Congo - Ebola - 183 deaths + 187 suspected cases

Treyfish · Sep 11, 2007

Re: 100 dead Congo hemorrhagic fever-WHO Experts In Congo To Study Mysterious Disease

Re: 100 dead Congo hemorrhagic fever-WHO Experts In Congo To Study Mysterious Disease

<TABLE cellSpacing=0 cellPadding=0 width=629 border=0><TBODY><TR><TD vAlign=top width=629>Last Updated: Tuesday, 11 September 2007, 12:49 GMT 13:49 UK

<TABLE cellSpacing=0 cellPadding=0 width=416 border=0><TBODY><TR><TD width=213>http://newsvote.bbc.co.uk/mpapps/pagetools/email/news.bbc.co.uk/1/hi/world/africa/6989194.stm</TD><TD width=203>http://newsvote.bbc.co.uk/mpapps/pagetools/print/news.bbc.co.uk/1/hi/world/africa/6989194.stm</TD></TR></TBODY></TABLE>
</TD></TR></TBODY></TABLE><TABLE cellSpacing=0 cellPadding=0 width=629 border=0><TBODY><TR><TD colSpan=3>Deadly Ebola resurfaces in Congo

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More than 200 people died in a previous outbreak in Kikwit

</TD></TR></TBODY></TABLE>An outbreak of the deadly Ebola virus in the Democratic Republic of Congo has killed at least five people says the World Health Organisation.
Blood samples from the southern province of Kasai were sent to laboratories specialising in haemorrhagic fever.
More than 100 people have died and many more have fallen sick in a recent fever epidemic in central DR Congo.
Scientists say some deaths could have been from a bacterium called Shigella. 
Three months ago, people started falling sick from a mystery virus in several villages around Kananga, the capital of West Kasai region.
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Emergency response teams are now being sent to DR Congo to try to contain the outbreak.
Ebola is untreatable and almost always fatal.
It is thought to be transmitted through the consumption of infected bush meat and can also be spread by contact with the blood secretions of infected people. DR Congo's last major Ebola outbreak killed more than 200 people in 1995 in Kikwit, about 400km (249 miles) west of the current outbreak. The last major incidence of the disease was in Uganda in 2001 when more than 400 cases were reported and more than half of the patients died. :tiphat:
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http://news.bbc.co.uk/1/hi/world/africa/6989194.stm

Treyfish · Sep 11, 2007

Re: 100 dead Congo hemorrhagic fever-WHO Experts In Congo To Study Mysterious Disease

Re: 100 dead Congo hemorrhagic fever-WHO Experts In Congo To Study Mysterious Disease

<TABLE xmlns:fo="http://www.w3.org/1999/XSL/Format"><TBODY><TR><TD class=ArticleHead colSpan=2>Experts sound ebola alarm ?</TD></TR><TR><TD class=Byline>Sashni Pather and Borrie La Grange</TD><TD class=Published align=right>Published:Sep 12, 2007</TD></TR><TR><TD class=ArticleHead colSpan=2><HR class=ArticleLine width="100%" SIZE=1></TD></TR><TR><TD colSpan=2><TABLE cellSpacing=0 cellPadding=5 width=200 align=right border=0><TBODY><TR><TD><TABLE cellSpacing=0 cellPadding=0 width=200 border=0><TBODY><TR><TD class=ArticleImg><TABLE cellSpacing=0 cellPadding=0 width=200 align=right border=0><TBODY><TR><TD class=storybody width=200>

?What is even scarier is there are no tell-tale signs of the disease?

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</TD></TR></TBODY></TABLE>Fear that infected travellers arrive in SA.


South Africa?s medical experts are alarmed by an outbreak of the deadly ebola virus in the Democratic Republic of Congo ? fearing that infected travellers could spread the disease here.

This comes after World Health Organisation officials confirmed yesterday that five people had tested positive for the virus in the Congo. 

Authorities have reported some ?120 deaths among 300 sick people? over just the past four months, said its spokesman, Gregory Hartl.

Professor Robert Swanepoel , a consultant in the special pathogens unit at South Africa?s National Institute of Communicable Diseases, said while the fatal disease occurred mainly in the Congo, Nigeria and Sierra Leone, infected people are known to travel to South Africa and other parts of the world for medical treatment.

The World Health Organisation has now activated its global outbreak alert and response network , asking health organisations to send epidemiologists and other medical experts to the Congo.

Ebola, which causes death in 50percent to 90percent of cases, is transmitted by contact with the blood, secretions, organs or other bodily fluids of infected persons.

Symptoms begin with fever and muscle pain, followed by vomiting and diarrhoea. 
Foreign affairs ministry spokesman Ronnie Mamoepa said: ? An ebola outbreak is an ongoing problem in the region. However, I am not aware of South Africa being asked to assist with any outbreak.?

Swanepoel said it was not uncommon for medical evacuation companies to transport infected patients to South Africa, as was the case recently when an doctor infected with ebola was brought into the country.

The doctor, from Nigeria, was treated at the Unitas Hospital, outside Pretoria.
Swanepoel said: ?He obviously died as there is no cure for the disease. It is known that people come to South Africa for treatment.?

Three airlines ? SAA, Hewa Bora Airlines and Kenya Airways ? operate flights between Johannesburg and the Congo capital of Kinshasa.

SAA is the only carrier that flies direct between the two destinations, four days a week, while the other two carriers have stop-overs in Lumbumbashi and Nairobi respectively.

SAA said it had noted the reports of ?a suspected haemorrhagic fever outbreak in a remote part of the Congo?.

SAA spokesperson Sarah Uys said if the situation worsened , passengers would be warned about a possible danger. 
?But for now we don?t foresee problems,?

she said.
Swanepoel said viruses such as ebola usually stem from war- torn areas, and regions where there was bad governance.

He said: ?I can?t explain why this is, but this outbreak in the Congo is yet another in a long succession.?

Jaco Folmer, medical director of SAA-Netcare Travel Clinics, said the people most at risk were health workers in the affected areas.
In 1996, a nurse in Johannesburg was diagnosed with ebola haemorrhagic fever and a frantic search ensued to locate the source, a doctor in Gabon who had sought treatment for his illness in South Africa.

The nurse died, but the spread of the infection was prevented.
Folmer said the risk of contracting the virus was greater when travelling.

He said: ?Infected people start bleeding from the nose and ears and [should be] kept in strict isolation.
?What is even scarier is that there are no tell-tale signs for the disease, so you can?t tell one infected person from another just by looking at them.?:tiphat: 


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http://www.suntimes.co.za/News/Article.aspx?id=562209

Treyfish · Sep 11, 2007

Re: 100 dead Congo hemorrhagic fever-WHO Experts In Congo To Study Mysterious Disease

Re: 100 dead Congo hemorrhagic fever-WHO Experts In Congo To Study Mysterious Disease

<TABLE xmlns:fo="http://www.w3.org/1999/XSL/Format"><TBODY><TR><TD class=ArticleHead colSpan=2>Ebola outbreak in DRC</TD></TR><TR><TD class=Byline>AFP</TD><TD class=Published align=right>Published:Sep 11, 2007</TD></TR><TR><TD class=ArticleHead colSpan=2><HR class=ArticleLine width="100%" SIZE=1></TD></TR><TR><TD colSpan=2><TABLE cellSpacing=0 cellPadding=5 width=200 align=right border=0><TBODY><TR><TD>
</TD></TR></TBODY></TABLE>GENEVA - The World Health Organisation (WHO) said today that five cases of the deadly Ebola virus had been confirmed in the Democratic Republic of Congo (DRC), after dozens of people have succumbed to an unidentified illness in recent months.


Five cases of the viral haemorrhagic illness have been confirmed in western Kasai in the centre of the vast African country, WHO spokeswoman Fadela Chaib told journalists in Geneva.

Viral haemorrhagic fever causes the patient to bleed under the skin and in severe cases, from the mouth, ears and eyes.

Blood loss, shock and organ failure lead to coma and delirium and, in many cases, to death.

The WHO is not in a position to say whether the five people confirmed with Ebola are presently alive or dead, she added.

Ebola has killed some 450 people in the Democratic Republic of Congo since 1976.

Local authorities said at the end of August that 68 people had died from an unknown illness within the space of four months in western Kasai.

Chaib stressed that another illness other than Ebola could yet be responsible for some of these deaths, possibly the Shigella infectious disease which is less deadly than Ebola.:tiphat: 



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http://www.suntimes.co.za/News/Article.aspx?id=561914

Treyfish · Sep 11, 2007

Re: 100 dead Congo hemorrhagic fever-WHO Experts In Congo To Study Mysterious Disease

Re: 100 dead Congo hemorrhagic fever-WHO Experts In Congo To Study Mysterious Disease

Also a video here..:tiphat: http://article.wn.com/view/2007/09/11/Officials_Congo_Outbreak_is_Ebola/

Shannon Bennett · Sep 11, 2007

Re: 100 dead Congo hemorrhagic fever-WHO Experts In Congo To Study Mysterious Disease

Re: 100 dead Congo hemorrhagic fever-WHO Experts In Congo To Study Mysterious Disease

An infected person was put on a commercial aircraft? Please tell me I misread this.

Treyfish · Sep 11, 2007

Re: 100 dead Congo hemorrhagic fever-WHO Experts In Congo To Study Mysterious Disease

Re: 100 dead Congo hemorrhagic fever-WHO Experts In Congo To Study Mysterious Disease

from a french paper with google translation..... YIKES:surrender: Ebola keep silent from Western Kasa?
(F.M.)

352 cases including 160 dead, such are the macabre assessment of an epidemic which has prevailed for more than four months in the province of Kasa? Occidental. The Minister for the Health of the central government confirmed yesterday that the epidemic which already killed 160 compatriots is indeed the hemorrhagic fever Ebola. This mortal virus was attested by doctors of a large laboratory of France-city in Gabon. Until there is little, only the zone of health of Mweka was struck by this plague but very recently two cases have been just announced, of which one in Kananga and another in the locality of Bena Leka, always in the province of Kasa? Occidental.

Approached by the press, Dr. Fortunat Ntumba Tshitoko, provincial Minister for Health, indicated that this plague is communicated in several ways. In particular by the postilions and sneezes. Thus, to avoid any contagion, finished contacts of the greetings kind, embraces. It is what is serious, because in other words, it people should be obliged to provide itself with the diving-suits or the special clothes generally reserved to the astronauts.
The provincial Minister for Health all the same recommended to the inhabitants to observe scrupulously certain rules of hygiene. In particular to wash the hands with the return of the toilets, not to keep patients presenting the symptoms of this epidemic in the public houses, places and of worship and especially to disinfect the interior and the outside of the installations where one keeps the domestic animals.
It is pointed out that samples taken by experts of the ministry for Health were dispatched in the United States of America and Kinshasa with an aim of carrying out the identification of the elements carrying the germs of this epidemic. In fact the samples made it possible to the specialists to note that it is indeed about Ebola fever. What will make it possible to plan therapeutic capable to relieve and to save certain patients.

Whole country under the threat of a generalized contagion
As Kasa? Occidental is located at the center of the country and that the movements of the populations are often carried out towards the political capital and the other cities of the Republic, it is extremely to fear that this epidemic is spread through all the Republic in a rather short lapse of time. The flights of planes in departure or bound for Kananga are so frequent that the risks of contagion are obvious. Since the contagion is made by simple physical contacts if one believes Dr. Ntumba Tshitoko of it.
As usual, the authorities of the central government seem to neglect this danger and will awake only when this epidemic causes enormous damage among the populations innocent and given up with themselves. The speed of contagion is noticed by the number of the victims which reached the macabre figure of 16O died in the 18 weeks space only in the zone of Mweka.:tiphat:
http://www.lepharerdc.com/www/index_view.php?storyID=3773&rubriqueID=1
2007-09-11

Treyfish · Sep 11, 2007

Re: 100 dead Congo hemorrhagic fever-WHO Experts In Congo To Study Mysterious Disease

Re: 100 dead Congo hemorrhagic fever-WHO Experts In Congo To Study Mysterious Disease

Congo's deadly outbreak identified<TABLE style="WIDTH: 405px; HEIGHT: 44px; BACKGROUND-COLOR: #ffffff" cellSpacing=0 cellPadding=0><TBODY><TR><TD class=caption style="WIDTH: 360px">September 11 2007 at 03:21PM </TD></TR><TR><TD style="HEIGHT: 1px; BACKGROUND-COLOR: #cccccc" colSpan=2></TD></TR></TBODY></TABLE><TABLE cellSpacing=0 cellPadding=23 border=0><TBODY><TR><TD class=svarticletext>[SIZE=+1][/SIZE]Kinshasa - The World Health Organisation issued an alert on Tuesday requesting more doctors and other experts to travel to southeastern Congo to combat an outbreak of Ebola, a highly contagious fever that kills up to 90 percent of people infected and has no cure or treatment.

Experts from Medicines Sans Frontieres are already treating patients, but more help was needed. The Congolese government declared a quarantine of the area on Tuesday, spokesperson Toussaint Tshilobo said.

The United States' Centres for Disease Control and Prevention in Atlanta and another lab in Gabon confirmed the disease as a hemorrhagic fever, and specifically as Ebola, Health Minister Makwenge Kaput said on national television on Monday. He did not provide further details.:tiphat:

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http://www.iol.co.za/index.php?set_id=1&click_id=136&art_id=nw20070911150500998C302842

Laidback Al · Sep 11, 2007

Re: 100 dead Congo hemorrhagic fever-WHO Experts In Congo To Study Mysterious Disease

Re: 100 dead Congo hemorrhagic fever-WHO Experts In Congo To Study Mysterious Disease

He says the infections are mostly in two areas, Mweka and Luebo and the majority of the deaths ocurred at the beginning of the outbreak.

Map:

Sally Furniss · Sep 11, 2007

Re: 100 dead Congo hemorrhagic fever-WHO Experts In Congo To Study Mysterious Disease

Re: 100 dead Congo hemorrhagic fever-WHO Experts In Congo To Study Mysterious Disease

Shannon said:
An infected person was put on a commercial aircraft? Please tell me I misread this.

It does not say that.

Could be private craft.

AlaskaDenise · Sep 12, 2007

Re: 100 dead Congo hemorrhagic fever-WHO Experts In Congo To Study Mysterious Disease

Re: 100 dead Congo hemorrhagic fever-WHO Experts In Congo To Study Mysterious Disease

Ebola Outbreak Confirmed in Congo

NAIROBI, Kenya, Sept. 11 ? The lethal Ebola virus has resurfaced in central Congo, United Nations officials said Tuesday, and health experts were rushing supplies and doctors into the remote, densely forested area to contain the disease.

Five samples taken from sick people in Congo have tested positive for Ebola, said Gregory Hartl, a spokesman for the World Health Organization. But another disease may be involved because some patients have responded to antibiotics, which would not work on a virus like Ebola.

Already, more than 150 people have died.

?It wouldn?t be surprising if something else was going on,? Mr. Hartl said. ?But because Ebola is involved, we have to be on high alert.?

Ebola is one of the deadliest pathogens, killing 50 to 80 percent of the people it infects. In severe cases, victims hemorrhage all over and bleed from body orifices before dying.

Because it is highly contagious, health officials in Congo are trying to quarantine anyone with symptoms, and Congolese ministers are going on radio and television to educate villagers about the crisis.

?We are extremely concerned,? said Dr. Benoit Kebela Ilunga, secretary general of the Congo Health Ministry. ?But we also have experience dealing with this.?

Congo is thought to be the birthplace of the Ebola virus, which is named after a river in the north where one of the first documented outbreaks occurred in 1976, killing nearly 300 people. Congo has had at least three other major outbreaks, including one in Kikwit, a town about 200 miles west of the current disease zone.

The virus strikes fast, and many patients die within days of showing symptoms, which start out as stomachaches and headaches and progress to bloody vomiting and organ failure. In some patients veins burst under the skin, causing a purple rash, and blood streams from the nose and mouth.

Health officials said the strange thing about this outbreak, which began in June, was that very few early victims showed any sign of hemorrhaging. Half the initial victims were children with flulike symptoms and many were surviving, which did not seem to fit the Ebola pattern.

?It was a bit of a puzzling picture at the beginning,? said Scott F. Dowell, the director of the Global Disease Detection Program at the Centers for Disease Control and Prevention in Atlanta, which has been in close contact with Congolese officials for several weeks.

But once health workers started dying, Dr. Dowell said, it began to look like Ebola, which is often transmitted through contact with corpses, body fluids and contaminated equipment like needles and surgical tubing. He now thinks that the early stages of the Ebola outbreak may have been masked by more common germs like shigella, a waterborne bacterium that causes severe dysentery.

That is consistent with findings from the W.H.O., which reported that some Congo patients were responding well to ciprofloxacin, a popular antibiotic.
?Over the next few days and weeks, the cases will be sorted out, and you?ll probably end with a picture that looks like the previous Ebola outbreak,? Dr. Dowell said. ?Most of the fatalities will be adults. The children cases will be attributed to other diseases.?

Scientists think the Ebola virus lives in an animal host, possibly a bat. Human outbreaks are thought to start when a person is infected by an animal and then passes the virus to other people. There is no cure.

Dr. Ilunga said that so far 372 people have fallen ill and 166 have died. He said the government was concerned that the disease would spread, adding that the first order of business was getting villagers to take sick people to quarantine centers.

Congo?s infrastructure woes might actually help. The country is the size of Western Europe but has less than 300 miles of paved roads. Although that makes it harder to get medical supplies and doctors in, health officials said the isolation of central Congo?s towns also means that terminally ill people cannot easily travel far, which can limit the infection?s spread.

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Treyfish · Sep 12, 2007

Re: 100 dead Congo hemorrhagic fever-WHO Experts In Congo To Study Mysterious Disease

Re: 100 dead Congo hemorrhagic fever-WHO Experts In Congo To Study Mysterious Disease

WHO Report ... Ebola haemorrhagic fever in the Democratic Republic of the Congo

11 September 2007
The Ministry of Health of the Democratic Republic of the Congo (DRC) has confirmed an outbreak of Ebola haemorrhagic fever, in the province of Kasai Occidental. Laboratory analysis undertaken at the Centre International de Recherches Médicales de Franceville (CIRMF), Gabon, and at the Centres for Disease Control and Prevention (CDC), Atlanta, USA has confirmed the presence of Ebola virus in samples taken from cases associated with the outbreak. Laboratory tests conducted by Institut National de Recherches Biologiques (INRB) in Kinshasa on urine and blood samples collected from suspected cases, have also confirmed the presence of Shigella dysentery type 1, further complicating operations while case definitions and clinical descriptions, particularly in response to rehydration and antibiotic treatment, support a possible concurrent outbreak of another etiology.
As of 11 September 2007, WHO is aware of 372 cases and 166 deaths associated with the ongoing event in the province. Additional samples have been taken for further laboratory analysis.
The WHO Country Office, Regional Office and Headquarters are supporting the MoH in Kinshasa and in the field at the location of the outbreak. Additional staff, outbreak response equipment and supplies, including Personal Protective Equipment (PPE) are being sent to the area. A enhanced team of national and international experts is being mobilized to implement control strategies for Ebola haemorrhagic fever and to support outbreak field response in the province.
Médecins Sans Frontières (Belgium) has deployed clinicians, water and sanitation experts and logisticians to the area and has established appropriate isolation facilities.
A request for additional support has been sent to the Global Outbreak Alert and Response Network in the areas of clinical case management and infection control, surveillance and field epidemiology, risk communications and social mobilization, and outbreak response logistics.
WHO is also working with the INRB, CIRMF, CDC, Atlanta and the Public Health Agency of Canada laboratory in Winnipeg to ensure the MoH is provided with comprehensive laboratory support in the control and investigation of the outbreak.
WHO advises that there is no indication of the need for any restrictions on travel or trade with the Democratic Republic of the Congo.:tiphat: http://www.who.int/csr/don/2007_09_11/en/index.html

Laidback Al · Sep 12, 2007

Re: 100 dead Congo hemorrhagic fever-WHO Experts In Congo To Study Mysterious Disease

Re: 100 dead Congo hemorrhagic fever-WHO Experts In Congo To Study Mysterious Disease

Until there is little, only the zone of health of Mweka was struck by this plague but very recently two cases have been just announced, of which one in Kananga and another in the locality of Bena Leka, always in the province of Kasa? Occidental.

There are several locations in the Democratic Republic of Congo that have the name Kananga. This reference is most likely to the Administrative Zone called Kananga. Bena Leka is a town (?, populated place) in the Demba Administrative Zone which is adjacent to the Mweka and Luebo Administrative Zones. See map below.

Sally Furniss · Sep 12, 2007

Re: 160+ dead Congo hemorrhagic fever-WHO Experts In Congo To Study Mysterious Diseas

Re: 160+ dead Congo hemorrhagic fever-WHO Experts In Congo To Study Mysterious Diseas

http://english.people.com.cn/90001/90777/90855/6260739.html

An illness that has killed more than 160 people in southeastern the Democratic Republic of the Congo has been confirmed as Ebola, a highly contagious fever that kills up to 90 percent of people infected and has no cure or treatment.

The United States' Centers for Disease Control and Prevention in Atlanta and another lab in Gabon confirmed the disease as a hemorrhagic fever, and specifically as Ebola, Health Minister Makwenge Kaput said on national television on Monday. He did not provide further details.

According to the World Health Organization (WHO), five samples have tested positive for Ebola. About 40 more samples are still pending.

At least 167 people have died in the affected region since late August and nearly 400 have fallen ill, said Jean-Constatin Kanow, the chief medical inspector for the affected province. Kinshasa, the capital, is 690 km northwest of the area.

Some of the patients have improved after being given antibiotics, which would have no impact on Ebola, WHO experts said. The experts said that led them to suspect that shigella, a diarrhea-like disease, or typhoid has broken out in the same area. Symptoms for the three diseases are similar in early stages. In severe cases of shigella and typhoid, hemorrhaging can also occur.

In the Congolese hospital where patients were being treated - a mud hut with a corrogated roof - patients are not being isolated. That means that patients who have shigella, which is not usually a fatal disease, might be mixed with those who have Ebola, putting them at risk at catching the highly fatal fever.

"There's no way we can be sure at this time how many cases are shigella and how many cases are Ebola," said Gregory Hartl, a WHO spokesman.

Yesterday, WHO issued an alert to its international partners, requesting more doctors and other experts, to travel to the Congo to help contain the outbreak. Experts from Medecins Sans Frontieres are already treating patients, but more help is needed.

Ebola is spread through direct contact with the blood or secretions of an infected person, or objects that have been contaminated with infected secretions. It is not known where the initial infection came from, though medical researchers say it is likely from contact with an infected animal.

In the past, Congo has seen large outbreaks of Marburg and Ebola, both hemorrhagic fevers caused by viruses that, in severe cases, attack the central nervous system and cause bleeding from the eyes, ears and other parts of the body. By the end of August, four villages had been affected and 217 people had come down with the illness, including 103 who died. About 140,000 people live in the Mweka area.

Congo's last major Ebola outbreak struck in Kikwit in 1995, killing 245 people. Kikwit is about 300 km from the site of the current outbreak.

Sally Furniss · Sep 12, 2007

Re: 160+ dead Congo hemorrhagic fever-WHO Experts In Congo To Study Mysterious Diseas

Re: 160+ dead Congo hemorrhagic fever-WHO Experts In Congo To Study Mysterious Diseas

Africa: Ebola Haemorrhagic Fever - Fact Sheet

http://allafrica.com/stories/200709120520.html?viewall=1

World Health Organization (Geneva)

DOCUMENT
12 September 2007
Posted to the web 12 September 2007

Ebola virus, Filoviridae family, is comprised of four distinct subtypes: Za?re, Sudan, C?te d'Ivoire and Reston. Three subtypes, occurring in the Democratic Republic of the Congo (formerly Zaire), Sudan and C?te d'Ivoire, have been identified as causing illness in humans. Ebola haemorrhagic fever (EHF) is a febrile haemorrhagic illness which causes death in 50-90% of all clinically ill cases. Human infection with the Ebola Reston subtype, found in the Western Pacific, has only caused asymptomatic illness, meaning that those who contract the disease do not experience clinical illness. The natural reservoir of the Ebola virus seems to reside in the rain forests of the African continent and in areas of the Western Pacific .

Ebola outbreak chronology

Transmission

* The Ebola virus is transmitted by direct contact with the blood, secretions, organs or other bodily fluids of infected persons.

* Burial ceremonies where mourners have direct contact with the body of the deceased person can play a significant role in the transmission of Ebola.

* The infection of human cases with Ebola virus has been documented through the handling of infected chimpanzees, gorillas, and forest antelopes--both dead and alive--as was documented in C?te d'Ivoire, the Republic of Congo and Gabon. The transmission of the Ebola Reston strain through the handling of cynomolgus monkeys has also been reported.

* Health care workers have frequently been infected while treating Ebola patients, through close contact without the use of correct infection control precautions and adequate barrier nursing procedures.

Incubation period: two to 21 days.

Symptoms

Ebola is often characterized by the sudden onset of fever, intense weakness, muscle pain, headache and sore throat. This is often followed by vomiting, diarrhoea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding. Laboratory findings show low counts of white blood cells and platelets as well as elevated liver enzymes.

Diagnosis

Specialized laboratory tests on blood specimens detect specific antigens and/or genes of the virus. Antibodies to the virus can be detected, and the virus can be isolated in cell culture. Tests on samples present an extreme biohazard risk and are only conducted under maximum biological containment conditions. New developments in diagnostic techniques include non-invasive methods of diagnosis (testing saliva and urine samples) and testing inactivated samples to provide rapid laboratory diagnosis to support case management during outbreak control activities.

Therapy and vaccine

* Severe cases require intensive supportive care, as patients are frequently dehydrated and in need of intravenous fluids or oral rehydration with solutions containing electrolytes.

* No specific treatment or vaccine is yet available for Ebola haemorrhagic fever. Several vaccine candidates are being tested but it could be several years before any are available. A new drug therapy has shown early promise in laboratory studies and is currently being evaluated further. However, this too will take several years.

* Experimental studies involving the use of hyper-immune sera on animals have demonstrated no protection against the disease.

Containment

* Suspected cases should be isolated from other patients and strict barrier nursing techniques implemented.

* Contact tracing and follow-up of people who may have been exposed to Ebola through close contact with other cases is essential.

* All hospital personnel should be briefed on the nature of the disease and its routes of transmission. Particular emphasis should be placed on ensuring that invasive procedures such as the placing of intravenous lines and the handling of blood, secretions, catheters and suction devices are carried out under strict barrier nursing conditions. Hospital staff should have individual gowns, gloves, masks and goggles. Non-disposable protective equipment must not be reused unless they have been properly disinfected.

* Infection may also be spread through contact with the soiled clothing or bed linens from a patient with Ebola. Disinfection is therefore required before handling these items.

* Communities affected by Ebola should make efforts to ensure that the population is well informed, both about the nature of the disease itself and about necessary outbreak containment measures, including burial of the deceased. People who have died from Ebola should be promptly and safely buried.

Contacts

* As the primary mode of person-to-person transmission is contact with contaminated blood, secretions or body fluids, any person who has had close physical contact with patients should be kept under strict surveillance, i.e. body temperature checks twice a day, with immediate hospitalization and strict isolation recommended in case of the onset of fever.

* Hospital personnel who come into close contact with patients or contaminated materials without barrier nursing attire must be considered as contacts and followed up accordingly.

History

The Ebola virus was first identified in a western equatorial province of Sudan and in a nearby region of Za?re (now the Democratic Republic of the Congo) in 1976 after significant epidemics in Yambuku, northern Democratic Republic of the Congo, and Nzara, southern Sudan.

* Between June and November 1976, the Ebola virus infected 284 people in Sudan, causing 151 deaths. In the Democratic Republic of the Congo, there were 318 cases and 280 deaths in September and October. An isolated case occurred in the Democratic Republic of the Congo in 1977, and there was another outbreak in Sudan in 1979 (33 cases, including 22 deaths).

* In 1989, an Ebola virus subtype Reston, was isolated in quarantined laboratory cynomolgus monkeys (Macacca fascicularis) in Reston, Virginia, USA. From 1989 to 1996, several outbreaks caused by the Ebola Reston subtype occurred in monkeys imported from the Philippines to the USA (Reston in Virginia, Alice in Texas and Pennsylvania) and to Italy. Investigations traced the source of all Ebola Reston outbreaks to one export facility near Manila in the Philippines, but the mode of contamination of this facility was not determined. Several monkeys died, and at least four people were infected, although none of them suffered clinical illness.

* One human case of Ebola haemorrhagic fever of the Cote d'Ivoire subtype and several cases in chimpanzees were confirmed in C?te d'Ivoire in November 1994.

* A large epidemic occurred in Kikwit, the Democratic Republic of the Congo in 1995 with 315 cases, 250 of which had fatal outcomes.

* In Gabon, Ebola haemorrhagic fever was first documented in 1994 (19 cases including 9 deaths). Successive outbreaks occurred in February (37 cases including 21 deaths) and July of 1996 (60 cases including 45 deaths).

* In October 2000, Ebola was reported in Gulu district in northern Uganda. Between September 2000 and January 2001, the Sudan subtype of the Ebola virus infected 425 cases, including 224 deaths, making this the largest epidemic so far documented of Ebola. This was the first reported emergence of the Sudan Ebola virus since 1979.

* From October 2001 to December 2003, several EHF outbreaks of the Za?re subtype, were reported in Gabon and the Republic of Congo with a total of 302 cases and 254 deaths: M?kambo-Mbomo-K?ll? 2001-2002, K?ll?-Mbomo 2003 and Mbandza-Mbomo 2003.

Approximately 1,850 cases with over 1,200 deaths have been documented since the Ebola virus was discovered.

Natural reservoir

* The natural reservoir of the Ebola virus is unknown despite extensive studies, but seems to reside in the rain forests on the African continent and in the Western Pacific.

* Although non-human primates have been a source of infection for humans, they are not thought to be the reservoir. They, like humans, are believed to be infected directly from the natural reservoir or through a chain of transmission from the natural reservoir.

* On the African continent, Ebola infections of human cases have been linked to direct contact with gorillas, chimpanzees, monkeys, forest antelope and porcupines found dead in the rainforest. So far, the Ebola virus has been detected in the wild in carcasses of chimpanzees (in C?te-d'Ivoire and Republic of Congo), gorillas (Gabon and Republic of Congo) and duikers (Republic of Congo).

* Different hypotheses have been developed to try to explain the origin of Ebola outbreaks. Laboratory observation has shown that bats experimentally infected with Ebola do not die, and this has raised speculation that these mammals may play a role in maintaining the virus in the tropical forest.

* Extensive ecological studies are underway in the Republic of Congo and Gabon to identify the Ebola's natural reservoir.

Shannon Bennett · Sep 12, 2007

Re: 100 dead Congo hemorrhagic fever-WHO Experts In Congo To Study Mysterious Disease

Re: 100 dead Congo hemorrhagic fever-WHO Experts In Congo To Study Mysterious Disease

Actually, the article mentions only commercial carriers and quotes a spokesperson from one of them. Even if it were a private aircraft it would be extremely difficult to limit exposure for an extended trip from central Africa to South Africa. Ambulance crews, aircraft personal from the pilot to the cleaning crews, etc... would all have had to be in bio-hazard suits.
The logistics of maintaining a strict quarantine between two such distant points is suspect. If you also add in that one of these countries is experiencing political unrest and lacks good infrastructure, as well as adequate numbers of well trained medical personnel and you compound the problem. The man was obviously moved from the Congo to Pretoria before they had identified the disease as Ebola. Given the time of movement, the distance, and the nature of the disease, I too would be worried of possible infections outside of Nigeria.

The doctor, from Nigeria, was treated at the Unitas Hospital, outside Pretoria.
Swanepoel said: ?He obviously died as there is no cure for the disease. It is known that people come to South Africa for treatment.?

Three airlines ? SAA, Hewa Bora Airlines and Kenya Airways ? operate flights between Johannesburg and the Congo capital of Kinshasa.

SAA is the only carrier that flies direct between the two destinations, four days a week, while the other two carriers have stop-overs in Lumbumbashi and Nairobi respectively.

SAA said it had noted the reports of ?a suspected haemorrhagic fever outbreak in a remote part of the Congo?.

SAA spokesperson Sarah Uys said if the situation worsened , passengers would be warned about a possible danger.
?But for now we don?t foresee problems,? she said.
Swanepoel said viruses such as ebola usually stem from war- torn areas, and regions where there was bad governance.

Click to expand...

AnneZ said:
It does not say that.

Could be private craft.

</IMG>

Vibrant62 · Sep 12, 2007

Re: Congo - Ebola - 160 dead - WHO Experts In Congo To Study Mysterious Disease

Re: Congo - Ebola - 160 dead - WHO Experts In Congo To Study Mysterious Disease

Are we suggesting a possible link between the Nigeria case and this outbreak in Congo linked to this transfer of the ill man?

JJackson · Sep 12, 2007

Re: Congo - Ebola - 160 dead - WHO Experts In Congo To Study Mysterious Disease

Re: Congo - Ebola - 160 dead - WHO Experts In Congo To Study Mysterious Disease

Re this article.

The doctor, from Nigeria, was treated at the Unitas Hospital, outside Pretoria.
Swanepoel said: “He obviously died as there is no cure for the disease. It is known that people come to South Africa for treatment.”

Three airlines — SAA, Hewa Bora Airlines and Kenya Airways — operate flights between Johannesburg and the Congo capital of Kinshasa.

SAA is the only carrier that flies direct between the two destinations, four days a week, while the other two carriers have stop-overs in Lumbumbashi and Nairobi respectively.

SAA said it had noted the reports of “a suspected haemorrhagic fever outbreak in a remote part of the Congo”.

SAA spokesperson Sarah Uys said if the situation worsened , passengers would be warned about a possible danger.
“But for now we don’t foresee problems,” she said.
Swanepoel said viruses such as ebola usually stem from war- torn areas, and regions where there was bad governance.

“He obviously died as there is no cure for the disease." CFR is not 100% (I have seen 60 to 90% quoted not dissimilar to H5N1) there is no cure for a common cold either.

"It is known that people come to South Africa for treatment.” What treatment? This is a rare disease and to the best of my knowledge people are cared for in situ by courageous HCWs. I have read a fair number of accounts on Marburg and Ebola outbreaks and dont remember infected people being deliberately moved out of area. Anyone else know of international movement of Ebola (or Marburg).

"Three airlines — SAA, Hewa Bora Airlines and Kenya Airways — operate flights between Johannesburg and the Congo capital of Kinshasa." I dare say but that does not mean thats how the patient got there.

"Swanepoel said viruses such as ebola usually stem from war- torn areas, and regions where there was bad governance." Yes they come from an area of the world that has a particular ecology but I am not sure the number of guns or political system have much to do with it.
"Many of the worlds largest Diamonds come from areas that had Apartheid regimes" a JJackson original, true but devoid of any useful information.

All in all slightly sloppy journalism rather than proof of anything and I am not impressed with Dr. Swanepoel. JMHO

Shannon Bennett · Sep 12, 2007

Re: Congo - Ebola - 160 dead - WHO Experts In Congo To Study Mysterious Disease

Re: Congo - Ebola - 160 dead - WHO Experts In Congo To Study Mysterious Disease

Vibrant no, that is not what I am suggesting. I just found it surprising that they would put anyone on any airplane after helping sick persons suffering from any hemorrhagic disease. It seems to me like profound folly. It does have implications not only with ebola but with pandemic flu as well given that victims often die from profound and unstoppable bleeding.

Jackson, they obviously put at least one health care woker on a plane. It would be interesting to see how often they did move infected persons out of the area. Something to bear in mind however, they moved this man PRIOR to knowing it was ebola.

Laidback Al · Sep 12, 2007

Re: Congo - Ebola - 160 dead - WHO Experts In Congo To Study Mysterious Disease

Re: Congo - Ebola - 160 dead - WHO Experts In Congo To Study Mysterious Disease

Vibrant62 said:
Are we suggesting a possible link between the Nigeria case and this outbreak in Congo linked to this transfer of the ill man?

There is definitely some confusion about an Ebola infected Nigerian doctor transported to South Africa. This seems to be incorrect.

Hat-tip to Nimbus at FW for this posting from February 22, 2007

South Africa: Nigerian Man Treated for Lassa Fever
http://allafrica.com...
A Nigerian medical doctor who contracted Lassa fever in Nigeria is being treated at the Unitas Hospital in Pretoria, the Gauteng Department of Health said on Wednesday.
"The patient is under continuous observation and is receiving treatment in the hospital's special isolation ward," said departmental spokesperson, Vusi Sibiya.
Western Union
According to the department's Chief of Operations Dr Abdul Rahman, the patient was flown from Abuja in Nigeria on Monday, for treatment of suspected malaria or septicaemia.
"Following tests Lassa fever was diagnosed and he was immediately admitted to the isolation ward at Unitas hospital," said Dr Rahman.
Lassa fever - is endemic in West-African countries such as Nigeria, Guinea, Liberia and Sierra Leone but is very rarely found in South Africa.
It is a viral haemorrhagic fever with symptoms that are similar to Marburg disease and malaria.
Its initial symptoms include fever, nausea, headaches, sore throat, muscle pains and a general feeling of weakness.
"Severe cases may progress to show facial swelling, fluid in the lung cavity and bleeding from the mouth and nose," explained Dr Rahman.
[snip] Their statistics show that up to 500 000 cases of Lassa fever are diagnosed in West Africa every year and the fatality rate among hospitalised patients vary between one percent and 15 percent. [more]

And from a forum on a South Africa website talking about a "lockdown" on August 10th at Centurion High School which is across the street from Unitas Hospital.

<TABLE cellSpacing=0 cellPadding=3 width="100%" border=0><TBODY><TR vAlign=top bgColor=#ffffff><TD class=posttext vAlign=top noWrap>Subject:</TD><TD class=posttext width="100%">RE: Centurion High school </TD></TR><TR bgColor=#ffffff><TD class=posttext vAlign=top noWrap>Posted by:</TD><TD class=posttext width="100%">Carol A.</TD></TR><TR class=posttext bgColor=#ffffff><TD class=posttext vAlign=top noWrap colSpan=2>Message: </TD></TR><TR bgColor=#ffffff><TD class=posttext vAlign=top colSpan=2>Hi Me- some of our members have posted on the site. I copied and pasted your question and 6 members wrote different answers to you. I hope you will go to the site-register and go to the Incident report page. look for Centurion High and click on the posting.all the comments will be there. If you have registered you can then ask your own questions of them.There is also a PM button next to the persons name (real 1st name) so you can send them a Private Message if you so wish.

Grietjie e Wrote Please contact the school.they will be willing to answer your questions.
Tel No -012 664 5803 or fax 012 664-7969
or e-mail info at hscenturion dot co dot za (on eblockwatch we can actually write this out properly.)

According to another member who also lives in the area and works at the Hospital (i take it ) says. On the Fri 10th a case of Meningococcal Septicemia was admitted to Unitas Hospital and there was a rumour it could have been Ebola or Sars-which was found to be Untrue.(this you could also check with the Hospital.

Another member wrote- At there High School in Montana,Northern part of Pta, the police checked the school using sniffer dogs for drugs ,she said maybe the same might have happened there.

Another member wrote-the school was closed on the 10th(extended holiday) so check with Unitas.

I hope this helps a little.

</TD></TR><TR bgColor=#ffffff><TD class=posttext noWrap></TD><TD class=posttext width="100%">17/8/2007

http://www.health24.com/Talk/Crime_Forum/2282-3888.asp?ForumID=219&PostID=1631291

</TD></TR></TBODY></TABLE>

JJackson · Sep 12, 2007

Re: Congo - Ebola - 160 dead - WHO Experts In Congo To Study Mysterious Disease

Re: Congo - Ebola - 160 dead - WHO Experts In Congo To Study Mysterious Disease

Shannon:

Yes it is worrying that he was moved before they know what they were dealing with and this is a real concern with all untreatable infectious disease. As you probably gathered I was just a bit annoyed by the good doctors daft comments and the leaps in 'logic' by the reporter. An important story poorly handled.

Congo - Ebola - 183 deaths + 187 suspected cases

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