Record Drop in Ebola Cases since June

Medic-ALL (01:29:2015)

The health world continues to get the better of the deadly Ebola virus disease with latest reports showing a significant drop in the number of cases of the disease since June, 2014 when the disease began ravaging parts of the African continent  (where many of the countries initially affected have now been declared Ebola-free) and later spread to other parts of the world including the United States and parts of Europe. This Cable News Network (CNN) report puts in perspective the road to achieving this decline in the number of cases of the deadly virus particularly in the largely affected nations of Guinea, Sierra Leone and Liberia.
Read Here
http://www.cnn.com//2015/01/29/africa/ebola-virus/index.html

Ebola: West African Nation Declared Free

Medic-ALL (01:18:2015) Healthcare News-

Ebola virus stopped in yet another West African Country

The Government of the West African nation, Mali today declared the country free of the deadly Ebola virus following a 42-day period without a new case of the disease.

Mali's Health Minister Ousmane Koné declared this in a statement in which he thanked the country's health workers and international partners for their work which helped to see a halt to the outbreak.

Countries must report no new cases for 42 days - or two incubation periods of 21 days - to be declared Ebola-free.

Mali recorded a total of seven deaths caused by the Ebola outbreak that began just over a year ago

According to World Health Organization (WHO) data the worst epidemic of the viral haemorrhagic fever on record has killed more than 8,400 people, mostly in neighbouring Guinea, Sierra Leone and Liberia.

At least 21,296 people have so far been infected with the virus worldwide.

Mali's last infected patient recovered and left hospital early last month. At one point health officials had been monitoring more than 300 contact cases.

Mali became the sixth West African country to record a case of Ebola when a two-year-old girlfrom Guinea died in October. It was close to being declared Ebola free in November before a second wave of infections.

The country now joins other West African countries Nigeria and Senegal who had been declared Ebola-free in the last couple of months.

Medic-ALL.Inc 2015

Ref: BBC, WHO

Ebola Response On Track -WHO

Medic-ALL (19:12:2014) Via MedPage Today

The response to the Ebola epidemic is on track to meet U.N. targets, the World Health Organization said in a mildly optimistic midweek situation report.
By New Year's Day, the agency said, the three hardest-hit countries will likely have the capacity to isolate and treat all cases and to bury all Ebola victims "safely and with dignity."

Guinea, Liberia, and Sierra Leone all now have more available beds than reported patients, the WHO said, although they are not distributed evenly and some regions still have "serious shortfalls." By the same token, each country has enough safe burial teams to handle all people known to have died from Ebola; however, some regions might lack enough capacity.

The U.N. goals are to have 100% of new patients under treatment by Jan. 1 and all known Ebola victims buried safely. Isolating patients breaks the chain of transmission, while safe burials -- avoiding unprotected contact with the highly infectious body of an Ebola victim -- avoid an important risk factor for new cases.
The agency also had a brighter picture of the incidence of cases, suggesting there are signs that the epidemic in Sierra Leone might be starting to slow -- even though the country reported 327 new confirmed cases in the week ending Dec. 14.
Most of the cases are in the western part of the country, with the capital, Freetown, accounting for 125 of the new cases. Teams began house-to-house searches in Freetown yesterday, seeking hidden Ebola patients, according to the BBC.
The searches are part of the so-called Western Area Surge, which aims to get Ebola patients into treatment and also to raise the number of available beds in the capital, the WHO said.

In Guinea, there has been no evident pattern in recent weeks, with the number of new confirmed cases each week fluctuating between 75 and 148. For the week ending Dec. 14, there were 76.
In Liberia, on the other hand, incidence is falling, with only six districts reporting new confirmed or probable cases in the week ending Dec. 14, although data are missing for much of the week.
The cumulative Ebola toll worldwide, to Dec. 14, is 18,603 confirmed, probable, and suspected cases in five affected countries (Guinea, Liberia, Mali, Sierra Leone, and the U.S.) and three previously affected countries (Nigeria, Senegal, and Spain), the agency said.

The U.S. has not had a new Ebola case since Craig Spencer, MD, was reported to be be cured Nov. 9; the country can be declared free of the disease Sunday, which will be 42 days after Spencer tested negative.
Mali also appears to have controlled the disease; all of the contacts of the country's eight confirmed and probable Ebola patients (six of whom died) have now passed the 21-day incubation period without developing the disease.


The last patient tested negative for the disease Dec. 6.

The WHO also reported, for the first time, population-based Ebola rates for Guinea, Liberia, and Sierra Leone:

In Guinea, there have been 22 reported cases and 14 deaths per 100,000 people, with a cumulative total of 2,416 cases and 1,525 fatalities.

Liberia has had 197 reported cases and 83 deaths per 100,000 population, with a total of 7,790 cases and 3,290 deaths.

And Sierra Leone has had 145 cases and 36 deaths per 100,000 people, for a total of 8,356 cases and 2085 deaths.

Meanwhile, researchers are reporting that laboratory tests show that 53 existing and approved drugs have the effect of blocking ebolavirus entry to target cells.

The list includes a wide range of drug classes: microtubule inhibitors, estrogen receptor modulators, antihistamines, antipsychotics, pump/channel antagonists, anticancer drugs, and antibiotics, according to Adolfo Garcia-Sastre, PhD, of the Icahn School of Medicine at Mount Sinai Hospital in New York City, and colleagues.
But more experiments will be needed to understand how useful any of the compounds might be, Garcia-Sastre and colleagues cautioned in Emerging Microbes and Infections.

The work is a positive step, commented Ben Neuman, PhD, of England's University of Reading, who was not part of the study.
The research "extends the list of drugs that are safe to use in people, and have been shown to interfere with Ebola in the lab," he said. But, he added, "it takes a lot to stop Ebola and none of the drugs identified in this study has been shown to protect an experimental animal yet."

"We now have a longer list of things that might work, but the list of things that definitely will work still unfortunately stands at zero," Neuman said.
Indeed, there is little evidence of efficacy even for the drugs that have been used experimentally during this current outbreak, according to the European Medicines Agency, which is conducting a continuing review of them.

The agency is looking at such medicines as brincidofovir, favipiravir, TKM-100802, and ZMapp -- all used to treat one or more patients -- but there is nothing to be said so far about their efficacy, according to an interim report.
"Treatments for patients infected with the Ebola virus are still in early stages of development," an agency spokesman said in a statement. "We encourage developers to generate more information on the use of these medicines in the treatment of Ebola patients."

Ref: World Health Organization
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Ebola: Poorer Economies Lose Out

Medic-ALL (23:11:2014) by Kayode Kuku

Having devoted a good percentage of posts on this blog to news on the ravaging impact of the Ebola virus epidemic over the last couple of months, the varying degrees of successes achieved in containing the deadly disease in different parts of the world seems to point indispuatably but not entirely to the inequality in healthcare systems.

Now we know that Ebola had been in existence as early as nearly 4 decades ago, with outbreaks in Sudan and Zaire occurring between June and November 1976. But asides from laymen hearing of "Ebola" in some Hollywood movies or medical students reading a few lines about the disease in their medicine notes, not even the March 2014 outbreak in Guinea  reported by the World Health Organization attracted any real attention either from the media or the World's biggest economies. It can easily be inferred by the closest observers that Ebola in Africa was not taken seriously until it entered into the commercial capital of one of Africa's biggest economies and one of the World's Biggest crude oil producing countries in Nigeria.

About a week following the entry of the Ebola-infected Liberian into Nigeria in July 2014, The WHO On 8 August 2014, the declared the epidemic to be an international public health emergency. Urging the world to offer aid to the affected regions, the Director-General said, "Countries affected to date simply do not have the capacity to manage an outbreak of this size and complexity on their own. I urge the international community to provide this support on the most urgent basis possible. This was after about 4 months of the disease ravaging the West African countries of Guinea, Sierra Leone and Liberia with death toll rising, about 1000 as at early August.


The truth is that the disease which is said to have entered into West Africa in December 2013, had unfortunately hit , "3 of Africa's Poorest economies" (to borrow the CNBC Africa headline from September 2014). The reality of this is that Ebola choose countries whose contributions to the Global Gross Domestic Product could easily be considered negligible by most. In a blog post in August "The Economics of Ebola",
The Liberian Finance Minister, cited the international aid of $200 million recieved via the specially set-up Ebola Fund established by the World Health Organization and World Bank in August to provide support for the 3 West African Countries. The question is how much attention would the the deadly disease have received if the countries affected were some of the region's biggest economies.

The disease however continues to have huge economic impacts even in this so-called poor economies with Ebola itself directly costing the governments of these countries increasingly. The factors  contributing to the growing cost of Ebola include direct costs of the illness (government spending on health care) and indirect costs, such as lower labor productivity as a result of workers being ill, dying or caring for the sick.

But the majority of the costs stem from the higher costs of doing business within countries or across borders. These are largely due to “aversion behavior”, or changes in the behavior of individuals due to fear of contracting the disease, which has also left many businesses without workers, disrupted transportation and led to restrictions on travel for citizens from the afflicted countries.

According to the latest World Bank group report, if the Ebola epidemic is contained by the end of 2014, the economic impacts on West Africa, including on Guinea, Liberia and Sierra Leone, could be lessened and economies would begin to recover and catch up quickly. If the crisis continues into 2015 as predicted, slower growth could cost the region $32.6 billion over 2014 and 2015 and lead to much higher levels of poverty.

There is no doubt that the inadequacies of the health-care systems in the three most-affected countries help to explain how the Ebola outbreak got this far. Spain spends over $3,000 per person at purchasing-power parity on health care; for Sierra Leone, the figure is just under $300. The United States has 245 doctors per 100,000 people; Guinea has ten. The particular vulnerability of health-care workers to Ebola is therefore doubly tragic: as of November 18th there had been 588 cases among medical staff in the three west African countries, and 337 deaths. The hope for these countries therefore lies in the hands of some of the world's bigger economies (who may not necessarily benefit in anyway from the epidemic stricken countries) to help their healthcare sysytem and invariably the "receeding" economy.

Refs: The Economics of Ebola (Medic-ALL blog)

The Economist 

TheWorldBank.org

Nigeria Declared Ebola-Free by WHO

Medic-ALL (20:10:2014) by Kayode Kuku

With no new cases of Ebola reported in Nigeria over the last 42 days, the World Health Organization (WHO) today declared the country "Ebola Free", a sign of how the deadly virus could have been easily contained had the other West African countries ravaged by the disease acted swiftly.

There haven’t been any cases of Ebola in 42 days, said WHO Country Representative Rui Gama Vaz in a news conference in Abuja, Nigeria’s capital.

“The last chain of transmission has been broken. The disease is gone,” said Dr. Vaz. “This is a spectacular story, that Ebola can be defeated.”

This is following an announcement that Senegal is also rid of the virus.

The entire world and health officials particularly were concerned of a possible worldwide outbreak  and wary of the spread throughout the world when a Liberian-American "transported" the virus into Nigeria when he flew into Lagos, the Country's most populous city with a population of about 21 million people late July.

A different story has been unfolding in Liberia, Sierra Leone, and Guinea, whose governments didn’t notice Ebola had arrived in their interiors until March, four months after the disease first erupted in rural Guinea late last year.

More than 4,500 people are known to have died from the disease in those countries, the WHO says. Thousands more are thought to have contracted it without ever being tallied in the United Nations health agency’s records.

Meanwhile the United States continue to put in place measures to ensure the diseses which has so far been confirmed in 3 persons in the U.S. 43 contacts of the country's first Ebola case, Thomas Eric Duncan have been cleared after not developing any symptoms following a 21-day period in quarantine, while 4 others are close to the end of the isolation period.

 Reports from Spain, reveal that the nurse's aide has also beaten Ebola after spending weeks hospitalized with the disease.

Ref : Wall Street Journal

Related posts: Yes!! Nigeria, Ebola Free

Ebola In America: Nigerian Flight raises Fears

Medic-ALL (17:10:2014)

A man died on a plane from Nigeria landing at Kennedy Airport in Queens early Thursday, sparking fears that the deadly Ebola virus had finally touched down in New York, sources said.

Unnamed man aboard an Arik Air flight from Lagos, Nigeria, died an hour before the plane landed at Kennedy Airport

.

Centers for Disease Control and Health Department members in protective gear swarmed the Arik Air flight landing at JFK’s Terminal 4 after the 63-year-old man, a U.S. citizen, died on the plane about an hour before landing at 5:45 a.m.

The Arik air plane had departed from Lagos, officials said.

The man, who was traveling alone, was vomiting profusely and complaining of chest pains before he died of an apparent heart attack, a Port Authority source said.

Passengers were held on the plane for about 45 minutes after arrival as CDC officials determined that the dead passenger didn’t have the disease that’s infected more than 7,500 people in the West African countries of Liberia, Sierra Leone, Guinea and has recently surfaced in Dallas.

The United States has recently been hit by the deadly Ebola virus that has ravaged parts of West Africa in the past months with three cases diagnosed on U.S soil and five others infected in the West Aftrican outbreak treated in the U.S.

About  3400 people have died from the outbreak as the world continues to fear a pandemic.

Ref: DailyNews, New York

Ebola: Containing The Spread...How Feasible?

Medic-ALL (13:10:2014) by Kayode Kuku

Nearly 3 months ago, the news of a Liberian-American infected with the Ebola virus entering into Africa's most populous nation, Nigeria filled the air and the spotlight was on the African continent, particularly the West African countries; Guinea, Sierra Leone and Liberia that had been ravaged by the outbreak of the  deadly disease many months before one of Africa's biggest economies was hit by the news of the "immigrant" index patient ; a remarkable 38 years after the first recorded outbreak in the Democratic Republic of Congo in 1976.

Fears were raised at the time as to the the likelihood of the virus to spread to other parts of the world as many believed the alarming spread in the lesser developed West African countries may have been due to sub-standard level of their healthcare systems. 

HOW MUCH ATTENTION AND ASSISTANCE DID THIS COUNTRIES REALLY GET FROM THE INTERNATIONAL COMMUNITY before the Nigeria incident was reported late July?

In a Medic-ALL blog post titled "Ebola; Will it Keep Spreading" at the outset of the now aborted outbreak in Nigeria, it was reported that Public health experts expect the virus to reach other parts of the world including the United States but unlikely to spread in regions with well-funded hospitals and standard infection-control procedures. Barely months later and the news of the first case diagnosed in the United States and then another case of an infected healthworker in Spain were reported, raising worldwide fears of a pandemic if more austere measures are not in place to contain the virus and its spread from continent to continent. ARE WE REALLY WINNING ?

More disturbing news emanated yesterday, with the United States confirming a second case involving a female nurse at the Texas Health Presbyterian Hospital infected as a result of an unknown breech in hospital Protocol and was confirmed positive for the virus on Sunday afternoon according to the CDC. She is said to have attended to Duncan (the first U.S patient) after his second visit to the emergency room on September 28 and followed all CDC precautions including wearing of masks ,gowns, gloves and protective face shield. The CDC's Thomas Frieden in a statement outlined several steps taken to care for the health worker and prevent the infection of others, he however said more cases of the deadly virus may be likely.

There is no doubt that we are dealing with a highly transmissible and truly lethal disease that deserves worldwide attention. The question of whether the virus will "Keep spreading" seems to be getting answered on a daily basis and the staggering figures of the lives that have been claimed so far, particularly in the West African region is enough to put the whole world on our toes.

Containing the spread of the virus in countries with reported cases is most paramount at this stage and it is obvious that this will require not just a "well-funded healthcare system" but a step up in our standard infection-control procedures worldwide, as Frieden highlighted that taking off protective equipment- gowns, gloves, face masks and goggles is one of the greatest areas of contamination and risk. Certainly there is need for a new note of urgency to this outbreak , this cannot be over-emphasized.

Medic-ALL.Inc 2014 

WHO: Ebola Surging Beyond Control

Medic-ALL(13:09:2014) via CBC News:

Ebola virus cases in West Africa are rising faster than the ability to contain them, the World Health Organization says, as experts warn that the exponential rise could become a worldwide disaster.

The death toll has risen to more than 2,400 people out of 4,784 cases, WHO director general Margaret Chan told reporters at the UN health agency’s headquarters in in Geneva on Friday, noting the figures could be an underestimate.

In the three hardest hit countries, Guinea, Liberia and Sierra Leone, the number of new patients is moving far faster than the capacity to manage them. We need to surge at least three to four times to catch up with the outbreaks," Chan said.

She called for urgent international support in the form of doctors, nurses, medical supplies and aid to the worst-affected countries.

Health-care workers have been infected with Ebola while treating patients in West Africa. Almost half of the 301 health-care workers who have developed the disease have died.

Chan welcomed Cuba's announcement that it will send 165 health-workers to fight the outbreak , but added that at least 500 doctors from abroad are needed.

An infectious disease expert warned in Friday’s New York Times that "the Ebola epidemic in West Africa has the potential to alter history as much as any plague has ever done."

Michael Osterholm is the director of the Center for go backrian aid from countries and non-governmental groups. Disease Research and Policy at the University of Minnesota.

Ebola spreads through direct contact with bodily fluids, but Osterholm raised a possibility that he said virologists are loath to discuss openly but consider behind closed doors: the prospect that the Ebola virus could mutate to become transmissible through the air.

Osterholm cites a 2012 study by researchers at the National Microbiology Laboratory in Winnipeg that showed the Ebola Zaire strain behind West Africa’s outbreak could spread by the respiratory route between pigs and monkeys.

The key to containing the outbreak, Osterholm stressed, is to beef up efforts to stop the spread of the virus.

To that end, he suggested that the United Nations take over the position of "command and control" to direct the efforts of medical, public health and humanitarian aid from countries and non-governmental groups.

Culled from CBC News

WHO: Ebola Death Toll, over 1900

Medic-ALL (03:09:2014):

According to the World Health Organisation, over 1,900 people have now died in West Africa’s Ebola outbreak.

WHO Director-General,  Margaret Chan MD said there were 3,500 confirmed or probable cases of the deadly virus in Guinea, Sierra Leone and Liberia.

“The outbreaks are racing ahead of the control efforts in these countries,” she said.

On Thursday the WHO, will be holding a meeting to examine the most promising treatments and to discuss how to fast track their testing and production.

Disease control experts, medical researchers, officials from affected countries, and specialists in medical ethics will all be represented at the meeting in Geneva.

The WHO has previously warned that more than 20,000 people could be infected before the outbreak of the virus is brought under control.

Dr Chan described the outbreak as “the largest, most severe and most complex we have ever seen”.

“No one, even outbreak responders with experience dating back to 1976, to 1995, people that were directly involved with those outbreaks, none of them have ever seen anything like it,” she said.

Forty per cent of the deaths have occurred in three weeks leading up to September 3, the WHO says.

Ref: WHO media centre

Ebola: New Cases unrelated to West African Outbreak

Medic-ALL (02:09:2014),Courtesy Forbes by David Kroll

The World Health Organization(WHO) has just confirmed that the newly-identified cases of Ebola Virus Disease (EVD) in the Democratic Republic of Congo is genetically unrelated to the strain currently circulating in Liberia, Guinea, Sierra Leone, and Nigeria.

A WHO collaborating research center in Franceville, Gabon, the Centre International de Recherches Médicales, had previously identified six Ebola positive samples sent to the laboratory. They report today that, “the virus in the Boende district is definitely not derived from the virus strain currently circulating in west Africa.”

The finding is worthy of such emphasis because of concerns that the west African outbreak had somehow spread to the DRC, formerly Zaire. The viruses in each outbreak are genetically distinct, but they are both of the Zaire species of Ebola virus, a fact that might be confused as meaning the outbreaks are related.

We know previously, that there are 5 strains of the deadly Ebola virus  which has being ravaging the Aftican continent, particularly the West African sub-region over the past few weeks.

The new outbreak of Ebola in the Democratic Republic of Congo is unrelated to the ongoing west African strain of the disease. (Credit: Wikimedia Commons user Vardion, CC BY-SA 3.o License)

The form of the Zaire virus currently The index case has been clearly identifiedas a pregnant woman from Ikanamongo Village who died on August 11 after preparing bushmeat that her husband had hunted.

The means of viral spread, as reported by the WHO, is typical of most Ebola outbreaks: “Local customs and rituals associated with death meant that several health-care workers were exposed and presented with similar symptoms in the following week.”

Thus far, the WHO has identified 53 cases consistent with a diagnosis of Ebola, including 31 deaths. Seven of the dead were healthcare workers.

But the WHO stressed that the outbreak is primarily occurring in a remote region of the DRC, about 750 miles from the capital of Kinshasa. in the DRC is most closely related to one responsible for an outbreak in 1995 in the city of Kikwit. Ebola virus first emerged in the DRC and South Sudan in 1976. The current outbreak in the DRC is the seventh on record.

Medic-ALL. inc 2014

Ebola: CDC in talks with Nigeria over Human trial as suspected cases rise

Medic-ALL (01:09:2014)

There are strong indications that officials from the Centers for Disease Control and Prevention (CDC) in USA are in talks with health officials in Nigeria about the prospects for conducting a phase 1 safety study of the Ebola vaccine among healthy adults in the country amid mounting anxiety about the spread of the deadly virus in West Africa, according to the National Institutes of Health (NIH).

The pace of human safety testing for experimental Ebola vaccines has been expedited in response to the ongoing virus outbreak in West Africa which has impacted negatively on businesses in the three affected countries of Liberia, Sierra Leone and Guinea, with neighbouring countries closing their borders and banning flights from affected countries to other parts of Africa.

NIH explained that “the early-stage trial will begin initial human testing of a vaccine co-developed by NIAID [National Institute of Allergy and Infectious Diseases] and GlaxoSmithKline (GSK) and will evaluate the experimental vaccine’s safety and ability to generate an immune system response in healthy adults. Testing will take place at the NIH Clinical Center in Bethesda, Maryland, USA.”

The experimental vaccine is expected to first be given to three healthy human volunteers to see if they suffer any adverse effects. If deemed safe, it will then be given to another small group of volunteers, aged 18 to 50, to see if it produces a strong immune response to the virus. All will be monitored closely for side effects.

It is understood that the vaccine will be administered to volunteers by an injection in the deltoid muscle of their arm, first in a lower dose, then later in a higher dose after the safety of the vaccine has been determined.

Anthony Fauci, NIAID director, explained that there is an urgent need for a protective Ebola vaccine, as it is important to establish that a vaccine is safe and spurs the immune system to react in a way necessary to protect against infection.

“We know the best way to prevent the spread of Ebola infection is through public health measures, including good infection control practices, isolation, contact tracing, quarantine, and provision of personal protective equipment. However, a vaccine will ultimately be an important tool in the prevention effort. The launch of phase 1 Ebola vaccine studies is the first step in a long process.”

Preclinical studies that are usually carried out on such drugs were waived by the FDA (Food and Drug Administration) during the expedited review and care is being taken to go slowly, particularly as it pertains to the dosing .

Meanwhile, the number of suspected cases in Nigeria has continued to rise after one of the initial contacts of the Liberian-American-Sawyerr, a Nigerian Diplomat working with ECOWAS, Olu-Ibukun Koye who was said to have escaped from quarantine and traveled to Rivers State in the Southern Part of the country. Where he was attended to by a now late medical doctor, Dr Enemuo, who died a few days afterwards and whose corpse tested positive to the deadly virus. The late doctor's wife and other possible contacts in the Southern State have now being placed under quarantine.

Ref: BusinessDay

Medic-ALL.Inc 2014

Ebola Travel: South Africa bans West African incomers

BBC  (21:08:2014):

South Africa says non-citizens arriving from Ebola-affected areas of West Africa will not be allowed into the country, with borders closed to people from Guinea, Liberia and Sierra Leone.

Passenger being screened at the Kenyan airport, a common transit point for African travellers

All non-essential outgoing travel to the affected countries has been banned.

Senegal also said it was suspending flights with Ebola-affected countries, and closing the border with Guinea.

Cameroon and the Ivory Coast earlier imposed travel bans, despite World Health Organization warnings not to.

Medium-risk

South African nationals will be allowed to re-enter the country when returning from high-risk countries, but will undergo strict screening, the health ministry said on Thursday.

Usual screening procedures are in place for those who travel between Nigeria, Kenya and Ethiopia, which have been defined as medium-risk countries.

Nigerian Airport: screening processes stepped up

South Africa has experienced two Ebola scares in recent weeks, involving passengers arriving from Liberia and Guinea, but the country has so far remained Ebola-free.

Johannesburg has one of the major transit airports, connecting southern Africa with the rest of the continent. Several airlines, including British Airways and Emirates Airlines, have stopped flights to some of the affected countries.

Meanwhile, Senegal's interior ministry announced on Friday it was closing the land borders with Guinea "once again".

Senegal shut its border with Guinea for the first time in March after the virus reached the capital Conakry.

In a statement, it said this extends to "air and sea borders for aircraft and ships from the Republic of Guinea, Sierra Leone and Liberia".

AU team

Separately, the African Union (AU) announced plans to send a special team to the four affected countries.

The six-month-long operation, involving volunteer doctors, nurses and medical personnel, will cost about $25m (£15m) and begin immediately, the AU said in a statement.

Aid workers and medical staff are most exposed to the virus, and have been most at risk of becoming infected.Two US aid workers were discharged from hospital on Tuesday, after recovering from the virus they contracted in Liberia.

The supply of the experimental drug used to treat the couple, ZMapp, has been exhausted.

As Ebola has no known cure, it is being controlled by isolating victims and those who have come into contact with them.

Liberia's attempt to prevent the spread of the virus by imposing quarantines has led to unrest.

Medic-ALL.Inc 2014

Ebola Contaimment: A Rare piece of Good News from Nigeria

BusinessDay (19:08:2014):

In the midst of the gloomy news that Nigeria is often associated with comes a ray of hope that the country can indeed get things right when its officials and people put their hearts to work.This is the story emerging from the handling of Ebola outbreak in West Africa, where Nigeria’s officials have been able to contain its spread in Africa’s most populous country with over 168 million people.

This response has received huge commendations from the United Nations Population Fund (UNFPA) and the international community.

Following fear and anxiety the lethality of the Ebola outbreak has generated since it came into the country through late Patrick Sawyer, a Liberian-American, on July 20, 2014, Nigeria is racing to halt Ebola Virus Disease (EVD) from spreading, including tracing individuals known to have had contact with confirmed cases, training health care professionals to identify EVD, and raising public awareness of symptoms.

This cheery news comes as contact tracing in Nigeria has resulted in a range of between 94 percent and 98 percent of contacts of EVD cases being identified and followed up, according to the World Health Organisation (WHO).

With Nigeria recording 12 confirmed EVD cases, this development comes as a relief and provides a window to wipe out the disease before it gets out of control, as it has in Guinea, Liberia and Sierra Leone, claiming 1,066 lives, with 1,963 EVD cases confirmed since the outbreak began in December 2013. Onyebuchi Chukwu, minister of health, had announced yesterday that four additional confirmed cases of EVD who had been managed successfully and were now disease-free had been discharged.

“The four persons include two male medical doctors and one female nurse. The three participated in the treatment of the index case, while the fourth person was a female patient at the time the index case was on admission,” a statement from the ministry said.

This brings to five the total number of patients diagnosed with EVD who have now been discharged from hospital.

On the Federal Government’s containment efforts, Chukwu told BusinessDay that state governments were urged to institute a communication strategy to ensure mass awareness creation and sensitisation for individuals and communities on EVD in a bid to halt the spread of the disease. Federal and state ministries of health and the human services secretariat of the FCT administration were also directed to provide adequate incentives to health workers participating in the management of EVD patients, he said.

Chukwu said Nigeria’s partnership with WHO, UNICEF, the United States Centre for Disease Control and Prevention (CDC), local authorities and international partners in the area of technical capacity, health facilities for isolation of EVD patients and other containment efforts was aimed at halting EVD spread.

“The Ministry of Health is procuring isolation tents to quicken the pace of providing isolation wards in all states of the federation and the Federal Capital Territory. We are also setting up a special team to provide counselling and psychosocial support to patients, identified contacts and their families,” Chukwu explained.

“189 persons are under surveillance in Lagos and six persons under surveillance in Enugu. All the persons under surveillance were secondary contacts. All the patients under treatment have now moved to the new 40-bed capacity isolating ward provided by the Lagos State government. Additional equipment has also been made available to the new isolating ward by the Federal Government,” he said.

Chika Mordi, CEO, National Competitiveness Council of Nigeria, said Nigeria has done creditably well in containing the spread of EVD in the country. While Nigeria is perceived in the international community not to have functional institutions, Mordi said the case management of EVD in Nigeria has proven that the nation has functional institutions.

He said “If you compare the way Nigeria have handled the case of EVD outbreak when compared to other Ebola affected countries within the West-African sub-region, you will agree that we have done an excellent job. We can also improved upon the success.

“You may remember that the outbreak started in Guinea and then spread to neighbouring Sierra Leone and Liberia. Remember that the index case who brought EVD into Nigeria was visibly ill when he stopped over in Togo and yet Togo said they dont have any case of EVD. Ivory Coast which borders Guinea say they dont have EVD cases.

Don’t forget that in the last few months, Nigeria has been on the front burner on CNN and other news channels in the area of insecurity, suggesting that we don’t have functional institutions. The way we have effectively managed EVD in Nigeria suggests that the country has functional systems in place which could be improved upon.”

Another impressed observer of Nigeria’s handling of the Ebola outbreak narrated his experience at the Murtala Muhammed International Airport, Lagos yesterday. He said, “I was at the airport this morning (yesterday) to see off a relation and as she went in to board, she and other passengers were screened by health officials who not only checked their temperature but asked questions like how they felt, where they had been and it was damn effective. A rare case of us doing the right thing. I was so impressed and it shows how far we can go if we do the right things.

Babatunde Fashola, Lagos State governor, said the government was not shying away from its primary purpose of protecting and saving lives, as the state House of Assembly had approved additional expenditure to fund efforts at containing the spread of the disease. “My view of the fact that we are gaining control is informed by verifiable facts that I receive daily from our health workers that all the cases of those who have either unfortunately died, or those who are sick, and those who are contacts under surveillance are directly traceable to the imported case. This is encouraging news from which our containment strategy can profit greatly; because it means that we do not have any case of unknown origin, which will raise the risk of an epidemic,” Fashola said.

Adebayo Onajole, director of communication and community mobilisation for Ebola in Nigeria, said the country had been able to contain the spread through increased surveillance at the country’s borders (air, land and sea), increased awareness and less of disinformation of the disease in the country.

Onajole, who is also a consultant public health physician, noted that universal health precautions and personal hygiene were currently being encouraged, a situation  that would halt the spread of the disease.

“Efforts are currently ongoing to scale up and strengthen all aspects of response, including contact tracking, public information and community mobilisation, case management and infection prevention and control, and coordination,” he said.

“There is now increased disease surveillance system in a bid to monitor, control, and prevent any occurrence of the disease,” he added.

Five committees have been put in place in the country to halt the spread of the disease, BusinessDay investigation reveals. These committees include contact tracing (responsible for tracing contacts of infected person), case management unit (responsible for managing established cases), and point of entry unit, which is charged with the responsibility of examining persons entering Nigeria from various borders.

Besides the Federal Government’s N1.9 billion Ebola Intervention Plan announced by President Goodluck Jonathan, Aliko Dangote, chairman, Dangote Group, announced the donation of over N150 million from Dangote Foundation for the establishment of a National Ebola Emergency Operations Centre (EOC) at Yaba, Lagos.

The EOC is a key part of Nigeria’s response to the outbreak of Ebola on its shores. Headed by Faisal Shuaib, a US-trained public health expert with extensive international experience, the centre serves as the engine room of national response, providing a coordinating mechanism for prevention, surveillance, patient care, tracking, data analysis and containment of the spread of the virus.

It also facilitates coordination of partners, serves as a platform to link to the medical community across the country and also internationally, especially with countries also battling the virus in West Africa.

Public health experts believe EVD can be stopped through maintaining high effective control mechanism and communication within communities on proper hygiene practice.

“We do know how to stop Ebola. Its old-fashioned plain and simple public health: find the patients, make sure they get treated, find their contacts, track them, educate people and do infection control in hospitals,” said Thomas Frieden, director, United States Centre for Disease Control and Prevention.

By Alexander chiejina