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Ebola study notes afebrile patients, calls into question WHO criteria

CENTER FOR DISEASE RESEARCH AND POLICY        July 24, 2015

(Also scroll down for: Ebola case definition quandary; Public health worker Ebola unease)

Researchers found that the World Health Organization (WHO) Ebola case definition has a specificity of only 31.5%, and they noted that 9% of Ebola patients reported neither a fever nor any Ebola risk exposure, calling into question WHO norms, according to a large study yesterday in The Lancet Infectious Diseases.

Researchers from Britain and Sierra Leone analyzed data on 850 suspected and 724 lab-confirmed Ebola patients who presented to the holding unit of Connaught Hospital in Freetown from May 29 to Dec 8, 2014. Fever or history of fever (n=599, 83%), intense fatigue or weakness (495, 68%), vomiting or nausea (365, 50%), and diarrhea (294, 41%) were the most common presenting symptoms in suspected cases.

Based on data from these patients, the investigators found the sensitivity of the WHO case definition to be 79.7%, which means about 20% of true Ebola cases would be missed (false-negatives). They found the specificity of the case definition to be 31.5%, which means 68.5% of patients who would be selected for admission would not actually have Ebola virus disease (false-positives).

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Ebola's not done with West Africa

 

This map, dated July 15, shows the number of days since active cases were discovered in the three countries where ebola is still a threat. CDC

SCIENCE  by Nick Stockton                               July 23, 2015

Officially, it’s called the Ebola Outbreak of 2014. But it’s 2015 now, and the disease is still infecting people. For the past two months, that rate was about 15 people a week. But in the past two weeks, the rate has doubled.....

What’s behind the continued spread? Depends on where you go. In Guinea and Sierra Leone, Ebola never died, and the new cases are a continuation of the same strain that first emerged in December of 2013. In Liberia—which declared itself ebola-free on May 12—experts believe the new outbreak was transmitted through sexual intercourse, from latent viral bodies that were alive in a man’s sperm.

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Ebola cases ebb a bit, with Conakry, Freetown as hot spots

CENTER FOR INFECIOUS DISEASE AND POLICY  by Lisa Schnirring     July 22, 2015

The number of new Ebola cases in Guinea and Sierra Leone declined a bit last week, with much of the disease activity centered in the two capital cities for the second week in a row, the World Health Organization (WHO) said in its weekly epidemiologic update today.

Tests confirmed 26 Ebola cases among the two countries, 22 in Guinea and 4 in Sierra Leone. The total is down from 30 reported the previous week, but progress against the disease has been stagnant over the past several weeks, hovering around 25 to 30 cases. Officials, however, said they saw more hopeful signs in contact tracing.

No new cases were reported in Liberia.

Overall, the total in the three countries has reached 27,705 confirmed, probable, and suspected cases, including 11,269 deaths, according to the WHO.

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http://www.cidrap.umn.edu/news-perspective/2015/07/ebola-cases-ebb-bit-conakry-freetown-hot-spots

WHO:  Ebola Situation Report - 22 July 2015

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Campaign group accuses Liberia palm oil firm of exploiting Ebola crisis

REUTERS by  Makini Brice                                 July 23, 2015

DAKAR --Anti-corruption campaign group Global Witness on Thursday accused palm oil company Golden Veroleum of taking advantage of the Ebola epidemic in Liberia to double the size of its plantation.

 The Ebola virus treatment center where four people are currently being treated is seen in Paynesville, Liberia, July 16, 2015. Reuters/James Giahyue

Golden Veroleum, controlled by Singapore-listed Golden Agri-Resources, signed a deal with Liberia in 2010 to develop a 220,000 hectare plantation. However, the company also has to reach agreement with local communities that have customary titles over the land.

The company denied any wrongdoing.

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Ebola-Affected Countries Brainstorm Infection Prevention Control

      

frontpageafricaonline.com - by Bettie K. Johnson / Monica Melton - July 20, 2015

Monrovia - Liberia, Sierra Leone and Guinea are the worst affected countries from the 2014 to 2015 Ebola outbreak, the worse ever in the history of the virus. The three countries are currently struggling to reach to zero infection of the Ebola virus. The World Health Organization and health practitioners from Sierra Leone, Guinea and Liberia gathered Monday to discuss infection prevention and control in all three countries. . . .

. . . The three day consultative meeting is expected to discuss the current status of IPC and WASH in health care facilities in each country describing the progress achieved so far during the response and transition phase. It will also share the strategic plans for the IPC and WASH improvement in the context of health systems recovery, for both the current early phase and the medium/term. The consultative meeting is sponsored by World Bank and Centers for Disease Control, among others.

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Last four Ebola cases in Liberia discharged from clinic

REUTERS by James Giahyue                  July 20, 2015

MONROVIA  - The last four cases of Ebola in Liberia were discharged from a treatment clinic in the capital of Monrovia on Monday, meaning there were no more confirmed carriers of the deadly virus in the West African country.

The group of four, released from the ELWA treatment unit to cheers and applause, were part of new wave of Ebola infections in Margibi County just outside Monrovia discovered in late June.

Two other confirmed cases have since died, including the sister of one of the released patients.

"The (Ebola treatment unit) is not a death camp; you can come here and survive," said Tolbert Nyenswah, head of Liberia's Ebola response. "This is what we can demonstrate even if Ebola comes back...."

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http://www.reuters.com/article/2015/07/20/health-ebola-liberia-idUSL5N10030X20150720

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Liberia - Nimba Reinforces Ebola Control Measures

liberianewsagency.org - by Wellington G Patrick, LINA Nimba County Correspondent - July 20, 2015

SANNIQUELLIE, July 19 (LINA) - Following an emergency Ebola meeting, Nimba County has reorganized its Ebola Task Force with more focus on case finding and social mobilization to resist the recurrence of the Ebola virus in the county.

Making the disclosure in an interview with the Liberia News Agency in Sanniquellie recently, the Media Coordinator of the county’s Ebola Task Force, Paul K. Karnue, said the exercise is to reinforce the previous preventive measures carried out by the taskforce during the height of the disease in the country.

Karnue noted that the reoccurrence of Ebola in Margibi County as reported recently has frightened several citizens in Nimba, leading them to call for gthe strengthening of measures to avoid the recurrence of the virus in the county.

At the meeting, the stakeholders resolved that all citizens should report all dead bodies and strangers to the county health authorities, and restrict all cultural practices, including the bathing of dead bodies and sick people anywhere in the county.

http://www.liberianewsagency.org/pagesnews.php?nid=5403

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Ebola crisis update MSF

 

MSF                                                  July 17, 2015

Though Ebola has faded from the news headlines, the epidemic in West Africa continues to claim lives today. Around 30 people become infected each week in Sierra Leone and Guinea – a number that would be considered a major disaster under normal circumstances – and the outbreak has recently re-emerged in Liberia.

  • Liberia: After being declared Ebola-free on 9May, six (6) new cases have been confirmed since the re-emergence of the virus at the end of June.
  • Guinea: 13 confirmed cases in the country in the week to 12July in three main hotspots (Forecariah, Boké/Fria, Conakry)
  • Sierra Leone: 14 confirmed cases in the country in the week to 12July in three main hotspots (Freetown, Port Loko, Kambia).  

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http://www.msf.org/article/ebola-crisis-update-17-july-2015

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Liberia Authorities Track Herbalist Who Escaped Ebola Quarantine

      

The Ebola virus treatment center where four people are currently being treated is seen in Paynesville, Liberia, July 16, 2015. REUTERS/James Giahyue

af.reuters.com - July 17, 2015

MONROVIA (Reuters) - A herbalist who treated the 17-year-old boy who sparked Liberia's third wave of Ebola infections has escaped quarantine and fled to Nimba County in the north of the country near Guinea, officials said on Thursday.

He was one of 120 people placed under quarantine for coming into contact with the deceased.

"The herbalist evaded quarantine and is on the run, this is a reason we are putting everybody on alert," Paul Karnue, a spokesman for the Nimba local government said.

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Liberia says 4 remaining Ebola patients have recovered: surveillance continues

ASSOCIATED PRESS by JONATHAN PAYE-LAYLEH   July 17, 2015

MONROVIA, Liberia (— The four remaining patients infected during Liberia's recent string of Ebola cases have recovered, meaning there are currently no confirmed cases in the country though more than 100 people are still under surveillance, a health official said Friday.

"There are no Ebola cases anywhere in Liberia as we speak," Deputy Health Minister Tolbert Nyenswah told The Associated Press.

In an interview earlier with state media, he said the four patients had recovered and would be discharged in a ceremony on Monday.

"It is still too early to say is it is over," Nyenswah cautioned in the interview, noting that 123 contacts were being monitored.

http://www.usnews.com/news/world/articles/2015/07/17/liberia-says-4-remaining-ebola-patients-have-recovered

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