October: A summary of what happened so far source: https://www.internationalsos.com/ebola/index.cfm?content_id=407&
Latest News
Last Updated: October 08, 2014 16:20 GMT
Imported cases
Many locations are testing people who have travelled to Ebola-affected countries and returned with a fever and other symptoms. Nigeria, Senegal and the United States have confirmed imported cases of Ebola. International SOS is monitoring these closely. Click here for more details.
8 October
Sierra Leone: The Health Ministry has reported new cases and deaths in their latest update. Read more…
United States: The photojournalist evacuated from Liberia who is being treated at the Nebraska Medical Center has begun treatment with the experimental drug Brincidofovir.
In other news, a number of media outlets have reported US authorities plan to augment the screening at US airports for passengers arriving from West Africa. Although outlined by the White House, the nature of these additional measures has not yet been published by the US Centers for Disease Control (CDC) or the Transportation Security Administration (TSA).
The confirmed case of Ebola, hospitalised in Dallas, has died. Read more...
Liberia: An interim care centre has been opened by Child Fund International in Monrovia, to look after children who have been orphaned by Ebola.
There are several reports that all Ebola media coverage at health facilities will be restricted, to protect the privacy of patients and healthcare workers and ensure safety of staff and journalists. The Liberian Ministry of Health and Social Welfare and Ministry of Information have reportedly established a new Ebola media policy. Healthcare workers will not be allowed to give any information and no interviews will be conducted without advance approval from the Ministry of Information.
Samaritan purse has launched a new program on home-based interventions for Ebola. The training will help community members support Ebola patients in remote areas. Each family will receive training on Ebola patient care and will be provided a kit which includes protective clothing, medicines, disinfectants and hydration items. The first round is being implemented at River Gee County. The organisation has also planned to build the first Community Care Centre in the county. Read more...
Sierra Leone, Norway: A Norwegian aid worker has been infected with Ebola in Sierra Leone while volunteering with MSF in Bo district. She was isolated and has been repatriated to Norway to receive treatment in Oslo.
Outlook: The World Bank has cautioned that the economic impact of the Ebola outbreak, which already is projected at US$2.2-7.4 billion loss by the end of 2014, could be as high as US$32 billion if neighbouring countries are also significantly infected. This is classed as a "High Ebola" scenario where containment of the outbreak is slower and more of the region is affected. The report (PDF) highlights the successful containment in Nigeria and Senegal and suggests that the losses could be mitigated if other countries can mount a similarly robust response.
The Food and Agriculture Organization has published their year-long response plan (PDF) to the Ebola outbreak. The four pillars of the response aim to: stop the spread of disease; boost income and agricultural production; build resilience in the communities, and; strengthen coordination of response. The harvest is projected to be severely affected by the lack of available labour in Guinea, Sierra Leone and Liberia and this threatens the food security of these countries. The impact will be felt by tens of thousands of people.
7 October
Nigeria: The US CDC has downgraded the travel alert for Nigeria to Level 1 (Watch) in line with the decreased risk of Ebola in the country.
Liberia: The World Health Organization (WHO) and Ministry of Health have launched a new training program for healthcare workers in Monrovia. At least six people who survived Ebola infections will participate and share their experiences. A mock Ebola treatment unit has been constructed for the two-week long course. Over 400 health workers will attend sessions. Once they successfully complete the program, trainees will be eligible to work in Ebola treatment centres across the country.
In their latest situation report, the Ministry of Health confirmed additional cases and deaths.
The US CDC released an assessment of the Ebola case burden, health care infrastructure, and emergency preparedness in four counties in southeastern Liberia (Grand Gedeh, Grand Kru, River Gee, and Maryland) in August. This was before any of these areas had Ebola cases, but while the outbreak was affecting other parts of the country. These areas previously had six physicians, but half of them had already left the country due to the epidemic. Nursing staff had abandoned their posts in half the hospitals reviewed, and students and volunteers were often found providing medical care and responding to emergencies in their absence. Gloves were in low supply or completely absent. There was not enough personal protective equipment to care for Ebola patients and healthcare providers were not trained in its use. Handwashing stations were found only in operating rooms, if anywhere, and supplies of soap, bleach, and alcohol-based hand gel had run out. Only two of the four counties had isolation facilities and these lacked water, electricity, and waste disposal facilities. No Ebola surveillance systems were in place. Some of these issues have been remedied since August, but this report paints a clear and unfortunate picture of the limited resources available in some affected areas to fight this Ebola outbreak.
Spain: Media sources reported that a second healthcare worker has been isolated at a hospital in Madrid with diarreha, a possible symptom of Ebola, though initial tests for Ebola were negative. Read more...
WHO: The World Health Organization released a situation assessment regarding the mode of transmission of the Ebola virus. They refute claims that Ebola can spread through the air and state that speculations that the virus may mutate into an airborne disease are unfounded. The Ebola virus spreads thought direct physical contact with infected bodily fluids or contaminated surfaces and objects. This echoes the report issued by the UN a few days prior on the same topic (see story below dated October 3).
Also making headlines from WHO is a statement from the European Director that additional cases of Ebola in Europe are "unavoidable" due to international travel between Europe and Africa. In actuality, imported cases of Ebola are a threat in countries worldwide until the epidemic in West Africa is controlled - a point highlighted by the recent case in the United States and discussed on our Outbreak Outlook page.
The WHO will be convening an informal consultation on to discuss how science can assist in the response to the Ebola epidemic. The teleconference is scheduled for 7 October.
Uganda: A 30-year-old man died from Marburg haemorrhagic fever in Kampala on 28 September. Dozens of people are being monitored after having had contact with the man with several developing symptoms. It is unknown how the first case contracted the disease, investigations into this outbreak continue. Marburg virus belongs to the same family of viruses as Ebola virus and is also transmitted through contact with bodily fluids. Marburg disease has no vaccine or cure, and can cause similar symptoms to Ebola such as fever, headache, vomiting, diarrhoea and bleeding. Public health measures will be needed to prevent this outbreak spreading. This outbreak is independent to the Ebola epidemic ongoing in West Africa.
Aid: Norway is extending support to control the Ebola outbreak in the affected countries in the form of funds, personnel and equipment.
US: The patient in Dallas remains in critical but stable condition, and the treating hospital revealed that he has been receiving an experimental antiviral medication called brincidofovir since 4 October. The drug is manufactured by a North Carolina-based company, Chimerix, who stated that their drug had been given Emergency Investigational New Drug Applications (EIND) by the U.S. Food and Drug Administration (FDA).
6 October
Spain: A nurse who cared for two Ebola patients evacuated from Liberia and Sierra Leone in August and September has been confirmed infected with the virus. This is the first know instance of a person being infected with Ebola outside Africa. Read more...
MSF: Another Medecins Sans Frontieres health worker has been infected with Ebola. The Norwegian doctor has been working in Bo, Sierra Leone, and developed a fever on 5 October. She will be evacuated to Oslo for treatment. Norway has designated the Oslo University Hospital as the country's Ebola treatement centre. An investigation into how she was infected is underway.
United States: Media sources have reported that the American patient, a photojournalist infected with Ebola in Liberia, will be arriving in the country today and admitted to Nebraska Medical Centre.
In other news, media sources report that there are seven healthcare workers among the 10 close contacts of the Dallas case. Read more...
Sierra Leone: The Ministry of Health has reported new confirmed cases. Read more...
Liberia: US Navy mobile Ebola laboratories are operating at the Island clinic, Monrovia and in Bong County.
In other news, the Ministry of Information Culture Affairs and Tourism has introduced a new media access policy. Journalists must secure written permission if they want to take photographs or conduct interviews at Ebola healthcare facilities. According to the Minister, this policy protects the privacy of patients and healthcare workers and to protects the health and safety of both Liberians and international journalists. Read more...
Ethiopia: New sources are reporting that a 24-hour Ebola testing service has been launched at Bole International Airport, Addis Ababa, specifically to monitor and test passengers from 21 West African destinations.
5 October
Sierra Leone: The Public Health Agency of Canada has deployed a second field laboratory and staff to join an existing PHAC team working in Kailahun, eastern Sierra Leone. The laboratories will contribute to efforts to rapidly diagnose Ebola. The team will monitor the effectiveness of measures designed to prevent infection in the local communities.
Treatment: The World Health Organization has issued a position paper on the use of convalescent blood or plasma in treating Ebola outbreaks. This interim guidance for national health authorities and blood transfusion services covers guidelines on selecting donors; screening and handling blood; transfusion processes and other topics. Read more...
4 October
Canada: The Public Health Agency of Canada has clarified their position on donated vaccines. The Agency has confirmed that the 800-1000 vaccine doses are ready to be transported once "WHO requests that they be transferred or deployed." This shipment is dependent on safety and ethical considerations which are yet to be resolved by WHO and the global community.
Aid: The German government has delivered medical supplies to Liberia in the first mission involving the German Air Force. The NGO-led German Liberia clinic (GERLIB) has established a 48-bed isolation centre for Ebola cases in Paynesville, Monrovia.
US: The number of contacts under close monitoring in Dallas has been reduced from 100 to around 50, with 10 labelled as "high risk" contacts. CDC officials met a flight landing in Newark, New Jersey from Brussels, Belgium on 4 October following reports that a passenger from Liberia was ill on board. Read more...
France: The French nurse who was medically evacuated to France for treatment on 19 September has recovered and been discharged from hospital. The nurse was infected while working as a volunteer with MSF in Liberia. A health ministry statement confirmed the nurse received a number of new antiviral medications, including Avigan (favipiravir).
Germany: The doctor from Senegal who was evacuated to Hamburg has recovered and been discharged from hospital. The doctor had contracted Ebola whilst working for the World Health Organization in Sierra Leone.
Nigeria: The Federal Ministry of Health has finalised plans to carry out "Train the Trainer" sessions across all states as part of enhanced preparedness for Ebola. These sessions will be directed at both health workers and state health educators to ensure the response is coordinated and that health workers are appropriately knowledgeable and protected. Training has also been offered to health workers from Guinea, Sierra Leone and Liberia.
Europe: In an open letter to European governments published in The Lancet, over 40 signatories have called on government leaders to "mobilise all possible resources to assist West Africa." This includes the need to free up medical staff to volunteer, establish field laboratories and support the epidemiological surveillance. The authors also call for critical infrastructure to be built up, including telecommunications, clean water and fuel. They highlight the critical shortage of appropriate personal protective equipment (PPE) and urge local groups in West Africa to be empowered to bridge the gap between the international responders and the local communities.
Outlook: Two authors have called into question the apparently low case fatality rate in the current Ebola outbreak in West Africa. The report published in The Lancet states that the current values do not take into account the interval between confirming a case and knowing whether the case died or survived. They conclude, "The widely cited 2014 CFR of around 50% is therefore likely to be a substantial underestimate of the true value, and so the number could apparently rise over the course of the outbreak."
3 October
UN: The United Nations Mission for Ebola Emergency Response (UNMEER) has responded to recent media speculation that the Ebola virus could mutate or become airborne (PDF). The organisation states that there is no evidence that the Ebola virus is mutating to become airborne. UNMEER does not anticipate such a mutation and calls for Ebola response efforts to focus on the real needs in affected communities.
UNMEER has also released a statement (PDF) detailing the recent developments and international pledges of support following the "Defeating Ebola in Sierra Leone" conference held in London. The report also draws attention to the potential food crisis, given the impact Ebola has had on local and international trade in affected nations. Harvests are also threatened, further eroding food security in the region.
Liberia: A fifth American citizen working in West Africa is reported to have contracted Ebola. The 33-year-old man was working in Liberia as a freelance camera operator. He developed symptoms on 1 October and immediately isolated himself. Tests performed at an MSF treatment centre in Monrovia were reported to be positive on 2 October. It is unknown how he contracted the virus. The man will be medically evacuated back to the United States for treatment.
In other news, media sources have reported that, in the event the confirmed case in Dallas returns to Liberia, authorities there may prosecute him. He may have made a false declaration on the screening questionnaire before departing Liberia, stating he had no contact with Ebola patients. Yet it is believed that, before leaving Liberia for the US, he helped care for an infected pregnant woman in Monrovia who later died of the disease. It is not clear whether the man knew the woman died of Ebola.
United States: Health officials in Texas have legally ordered four close family members of the Dallas Ebola patient to stay home until at least 19 October. This is a precautionary measure. At this time, none of the family members have symptoms. The family have also been asked not to have any visitors without approval from the local or state health departments. The order will remain in place until after one 21-day incubation period passes. (The incubation period is the time between when someone is exposed to the Ebola virus and when they begin to have symptoms.)
Three healthcare workers who survived infection with Ebola have been interviewed. In the journal Science, the survivors recall their stringent precautions taken against Ebola and all wonder how they were infected. The call patients whose Ebola status is unknown a "hidden danger"; people who have symptoms but do not disclose them or patients who may withhold information about contacts.
Germany: A Ugandan doctor, who was working in Sierra Leone, has been medically evacuated to Frankfurt suffering from Ebola. The patient will be treated in isolation at the Frankfurt University hospital. He is the second Ebola case to be treated in Germany following medical evacuation from West Africa.
Sierra Leone: New cases have been reported. Read more...
WHO: In their latest Ebola Response Roadmap Update, 7,470 total cases and 3,431 deaths have been reported up to 1 October in Guinea, Liberia and Sierra Leone. Exposure of healthcare worker has resulted in more than 380 of them becoming infected and at least 216 have died since the start of the outbreak. Nigeria and Senegal have completed at least 30 days since the last confirmed case in both nations and all contacts have completed the 21-day monitoring period in isolation with no new cases. The WHO update also includes confirmation of the patient in Dallas, Texas which is detailed on the United States page.
2 October
United States: The man who has Ebola in Texas first sought medical care on 25 September, several days before he was tested for Ebola and admitted to a hospital. He visited an emergency department on 25 September with abdominal pain and a low-grade fever. He reportedly told a nurse he had been in Liberia recently, but he was not screened for Ebola. His symptoms worsened and he returned to the hospital (via ambulance) on 28 September, when he was admitted into isolation and tested for Ebola.
Authorities will monitor around 100 people who may have had contact with this man, including ambulance staff and several school children. This is a conservative approach which casts a 'wide net' and includes people who are likely not at risk but will be screened anyway. None of them have any symptoms. Public health officials stated it was unnecessary to contact trace fellow passengers on this man's commercial flights since he felt well while travelling. Ebola is contagious only after the patient develops symptoms. Nevertheless, one airline has made an announcement about the flights they think he was on. Read more...
WHO: The World Health Organization organised an expert consultation on Ebola vaccines. More than 70 experts attended the meeting to assess the status of testing and to licensing two candidate Ebola vaccines. Experts from both affected and neighbouring countries in West Africa also attended the event. All participants agreed that the main immediate goal is"to have a fully tested and licensed product that can be scaled up for use in mass vaccination campaigns."
ECDC: The European Centre for Disease Control and Prevention has updated their Rapid Risk Assessment (RRA) for the Ebola outbreak in West Africa. A dramatic increase in trend in Guinea, Liberia and Sierra Leone in the coming months is indicated by projections published by different models. It further quoted "These projections should be regarded as indicative of possible trends and not as exact predictions. Yet, all models point to a substantial increase in the number of cases if control efforts remain unchanged." The RRA also assesses the risk to Europe and outlines what European Union (EU) member states can do to reduce these risks. The RRA explores the risk of infection for EU residents who may visit affected countries, and the risk of spread following importation into Europe, either as a planned medical evacuation or following commercial flight of an infected traveller.
1 October
WHO: In their latest Roadmap Situation Report #6, the World Health Organization says there have been 7,178 cases and 3,338 deaths up to 28 September. The situation in Guinea appears stable, there has been a slight fall in the number of new cases reported, mainly due to a drop in the number of new cases reported from Macenta. Liberia has also reported a fall in cases, it is likely that this is due to delays matching laboratory results with clinical surveillance data. The situation in Sierra Leone continues to deteriorate, as case numbers continue to increase. Port Loko, Bombali and Moyamba districts have been quarantined after a surge in cases over the past four weeks.
In Guinea, Liberia and Sierra Leone, the WHO is monitoring response efforts in the following 5 domains:
Case management: Ebola treatment centres, referral, and infection prevention and control.
Case confirmation
Surveillance
Safe and dignified burials
Socialisation
Liberia: Media sources report that soldiers at the Edward Beyan Kesselley Barrack have been quarantined and the facility has been closed for 21 days. The step was initiated after at least seven soldiers from the Liberian army were infected with Ebola. The soldiers have been admitted to John F Kennedy Ebola Treatment Centre. It is reported that one of the soldier’s may have acquired the infection from his spouse, which then spread to his close contacts at the barrack.
Sierra Leone: Ministry of Health and Sanitation has reported more new cases. Read more...
Nigeria: All contacts have completed 21 days monitoring with no further cases identified. Read more...
Latest News
Last Updated: October 08, 2014 16:20 GMT
Imported cases
Many locations are testing people who have travelled to Ebola-affected countries and returned with a fever and other symptoms. Nigeria, Senegal and the United States have confirmed imported cases of Ebola. International SOS is monitoring these closely. Click here for more details.
8 October
Sierra Leone: The Health Ministry has reported new cases and deaths in their latest update. Read more…
United States: The photojournalist evacuated from Liberia who is being treated at the Nebraska Medical Center has begun treatment with the experimental drug Brincidofovir.
In other news, a number of media outlets have reported US authorities plan to augment the screening at US airports for passengers arriving from West Africa. Although outlined by the White House, the nature of these additional measures has not yet been published by the US Centers for Disease Control (CDC) or the Transportation Security Administration (TSA).
The confirmed case of Ebola, hospitalised in Dallas, has died. Read more...
Liberia: An interim care centre has been opened by Child Fund International in Monrovia, to look after children who have been orphaned by Ebola.
There are several reports that all Ebola media coverage at health facilities will be restricted, to protect the privacy of patients and healthcare workers and ensure safety of staff and journalists. The Liberian Ministry of Health and Social Welfare and Ministry of Information have reportedly established a new Ebola media policy. Healthcare workers will not be allowed to give any information and no interviews will be conducted without advance approval from the Ministry of Information.
Samaritan purse has launched a new program on home-based interventions for Ebola. The training will help community members support Ebola patients in remote areas. Each family will receive training on Ebola patient care and will be provided a kit which includes protective clothing, medicines, disinfectants and hydration items. The first round is being implemented at River Gee County. The organisation has also planned to build the first Community Care Centre in the county. Read more...
Sierra Leone, Norway: A Norwegian aid worker has been infected with Ebola in Sierra Leone while volunteering with MSF in Bo district. She was isolated and has been repatriated to Norway to receive treatment in Oslo.
Outlook: The World Bank has cautioned that the economic impact of the Ebola outbreak, which already is projected at US$2.2-7.4 billion loss by the end of 2014, could be as high as US$32 billion if neighbouring countries are also significantly infected. This is classed as a "High Ebola" scenario where containment of the outbreak is slower and more of the region is affected. The report (PDF) highlights the successful containment in Nigeria and Senegal and suggests that the losses could be mitigated if other countries can mount a similarly robust response.
The Food and Agriculture Organization has published their year-long response plan (PDF) to the Ebola outbreak. The four pillars of the response aim to: stop the spread of disease; boost income and agricultural production; build resilience in the communities, and; strengthen coordination of response. The harvest is projected to be severely affected by the lack of available labour in Guinea, Sierra Leone and Liberia and this threatens the food security of these countries. The impact will be felt by tens of thousands of people.
7 October
Nigeria: The US CDC has downgraded the travel alert for Nigeria to Level 1 (Watch) in line with the decreased risk of Ebola in the country.
Liberia: The World Health Organization (WHO) and Ministry of Health have launched a new training program for healthcare workers in Monrovia. At least six people who survived Ebola infections will participate and share their experiences. A mock Ebola treatment unit has been constructed for the two-week long course. Over 400 health workers will attend sessions. Once they successfully complete the program, trainees will be eligible to work in Ebola treatment centres across the country.
In their latest situation report, the Ministry of Health confirmed additional cases and deaths.
The US CDC released an assessment of the Ebola case burden, health care infrastructure, and emergency preparedness in four counties in southeastern Liberia (Grand Gedeh, Grand Kru, River Gee, and Maryland) in August. This was before any of these areas had Ebola cases, but while the outbreak was affecting other parts of the country. These areas previously had six physicians, but half of them had already left the country due to the epidemic. Nursing staff had abandoned their posts in half the hospitals reviewed, and students and volunteers were often found providing medical care and responding to emergencies in their absence. Gloves were in low supply or completely absent. There was not enough personal protective equipment to care for Ebola patients and healthcare providers were not trained in its use. Handwashing stations were found only in operating rooms, if anywhere, and supplies of soap, bleach, and alcohol-based hand gel had run out. Only two of the four counties had isolation facilities and these lacked water, electricity, and waste disposal facilities. No Ebola surveillance systems were in place. Some of these issues have been remedied since August, but this report paints a clear and unfortunate picture of the limited resources available in some affected areas to fight this Ebola outbreak.
Spain: Media sources reported that a second healthcare worker has been isolated at a hospital in Madrid with diarreha, a possible symptom of Ebola, though initial tests for Ebola were negative. Read more...
WHO: The World Health Organization released a situation assessment regarding the mode of transmission of the Ebola virus. They refute claims that Ebola can spread through the air and state that speculations that the virus may mutate into an airborne disease are unfounded. The Ebola virus spreads thought direct physical contact with infected bodily fluids or contaminated surfaces and objects. This echoes the report issued by the UN a few days prior on the same topic (see story below dated October 3).
Also making headlines from WHO is a statement from the European Director that additional cases of Ebola in Europe are "unavoidable" due to international travel between Europe and Africa. In actuality, imported cases of Ebola are a threat in countries worldwide until the epidemic in West Africa is controlled - a point highlighted by the recent case in the United States and discussed on our Outbreak Outlook page.
The WHO will be convening an informal consultation on to discuss how science can assist in the response to the Ebola epidemic. The teleconference is scheduled for 7 October.
Uganda: A 30-year-old man died from Marburg haemorrhagic fever in Kampala on 28 September. Dozens of people are being monitored after having had contact with the man with several developing symptoms. It is unknown how the first case contracted the disease, investigations into this outbreak continue. Marburg virus belongs to the same family of viruses as Ebola virus and is also transmitted through contact with bodily fluids. Marburg disease has no vaccine or cure, and can cause similar symptoms to Ebola such as fever, headache, vomiting, diarrhoea and bleeding. Public health measures will be needed to prevent this outbreak spreading. This outbreak is independent to the Ebola epidemic ongoing in West Africa.
Aid: Norway is extending support to control the Ebola outbreak in the affected countries in the form of funds, personnel and equipment.
US: The patient in Dallas remains in critical but stable condition, and the treating hospital revealed that he has been receiving an experimental antiviral medication called brincidofovir since 4 October. The drug is manufactured by a North Carolina-based company, Chimerix, who stated that their drug had been given Emergency Investigational New Drug Applications (EIND) by the U.S. Food and Drug Administration (FDA).
6 October
Spain: A nurse who cared for two Ebola patients evacuated from Liberia and Sierra Leone in August and September has been confirmed infected with the virus. This is the first know instance of a person being infected with Ebola outside Africa. Read more...
MSF: Another Medecins Sans Frontieres health worker has been infected with Ebola. The Norwegian doctor has been working in Bo, Sierra Leone, and developed a fever on 5 October. She will be evacuated to Oslo for treatment. Norway has designated the Oslo University Hospital as the country's Ebola treatement centre. An investigation into how she was infected is underway.
United States: Media sources have reported that the American patient, a photojournalist infected with Ebola in Liberia, will be arriving in the country today and admitted to Nebraska Medical Centre.
In other news, media sources report that there are seven healthcare workers among the 10 close contacts of the Dallas case. Read more...
Sierra Leone: The Ministry of Health has reported new confirmed cases. Read more...
Liberia: US Navy mobile Ebola laboratories are operating at the Island clinic, Monrovia and in Bong County.
In other news, the Ministry of Information Culture Affairs and Tourism has introduced a new media access policy. Journalists must secure written permission if they want to take photographs or conduct interviews at Ebola healthcare facilities. According to the Minister, this policy protects the privacy of patients and healthcare workers and to protects the health and safety of both Liberians and international journalists. Read more...
Ethiopia: New sources are reporting that a 24-hour Ebola testing service has been launched at Bole International Airport, Addis Ababa, specifically to monitor and test passengers from 21 West African destinations.
5 October
Sierra Leone: The Public Health Agency of Canada has deployed a second field laboratory and staff to join an existing PHAC team working in Kailahun, eastern Sierra Leone. The laboratories will contribute to efforts to rapidly diagnose Ebola. The team will monitor the effectiveness of measures designed to prevent infection in the local communities.
Treatment: The World Health Organization has issued a position paper on the use of convalescent blood or plasma in treating Ebola outbreaks. This interim guidance for national health authorities and blood transfusion services covers guidelines on selecting donors; screening and handling blood; transfusion processes and other topics. Read more...
4 October
Canada: The Public Health Agency of Canada has clarified their position on donated vaccines. The Agency has confirmed that the 800-1000 vaccine doses are ready to be transported once "WHO requests that they be transferred or deployed." This shipment is dependent on safety and ethical considerations which are yet to be resolved by WHO and the global community.
Aid: The German government has delivered medical supplies to Liberia in the first mission involving the German Air Force. The NGO-led German Liberia clinic (GERLIB) has established a 48-bed isolation centre for Ebola cases in Paynesville, Monrovia.
US: The number of contacts under close monitoring in Dallas has been reduced from 100 to around 50, with 10 labelled as "high risk" contacts. CDC officials met a flight landing in Newark, New Jersey from Brussels, Belgium on 4 October following reports that a passenger from Liberia was ill on board. Read more...
France: The French nurse who was medically evacuated to France for treatment on 19 September has recovered and been discharged from hospital. The nurse was infected while working as a volunteer with MSF in Liberia. A health ministry statement confirmed the nurse received a number of new antiviral medications, including Avigan (favipiravir).
Germany: The doctor from Senegal who was evacuated to Hamburg has recovered and been discharged from hospital. The doctor had contracted Ebola whilst working for the World Health Organization in Sierra Leone.
Nigeria: The Federal Ministry of Health has finalised plans to carry out "Train the Trainer" sessions across all states as part of enhanced preparedness for Ebola. These sessions will be directed at both health workers and state health educators to ensure the response is coordinated and that health workers are appropriately knowledgeable and protected. Training has also been offered to health workers from Guinea, Sierra Leone and Liberia.
Europe: In an open letter to European governments published in The Lancet, over 40 signatories have called on government leaders to "mobilise all possible resources to assist West Africa." This includes the need to free up medical staff to volunteer, establish field laboratories and support the epidemiological surveillance. The authors also call for critical infrastructure to be built up, including telecommunications, clean water and fuel. They highlight the critical shortage of appropriate personal protective equipment (PPE) and urge local groups in West Africa to be empowered to bridge the gap between the international responders and the local communities.
Outlook: Two authors have called into question the apparently low case fatality rate in the current Ebola outbreak in West Africa. The report published in The Lancet states that the current values do not take into account the interval between confirming a case and knowing whether the case died or survived. They conclude, "The widely cited 2014 CFR of around 50% is therefore likely to be a substantial underestimate of the true value, and so the number could apparently rise over the course of the outbreak."
3 October
UN: The United Nations Mission for Ebola Emergency Response (UNMEER) has responded to recent media speculation that the Ebola virus could mutate or become airborne (PDF). The organisation states that there is no evidence that the Ebola virus is mutating to become airborne. UNMEER does not anticipate such a mutation and calls for Ebola response efforts to focus on the real needs in affected communities.
UNMEER has also released a statement (PDF) detailing the recent developments and international pledges of support following the "Defeating Ebola in Sierra Leone" conference held in London. The report also draws attention to the potential food crisis, given the impact Ebola has had on local and international trade in affected nations. Harvests are also threatened, further eroding food security in the region.
Liberia: A fifth American citizen working in West Africa is reported to have contracted Ebola. The 33-year-old man was working in Liberia as a freelance camera operator. He developed symptoms on 1 October and immediately isolated himself. Tests performed at an MSF treatment centre in Monrovia were reported to be positive on 2 October. It is unknown how he contracted the virus. The man will be medically evacuated back to the United States for treatment.
In other news, media sources have reported that, in the event the confirmed case in Dallas returns to Liberia, authorities there may prosecute him. He may have made a false declaration on the screening questionnaire before departing Liberia, stating he had no contact with Ebola patients. Yet it is believed that, before leaving Liberia for the US, he helped care for an infected pregnant woman in Monrovia who later died of the disease. It is not clear whether the man knew the woman died of Ebola.
United States: Health officials in Texas have legally ordered four close family members of the Dallas Ebola patient to stay home until at least 19 October. This is a precautionary measure. At this time, none of the family members have symptoms. The family have also been asked not to have any visitors without approval from the local or state health departments. The order will remain in place until after one 21-day incubation period passes. (The incubation period is the time between when someone is exposed to the Ebola virus and when they begin to have symptoms.)
Three healthcare workers who survived infection with Ebola have been interviewed. In the journal Science, the survivors recall their stringent precautions taken against Ebola and all wonder how they were infected. The call patients whose Ebola status is unknown a "hidden danger"; people who have symptoms but do not disclose them or patients who may withhold information about contacts.
Germany: A Ugandan doctor, who was working in Sierra Leone, has been medically evacuated to Frankfurt suffering from Ebola. The patient will be treated in isolation at the Frankfurt University hospital. He is the second Ebola case to be treated in Germany following medical evacuation from West Africa.
Sierra Leone: New cases have been reported. Read more...
WHO: In their latest Ebola Response Roadmap Update, 7,470 total cases and 3,431 deaths have been reported up to 1 October in Guinea, Liberia and Sierra Leone. Exposure of healthcare worker has resulted in more than 380 of them becoming infected and at least 216 have died since the start of the outbreak. Nigeria and Senegal have completed at least 30 days since the last confirmed case in both nations and all contacts have completed the 21-day monitoring period in isolation with no new cases. The WHO update also includes confirmation of the patient in Dallas, Texas which is detailed on the United States page.
2 October
United States: The man who has Ebola in Texas first sought medical care on 25 September, several days before he was tested for Ebola and admitted to a hospital. He visited an emergency department on 25 September with abdominal pain and a low-grade fever. He reportedly told a nurse he had been in Liberia recently, but he was not screened for Ebola. His symptoms worsened and he returned to the hospital (via ambulance) on 28 September, when he was admitted into isolation and tested for Ebola.
Authorities will monitor around 100 people who may have had contact with this man, including ambulance staff and several school children. This is a conservative approach which casts a 'wide net' and includes people who are likely not at risk but will be screened anyway. None of them have any symptoms. Public health officials stated it was unnecessary to contact trace fellow passengers on this man's commercial flights since he felt well while travelling. Ebola is contagious only after the patient develops symptoms. Nevertheless, one airline has made an announcement about the flights they think he was on. Read more...
WHO: The World Health Organization organised an expert consultation on Ebola vaccines. More than 70 experts attended the meeting to assess the status of testing and to licensing two candidate Ebola vaccines. Experts from both affected and neighbouring countries in West Africa also attended the event. All participants agreed that the main immediate goal is"to have a fully tested and licensed product that can be scaled up for use in mass vaccination campaigns."
ECDC: The European Centre for Disease Control and Prevention has updated their Rapid Risk Assessment (RRA) for the Ebola outbreak in West Africa. A dramatic increase in trend in Guinea, Liberia and Sierra Leone in the coming months is indicated by projections published by different models. It further quoted "These projections should be regarded as indicative of possible trends and not as exact predictions. Yet, all models point to a substantial increase in the number of cases if control efforts remain unchanged." The RRA also assesses the risk to Europe and outlines what European Union (EU) member states can do to reduce these risks. The RRA explores the risk of infection for EU residents who may visit affected countries, and the risk of spread following importation into Europe, either as a planned medical evacuation or following commercial flight of an infected traveller.
1 October
WHO: In their latest Roadmap Situation Report #6, the World Health Organization says there have been 7,178 cases and 3,338 deaths up to 28 September. The situation in Guinea appears stable, there has been a slight fall in the number of new cases reported, mainly due to a drop in the number of new cases reported from Macenta. Liberia has also reported a fall in cases, it is likely that this is due to delays matching laboratory results with clinical surveillance data. The situation in Sierra Leone continues to deteriorate, as case numbers continue to increase. Port Loko, Bombali and Moyamba districts have been quarantined after a surge in cases over the past four weeks.
In Guinea, Liberia and Sierra Leone, the WHO is monitoring response efforts in the following 5 domains:
Case management: Ebola treatment centres, referral, and infection prevention and control.
Case confirmation
Surveillance
Safe and dignified burials
Socialisation
Liberia: Media sources report that soldiers at the Edward Beyan Kesselley Barrack have been quarantined and the facility has been closed for 21 days. The step was initiated after at least seven soldiers from the Liberian army were infected with Ebola. The soldiers have been admitted to John F Kennedy Ebola Treatment Centre. It is reported that one of the soldier’s may have acquired the infection from his spouse, which then spread to his close contacts at the barrack.
Sierra Leone: Ministry of Health and Sanitation has reported more new cases. Read more...
Nigeria: All contacts have completed 21 days monitoring with no further cases identified. Read more...
but things are getting more and more crazy...
_http://abcnews.go.com/Politics/wireStory/us-orders-agents-monitor-travelers-ebola-26043345
