Doctors Without Borders: Ebola 'out of control'

[Pathfinder]

Doctors Without Borders: Ebola 'out of control'

By SARAH DiLORENZO
Associated Press
June 20, 2014 8:54 AM

DAKAR, Senegal (AP) ? The Ebola outbreak ravaging West Africa is ??totally out of control,?? according to a senior official for Doctors Without Borders, who says and the medical group is stretched to the limit in its capacity to respond.

International organizations and the governments involved need to send in more health experts and to increase the public education messages about how to stop the spread of the disease, Bart Janssens, the director of operations for the group in Brussels, told The Associated Press on Friday.
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??The reality is clear that the epidemic is now in a second wave,?? Janssens said. ??And, for me, it is totally out of control.??
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??I'm absolutely convinced that this epidemic is far from over and will continue to kill a considerable amount of people, so this will definitely end up the biggest ever,?? he said.

The multiple locations of the outbreak and its movement across borders make it one of the ??most challenging Ebola outbreaks ever,?? Fadela Chaib, a spokeswoman for the World Health Organization, said earlier in the week.
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But Janssens? description of the Ebola outbreak was even more alarming, and he warned that the governments affected had not recognized the gravity of the situation. He criticized the World Health Organization for not doing enough to prod leaders and said that it needs to bring in more experts to do the vital work of tracing all of the people who have been in contact with the sick.

??There needs to be a real political commitment that this is a very big emergency,?? he said. ??Otherwise, it will continue to spread, and for sure it will spread to more countries.??

The World Health Organization did not immediately respond to requests for comment.

More...
http://www.boston.com/health/2014/0...out-borders/gxjq53wYl4CVS9QFh73ALI/story.html

 

[Pathfinder]

Re: Doctors Without Borders: Ebola 'out of control'

<IFRAME height=360 src="//www.youtube.com/embed/4vTrTgQb0YU" frameBorder=0 width=640 allowfullscreen></IFRAME>

BBC News Africa's Ebola outbreak 'out of control', warns MSF

 

[Pathfinder]

Re: Doctors Without Borders: Ebola 'out of control'

West Africa Is 'Overwhelmed' By Ebola

by Marc Silver
June 20, 2014 3:01 PM ET
...
In past outbreaks, there have been what are called "satellite cases," where the disease appears in different locations. But "not nearly as many as we've seen in this outbreak," says Sprecher. That may be because people move around a lot in West Africa.

"More manpower would certainly help," Sprecher says. "We are spread thin." When a new case is reported, medical staff tries to visit everyone that person has had contact with. The villages that workers must go to may be many miles from each other....
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The reaction of locals makes it harder for medical workers to do their job. If someone is running a fever and has had previous contact with an Ebola victim, medical workers want to bring that individual to a "treatment unit" to be tested, Sprecher says. But people seek to conceal their illness because of the stigma of Ebola: "They don't want us to know; they don't want their neighbors to know."
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Previous Ebola outbreaks have been controlled with a matter of weeks or months. That's partly because victims die so quickly, sometimes just days after the virus sets in. And when the outbreak is confined to a relatively small area, quarantines are easier to enforce.

This time around, says Sprecher, the fear is that the outbreak will become "a regional health issue" that will not go away.

http://www.npr.org/blogs/health/2014/06/20/323985117/west-africa-is-overwhelmed-by-ebola

 

[Shiloh]

Re: Doctors Without Borders: Ebola 'out of control'

Source: http://www.nbcnews.com/health/health-news/ebola-outbreak-tip-iceberg-experts-say-n137081


Ebola Outbreak 'Tip of the Iceberg,' Experts Say
By Maggie Fox

An "out of control" outbreak of Ebola in West Africa that?s being called the deadliest ever is far from over and it?s likely to get worse before it gets better, experts predict.

And health workers who have been fighting the outbreak, which spans three countries and has killed more than 300 people, say they are certain many cases are going unreported as they see gruesome infections, dangerous myths and people fleeing the virus, potentially spreading it further.

?This is the tip of the iceberg,? said Robert Garry, a microbiology professor at the Tulane University School of Medicine who?s been leading relief and investigation efforts in Sierra Leone for the Viral Hemorraghic Fever Consortium...

 

[Donners]

Re: Doctors Without Borders: Ebola 'out of control'

Ebola spread due to 'relaxation' of efforts

22 June 2014

GENEVA - The recent rapid spread of Ebola in three countries in West Africa has come in part because efforts to contain the deadly virus have been relaxed, Pierre Formenty, a World Health Organisation specialist, told AFP on Saturday.

Question: We have around 530 cases of hemorrhagic fever, mostly from the Ebola virus, in the region, compared to 225 at the end of April. How do you explain this leap?

Answer: We have had since March 21, when the epidemic was declared in Guinea, a first wave that has started to diminish. Since the start of May we have had a sort of resurgence with an increase in the number of cases and notably also with an epidemic which has spread to Sierra Leone and Liberia. We are seeing a second wave of cases for West Africa.

How do you explain this new peak?

When the epidemic started, it was a little under-estimated, so that the states took a while to really prepare themselves. At the end of April, we started to see a decrease in the number of cases and we maybe saw a relaxation by the teams in the three countries, and this relaxation allowed things to restart.

In addition, there were some problems with the affected populations which were sometimes not fully listened to.

...

http://www.newvision.co.ug/news/656806-ebola-spread-due-to-relaxation-of-efforts.html?

 

[Pathfinder]

Re: Doctors Without Borders: Ebola 'out of control'

West African Ebola epidemic "out of control": aid group

Mon Jun 23, 2014 1:56pm GMT

ACCRA (Reuters) - An Ebola epidemic in Guinea, Liberia and Sierra Leone is out of control and requires massive resources from governments and aid agencies to prevent it from spreading further, medical charity M?decins Sans Fronti?res said on Monday.
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"Ebola is no longer a public health issue limited to Guinea: it is affecting the whole of West Africa," said Janssens, urging WHO, affected countries and their neighbours to deploy more resources especially trained medical staff.

MSF has treated some 470 patients, 215 of them confirmed cases, in specialised centres in the region but the organisation said it had reached the limit of its capacity.

Patients have been identified in more than 60 locations across the three countries making it harder to curb the outbreak.
...

http://af.reuters.com/article/topNews/idAFKBN0EY1JB20140623

 

[Pathfinder]

Re: Doctors Without Borders: Ebola 'out of control'

M?decins Sans Fronti?res

Ebola in West Africa: Epidemic requires massive deployment of resources

23 June 2014

Full text:
http://www.msf.org/article/ebola-west-africa-epidemic-requires-massive-deployment-resources

 

[Nika]

Re: Doctors Without Borders: Ebola 'out of control'

am curious if any of you all have links to recent seq data on this ebola zaire strain outbreak? If not - do you know if there hasnt been data (and thus a waste of time trying to find)

It seems like Flutrackers hasnt been hot on this topic since April (similar to actual dynamics on the ground in Guinea) and I was distracted by MERS and then my own treacherous back so I totally dropped the thread Perhaps I missed more posts?

Thnx ahead of time

 

[Pathfinder]

Re: Doctors Without Borders: Ebola 'out of control'

Hattip Shiloh:
http://www.flutrackers.com/forum/showthread.php?p=531556

Emergence of Zaire Ebola Virus Disease in Guinea ? Preliminary Report

Excerpt:
Discussion

This study demonstrates the emergence of EBOV in Guinea. The high degree of similarity among the 15 partial L gene sequences, along with the three full-length sequences and the epidemiologic links between the cases, suggest a single introduction of the virus into the human population. This introduction seems to have happened in early December 2013 or even before. Further epidemiologic investigation is ongoing to identify the presumed animal source of the outbreak. It is suspected that the virus was transmitted for months before the outbreak became apparent because of clusters of cases in the hospitals of Gu?ck?dou and Macenta. This length of exposure appears to have allowed many transmission chains and thus increased the number of cases of Ebola virus disease.

The clinical picture of the initial cases was predominantly fever, vomiting, and severe diarrhea. Hemorrhage was not documented for most of the patients with confirmed disease at the time of sampling but may have developed during the later course of the disease. The term Ebola virus disease (rather than the earlier term Ebola hemorrhagic fever) takes into account that hemorrhage is not seen in all patients15 and may help clinicians and public health officials in the early recognition of the disease.

The case fatality rate was 86% among the early confirmed cases and 71% among clinically suspected cases, which is consistent with the case fatality rates observed in previous EBOV outbreaks.15-17

Phylogenetic analysis of the full-length sequences established a separate clade for the Guinean EBOV strain in sister relationship with other known EBOV strains. This suggests that the EBOV strain from Guinea has evolved in parallel with the strains from the Democratic Republic of Congo and Gabon from a recent ancestor and has not been introduced from the latter countries into Guinea. Potential reservoirs of EBOV, fruit bats of the species Hypsignathus monstrosus, Epomops franqueti, and Myonycteris torquata, are present in large parts of West Africa.18 It is possible that EBOV has circulated undetected in this region for some time. The emergence of the virus in Guinea highlights the risk of EBOV outbreaks in the whole West African subregion.

http://www.nejm.org/doi/full/10.1056/NEJMoa1404505?query=featured_home&#t=article

 

[Donners]

Re: Doctors Without Borders: Ebola 'out of control'

There was another report which expands on the one above.

The phylogenetic analysis of the five ebolavirus species here does not substantially improve on that presented by Baize et al.1 in that even when partitioning the alignment into coding and non-coding regions we get inconsistent rooting positions for the EBOV clade. We believe that at present no suitable outgroup sequences to root the EBOV phylogeny exist and that a temporal rooting gives the most consistent results.

This approach indicates that the outbreak in Guinea is likely caused by a Zaire ebolavirus lineage that has spread from Central Africa into Guinea and West Africa in recent decades, and does not represent the emergence of a divergent and endemic virus.

As the GP sequences show, without more diverse sequences, especially those from the animal reservoir, it is difficult to narrow down the estimates of when and through what means the Central African EBOV lineage has been introduced into West Africa.

http://currents.plos.org/outbreaks/...is-of-guinea-2014-ebov-ebolavirus-outbreak-2/

 

[Nika]

Re: Doctors Without Borders: Ebola 'out of control'

Donners. Thats an awesome paper thnx. Does ebola circulate in the same types of bats as MERS in central Africa? Hmm

 

[Donners]

Re: Doctors Without Borders: Ebola 'out of control'

WHO urges 'drastic action' on Ebola

Source AAP 26 JUN 2014 - 9:30 PM

The World Health Organization has warned that dramatic steps are needed to fight the deadliest Ebola outbreak on record, calling an 11-nation meeting to address the crisis.

"As the number of deaths and cases of Ebola virus continues to rise in Guinea, Liberia and Sierra Leone, the World Health Organization is warning that drastic action is needed," the UN agency said on Thursday in a statement.

As of Sunday, 635 confirmed, probable and suspected cases of Ebola have been reported, including 399 deaths, making the ongoing outbreak the largest ever "in terms of the number of cases and deaths, as well as geographical spread," WHO said.

The agency was now "gravely concerned (by) the on-going cross-border transmission into neighbouring countries as well as the potential for further international spread," said WHO's regional director for Africa, Dr Luis Sambo.

"This is no longer a country specific outbreak but a sub-regional crisis that requires firm action by governments and partners," Sambo warned.

Since west Africa's first-ever epidemic of the deadly haemorrhagic fever emerged in Guinea in January, WHO has sent in more than 150 experts to help tackle the crisis.

But despite the efforts of the WHO and others, there had been a "significant increase" in the number of cases and deaths reported each day for the past three weeks, it said.

To address the growing crisis, the WHO said it would convene a meeting of the health ministers from 11 countries in Accra, Ghana on July 2 and 3 "to discuss the best way of tackling the crisis collectively as well as develop a comprehensive inter country operational response plan."

...

www.sbs.com.au/news/article/2014/06/26/who-urges-drastic-action-ebola?

 

[sharon sanders]

Re: Doctors Without Borders: Ebola 'out of control'

From: WorldHealthOrganizationNews@who.int
To: undisclosed-recipients@null, null@null
Subject: Ebola epidemic in West Africa: WHO urges comprehensive inter-country response
Date: Jun 26, 2014 6:27 AM
Dear journalists

Please find enclosed a press release by the WHO Regional office for Africa on an Ebola meeting to take place in Accra, Ghana from 2-3 July 2014

25 June 2014


Ebola epidemic in West Africa: WHO urges comprehensive inter-country response


Brazzaville 25 June 2014 - As the number of deaths and cases of Ebola virus continues to rise in Guinea, Liberia and Sierra Leone, the World Health Organization is warning that drastic action is needed.

The World Health Organization has so far provided technical assistance through the deployment of over 150 multidisciplinary team of experts involved in a range of outbreak response activities such as surveillance, communication and social mobilization, infection control, logistics, data management.

Despite this, there has been significant increase in the number of daily reported cases and deaths of Ebola as well as newly affected districts over the last three weeks. As of 23 June 2014, the total cumulative number of cases reported was 635 out of which 399 died. This makes the on-going Ebola outbreak, the largest in terms of the number of cases and deaths as well as geographical spread.

“This is no longer a country specific outbreak but a sub-regional crisis that requires firm action by Governments and partners. WHO is gravely concerned of the on-going cross-border transmission into neighbouring countries as well as the potential for further international spread. There is an urgent need to intensify response efforts; to promote cross-border collaboration and information sharing of suspected cases and contacts in line with WHO guidelines and to mobilise all sectors of the community to ensure unhindered access to affected areas. This is the only way that the outbreak will be effectively addressed”, said Dr Luis Sambo, WHO Regional Director for Africa.

In an effort to interrupt further spread of this virus in the shortest possible time, the World Health Organization is convening a special meeting of Ministers of Health of eleven (11) countries and partners involved in the Ebola outbreak response in Accra, Ghana from 2-3 July 2014 to discuss the best way of tackling the crisis collectively as well as develop a comprehensive inter country operational response plan.

Decisions taken at this meeting will be critical in addressing the current and future outbreaks.
End

For more information, please contact:
Dr Francis Kasolo + 4724139983 E-mail: kasolof@who.int
C. Boakye-Agyemang + 4724139420 E-mail: boakyeagyemangc@who.int

 

[Pathfinder]

Re: Doctors Without Borders: Ebola 'out of control'

Ebola outbreak ?not out of hand?, UN health agency says readying response

27 June 2014 ? The United Nations health agency and partners are working with the Governments of Guinea, Liberia and Sierra Leone to control an outbreak of Ebola in West Africa, an official today said, announcing an international meeting next week to agree on a coordinated regional response.

?The situation is not out of hand,? Pierre Formenty told journalists in Geneva on behalf of the UN World Health Organization (WHO). ?WHO has been supporting the three affected countries and their Ministries of Health staff, and are working with them on a daily basis to try to contain the outbreak.?

Those Ministers will meet in Accra, Ghana, next week to agree on a ?comprehensive operational response? to control the Ebola virus, which has been reported in more than 600 cases since March, and over 390 deaths.

There are difficulties, notably in the forests, in identifying cases and tracing the point of contact, Dr. Formenty said.

?WHO has not yet managed to explain to people the dangers to their lives in conducting an unsafe funeral during an Ebola outbreak, and it continues to work to rectify that,? he added, highlighting the challenges of educating people about the infection.

The Ebola virus, which causes severe haemorrhaging and can kill up to 90 per cent of those infected, is spread by direct contact with the blood and body fluids of infected animals or people.

?To be effective, WHO has to continue a dialogue with the population, the affected families and the patients to make them understand the mode of transmission of the disease,? said Dr. Formenty, ?and how to change their behaviour in order to stop the chain of transmission and the outbreak.?
The agency has stressed that any response to the outbreak must fully respect people?s human rights, and said they would not advocate for restrictions to stop people traveling from one place to another.

Ebola

Virus disease in West Africa. Credits: WHO


?If restrictive measures are imposed, it would only fuel the outbreak,? Dr. Formenty said. He added WHO was more in favour of ?dialogue with affected families, cities and districts rather than to be a sort of ?sanitary police?.?In Guinea, 386 cases of the disease had been reported, including 280 deaths; 78 deadly cases out of 176 reported in Sierra Leone, and 63 reported cases in Liberia, including 41 deaths, WHO announced.

http://www.un.org/apps/news/story.asp?NewsID=48156

 

[Pathfinder]

Re: Doctors Without Borders: Ebola 'out of control'

Guinea -

Translation Google

Sat, June 28th, 2014, 22:12 Posted By  Tokpana 

The committee against hemorrhagic fever clarifies the "out of control" of Doctors Without Borders

To the press on Saturday, the National Committee against the Ebola virus had to react to the latest communications of M?decins Sans Fronti?res. No contradiction. But clarifications, says Dr. Sakoba Keita, Division Prevention and Fight against Disease Guinean Ministry of Health, the expression "out of control" used by M?decins Sans Fronti?res is purely technical. "This is an epidemiological term," said Dr. Sakoba Keita.

According Sakoba Keita, "out of control" is mostly used due to the fact that the health control measures are not implemented in Sierra Leone and Liberia, the two neighboring countries affected by the disease. "First, these two countries do not have a treatment center. Secondly, contact tracing is not as well organized as is the case in Guinea, "said Sakoba Keita. Adding that patients from other countries leave their country to come to seek treatment Gueckedou. "In our treatment center Gueckedou, 30% of patients are Sierra Leoneans," said Sakoba Keita.

Marc Poncin, national coordinator of Ebola Emergency Doctors Without Borders, also came back on the words of his institution. According to him, "out of control" first concern the three countries -. Guinea, Liberia and Sierra Leone, but especially when we talk about "an epidemic out of control", we talk about the rapid spread to the other two countries in which control measures are not effective today. "

By providing this clarification, Marc Poncin called to make a distinction between the case in Guinea and those in the other two countries. Guinea, according Poncin, the country is well organized to cope with the epidemic. In addition, partners are deployed and the Ministry of Health has developed real expertise to lead the response. This is not the case in Sierra Leone and Liberia.

Poncin said he was not worried by the situation in Guinea. But it is the two neighbors that worries him, and which raise the threat to Guinea. "Even if outbreaks in Guinea are cleaned, you may have at any time someone from Sierra Leone or Liberia that will bring the disease in Guinea ... It is on this that our Director of Operations intended to alert the community international and ministries of health in the area, "said Poncin.

The National Coordinator for M?decins Sans Fronti?res reported that the alert has even begun to bear fruit with the next organization in Accra a meeting of Health Ministers of ECOWAS. "We need to organize, but we must mobilize a lot of resources," said Marc Poncin.

http://guineenews.org/2014/06/le-co...hors-de-controle-de-medecins-sans-frontieres/

 

[Pathfinder]

Re: Doctors Without Borders: Ebola 'out of control'

Scientist who discovered Ebola: ?This is unprecedented?

July 2nd, 2014
02:51 PM ET
By Mick Krever, CNN

...
?One, [this is] the first time in West Africa that we have such an outbreak,? Dr. Peter Piot told CNN?s Christiane Amanpour. ?Secondly, it is the first time that three countries are involved. And thirdly it?s the first time that we have outbreaks in capitals, in capital cities.?
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There is no cure for Ebola, but in theory the disease should be easy to fight, Piot said.

?You need really close contact to become infected. So just being on the bus with someone with Ebola, that?s not a problem.?

Simple hygienic measures like washing with soap and water, not re-using syringes, and avoiding contact with infected corpses are sufficient to stop spread of the disease, Piot said.

?This is an epidemic of dysfunctional health systems.?

?Fear of the virus, and the lack of trust in government, in the health system, is as bad as the actual virus.?

What happens ?is that a person is infected, is hospitalized, infects other patients and particularly health care workers.?

?They?re buried somewhere; around that funeral, people are infected when they touch the body, and so on. And then they get ill, and then they go somewhere else, and then they go to relatives in town, maybe because they hope to have better health care. That?s how it spreads.?
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The current outbreak is ?already a mega-crisis,? Piot said.

?For me, this is a reason for a state of emergency, you know, in these countries.?
...

Full text:
http://amanpour.blogs.cnn.com/2014/07/02/scientist-who-discovered-ebola-this-is-unprecedented/