standardization of prevention measures in schools and for domestic flights. - Mod.JW]

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

[A good map with the latest case locations and counts is available at http://healthmap.org/ebola. - Mod.JW]

Annotations

by : Timothy Muokadisease : Ebola place : West Africa Number of cases : unknown

by : Walter Ndegwadisease : Ebola place : West Africa Number of cases : 2

by : Stephen Mutuvidisease : Ebola place : West Africa Number of cases : 2

Annotation

Consult the guidelines

Disease

enter a new one

Location

enter a new one

Number
of Cases Comment

See Also

Annotations

Annotation

Consult the guidelines