Ebola Spreads to Sixth Country as Mali Confirms First Case
October 24, 2014 in Mali
Just a week after the World Health Organization (WHO) announced that it would deploy experts to the Ivory Coast and Mali to test their Ebola-preparedness measures, on Thursday, Mali’s Health Minister confirmed the country’s first Ebola case.
Speaking on state television late Thursday, Malian Health Minister Ousmane Kone confirmed that a two-year-old girl has tested positive for the deadly virus, disclosing that she was currently being treated at a hospital in the western town of Kayes, which is located 600 kilometres (375 miles) from the capital city Bamako. According to the Health Minister, the girl was brought to the Fousseyni Daou hospital on Wednesday, where she was immediately tested for the virus, which came back positive. Reports have indicated that the girl had recently returned from Kissidougou, in neighbouring Guinea, where the Ebola outbreak first emerged last December. Her mother died in Guinea several weeks ago, with the girl recently being brought to Bamako by relatives. She stayed in the Malian capital for ten days, in the Bagadadji neighbourhood, before leaving for Kayes. The child and 43 people who have come into contact with her have been put in quarantine, with the health minister urging anyone who may have had contact with the girl to come forward. A source within the health ministry has reported that the child’s condition is said to be improving.
Mali is now the sixth country in West Africa to be affected by the worst-ever Ebola outbreak, however both Senegal and Nigeria have in the past week been declared Ebola-free by WHO officials. Health officials have long viewed Mali as one of the most vulnerable to Ebola’s spread as the West African country borders both Guinea, which has been one of the hardest-hit countries by the current outbreak, and Senegal. The WHO’s list of fifteen African countries that need to be prepared for a possible Ebola case identified both Mali and the Ivory Coast as top priorities. Last week, WHO officials announced that they will deploy experts to both countries in order to test their Ebola-preparedness measures as both countries are currently at the greatest risk of being the next to be affected by the outbreak. Speaking during a news conference in Geneva last week, Isabell Nuttal, the WHO’s health security response chief disclosed, “as the number of cases is increasing, it wouldn’t be a surprise to have a case in neighbouring countries. And its for this very reason that we are working with them so that they are able to detect and take immediate action,” adding, “border checkpoints and health points have been implemented on the major roads that are crossing between the countries, so it provides a level of reassurance in terms of travelling.” On Sunday, a team of ten experts was set to deploy to Mali, with another team set to deploy to the Ivory Coast in the coming days.
An outbreak of the Ebola virus in Mali would likely severely threaten the country’s already fragile security situation, as Mali is continuing to stabilize after a coup and Islamist militant takeover of its northern region. It could also result in a greater risk to healthcare workers deployed in the country. While several teams of health workers have been attacked in Guinea, with several workers killed in September by locals as they attempted to spread awareness about the deadly virus, terrorist groups operating in the northern regions could target health workers for kidnap-for-ransom or could carry out violent attacks similar to those that targeted polio vaccination workers in Nigeria and Pakistan.
New figures released by the WHO on Wednesday indicate that Ebola has now killed 4,877 people and infected 9,936 across West Africa, with most of the deaths and cases occurring in Guinea, Liberia and Sierra Leone. The official number of cases and deaths however remains unknown as under-reporting continues to be a major issue in this outbreak, however the WHO indicated last week that the true death toll may be three times as high as the one currently being reported. A separate and unrelated outbreak in the Democratic Republic of Congo in central Africa currently appears to have been contained.
Ebola Cases Continue To Rise; Nigeria and Senegal Could Be Declared Ebola-Free in Days
October 15, 2014 in Guinea, Liberia, Nigeria, Senegal, Sierra Leone, West AfricaNew figures released by the World Health Organisation on Tuesday 14 October revealed that over 8,900 confirmed, probable and suspected cases of the Ebola Virus Disease (EVD) have been reported in seven affected countries: Guinea, Liberia, Nigeria, Senegal, Sierra Leone, Spain and the United States of America. As of 14 October there have been 4,447 deaths. Health workers have been hit hard by the outbreak, with Doctors Without Borders reporting that sixteen of its employees have been infected with Ebola, in which nine of them have died. A top United Nations official warned this week that Ebola was winning the race as the WHO warned that within the next two months, West Africa could face up to 10,000 new Ebola cases per week if the outbreak is not contained.
Speaking at a news conference in Geneva, WHO assistant director-general Dr Bruce Aylward, disclosed that the death rate in the current outbreak had risen to 70 percent, from the previously estimated mortality rate of 50 percent. Acknowledging that Ebola was “a high mortality disease,” Dr Aylward noted that the UN health agency was still focused on getting six people into isolation and providing treatment to them as early as possible, adding that if the global response to the current Ebola outbreak is not stepped up in the coming sixty days, “a lot more people will die” and health workers will be stretched even further.
Experts in the field have indicated that the epidemic is doubling in size about every three weeks, with Dr Aylward indicating that over the last month, there have been about 1,000 new Ebola cases per week. This included confirmed, suspected and probable cases. Guinea, Liberia and Sierra Leone continue to the be the hardest-hit countries in the current epidemic, with WHO officials particularly concerned about the spread of Ebola in their capital cities – Conakry, Monrovia and Freetown – where people move freely across borders. While some regions in these countries have seen the number of Ebola cases either stabilize or fall, this does not mean that the regions are Ebola-free. Neighbouring countries, including Guinea-Bissau, the Ivory Coast and Mali are currently at a high risk of importing the disease.
The WHO also announced Tuesday that Nigeria and Senegal could be declared Ebola-free in the coming days after completing a 42-day period with no new cases. A statement released on Tuesday revealed “if the active surveillance for new cases that is currently in place continues, and no new cases are detected, WHO will declare the end of the outbreak of Ebola virus disease in Senegal on Friday 17 October.” If no new cases are reported in Nigeria, then the WHO will declare it Ebola-free on 20 October.
Senegal had one patient who was confirmed to have EVD. He has since recovered and it does not appear that anyone else was infected with the deadly disease. In Nigeria, one traveller from Liberia triggered an outbreak in which eight people died, most of them health workers. The virus spread from the initial case in Lagos to Port Harcourt however it has since been contained with no new reported cases. The situation in Guinea, Liberia and Sierra Leone however is far different as, according to the WHO, “new cases continue to explode in areas that looked like they were coming under control.” Adding “an unusual characteristic of this epidemic is a persistent cyclical pattern of gradual dips in the number of new cases, followed by sudden flare-ups.”
Officials at the WHO indicate that waiting for forty-two days from the time when the last person with high risk exposure has tested negative for the disease effectively provides sufficient confidence to declare that the outbreak is over. The 42-day period is twice the generally accepted maximum incubation period of the virus however some incubation periods are longer, with the WHO is indicating that in 95 percent of Ebola cases, the incubation period was between one and 21 days while in 98 percent, it was no longer than 42 days.
2014 Ebola Outbreak – October Review
October 11, 2014 in West AfricaExecutive Summary
Total Cases and Deaths: As of 23 September 2014 (WHO)
3,083 people have died from Ebola in Guinea, Liberia, Nigeria and Sierra Leone. 6,553 (probable, confirmed and suspected) cases.
The current Ebola Virus Disease (EVD) outbreak in West Africa has not been contained, with transmission continuing to occur in both community and healthcare settings. Resistance to efforts to control the disease, including outright denials that EVD exists and fears that healthcare workers deployed to combat the virus are spreading it, have further hindered efforts to prevent the disease from spreading and have effectively resulted in the region developing into a fertile ground for speculation and mistaken beliefs. This has sparked a rise in attacks on healthcare workers, including the recent death of an eight-member team in Guinea.
Over the past several weeks, the spread of EVD in West Africa has continued to accelerate. As of 23 September 2014, a total of 3,083 people have died of EVD, with another 6,553 reported cases. While the disease remains concentrated in three countries – Guinea, Liberia and Sierra Leone – it has continued to spread to new regions within these affected countries. On 30 September 2014, officials in the United States confirmed the first Ebola case. The current West Africa Ebola outbreak is likely to continue for another six – nine months before it is completely contained, with World Health Organization (WHO) officials predicting upwards of 20,000 cases.
Affected countries currently fall into two categories: Those with widespread and intense transmission – Guinea, Liberia and Sierra Leone – and those with either an initial case or cases, or with localized transmission – Lagos and Port Harcourt in Nigeria; Dakar in Senegal; Dallas, Texas in the United States. The capital cities of Guinea (Conakry), Liberia (Monrovia) and Sierra Leone (Freetown) have all been affected by the current outbreak.
The World Health Organization (WHO) has identified three patterns of transmission:
- In rural communities, which is facilitated by strong cultural practices and traditional beliefs;
- In densely populated urban communities;
- Cross-border transmission
- Countries with Widespread and Intense Transmission
Guinea
Total Cases: As of 23 September 2014
1074 clinical cases (876 confirmed; 162 probable; 36 suspected); 648 deaths (481 confirmed; 162 probable; 5 suspected)
Current Affected Areas: Conakry, Coyah, Forecariah, Gueckedou, Kouroussa, Macenta, Siguiri, Pita, Nzerekore, Dubreka, Youmou, Kerouane.
No Longer Active: Boffa, Dabola, Dinguiraya, Kissidougou, Telimele
In September, the district of Kindia reported its first confirmed case of EVD. While there have been a number of other areas across the country that have not reported any new cases of EVD, currently there is no indication of a sustained reduction in case incidence in Guinea.
In mid-September, eight people, involved in Ebola awareness-raising activities, were killed near Womey, near the town of Nzerekore in the Forest region of Guinea. Police officials in the region have confirmed that the team was targeted on suspicion that they were attempting to spread the virus. In a separate incident on 24 September, a Red Cross team was attacked while collecting bodies believed to be infected with Ebola in south-eastern Guinea. Further such incidents in the coming weeks are likely to occur.
Land borders with Liberia, Senegal and Sierra Leone have been closed. Health screenings at all border crossings have been set up and all travellers displaying a fever, or EVD-like symptoms, will be subject to quarantine and/or denied entry/exit, from the country. Expect to experience delays at land border crossings. Enhanced screening measures have been introduced for outbound passengers at Conakry airport.
Liberia
Total Cases: As of 23 September 2014
3458 clinical cases (914 confirmed, 1539 probable, 1005 suspected); 1830 deaths (792 confirmed; 623 probably; 415 suspected)
Current Affected Areas: Lofa, Montserrado, Margibi, Bomi, Bong, Grand Cape Mount, Nimba, Grand Bassa, Grand Gedeh, River Cess, River Gee, Sinoe, Gbarpolu, Grand Kru
Liberia remains the most-affected country in the current Ebola outbreak. The number of newly reported cases continues to rise on a week-to-week basis. This is primarily driven by a continuation of a recent surge in cases in the capital city, Monrovia, coupled with a lack of capacity in Ebola treatment centres.
In September, six confirmed cases of EVD and four deaths were reported in the district of Grand Kru, a rural area located near the border with the Ivory Coast. This is the first time the EVD cases have been reported in this area of the country.
Since 20 August, a state of emergency has been in place, with security forces enforcing a nationwide curfew. Between 11PM and 6AM every night no movement is allowed anywhere in the entire country. Liberian authorities have set up road blocks in a bid to restrict movement around the country while security forces have been deployed in order to enforce quarantine for certain areas, including Lofa county. In Monrovia, the army and police have sealed off the neighbourhood of West Point with the area being placed under quarantine. There have been a number of outbreaks of violence, with civilians rioting at hospitals and attacking health workers.
All borders of Liberia have been closed, with the exception of major entry points, including the Roberts International Airport and James Spriggs Payne Airport. The Bo Waterside Crossing to Sierra Leone remains closed along with the Foya Crossing to Guinea. Any remaining border crossings may be closed with minimal notice. The Liberia Airport Authority has introduced enhanced screening measures for both inbound and outbound travellers at airport facilities.
The Ministry of Health and Social Welfare has established hotlines for the public to get basic information on Ebola: Call 0770198517 or 0777549805 or 0886530260 or 0886549805.
General medical facilities throughout the country are currently under severe strain as a result of the Ebola outbreak. Dedicated healthcare facilities for Ebola are overwhelmed and may not accept further cases.
Sierra Leone
Total Cases: As of 23 September 2014
2021 clinical cases (1816 confirmed, 37 probable, 168 suspected); 605 deaths (557 confirmed; 37 probable; 11 suspected)
Current Affected Areas: Kailahun, Kenema, Kono, Kambia, Bombali, Tonkolili, Port Loko, Pujehun, Bo, Moyamba, Bonthe, Western Area
EVD cases in Sierra Leone continue to increase. Transmission remains high in the capital city, Freetown, and in the surrounding urban areas. Although over the past several weeks the number of newly reported cases in the districts of Kailahun and Kenema appear to have stabilized, a number of other districts have reported an increase. These include Port Loko, a district adjacent to Freetown, Bo, Bombali and Tonkolili.
Between 19 – 21 September, the Sierra Leonean government imposed a three-day nationwide shutdown. During this period, civilians were required to remain in their homes while Ebola awareness teams were deployed across the country to search for possible EVD patients. The government has since deemed the programme a success, adding that further such shutdowns may be implemented in the near future.
- Countries with Initial Case/Cases or Localized Transmission
Three countries, Nigeria and Senegal and most recently the United States, have reported a case or cases imported from a country with widespread and intense transmission.
Nigeria
Total Cases: As of 23 September 2014
20 clinical cases (19 confirmed; 1 probable; 0 suspected); 8 deaths (7 confirmed; 1 probable)
Current Affected Areas: Lagos and Port Harcourt
While Nigeria has not reported any new EVD cases since the first week of September, the country has not been deemed Ebola-free however the spread of EVD has been contained. All EVD cases in Nigeria occurred in Lagos and Port Harcourt.
Nigeria’s first Ebola case was an imported one and all cases in the transmission chain have been linked to a single person. Contact tracing and follow-up is on-going. In Nigeria, 847 contacts (out of a total of 872) have now completed the 21-day follow-up (349 contacts in Lagos; 498 in Port Harcourt). The last confirmed case in Lagos was reported on 5 September while the last confirmed case in Port Harcourt was reported on 1 September. In Lagos, all contacts have completed the 21-day follow-up.
Senegal
In Senegal, all contacts have now completed the 21-day follow-up and there have been no further reported cases of EVD. The last confirmed case of EVD was reported on 28 August. While the country has not been confirmed to be Ebola-free, the spread of EVD has been contained.
United States
Total Cases: As of 23 September 2014
1 Confirmed Case; 0 deaths
Current Affected Areas: Dakar
On 30 September, officials confirmed the first Ebola case in Dallas, Texas. Officials have confirmed that the unidentified male patient is being kept in isolation at Texas Health Presbyterian Hospital. It is believed that the man contracted the virus in Liberia prior to travelling to the US nearly two weeks ago. He arrived in the US on September 20. Symptoms of the virus became apparent on September 24 and the patient was admitted and placed in isolation on 28 September. While previously US aid workers have come back to the US, after catching Ebola in West Africa, this is the first case of a patient developing the virus on US soil. Health officials are currently identifying all people who came into contact with the unnamed patient while he was infectious. Those people will then be monitored for a period of 21 days.
Ebola Outbreak in Democratic Republic of Congo (DRC)
Total Cases: As of 24 September 2014
70 clinical cases (30 confirmed; 26 probable; 14 suspected); 40 deaths
Current Affected Areas: Equateur province
An epidemic has since been declared in the region of Djera, in the territory of Boende in the province of Equateur. Officials however believe that the infections are of a different strain to those in the outbreak in West Africa. One of the two cases tested positive for the Sudanese strain of the disease, while the other tested positive for a mixture between the Sudanese and the Zaire strain. The outbreak in West Africa is due to the Zaire strain.
First Ebola Case Confirmed Outside of Africa
October 1, 2014 in United StatesThe first case of the deadly Ebola Virus Disease (EVD) diagnosed on US soil has been confirmed in Dallas, Texas. Officials confirmed Tuesday that the unidentified male patient is being kept in isolation at Texas Health Presbyterian Hospital and have pledged to contain the virus that has already killed more than 3,000 people in West Africa.
It is believed that the man contracted the virus in Liberia prior to traveling to the US to visit family members nearly two weeks ago. He arrived in the US on September 20. Symptoms of the virus became apparent on September 24, with the patient being admitted to hospital on the 26th and placed in isolation on September 28. While previously US aid workers have come back to the US, after catching Ebola in West Africa, this is the first case of a patient developing the virus on US soil. It is believed that the patient was not in Liberia as part of on-going efforts to combat the spread of the virus there.
Health officials have disclosed that they are currently identifying all people who came into contact with the unnamed patient while he was infectious however officials at the Centres for Disease Control and Prevention have cautioned that since he was not sick on the plane, he was unlikely to have infected other travellers as Ebola is not contagious until the patient begins to display symptoms, which can include fatigue, fever, muscle aches, vomiting, diarrhoea and bleeding. According to CDC chief Tom Frieden, “at this point there is zero risk of transmission on the flight. The illness of Ebola would not have gone on for 10 days before diagnosis…he was checked for fever before getting on the flight and there is no reason to think that anyone on the flight that he was on would be at risk.” Anyone to have had contact with the patient will be monitored for a period of 21 days. According to Mr Frieden, currently there are only a “handful” of people, mainly family members, believed to have come in contact with the patient while he was sick. While measures, such as checking temperatures, have been implemented at airports and border crossings across the affected countries in West Africa, this case has demonstrated that patients deemed Ebola-free when leaving an infected region may not necessarily be free of the virus, but may only be not displaying any symptoms at the time.
Latest figures released by the World Health Organization (WHO) indicate that the world’s largest outbreak of Ebola has infected more than 6,500 people across five West African countries, killing 3,091 since the start of this year.
The beginning of the West Africa outbreak has been identified as a two-year-old boy in Guinea who became sick with EVD in December 2013. While experts do not know how the child came down with the virus, some believe that he may have come in contact with an infected fruit bat, which are the natural hosts for the virus. Since then, the disease has spread rapidly, primarily affecting Guinea, Liberia and Sierra Leone. In July, Ebola was confirmed in Nigeria when a dual US-Liberian citizen, who flew on a pane from Liberia to Lagos, died days later. The outbreak there killed eight and infected 20 people, however WHO officials have indicated that while Nigeria is not yet Ebola-free, the spread of the deadly virus has been contained, with no new confirmed cases reported since the beginning of September. One patient was also confirmed to have Ebola in Senegal, however like in Nigeria, the spread of the disease has been contained. The last confirmed case of Ebola reported in Senegal occurred on 28 August.
Sierra Leone’s Three-Day Lockdown Declared Success by Authorities
September 22, 2014 in Sierra LeoneWhile authorities in Sierra Leone have disclosed that a controversial three-day lockdown, which concluded Sunday, was a “success,” frustrated residents reported food shortages in some neighbourhoods of Sierra Leone’s capital city.
A three-day curfew, which began Friday in a bid to contain the spread of the Ebola outbreak in Sierra Leone, has been declared a success by authorities. According to the head of Sierra Leone’s Emergency Operations Centre Stephen Gaojia, the exercise was largely successful and the compliance and receptiveness of Sierra Leoneans was “overwhelming.” Speaking to reporters, Mr Gaoji further disclosed that officials “…were able to discover quite a lot of people who have been infected…” Deputy Chief Medical Officer Sarian Kamara confirmed that authorities managed to discover 22 new cases of the virus during the curfew, adding that between 60 and 70 Ebola victims had been buried over the past two days. There was only one incident of violence reported over the three-day period. On Saturday, local civilians attacked health workers trying to bury five bodies in a district located 20 kilometres east of the capital city Freetown. Police reinforcements later arrived to the area and the health workers were eventually able to compete the burial.
Although on Sunday rumours had circulated in Freetown that officials were opting to extend the lockdown, a Health Ministry statement issued Sunday evening confirmed that the lockdown had ended. The statement further disclosed that 75 percent of the targeted 1.5 million households had been contacted by outbreak teams, adding that outreach groups would continue to operate in “hot spots” across the country. Some residents also complained of food shortages in some neighbourhoods of Freetown. While the World Food Programme provided food packages including rice, beans and a form of porridge throughout the three-day lockdown, staffers were not going door-to-door and were instead focusing on serving houses placed under quarantine by medical teams. While agency officials confirmed that their workers had distributed two weeks’ worth of rations to 20,000 households, many residents complained that the provisions they received were insufficient.
The West African country announced the extreme measure in early September, announcing that the lockdown would effectively confine its population of six million to their homes for a period of 72 hours in a bid to stem the further spread of the deadly Ebola virus, which has already claimed more than 2,600 lives in Guinea, Liberia, Nigeria and Sierra Leone. Only essential workers, such as health professionals, were exempt from the lockdown, as were some 30,000 volunteers who went door-to-door to provide advice on halting the contagion and handling out bars of soap.
Despite most residents in the capital city welcoming teams of health workers and volunteers bearing information about the deadly virus, rumours continued to persist in some areas of the city, with some believing that soap which was distributed by health teams, was poisoned. Persistent rumours such as this one suggest that public education campaigns have not been entirely successful.
According to new data released by the World Health Organization (WHO) on Friday, the Ebola virus has killed more than 560 people in Sierra Leone and more than 2,600 across West Africa, in what is the largest outbreak of the deadly virus ever recorded. The disease, which is also affecting Guinea, Liberia, Nigeria and Senegal, is believed to have sickened more than 5,500 people. Sierra Leone’s three-day curfew is the most aggressive measure to be taken against the virus by a West African country.
