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Nigeria - 3 new suspected ebola cases: 2 in Lagos, 1 in in Kaduna - all 3 test NEGATIVE

Re: 3 new suspect in Nigeria

Re: 3 new suspect in Nigeria

3 Fresh Cases In Kaduna, Lagos

Fresh facts emerged yesterday that three new suspected cases of the deadly ebola virus disease have been discovered in Kaduna and Lagos states.

...
The commissioner said, ?As at yesterday, we have three new suspected cases. And one of them is a blood sample from Kaduna State while the two others are from Lagos, and they are primary contact. One reason for this was that they do not have the laboratory to test for the virus.

http://leadership.ng/news/381421/3-fresh-cases-kaduna-lagos-officials-beef-capacity
 
Re: 3 new suspect in Nigeria

Re: 3 new suspect in Nigeria

I suspect that there will be many more.
 
Re: 3 new suspect in Nigeria

Re: 3 new suspect in Nigeria

It isn't clear to me who these new suspects are. Two of them are in Lagos, and are described as primary contacts of Sawyer. Unless they have already died or recovered a few days ago, it seems a bit late for them to be reported. Sawyer died on July 25, so the 21 day incubation period should have expired almost a week ago. Perhaps these contacts simply developed unrelated fever after the 21 day period?

The case in Kaduna is even more mysterious. This is not a contact of Sawyer. Is it a contact of a contact? Is this someone with a wild animal exposure? Another traveler? Or just someone whose symptoms are so severe that Ebola testing is warranted, even without an obvious exposure?

We know that of the first 12 confirmed cases, 4 have died and 5 have recovered so there are 3 confirmed cases alive in Lagos (or is one of them in Enugu?).
 
Re: Nigeria - 3 new confirmed/suspected ebola cases: 2 in Lagos, 1 in in Kaduna

Re: Nigeria - 3 new confirmed/suspected ebola cases: 2 in Lagos, 1 in in Kaduna

So the case in Kaduna is a laboratory confirmed Ebola case? If so, that is very troubling.
 
Re: Nigeria - 3 new confirmed/suspected ebola cases: 2 in Lagos, 1 in in Kaduna

Re: Nigeria - 3 new confirmed/suspected ebola cases: 2 in Lagos, 1 in in Kaduna

So the case in Kaduna is a laboratory confirmed Ebola case? If so, that is very troubling.

No, I don't believe so. I think all three of these are suspect, hence the 12 confirmed and 3 suspect total for Nigeria as a whole.

In the absence of any links to either Mr. Sawyer, the other confirmed cases, wild animals, or other travelers, I would say it is unlikely to be Ebola considering the distance between Lagos and Kaduna.

Remember also that Lassa is endemic in Nigeria, further complicating the picture.
 
Re: Nigeria - 3 new confirmed/suspected ebola cases: 2 in Lagos, 1 in in Kaduna

Re: Nigeria - 3 new confirmed/suspected ebola cases: 2 in Lagos, 1 in in Kaduna

This article indicates that both Lagos suspected cases are alive and had contact with Sawyer (but might be beyond 21 days), and that the case in Kaduna has not received test results yet because they cannot test for Ebola in Kaduna:

http://www.osundefender.org/?p=182544&cpage=1

Confirmation any of these three cases would be troubling.
 
Re: Nigeria - 3 new suspected ebola cases: 2 in Lagos, 1 in in Kaduna

Re: Nigeria - 3 new suspected ebola cases: 2 in Lagos, 1 in in Kaduna

WHO also says that except for the confirmed cases, all Mr. Sawyer's contacts have reached 21 days symptom-free:

http://www.who.int/mediacentre/news/ebola/18-august-2014/en/

[snip]

The index case arrived in Lagos on 20 July and died on 25 July. The 21-day incubation period has lapsed. All 12 cases were confirmed in a WHO-approved laboratory.
 
Re: Nigeria - 3 new confirmed/suspected ebola cases: 2 in Lagos, 1 in in Kaduna

Re: Nigeria - 3 new confirmed/suspected ebola cases: 2 in Lagos, 1 in in Kaduna

Is there any precident for an incubation period beyond 21 days? Perhaps in the case of exposure to a very low viral load?

This article indicates that both Lagos suspected cases are alive and had contact with Sawyer (but might be beyond 21 days), and that the case in Kaduna has not received test results yet because they cannot test for Ebola in Kaduna:

http://www.osundefender.org/?p=182544&cpage=1

Confirmation any of these three cases would be troubling.
 
Re: Nigeria - 3 new suspected ebola cases: 2 in Lagos, 1 in in Kaduna

Re: Nigeria - 3 new suspected ebola cases: 2 in Lagos, 1 in in Kaduna

I'm not aware of any. I can think of a few possibilities:

1. The cases might have had additional exposures to their co-workers (the confirmed cases) in early August, making them in fact tertiary cases.

2. They might have had fomite exposure to things like urine-soaked bed linens in the hospital long after Mr. Sawyer died.

3. They had exposure to a previously unreported case.

4. They have something other than Ebola.

The earliest reports on these cases I can find are from around the 16th, so I hope we have results shortly.
 
Re: Nigeria - 3 new suspected ebola cases: 2 in Lagos, 1 in in Kaduna

Re: Nigeria - 3 new suspected ebola cases: 2 in Lagos, 1 in in Kaduna

Or they may be a week into their infection experiencing only mild symptoms to date, which then progressed into something more serious. This would be the worst of all options, especially if they were not already in isolation.
 
Re: Nigeria - 3 new suspected ebola cases: 2 in Lagos, 1 in in Kaduna

Re: Nigeria - 3 new suspected ebola cases: 2 in Lagos, 1 in in Kaduna

....?We have 12 confirmed cases and that includes the index (first) case and all the other cases that we have confirmed positive and those who have died. And today, we have four more patients ready for discharge, and they have gone through the same protocol ? the protocol is that before we release anyone or certify him or her negative, he or she has to be symptoms-free for over three days. Also, we had to test their blood and the result proved negative of the virus.
?They will be released today (yesterday) after they have completed their counselling exercise being conducted by our psycho-social team, but they will come periodically for check-ups; though they are okay.?
Three others in Isolation
Assuring that everything was under control, the commissioner said the new cases were being closely monitored.
?The other three patients are still being monitored at the isolation centre. Once they get better, they will be released too.
?The lady who ran to Enugu is still in isolation and has tested positive to the virus. She is among the three still under isolation.?
Three quarantined in Makurdi
Meanwhile, two missionary workers and their driver have been quarantined at the Benue State University Teaching Hospital, BSUTH, Makurdi, the Benue state capital, on suspicion of infection with Ebola virus.
Chief Medical Director of BSUTH, Professor Orkurga Malu, who disclosed this to newsmen in Makurdi, dispelled rumours that the quarantined persons were infected with the virus.
Malu explained that Benue indigenes who hitherto resided in Monrovia for a year where they engaged in missionary work, relocated from the Liberian capital in the wake of the Ebola outbreak.
?There is no truth that some Benue indigenes from Monrovia, Liberia are victims of the deadly Ebola virus. What happened is that since some airlines have shut down operations to Liberia, the couple and their driver had to take a connecting flight from their base to Accra, Ghana where they stayed for a week before travelling to Nigeria.?
While refusing to disclose the identity of the persons concerned, Malu said, on arrival in the state, they were quickly admitted in the hospital and have been kept under close observation.
?They have not shown any symptoms of the disease because at every stage their temperature is checked and tested right from Monrovia before they boarded the plane to Ghana and then Nigeria.
?Since they came in here on Thursday, we have been testing them on a daily basis and there is no evidence of temperature rise or any of the symptoms of the virus.
?So we are 99.9 per cent sure that they do not have Ebola virus. But just in the remotest case of 0.1 percent, we have kept them to ensure they do not have the disease,? he stated.
The CMD who urged the people of the state not to panic assured that the hospital has adequate facilities to cater for any victim of the virus.
 
Re: Nigeria - 3 new suspected ebola cases: 2 in Lagos, 1 in in Kaduna

Re: Nigeria - 3 new suspected ebola cases: 2 in Lagos, 1 in in Kaduna

Here's the details on Kaduna. It's another suspected importation from Liberia, not connected to Sawyer at all:

http://news.findnigeria.com/article...s-liberia-returnee-soldier-as-residents-panic

We'll have to see if he tests positive or not. And according to this article:

http://dailytimes.com.ng/article/kaduna-quarantines-liberia-returnee-soldier-residents-panic

his only symptom so far is fever.
 
Re: Nigeria - 3 new suspected ebola cases: 2 in Lagos, 1 in in Kaduna

Re: Nigeria - 3 new suspected ebola cases: 2 in Lagos, 1 in in Kaduna

I have tried to summeraize what we know.

Confirmed cases:
No:1 ? Mr Sawyer ? dead 25 July
No:2 - Colleague to Sawyer ? dead: 11 August
No:3 ? Nurse 1 ? dead 6 August
No:4 ? Nurse 2 ? dead 14 August
No:5 ? Doctor 1 ? dead 19 August
No:6 ? Doctor 2- recovered 17 August
No:7 ? Doctor 3- recovered 18 August
No:8 ? Doctor 4- recovered 18 August
No:9 ? Nurse 3- recovered 18 August
No:10 ? Patient- recovered 18 August
No:11 - ? ? in isolation
No:12 - ? ? in isolation
All confirmed cases are conected to Index case No:1

Suspect cases:
No:13 ? Lagos X - Connection?
No: 14 ? Lagos Y - Connection?
No:15 ? Kaduna ?Soldier returning from Liberia - No connection to Index case
 
Re: Nigeria - 3 new suspected ebola cases: 2 in Lagos, 1 in in Kaduna

Re: Nigeria - 3 new suspected ebola cases: 2 in Lagos, 1 in in Kaduna

This could be a misreporting of everything we have above (including the suspect in Kaduna), but this seems worrying and doesn't match any case I am aware of:

http://www.nigerianbulletin.com/threads/has-another-liberian-brought-ebola-to-lagos.88895/


Has Another Liberian Brought Ebola to Lagos?

As we recall, Patrick Sawyer introduced the deadly Ebola virus to Lagos, Nigeria a few weeks ago. However, today, CKN Nigeria has alleged that another Liberian has been found with the dreaded virus.

According to the online newspaper, Senior Registrar with the Igbobi Orthopaedic hospital, Lagos, Dr. Akindele Akintayo revealed this while speaking on a Morning TV program.

CKN says: "...the Liberian has been kept at the IDH in Lagos. Dr Akintayo said it cannot be confirmed if the new case had a contact with late Mr Sawyer or not."

This remains unconfirmed by any other news source.

We will update you as soon as we have more information.
 
Re: Nigeria - 3 new suspected ebola cases: 2 in Lagos, 1 in in Kaduna

Re: Nigeria - 3 new suspected ebola cases: 2 in Lagos, 1 in in Kaduna

In my opinion the outbreak in Nigeria is just getting started. It's happening slower than in the other affected countries but has the potential to become far worse. It might be a good idea for the outside world to pay particular attention to this outbreak.
 
Re: Nigeria - 3 new suspected ebola cases: 2 in Lagos, 1 in in Kaduna

Re: Nigeria - 3 new suspected ebola cases: 2 in Lagos, 1 in in Kaduna

Given the widespread nature of the outbreak in Sierra Leone, Guinea and Liberia and the high degree of travel between these countries, it is highly plausible that there may have been multiple introductions, with the majority not developing symptoms until back in Nigeria for some days or weeks.

All that can be done is watch, wait and as cases arrive, hope that the Nigerian authorities are able to take the correct measures. Some areas of the country are almost autonomous, and we may only see evidence of an outbreak once it has developed and caused secondary or tertiary cases. The next few weeks will be telling.
 
Re: Nigeria - 3 new suspected ebola cases: 2 in Lagos, 1 in in Kaduna

Re: Nigeria - 3 new suspected ebola cases: 2 in Lagos, 1 in in Kaduna

I'm beginning to believe that the Nigerian authorities are attempting to limit the information they are releasing to prevent panic, for which I don't blame them. But, that could mean that there is more going on than we know. For example, they have set up dedicated treatment centers for ebola patients and even identified several sites for cremation of bodies. I know they are going to great lengths to be prepared, but these kinds of preparations suggest that they are dealing with more than just the 15 total cases (confirmed, probable, and suspected) that have been identified publicly. I'm not suggesting that they have more confirmed cases, but I wouldn't be surprised if they have more people under observation or have done more testing than is being reported. After all, they can do their own tests and they don't have to report to the WHO until there is confirmation.
 
Re: Nigeria - 3 new suspected ebola cases: 2 in Lagos, 1 in in Kaduna

Re: Nigeria - 3 new suspected ebola cases: 2 in Lagos, 1 in in Kaduna

All three cases are NEGATIVE for Ebola:

http://www.dailytrust.com.ng/daily/news/32180-suspected-patients-test-negative-in-kaduna-oyo-lagos

---------------

By my calculations, all contacts have now reached 21 days, and only the two confirmed cases are in isolation.

Whatever caused the fever in two of Mr. Sawyer's contacts after 21 days, it wasn't Ebola.
 
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