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PostPosted: Wed Aug 20, 2014 1:50 pm 
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WHO update for August 17-18 has 95 more deaths and 128 more cases for Liberia

http://www.who.int/csr/don/2014_08_20_ebola/en/

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PostPosted: Wed Aug 20, 2014 1:51 pm 
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New (1) Confirmed Probable Suspect Totals
Liberia
Cases 126 242 502 228 972
Deaths 95 212 239 125 576

1. New cases were reported between 17 and 18 August 2014.
The total number of cases is subject to change due to ongoing reclassification, retrospective investigation, and availability of laboratory results. Data reported in the Disease Outbreak News are based on official information reported by Ministries of Health.

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PostPosted: Wed Aug 20, 2014 1:54 pm 
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20 August 2014

Epidemiology and surveillance

Between 17 and 18 August 2014, a total of 221 new cases of Ebola virus disease (laboratory-confirmed, probable, and suspect cases) as well as 106 deaths were reported from Guinea, Liberia, Nigeria, and Sierra Leone.

Health sector response

WHO continues to engage in high-level communication efforts with affected countries, companies and organizations doing business in and from Africa, and national and global leaders. Currently, some companies have taken the decision to suspend services to the affected countries. This includes airlines and shipping companies. As a result of these decisions, countries are beginning to experience supply shortages, including fuel, food, and basic supplies. WHO is working with the UN World Food Programme to ensure adequate food and supplies, but calls on companies to make business decisions based on scientific evidence with regard to the transmission of Ebola virus.

In the current outbreak, the majority of Ebola virus disease cases are a result of human-to-human transmission and failure to apply appropriate infection prevention and control measures in home care, some clinical settings, and in burial rituals. It is important to understand that EVD is not an airborne disease. Individuals may become infected as a result of contact with the bodily fluids (vomit, diarrhoea, sputum, blood, etc.) from persons who are confirmed to have EVD or who have died from EVD. Companies bringing goods and services to the affected countries are at low risk for exposure to EVD and WHO, under the International Health Regulations, encourages companies and organizations to continue providing these necessary supplies.

Countries around the world continue to engage in active surveillance for cases of EVD. Reports have been received by WHO of suspected cases and systematic verification is underway in a number of countries to confirm whether these are actual EVD cases. Overall, these reports are a positive sign that surveillance is working and countries are stepping up their preparedness to respond. As of today, no cases have been confirmed outside Guinea, Liberia, Nigeria, or Sierra Leone.

A high-level delegation from WHO is currently in the affected countries, working with the national authorities and partners to adapt strategic operations response plans. Meetings are planned with leaders in Liberia and Sierra Leone, where transmission continues to be high.

WHO does not recommend any travel or trade restrictions be applied except in cases where individuals have been confirmed or are suspected of being infected with EVD or where individuals have had contact with cases of EVD. (Contacts do not include properly-protected health-care workers and laboratory staff.) Temporary recommendations from the Emergency Committee with regard to actions to be taken by countries can be found at:

IHR Emergency Committee on Ebola outbreak in west Africa
Disease update

Confirmed, probable, and suspect cases and deaths from Ebola virus disease in Guinea, Liberia, Nigeria, and Sierra Leone, as of 18 August 2014

New (1) Confirmed Probable Suspect Totals
Guinea
Cases 36 423 140 16 579
Deaths 2 254 140 2 396
Liberia
Cases 126 242 502 228 972
Deaths 95 212 239 125 576
Nigeria
Cases 0 12 0 3 15
Deaths 0 4 0 0 4
Sierra Leone
Cases 59 783 52 72 907
Deaths 9 335 34 5 374
Totals
Cases 221 1460 694 319 2473
Deaths 106 805 413 132 1350
1. New cases were reported between 17 and 18 August 2014.
The total number of cases is subject to change due to ongoing reclassification, retrospective investigation, and availability of laboratory results. Data reported in the Disease Outbreak News are based on official information reported by Ministries of Health.

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PostPosted: Wed Aug 20, 2014 2:09 pm 
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niman wrote:
New (1) Confirmed Probable Suspect Totals
Liberia
Cases 126 242 502 228 972
Deaths 95 212 239 125 576

1. New cases were reported between 17 and 18 August 2014.
The total number of cases is subject to change due to ongoing reclassification, retrospective investigation, and availability of laboratory results. Data reported in the Disease Outbreak News are based on official information reported by Ministries of Health.

The Liberia totals for deaths and cases are greater than the sum of yesterday's totals plus the new cases reported for today. The 972 cases and 576 deaths are the highest on record for any country.

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PostPosted: Wed Aug 20, 2014 8:01 pm 
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WHO sees start of shortages due to Ebola-related restrictions
Filed Under: Ebola
Lisa Schnirring | Staff Writer | CIDRAP News | Aug 20, 2014

Service interruptions by shippers are starting to cause food and fuel shortages in Ebola-hit countries, the WHO said.
The World Health Organization (WHO) today aired concern about companies suspending services to countries affected by the Ebola outbreak, with some starting to feel shortages of food and other supplies, and said the pace of new illnesses and deaths continues to surge, especially in Liberia and Sierra Leone.

High-level communications between the WHO and affected countries, companies, and groups that conduct business in and with Africa are still underway, and some companies have suspended services to the affected countries, according to a WHO statement today. Last week the agency aired concerns about flight bans and said the actions could hamper the flow of needed supplies to the outbreak region.

Shortages could hamper response, relief efforts
Delivery suspensions by shipping companies are starting to cause shortages of food, fuel, and basic supplies in affected countries, the WHO said, adding that it is already working with the United Nations World Food Programme to shore up food and other supplies for the region. It called on companies to make their decisions based on sound science about Ebola virus transmission.

Some airlines, such as British Airways and Emirates Airlines, have suspended service to outbreak areas. In a related development, some Air France flights crews are refusing to board planes because of outbreak fears, Agence France-Presse (AFP) reported today. A spokesman for the airline told AFP that flights scheduled for the region have not been left shorthanded.

Besides one sick airline traveler whose illness was detected in Nigeria, no travel-linked Ebola virus disease (EVD) cases have been detected anywhere in the world. The WHO and its emergency committee have said the risk for travel-related spread is very low and have urged countries not to issue trade or travel bans.

Illnesses and deaths rise in three countries
In outbreak developments, the WHO said today that between Aug 17 and 18, 221 new EVD cases and 106 deaths were reported from the West African outbreak countries, lifting the overall total to 2,473 illnesses with 1,350 deaths.

Liberia, which carries the biggest burden of cases, reported 126 more EVD cases and 95 deaths, boosting its total to 972 infections, 576 of them fatal. Sierra Leone health officials reported 59 more illnesses and 9 more deaths, bringing its total to 907 EVD cases, 374 of them fatal.

Civil unrest in the Liberian capital, Monrovia, has been hampering disease control efforts and fueling fears of further spread, and today police used tear gas and live ammunition to scatter a crowd attempting to break out of a quarantined neighborhood, according to a Reuters report.

The conflict occurred in the city's West Point slum area, where on Aug 16 a crowd looted an Ebola holding area, scattering patients and clinic supplies, including soiled items, into the community. The country's health ministry said yesterday that all of the patients, who were being evaluated for possible exposure to the virus, had been found and were being monitored at one of the city's hospitals.

In Guinea, which has recently seen some hopeful signs in the battle to curb the virus, authorities reported 36 more illnesses and 2 more deaths, raising its total to 579 cases and 396 deaths. Nigeria, where cases were linked to a sick traveler, reported no new cases or deaths, keeping its tally at 15 cases and 4 deaths.

California, New Mexico isolate patients, await test results
In other developments, California health officials said today that a patient identified as low-risk for EVD infection is in an isolation unit at a Sacramento County hospital awaiting the results of EVD testing, which is underway at the US Centers for Disease Control and Prevention (CDC).

Kaiser Permanente said yesterday in a statement that it was working with county health officials regarding a patient admitted to Kaiser Permanente South Sacramento Medical Center who may have been exposed to the Ebola virus. Kaiser said it was taking the same precautions it uses for other patients with suspected infectious diseases, which include isolating the patient in a negative-pressure room, use of personal protective equipment (PPE) by trained staff, and coordination with infectious disease specialists.

Gil Chavez, MD, state epidemiologist at the California Department of Public Health (CDPH), said at a media telebriefing today that he couldn't share any patient details because of privacy rules, but federal, state, and local health officials have deemed the patient at low risk on the basis of a CDC assessment of travel history, exposure, and symptoms. He added that the patient is being tested out of an abundance of caution and that test results are expected back in about 3 days.

In another precaution, California health officials are already identifying the patient's close contacts. "We are being very proactive very early on. There have been no cases that have met the CDC definition of high risk," Chavez said. He said identification of a low-risk patient isn't surprising, because other diseases resemble the initial symptoms of EVD and patients travel to California from all over the world.

The CDC has urged states to increase their surveillance for possible cases, and so far hospitals in 27 states have alerted the agency about possible cases, CDC officials told ABC News today. Among the states reporting, 58 cases were ruled out in view of patient exposures and symptoms, but blood samples were sent to the CDC for 10 patients. So far 7 have tested negative and test results are pending for 3, according to the ABC News report.

On Aug 17 the New Mexico Department of Health (NMDH) said it was working with the CDC regarding tests to rule out an EVD infection in a 30-year-old woman who came down with a sore throat, headache, muscle aches, and fever after teaching in Sierra Leone. It said the University of Mexico Hospital has isolated the patient, and tests are being done out of an abundance of caution.

Since early August, when West Africa's EVD outbreak became much worse, with two American medical missionaries evacuated to the United States for treatment, the CDC has issued several guidance documents for health providers and has activated its emergency operations center (EOC) at its highest level to devote more resources to monitoring and responding to the outbreak.

CDC guidance tackles environmental issues
Yesterday the CDC posted interim guidance for EVD environmental control in hospitals. It said that though the role of the environment in transmission hasn't been pinned down, limited lab studies suggest the virus can remain viable on solid surfaces, with slowly declining concentrations, over several days. Though there is no evidence that the virus transmits through the environment or fomites, stronger precautions are warranted, given the apparently low infectious dose, the potential for high virus titers in the blood of sick patients, and the severity of the disease, the agency said.

The CDC's guidance covers PPE for environmental services staff, disinfectants that should be used, considerations about porous surface contamination, and laundry.

See also:

Aug 20 WHO update

Aug 20 AFP story

Aug 20 Reuters story

Aug 14 CIDRAP News story "WHO pushes back against Ebola-related flight bans"

Aug 19 CDPH press release

Aug 19 Kaiser Permanente statement

Aug 17 NMDH press release

Aug 20 ABC News report

Aug 19 CDC interim guidance on environmental infection control for Ebola virus

http://www.cidrap.umn.edu/news-perspect ... strictions

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PostPosted: Fri Aug 22, 2014 10:34 am 
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WHO ‏@WHO 4m
In parts of #Liberia, as soon as a new #Ebola treatment facility is opened, patients immediately come, many not previously identified 1/2

WHO ‏@WHO 4m
This phenomenon suggests the existence of an invisible caseload of patients who are not being detected by the surveillance system #Ebola 2/2

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PostPosted: Fri Aug 22, 2014 2:35 pm 
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Every region of Liberia has now been hit by Ebola, officials said on Friday, as other affected west African nations scrambled to contain the spread of the killer virus.

After seeing people fall to the deadly disease in area after area, Liberia said two people had succumbed to the virus in Sinoe province, the last Ebola-free bastion in a country that has seen the biggest toll with 576 deaths.

The virus has spread relentlessly through Liberia, Guinea and Sierra Leone over the past months, killing 1,350 people since March, and Nigeria has also been affected despite showing some progress in fighting the epidemic.

"(Sinoe) was the last area untouched by Ebola," George Williams, head of the Health Workers Association of Liberia, said.

The country has witnessed chaotic scenes in recent days following a surge in the number of patients dying of the haemorrhagic fever.

Aid workers said crematoriums in the capital of Monrovia were struggling to deal with dozens of bodies arriving every day, and earlier this week, violence erupted in an Ebola quarantine zone in the capital after soldiers opened fire on protesting crowds.

In bad news for neighbouring Nigeria, officials said that two more people had tested positive for Ebola, taking the total number of confirmed cases to 14, including five deaths.

The World Health Organisation said earlier this week that it was encouraged by the situation in Africa's most populous country, given that all of the confirmed cases came from a single chain of transmission.

But the country's health minister Onyebuchi Chukwu told a news conference in Abuja that the two new cases were the first to contract the virus from a secondary source.

Most of the deaths in what has become the worst-ever outbreak of Ebola have occurred in Guinea, Liberia and Sierra Leone.

David Nabarro, a British physician appointed by the UN last week to co-ordinate the global response to the crisis, was in Monrovia on Friday for the second day of a tour of the region.

Speaking to AFP during a stopover at Conakry airport en route to Monrovia, he said he was determined to "ensure that every piece of our apparatus is at its optimum so it could deal possibly with a flare-up if that's necessary".

Nabarro is also due to visit Freetown, Conakry and Abuja during the trip, where he is tasked with revitalising the health sectors of affected countries.

Authorities in the region have been hampered in their fight against Ebola by the deaths of several top health officials and numerous frontline doctors to the virus.

No cure or vaccine is currently available for the deadly disease, which is spread by close contact with body fluids, meaning patients must be isolated.

However, two American missionaries who contracted Ebola while treating patients in Liberia left hospital in the US in recent days after making a full recovery. The two were treated with experimental drugs.

WHO warns of ‘shadow zones’

The scale of the world's worst Ebola outbreak has been concealed by families hiding infected loved ones in their homes and the existence of "shadow zones" that medics cannot enter, the WHO said on Friday.

The UN agency issued a statement detailing why the outbreak in west Africa had been underestimated, following criticism that it had moved too slowly to contain the killer virus, now spreading out of control.

Independent experts raised similar concerns a month ago that the contagion could be worse than reported because suspicious local inhabitants are chasing away health workers and shunning treatment.

Under-reporting of cases is a problem especially in Liberia and Sierra Leone. The WHO said it was now working with Medecins Sans Frontières (MSF) and the US Centers for Disease Control and Prevention to produce "more realistic estimates".

The WHO said it had drawn up a draft strategy plan to combat Ebola in west Africa over the next six to nine months, implying that it does not expect to halt the epidemic before the end of the year.

http://www.gulf-times.com/africa/243/de ... s-to-virus

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