Part 3, Continuation on Ebola Virus outbreak... WHO estimated on 21 September that Guineas capacity to treat EVD cases falls short by the equivalent of 40 beds. Liberia: Main article: 2014 Ebola virus epidemic in Liberia In Liberia, the disease was reported in Lofa and Nimba counties in late March. By 23 July, the health ministry implemented measures to improve the countrys response. On 27 July, Ellen Johnson Sirleaf, the Liberian president, announced that Liberia would close its borders, with the exception of a few crossing points, such as the airport, where screening centres would be established, and the worst-affected areas in the country would be placed under quarantine. Football events were banned, because large gatherings and the nature of the sport increase transmission risks. Three days after the borders were closed, Sirleaf announced the closure of all schools nationwide, including the University of Liberia, and a few communities were to be quarantined. Sirleaf declared a state of emergency on 6 August, partly because the diseases weakening of the health care system has the potential to reduce the systems ability to treat routine diseases such as malaria; she noted that the state of emergency might require the suspensions of certain rights and privileges. On the same day, the National Elections Commission announced that it would be unable to conduct the scheduled October 2014 senatorial election and requested postponement,[55] one week after the leaders of various opposition parties had publicly taken different sides on the question. On 30 August, Liberias Port Authority cancelled all shore passes for sailors from ships coming into the countrys four seaports. On 20 September, Liberia opened a new 150 bed treatment unit clinic in Monrovia. At the opening ceremony of the Old Island Clinic on Bushrod Island six ambulances were already waiting with potential patients. More patients were waiting by the clinic after making their way on foot with the help of relatives.[58] Two days later 112 beds were already filled with 46 patients testing positive for Ebola, while the rest were admitted for observation. As of 8 September, Ebola had been identified in 14 of Liberias 15 counties.[60] A team from CDC which visited four counties in Liberia reported on 7 October that some hospitals had been abandoned while those which were still functioning lack basic facilities such as running water, rubber gloves, and sanitizing supplies. WHO estimated on 21 September that Liberias capacity to treat EVD cases falls short by the equivalent of 1,550 beds. Sierra Leone: Main article: 2014 Ebola virus epidemic in Sierra Leone The first person reported infected in the spread to Sierra Leone was a tribal healer. She had treated one or more infected people and died on 26 May. According to tribal tradition, her body was washed for burial and this appears to have led to infections in women from neighbouring towns. On 31 March, Sierra Leone declared a state of emergency and instituted measures to screen travelers from Guinea and Liberia. On 30 July, the government began to deploy troops to implement quarantines. On 29 July, well-known physician Sheik Umar Khan, Sierra Leones only expert on hemorrhagic fever, died after contacting Ebola at his clinic in Kenema. Khan had long worked with Lassa fever, a disease that kills over 5,000 a year in Africa. He had expanded his clinic to accept Ebola patients. Sierra Leones President, Ernest Bai Koroma, celebrated Khan as a national hero. In August, awareness campaigns in Freetown, Sierra Leones capital, were delivered over the radio and through loudspeakers. Also in August, Sierra Leone passed a law that subjected anyone hiding someone believed to be infected to two years in jail. At the time the law was enacted, a top parliamentarian was critical of failures by neighboring countries to stop the outbreak. In an attempt to control the disease, Sierra Leone imposed a three-day lockdown on its population from 19 to 21 September. During this period 28,500 trained community workers and volunteers went door-to-door providing information on how to prevent infection, as well as setting up community Ebola surveillance teams. On 22 September, government officials said that the three day lock down had obtained its objective and would not be extended. Eighty percent of targeted households were reached in the operation. A total of around 150 new cases were uncovered, although reports from remote locations had not yet been received. On 25 September, the government added three more districts under isolation, in an effort to contain the spread. The districts include Port Loko, Bombali, and Moyamba. This brings the total areas under isolation to five, including the outbreak hot spots Kenema and Kailahun which were already in isolation. Only deliveries and essential services were to be allowed in and out. A sharp rise in cases in these areas was noted by the WHO. WHO estimated on 21 September that Sierra Leones capacity to treat EVD cases falls short by the equivalent of 532 beds. There have been reports that political interference and administrative incompetence have hindered the flow of medical supplies into the country. On Oct. 4, Sierra Leone recorded 121 fatalities, the most in a single day. On October 8, Sierra Leone burial crews went on strike. (Countries with local transmission) Nigeria: Nigeria Ebola areas – 2014 Nigeria Situation Map as of 5 September 2014 Date July 2014 – present Casualties Cases / Deaths (as of 21 September 2014) Nigeria: 20 / 8 The first case in Nigeria was a Liberian-American, Patrick Sawyer, who flew from Liberia to Nigerias former capital Lagos on 20 July. Sawyer became violently ill upon arriving at the airport and died five days later. In response, the Nigerian government observed all of Sawyers contacts for signs of infection and increased surveillance at all entry points to the country. On 6 August, the Nigerian health minister told reporters, Yesterday the first known Nigerian to die of Ebola was recorded. This was one of the nurses that attended to the Liberian. The other five [newly confirmed] cases are being treated at an isolation ward. On 9 August, the Nigerian National Health Research Ethics Committee issued a statement waiving the regular administrative requirements that limit the international shipment of any biological samples out of Nigeria and supporting the use of non-validated treatments without prior review and approval by a health research ethics committee. Other than increased surveillance at the country’s borders, the Nigerian government states that they have also made attempts to control the spread of disease through an improvement in tracking, providing education to avert disinformation and increase accurate information, and the teaching of appropriate hygiene measures. On 19 August, it was reported that the doctor who treated Sawyer, Ameyo Adadevoh, had also died of Ebola disease. Adadevoh was posthumously praised for preventing the index case (Sawyer) from leaving the hospital at the time of diagnosis, thereby playing a key role in curbing the spread of the virus in Nigeria. On 19 August, the Commissioner of Health in Lagos announced that Nigeria had seen twelve confirmed cases; four died (including the index case) while another five, including two doctors and a nurse, were declared disease-free and released. On 22 September, the Nigeria health ministry announced As of today, there is no case of Ebola in Nigeria. All listed contacts who were under surveillance have been followed up for 21 days.The WHO stated that Nigeria had not reported any new cases since 8 September and if no further cases are reported, Nigeria will be declared Ebola-free on 20 October. Spain; On 5 August 2014, the Brothers Hospitallers of St. John of God confirmed that Brother Miguel Pajares, who had been volunteering in Liberia, had become infected. He was evacuated to Spain on 6 August 2014, and subsequently died on 12 August. On 21 September it was announced that Brother Manuel García Viejo, another Spanish citizen who was medical director at the San Juan de Dios Hospital in Lunsar, had been evacuated to Spain from Sierra Leone after being infected with the virus. His death was announced on 25 September. Both of these cases were treated at the Hospital Carlos III in Madrid. In October 2014, a nurse who had cared for these patients at the Hospital Carlos III became unwell and on 6 October tested positive for Ebola.[87] A second test confirmed the diagnosis, making this the first confirmed case of Ebola transmission outside Africa. There are currently 50 contacts being monitored. As of 8 October, the nurse, her husband and another nurse are interned, while tens of persons are monitored for symptoms. Medical staff have expressed public outcry for a perceived lack of coordination, including lack of training and unsafe protecting uniforms (Biosafety level II instead of the WHO mandated level IV), no decontamination of the first nurse house or Manuel García Viejo hospital room. The nurse went for six days untreated and cared for normal patients at her ambulatory duties, before reporting fever and self-quarantining. ..... (To Be continued)
Posted on: Fri, 10 Oct 2014 10:41:37 +0000
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