From: [email protected] Date: July 31, 2014 at 18:16:10 AKDT To: [email protected], [email protected], [email protected] Subject: PRO/AH/EDR> Ebola virus disease - West Africa (108): WHO, situation, Guinea-Bissau alert Reply-To: [email protected] EBOLA VIRUS DISEASE - WEST AFRICA (108): WHO, SITUATION, GUINEA-BISSAU ALERT **************************************************************************** A ProMED-mail post ProMED-mail is a program of the International Society for Infectious Diseases In this posting: [1] WHO meeting in Guinea [2] Situation report [3] Guinea-Bissau alert ****** [1] WHO meeting in Guinea Date: Thu 31 Jul 2014 Source: ReliefWeb, WHO report [edited] The Director-General of WHO, Dr Margaret Chan, and presidents of west African nations impacted by the Ebola virus disease [EVD] outbreak will meet Friday [1 Aug 2014] in Guinea to launch a new joint USD 100 million response plan as part of an intensified international, regional and national campaign to bring the outbreak under control. The scale of the Ebola outbreak, and the persistent threat it poses, requires WHO and Guinea, Liberia and Sierra Leone to take the response to a new level, and this will require increased resources, in-country medical expertise, regional preparedness and coordination, says Dr Chan. The countries have identified what they need, and WHO is reaching out to the international community to drive the response plan forward. The Ebola Virus Disease Outbreak Response Plan in West Africa identifies the need for several hundred more personnel to be deployed in affected countries to supplement overstretched treatment facilities. Hundreds of international aid workers, as well as 120-plus WHO staff, are already supporting national and regional response efforts. But more are urgently required. Of greatest need are clinical doctors and nurses, epidemiologists, social mobilization experts, logisticians and data managers. [Do they have enough trained laboratory staff? - Mod.JW] The plan also outlines the need to increase preparedness systems in neighbouring nations and strengthen global capacities. [See more at source URL.] -- Communicated by: ProMED-mail ****** [2] Situation report Date: Wed 30 Jul 2014 [updated 31 Jul 2014] Source: CNN [edited] In Ebola virus disease [EVD] fight, security forces to make villagers comply with medical plan -------------------------------------------------------------------------------- Hundreds dead. Many more infected. Pervasive fear and denial are challenging authorities in west Africa who are trying to assess and address the EVD crisis. So far, it has killed more than 650 people, says Doctors Without Borders [MSF] [729 deaths out of 1323 cases as of 27 Jul 2014 -- see WHO update in ProMED-mail archive 20140730.2646645]. Thats the highest death toll the World Health Organization has ever recorded in an EVD outbreak. And its getting worse. The swelling numbers prompted heads of state to cancel travel plans on Thursday [31 Jul 2014] to direct their full attention toward fighting the outbreak of the virus that has crippled parts of Liberia, Sierra Leone and Guinea and stirred palpable concerns that it will spread around the region and the world. Liberian President Ellen Johnson Sirleaf and Sierra Leones President Ernest Koroma both canceled trips to the USA. State of emergency ------------------ Koroma declared a state of emergency. He announced an action plan that addressed many of the barriers international medical workers complain they face while fighting disease. Some residents in affected villages have accused them of bringing the disease into the country and have barricaded their towns or otherwise blocked access to EVD victims. A nurse with Doctors Without Borders [MSF], Monia Sayah, told CNN, the most challenging aspect of trying to help people is that we go into communities where we are not necessarily welcome, because people dont want to believe they or their loved ones have Ebola -- in part because they understand now that the survival rate is not very high. Koroma said he will deploy police and military to accompany the aid workers. They will search house to house for the infirm and enforce orders designed to curb the virus spread. [That is a time-tested way of motivating people to hide their sickness. I hope the enforcers will wear masks and gloves. - Mod.JW] What is the risk of catching Ebola on a plane? ---------------------------------------------- The matter has reached a crisis point, Liberian Information Minister Lewis Brown told CNNs Richard Quest. The dire prognosis is that it will get worse before it gets better. The dangers are so real that some humanitarian organizations are pulling out to protect their own. Samaritans Purse -- an international evangelical Christian humanitarian agency -- and the missionary group Serving in Mission [SIM] have recalled all nonessential personnel from Liberia. [SIM is managing the isolation hospital where Samaritans Purse is providing expatriate doctors.] The Peace Corps [PC] announced Wednesday [30 Jul 2014] it is doing the same, removing its 340 volunteers from that country, Sierra Leone and Guinea. While there are no confirmed cases, a spokeswoman for the agency did say that 2 PC volunteers did come in contact with someone who ended up dying from the virus. Those 2 Americans havent shown signs of Ebola but are being isolated just in case, with the spokeswoman saying they cant return home until they get medical clearance to do so. One American, 40-year-old Patrick Sawyer, died in a Nigerian hospital earlier this month [July 2014] -- having come from Liberia, where he was a top Ministry of Finance official, and before he could go back home to Minnesota. But the vast majority of those afflicted are Africans. They come from big cities and small villages, some of them falling ill without really knowing what hit them. This epidemic is without precedent, said Bart Janssens, director of operations for Doctors Without Borders, a group also known as Medecins Sans Frontieres [MSF]. Its absolutely not under control, and the situation keeps worsening. As of now, the outbreak has been confined to west Africa. But there are rising concerns that it could spread, especially since a person may not know they have EVD or show symptoms for 2- 21 days after being infected. Sawyer, for example, collapsed getting off a plane in Lagos, Nigeria. He very well could have made it out of the region, perhaps to the USA, before showing symptoms of EVD; its only then that the virus spreads. To further complicate matters, signs of EVD include fever, headaches, weakness and vomiting -- symptoms that also define many other ailments, from malaria to the flu that Brown notes often pop up at this time of year. For all these reasons and more, Janssens says, If the situation does not improve fairly quickly, there is a real risk for new countries to be affected. [Dr. Peter Piot, a discoverer of the Zaire ebolavirus and head of the London School of Hygiene and Tropical Medicine, said there was little risk of pandemic. Spreading in the population here [in the UK], Im not that worried about it, he told AFP. I wouldnt be worried to sit next to someone with ebolavirus on the Tube as long as they dont vomit on you, he said, referring to Londons underground train system. This is an infection that requires very close contact. Ebola is spread through contact with bodily fluids. .] Could the outbreak spread to the USA? ------------------------------------- Ebolaviruses spread through the transmission of bodily fluids. Those most at risk are loved ones of those infected, as well as health care workers tending to the ill. Sawyer is believed to have been infected by his ailing sister, with whom he spent time in Liberia -- even though neither likely knew she had EVD -- according to Brown. Then there are those like Dr. Sheik Humarr Khan, who fell ill early last week [22 Jul 2014] while overseeing EVD treatment at a Sierra Leone hospital and died days later. 2 Americans affiliated with Samaritans Purse who also were infected have shown a slight improvement in the past 24 hours though both are in serious condition, according to the Christian humanitarian agency. One of them is Dr. Kent Brantly, a 33-year-old who last lived in Fort Worth, Texas. He has been the medical director for the Ebola Consolidated Case Management Center in Monrovia, Liberia, where he has been providing care for patients since October [2013]. After testing positive for the virus, Brantly went into treatment at ELWA [Eternal Love Winning Africa] Hospital. The other is Charlotte, North Carolina, resident Nancy Writebol, a Serving in Mission member working with Samaritans Purse to help fight the EVD outbreak. It is believed one of the local staff was infected with EVD and came to work with the virus on 21 and 22 Jul 2014, Samaritans Purse Vice President Ken Isaacs said. That staff member died Thursday [31 Jul 2014]. We think it was in the scrub-down area where the disease was passed to both Nancy and Kent, Isaacs said. Brown, the Liberian information minister, noted Brantly and Writebols fight in his CNN interview, as well as Liberias need for more health care workers like them. We join the families in prayers that they can come through this and become ... shining examples that, if care is taken, one can come out of this. [Franklin Graham, president of the charity Samaritans Purse, said, Yesterday, an experimental serum arrived in the country, but there was only enough for one person. Dr Brantly asked that it be given to Nancy Writebol. The charity also said Dr Brantly, 33, had been given a unit of blood from a 14-year-old boy who survived EVD because of the Americans medical care. . Emory University Hospital is expected to receive a patient infected with the deadly ebolavirus within the next several days, the university announced Thursday [31 Jul 2014]... Quoting an unidentified source, CNN reported Thursday evening that a medical charter flight left Cartersville [Georgia, USA] to evacuate the 2 Americans from Monrovia, Liberia. . CDC has outfitted a Gulfstream jet with an isolation pod designed and built by the US Defense Department, the CDC and a private company. The pod, officially called an Aeromedical Biological Containment System, is a portable, tent-like device that ensures the flight crew and others on the flight remain safe from an infectious disease. (CNN -- see photo at .)] CDC alert --------- On Monday [28 Jul 2014], the CDC issued an alert, warning travelers to avoid hospitals with EVD patients and funerals for those patients in Liberia, Sierra Leone and Guinea due to the outbreak. The USA is considering raising the alert to discourage nonessential travel to those 3 countries, a spokesman said. [The CDC raised its travel warning for Guinea, Liberia, and Sierra Leone from Level 2 to Level 3 on Thursday [31 Jul 2014], warning against any nonessential travel to the region. Since 2003, the agency has only issued Level 3 alerts on 2 occasions: during the outbreak of SARS, severe acute respiratory syndrome, in 2003, and in the aftermath of the 2010 Haiti earthquake. .] Liberian President Ellen Johnson Sirleaf has told the Ministry of Health to consider quarantines in some areas and cremating bodies in an attempt to prevent further infection, according to Brown. [I do not think the country has many public cremation facilities, and I dont think funeral pyres as in India would be culturally acceptable. - Mod.JW] The president also urged residents to avoid public amusement and entertainment areas, and set aside Friday [1 Aug 2014] for the disinfection and chlorination of all public facilities. My fellow Liberians, EVD is real. EVD is contagious. And EVD kills, Sirleaf said. All of us must all take extra measures announced by the Ministry of Health to keep ourselves safe. The government will do its part. But you must do yours. [Byline: Greg Botelho, Jacque Wilson & Ben Brumfield] -- Communicated by: ProMED-mail Rapporteur Kunihiko Iizuka ****** [3] Guinea-Bissau alert Date: Wed 30 Jul 2014 Source: TVI24 [in Portuguese, machine transl., edited] Portugal sends medicines to Guinea-Bissau to prevent Ebola virus disease ------------------------------------------------------------------------ Prime Minister Domingos Simoes Pereira, Portugal, announced on Wednesday [30 Jul 2014], We have received confirmation from the Portuguese Government that it is providing 15 tons of medicines so that the Ministry of Health is able to have an emergency program and monitor the state of EVD and other potential epidemics, he said. Assistance should arrive in the country in the coming days, he said. Tomorrow [31 Jul 2013] the Council of Ministers will have specific and detailed information on all programs that the Ministry of Health considers important for the prevention of this scourge, he concluded. 6 doctors and 2 technicians from the Ministry of Public Health of Guinea-Bissau linked to water and sanitation received [in July 2014] a 5-day training on the prevention and care of the virus. The team is able to move quickly to any part of the country to give assistance in case of suspected infection. Training was given by a Spanish team of Medecins Sans Frontieres (MSF), which was in Bissau, the Guinea-Bissau capital, to deal with childrens health, but offered its services in the EVD area. -- Communicated by: ProMED-mail [Guinea-Bissau borders Guinea in the north -- see map at . TAP airlines is planning to fly direct from there to Portugal. In Nigeria there has been another scare today [31 Jul 2014]. A body was brought back from Liberia through Lagos and deposited in the mortuary at Nkwelle-Ezenaka in Oyi Local Government of Anambra state. See more at: . For a location map of Anambra state, see: . Liberia has already shut down schools and ordered most public servants to stay home from work in an effort to stop the disease spreading. The Sierra Leone football squad has, meanwhile, been prevented from travelling to the Seychelles for an African Cup of Nations qualifier because of fears over the virus. But it cannot be spread like flu through casual contact or breathing in the same air, according to experts. See more at: . The International Air Transport Association (IATA) is coordinating closely with the World Health Organization (WHO) and the International Civil Aviation Organization (ICAO) with respect to potential implications for air connectivity. WHOs current risk assessment for travel and transport is not recommending any travel restrictions or the closure of borders at points of entry. Further, the WHO states that The risk of a tourist or businessman/woman becoming infected with ebolavirus during a visit to the affected areas and developing disease after returning is extremely low, even if the visit included travel to the local areas from which primary cases have been reported. Transmission requires direct contact with blood, secretions, organs or other body fluids of infected living or dead persons or animals, all unlikely exposures for the average traveler. Tourists are in any event advised to avoid all such contacts. . In the UK, on 31 Jul 2014 it has emerged that an asylum seeker was suspected of having the deadly ebolavirus after developing symptoms within days of arriving in Britain from Liberia. The man, who was awaiting processing at an immigration centre run by security company G4S in Gatwick, was feared to be carrying the disease. Immigration staff isolated the man and tested him for ebolavirus earlier this week [of 28 Jul 2014], but he did not have the infection. However, the incident shows how easy it would be for the deadly disease to enter Britain through [immigrants]. ProMED thanks Nicholas Haley and other readers who sent press reports through the Submit Info tab at the top of the ProMED homepage. - Mod.JW] [For a map of West Africa, see .- Mod.MPP]
Posted on: Fri, 01 Aug 2014 06:03:55 +0000
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