Guinea: Donka Ebola treatment centre in Conakry stretched to the limit

[BestlaStormcrow]

Can anyone elaborate on the "known but not well-understood" chains of transmission mentioned in this article?

................................................
Conakry – the first major city to be affected by the West Africa Ebola outbreak – is currently seeing a massive spike in cases. In July, case numbers appeared to decrease in Guinea, suggesting the end of the outbreak might be near. But MSF is now caring for more than 120 patients – of whom 85 are confirmed to have the virus – in its two case management facilities in the country, Conakry and Guéckédou.

..snip..

Stephane Hauser, Field Coordinator in Donka, has noted a consistent increase in cases since his arrival at the end of August:

“Right now there are three transmission chains in four neighbourhoods of Conakry. With this new chain in Coyah – whose origins we don’t know at the moment – and the ones in Forecariah and Dalaba – which are known but not well-understood – we risk becoming overwhelmed. Since the beginning we’ve adapted by scaling up. But renovating the site to increase available space may simply not be enough.”

More...
http://www.msf.org/article/guinea-donka-ebola-treatment-centre-conakry-stretched-limit

 

[Vibrant62]

Re: Guinea: Donka Ebola treatment centre in Conakry stretched to the limit

I am sorry - we can only speculate as there is no more information, but it is interesting language.

It is bad news. Guinea had looked like it was being brought under control.

 

[MHSC]

Re: Guinea: Donka Ebola treatment centre in Conakry stretched to the limit

Can anyone elaborate on the "known but not well-understood" chains of transmission mentioned in this article?

................................................
Conakry – the first major city to be affected by the West Africa Ebola outbreak – is currently seeing a massive spike in cases. In July, case numbers appeared to decrease in Guinea, suggesting the end of the outbreak might be near. But MSF is now caring for more than 120 patients – of whom 85 are confirmed to have the virus – in its two case management facilities in the country, Conakry and Guéckédou.

..snip..

Stephane Hauser, Field Coordinator in Donka, has noted a consistent increase in cases since his arrival at the end of August:

“Right now there are three transmission chains in four neighbourhoods of Conakry. With this new chain in Coyah – whose origins we don’t know at the moment – and the ones in Forecariah and Dalaba – which are known but not well-understood – we risk becoming overwhelmed. Since the beginning we’ve adapted by scaling up. But renovating the site to increase available space may simply not be enough.”

More...
http://www.msf.org/article/guinea-donka-ebola-treatment-centre-conakry-stretched-limit

Are you asking what is a transmission chain? In case you are, I'll explain.

When they talk about a transmission chain, they mean where the disease came from and where it went, the links in the chain are people. Here is a quote from the roadmap that might help.

In Nigeria, all cases in the transmission chain are linked to a single person who travelled from Liberia to Lagos on 20 July.

The Nigeria transmission chain started with Patrick Sawyer, the rest of the links in the chain were his contacts and their contacts, etc.

The way I read this article is they have one chain with a unknown origin, meaning they don't know how the index case came into contact with the virus. Then they have two chains with known origins, but the rest of the chain doesn't make sense, perhaps they don't have all the contacts accounted for so there are links missing.

Does that help?

 

[BestlaStormcrow]

Re: Guinea: Donka Ebola treatment centre in Conakry stretched to the limit

Thank you for explaining in more depth.

So transmission chain only refers to the human part of disease spread, not other aspects like contaminated surfaces etc.

It makes sense that they are referring to missing human links, rather than not knowing the vector or mechanical means these chains have continued. I first thought maybe they were talking about spread via some means not previously encountered or documented, which would be worrisome.

While looking for more information about this statement I saw a few previous headlines talking about the outbreak in Guinea winding down, then ramping back up again. In August I think. Where is the ebolavirus hiding so that it can keep coming back in waves like this? Are the unknown chains going back to animal vectors possibly?

 

[Graupel]

Re: Guinea: Donka Ebola treatment centre in Conakry stretched to the limit

I suspect in this case the 'known but not well-understood' likely refers to outlying areas, where there is potentially little good information. So likely the MSF centers are hearing rumors or seeing cases from these areas, but have little understanding about what is really going on in households.

While there is the potential for re-introduction from fruit bats etc, I imagine it's just simmering in homes below the surveillance thresholds, and then propagates out to become apparent.

 

[MHSC]

Re: Guinea: Donka Ebola treatment centre in Conakry stretched to the limit

It makes sense that they are referring to missing human links, rather than not knowing the vector or mechanical means these chains have continued. I first thought maybe they were talking about spread via some means not previously encountered or documented, which would be worrisome.

I can't guarantee it, but I would lean heavily toward the missing human links.

Where is the ebolavirus hiding so that it can keep coming back in waves like this? Are the unknown chains going back to animal vectors possibly?

I haven't been keeping tabs on specific country counts but epidemics can travel in waves. Here is a link to a graph, though its older, it was the first one that popped up for me in a search. You can see how it goes up and down, but gradually grows.

http://scienceblogs.com/gregladen/files/2014/08/Ebola_2014_outbreak_cases_per_day_Aug_15Update.png

 

[Vibrant62]

Re: Guinea: Donka Ebola treatment centre in Conakry stretched to the limit

As the situation in Guinea has been more under control than the situation in Liberia or Sierra Leone, contact tracing has been able to continue and has been quite thorough, on the whole. However, there have been some remote areas where teams have not been able to access, but instead this report has highlighted transmission chains that dont make sense.

Therefore, if there are transmissions that make no sense it would lean towards either unidentified human cases or another unexplained cause, where they can find no standard 'contact' for transmission.

Generally, if an individual has visited a sick persons house but not touched the person, they would assume some fomite transmission and that case would be accounted for and 'explainable'.

Hopefully the teams on the ground will provide us with more information asap

 

[BestlaStormcrow]

Re: Guinea: Donka Ebola treatment centre in Conakry stretched to the limit

Thanks for sharing the graph. It must be so wearing on people in affected areas, to think maybe it's actually on the decline only to have another wave hit.

I'm concerned about the unexplained aspect, so hopefully we'll have more information soon. I just dread hearing that infection parameters are wider than originally thought, like the asymptomatic early stage being contagious, or the virus surviving longer on surfaces, etc.

 

[Pathfinder]

Re: Guinea: Donka Ebola treatment centre in Conakry stretched to the limit

Translation Google

Explosion of Ebola in Guinea: The treatment center Donka increases its capacity ...

Conakry- Facing the new outbreak of the epidemic of Ebola viral hemorrhagic fever in Guinea, the Ebola treatment center (ETC) located in the enclosure of CHU Donka, increases its capacity of patients, has found on place Africaguinee.com .

The Ebola epidemic that devastates mainly three countries in West Africa (Guinea-Sierra Leone-Liberia) seems not manageable. Last week, the isolation center in Donka, experienced a massive influx of patients. The new outbreak has forced M?decins Sans Fronti?res (MSF), which manages the center to install 14 new beds in the center. 14 more are planned this week.

Interviewed by our reporter in the middle of last week, the head of communications of MSF, Julien Rey explained that when he arrived at ETC Donka, 'there were 25 patients'.

Today, the number has doubled to 65 patients, he added. ''14 Beds have been added in the center to meet the arrival of new cases', he says.

The center was planned for 20 patients, but today has doubled its capacity to 55 beds, with an additional 14 newly installed beds. 'Suspected cases require as much care as a confirmed case, "said Julien Rey.
...
Fatoumata Ke?ta

http://www.africaguinee.com/article...-le-centre-de-traitement-de-donka-augmente-sa

 

[Pathfinder]

Re: Guinea: Donka Ebola treatment centre in Conakry stretched to the limit

Translation Google

One death of Ebola per day in Conakry, at least! Guineematin.com offers images ...

Post by Guineematin 15 - October - 2014

About fifty patients are currently at the Ebola treatment center (CTE) in Donka which has a capacity of about 80 patients. But what seems more grave than the anxiety of the MSF agents to see this center reject people , are the community deaths and especially of the "not identified" ... Very often, people complain in Conakry having unsuccessfully called the 115 (toll-free for information or request information about Ebola) without respondent or with promises of coming rarely honored in time. Sometimes a person dies and his body be "abandoned" a whole day or even more without having any "specialist" to "pick up" the suspect body.

Today, many commentators questioned the effectiveness propaganda awareness on Ebola, while the State and technical partners do not even ensure their most basic roles ...

Meanwhile in the wait of illustrative and eloquent enough videos of this situation, Guineematin.com offers below some images of this Tuesday, October 14, 2014 in Madina Pharmaguin?e, at the ETC Donka and the cemetery of Cameroon:
...
http://guineematin.com/?p=5187

 

[BestlaStormcrow]

Re: Guinea: Donka Ebola treatment centre in Conakry stretched to the limit

Just not quite enough...the containment battle isn't going so well.