Is Sex Bringing Ebola Back?

Medic-ALL (03:29:2014) -DISEASE

Its been a year long outbreak of the deadly Ebola virus and whilst the whole world looked back at the losses and lessons from the epidemic this past year, the virus appears to be making an unheralded comeback.

On Friday, in Liberia (one of the hardest hit countries alongside Sierra Leone and Guinea) , a 44 year old victim of the deadly virus was reported dead. There are indications that the new case may have occured via sexual transmission from a survivor she was said to be dating. Additional tests are being carried out to confirm this.

Research has shown traces of Ebolacan remain  in the  semen of some survivors for at least 82 days after the onset of symptoms. There is no conclusive scientific proof these traces are infectious. But anecdotal evidence in the latest case, and several others in West Africa, along with and confirmed transmission of Marburg, another viral hemorrhagic fever, have led experts to warn of the potential risk of sexually transmitted Ebola.

The World Health Organization, as a precautionary measure, advises Ebola survivors to abstain from sex during a 90-day period following recovery. At the very least, they should practice safe sex.

The case threatens to undermine the country's efforts to end a year long outbreak which has claimed over 10,300 lives across the African continent.

The country was on it's way to completing a 42-days period without a new case of the disease, which is necessary to declare the country free of the disease when it recorded the recent case.

Ebola continues to spread in Africa, though not as bad as it was some months ago. 79 new cases were reported last week. 

Though, it was known that Ebola was largely transmitted through body fluids of close contacts, no case of transmission via sex had been previously documented. 

Ref: World Health Organization, NBCNews

    

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

Flu Deaths hit Epidemic threshold

Medic-ALL (01-04-2015) via MedPage Today's Michael Smith

The year 2014 ended with the Center for Disease Control and Prevention, CDC reporting the onset of the dreaded flu season, with the proportion of deaths attributed to pneumonia and influenza reaching the epidemic level.

In the week ended Dec. 20, 6.8% of all deaths observed through the agency's 122 Cities Mortality Reporting System were attributed to pneumonia and flu.

That matches the epidemic threshold for week 51 of 2014, calculated to be significantly higher than a seasonal baseline that uses data for the same week in the previous 5 years, the CDC reported.
At the same time, the rate of influenza-like illness, reported as a percentage of outpatient visits, is elevated both nationwide and in all 10 of the CDC's surveillance regions, the agency said in its weekly flu report.
The proportion of respiratory specimens testing positive for the flu was 28.1% nationally, with a range from 11.3% to 35.9%.

As well, the CDC said, there were four pediatric deaths associated with the flu in week 51, leading to a cumulative total of 15 since the week ending Sept. 28.
Most of the circulating flu is influenza A (H3N2), with a small amount of A (pH1N1) -- the strain responsible for the 2009-2010 pandemic. Only 2.7% of tested samples are influenza B.

Within the 2,023 influenza A samples that were subtyped in week 51, all but one were H3N2, the agency reported.

Flu seasons in which H3N2 virus predominates are usually more severe, and the CDC has previously noted that most of the H3N2 flu that is circulating does not match the H3N2 component of the seasonal vaccine. That continued to be the case in week 51, the agency said.

Those two factors could combine to make this an unusually harsh flu season, but, on the positive side, all of the tested samples, regardless of subtype or strain, were susceptible to neuraminidase inhibitors such as oseltamivir (Tamiflu) and zanamivir (Relenza).

Medic-ALL.inc 2015
medicallblog@gmail.com

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

Sadly, Doctor loses Ebola Battle, Dies in Omaha

Medic-ALL (17:11:2014) Courtesy New York Times 

WASHINGTON — This time, the challenge of Ebola was much steeper for the doctors and nurses at Nebraska Medical Center, one of a handful of hospitals specially designated to handle cases of the deadly virus in the United States.

Unlike the two Ebola patients they had successfully treated earlier this year at the hospital’s biocontainment unit in Omaha, the man who arrived from Sierra Leoneon Saturday, Dr. Martin Salia, was in extremely critical condition. Dr. Salia, a legal permanent resident of the United States who had been working as a surgeon in Sierra Leone, died early Monday morning, barely into his second day of treatment, but almost two weeks into his illness.

The Late Dr Martin Saila

“Even the most modern techniques that we have at our disposal are not enough to help these patients once they reach a critical threshold,” said Dr. Jeffrey P. Gold, chancellor of the University of the Nebraska Medical Center, the hospital’s academic partner.

Dr. Philip Smith, the medical director of the biocontainment unit, said that Dr. Salia, 44, had initially been tested for Ebola in Freetown, the capital of Sierra Leone, on Nov. 7, but that the test came back negative. He was retested there on Nov. 10, at which point the results were positive. Dr. Smith said such false negatives were not uncommon early in the illness.

Dr. Daniel W. Johnson, a critical care specialist at Nebraska Medical Center, said that Dr. Salia’s kidneys had stopped functioning and that he was laboring to breathe when he arrived at the hospital late Saturday afternoon after a 15-hour flight. Doctors quickly tried two treatments they had used on their other Ebola patients: an experimental antiviral drug and a plasma transfusion from theblood of an Ebola survivor, which researchers believe may provideantibodies against the virus.

But Dr. Salia was already so ill that within hours of his arrival at the hospital, he needed continuous dialysis to replace his kidney function. By the pre-dawn hours of Sunday, he was in respiratory failure and needed a ventilator, Dr. Johnson said on Monday. Around the same time, he added, Dr. Salia’s blood pressure plummeted.

“He progressed to the point of cardiac arrest, and we weren’t able to get him through this,” Dr. Johnson said at a news conference in Omaha. “We really, really gave it everything we could.”

Dr. Smith said he did not know how Dr. Salia had contracted the virus. “He worked in an area where there was a lot of Ebola disease, much of it probably unrecognized,” Dr. Smith said, “and there were many opportunities for him to have contracted it.”

In the frenetic neighborhood of Kissy, on the eastern end of Freetown, an eerie quiet hung over the United Methodist Hospital on Monday as news spread that Dr. Salia had died. He was the chief medical officer and the only surgeon at United Methodist Kissy Hospital, according to United Methodist News Service.

Leonard Gbloh, the administrator of the hospital, said he did not think Dr. Salia could have contracted Ebola there.

“We have not been taking Ebola patients here” he said. “And we had stringent control measures in place to prevent it entering.”

The hospital even stopped all surgical work several months ago as a precaution, Mr. Gbloh said. Now, the hospital is being decontaminated and several staff members who came into contact with Dr. Salia after he fell ill are in quarantine there.

U.S free of Ebola case as New York Doctor is Cleared!

Washington Post (10:11:2014) by Mark Berman

The doctor who contracted Ebola in West Africa before returning to New York City has been declared free of the virus, hospital officials announced Monday. This news means that 41 days after the first Ebola diagnosis in the United States, there are no known cases of the virus in the country.

Craig Spencer, 33, who had been treating Ebola patients in Guinea, was diagnosed with Ebola on Oct. 23. Bellevue Hospital Center in New York City, where Spencer was being treated, confirmed in a statement Monday that he “has been declared free of the virus.” Spencer will be discharged on Tuesday, according to the hospital. (News of his release was first reported Monday by theNew York Times.)

Spencer’s diagnosis created concerns in New York, as the news of his illness was followed by the revelation that he visited a popular restaurant and coffee shop, rode multiple subway lines and went to a bowling alley and bar in Brooklyn. As city officials preached caution and calm,“disease detectives” fanned out to visit the places Spencer had gone and visit the people with whom he had interacted.

After returning to New York, Spencer had been self-monitoring and taking his temperature. He reported a fever of 100.3 degrees on Oct. 23, two days after he began feeling sluggish, and was taken to the hospital and isolated. He was the fourth person diagnosed with Ebola in the United States and the only one of this group to contract the disease after treating patients overseas. (Other people responding to the epidemic in West Africa have been diagnosed and brought back to the country for treatment.)

His diagnosis also sparked a panic among authorities, as the governors of New York and New Jersey hurriedly announced that they would quarantine any medical workers returning from West Africa, a highly-criticized move that went against the advice of public-health officials. This drama spilled up the East Coast, as a nurse who had treated patients in West Africa (and had no symptoms of Ebola) was quarantined in New Jersey and had a prolonged confrontation with authorities in Maine over her treatment.

The first person diagnosed in this country, Thomas Duncan, was a Liberian man who contracted it before flying to Texas in September; two nurses who treated Duncan were infected during his hospitalization. Duncan died eight days after he was diagnosed, becoming the only person to die from Ebola in the United States, while the Texas nurses who contracted Ebola were both treated and declared safe. The news that Spencer was cleared came three days after the last person being monitored for Ebola in Texas was also cleared, ending the Ebola saga there.

More than 350 people were being actively monitored by the New York City health department for Ebola as of last week, the department said in a statement. Most of these people had traveled to New York City from Liberia, Guinea or the Sierra Leone, but that number also included Bellevue staff members treating Spencer and lab workers who took his blood.

Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said Monday that people should be reassured by the fact that tried-and-true approaches, such as contact-tracing and active monitoring, have helped to prevent broader transmission of the disease in the United States.

“In fact, it has worked,” he said, noting that contacts of patients in Dallas have all been cleared and that people who interacted with Spencer so far appear healthy.

“That doesn’t mean we are not going to see another case; it’s possible we will,” he said. “[But] I think we are pretty well prepared.”

Medic-ALL.Inc.2014

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 

First Ebola Patient Dies in the U.S

Medic-ALL (08:10:2014)

The first Ebola patient diagnosed in the U.S. died this morning in Dallas at 7:51 A.M. local time. The sad news was announced by the facility offering his care, Texas Health Presbyterian Hospital Dallas, in an emailed statement this morning that read:

 

“It is with profound sadness and heartfelt disappointment that we must inform you of the death of Thomas Eric Duncan this morning at 7:51 am. Mr. Duncan succumbed to an insidious disease, Ebola. He fought courageously in this battle. Our professionals, the doctors and nurses in the unit, as well as the entire Texas Health Presbyterian Hospital Dallas community, are also grieving his passing. We have offered the family our support and condolences at this difficult time.”

 

Texas health official David Lakey, commissioner of the state’s health department, also offered his condolences to the family and said, in a statement, that the past week was an “enormous test of our health system.”

 

The patient, who had been admitted to the hospital on September 28 after contracting the virus in Liberia, had been placed on a ventilator and was receiving dialysis in the final days before his death. 

Courtesy : Scientific American

True Hero: A Tribute to Dr. Adadevoh

Medic-ALL (20:08:2014)

As we mourn the death of Dr. Ameyo Adadevoh, the Nigerian Consultant physician who passed on last night after having contracted the dreaded Ebola Virus from the Liberian-American Patrick Sawyer, it has been revealed that she indeed did a heroic job for the country when she forced the Nigerian Patient Zero, Sawyer, to his bed after he attempted to escape from the hospital .

Report says Dr. Adadevoh was infected when she forcefully restricted Mr. Patrick Sawyer to his bed after he tried to remove the intravenous giving set administered on him.

That one action, according to experts saved many Nigerian lives because, if Sawyer had succeeded in forcing himself out of the hospital, it would have been nearly impossible to trace those who had contact with him.

Dr. Adadevoh died at an isolation centre where she had been quarantined alongside other doctors and nurses who treated Sawyer at First Consultants Hospital, Obalende, Lagos.

Reports earlier in the week  had suggested that she had survived the disease and had been discharged from quarantine, until the Minister of Health, Professor Onyebuchi Chukwu issued a statement clarifying that she was not the survivor.

Her passing on brings the total number of deaths from the Ebola virus to five in Nigeria.

Our sincere condolences go out to her entire family. She is survived by her husband and kids.

Ref: DailyPost

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

Ebola Fight: Nigeria trains Volunteers amidst Doctors' suspension

Medic-ALL (16:08:2014): 

Nigeria has said it has trained 800 volunteers to battle Ebola as fears rose that the worst-ever outbreak of the deadly disease could spread across Africa's most populous nation.

Authorities in the capital Lagos last week appealed for volunteers to make up for a shortage of medical personnel because of a six-week nationwide doctors' strike over pay.

Volunteers have so far been deployed to 57 districts of Lagos state but more are needed, particularly to treat those already infected with the disease, Hakeem Bello, a spokesman for Lagos State Governor Babatunde Fashola.

"We have trained some 800 volunteers in the area of contact tracing, sensitisation and treatment of the Ebola disease." said Bello.

Four people have died and six more are infected by Ebola in Nigeria as part of the worst-ever outbreak of the deadly virus, which has killed 1,145 people across west Africa this year.

Experts say Ebola is spreading out of control in the region, and the UN World Health Organization has declared the epidemic an international health emergency and appealed for global aid. The disease erupted in the forested zone straddling the borders of Guinea, Sierra Leone and Liberia earlier this year and spread to Nigeria last month. The districts of Kailahun and Kenema in eastern Sierra Leone have become the new epicentres of the outbreak, with charities and health authorities there scrambling to contain the spread of the disease.

US to provide extra aid

But officials fear an outbreak in the key regional hub of Nigeria could be far more dangerous, and US health authorities pledged this month to send extra personnel and resources to Africa's most populous country, as Nigerian doctors continue a strike across the country since July 1 to demand a pay rise and better working conditions. The Lagos' state government has stepped up a media campaign to raise awareness of how to prevent the spread of the disease, including radio and television advertisements and public health announcements.Nigeria has also withdrawn its athletes from the Youth Olympics in the Chinese city of Nanjing as a result of the outbreak, state media reported as the games opened on Saturday. The International Olympic Committee has barred athletes from Ebola-hit countries from competing in pool events and combat sports, affecting three athletes.

Canada and the United States are both sending consignments of largely untested drugs in the hope of saving hundreds of lives, but officials warn they are likely to have little impact.

Source: AlJazeera

Medic-ALL.Inc 2014a

Ebola Outbreak: Vastly Underestimated

WHO (15:08:2014)
Though more than 1,000 people have died in the world's worst ever outbreak, the UN now says that number may be higher.

Staff with the World Health Organisation battling an Ebola outbreak in West Africa see evidence the numbers of reported cases and deaths vastly underestimates the scale of the outbreak, the UN agency has said on its website.

The death toll from the world's worst outbreak of Ebola stood on Wednesday at 1,069 from 1,975 confirmed, probable and suspected cases, the agency said. The majority were in Guinea, Sierra Leone and Liberia, while four people have died in Nigeria.

The agency's apparent acknowledgement the situation is worse than previously thought could spur governments and aid organisations to take stronger measures against the virus.

"Staff at the outbreak sites see evidence that the numbers of reported cases and deaths vastly underestimate the magnitude of the outbreak," the organisation said.

"WHO is coordinating a massive scaling up of the international response, marshalling support from individual countries, disease control agencies, agencies within the United Nations system, and others."

International agencies are looking into emergency food drops and truck convoys to reach hungry people in Liberia and Sierra Leone cordoned off from the outside world to halt the spread of the virus, a top World Bank official said.

In the latest sign of action by West African governments, Guinea has declared a public health emergency and is sending health workers to all affected border points, an official said.

An estimated 377 people have died in Guinea since the outbreak began in March in remote parts of a border region near Sierra Leone and Liberia.

Guinea says its outbreak is under control with the numbers of new cases falling, but the measures are needed to prevent new infections from neighbouring countries.

"Trucks full of health materials and carrying health personnel are going to all the border points with Liberia and Sierra Leone," Aboubacar Sidiki Diakit president of Guinea's Ebola commission, said late on Wednesday.

As many as 3,000 people are waiting at 17 border points for a green light to enter the country, he said.

"Any people who are sick will be immediately isolated. People will be followed up on. We can't take the risk of letting everyone through without checks."

Experimental drugs

Sierra Leone has declared Ebola a national emergency as has Liberia, which is hoping that two of its doctors diagnosed with Ebola can start treatment with some of the limited supply of experimental drug ZMapp.

Canada's Tekmira Pharmaceuticals Corp is also exploring making more of its experimental Ebola treatment, Chief Executive Officer Mark Murray said.

Nigeria also has declared a national emergency, although it has so far escaped the levels of infection seen in the three other countries.

Ebola is one of the world's most deadly diseases and kills the majority of those infected. Its symptoms include internal and external bleeding, diarrhoea and vomiting.

The US State Department ordered family members at its embassy in Freetown to depart Sierra Leone because of limitations on regular medical care as a result of the outbreak.

Source: World Health Organization(WHO)                  AlJazeera

Medic-ALL.Inc 2014

Patient Zero: How the Ebola Outbreak Began

CNN: The worst outbreak of Ebola, which has killed 961 people and triggered an international public health emergency, may have started with a 2-year-old patient in a village in Guinea.

About eight months ago, the toddler, whom researchers believe may have been Patient Zero, suffered fever, black stool and vomiting. Just four days after showing the painful symptoms, the child died on December 6, 2013, according to a report published in The New England Journal of Medicine.

Scientists don't know exactly how the toddler contracted the virus. Ebola is spread from animals to humans through infected fluids or tissue, according to the World Health Organization.

"In Africa, infection has been documented through the handling of infected chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines," WHO says, though researchers think fruit bats are what they call the virus's "natural host."

Researchers who published the paper this year found a chain of illnesses in the toddler's family.

After the child's death, the mother suffered bleeding symptoms and died on December 13, according to the report. Then, the toddler's 3-year-old sister died on December 29, with symptoms including fever, vomiting and black diarrhea. The illness subsequently affected the toddler's grandmother, who died on January 1, in the family's village of Meliandou in Guéckédou.

Two of the funeral attendees appeared to bring back the virus to their village, and it spread to health care workers and other family members who took care of infected patients.

"A health care worker from Guéckédou with suspected disease, seems to have triggered the spread of the virus to Macenta, Nzérékoré, and Kissidougou in February 2014," stated the report, noting that more Guinea towns were affected.

Clusters of the disease popped up in early 2014 in these areas, with the initial patients suffering fever, vomiting and severe diarrhea, according to the report. Hemorrhaging was less frequent, the report noted.

In early March, the Ministry of Health in Guinea and Doctors Without Borders in Guinea were notified about the disease clusters.

Health investigators arrived that month and began tracing the disease by examining hospital documents and conducting interviews with affected families and villagers.

Ebola has now spread to Liberia, Sierra Leone and Nigeria, prompting global concerns.

The report about the emergence of Ebola in Guinea was authored by dozens of international doctors and researchers from institutions in France, Germany, Guinea, WHO and Doctors Without Borders. 

Medic-ALL.Inc 2014