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PostPosted: Fri Nov 28, 2014 11:54 am 
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WHO has issued an update on Ebola in semen after recovery.

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PostPosted: Fri Nov 28, 2014 11:55 am 
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Ebola virus in semen of men who have recovered from Ebola virus disease

Key messages

26 November 2014
Survivors of Ebola working with WHO WHO/Winnie RomerilSurvivors of Ebola working with WHO, Sierra Leone
Sexual transmission of Ebola virus disease (EVD) has not been documented
In four studies that investigated persistence of Ebola virus in seminal fluid from convalescent patients (a total of 43 patients), three men who had recovered from Ebola virus disease were reported to shed live virus in semen 40 days, 61 days and 82 days after onset of symptoms, respectively.
In two studies, Ebola virus was isolated from semen, but subsequent infections were not identified in household contacts.
Men who have recovered from Ebola virus disease should be aware that seminal fluid may be infectious for as long as three months after onset of symptoms.
Because of the potential to transmit the virus sexually during this time, they should maintain good personal hygiene after masturbation, and either abstain from sex (including oral sex) for three months after onset of symptoms, or use condoms if abstinence is not possible.
WHO does not recommend isolation of male convalescent patients whose blood has been tested negative for EVD.
The Ebola virus is shed in bodily fluids such as blood, vomit, faeces, saliva, urine, tears, and vaginal and seminal fluids. There is evidence that seminal fluids of convalescing men can shed the Ebola virus for at least 82 days after onset of symptoms. Although the scientific evidence is limited, it is clear that semen is a potential source of infection and could therefore cause transmission of the virus through delivery of the infectious virus on a mucosal surface.

1. How long is Ebola virus present in semen?

In a study performed during the Ebola outbreak in Gulu, Uganda, in 2000, the authors tested the semen of a single convalescent patient and were able to isolate Ebola virus up to 40 days after the onset of illness. One study in 1977 (Edmond et al., laboratory infection in England) detected live Ebola virus in semen of one convalescent man 61 days after onset of symptoms. One study in1995 (Rodriguez et al. Ebola outbreak in Kikwit, Democratic Republic of Congo) also detected live Ebola virus in semen in one convalescent man 82 days after disease onset. Therefore, it is possible for Ebola virus to be present in semen for 3 months after disease onset.

2. Is semen that tests positive for Ebola virus infectious?

The evidence is inconclusive. One study (Rowe et al.) that followed four men recovering from Ebola virus disease and their sexual partners found that no sexual partner developed symptoms.

References

Bausch, D. et al. (2007) Assessment of the risk of Ebola virus transmission from bodily fluids and fomites, The Journal of Infectious Diseases, 196, pp. S142-7.
Emond, R. et al. (1977) A case of Ebola virus infection, British Medical Journal, 2, pp. 541-544.
Rodriguez, L. et al. (1999) Persistence and genetic stability of Ebola virus during the outbreak in Kikwit, Democratic Republic of Congo, 1995, The Journal of Infectious Diseases, 179(1), pp. S170-6.
Rowe, A. et al. (1999) Clinical, Virologic, and Immunologic Follow-up of Convalescent Ebola Hemorrhagic Fever Patients and their Household Contacts, Kikwit, Democratic Republic of the Congo, The Journal of Infectious Diseases, 179(1), pp.S28-35.

http://www.who.int/reproductivehealth/t ... -semen/en/

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PostPosted: Fri Nov 28, 2014 12:03 pm 
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Published Date: 2014-11-27 20:10:40
Subject: PRO/AH/EDR> Ebola virus disease - West Africa (218): Liberia clinics, semen trans., S. Leone
Archive Number: 20141127.2995708

EBOLA VIRUS DISEASE - WEST AFRICA (218): LIBERIA CLINICS, SEMEN TRANSMISSION, SIERRA LEONE
******************************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

In this update:
[1] Liberia: Chinese-built Ebola center dedicated
[3] Liberia: US DoD/IOM Ebola Treatment Units
[4] Liberia: Monrovia Medical Unit opened
[5] Liberia: sexual transmission reported
[6] Sierra Leone: 8 day wait for test result in health care unit
[7] Sierra Leone: 100 Nigerian medics for Ebola war

******
[1] Liberia: Chinese-built Ebola center dedicated
Date: Tue 25 Nov 2014
Source: ABC News [edited]
http://abcnews.go.com/International/wir ... a-27162074


Chinese-built Ebola center dedicated in Liberia
-----------------------------------------------
China, one of the 1st countries to send aid to battle Ebola in West Africa, ramped up the assistance significantly Tue 25 Nov 2014 by opening a 100-bed treatment center in Liberia. Liberian President Ellen Johnson Sirleaf toured the Ebola treatment center, calling it "1st-class." "We want to commend China for this exceptional response," Sirleaf said.

The facility, which is air-conditioned and has digital document keeping instead of paper, will start accepting patients next week, Chinese Embassy officials said. The giant white building was built in the parking lot of a stadium, outside Monrovia, Liberia's capital. Soldiers from USA, which has also sent troops and is building treatment units in Liberia, were present at the ceremony.

China is Africa's largest trading partner and has especially close ties with Liberia, where many Chinese firms won contracts for post-war reconstruction projects. It has pledged USD 81 million in aid to West Africa, including the money for the treatment center, to stem the Ebola outbreak and has also sent at least 200 medical staff and promised more.

[Byline: Jonathan Paye-Layleh & Clarence Roy-Macaulay]

--
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Roger Feldman
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******
[3] Liberia: US DoD/IOM Ebola Treatment Units
Date: Tue 25 Nov 2014
Source: International Organization for Migration [edited]
http://www.iom.int/cms/en/sites/iom/hom ... -hots.html


Fighting Ebola in Liberian "hotspots"
-------------------------------------
On Fri 21 Nov 2014, Buchanan's 1st Ebola Treatment Unit (ETU), constructed by the US Department of Defence [DoD], was opened, to be run by IOM [International Organization for Migration] international, with local staff currently being trained by WHO and Liberia's Ministry of Health and Social Welfare. The ETU is equipped to receive and treat up to 50 patients and will likely begin receiving transfers and suspected cases in the 1st week of December 2014. Training includes educating communities about the importance of seeking early treatment at an ETU.

The Buchanan ETU is one of 3 facilities planned for Bomi, Grand Bassa and Grand Cape Mount counties. The 1st was opened in mid November 2014 in Tubmanburg in Bomi county. A team of 22 foreign medical workers and 138 national staff are running that unit. The 3rd ETU will open shortly in Sinje, Grand Cape Mount country, with the capacity to serve up to 50 patients. All 3 ETUs have all been built by the US Department of Defense, with the support of the Armed Forces of Liberia (AFL).... -- more

[Byline: Sandra Tumwesigye]

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******
[4] Liberia: Monrovia Medical Unit opened
Date: Sat 22 Nov 2014
Source: US Department of State blog [edited]
http://blogs.state.gov/stories/2014/11/ ... inst-ebola


Monrovia Medical Unit is aiding healthcare workers in the fight against Ebola
-----------------------------------------------------------------------------
The United States has been engaged with the Ebola outbreak since the 1st cases were reported in March 2014 -- and on Wed 5 Nov 2014, opened the Monrovia Medical Unit, to provide care to healthcare workers who become infected with Ebola while treating patients.

Liberian President Ellen Johnson Sirleaf was present to mark the inauguration of the Monrovia Medical Unit (MMU), a 25-bed field hospital located in Margibi County, Liberia. The MMU is currently [22 Nov 2014] treating 3 Liberian health care workers.

The MMU was constructed by the US Department of Defense and [is] staffed by the men and women of the U.S. Public Health Service. [In response to the Ebola outbreak], the U.S. government has deployed more than 2500 personnel to West Africa, making this the largest-ever U.S. government response to a global health crisis.

[Byline: Deborah R. Malac]

--
communicated by:
ProMED-mail
<promed@promedmail.org>

Roger Feldman
<promedrf@gmail.com>

******
[5] Liberia: sexual transmission reported
Date: Thu 27 Nov 2014
Source: AllAfrica, Liberian Observer report [edited]
http://allafrica.com/stories/201411271023.html


Liberia: Ebola doctor alarmed over male survivors infecting partners
--------------------------------------------------------------------
Dr. Atai Omurutu, head doctor at the Island Clinic Ebola treatment unit, has raised an alarm over the disturbing incidents of male Ebola survivors infecting their partners and putting entire families at risk. Dr. Omurutu said wives of male survivors are being admitted to the facility because they have contracted the disease from their partners. She appealed to the Ministry of Health for condoms to be given to male survivors in order to stop this mode of transmission of the Ebola virus.

She disclosed this new wave of infection to President Ellen Johnson Sirleaf when the President toured the Island Clinic ETU and the Alpha OAU ETU in Tweh Farm and Virginia, respectively. Dr. Omurutu, a Ugandan doctor, stated that once a man survives Ebola, he still has the virus in his semen for up to 3 months, therefore it is extremely important that male survivors abstain from sex during that period or use a condom to avoid infecting their partner.

[Byline: Alaskai Moore Johnson]

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******
[6] Sierra Leone: 8 day wait for test result in health care unit
Date: Tue 25 Nov 2014
Source: Telegraph [edited]
http://www.telegraph.co.uk/news/worldne ... ative.html


Sierra Leone: 8 days in a health care unit before tests proves negative
After the long wait for an Ebola test, a patient is told he can go home
-----------------------------------------------------------------------
A wonderful thing happened today. I was able to give a patient in our unit the news that he tested negative for Ebola and was free to go home. He leapt out of bed and danced for joy, praised the Lord and us -- and even, mortifyingly, bowed to our PPE-clad feet. Throughout the unit, we could hear him singing and I know I'm not the only one who got a bit weepy. As a qualified doctor in 2006, and then a paediatrician studying for a PhD in infectious diseases at the UCL Institute of Child Health, a month ago I volunteered to work in Freetown with the UK's King's Sierra Leone Partnership and am working at the Connaught Hospital Ebola Isolation Unit.

When a patient attends a health care unit, they are immediately screened for symptoms of Ebola -- fever plus abdominal pain, vomiting, headache and so on. The symptoms are non-specific and [they can also result from] anything from malaria to flu. If there is any suspicion of Ebola, they are admitted to an Isolation Unit -- beds permitting -- to be tested for the Ebola virus. And there they are kept until the results are available. This is intended to be within 24 hours.

The implications of delayed laboratory results are that those who turn out to be negative may be in beds next to positive patients with profuse diarrhoea, vomiting and even bleeding. The potential risk of infection is considerable. Patients are separated from each other by a wall of plastic sheeting; chlorine is used to decontaminate our gloved hands in between tending each patient; they are told to not leave their bed. [Even delayed, the news today was welcome.]

[Byline: Dr Felicity Fitzgerald]

--
communicated by:
ProMED-mail
<promed@promedmail.org>

Roger Feldman
<promedrf@gmail.com>

******
[7] Sierra Leone: 100 Nigerian medics for Ebola war
Date: Tue 25 Nov 2014
Source: Awoko [edited]
http://awoko.org/2014/11/25/sierra-leon ... -nig-envoy


Sierra Leone: 100 Nigerian medics for Ebola war
-----------------------------------------------
The Nigerian Envoy over the weekend disclosed that 100 Nigerian medics will be arriving in Sierra Leone the 1st week December [2014], under the auspices of the African Union, to help boost the fight against the deadly Ebola virus. Nigerian High Commissioner to Sierra Leone, Gladys Modupeola Aquist-Adebiyi made this disclosure during a one-day visit at the Magbenteh Ebola Treatment centre in Makeni, manned by the African Union medical team.... -- more

[Byline: Mariam Bah]

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[A HealthMap/ProMED-mail map is available at http://healthmap.org/promed/p/54.]

See Also

Ebola virus disease - West Africa (217): Sierra Leone, aid, WHO, CDC, Congo 20141126.2993049
Ebola virus disease - West Africa (216): Mali, Sierra Leone, W.Africa, Liberia 20141124.2987150
Ebola virus disease - West Africa (215): Mali more cases, WHO, Sierra Leone 20141122.2982863
Ebola virus disease - West Africa (214): WHO, Sierra Leone, Liberia 20141119.2972544
Ebola virus disease - West Africa (213): Sierra Leone, Benin false alarm, Mali 20141118.2966829
Ebola virus disease - West Africa (212): Mali, Guinea-Bissau reopens, Liberia 20141116.2960393
Ebola virus disease - West Africa (211): Mali, Liberia, aid, S Leone, Guinea 20141116.2958823
Ebola virus disease - West Africa (210): Mali, Liberia, WHO 20141114.2955997
Ebola virus disease - West Africa (209): Mali update 20141114.2954914
Ebola virus disease - West Africa (208): WHO, Mali conf, deaths 20141112.2950138
Ebola virus disease - West Africa (206): Sierra Leone, Liberia, more 20141111.2944063
Ebola virus disease - West Africa (201): WHO updates, Liberia new hospital 20141101.2922141
Ebola virus disease - West Africa (200): Mali, Liberia, cremation, case numbers 20141031.2920082
Ebola virus disease - West Africa (199): WHO, Liberia, asymptomatic infection 20141030.2913982
Ebola virus disease - West Africa (196): WHO, Mali conf. case ex Guinea, Liberia 20141024.2894887
Ebola virus disease - West Africa (192): WHO, S. Leone soldier, MSF, new drug 20141016.2870865
.................................................sb/jw/je

http://www.promedmail.org/direct.php?id=2995708

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PostPosted: Fri Nov 28, 2014 12:05 pm 
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Liberia: Male Ebola Survivors Infecting Partners, Ugandan Doctor Alarms

Monrovia — In continuation of her visits to various Ebola Treatment Units (ETUs), President Ellen Johnson Sirleaf expressed happiness that all the ETUs around Monrovia are experiencing a drastic decline in patient intake. However, she continues to warn Liberians to follow the advice and measures specified by healthcare workers in order to break the transmission of the disease, as there are still hotspots and pockets in communities.

According to an Executive Mansion release, President Sirleaf made the comments on Wednesday, November 26, 2014 when she visited the 96-bed Alpha OAU Ebola Center in Virginia and the 100-bed Island Clinic Ebola Center near St. Paul's Bridge, Bushrod Island to assess conditions there, including constraints, and to thank health care workers, partners, and volunteers for their services to the country especially in the fight against the Ebola virus disease.

At the Alpha OAU Ebola Center in Virginia, near Hotel Africa, the head of the ETU, Dr. Jonathan Hart, informed President Sirleaf that they commenced operations two weeks ago, precisely on November 10. With a total of 80 staff, they currently host 20 suspected patients, most of whom have been there for a week.

Responding to the Liberian leader's question about constraints, Dr. Hart, who previously worked at ELWA-2, confirmed that the payment of salaries is not an issue presently, there was sufficient beds and mattresses, while regular meals (3X/day) is available for patients.

However, for the patients, he appealed for more clothing (clothes, blankets, beddings, pampers, etc.), and supplements like biscuits, juices, etc. "We need to make sure our patients are rehydrated constantly and adequately unless they will die from dehydration and not Ebola," he said. He also appealed for medical clothes and transportation for the staff as there's only one vehicle that serves all purposes.

Speaking to the staff, President Sirleaf thanked the health care workers for serving their country during this difficult time and working with this kind of disease, but thanked them for their commitment and dedication.

At the Island Clinic Ebola Treatment Unit, the head of the clinical team, Dr. David Kaggwa provided President Sirleaf with the statistics since the ETU opened in late September. They have seen 1,015 patients to date; while 582 were confirmed with the Ebola virus disease. A total of 301 deaths occurred at the ETU and the survival rate at the ETU stands between 50 - 55 percent.

Dr. Kaggwa reiterated that there is a decline in the cases of Ebola being treated there, noting, "We are operating below 50 patients because shortly we will be discharging 28 patients - 22 Ebola survivors and six were tested negative twice - by this we will be operating below 30 patients." President Sirleaf later interacted with 28 patients that were about to be discharged from the Center.

Adding her voice, the overall head of the ETU, Dr. Atai Omurutu, who returns to Uganda next week, hoped that Liberia will have an Ebola free Christmas that President Sirleaf has targeted. In addition, Dr. Omurutu said Island Clinic has played a very big role in the reduction in the transmission of Ebola, because of the location; noting that they are located in the middle of the hotspots - West Point, New Kru Town, St. Paul's Bridge, Brewerville, among others.

"The moment we opened we kind of soaked in all those cases that were continuing the transmission. So I think it's important that Island Clinic stays because it is a window of hope for the community around here," she appealed.

But Dr. Omurutu alarmed over one disturbing trend where male Ebola survivors are infecting their partners and putting entire families at risk. "Almost all the wives of male Ebola survivors is coming to the ETU as patients," Dr. Omurutu stressed and appealed to President Sirleaf to see how the Ministry of Health can freely distribute condoms in the various communities to avoid this disturbing trend.

The Ugandan doctor confirmed that once a person survives Ebola, they still have the virus in the semen for up to three months, and it's extremely important that one abstains from sex during that period or use a condom to avoid infecting one's partner.

During the Liberian leader's interaction with health workers at the ETU, they raised a number of concerns, including outstanding hazard allowances, contractors still to receive pay for two months, workers with expired contracts still hoping to be transferred to other facilities, transportation for workers, among others. The Red Cross workers, for their part, appealed to President Sirleaf to visit their office at the old Ministry of Health where they would like to discuss issues with her privately. She readily accepted their invitation.

In response, the Liberian leader appealed to the health workers to have patience and promised to raise their concerns with the Ministry of Health in order to resolve the issues. With regards to outstanding arrears owed the healthcare workers, she assured them that they will receive their salaries that they diligently worked for. "Once you sign a contract, you'll have to get paid, no doubt about that," she assured.

On each stop, President Sirleaf thanked the healthcare workers, partners, and volunteers for their services to the country. "We would like to appreciate all of you for making this big sacrifice to come and join us to fight this problem and for your service to the country," she told everyone. As usual, the Liberian leader, at each stop provided assorted food items and some cash to the health workers as a token of appreciation.

In another development, President Sirleaf also stopped over at the new site of the Ma Juah Market to inspect the ongoing renovation work there. Marketers at the Ma Juah Market in Vai Town are to shortly relocate to Old Kru Town on UN Drive, Waterside.

http://allafrica.com/stories/201411271561.html

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