EBOLA STORY (CONTAGIOUS#3)

Key facts

• Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, is a severe, often fatal illness in humans.
• The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission.
• The average EVD case fatality rate is around 50%. Case fatality rates have varied from 25% to 90% in past outbreaks.
  
• The first EVD outbreaks occurred in remote villages in Central Africa, near tropical rainforests, but the most recent outbreak in west Africa has involved major urban as well as rural areas.
• Community engagement is key to successfully controlling outbreaks. Good outbreak control relies on applying a package of interventions, namely case management, surveillance and contact tracing, a good laboratory service, safe burials and social mobilisation.
• Early supportive care with rehydration, symptomatic treatment improves survival. There is as yet no licensed treatment proven to neutralise the virus but a range of blood, immunological and drug therapies are under development.
• There are currently no licensed Ebola vaccines but 2 potential candidates are undergoing evaluation.
  

Symptoms of Ebola virus disease

• The incubation period, that is, the time interval from infection with the virus to onset of symptoms is 2 to 21 days. Humans are not infectious until they develop symptoms. 
  
  
• First symptoms are the sudden onset of fever fatigue, muscle pain, headache and sore throat. This is followed by vomiting, diarrhoea, rash, symptoms of impaired kidney and liver function, and in some cases, both internal and external bleeding (e.g. oozing from the gums, blood in the stools). Laboratory findings include low white blood cell and platelet counts and elevated liver enzymes. 

UPDATED--CONTAGIOUS#3 (THE EBOLA STORY)

With only 50 physicians in the entire country—one for every 70,000 Liberians—Liberia already faced a health crisis even before the outbreak.^[64] In September the US CDC reported that some hospitals had been abandoned while those which were still functioning lacked basic facilities and supplies.^[65] In October, the Liberian ambassador in Washington was reported as saying that he feared that his country may be "close to collapse".^[64] By 24 October, all of the 15 Liberian districts had reported Ebola cases.^[6][66]

In November the rate of new infections in Liberia appeared to be declining. The drop in cases was believed to be related to an integrated strategy combining isolation and treatment with community behaviour change including safe burial practices, case finding and contact tracing^[67][68][69] On 13 November, the Liberian president announced the lifting of the state of emergency in the country following the decrease in the number of new cases.^[70] 

On 15 December, Liberia started treating patients with serum therapy; as one medical source said, "this will empower local health care systems to become more self-sufficient and better serve their patients during this current epidemic."^[71] On December 29th, it was reported that dozens of new cases are developing along the border with Sierra Leone.^[72]

EBOLA HUNT -NEW -CONTAGIOUS#3

In Liberia, the disease was reported in Lofa and Nimba counties in late March. On 27 July, Ellen Johnson Sirleaf, the Liberian president, announced that Liberia would close its borders, with the exception of a few crossing points such as the airport, where screening centres would be established. Schools and universities were closed,and the worst-affected areas in the country were placed under quarantine.

With only 50 physicians in the entire country—one for every 70,000 Liberians—Liberia already faced a health crisis even before the outbreak. In September the US CDC reported that some hospitals had been abandoned while those which were still functioning lacked basic facilities and supplies.In October, the Liberian ambassador in Washington was reported as saying that he feared that his country may be "close to collapse".By 24 October, all of the 15 Liberian districts had reported Ebola cases.

On 29 October, the WHO announced that the rate of new infections in Liberia was declining, but urged continued vigilance against a reversal of this trend.A report by CDC released on 14 November, based on data collected from Lofa county, indicates that there has been a genuine reduction in new infections. 

This is credited to an integrated strategy combining isolation and treatment with community behaviour change including safe burial practices, case finding and contact tracing. This strategy might serve as a model to implement in other affected areas to accelerate control of Ebola.

NEW: CONTAGIOUS#3

Thinking that the virus was contained, MSF closed its treatment centers in May leaving only a small skeleton staff to handle the Macenta region. However, high numbers of new cases reappeared in the region in late August. According to Marc Poncin, a coordinator for MSF, the new cases were related to persons returning to Guinea from neighbouring Liberia or Sierra Leone

On 19 October, the WHO reported that although disease transmission remained intense, of the three districts affected, transmission remained the lowest in Guinea. In mid-November it was reported that, while all cases and deaths continued to be under-reported, there was some evidence that case incidence was no longer increasing.

However, on 7 December, the WHO reported that the trend in Guinea since early October had been slightly increasing, with between 75 and 148 confirmed cases reported in each of the past 7 weeks

FRESH_CONTAGIOUS#3

The decline in Liberia cases is contradicted in the latest reports from WHO with 439 new cases reported between 23 and 28 November. Sierra Leone also noted a sharp increase in new cases between 23 and 30 November according to the same reports with an increase of 713 new cases in that week.

By the end of November the total number of cases exceeded 17,000 since the outbreak started nearly a year ago.

On 25 March, the World Health Organization (WHO) reported an outbreak of Ebola virus disease in four southeastern districts with a total of 86 suspected cases, including 59 deaths. MSF was helping the Ministry of Health of Guinea in establishing Ebola treatment centers in the epicenter of the outbreak

  On 31 March, the U.S. Centers for Disease Control and Prevention (CDC) sent a five-person team to assist Guinea's Ministry of Health and the WHO as they led an international response to the Ebola outbreak

FRESH UPDATE: CONTAGIOUS#3

According to a WHO report released on 19 November 72% of patients in Guinea are recorded and isolated, while the figure for Sierra Leone and Liberia is still dire. During the week of 9 November only 20% of cases were in isolation or treatment in Liberia, and in Sierra Leone the figure was as low as 13%. Most of these cases not in treatment or isolation are not counted in the official reports, while patients at home were also excluded.

In mid-November the WHO reported that while all cases and deaths continue to be under-reported, "there is some evidence that case incidence is no longer increasing nationally in Guinea and Liberia, but steep increases persist in Sierra Leone".

EBOLA VIRUS_FRESH UPDATE CONTAGIOUS#3

On 29 August, Senegalese Minister of Health announced the first case in Senegal. The victim was subsequently identified as a Guinean national who had been exposed to the virus and had been under surveillance, but had travelled to Dakar by road and fallen ill after arriving.This person subsequently recovered, and on 17 October, the WHO officially declared that the outbreak in Senegal had ended.

Two Spanish health care workers contracted Ebola and were transferred to Spain for treatment where they both died. In October, a nursing assistant who had been part of their health care team was diagnosed with Ebola, making this the first Ebola case contracted outside of Africa. 

The nursing assistant recovered and was declared disease-free on 19 October.There have been Ebola cases in the United States of America as well. A Liberian man who had traveled from Liberia to be with his family in Texas was declared to have Ebola and subsequently died on 8 October. 

Two nurses who had cared for the patient contracted the disease; both of the nurses have subsequently recovered and tested Ebola-free on 27 October 2014. On 23 October, the first case of Ebola in Mali was confirmed, a two year-old girl who had returned from Guinea,and further cases were reported in November.

CONTAGIOUS #3 EBOLA

Researchers believe that a 2-year-old boy, later identified as Emile Ouamouno, who died in December 2013 in the village ofMeliandou, Guéckédou Prefecture, Guinea, was the index case of the current Ebola virus disease epidemic.His mother, sister, and grandmother then became ill with similar symptoms, and also died. People infected by those initial cases spread the disease to other villages. Although Ebola represents a major public health issue in sub-Saharan Africa, no cases had ever been reported in West Africa and the early cases were diagnosed as other diseases more common to the area. Thus, the disease had several months to spread before it was recognized as Ebola.

On 25 March, the World Health Organization (WHO) reported that Guinea's Ministry of Health had reported an outbreak of Ebola virus disease in four southeastern districts, with suspected cases in the neighbouring countries of Liberia and Sierra Leone being investigated. 

In Guinea, a total of 86 suspected cases, including 59 deaths had been reported as of 24 March.By late May, the outbreak had spread to Conakry, Guinea's capital, a city of about two million inhabitants.On 28 May, the total number of cases reported had reached 281 with 186 deaths.

In Liberia, the disease was reported in four counties by mid-April and cases in Liberia's capital Monrovia were reported in mid-June. The outbreak then spread to Sierra Leone and progressed rapidly. By 17 July, the total number of suspected cases in the country stood at 442, overtaking the number in Guinea and Liberia.By 20 July, additional cases of the disease had been reported in the Bo District and the first case in Freetown, Sierra Leone's capital, was reported in late July

The first death in Nigeria was reported on 25 July: a Liberian-American with Ebola flew from Liberia to Nigeria and died inLagos soon after arrival.As part of the effort to contain the disease, possible contacts were monitored – 353 in Lagos and 451 in Port Harcourt. On 22 September, the WHO reported a total of 20 cases, including eight deaths. The WHO's representative in Nigeria officially declared Nigeria Ebola-free on 20 October after no new active cases were reported in the follow up contacts

Contagious #1

As of 2014, the most widespread epidemic of Ebola virus disease (commonly known as "Ebola") in history is currently ongoing in several West African countries. It has caused significant mortality, with a reported case fatality rate of about 71%.It began in Guinea in December 2013 and then spread to Liberia and Sierra Leone.

A small outbreak of twenty cases occurred in Nigeria and one case occurred in Senegal; both countries were declared disease-free on 20 October 2014.Several cases have been reported in Mali. Imported cases in the United States and Spain have led to secondary infections of medical workers but have not spread further. An independent Ebola outbreak in the Democratic Republic of the Congo that started in August 2014 has been shown by genetic analysis to be unconnected to the main epidemic.^[

As of 16 November 2014, the World Health Organization (WHO) and respective governments has reported a total of 15,145 suspected cases and 5,741 deaths,though the WHO believes that this substantially understates the magnitude of the outbreak. with true figures numbering three times as many cases as have been reported.The assistant director-general of the WHO warned in mid-October that there could be as many as 10,000 new Ebola cases per week by December 2014.Almost all of the cases have occurred in the three initial countries.

Some countries have encountered difficulties in their efforts to control the epidemic.In some areas, people have become suspicious of both the government and hospitals, some of which have been attacked by angry protesters who believe either that the disease is a hoax or that the hospitals are responsible for the disease.

Many of the areas seriously affected by the outbreak are areas of extreme poverty with limited access to the soap and running water needed to help control the spread of disease.Other factors include reliance on traditional medicine and cultural practices that involve physical contact with the deceased, especially death customs such as washing the body of the deceased.Some hospitals lack basic supplies and are understaffed, increasing the chance of staff catching the virus themselves.

 In August, the WHO reported that ten percent of the dead have been health care workers.By the end of August, the WHO reported that the loss of so many health workers was making it difficult for them to provide sufficient numbers of foreign medical staff.In September, the WHO estimated that the countries' capacity for treating Ebola patients was insufficient by the equivalent of 2,122 beds.

 By the end of October many of the hospitals in the affected area had become dysfunctional or had been closed, leading some health experts to state that the inability to treat other medical needs may be causing "an additional death toll [that is] likely to exceed that of the outbreak itself".

Contagious #2

FINALLY HERE, THE VIRUS HUNT CONTINUES

By September 2014, Médecins Sans Frontières/Doctors Without Borders (MSF), the NGO with the largest working presence in the affected countries, had grown increasingly critical of the international response. 

Speaking on 3 September, the president of MSF spoke out concerning the lack of assistance from the United Nations member countries saying, "Six months into the worst Ebola epidemic in history, the world is losing the battle to contain it."

On 3 September, the United Nations’ senior leadership said it could be possible to stop the Ebola outbreak in 6 to 9 months, but only if a “massive” global response is implemented.

The Director-General of the WHO, Margaret Chan, called the outbreak "the largest, most complex and most severe we've ever seen" and said that it is "racing ahead of control efforts".

 In a 26 September statement, the WHO said, "The Ebola epidemic ravaging parts of West Africa is the most severe acute public health emergency seen in modern times. Never before in recorded history has a biosafety level four pathogen infected so many people so quickly, over such a broad geographical area, for so long