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Liberia - Health Authorities confirm 3 new Ebola Cases, 1 Death - All contacts completed 21-day follow-up - dec 16, 2015

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  • #16
    Fresh Ebola Cases Damp Liberia Hopes of Eliminating Deadly Disease

    New cases serve notice that the fight against the disease will take months, even years

    By DREW HINSHAW in Monrovia, Liberia, and BETSY MCKAY in Atlanta
    Dec. 9, 2015 7:31 p.m. ET

    Nurses at a downtown Monrovia hospital were about to punch out from work late one November afternoon when a feverish teenager, convulsing and bleeding from his mouth, stumbled into the waiting room.

    For Mosoka Fallah, the boy’s symptoms pointed in a grimly familiar direction. He drove off—speeding in the wrong lane and dodging head-on traffic—to a meeting of government officials in the center of the capital, where he burst into the room with the news: Ebola is back.
    Dr. Fallah, the physician who drove off to deliver the news, said the boy’s mother had survived Ebola last year, then gave birth to a child in September.

    About two weeks after the birth, her husband fell ill with fever. He later tested positive for Ebola, raising the question whether childbirth presents a window when survivors of the disease can infect people close to them, Dr. Fallah said.

    “It is exhausting,” he said. “Nobody knew these recurrences would happen.”

    On a recent morning, Dr. Fallah was in the government’s Ebola command center, surrounded by bone-weary health workers trying to monitor the condition and whereabouts of 139 potentially infected people.

    Some patients had slipped out of quarantine because nobody remembered to bring them breakfast. “Contacts not getting food!” screamed an angry worker.

    A whiteboard listed 20 people still unaccounted for, several of whom seemed to have turned off their phones.

    Holding up a map of Monrovia, a city of one million people stretching across 100 square miles, Dr. Fallah pleaded to his staff, “I need you to find those people!”
    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
    -Nelson Mandela


    • #17
      Ebola Situation Report - 16 December 2015

      No confirmed cases of Ebola virus disease (EVD) were reported in the week to 13 December. All contacts associated with the cluster of 3 confirmed cases of EVD reported from Liberia in the week to 22 November have now completed 21-day follow-up. The first-reported case in the cluster, a 15-year-old boy, died on 23 November. Two subsequent cases, the boy’s father and younger brother, tested negative twice for Ebola virus on 3 December and were discharged. As of 11 December, 210 eligible recipients associated with the cluster had received the rVSV-ZEBOV Ebola vaccine as part of the Partnership for Research on Ebola Vaccines in Liberia (PREVAIL study), which is administered by the Government of Liberia and the US National Institutes of Health.

      Human-to-human transmission linked to the recent cluster of cases in Liberia will end on 14 January 2016, 42 days after the 2 most-recent cases received a second consecutive negative test for Ebola virus, if no further cases are reported. Human-to-human transmission linked to the primary outbreak in Guinea will end on 28 December 2015, 42 days after the country’s most recent case, reported on 29 October, received a second consecutive negative test for Ebola virus. In Sierra Leone, human-to-human transmission linked to the primary outbreak was declared to have ended on 7 November 2015. The country has now entered a 90-day period of enhanced surveillance scheduled to conclude on 5 February 2016.

      The recent cluster of cases in Liberia is now understood to have been a result of the re-emergence of Ebola virus that had persisted in a previously infected individual. Although the probability of such re-emergence events is low, the risk of further transmission following a re-emergence underscores the importance of implementing a comprehensive package of services for survivors that includes the testing of appropriate bodily fluids for the presence of Ebola virus RNA. The governments of Liberia and Sierra Leone, with support from partners including WHO and US CDC, have implemented voluntary semen screening and counselling programmes for male survivors in order to help affected individuals understand their risk and take necessary precautions to protect close contacts. A network of clinical services for survivors is also being expanded in Liberia and Sierra Leone, with plans for comprehensive national policies for the care of EVD survivors due to be completed in January 2016.
      Last edited by Gert van der Hoek; December 17, 2015, 12:28 AM. Reason: Added bolding
      "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
      -Nelson Mandela


      • #18
        Ebola Mystery: Did A Mom Who Tested Negative Infect Her Family?

        December 22, 20154:52 PM ET

        That's what Dr. Mosoka Fallah, a Harvard-trained epidemiologist in Liberia who specializes in tracing the origins of Ebola cases, is trying to determine.

        The first member of the family to be diagnosed was the 15-year-old son...
        Then, the father and another son, who was actually 10 years old, were both diagnosed with Ebola. The 15-year-old died of the disease.

        The mother, meanwhile, had her own complicated medical history. She had taken care of her brother, who had Ebola, in the summer of 2014. She could have contracted Ebola from him at the time — she fell ill with symptoms that looked suspiciously like Ebola, but she was never tested. She recovered on her own.

        She subsequently had a baby in September, became ill again in October, and then recovered once more. At that time she was tested for Ebola — twice — and the results were negative. Yet her system contained antibodies that develop when the body fights off an Ebola infection. She had what Fallah calls "the footprint of Ebola."
        Did the mother, who might have been carrying Ebola she contracted from her brother, infect her husband and sons?

        All the information that we've gathered points to the mom. If that is true, we've got to answer the fundamental question: Is there a potential for people to become carriers [yet] they themselves don't get sick? Is it possible that the mother [somehow fought off] the virus [in her system] because she had antibodies but infected others?

        Might the mom's pregnancy have somehow figured in?

        If she got sick with Ebola last year, is it possible that [the virus] got reactivated because of her lowered immune system [due to her pregnancy]. But she did not develop Ebola [this year] because she already had antibodies.

        So is sexual transmission from the mother to her husband a possibility?

        We do know that there can be sexual transmission from male to female. We have never had a documented incident of a female to male. That's a key question we have to answer.

        My gut feeling tells me there are some rare cases where it can be a female to male [transmission]. Some people don't agree with me; some tend to agree with me now.
        What's an important lesson from your investigation so far?

        The mistake is to assume we know everything about Ebola. I think it would be the worst mistake any of us in the Ebola field would make.
        "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
        -Nelson Mandela