Rhiza Labs FluTracker Forum

The place to discuss the flu
It is currently Tue Oct 24, 2017 5:40 am

All times are UTC - 5 hours [ DST ]




Post new topic Reply to topic  [ 14 posts ]  Go to page 1, 2  Next
Author Message
PostPosted: Thu Jul 31, 2014 8:20 am 
Offline

Joined: Wed Aug 19, 2009 10:42 am
Posts: 56044
Location: Pittsburgh, PA USA
Media report indicates Lagos, Nigeria fatal Ebola case (40M) is the Zaire clade, which would match sequences from Guinea and Sierra Leone. Moreover, contact of the fatal case with blood from is fatally infected sister in Monrovia, Liberia suggests the Liberia cases also match Sierra Leone and Guinea sequences.

_________________
www.twitter.com/hniman


Top
 Profile  
 
PostPosted: Thu Jul 31, 2014 8:21 am 
Offline

Joined: Wed Aug 19, 2009 10:42 am
Posts: 56044
Location: Pittsburgh, PA USA
Lagos, Nigeria - Barely 24 hours before his death, Patrick Sawyer had a rather strange - and in the words of medical and diplomatic sources here, “Indiscipline” encounter with nurses and health workers at First Consultants Hospital in Obalende, one of the most crowded parts of Lagos, a population of some 21 million inhabitants, FrontPageAfrica has learned.

Looking to get to the bottom of Sawyer’s strange ailment on the Asky Airline flight, which Sawyer transferred on in Togo, hospital officials say, he was tested for both malaria and HIV AIDS. However, when both tests came back negative, he was then asked whether he had made contact with any person with the Ebola Virus, to which Sawyer denied. Sawyer’s sister, Princess had died of the deadly virus on Monday, July 7, 2014 at the Catholic Hospital in Monrovia. On Friday, July 25, 2014, 18 days later, Sawyer died in Lagos.

The Center for Disease Control (CDC) recommends that the average incubation period for suspected cases or someone who has made contact with an Ebola patient is eight to ten days from exposure to onset of symptoms. The range is from two to 21 days. “That's why we recommend that contacts of an infected person go on a fever watch for 21 days,” says Stephan Monroe, deputy director of CDC's National Center for Emerging Zoonotic and Infectious Diseases, at a briefing Monday.

‘Against Medical Advice’

Since the first report surfaced in March, there have been more than 1,201 cases reported and unfortunately 672 deaths in Guinea, Liberia and Sierra Leone, the CDC says. “This is the largest Ebola outbreak in history and the first in West Africa. It’s a rapidly changing situation and we expect there will be more cases in these countries in the coming weeks and months. The response to this outbreak will be more of a marathon than a sprint.”

Back in Lagos, authorities at the First Consultants Hospital in Obalende decided that despite Sawyer’s denial, they would test him for Ebola, due to the fact that he had just arrived from Liberia, where there has been an outbreak of the disease with more than 100 deaths.

The hospital issued a statement this week stating that Sawyer was quarantined immediately after he was discovered to have been infected with the deadly virus. In addition, a barrier nursing was implemented around Sawyer and the Lagos State Ministry of Health was immediately notified. Hospital authorities also requested the Federal Ministry of Health for additional laboratory test based on its suspicion of Ebola.

FrontPageAfrica has now learned that upon being told he had Ebola, Mr. Sawyer went into a rage, denying and objecting to the opinion of the medical experts. “He was so adamant and difficult that he took the tubes from his body and took off his pants and urinated on the health workers, forcing them to flee.

The hospital would later report that it resisted immense pressure to let out Sawyer from its hospital against the insistence from some higher-ups and conference organizers that he had a key role to play at the ECOWAS convention in Calabar, the Cross River State capital. In fact, FrontPageAfrica has been informed that officials in Monrovia were in negotiations with ECOWAS to have Sawyer flown back to Liberia.

A text message in possession of FrontPageAfrica from the ECOWAS Ambassador in Liberia, responding to a senior GoL official reads: Your Excellency, the disease control department of the Federal Ministry of Health just contacted me through the hospital now, insisting that Mr. Sawyer be evacuated for now. Pls advise urgently.”

LUTH Lab positive on Ebola

First Consultants said that it then went further to reach senior officials in the Office of the Secretary of Health of the USA who assisted it with contacts at the Centre for Disease Control and W.H.O Regional Laboratory Centre in Senegal. According to the hospital, the initial results from LUTH laboratory showed a signal of possible Ebola virus, but required confirmation.

The First Consultants statement noted that it was able to obtain confirmation of Ebola virus disease, (Zaire strain) after working with the state, federal and international agencies. Sawyer was pronounced dead at 6:50 AM Nigeria time, on July 25 and all agencies were properly notified.

Once the case was officially confirmed, the hospital was temporarily shut down and in-house patients immediately evacuated. Sawyer’s body was subsequently cremated under W.H.O guidelines and witnessed by all appropriate agencies, according to the hospital statement. “In keeping with W.H.O guidelines, the hospital is shut down briefly as full decontamination exercise is currently in progress. The re-opening of the hospital will also be in accordance with its guidelines”, the hospital said.

In the aftermath of Sawyer’s death, both federal and state authorities in Lagos have instituted measures to curb the spread of the disease and quarantining all those who came in contact with Sawyer.

In total, Sawyer reportedly came in direct contact with 59 persons, 44 of whom were at the hospital he was taken to when he fell ill, according to the Lagos State government. The Lagos state government clarified in a statement Monday that Ms. Obi-Nnadozie, Nigeria’s Ambassador to Liberia was not among the 15 people at the airport who had had direct contact with Mr. Sawyer before his death as was initially believed.





Ashes Returned to Liberia

However, it has been reported that Sawyer came in contact with three ECOWAS officials – a driver, a liaison officer and a protocol officer. Also in the list are two nursing staff and five airport handlers.

Dr. Jide Idris, the Lagos State Health Commissioner, told a news conference this week that 20 per cent of those that came in contact with the deceased had been physically screened. “The private hospital (First Consultants Medical Centre) was demobilized and primary source of infection eliminated. The patient has been cremated and the ash will be transferred to the Liberian government whenever the need arises. Decontamination process in all affected areas has commenced,” Dr. Idris said.

In the aftermath of Sawyer’s death, diplomatic, ECOWAS and medical authorities here are baffled over Sawyer’s deception, especially armed with new information that his sister, Princess had died of the deadly virus and his denial. Finance Ministry sources in Monrovia are in quiet murmur over what they feel was a letdown by Sawyer for not being forthcoming with his peers he worked with.

The ministry has since been temporarily shut down and those who came in contact with Sawyer are on a 21-day forced incubation monitoring process. "All senior officials coming in direct or indirect contact with Mr. Sawyer has been placed on the prescribed 21 days of observatory surveillance," the ministry said in a statement this week.

FrontPageAfrica has now learnt that Sawyer exhibited similar indiscipline behavior during his sister’s stay at the Catholic Hospital in Monrovia where she was taken because he noticed she was bleeding profusely and was later found to be a victim of Ebola.

‘Indiscipline’ Sawyer, EJS Says

Sawyer was seen with blood on his clothing after his sister’s death and had earlier demanded that she be placed in a private room. President Ellen Johnson-Sirleaf cited indiscipline and disrespect as a key reason why Sawyer contracted the Ebola virus. She said his failure to heed medical advice put the lives of other residents across the nation’s border at risk.

A disease which now claimed more than a hundred Liberians has now forced the Sirleaf-lead government to shut down the borders, schools and a host of other measures to ensure that the disease does not get out of hand, including a US$5 million initial contribution to begin the immediate implementation of this plan. “Our immediate strategy is to contain the spread, care for the afflicted with the goal of “No New Cases”,” Sirleaf told the nation in an address Wednesday. FrontPageAfrica has learned that the Ministry of Health is requesting US$20 million to combat the disease.

In addition, the President has mandated that all non-essential staff, to be determined by the Minister or Head of Agency, are to be placed on a 30-day compulsory leave and Friday, August 1, is declared a non-working day and is to be used for the disinfection and chlorination of all public facilities.

“All borders that are to remain opened are to be directly supervised and controlled by the Bureau of Immigration and Naturalization whose duties it shall be, working with the assigned health authorities, to ensure strict adherence to announce preventive measures including preliminary testing for fever. Without exceptions, all schools are ordered closed pending further directive from the Ministry of Education. All markets at border areas including Foya, Bo Waterside, and Ganta are hereby ordered closed until further notice.

But despite the measures put in place by Liberia, the effect of Sawyer’s ‘indiscipline has already taken a toll. ASKY, the Pan-African airline ASKY on which Sawyer flew, has suspended all flights to and from Monrovia and Sierra Leone as has other regional carriers, Arik Air and Gambia Bird dealing a huge blow to commercial aviation.

Linger Questions Over Behavior

Back in Monrovia, Samaritan Purse, the U.S. missionary group helping to treat Ebola patients is scaling down, announcing Wednesday, plans to evacuate nonessential personnel given the five-month-old outbreak is worsening as the fate of two Americans infected with the Ebola hang in the balance on hope and prayers.

For Sawyer, questions are lingering over his behavior, both at the Catholic Hospital in Monrovia and the First Consultants in Lagos and what led him to behave the way he did. More importantly diplomatic observers here are puzzled over his demise: The timing and behavior. A few persons who spoke to Sawyer, including FrontPageAfrica reported that he sounded fine hours before his death. It is unclear what pushed him to the wall and why?

As for the other eight members of the delegation that flew to Lagos, along with Sawyer, diplomatic sources in Lagos confirmed to FrontPageAfrica Wednesday that they were all checked and told to report to the Ministry of Health in Monrovia upon their arrival. It is unclear how close they were to Sawyer or whether authorities in Monrovia have begun monitoring them as the clock ticks on the recommended 21-day incubation period.

http://frontpageafricaonline.com/index. ... ge-strange

_________________
www.twitter.com/hniman


Top
 Profile  
 
PostPosted: Thu Jul 31, 2014 8:28 am 
Offline

Joined: Wed Aug 19, 2009 10:42 am
Posts: 56044
Location: Pittsburgh, PA USA
niman wrote:

The First Consultants statement noted that it was able to obtain confirmation of Ebola virus disease, (Zaire strain) after working with the state, federal and international agencies.
http://frontpageafricaonline.com/index. ... ge-strange

98 June sequences from Sierra Leone were virtually identical with each other and closely related to 3 March sequences from Guinea. These sequences created a novel Zaire sub-clade and comments above suggest Nigeria sequence is a match.

_________________
www.twitter.com/hniman


Top
 Profile  
 
PostPosted: Thu Jul 31, 2014 8:34 am 
Offline

Joined: Wed Aug 19, 2009 10:42 am
Posts: 56044
Location: Pittsburgh, PA USA
Ebola: Nigeria is not out of the woods yet — Prof. Tomori

on July 30, 2014 / in Ebola Outbreak 7:21 am / Comments


Since the confirmation and subsequent death of a Liberian man who was the first to be diagnosed with the Ebola Virus Disease on Nigerian soil, anxiety, shock and fear have been expressed by a wide section of the populace. Although several assurances have been given by officials of the Federal and state governments, the generality of Nigerians remain worried and doubtful about their safety.

Foremost virologist and Vice-Chancellor of Redeemer’s University, President of the Nigeria Academy of Science, Prof. Oyewale Tomori, is of the view that Nigeria’s effort in containing the first reported Ebola case was commendable. However, Tomori, who is currently the regional virologist with the World Health Organisation Africa Region and a Fellow of the Nigeria Academy of Science, the College of Veterinary Surgeons of Nigeria and the Royal College of Pathologists of the United Kingdom, warns that as far as Ebola is concerned, Nigeria is not yet out of the woods. He speaks to Sola Ogundipe. Excerpts .

WHAT should be the best step for monitoring passengers entering Nigeria by air, land and sea from Ebola affected countries? Do they need to be quarantined?
Not necessarily. The Port Health staff needs to screen passengers coming into Nigeria from Ebola affected countries, by checking for anyone ill with fever plus signs and symptoms of Ebola fever. The screening can be done using a prepared investigation form for taking details of the passenger – name, age, contact address, travel history (which countries visited, for how long and which part of the country, etc), plus any history of illness or sickness over the last 2-3 weeks.

Prof Oyewale Tomori
Prof Oyewale Tomori
Those who are sick, like the Liberian case, must be taken for observation to hospital with isolation facilities. Others must be let off, but monitored and contacted DAILY by phone to check if they fall sick over the next 3 weeks covering the incubation period of Ebola infection. They should be carefully monitored by competent health staff

From what we have witnessed in the handling of the first Ebola victim, is Nigeria in any way up to the task of containing a possible outbreak of Ebola?
I will say that the health staff – federal, state and the hospital where the case was admitted and the laboratory staff have performed creditably well. However, the detection of the case was purely fortuitous and not because we had our preparedness machinery in place. We should count ourselves lucky that the Liberian case came into Nigeria already sick and landed in Lagos too sick to continue his journey to Calabar.

He arrived at a time when our government hospitals were operating at “half mast” because the doctors were on strike. We might have had a bigger problem in our hands, assuming this case was well enough to get to Calabar – (in which case he would have mingled with more passengers at the local airport and in Calabar) or that government hospitals were in full operation, (in which case he would not have been admitted into a private hospital, where there are fewer contacts). So, I am saying we were able to detect the case through fortuitous circumstances and not because of our preparedness.

We were simply lucky. In spite of our national penchant for declaring ourselves always on top of the situation, we were plain lucky on this occasion, not because we were prepared. Next time, we may not be so lucky. We must, however, commend staff of the Federal and State Ministries of Health and of the private hospital where the case was admitted for being alert and taking prompt action as soon as suspicion was raised. Another point about this issue which made me proud was the laboratory support within the country.

The lab in LUTH under Prof Omilabu received samples on July 22nd and the next day provided results of a pan-FILOVIRUS family diagnosis, that is evidence of presence of a virus belonging to the family of Ebola virus (including Marburg, Ebola-Zaire, Ebola-Sudan Bundibugyo virus, Reston virus, and Taï Forest virus).

Samples were also sent to Prof. Happi’s lab at the Redeemer’s University (RUN), late on July 23. The Happi team worked and tested and confirmed that the virus was the specific Ebola-Zaire type virus early on July 25, 2014. All these happened before confirmation came in from Dakar. I understand the RUN lab will commence sequencing studies pretty soon. My congratulations to our colleagues in LUTH and RUN for a great job.

What should we be doing currently that we are not in terms of (a) preparedness (b) response?
We are certainly not out of the woods yet, until we ensure that we monitor and ascertain that every of his contact is free from infection. We must trace all the passengers in the plane that brought him to Nigeria, to those in contact with him at the Lagos airport, and all those who attended to him, in the hospital where he was treated.

Every such person must be monitored for the duration of the incubation period of Ebola virus infection that is up to 21 days from point of contact. We must get in touch with them on a daily basis to find out if they fall sick, with fever and showing the signs and exhibiting the symptoms of viral hemorrhagic fever. This must be carried out thoroughly, efficiently and rapidly. I repeat, we are not out of the woods yet.

One other issue we should take note of is to find out the itinerary of the ASKY flight that brought the case to Nigeria. Did the flight come direct from Liberia or were there stops on the way say, Lome, etc., and who had contact with the case.

We need to contact other countries where ASKY might have landed and is still landing. I hear also that other airlines – Arik does direct Abuja-Monrovia-Freetown flights. If that is so, then we must also mount our surveillance not only on Lagos, but also on Abuja, Not forgetting Idi-Iroko, Seme borders.

In the event of detection of subsequent confirmed cases of Ebola, what would be the implication and how should we respond to such?
Any suspected case arising from new comers into Nigeria or should any of the contact of the Liberian case become ill, the case should be admitted immediately into a hospital with isolation facilities and barrier nursing instituted.

Isolation facilities
This is why the monitoring at the border must not be scaled down. So long as we are still having people coming in from the affected West African countries, we must be on top alert with our border monitoring.

Are there any issues regarding the hospital where the victim was admitted and eventually died?
I am very pleased to say that the staff of the private hospital acted professionally in every aspect of the treatment and eventual containment of the case. I understand that the hospital has been decontaminate and closed for a period of time.

What is your last word on this?
As I mentioned earlier, the detection of the case was purely fortuitous and not because we had our preparedness machinery in place. We should have had our border monitoring in place soon after we learnt of the first case in Guinea.

Again, so long as ASKY or any other airlines are bringing in passengers from Liberia, Sierra Leone or Guinea, our border monitoring must remain in place until the countries are declared free and for another 2-3 weeks after the declaration

- See more at: http://www.vanguardngr.com/2014/07/ebol ... S8wmV.dpuf

_________________
www.twitter.com/hniman


Top
 Profile  
 
PostPosted: Thu Jul 31, 2014 8:38 am 
Offline

Joined: Wed Aug 19, 2009 10:42 am
Posts: 56044
Location: Pittsburgh, PA USA
niman wrote:
Ebola: Nigeria is not out of the woods yet — Prof. Tomori

on July 30, 2014 / in Ebola Outbreak 7:21 am / Comments




Samples were also sent to Prof. Happi’s lab at the Redeemer’s University (RUN), late on July 23. The Happi team worked and tested and confirmed that the virus was the specific Ebola-Zaire type virus early on July 25, 2014. All these happened before confirmation came in from Dakar. I understand the RUN lab will commence sequencing studies pretty soon. My congratulations to our colleagues in LUTH and RUN for a great job.


- See more at: http://www.vanguardngr.com/2014/07/ebol ... S8wmV.dpuf

More confirmation that Nigeria sequence matches Sierra Leone & Liberia

_________________
www.twitter.com/hniman


Top
 Profile  
 
PostPosted: Thu Jul 31, 2014 8:43 am 
Offline

Joined: Wed Aug 19, 2009 10:42 am
Posts: 56044
Location: Pittsburgh, PA USA
niman wrote:

FrontPageAfrica has now learnt that Sawyer exhibited similar indiscipline behavior during his sister’s stay at the Catholic Hospital in Monrovia where she was taken because he noticed she was bleeding profusely and was later found to be a victim of Ebola.

‘Indiscipline’ Sawyer, EJS Says

Sawyer was seen with blood on his clothing after his sister’s death
http://frontpageafricaonline.com/index. ... ge-strange

Above comments indicate the Lagos (Nigeria) Ebola will match Monrovia (Liberia) Ebola and both are Zaire strain, which matches Sierra Leone and Guinea.

_________________
www.twitter.com/hniman


Top
 Profile  
 
PostPosted: Thu Jul 31, 2014 9:39 am 
Offline

Joined: Wed Aug 19, 2009 10:42 am
Posts: 56044
Location: Pittsburgh, PA USA
IN the interest of our patients, staff, the general public and the nation at large we state the following:

A 40-year old gentleman came into the hospital with symptoms suggestive of Malaria (fever, headache, extreme weakness) on Sunday night (20th July, 2014);

He was fully conscious and gave us his clinical history and told us he is a Senior Diplomat from Liberia. Laboratory investigations confirmed malaria whilst other tests for HIV, Hepatitis B & C were negative. He was admitted and treatment commenced.

However, due to the fact that he was not responding to treatment but rather was developing haemorrhagic symptoms we further questioned him. He denied having been in contact with any person with EVD (Ebola Virus Disease) at home, in any hospital or at any burial. In spite of this denial we immediately decided to do the following:

1. To conduct further tests for possible infectious Haemorrhagic Disease, especially Ebola Virus Disease, based on the fact that he was a Liberian citizen and the recent outbreak of Ebola Virus Disease in that country.

2. We immediately isolated/quarantined the patient, commenced barrier nursing and simultaneously contacted the Lagos State Ministry of Health and the Federal Ministry of Health to enquire where further laboratory tests could be performed as we had a high index of suspicion of possible Ebola Virus Disease.

3.We refused for him to be let out of the hospital in spite of intense pressure, as we were told that he was a senior ECOWAS official and had an important role to play at the ECOWAS convention in Calabar, Cross River State.

4.The initial test results from LUTH laboratory indicated a signal of possible Ebola Virus Disease, but required confirmation.

5.We then took the further step of reaching out to Senior Officials in the office of the Secretary of Health of the United States of America who promptly assisted us with contacts at the Centres for Disease Control (CDC) and World Health Organisation Regional Laboratory Centre in Senegal.

6.Working jointly with the State, Federal Agencies and International Agencies, we were able to obtain confirmation of Ebola Virus Disease (Zaire Strain), (W.H.O. Regional Centre Lab - Senegal/Redeemers Lab/LUTH Laboratory).

7.The gentleman subsequently died on Friday at 6.50 a.m. (25th July, 2014);

8.All agencies were promptly notified and in consultation with W.H.O. Regional Ebola Virus Disease Centre in Conakry, Guinea and Best Practices, the following was commenced:

(a)Orderly temporary shut down of the hospital with immediate evacuation of in-house patients.

(b)The appropriate professional removal of the body and its incineration under W.H.O. guidelines witnessed by all appropriate agencies

9. Having concluded the above, it is now appropriate to give the Press release in the interest of our patient, staff, the general public and the nation at large.

10.In keeping with W.H.O. guidelines, the hospital is shutdown briefly as full decontamination exercise is currently in progress. The reopening of the hospital will also be in accordance with W.H.O. guidelines.

n conclusion, working with the State, Federal and International Agencies, we were able to identify and confirm the diagnosis of the Ebola Virus Disease.

We hope that by our action of preventing this gentleman from being extracted from our hospital and travelling to Calabar we have been able to prevent the spread of Ebola Virus Disease in Nigeria.

The Board and Management of the Hospital wish to thank all our staff members for their diligence and professionalism.

Thank you.

First Consultants Medical Centre Limited, 16/24 Ikoyi, Road, Obalende, Lagos.

http://allafrica.com/stories/201407311324.html

_________________
www.twitter.com/hniman


Top
 Profile  
 
PostPosted: Sat Aug 02, 2014 6:57 pm 
Offline

Joined: Wed Aug 19, 2009 10:42 am
Posts: 56044
Location: Pittsburgh, PA USA
Th e new england journal o f medicine
n engl j med nejm.org 1
brief report
Emergence of Zaire Ebola Virus Disease
in Guinea — Preliminary Report
Sylvain Baize, Ph.D., Delphine Pannetier, Ph.D., Lisa Oestereich, M.Sc.,
Toni Rieger, Ph.D., Lamine Koivogui, Ph.D., N’Faly Magassouba, Ph.D.,
Barrè Soropogui, M.Sc., Mamadou Saliou Sow, M.D., Sakoba Keïta, M.D.,
Hilde De Clerck, M.D., Amanda Tiffany, M.P.H., Gemma Dominguez, B.Sc.,
Mathieu Loua, M.D., Alexis Traoré, M.D., Moussa Kolié, M.D.,
Emmanuel Roland Malano, M.D., Emmanuel Heleze, M.D., Anne Bocquin, M.Sc.,
Stephane Mély, M.Sc., Hervé Raoul, Ph.D., Valérie Caro, Ph.D.,
Dániel Cadar, D.V.M., Ph.D., Martin Gabriel, M.D., Meike Pahlmann, Ph.D.,
Dennis Tappe, M.D., Jonas Schmidt-Chanasit, M.D., Benido Impouma, M.D.,
Abdoul Karim Diallo, M.D., Pierre Formenty, D.V.M., M.P.H.,
Michel Van Herp, M.D., M.P.H., and Stephan Günther, M.D.
The authors’ affiliations are listed in the
Appendix. Address reprint requests to
Dr. Günther at the Bernhard Nocht
Institute for Tropical Medicine, Bernhard
Nocht Str. 74, 20359 Hamburg, Germany,
or at guenther@bni.uni-hamburg.de.
This article was published on April 16,
2014, at NEJM.org.
DOI: 10.1056/NEJMoa1404505
Copyright © 2014 Massachusetts Medical Society.
Summary
In March 2014, the World Health Organization was notified of an outbreak of a
communicable disease characterized by fever, severe diarrhea, vomiting, and a high
fatality rate in Guinea. Virologic investigation identified Zaire ebolavirus (EBOV) as
the causative agent. Full-length genome sequencing and phylogenetic analysis
showed that EBOV from Guinea forms a separate clade in relationship to the known
EBOV strains from the Democratic Republic of Congo and Gabon. Epidemiologic
investigation linked the laboratory-confirmed cases with the presumed first fatality
of the outbreak in December 2013. This study demonstrates the emergence of a
new EBOV strain in Guinea.

http://www.nejm.org/doi/pdf/10.1056/NEJMoa1404505

_________________
www.twitter.com/hniman


Top
 Profile  
 
PostPosted: Sat Aug 02, 2014 7:03 pm 
Offline

Joined: Wed Aug 19, 2009 10:42 am
Posts: 56044
Location: Pittsburgh, PA USA
Table 1. Demographic, Clinical, and Virologic Characteristics of 15 Patients with Confirmed Ebola Virus Disease during the 2014 Outbreak in Guinea.*
Patient Number Age (yr) Sex Hospital Date of Sampling Symptoms Outcome Date of Death Virus Isolation GenBank Accession Number
C1 20 F Guéckédou March 12 Fever, diarrhea, vomiting Died March 18 No ND
C2 25 F Guéckédou March 13 Fever, diarrhea, vomiting Died March 25 No ND
C3 35 M Guéckédou March 13 Fever, vomiting Died March 17 No ND
C4 25 M Guéckédou March 18 Fever, diarrhea, vomiting, hemorrhage Died March 18 No ND
C5 16 F Guéckédou March 19 Spontaneous abortion Survived — Yes KJ660348
C6 27 F Guéckédou March 20 Fever, diarrhea, vomiting Died ND No ND
C7 47 F Guéckédou March 20 Fever, diarrhea, vomiting Died March 22 Yes KJ660347
C8 29 M Macenta March 16 Fever, hemorrhage Died March 16 No ND
C9 55 F Macenta March 16 Fever, diarrhea, vomiting Died March 19 No ND
C10 17 M Macenta March 16 Fever, diarrhea, vomiting ND ND No ND
C11 7 M Macenta ND Fever, diarrhea, vomiting Died March 26 No ND
C12 30 M Macenta, Nzérékoré February 28 Fever, vomiting Died February 28 Yes ND
C13 50 M Macenta March 12 Fever, diarrhea, vomiting Died March 12 Yes ND
C14 41 M Macenta, Nzérékoré March 13 Fever, diarrhea, vomiting, hemorrhage Died March 16 No ND
C15 28 F Kissidougou March 17 Fever, diarrhea, vomiting, hemorrhage Survived — Yes KJ660346

* All sampling and recording of patients’ status were performed in 2014. ND denotes not determined.

_________________
www.twitter.com/hniman


Top
 Profile  
 
PostPosted: Sat Aug 02, 2014 7:21 pm 
Offline

Joined: Wed Aug 19, 2009 10:42 am
Posts: 56044
Location: Pittsburgh, PA USA
niman wrote:
Table 1. Demographic, Clinical, and Virologic Characteristics of 15 Patients with Confirmed Ebola Virus Disease during the 2014 Outbreak in Guinea.*
Patient Number Age (yr) Sex Hospital Date of Sampling Symptoms Outcome Date of Death Virus Isolation GenBank Accession Number
C1 20 F Guéckédou March 12 Fever, diarrhea, vomiting Died March 18 No ND
C2 25 F Guéckédou March 13 Fever, diarrhea, vomiting Died March 25 No ND
C3 35 M Guéckédou March 13 Fever, vomiting Died March 17 No ND
C4 25 M Guéckédou March 18 Fever, diarrhea, vomiting, hemorrhage Died March 18 No ND
C5 16 F Guéckédou March 19 Spontaneous abortion Survived — Yes KJ660348
C6 27 F Guéckédou March 20 Fever, diarrhea, vomiting Died ND No ND
C7 47 F Guéckédou March 20 Fever, diarrhea, vomiting Died March 22 Yes KJ660347
C8 29 M Macenta March 16 Fever, hemorrhage Died March 16 No ND
C9 55 F Macenta March 16 Fever, diarrhea, vomiting Died March 19 No ND
C10 17 M Macenta March 16 Fever, diarrhea, vomiting ND ND No ND
C11 7 M Macenta ND Fever, diarrhea, vomiting Died March 26 No ND
C12 30 M Macenta, Nzérékoré February 28 Fever, vomiting Died February 28 Yes ND
C13 50 M Macenta March 12 Fever, diarrhea, vomiting Died March 12 Yes ND
C14 41 M Macenta, Nzérékoré March 13 Fever, diarrhea, vomiting, hemorrhage Died March 16 No ND
C15 28 F Kissidougou March 17 Fever, diarrhea, vomiting, hemorrhage Survived — Yes KJ660346

* All sampling and recording of patients’ status were performed in 2014. ND denotes not determined.

Clinical and Epidemiologic Analysis
The prominent clinical features of the EBOV infection in the confirmed cases were fever, severe diarrhea, and vomiting; hemorrhage was less frequent. The case fatality rate in the initial cases was 86% (12 of 14 patients with a known outcome died). Confirmed cases originated from hospitals in Guéckédou, Macenta, Nzérékoré, and Kissidougou prefectures (Fig. 1). We performed an epidemiologic look-back investigation of the transmission chains by reviewing hospital documentations and interviews with affected families, patients with suspected disease, and inhabitants of villages in which cases occurred. According to the current state of the epidemiologic investigation, the suspected first case of the
outbreak was a 2-year-old child who died in Meliandou in Guéckédou prefecture on December 6, 2013 (Fig. 2). Patient S14, a health care worker from Guéckédou with suspected disease, seems to have triggered the spread of the virus to Macenta, Nzérékoré, and Kissidougou in February 2014. As the virus spread, 13 of the confirmed cases could be linked to four clusters: the Baladou district of Guéckédou, the Farako district of Guéckédou, Macenta, and Kissidougou. Eventually, all clusters were linked with several deaths in the villages of Meliandou and Dawa between December 2013 and March 2014.

http://www.nejm.org/doi/pdf/10.1056/NEJMoa1404505

_________________
www.twitter.com/hniman


Top
 Profile  
 
Display posts from previous:  Sort by  
Post new topic Reply to topic  [ 14 posts ]  Go to page 1, 2  Next

All times are UTC - 5 hours [ DST ]


Who is online

Users browsing this forum: Majestic-12 [Bot], Yahoo [Bot] and 71 guests


You cannot post new topics in this forum
You cannot reply to topics in this forum
You cannot edit your posts in this forum
You cannot delete your posts in this forum
You cannot post attachments in this forum

Search for:
Jump to:  
cron
Powered by phpBB® Forum Software © phpBB Group