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Ebola - Existence of an Invisible Caseload of Patients Who are Not Being Detected by the Surveillance System

Photo: CDC

As Ebola outbreak grows, WHO notes case-count difficulties

cidrap.umn.edu - by Robert Roos - August 22, 2014

. . . the World Health Organization (WHO) conceded that the size of the epidemic has been underestimated and cited a list of reasons for that, from concealment and denial of cases to the closing of treatment centers and clinics. . .

. . . The WHO also said that in parts of Liberia, newly opened treatment facilities have been immediately flooded with patients, many of whom were not previously identified. "This phenomenon strongly suggests the existence of an invisible caseload of patients who are not being detected by the surveillance system."

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Assessment of the Risk of Ebola Virus Transmission from Bodily Fluids and Fomites

      

jid.oxfordjournals.org

  1. J Infect Dis. (2007) 196 (Supplement 2): S142-S147. doi: 10.1086/520545

Abstract

Although Ebola virus (EBOV) is transmitted by unprotected physical contact with infected persons, few data exist on which specific bodily fluids are infected or on the risk of fomite transmission. Therefore, we tested various clinical specimens from 26 laboratory-confirmed cases of Ebola hemorrhagic fever, as well as environmental specimens collected from an isolation ward, for the presence of EBOV. Virus was detected by culture and/or reverse-transcription polymerase chain reaction in 16 of 54 clinical specimens (including saliva, stool, semen, breast milk, tears, nasal blood, and a skin swab) and in 2 of 33 environmental specimens.We conclude that EBOV is shed in a wide variety of bodily fluids during the acute period of illness but that the risk of transmission from fomites in an isolation ward and from convalescent patients is low when currently recommended infection control guidelines for the viral hemorrhagic fevers are followed.

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Ebola - Aligned Organizations

The following is a list of aligned organizations for Ebola response . . .

Mission Aviation Fellowship (MAF) - John Boyd, CEO
http://www.maf.org/

King's Sierra Leone Partnership (KSLP) Ebola Response Volunteers
http://kslp.org.uk/get-involved/lend-your-skills/ebola-volunteers/

Minnesotans offer helping hands, aid at epicenter of Ebola outbreak
http://www.startribune.com/lifestyle/health/271472521.html

Global Health Ministries - Ebola Outbreak Response Shipments (photos at the bottom)
http://www.ghm.org/index.php/liberia/57-projects/277-ebola-outbreak-response-shipments

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Over 300 Ebola deaths traced back to a healer in Sierra Leone

Source: http://www.enca.com/sierra-leones-ebola-deaths-traced-back-one-healer

 

FREETOWN, Sierra Leone - It has laid waste to the tribal chiefdoms of Sierra Leone, leaving hundreds dead, but the Ebola crisis began with just one healer's claims to special powers.

The outbreak need never have spread from Guinea, health officials  told  AFP, except for a herbalist in the remote eastern border village of Sokoma.

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Liberian Security Forces Seal Slum

      

Associated Press

Security forces deployed Wednesday to enforce a quarantine around a slum in the Liberian capital, stepping up the government's fight to stop the spread of Ebola and unnerving residents.

Liberia has the highest death toll of the four West African countries affected by the dreaded disease, and its number of cases is rising the fastest. President Ellen Johnson Sirleaf ordered the quarantine and imposed a nighttime curfew that begins Wednesday, saying that authorities have not been able to curtail the spread of Ebola in the face of defiance of their recommendations. 

"These measures are meant to save lives," she said in an address Tuesday night.

During the raid this weekend in West Point slum, bloody items were stolen and potential Ebola patients fled, raising fears the disease would spread out of control in a densely populated area. It was not clear why people would steal items that might spread infection, but there are still many misconceptions about how dangerous the disease is and how it is spread.

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WHO: Ebola-Hit Countries Must Screen All Departing Travellers

        

An immigration officer uses an infra-red laser thermometer to examine a policeman on his arrival at Nnamdi Azikiwe International Airport in Abuja, August 11, 2014.  Credit: Reuters/Afolabi Sotunde

reuters.com - August 18, 2014

GENEVA (Reuters) - Authorities in countries affected by Ebola should check people departing at international airports, seaports and major border crossings and stop any with signs of the virus from travelling, the World Health Organization (WHO) said on Monday.

The U.N. health agency reiterated that the risk of getting infected with Ebola on an aircraft was small as infected people are usually too ill to travel, and said that the risk is also very low to travellers in affected countries, namely Guinea, Liberia, Nigeria and Sierra Leone.

There was no need for wider travel or trade restrictions, the WHO said in a statement.

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MSF Begins Admitting Patients to Ebola Center in Monrovia, Liberia

      

A Doctors Without Borders staffer supervises as construction workers complete the new Ebola treatment center on August 17, 2014 near Monrovia, Liberia.  John Moore—Getty Images

doctorswithoutborders.org - August 18, 2014

Doctors Without Borders/Médecins Sans Frontières (MSF) admitted nine patients today into its newly constructed ELWA 3 Ebola Management Center in Monrovia, Liberia, beginning a process of scaling up operations at the 120-bed facility.

An Ebola outbreak continues to rage virtually unchecked in this city of approximately one million people, far exceeding the capacity of the few medical facilities accepting Ebola patients. Much of the city’s health system has shut down over fears of Ebola among staff members and patients, leaving many people without treatment for other conditions.

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CDC’s Disease Detectives Respond to the 2014 Ebola Outbreak

Ute, a CDC laboratory specialist, works on viruses like Ebola.

cdc.gov - August 18, 2014

The Most Important Test in West Africa

When a person in West Africa suddenly has a fever, how do you know whether it’s Ebola or something else?  When an Ebola patient gets better, how do you know when that person is no longer infectious to others?

To get answers to both questions, you need a laboratory equipped with state of the art equipment. To get those urgently needed answers quickly, that lab ideally would be located close to an Ebola treatment center.

It sounds difficult to build such a safe, sophisticated lab in a major city – and seems nearly impossible in the remote parts of Africa where Ebola outbreaks occur – but CDC has done it for other outbreaks and is doing it now in West Africa.  CDC mobile labs equipped with real-time polymerase chain reaction (RT-PCR) equipment already are being set up next to West African Ebola treatment centers.

And Ute, a CDC expert, heads up the teams going with them.  When she’s not traveling to remote regions of the world, she’s at CDC headquarters in Atlanta working to speed diagnosis of the world’s worst viruses.

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