Guinea records probable case of Ebola-like Marburg virus - Confirmed - Outbreak declared over

[Gert van der Hoek]

Fri, August 6, 2021,

Fri, August 6, 2021, 7:29 PM·1 min read
In this article:

• Coronavirus

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DAKAR (Reuters) - A probable case of Marburg virus, a deadly hemorrhagic fever similar to Ebola, has been detected in Guinea, the health ministry said on Friday.

Two laboratories in Guinea confirmed the case of Marburg and a sample has been sent to neighbouring Senegal for further confirmation, the ministry's National Agency of Health Safety (ANSS) said in a statement.

If confirmed, it would represent the first case of Marburg in West Africa. There have been 12 major Marburg outbreaks since 1967, most in the south and east of Africa as well as in Europe.

READ MORE

 

[Pathfinder]

Translation Google

Urgent: After Ebola, Lassa, Corona ... a "probable" case of the Marburg virus reported in Guinea


CONAKRY- Is Guinea becoming the territory where all the cursed viruses in the world meet? Already struck by a series of epidemics (Coronavirus, Lassa, yellow fever), Guinea, which recently defeated Ebola, has just recorded a first probable case of Marburg fever.

This case was recorded on Thursday, August 05, 2021 in Tèmessadou M'boke, sub-prefecture of Koundou, prefecture of Guéckédou in the health region of Nzérékoré, by two (2) national laboratories based in Guéckédou and Conakry at level P2, announced this Friday, August 6, 2021, the national health security agency.

Considering that this is the first time that this disease has been notified in Guinea, the health authorities in collaboration with its partners have decided as follows:

1. Sending a sample to the Pasteur Institute in Dakar (laboratory P3) for a re-confirmation
2. Investigate around the case in order to detect other suspected cases and list the contacts;
3. Strengthen surveillance in the suspected area;
4. Raise awareness among the populations of the suspected area on preventive measures.

A joint mission of the Regional Health Directorate of Nzérékoré, Prefectural Health Directorate of Guéckédou and the WHO is deployed to investigate the case. To date, no new suspected case has been detected pending the end of the investigations, specifies the briefing note of Dr Sakoba Keita.

We will come back to that!

https://www.africaguinee.com/articl...a-un-cas-probable-du-virus-marburg-signale-en

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[Gert van der Hoek]

How did the Marburg hemorrhagic fever appear?

Saturday 07 August 2021

GUECKEDOU-A probable case of Marburg hemorrhagic fever, the very first in Guinea, has been discovered in Tèmèssadou N'bôkêh, a district located 50 kilometers from the urban commune of Guéckédou in Forest Guinea. The first victim is a 46-year-old father. Father of 5 children, his wife fled after the tragic death of her husband.

Our regional correspondent based in Nzérékoré went to Tèmèssadou this Friday 06 August. He met Sandouno Félix, the head of the post who received the patient before his death. According to his testimony, the victim had red lips, a sign of bleeding. However, he did not know what caused the bleeding. He returned to what happened.

"You know, when a sick person comes in, you have to do the interrogation. When I asked, the parents told me that he suffers from mental depression and that he has been on treatment for 6 months. Four (4) days before we brought him to the health post, he had started doing things like someone who is disturbed, he was not sleeping and he was always on the move (…).

It was on Sunday August 1 that he started to feel hot. The state in which I saw him made me doubt. So I made arrangements at the same time to protect myself. I took the TDR test which was positive. He had red lips. When I asked, I was told he has a mouth problem. After the treatment, in the afternoon, the parents asked to go home. The next day, which was Monday, I told them that it is preferable that the patient be referred to Guéckédou, given his condition. The parents informed the patient who told them not to rush to refer him to Guéckédou. To wait a bit. But it was really wrong.

In the evening around 9 p.m., I heard screams. The time for me to go and look over there, I met the president of the district who told me that Doctor Pascal, who is in Conakry, instructed him not to touch the body. Because he was bleeding through his mouth, it's very complicated. And parents said that while he was sick he banged his head against the wall. I don't know if it was those injuries that caused the bleeding. So, it is a bleeding which I could not know the origin. Something that prompted me to tell them to refer him. But if the parents or the patient refuses, it becomes complicated. It's like that, when the man died, the village chief

So I sensitized the community. It was expected that the next morning that a team would come from Guéckédou. The next day they came in the afternoon. When they arrived, they put on their suits as usual. They sprayed the place before taking the blood sample and turned around. They promised that we would have the results at 6 p.m. To date, we have not received the result. The next day also the same, but they always told us to keep the door closed without going there. So people started to worry ", told us Mr. Sandouno Félix, head of the Tèmèssadou post.

The result is positive, it is the Marburg hemorrhagic fever we are told. 13 first contacts were recorded in the village, while the wife of the deceased took the loose.

"The result is today that we received. They said it is the Marburg hemorrhagic fever. The contacts are 13 people. These are the first contacts. But some people have fled. In particular his woman, ”adds the post manager.

The burial took place on Thursday 05 August 2021 in the same village by a team of the red cross. A team from the regional health directorate of Nzérékoré was in the village with the prefectural health directorate of Guéckédou on Friday 06 August for investigations.

"As the body had already spent several days, we had already dug the grave to await the burial. But when they told us that there are people who must come from Nzérékoré and Guéckédou, we were ready to completely empty the village, because there was fear. They were not going to find anyone here. But it is thanks to the sensitization of the sub-prefect of Koundou, and the head of the post that we stayed to welcome the delegation. It has just returned ", testifies Faya Moussa Millimono, village chief of Tèmèssadou N'bôkêh.

https://www.africaguinee.com/articl...nt-la-fievre-hemorragique-marburg-est-apparue

 

[Gert van der Hoek]

MARGBURG FEVER IN GUECKEDOU: one death and more than ten contacts


By LEDJELY.COM - Sunday, August 8, 2021


Ledjely.com met the health worker from Témessadou M'Boket who had received the patient who finally died. "When this patient arrived with his parents last Sunday, I was told he has a hot body, he is not sleeping. All night long he comes and goes and talks alone. When I did his RDT I found it to be positive, then I saw that he had red lips and his body was pale and he was bleeding from his mouth and I didn't know not the origin of this bleeding. After the diagnosis, I put him on treatment for malaria. Some time later, the parents decided to return home with the patient. So, on Monday morning, as it is the day of the weekly market in Koundou, I went to tell his parents that the way I find your son there, the best way would be to refer him. They asked me where? I told Koundou and Koundou refers to Gueckédou. After their interview, “, Said Félix Sandouno, head of the Temessadou M'Boket health post.

Further on, Félix Sandouno specifies: “as soon as there was this death on August 2 at 10:30 pm we received calls everywhere asking us not to touch the body. The red cross came to take the sample the next day. We were told the result would be available at 6 p.m. Tuesday. After that, a team came to take the sample, it was only on Friday that the mission came to tell me that the test was positive for the Marburg virus but another sample is sent to Senegal, we are waiting for that. first to actually confirm the disease. Otherwise the body was three days before being buried by the red cross ”.

There are many people in the general population who believe that the bleeding in the body is due to another factor. “ This gentleman was suffering from dementia. He was once sent to Conakry for treatment. When he returned it was over 2 years before the insanity resumed. So when his madness started he could bang his head against the wall, tree trunks and other objects. He could go 4 to 5 days without sleeping and he spoke to himself. The last time he fell ill he complained of malaria and fatigue. If he dies and we find blood in his mouth we say to ourselves that these are effects. But to say that it is the disease really surprises us. He never left here to go anywhere else and how he can have that», Explains Faya Moussa Millimouno, head of the central sector of the district of Temessadou M'Boket. And to add: “ even when the red cross came for the burial, it was difficult to find people to close the tomb. People had fled the village. It is thanks to the awareness of the mayor, the sub-prefect, the head of the center, you have found people here ”.

As of August 6, 2021, several contacts have been identified but the victim's wife is on the run. “ We have already identified 13 people who are contacts. Since August 3 we started and we did the 3, 4 and 5. This is the result. However, we continue to raise awareness so that people remain calm and continue to wash their hands. Our concern is linked to the fact that the deceased's wife is missing. We do not know is gone, research is underway to find it, ”reassures Félix Sandouno.

On the side of the health authorities of Gueckédou, it is radio silence, no one wants to comment on the issue even if investigation and awareness teams are deployed in the field. It should be noted that the deceased who was 46 years old leaves behind 6 children and a widow.

https://ledjely.com/2021/08/08/fievr...e-de-contacts/

 

[alert]

Hmm. A man who has been institutionalized for the past 2 years with mental issues and dementia doesn't seem likely to be the first person in his country to contract Marburg. Many hemorrhagic fevers, including Lassa, Ebola, and Marburg can cause acute mental issues, but it's not likely to produce an illness lasting for years. Could the man have contracted the virus as a patient in a hospital at some point in the past couple weeks?

Are we sure the man didn't have Ebola? Ebola and Marburg are both filoviruses and could conceivably be cross-reactive in a rapid-test. Is there any evidence that this man might have had contacts to the previous Ebola outbreaks in this area, and perhaps was suffering from the after-effects or relapse of a previous infection? Other than the rapid-test positive for Marburg, there's no mention of any other tests on the patient.

Obviously, there are a wide range of things other than Ebola and Marburg that could have caused this man's illness.

There's more questions than answers here so far.

 

[sharon sanders]

bump this

 

[Pathfinder]

Translation Google

Marburg fever in Guinea: the Pasteur Institute in Dakar reconfirms !!!

Mediaguinee
August 9, 2021

Bad news for Guinea. The Pasteur Institute in Dakar has just confirmed a case of Marburg Fever from the sample that was sent from Guinea, indicates to Mediaguinee a source close to the ANSS.

...

https://mediaguinee.org/la-fievre-de-marburg-en-guinee-linstitut-pasteur-de-dakar-reconfirme/

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Guinea-Fièvre Marburg: the case of Guékédou confirmed by the Pasteur Institute in Dakar

Posted By: Thierno Souleymane Diallo On: Monday, August 09, 2021 At 4:16 P.M.

Less than two months after the end of Ebola fever, Marburg fever must be counted among the diseases that Guinea now has to face, in addition to the Coronavirus and Lassa fever. The results of the examination of the sample, hitherto described as a "probable" case, have fallen. In any case, Guinéenews has just learned from a medical source close to the French institute.

According to our source, “Marburg fever is confirmed by the Pasteur Institute in Dakar”. Our interlocutor specifies that an official declaration is being prepared ”.

This is confirmed by the director of the communication department of the National Agency for Health Security. In turn, Sory 2 Keïra declares that: "the Pasteur Institute in Dakar has just confirmed". Before adding that: “the declaration is being drafted.

https://guineenews.org/guinee-fievr...edou-confirme-par-linstitut-pasteur-de-dakar/

 

[Pathfinder]

Translation Google

GUECKEDOU: the woman on the run, whose husband died of Marburg fever, localized (prefect)

By LEDJELY.COM Monday August 9th, 2021 at 04:38 PM

After a case of probable death from the Marburg virus hemorrhagic fever, in the district of Témessadou M'Boket, the prefectural authorities of Gueckedou are making reassuring announcements about the wife of the deceased who was on the run.

According to the prefect, Tamba Nestor Tonguino, “ the only woman who had moved was located. We have sent the authorities to identify her whereabouts. The village has just been indicated and people will go for sensitization so that she agrees to go to the hospital for follow-up like the other suspected cases. I'm sure we'll be able to get her to come ”.

In addition, to curb the spread of this new virus in Guinea, the first magistrate of Gueckedou announces measures. "The whole village of Temessadou M'Boket is placed in quarantine and the contacts are identified, " he said.
...

Niouma Lazare Kamano for Ledjely.com

https://ledjely.com/2021/08/09/guec...ort-de-la-fievre-de-marburg-localisee-prefet/

 

[Shiloh]

Source: https://reliefweb.int/report/guinea...r-case-marburg-virus-disease-confirmed-guinea

West Africa's first-ever case of Marburg virus disease confirmed in Guinea

Format News and Press Release
Source WHO
Posted 9 Aug 2021
Originally published 9 Aug 2021

Brazzaville/Conakry, 9 August 2021 – Health authorities in Guinea today confirmed a case of Marburg virus disease in the southern Gueckedou prefecture. This is the first time Marburg, a highly infectious disease that causes haemorrhagic fever, has been identified in the country, and in West Africa.

Marburg, which is in the same family as the virus that causes Ebola, was detected less than two months after Guinea declared an end to an Ebola outbreak that erupted earlier this year. Samples taken from a now-deceased patient and tested by a field laboratory in Gueckedou as well as Guinea’s national haemorrhagic fever laboratory turned out positive for the Marburg virus. Further analysis by the Institut Pasteur in Senegal confirmed the result.

The patient had sought treatment at a local clinic in Koundou area of Gueckedou, where a medical investigation team had been dispatched to probe his worsening symptoms.

“We applaud the alertness and the quick investigative action by Guinea’s health workers. The potential for the Marburg virus to spread far and wide means we need to stop it in its tracks,” said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa. “We are working with the health authorities to implement a swift response that builds on Guinea’s past experience and expertise in managing Ebola, which is transmitted in a similar way.”

Gueckedou, where Marburg has been confirmed, is also the same region where cases of the 2021 Ebola outbreak in Guinea as well as the 2014–2016 West Africa outbreak were initially detected.

Efforts are underway to find the people who may have been in contact with the patient. As the disease is appearing for the first time in the country, health authorities are launching public education and community mobilization to raise awareness and galvanize support to help curb widespread infection.

An initial team of 10 WHO experts, including epidemiologists and socio-anthropologists is on the ground helping to investigate the case and supporting the national health authorities to swiftly step up emergency response, including risk assessment, disease surveillance, community mobilization, testing, clinical care, infection prevention as well as logistical support.

Cross-border surveillance is also being enhanced to quickly detect any cases, with neighbouring countries on alert. The Ebola control systems in place in Guinea and in neighbouring countries are proving crucial to the emergency response to the Marburg virus...

 

[Gert van der Hoek]

Guinea - Marburg Fever: the case of Guékédou confirmed by the Pasteur Institute in Dakar

Monday, August 09, 2021

Less than two months after the end of Ebola fever, Marburg fever must be counted among the diseases that Guinea now has to face, in addition to the Coronavirus and Lassa fever. The results of the examination of the sample, hitherto described as a "probable" case, have fallen. In any case, Guinéenews has just learned from a medical source close to the French institute.

According to our source, “Marburg fever is confirmed by the Pasteur Institute in Dakar”. Our interlocutor specifies that an official declaration is being prepared ”.

This is confirmed by the director of the communication department of the National Agency for Health Security. In turn, Sory 2 Keïra declares that: "the Pasteur Institute in Dakar has just confirmed".

https://guineenews.org/guinee-fievre...teur-de-dakar/

 

[alert]

Wow. I hope that in addition to his contacts after taking ill, they are tracing his steps backward, especially to the period he was institutionalized in Conakry. He doesn't have the kind of animal exposures one would suspect in an index case of such an outbreak, which leads me to believe he might have been infected by a previously unreported human case.

 

[sharon sanders]

bump this

 

[Pathfinder]

WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 32: 2 - 8 August 2021
Data as reported by: 17:00; 8 August 2021
...

Marburg virus disease Guinea

1 Cases
1 Deaths
100% CFR

EVENT DESCRIPTION

Health authorities in Guinea declared an outbreak of Marburg virus
disease in the southern Gueckedou prefecture on 9 August 2021.
This is the first time Marburg, a highly infectious disease that
causes haemorrhagic fever, has been identified in the country, and
in West Africa. On 6 August 2021, WHO was notified by the Ministry
of Health of Guinea of a confirmed Marburg virus disease (MVD)
case in the Guéckédou prefecture in the Nzérékoré Region of southwestern Guinea.
The case is a 46 years old male farmer, resident of Temessadou
M´Boké village, 9 km away from the Sierra Leone border, who died
within the community on 3 August. Following the onset of symptoms
that began on 25 July, the farmer visited a small healthcare center
in Koundou, in the Guéckédou prefecture, on 1 August with
symptoms of fever, headache, fatigue, abdominal pain, and gingival
haemorrhage. A rapid diagnostic test for malaria returned negative,
and the case received ambulatory supportive care with rehydration,
parental and symptomatic treatment. Upon returning home, his
condition worsened, and he died shortly thereafter on 3 August.
Kondou healthcare center sent an alert to the Provincial health
directorate of Gueckdou about a death in the community. The
investigation team was immediately deployed to the village to
conduct an in-depth investigation and collected a post-mortem
oral swab sample which was shipped on the same day to the Viral
Haemorrhagic Fevers laboratory in Guéckédou. The test results
on 3 August confirmed MVD by real-time reverse transcription
polymerase chain reaction (RT-PCR) and was negative for Ebola
virus disease. The deceased patient was safely buried on 4 August
2021, with the support of the national Red Cross.

The sample was also sent to the national reference laboratory for
Viral Hemorrhagic Fevers (LFHG) in Conakry on 4 August and the
Institut Pasteur in Dakar for re-confirmation. On 5 August, MVD was
confirmed using RT-PCR at the LFHG in Conakry. Further analysis
by the Institut Pasteur in Senegal confirmed the case positive for
Marburg.

The preliminary investigation identified four high risk contacts,
including three family members and one health care worker who
attended to the case. Further detailed investigation is ongoing to
identify the source of the infection and identify additional contacts
of this case.

Similar MVD outbreaks and sporadic cases of the disease have
previously been reported in African countries; including Angola, the
Democratic Republic of the Congo, Kenya, South Africa, Zimbabwe
and the last outbreak was reported in Uganda in 2017 with four
cases.

PUBLIC HEALTH ACTIONS

The Ministry of Health (MoH) together with WHO, USCDC,
Alima, Red Cross, UNICEF, FAO and other partners, have
initiated measures to control the outbreak and prevent further
spread.

The Incident management system has been activated with
intersectoral coordination through the One Health platform
planned. An emergency response plan for the outbreak is also
in place.

The MoH has activated the national and district emergency
management committees to coordinate the response and
engaging with community.

An initial team of 10 experts, including epidemiologists and
socio-anthropologists is on the ground helping to investigate
the case and supporting the national health authorities to swiftly
step up emergency response, including risk assessment,
disease surveillance, community mobilization, testing, clinical
care, infection prevention as well as logistical support.

Contact tracing is ongoing, as well as active case search in health
facilities and at the community level. Three family members and
a healthcare worker were identified as close contact and are
being followed up.

Health authorities are launching public education and community
mobilization to raise awareness and galvanize support to help
curb widespread infection.

Sierra Leone and Liberia health authorities have activated the
contingency plan and have started public health measures at
the point of entry with Guinea.

SITUATION INTERPRETATION

Guinea has recorded its first case of MVD in the same Nzérékoré
region where two Ebola virus disease (EVD) outbreaks occurred, the
first reported in 2014 and then in February 2021, which has since
been declared over. The current outbreak involved one confirmed
and remains localised. The national authorities have rapidly
responded to this event, promptly implementing control measures.
Further detailed investigation is ongoing to identify the source of
the infection and identify additional contacts of this case. There is
frequent international movement of persons between Guéckédou
prefecture in Guinea and the districts of Foya in Liberia and Kailahun
in Sierra Leone, which represents a high risk for trans-border
transmission. There is also a risk of geographical expansion in the
whole region of N’zérékoré due to frequent population movement.
While the country has overtime gained some experience and
capacity to respond to viral haemorrhagic fever outbreaks, this
event still calls for concerted efforts of all stakeholders.

PROPOSED ACTIONS

National authorities and partners need urgently to address any
shortfall in response activities to ensure that this outbreak is
contained rapidly. Authorities and partners in Guinea need to
rapidly implement full response capacity, including community
surveillance, strengthened testing capacity and improved case
management in order to rapidly bring this outbreak under
control.

Continued advocacy and community engagement remain
effective proactive measures to address this as were employed
during the recent EVD outbreaks.

The country is implementing the 90 days enhanced EVD
surveillance plan in the whole region of N’zérékoré focussing
mainly on community-based surveillance, and care for EVD
survivors. The human resource for EVD in place can be
repurposed to support MVD outbreak response.

Given the fact that, preparedness for outbreaks of MVD is
suboptimal in Guinea and neighbouring countries, this has the
potential to hasten cross border transmission of the outbreak,
therefore strengthening crossborder collaborations including
point of entry screenings is paramount.

https://apps.who.int/iris/bitstream/handle/10665/343824/OEW32-0208082021.pdf

 

[Pathfinder]

Translation Google

Marburg fever in Gueckédou: here is the version of the doctor who received the patient

Posted By: Moussa Kounady Camara Last Update Wednesday, Aug 11, 2021 At 11:11 A.M.

Recently cleared of Ebola virus fever and lassa fever, a new epidemic has just announced in the prefecture of Gueckédou, precisely in the district of Tèmessadou M'boket, causing the death of a father aged 46 years.

Informed of the situation, the health authorities went to the field for samples. Tests carried out in the viral laboratories of Guéckédou and that of Conakry revealed a positive case of Marburg fever, another viral disease little known in Guinea.

The forest region, which was the epicenter of Ebola and Lassa fever, is now facing the onset of a new epidemic called Marburg fever. This new hemorrhagic disease has appeared in Tèmessadou M'boket, a district of the Koundou sub-prefecture, located 54 kilometers from Gueckédou.

To date, more than 13 people are under health control and monitored by health workers. The wife of the deceased is on the run. But thanks to the awareness and collaboration of all, the village where she would be a refugee is located, according to the prefect of Gueckédou.

The health worker who performed the first aid explained the condition in which he received the patient long before his death.

“ I took the TDR test which was positive. Then , I noticed that her lips were red. Because a blood problem is complicated in the mouth. I was in front of a bleeding which I could not know the origin. I said that it is preferable that the patient be transferred , ”explained Félix Sandouno, health worker in Tèmessadou M'Boket.

In addition, according to the president of the district of Tèmessadou, the patient who would have died of the disease Marburg, had a mental depression. Faya Moussa Milimono explains his perception of the bleeding in the deceased.

“ He had a mental breakdown. If he was in this state, he was not sleeping. After his death, bleeding was noticed in his mouth. We figured it was his banging on his head that caused the bleeding. But to our surprise, we were called from Conakry, to tell us not to touch the body anymore , ”he said.

This announcement created psychosis among the local population. The body of the deceased received a dignified and secure burial in order to avoid possible contamination. “ When the Red Cross agents arrived for the funeral, people were in fear. And after the funeral, we were told that a mission came from Gueckédou and N'Zérékoré. It was ready s to leave the village , "said the head of the district.

More than 13 contacts have now been identified, including the wife of the deceased who took the loose. The village is therefore quarantined to cut the chain of transmission.

“ As soon as we received the information, the village was completely blocked. Regarding the deceased's wife is on Sunday I received this information on its location but for he provisions are already taken. We have just been told the village where the woman is. We are going to send people to sensitize her so that she can go to the hospital so that she can benefit from the observations made in the other contacts and I am sure that we will succeed again in this mission. As I speak to you, the village is quarantined, ”reassured Tamba Nestor Tonguino, prefect of Gueckédou.

Moussa Kounady Camara

https://guineenews.org/fievre-marburg-a-gueckedou-voici-la-version-du-medecin-ayant-recu-le-malade/

 

[Shiloh]

Source: https://www.who.int/emergencies/dise...em/2021-DON331


Marburg virus disease - Guinea

9 August 2021

On 6 August 2021, the Ministry of Health of Guinea informed WHO of a confirmed case of Marburg virus disease (MVD) in Guéckédou Prefecture, Nzérékoré Region, south-western Guinea. The village where the case resided is near both Sierra Leone and Liberian borders. This is the first known case of Marburg virus disease in Guinea and in West Africa.
The case, a male, had onset of symptoms on 25 July. On 1 August he attended a small health facility near his village of residence with symptoms of fever, headache, fatigue, abdominal pain, and gingival hemorrhage. A rapid diagnostic test for malaria was performed which was negative. The patient received supportive care with rehydration, parenteral antibiotics and treatment to manage symptoms.
On 2 August 2021, he died in the community and an alert was raised by the sub-prefecture public health care facility to the prefectorial department of health in Guéckédou. Following the alert, an investigation team comprosed of national authorities and WHO experts was deployed to conduct an in-depth investigation. The team collected a post-mortem oral swab sample, which was sent the same day to the viral haemorrhagic fever reference laboratory in Guéckédou.On 3 August a real-time PCR was conducted which confirmed the sample was positive for Marburg virus disease and negative for Ebola virus disease. On 5 August the National Reference Laboratory in Conakry provided confirmation by real-time PCR of the positive Marburg result and on 9 August Institut Pasteur Dakar in Senegal provided reconfirmation that the result was positive for Marburg virus disease and negative for Ebola virus disease.

Public health response

The Ministry of Health (MoH) together with WHO, US Centers for Disease Control and Prevention, ALIMA, Red Cross, UNICEF, The International Organization for Migration and other partners, have initiated measures to control the outbreak and prevent further spread. Contact tracing is ongoing, along with active case searching in health facilities and at the community level. Three family members and a healthcare worker were identified as high-risk close contacts and their health is being monitored.
The most recent Ebola virus disease (EVD) outbreak in Guinea was declared over on 19 June 2021 and a network of community health workers was set up as part of this recent outbreak along with a WHO technical team which has remained in country to support the government’s implementation of a post-EVD plan to enhance disease surveillance. This team has now been repurposed to support the government’s response activities to this outbreak of Marburg.
The MoH has activated the national and district emergency management committees to coordinate the response including:

• A public health emergency operations center has been activated and a base to support response workers will be set up in the sub-prefecture of Koundou.
• An in-depth epidemiological investigation is being conducted around the confirmed case to identify the source of the outbreak: to date, a total of 146 contacts were identified and as of 8 August, 145 contacts have been followed-up.
• Active searching for suspected cases in the community and health facilities is ongoing.
• A surveillance team has been deployed and briefings for health workers are underway, with particular focus on the village where the index case was identified along with villages within a 15 kilometer radius.
• Point of entry surveillance is being reinforced and two health control entry points were recently revitalized (Kiesseneye and Nongoa). The three main entry points with Sierra Leone and Liberia are active and the others are under evaluation.
• In collaboration with ALIMA, there is an ongoing assessment of the case management capacity in the health facilities.
• Risk communication activities are ongoing in the community.
• Infection prevention and control activities (IPC) are ongoing and briefing sessions are being conducted on IPC and water and sanitation hygiene (WASH) standards in Koundou health center, along with information sessions for the population of Temessadou Mboket village volunteers on safe and dignified burials

WHO risk assessment

Marburg virus disease (MVD) is a highly virulent, epidemic-prone disease associated with high case fatality rates (CFR 24-90%). In the early course of the disease, clinical diagnosis of MVD is difficult to distinguish from other tropical febrile illnesses, because of the similarities in the clinical symptoms. Differential diagnoses to be excluded include, Ebola virus disease, as well as malaria, typhoid fever, leptospirosis, rickettsial infection, and plague. MVD is transmitted by direct contact with the blood, bodily fluids and/or tissues of infected persons or wild animals (e.g. monkeys and fruit bats).

Currently, there is no specific therapeutic or drug approved for MVD. Nevertheless, supportive care including: close monitoring of vital signs, fluid resuscitation, electrolyte and acid base monitoring along with management of co-infections and organ dysfunction, are critical components of care and optimize patient outcomes and survival. Some monoclonal antibodies (Mabs) are under development and other antivirals are being explored for MVD (e.g. Galidesvir, Favipiravir, Remdesivir) as part of clinical trials, but without clear results in the current moment more evidence and further studies are required. However, these should only be used as part of a randomized controlled trial.

As of 7 August, only one case has been confirmed and all four identified high-risk close contacts are asymptomatic. Investigations are ongoing to identify the source of the infection and additional contacts of the index case.

Guinea has previous experience in managing recurring viral hemorrhagic diseases such as EVD and Lassa fever, but this is the first time that MVD has been reported. The country has a fragile healthcare system which is further exacerbated by multiple disease outbreaks, recurrent epidemics and the COVID-19 pandemic. The response activities to recent outbreaks such as EVD, COVID-19 and Lassa fever likely contributed to early detection and response to Marburg Virus Disease in Guinea.
Guinea’s health authorities have responded rapidly to this event, and measures are being quickly implemented to control the outbreak. The affected village is in a remote forested area located near the border with Sierra Leone and Liberia. Cross-border population movement and community mixing between Guinea and neighboring Sierra Leone and Liberia may increase the risk of cross-border spread and as such, the Ministry of Health and Sanitation has proactively assessed the situation together with stakeholders and the district health leadership in Kono and Kailahun districts of Sierra Leone have been alerted. Health authorities in Sierra Leone and Liberia have activated contingency plans and have started public health measures at the points of entry with Guinea. Additionally the potential transmission of the virus between bat colonies and humans also pose an increased risk for cross-border spread.

These factors suggest a high risk at the national level, requiring an immediate and coordinated response with support from international partners. The risk at the regional level is high, based on the fact that the Guéckédou prefecture is well connected to Liberia and Sierra Leone, although authorities are already taking action. The risk associated with the event at the global level is low.

WHO advice

Human-to-human transmission of Marburg virus is primarily associated with direct contact with blood and/or bodily fluids of infected persons. Transmission associated with the provision of healthcare has been reported when appropriate infection control measures are not in place.
Health workers should always implement standard precautions when caring for any patient, regardless of their presumed diagnosis. These include hand hygiene, respiratory hygiene and cough etiquette, use of risk based personal protective equipment (PPE), safe injection practices, environmental cleaning and disinfection, appropriate linen and waste management, and decontamination of reusable medical equipment.
Other key IPC measures to prevent healthcare associated infections include early recognition (screening, triage) along with isolation and monitoring of suspected cases, investigation of health workers exposed to Marburg cases, in-patient surveillance for Marburg cases, and safe and dignified burial practices in community settings.
Health workers caring for patients with suspected or confirmed Marburg virus should apply additional precautionary infection control measures to prevent contact with the patient’s body fluids and/or contaminated surfaces. This includes the following PPE items: face protection (a face shield or a medical mask and goggles), a clean, non-sterile long-sleeved gown, and gloves. This further emphasizes the importance of readily available PPE at health care facilities, appropriate donning/doffing areas, IPC/WASH supplies and training on their proper uses.
Laboratory workers are also at risk. Samples taken from humans and animals for investigation of Marburg infection should be handled by trained staff and processed in suitably equipped laboratories.
Surveillance activities, including contact tracing and active case searching, must be strengthened within all affected health zones. Thus, it is recommended that neighboring countries heighten their surveillance for Viral Hemorrhagic Fever (VHF) in border communities and health facilities as well as strengthening community engagement on alert reporting and preventive measures.
Risk communication and community engagement (RCCE) is key to successfully controlling outbreaks. Raising awareness of the risk factors for Marburg infection and the protective measures individuals can take to reduce human exposure to the virus are important to reducing infections and deaths. Key public health communication messages to be provided to the affected communities include the following:

• How to reduce the risk of transmission in the community arising from direct or close contact with infected patients, particularly with their bodily fluids. Close physical contact with Marburg patients should be avoided. Any suspected case, ill at home should not be managed at home, but instead immediately transferred to a health facility for treatment and isolation; during this transfer appropriate personal protective equipment should be worn. Regular hand hygiene should be performed after visiting anyone who is sick.
• Leaders and health workers in communities affected by Marburg, should make efforts to ensure that the population is well informed. This refers to informing the community of both the nature of the disease, to avoid further transmission, community stigmatization and encourage early presentation to treatment centers and other necessary outbreak containment measures, including safe burial of the dead. People who have died from Marburg should be promptly and safely buried.To reduce the risk of wildlife-to-human transmission, such as through contact with fruit bats, monkeys, and apes, the following advice should be communicated:
• Handle wildlife in conjunction with regular hand hygiene and where possible with gloves and other appropriate protective clothing.
• Cook animal products (blood and meat) thoroughly before consumption and avoid consumption of raw meat.
• During work or research activities or tourist visits in mines or caves inhabited by fruit bat colonies, people should wear masks and gloves.

Based on the current risk assessment and prior evidence on Ebola outbreaks, WHO advises against any restriction of travel and trade to and from Guinea.

Further information

• Marburg fact sheet (in 6 UN languages)
• Marburg virus disease health topic
• Interim version 1.2, Ebola and Marburg virus disease epidemics: preparedness, alert, control, and evaluation
• How to conduct safe and dignified burial of a patient who has died from suspected or confirmed Ebola virus disease
• Case definition recommendations for Ebola or Marburg virus diseases
• Optimized supportive care for Ebola virus disease

 

[Pathfinder]

Translation Google

Marburg virus: WHO insists on surveillance of contact cases in Guinea

By Le Figaro with AFP
Posted yesterday at 22:15, updated3 hours ago

"Investigations are underway", assures Guinea after the appearance of the first case of the Marburg virus

Only one case of the Marburg virus has been detected so far in Guinea, but the WHO insisted on Friday in Geneva on the importance of monitoring the some 150 contact cases who are in the "critical" incubation period. The Guinean health authorities indicated at a press conference in Conakry that one of these cases was missing, but were confident that they would find him and have minimized the health risks of this defection. .

West Africa recorded in early August in Guinea its very first case of the Marburg virus, a hardly less deadly cousin of the Ebola virus, against which there is no vaccine or treatment and which manifests itself in an acute fever. accompanied by internal and external bleeding resulting in death in 50% of cases on average. The virus, transmitted by bats, was discovered in samples taken from a man who died on August 2 in the prefecture of Guéckédou (South), in a village located in a forest region close to the borders of Sierra Leone and Liberia. His symptoms appeared on July 25, according to the World Health Organization (WHO).

"So far, there have been no other cases from Marburg since the index case which was confirmed on August 9," said a spokesperson for the health agency in Geneva, Fadela Chaib. So far some 150 contact cases have been identified and placed in isolation. The incubation period (the time between infection and the onset of symptoms) ranges from two to 21 days. “We have entered the critical period when anyone exposed to the virus is most likely to develop symptoms. Surveillance is therefore particularly important at this time and the teams are monitoring contacts twice a day, ” explained Fadela Chaib. "Screening of suspected cases is also underway" while“Efforts continue to locate people who may have been in contact with the deceased patient,” she said.

Cross-border surveillance has been strengthened. The director of the Guinean health agency, Sakoba Keita, told Conakry that the man who died of the virus seemed to live in a relatively isolated way and that no case had yet been declared in his close entourage. "We are very confident that the 21 days - we have 10 days left, it's the 23rd - may arrive (without us having) a case", he said. Guinea was one of the countries most affected by the Ebola epidemic which killed thousands of people in West Africa between the end of 2013 and 2016. In 2021, it experienced a resurgence of this disease which has killed 12 people and was declared complete in June. Each time, the disease left forest Guinea where the Marburg virus was detected. Case fatality rates have ranged from 24% to 88% in previous outbreaks of Marburg virus, depending on virus strain and case management.

https://www.lefigaro.fr/flash-actu/...veillance-des-cas-contacts-en-guinee-20210813

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Marburg fever / Minister of health calms “the game”

By Guinea7.com -August 13, 2021

During a press conference this Friday in Conakry, the Minister of Health, Remy Lamah called on the population not to panic in the face of the case of the Marburg fever virus, discovered in Guinea.

Regarding the only case discovered, Minister Rémy Lamah said: “This gentleman had developed a kind of dementia for three years. So practically He didn't live with the family. He was out of society. He preyed on beasts. He sometimes attacked his wife who had left him. Fortunately since this case was identified, there has not been a new case. According to the latest information we have received, the vaccine used against Ebola can also be used for the Marburg virus. So the WHO, in collaboration with the national health security agency, is in the process of making arrangements to vaccinate the contacts of this deceased who unfortunately died of this virus. ”

“So there is no panic. All measures are taken ”he concludes.

https://www.guinee7.com/fievre-de-marburg-le-ministre-de-la-sante-calme-le-jeu/

 

[Pathfinder]

WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 33: 9 - 15 August 2021
Data as reported by: 17:00; 15 August 2021
...

Marburg virus disease Guinea

1 Deaths
1 Cases
100% CFR

EVENT DESCRIPTION

The first confirmed case of Marburg virus disease in Guinea and in
West Africa was declared 9 August 2021. The case was a 46 years
old male farmer, resident of Temessadou M´Boké village, who died
within the community on 3 August. The deceased patient was safely
buried on 4 August 2021. His onset of symptoms began on 25 July.
The farmer visited a small healthcare center in Koundou, in the
Guéckédou prefecture, on 1 August presenting with symptoms of
fever, headache, fatigue, abdominal pain, and gingival haemorrhage.
Test results from the Viral Haemorrhagic Fevers laboratory in
Guéckédou on 3 August confirmed MVD by real-time reverse
transcription polymerase chain reaction (RT-PCR) and was negative
for Ebola virus disease. The sample was also sent to the national
reference laboratory for Viral Hemorrhagic Fevers (LFHG) in Conakry
on 4 August and the Institut Pasteur in Dakar for re-confirmation.
Further analysis by the Institut Pasteur in Senegal confirmed the
case positive for Marburg.

As of 15 August 2021, one case has been reported, with one death
(case fatality ratio 100%).

Three samples have been tested in the laboratories of Gueckedou
and Conakry, where results returned all negative for MVD. A total
of 173 contacts have been listed, of whom 172 (99%) have been
followed-up and one high risk contact (wife to the confirmed case)
has not been found yet. There were no suspected cases notified
among the contacts under followed up. Active case finding is also
ongoing in Temessadou M’Boket, Koundou. A total of seven alerts
including one death have been notified to the health authorities, of
which three including one deaths have been validated with three
samples collected for laboratory testing.

PUBLIC HEALTH ACTIONS

The Ministry of Health (MoH) together with WHO, USCDC,
Alima, Red Cross, UNICEF, FAO and other partners, have
initiated measures to control the outbreak and prevent further
spread.

The incident management system at the MoH has been
activated with intersectoral coordination through the One
Health platform planned. An emergency response plan for the
outbreak is also in place.

The MoH has activated the national and district emergency
management committees to coordinate the response and
engage with community.

Fifteen health workers at the Koundou health center were
briefed on specific precautions for Marburg; case definition
and management of infectious waste in 6 health facilities of
AGBEF Clinic, Phie Bilima, Camp Infirmary and Diarra Clinic
and 2 health offices in the Koundou RC.

A total of 140 travellers, including 76 women, and 64 men were
screened at the various entry points in Gueckedou, and no
suspected case was detected.

Hand washing devices and cleaning products have been
provided to 8 health facilities, including Koundou Health

Center and the 7 health posts in Koundou. Rehabilitation of the
Koundou Health Center borehole with the installation of a solar
pumping system is underway.

Continued investigation, contact tracing and active case
finding in the localities of Temessadou M’Boket, Koundou and
strengthening of surveillance in all districts given the declaration
of Ebola case in Cote d’ivoire.

Sierra Leone and Liberia health authorities have activated the
contingency plan and have started public health measures at
the point of entry with Guinea.

A total of 24 religious leaders including 18 women from the
Protestant Church of Temessadou M’boket, were sensitized on
the preventive measures against MVD and solicitation of their
involvement and commitment in the response to MVD, and the
preparations for the community dialogue scheduled for August
16-21 2021.

A total of 50 youth association leaders in Guéckédou, including 15
women, were briefed on the mode of transmission, symptoms,
and preventive measures against MVD. Two religious leaders
were also briefed on the preventive measures against MVD
and solicitation of their involvement and commitment in the
response.

SITUATION INTERPRETATION

The confirmation of a Marburg virus disease outbreak in Guinea is of
serious concern. Health teams in Guinea are acting rapidly to trace
the path of the virus and curb further infections. However, challenges
remain around a missing high risk contact and inadequate infection
prevention and control measures. In addition, the area is already
dealing with multiple outbreaks, for example COVID-19, yellow
fever, measles and vaccine-derived polio. While the country has
overtime gained some experience and capacity to respond to viral
haemorrhagic fever outbreaks, this event still calls for concerted
efforts of all stakeholders.

PROPOSED ACTIONS

Authorities and partners in Guinea need to continue with the response
activities and also; strengthen community engagement to foster
the implementation of public health interventions; conduct assessment of
screening, triage, isolation and care capacity within health
facilities within the hotspot and at the CT-EPI of Koundo; and support
preparedness and investigation efforts in neighbouring countries
including cross border surveillance.

https://apps.who.int/iris/bitstream/handle/10665/344261/OEW33-0915082021.pdf

 

[alert]

ProMED is reporting a second confirmed case, but their source is over a week old and no one else has reported a second confirmed case.

Published Date: 2021-08-18 21:10:57
Subject: PRO/AH/EDR> Marburg virus disease - Guinea (03): (GU)
Archive Number: 20210818.8605453

MARBURG VIRUS DISEASE - GUINEA (03): (GUECKEDOU)
************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Wed 11 Aug 2021
Source: Front Page Africa [edited]
https://frontpageafricaonline.com/fr...boring-guinea/


The World Health Organization (WHO)-Liberia Country Office has notified the National Public Health Institute of Liberia (NPHIL) of 2 confirmed cases of Marburg hemorrhagic fever in Gueckedou, the Republic of Guinea. The patients are a 46-year-old male and a female (age unknown) who were both residents of Temessadou, a sub-prefecture of Gueckedou. The Guinean Health Authorities were alerted by community members of Koundou Lengo Bengou, which is 54 km [33.5 mi] away from Gueckedou. This is the 1st time Marburg, a highly infectious disease that causes haemorrhagic fever, has been identified in the country, and in West Africa.

Gueckedou, where Marburg has been confirmed, is also the same region where cases of the 2021 Ebola outbreak in Guinea as well as the 2014-2016 West Africa outbreak were initially detected.

Marburg, which is in the same family as the virus that causes Ebola, was detected less than 2 months after Guinea declared an end to an Ebola outbreak that erupted earlier this year [2021].

Efforts are underway to find the people who may have been in contact with the patient. As the disease is appearing for the 1st time in the country, health authorities are launching public education and community mobilization to raise awareness and galvanize support to help curb widespread infection.

Liberia joins the [WHO] to applaud the alertness and the quick investigative action by Guinea's health workers. The potential for the Marburg virus to spread far and wide means we need to interrupt its transmission.

Gueckedou prefecture borders Liberia from Foya District, Iofa County, and there are active socio-economic activities across the 3 countries (Sierra Leone, Liberia, and Guinea).

With the aforementioned notification, Liberia has heightened cross-border surveillance to quickly detect any cases, with all neighbouring counties on highest alert. The Ebola control systems are in place in Liberia, and the health sector is finalizing the Marburg Preparedness and Response plan.

Marburg is transmitted to people from fruit bats and spreads among humans through direct contact with the bodily fluids of infected people, surfaces and materials.

Illness begins abruptly, with high fever, severe headache and malaise. Many patients develop severe haemorrhagic signs within 7 days. Case fatality rates have varied from 24% to 88% in past outbreaks depending on virus strain and case management.

Although there are no vaccines or antiviral treatments approved to treat the virus, supportive care - rehydration with oral or intravenous fluids - and treatment of specific symptoms, improves survival. A range of potential treatments, including blood products, immune therapies and drug therapies, are being evaluated.

In Africa, previous outbreaks and sporadic cases have been reported in Angola, the Democratic Republic of the Congo, Kenya, South Africa, and Uganda.

Some key facts of Marburg haemorrhagic fever (MVD):
- Marburg virus disease (MVD), formerly known as Marburg hemorrhagic fever, is a severe, often fatal illness in humans.
- _Rousettus aegyptiacus_, fruit bats of the Pteropodidae family, are considered to be natural hosts of Marburg virus.
- The Marburg virus is transmitted to people from fruit bats and spreads among humans through human-to-human transmission.
- The Marburg virus causes severe viral hemorrhagic fever in humans.
- The average MVD case fatality rate is around 50%.
- Case fatality rates have varied from 24% to 88% in past outbreaks depending on virus strain and case management.
- Community engagement is key to successfully controlling outbreaks.
- Early supportive care with symptomatic treatment improves survival.
- The incubation period (interval from infection to onset of symptoms) varies from 2 to 21 days.

--
Communicated by:
ProMED from HealthMap Alerts
<promed@promedmail.org>

[The male case is doubtless the same one that was posted on 11 Aug 2021 (see Marburg virus disease - Guinea (02): (GU) conf, WHO 20210811.8585938). The female case is a new, 2nd person infected with the virus. Although these are the 1st confirmed human infections with this virus in West Africa, this virus was found previously in neighboring Sierra Leone in 5 Egyptian rousette, or fruit bats (_Rousettus aegyptiacus_) (see Marburg virus disease - Sierra Leone: bat 20200125.6916732 and citation below).

The above reports provide no information about the source of the virus that infected these 2 individuals.

The virus has been present in the general area and, unfortunately, ended up in a man and a woman in Guinea. Health authorities in both Guinea and Sierra Leone would be prudent to increase surveillance and ensure that laboratory support was adequate to make a timely diagnosis. The advice from WHO, above, should be heeded for preventive measures in healthcare facilities and to avoid wildlife practices that risk transmission to humans. - Mod.TY

The citation of the article referenced above follows:
Amman BR, Bird H, Bakarr IA, et al. Nat Commun. 2020; 11:510; https://doi.org/10.1038/s41467-020-14327-8.

HealthMap/ProMED map of Gueckedou, Nzerekore, Guinea: http://healthmap.org/promed/p/44575]

 

[Pathfinder]

Translation Google

Marburg virus in Guinea: 172 contact cases followed

By Le Figaro with AFP
Posted yesterday at 19:04, updated yesterday at 19:20

The Guinean health authorities have identified and are monitoring 172 contact cases of a man who died of the Marburg virus on a daily basis, Minister of Health Rémy Lamah said on Thursday (August 19th).

West Africa recorded in early August in Guinea its very first case of the Marburg virus, a hardly less deadly cousin of the Ebola virus, against which there is no vaccine or treatment and which manifests itself in an acute fever. accompanied by internal and external bleeding resulting in death in 50% of cases on average.

"Struggling" health services

The virus, transmitted by bats, was discovered in samples taken from a man who died on August 2 in the prefecture of Guéckédou (south), in a village located in a forest region near the borders of Sierra Leone and Liberia. His symptoms appeared on July 25, according to the World Health Organization (WHO).

“ The teams follow 172 contacts per day looking for possible symptoms. So far, no further cases of Marburg have been reported. We are fully committed to strengthening infection prevention and control measures, detecting cases and raising public awareness , ”assured the Minister of Health, Rémy Lamah, during a virtual press conference organized by WHO. The organization insisted last week on the importance of monitoring contact cases that are in the " critical " incubation period, the time between infection and the onset of symptoms, which ranges from two to 21 days.

“ The last two weeks have been a real challenge for Guinea. We are dealing with an outbreak of Marburg virus disease and contact tracing for an Ebola case which is believed to originate from Guinea and is being treated in Côte d'Ivoire. We are dealing with all of this in the context of a resurgence of Covid-19. The number of cases has increased since early June and this wave is the worst we have seen. These multiple epidemics put our health services to the test, ”acknowledged the Minister.

Guinea was one of the countries most affected by the Ebola epidemic which killed thousands of people in West Africa between the end of 2013 and 2016. In 2021, it experienced a resurgence of this disease which has killed 12 people and was declared complete in June. Each time, the disease left Forest Guinea where the Marburg virus was also detected.

https://www.lefigaro.fr/flash-actu/virus-de-marburg-en-guinee-172-cas-contacts-suivis-20210820

 

[Pathfinder]

Translation Google

Guinea: according to the Minister of Health, "no other case of Marburg has been reported"

Published on : 08/20/2021 - 14:32

Text by:
RFI

In parallel with the response to the Covid-19 epidemic and the risk of a new Ebola epidemic, Guinea is also fighting a possible epidemic of Marburg fever. The Guinean Minister of Health wished to reassure on the rapid response provided by his services, as soon as a first case was detected.

A case of this highly contagious disease, with a case fatality rate ranging from 24 to 88%, was indeed confirmed there on August 10 , it was the first time in West Africa. Like Ebola, the Marburg virus is a hemorrhagic fever. It causes severe bleeding, fever, vomiting, and diarrhea. It is a zoonosis, which is transmitted to humans through certain bats, fruit bats. During a press conference organized by the World Health Organization yesterday, the Guinean Minister of Health, Dr. Rémy Lamah, took stock of the state of contact tracing.
...
" Our health workers noticed suspicious symptoms, and quickly performed a test for Marburg, it is thanks to them and the training they received that the epidemic was identified so quickly, and that we were able to start the response immediately. "

According to him, the speed of the detection made it possible to act quickly on the management of the contact cases. " We immediately tried to circumscribe the various contacts, and where the surprise came, it is that the funeral toilet has been made by a certain member of the family, but so far none of its members have developed any signs in favor of the Marburg. 175 people have been identified, they are monitored on a regular basis by examining possible symptoms. We do not neglect anything in relation to the follow-up of these contacts. So far, no further cases of Marburg have been reported. "

https://www.rfi.fr/fr/afrique/20210...té-aucun-autre-cas-de-marburg-n-a-été-signalé