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PostPosted: Wed Sep 03, 2014 3:29 pm 
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Media reports indicate the contact of the doctor who treated the Lagos diplomat in Port Harcourt has died.

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PostPosted: Wed Sep 03, 2014 3:30 pm 
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Enemuo’s wife dies of Ebola

on September 03, 2014 / in Ebola Outbreak, News 7:02 pm / Comments


LAGOS (AFP) – The Federal Government on Wednesday announced that a seventh person had died from Ebola and another person was confirmed as having the virus.

The latest death was a patient at the isolation ward in the oil city of Port Harcourt, where a doctor died on August 22 after treating a Liberian man who had brought the disease into the country.

Dr Ike Enemuo fell ill and died after treating an official from the ECOWAS regional bloc who travelled to Port Harcourt after having contact with a Liberian man who brought the virus into Nigeria. The Enemuo’s wife contacted the disease, which claimed the life of her husband, Ike Enemuo, on August 22

The other five deaths were in the financial capital, Lagos. Four were healthcare workers who had treated the Liberian, who also died.

Health ministry spokesman Dan Nwomeh said 18 people, including the deceased, had now been confirmed as having the virus in Nigeria — 14 in Lagos and four in Port Harcourt, 435 kilometres (270 miles) away.

The wife of the Port Harcourt doctor who died was being treated at an isolation unit in Lagos, while another case was in a quarantine facility in the oil industry hub.

Eight people who contracted the virus have been successfully treated and discharged, Nwomeh said in a series of statements on Twitter. A ninth person, who infected the Port Harcourt doctor, also recovered.

A total of 41 people were under surveillance in Lagos and 255 in Port Harcourt. And 320 people have been discharged in Lagos after being under surveillance for 21 days — the virus’ incubation period.

- See more at: http://www.vanguardngr.com/2014/09/enem ... cVwqc.dpuf

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PostPosted: Wed Sep 03, 2014 3:50 pm 
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Ebola situation in Port Harcourt, Nigeria

Situation assessment - 3 September 2014

The Minister of Health of Port Harcourt, Nigeria, has now reported 3 confirmed cases of Ebola virus disease in Port Harcourt, the country’s oil hub. Additional suspected cases are being investigated.

Background on the Port Harcourt index case

Ebola virus was imported into Nigeria via an infected air traveller, who entered Lagos on 20 July and died 5 days later. One close contact of the Lagos case fled the city, where he was under quarantine, to seek treatment in Port Harcourt.

The close contact was treated, from 1 to 3 August, at a Port Harcourt hotel, by what would turn out to be the city’s index case. This case was a male physician who developed symptoms of weakness and fever on 11 August and died of Ebola on 22 August. His infection was confirmed on 27 August by the virology laboratory at Lagos University Teaching Hospital.

The male physician in Port Harcourt is therefore indirectly linked to Nigeria’s first case.

The case history of the index case in Port Harcourt is important, as it reveals multiple high-risk opportunities for transmission of the virus to others.

After onset of symptoms, on 11 August, and until 13 August, the physician continued to treat patients at his private clinic, and operated on at least two. On 13 August, his symptoms worsened; he stayed at home and was hospitalized on 16 August.

Prior to hospitalization, the physician had numerous contacts with the community, as relatives and friends visited his home to celebrate the birth of a baby.

Once hospitalized, he again had numerous contacts with the community, as members of his church visited to perform a healing ritual said to involve the laying on of hands. During his 6 day period of hospitalization, he was attended by the majority of the hospital’s health care staff.

On 21 August, he was taken to an ultrasound clinic, where 2 physicians performed an abdominal scan. He died the next day.

The additional 2 confirmed cases are his wife, also a doctor, and a patient at the same hospital where he was treated. Additional staff at the hospital are undergoing tests.

Given these multiple high-risk exposure opportunities, the outbreak of Ebola virus disease in Port Harcourt has the potential to grow larger and spread faster than the one in Lagos.

The response

Nigerian health workers and WHO epidemiologists are monitoring more than 200 contacts. Of these, around 60 are considered to have had high-risk or very high-risk exposure.

The highest-risk exposures occurred in family members and in health care workers and patients at the facility where the index case was hospitalized. Church members who visited the index case while he was hospitalized are also considered at high risk.

The government, supported by WHO, UNICEF, and MSF (Doctors without Borders), has introduced a number of emergency measures. More will be introduced later this week.

An Ebola Emergency Operations Centre has been activated, with support from the US Centers for Disease Control and Prevention. A mobile laboratory, with RT-PCR diagnostic capacity, is set up and functional.

A 26-bed isolation facility for the management of Ebola cases is in place, with plans for possible expansion. WHO has 15 technical experts on the ground.

Twenty-one contact-tracing teams are at work; they have good training, provided by WHO, and adequate transportation, thanks to government support. Two decontamination teams are equipped and operational, as is a burial team.

Port Harcourt is the capital of Rivers State. WHO, together with the Rivers State Port Health Service, has assessed public health measures at airport gates and other points of entry. Screening is under way at domestic and international airport gates.

Social mobilization efforts have been stepped up, initially targeting key community and religious leaders.

However, civil unrest, security issues, and public fear of Ebola create serious problems that could hamper response operations. Military escorts are needed for movements into the isolation and treatment centre.

WHO media contacts:
Fadéla Chaib
Telephone: + 41 22 791 3228
Mobile:+ 41 79 475 55 56
Email: chaibf@who.int

Tarik Jasarevic
Mobile: +41 793 676 214
Tel: +41 22 791 5099
E-mail: jasarevict@who.int

http://www.who.int/mediacentre/news/ebo ... r-2014/en/

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PostPosted: Wed Sep 03, 2014 4:31 pm 
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A few hours after Nigerians were rejoicing over the news that yet another Ebola patient had been successfully manage and discharged from hospital, the ministry of health has announced that a separate victim has been killed by the virus.

Dan Nwomeh, special assistant on media and communication to the minister of health, said the latest victim died at an isolation ward in Port Harcourt, capital of Rivers state, having contracted the disease while receiving treatment at the hospital where a doctor died on August 22.

The doctor himself contracted the disease while treating an ECOWAS official that had contact with Mr. Patrick Sawyer, the Liberian-American who brought the disease into the country. “The [late] Port Harcourt-based doctor was not managed by us but… [he] died from Ebola Virus Disease,” he said.

“The elderly patient who was in the same hospital where that Port Harcourt doctor was managed but who was admitted and managed by us at the Port Harcourt isolation ward unfortunately didn’t make it because she also had other problems including heart problems. So she has passed on.”

Nwomeh said Nigeria was in effective control of the situation, as only two patients were being isolated in Lagos and Rivers, the only states where confirmed cases of Ebola have been recorded in the country.

“The total number of cases successfully managed and discharged from our isolation ward in Lagos stands at eight. “Eight Nigerians have been successfully treated in Lagos and are at home now, reunited with their families. The number of Ebola Virus Disease patients currently under treatment, as I speak to you, are two. One in Lagos and one in Port Harcourt.” Explaining that the latest death brings to seven the total number of people who have died of the virus, Nwomeh said 291 persons were under surveillance in the country.

Read more at: http://www.thecable.ng/breaking-port-ha ... ictim-dies | TheCable

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PostPosted: Wed Sep 03, 2014 7:44 pm 
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Quarantine escapee sparked more Ebola in Nigeria

Robert Roos | News Editor | CIDRAP News | Sep 03, 2014

The man escaped quarantine in Lagos and sought care in Port Harcourt, both in southern Nigeria.
A contact of Nigeria's first Ebola patient fled quarantine in August and passed the disease to a doctor, who subsequently infected at least two other people, offering a textbook example of how not to deal with the disease, the World Health Organization (WHO) reported today.

The episode extended Ebola's reach in Nigeria from Lagos, the capital, to Port Harcourt, the country's oil hub on the southeastern coast. Because of the number of people exposed to the doctor, the outbreak in Port Harcourt could grow bigger than the original outbreak in Lagos, the WHO said.

Meanwhile, a trio of United Nations (UN) and WHO officials today again stressed the urgent need to expand the international response to West Africa's Ebola epidemic, but insisted that the governments of the affected countries must remain in charge of efforts within their borders. The officials estimated that the international effort will cost at least $600 million.

Port Harcourt cases
A sick airline passenger, Patrick Sawyer, spread Ebola virus to Nigeria when he flew from Liberia to Lagos on Jul 20; he died on Jul 25. One of Sawyer's close contacts in Lagos fled the city, where he was under quarantine, to seek treatment in Port Harcourt, the WHO said in today's statement.

The contact was treated from Aug 1 to 3 by a male physician at a Port Harcourt hotel. The physician fell ill on Aug 11, but for 2 days afterward he continued treating patients at his private clinic, operating on at least two of them, the WHO said.

On Aug 13 his symptoms worsened, and he then stayed home until he was hospitalized on Aug 16, the WHO said. He died on Aug 22, and his Ebola virus disease (EVD) was confirmed on Aug 27 by a lab at Lagos University Teaching Hospital.

After he got sick, the doctor had numerous contacts with others, both before and after his hospitalization, the WHO said. In the hospital, members of his church visited him and performed a healing ritual said to involve the laying on of hands, and he was attended by most of the hospital staff.

The two people who caught the virus from the physician are his wife, also a doctor, and another patient at the hospital where he was treated, according to the WHO, which did not describe their conditions. Other hospital staff members are being tested.

"Given these multiple high-risk exposure opportunities, the outbreak of Ebola virus disease in Port Harcourt has the potential to grow larger and spread faster than the one in Lagos," the agency said.

It said Nigerian health workers and WHO epidemiologists are monitoring more than 200 contacts, including about 60 believed to have had high-risk or very high-risk exposures.

The Port Harcourt cases apparently raise Nigeria's Ebola count to at least 20 cases and 7 deaths. The latest WHO general update on Ebola in West Africa, on Aug 28, put Nigeria's tally at 17 cases and 6 deaths.

Nigeria responds
The WHO said the Nigerian government has taken a number of emergency steps in response to the new cases, with support from the WHO, the UN Children's Fund, and Medecins Sans Frontieres (MSF).

The government has activated an Ebola emergency operations center, set up a 26-bed isolation facility, and put 21 teams to work on contact tracing. The emergency center is supported by the US Centers for Disease Control and Prevention (CDC).

In addition, the WHO and local officials are assessing public measures at airport gates and other ports of entry in Port Harcourt.

But the agency warned that security problems and public fear of Ebola "create serious problems that could hamper response operations," with military escorts needed when moving patients into the Ebola treatment center.

WHO, UN officials underline urgency
At a press briefing in Washington, DC, today, WHO and UN officials again stressed the need to accelerate the response to West Africa's Ebola crisis.

"We're not in a position where we can afford to lose a day, because the outbreak is currently moving ahead of efforts to control it," said David Nabarro, MD, senior UN system coordinator for Ebola disease.

Nabarro, who just returned from a needs assessment trip to West Africa with the WHO's Keiji Fukuda, MD, said, "We need on the order of three to four times what is currently in place" in the way of resources to battle the epidemic.

He estimated that it will cost "at least $600 million and maybe a lot more to get the necessary support to the countries to get this under control."

Today's briefing followed a meeting in New York yesterday at which UN and other officials addressed UN member states to emphasize the seriousness of the Ebola situation in West Africa and urged them to send aid to the region.

Fukuda, the WHO's assistant director-general for health security and environment, said he and Nabarro met with a wide range of officials and people at all levels during their visit to Monrovia, Liberia, and Freetown, Sierra Leone.

The main message they heard was about the lack of capacity to respond to the epidemic, including the lack of treatment centers, vehicles, protective equipment, and funds, he said.

"But of all things that are low in capacity, the most important is that we don't have enough people on the ground," including nurses, doctors, drivers, contact investigators, Fukuda said.

Aside from Nabarro's cost estimate, he, Fukuda, and WHO Director-General Margaret Chan, MD, MPH, declined to estimate just how many health workers or other types of resources are needed. They noted previously announced goals of reversing the trend in cases within 3 months and stopping transmission in 6 to 9 months.

They also stressed the obstacles caused by the Ebola-inspired cancellations of airline flights to Liberia, Sierra Leone, and Guinea. Chan said she has talked with experts from around the world who are willing to go to the region to provide infection control and clinical care, but because of flight cancellations, "We are unable to deploy them."

Reporters asked the three officials why, given the magnitude or the problem, they weren't calling for more of a military-style, "command and control" response, like the "massive mobilization" coordinated by the US Navy in response to the 2004 tsunami in Aceh, Indonesia.

Nabarro replied that he believes it is possible to cope with the situation "with the institutions and resources we have," but added that scaling up the response sufficiently and fast enough is very difficult. "Over the next few days we are changing the way the WHO and UN works on this issue, and talking to governments to get them fully invested," he said. "We are talking to all other groups that could provide support."

He commented further, "The governments of the affected countries are in charge; our role is to help them do the job they need to do." He added that the UN aims to do all it can to ensure that responders are protected from infection.

Chan echoed the point about national sovereignty saying, "I don't think any government in this world will accept a takeover by others. So whatever we are doing, we are supporting national authorities to take the leadership."

UK patient released
In other developments, Royal Free Hospital in London today announced the release of William Pooley, a British nurse who contracted EVD in Sierra Leone and was treated at the hospital for 10 days. His treatment included the experimental drug ZMapp, which has been given to several other patients, including two Americans.

In addition, Nancy Writebol, an American missionary and medical worker who was flown back to the United States after contracting EVD in Liberia, talked about her illness and recovery at a press conference today. She was hospitalized at Emory University in Atlanta and was released Aug 19.

Writebol, who worked for the SIM (Service in Mission), said she initially thought she had malaria and was tested and treated for that disease. She said there were many times when she thought she wouldn't survive.

She said she didn't know if the ZMapp she received was what cured her, but suggested it was more the overall combination of treatment, prayers, and support from others that saw her through the illness.

Meanwhile, Bruce Johnson, president of SIM, identified the SIM worker who was recently infected with Ebola in Liberia as Rick Sacra, MD, a Boston doctor, according to a WSOC-TV news report on Writebol's press conference. Johnson said Sacra is in good spirits and communicating with his family by phone and the Internet, the story said.

Also today, the WHO released a list of 197 experts and officials who will take part in a WHO meeting in Geneva the next 2 days to discuss how experimental treatments and vaccines should be used in the Ebola epidemic.

In addition, the biopharmaceutical company Chimerix announced today that its investigational antiviral drug brincidofovir has shown in vitro activity against Ebola virus. The findings came in testing by the CDC and the US National Institutes of Health, the company said in a press release.

Chimerix said phase 3 trials of brincidofovir as a treatment for cytomegalovirus and adenovirus are currently under way. The company noted it will have representatives at the WHO meeting on Ebola treatments this week.

See also:

Sep 3 WHO statement on situation in Nigeria

Audio recording of Sep 3 UN press briefing

Sep 3 press release on release of William Pooley from Royal Free Hospital, London

Sep 3 WSOC-TV story on Nancy Writebol comments (with video link)

WHO's list of participants in Sep 4-5 meeting on Ebola interventions

Sep 3 Chimerix press release

http://www.cidrap.umn.edu/news-perspect ... la-nigeria

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