EBOLA VIRUS DISEASE UPDATE AS AT 13/09/14 FROM NPHCDA LABS & SIRVEILLANCE DESK: (CNN) -- Today, the Ebola virus spreads only through direct contact with bodily fluids, such as blood and vomit. But some of the nations top infectious disease experts worry that this deadly virus could mutate and be transmitted just by a cough or a sneeze. Its the single greatest concern Ive ever had in my 40-year public health career, said Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. I cant imagine anything in my career -- and this includes HIV -- that would be more devastating to the world than a respiratory transmissible Ebola virus. Osterholm and other experts couldnt think of another virus that has made the transition from non-airborne to airborne in humans. They say the chances are relatively small that Ebola will make that jump. But as the virus spreads, they warned, the likelihood increases. Every time a new person gets Ebola, the virus gets another chance to mutate and develop new capabilities. Osterholm calls it genetic roulette As of Friday, there have been 4,784 cases of Ebola, with 2,400 deaths, according to the World Health Organization, which says the virus is spreading at a much faster rate now than it was earlier in the outbreak. Ebola is an RNA virus, which means every time it copies itself; it makes one or two mutations. Many of those mutations mean nothing, but some of them might be able to change the way the virus behaves inside the human body. Imagine every time you copy an essay, you change a word or two. Eventually, its going to change the meaning of the essay, said Dr. C.J. Peters, one of the heroes featured in The Hot Zone. That book chronicles the 1989 outbreak of Ebola Reston, which was transmitted among monkeys by breathing. In 2012, Canadian researchers found that Ebola Zaire, which is involved in the current outbreak, was passed from pigs to monkeys in the air. Dr. James Le Duc, the Director of the Galveston National Laboratory at the University of Texas, said the problem is that no one is keeping track of the mutations happening across West Africa, so no one really knows what the virus has become. One group of researchers looked at how Ebola changed over a short period of time in just one area in Sierra Leone early on in the outbreak, before it was spreading as fast as it is now. They found more than 300 genetic changes in the virus. Its frightening to look at how much this virus mutated within just three weeks, said Dr. Pardis Sabeti, an associate professor at Harvard and senior associate member of the Broad Institute, where the research was done. Even without becoming airborne, the virus has overwhelmed efforts to stop it. The group Doctors Without Borders says Monrovia, Liberia, needs 1,000 beds for Ebola patients but has only 240, and it has had to turn patients away, sending them back to neighborhoods where they could infect more people. This week, a Pentagon spokesman said the United States is sending a 25-bed field hospital to Monrovia The death toll from the worst Ebola outbreak in history has jumped by almost 200 in a single day to at least 2,296 and is already likely to be higher than that, the World Health Organization said on Tuesday. But it still did not have new figures for Liberia, the worst-affected country, suggesting the true toll is already much higher. The WHO has said it expects thousands of new cases in Liberia in the next three weeks. Fourth Ebola patient arrives in United States A fourth Ebola patient arrived in the United States from West Africa on Tuesday, headed to the same Atlanta hospital where two other people were successfully treated for the disease. Liberian President Ellen Johnson Sirleaf said on Tuesday she expects the Ebola crisis gripping her country to worsen in the coming weeks as health workers struggle with inadequate supplies, a lack of outside support and a population in fear. It remains a very grave situation, she told an audience at Harvard University in Cambridge, Massachusetts, via Skype from Liberias capital Monrovia. It is taking a long time to respond effectively .... We expect it to accelerate for at least another two or three weeks before we can look forward to a decline. EBOLA VIRUS DISEASE OUTBREAK IN NIGERIA Daily Situation Report No: 40 as of 8th September, 2014 Highlights • No new suspect or confirmed case today in Lagos. One new suspected case was reported in Port Harcourt, Rivers State. • EOC Press conference on EVD held by the Incident Manager and other EOC members • Nineteen (19) additional contacts were listed in Port Harcourt today bringing the total contacts listed to 498 Issues & Activities: Epidemiology/Surveillance Lagos • Contacts followed up today are 19/19 (100%) • 335 contacts have completed 21 days follow up • Follow up of discharged suspected cases as contacts continues Rivers • Contacts followed up today were 463 (96%) out of 484 due for follow up. • Continued contact tracing and listing • 77 individuals deployed today (24 regular teams & 3 special teams). • Supervisory visit to team members on the field. • Number of difficult contacts identified was 29 of which Case Management/Infection Prevention and control • Lagos • One confirmed case is on admission in the Ebola Treatment Centre and the patient is doing well. • The office and car of the deceased probable case were finally decontaminated today • Rivers • Evacuation of one suspected case to the ETC. • Assessment of two contacts notified from the Alert system-No suggestive symptoms to classify as suspect following clinical evaluation. Contact tracing teams to continue follow up. • Burial of three corpses from the UPTH morgue finalized. • Data cleaning for laboratory results database completed. • Psychosocial support team made contact with two discharged suspected cases. Coordination: Lagos • Daily coordination meeting held by the Ebola Emergency Operations Centre (EEOC). The Hon. Commissioner for health in Lagos State, Dr Jide Idris, was in attendance today. Rivers • Daily coordination meeting held by the Ebola Emergency Operations Centre (EEOC), chaired by the Incident Manager. Points of Entry • Lagos • Training of health workers at Tin can sea port • Total number of passengers screened on 7 th Sep 2014 was 8411 including 4131 arrival and 4280 departure passengers. • Total number of passengers screened today is 2933 by 3pm including 1611 (Arrival) and 1322 (Departure). •Rivers • Supervision of screening at Port Harcourt airport ongoing. • Commenced on-board screening of international crew of vessels berthing at Onne port. • Meeting with Intel terminal operators at Onne port. • Total number of passengers screened yesterday, 7th Sept, at international wing were 155 (Arrival) and 150 (Departure). • Total number of passengers screened yesterday, 7 Sept, at domestic wing were 1030 (Arrival) and 1359 (Departure). Laboratory Lagos • No specimen received today Rivers • One blood sample collected today. Social mobilization: •Lagos • Distribution of IEC materials to different audiences. • 7 online newspapers were reviewed today on Ebola virus disease. Only 2 were found with inaccurate or negative reports. • Community education and mobilization continues. Rivers • 55 additional community mobilizers trained on interpersonal communication • Community entry conducted in the two most affected LGAs of Port Harcourt with community and traditional leaders and elders to facilitate the house to house interpersonal communication • Jingles aired on radio stations and continued airing within the airport • 4. Media briefing conducted at EOC today with FAQs disseminated to all media participants Logistics • Lagos • Adequate vehicles available. • 3260 PPEs available. • Rivers • 47 vehicles were provided for EOC operations, while 43 were used. A total of 49 vehicles are required. • NLNG still to provide incinerator at isolation centre. • Still available in store: PPEs (500); Mobile phones (50); Body bags (12); Infrared thermometers (10). Technical Support required • Lagos • One infectious disease or critical care physicians with special pathogen, IPC and field settings experience needed • Rivers • One infection prevention and control expert Challenges • Lagos • Inadequate numbers of screening forms at the airport • Rivers • Need for 30 more infrared thermometers and 20 hand-held counters at port of entry. • Renovation of quarantine center at the airport - running water, more beds, lightings, air- conditioner, toilets and exit point • More vehicles are required to support expanding teams especially contact tracing Technical Support required • Lagos • One infectious disease or critical care physicians with special pathogen, IPC and field settings experience needed. • Rivers • One infection prevention and control expert • One Point of Entry Officer Planned activities • Lagos • Organize the training team for the private airlines • Supportive supervision to Land Crossing at Seme (J J Ogun) • Sensitization of the hotel owners done on 11/09/2014 • Training of NOA COMMOS on Tuesday 09/09/2014 • Training of tertiary institution health workers on triaging of patients Rivers • Aggressive follow up of contacts remains a priority. • Continuous messaging on EVD. • Contact tracers to provide more information regarding evacuation procedure • Purchase of body bags by CMD UPTH – immediate – order already made • Psychosocial support team to meet with Epid/Surveillance team. • EOC/SMOH to emphasize issues of confidentiality with press - immediate • Set up Port Health Service office at the FAAN clinic in Port Harcourt airport. Organizations/Partners • Federal Ministry of Health (FMOH)- Nigeria Centre for Disease for Disease Control (NCDC); Port Health Services; Health Promotion department • Lagos State Ministry of Health • Rivers State Ministry of Health • Nigeria Field Epidemiology and Training Programme (NFELTP) • NPHCDA • WHO • CDC • UNICEF • MSF • Association of Public Health Physicians of Nigeria (APHPN) • Nigeria Red Cross • Nigerian Army • Elizabeth R. Griffin Research Foundation • Hospital for humanity • Please Continue active Surveillance and ensure personal hygiene as Ebola virus is still in the air! God is with us! Thank you,
Posted on: Sun, 14 Sep 2014 14:32:58 +0000
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