Nigeria - Ebola: 20 cases, 8 fatalities (WHO Ebola Roadmap Response, September 24, 2014)

[Emily]

Re: Nigeria - Ebola: Liberian man in Lagos dies- testing incomplete for ebola; 2nd suspected case reported

Re: Nigeria - Ebola: Liberian man in Lagos dies- testing incomplete for ebola; 2nd suspected case reported

From post #37:

The sample from this case is yet to be sent to the WHO Collaborating Centre at the Institute Pasteur in Dakar, Senegal, due to refusal by courier companies to transport this sample.

http://uk.reuters.com/article/2014/07/28/uk-health-ebola-nigeria-idUKKBN0FX15C20140728

...
Derek Gatherer, a virologist at Britain's University of Lancaster, said anyone on the plane near Sawyer could be in "pretty serious danger," but that Nigeria was better placed to tackle the outbreak than its neighbors.

"Nigerians have deep pockets and they can do as much as any Western country could do if they have the motivation and organization to get it done," he said.

If they can't get a sample transported for testing, authorities don't seem motivated to me. The epidemiology in this case may stand on it's own without any help from Nigerian authorities:

http://nationalchronicleliberia.com/news/politics/1024/how-patrick-sawyer-contracted-ebola/

How Patrick Sawyer Contracted Ebola

...

According to the Chronicle’s medical source, Sawyer personally undressed Princess, the suspected Ebola patient, changed her into a different set of clothes, placed her in a wheelchair, took her to a private room, and deposited US$500 for her care. The source said all the workers at the hospital were astonished by Sawyer’s behavior.

The Chronicle source disclosed that, while undressing his sister, her uncontrollable blood was seen on Patrick’s clothing, including his footwear. It was his brother-in-law who had to get him a pair of slippers, leaving the bloody footwear at the hospital.

Unfortunately, Princess was tested and confirmed with the Ebola virus; she died on July 7, 2014, and since, the private ward room where she was transferred has been closed, with her belongings and her brother’s footwear.
- See more at: http://nationalchronicleliberia.com...sawyer-contracted-ebola/#sthash.yP52Cd4s.dpuf

That's a truly tragic story, but it also may indicate that this strain of Ebola is not easy to transmit through casual contact.

 

[Nika]

Re: Nigeria - Ebola: Liberian man in Lagos dies- testing incomplete for ebola; 2nd suspected case reported

Re: Nigeria - Ebola: Liberian man in Lagos dies- testing incomplete for ebola; 2nd suspected case reported

He was asserting, vehemently, that he hadnt seen his ill sister right? Then the story about his violent psychotic behavior in the hospital. This person may become a quasi-superspreader just based on his erratic and bad decisions (dumping the sister while also infecting self, infecting his ministry and taking a multi layover flight home). Its a sad story that is echoing through Nigeria now.

 

[Emily]

Re: Nigeria - Ebola: Liberian man in Lagos dies- testing incomplete for ebola; 2nd suspected case reported

Re: Nigeria - Ebola: Liberian man in Lagos dies- testing incomplete for ebola; 2nd suspected case reported

He was asserting, vehemently, that he hadnt seen his ill sister right?

The article linked in this thread claims he denied having contact with an Ebola patient, rather than having contact with his sister, specifically. He was either in denial that his sister had Ebola, or testing on her was not complete at the time he intervened in her care.
I don't see him as having 'dumped' his sister. It seems to me that he cared a great deal about her, did what he thought he should do and then had to leave to attend to business.
If he was already irrational at that point, then maybe he was ill with something other than Ebola. Apparently Ebola infections can affect the mind, (like a lot of other serious illnesses):

http://www.newyorker.com/news/news-desk/takes-richard-preston-ebola

But we don't have enough information about Mr. Sawyer's case to say he showed any symptoms unique to Ebola infection. Too bad that Nigeria can't get that sample out. If all he had was malaria, a lot of contacts would be very relieved.

 

[Nika]

Re: Nigeria - Ebola: Liberian man in Lagos dies- testing incomplete for ebola; 2nd suspected case reported

Re: Nigeria - Ebola: Liberian man in Lagos dies- testing incomplete for ebola; 2nd suspected case reported

I wouldnt simply take my sister, oozing blood, to a clinic and leave. Perhaps other family members were with her. Not sure if that was mentioned.

 

[Emily]

Re: Nigeria - Ebola: Liberian man in Lagos dies- testing incomplete for ebola; 2nd suspected case reported

Re: Nigeria - Ebola: Liberian man in Lagos dies- testing incomplete for ebola; 2nd suspected case reported

Nika, you sound like a sister we'd all like to have at our side while fighting an illness. But I better share more info reported by that Chronicle article in case anyone hesitates to go to the link to be fair to Mr. Sawyer.

1) It was the fiancee who took Princess into a Catholic hospital for bleeding he believed was caused by a miscarriage.

2) The hospital performed a D&C and her bleeding worsened, causing the Ebola panic.

3) Mr. Sawyer entered the situation at that point and objected to what was going on. The Chronicle mentions no testing done at that point.

4) He bravely took care of his sister, paid her bill so she could have a private room, then obviously felt he had to leave. It does sound like at least her fiancee was still available.

Reading that more carefully made me wonder about the whole Ebola diagnosis again, but comments I've seen by family members of the Sawyer siblings seem to accept the diagnosis. (Also there is no ill will towards Mr. Sawyer from them.)

In the interview below, Nigerian virologist Prof. Sunday Omilabu says that the preliminary testing for Mr. Sawyer was positive for a filovirus of some sort. Only 2 are known currently, I think, with Ebola one of them.

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[Emily]

Re: Nigeria - Ebola: Liberian man in Lagos dies- testing incomplete for ebola; 2nd suspected case reported

Re: Nigeria - Ebola: Liberian man in Lagos dies- testing incomplete for ebola; 2nd suspected case reported

http://nationalchronicleliberia.com/news/health/1043/ebola-outbreak-no-immediate-solution-bad-news/

Ebola Outbreak, No Immediate Solution Bad News!
pic

30.07.2014 | 19:39 PM

...

Sawyer, who was in denial that his sister, Princess, was infected, told authorities at Catholic Hospital that she had a miscarriage; that is why she was hemorrhaging so much. It was Dr. Ruby, a Congolese who performed the D and C on Princess. After the procedure, the bleeding continued. This made the staff suspicious and tested her for Ebola.

Dr. Ruby is now quarantined and under observation at the hospital. Princess later died on July 7, and is highly suspected of infecting her brother, Patrick Sawyer. Princess, the girlfriend of Dr. Sam of Uganda, reportedly contracted the virus from her boyfriend because she was his caretaker during his time of illness.
- See more at: http://nationalchronicleliberia.com...diate-solution-bad-news/#sthash.b2Pzv7Rc.dpuf

They are losing a significant portion of their healthcare workers and those who love them.

This looks like a new report of a death.

At present, this paper has been informed that the chief medical officer of the Catholic Hospital, Dr. Patrick Mshamdze, a Catholic brother and a Cameroonian national, has succumbed to the disease. Dr. Mshamdze bit the dust yesterday at the hospital, and his remains was still locked up in a hospital room up to press time. - See more at: http://nationalchronicleliberia.com...diate-solution-bad-news/#sthash.b2Pzv7Rc.dpuf

 

[Nika]

Re: Nigeria - Ebola: Liberian man in Lagos dies- testing incomplete for ebola; 2nd suspected case reported

Re: Nigeria - Ebola: Liberian man in Lagos dies- testing incomplete for ebola; 2nd suspected case reported

Many thanks for the additional details. I can imagine being overwhelmed with the sadness of the miscarriage she had and then a bad outcome from a relatively routine D&C. I can also see why he might have thought it wasnt ebola (hoped it wasnt) as this poor outcome from a D&C isnt completely unexpected. (I think most see an ebola Dx a death sentence whether actually infected w it or not as they then get isolated with other dying ebola patients) I wonder if the miscarriage was caused by the ebola (can imagine placental abruption could happen easily w this disease).

 

[Emily]

Re: Nigeria - Ebola: Liberian man in Lagos dies- testing incomplete for ebola; 2nd suspected case reported

Re: Nigeria - Ebola: Liberian man in Lagos dies- testing incomplete for ebola; 2nd suspected case reported

I wonder if the miscarriage was caused by the ebola (can imagine placental abruption could happen easily w this disease).

I think you're raising a good question there. This article comparing Lassa and Ebola says that Lassa can cause miscarriages. We probably know more about that disease and its effects since it's more common than Ebola, even though Ebola gets more western press.

http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862010000700006

 

[Nika]

Re: Nigeria - Ebola: Liberian man in Lagos dies- testing incomplete for ebola; 2nd suspected case reported

Re: Nigeria - Ebola: Liberian man in Lagos dies- testing incomplete for ebola; 2nd suspected case reported

95.5% mortality rate for pregnant women with Ebola. Tho small N (105) 60% miscarriage rate in this population.

Mupapa et al, Ebola Hemorrhagic Fever and Pregnancy, The Journal of Infectious Diseases 1999;179(Suppl 1):S11?2


"Fifteen (14%) of 105 women with Ebola hemorrhagic fever hospitalized in the isolation unit of the Kikwit General Hospital (Democratic Republic of the Congo) were pregnant. In 10 women (66%) the pregnancy ended with an abortion. In 3 of them, a curettage was performed, and all 3 received a blood transfusion from an apparently healthy person. One woman was prematurely delivered of a stillbirth. Four pregnant women died during the third trimester of their pregnancy. All women presented with severe bleeding. Only 1 survived; she had a curettage because of an incomplete abortion after 8 months of amenorrhea. The mortality among pregnant women with Ebola hemorrhagic fever (95.5%) was slightly but not significantly higher than the overall mortality observed during the Ebola epidemic in Kikwit (77%; 245/316 infected persons)."

"The mortality rate of nonpregnant women with EHF hospitalized at the Kikwit General Hospital was 70% (28/40)."

"In Kikwit, only 1 full-term baby was born, and both the mother and infant died. In Yambuku, 10 live infants were born to mothers who died of EHF. All of these children also died within 19 days."


Whole paper here : http://m.jid.oxfordjournals.org/content/179/Supplement_1/S11.long

PDF here http://m.jid.oxfordjournals.org/content/179/Supplement_1/S11.full.pdf

 

[Vibrant62]

Re: Nigeria - Ebola: Liberian man in Lagos dies- testing incomplete for ebola; 2nd suspected case reported

Re: Nigeria - Ebola: Liberian man in Lagos dies- testing incomplete for ebola; 2nd suspected case reported

Please could we start a scientific library category for amassing publications/ abstracts on Ebola?

 

[sharon sanders]

Re: Nigeria - Ebola: Liberian man in Lagos dies- testing incomplete for ebola; 2nd suspected case reported

Re: Nigeria - Ebola: Liberian man in Lagos dies- testing incomplete for ebola; 2nd suspected case reported

Ebola - Research studies, Papers, Academia

http://www.flutrackers.com/forum/forumdisplay.php?f=3137

 

[Vibrant62]

Re: Nigeria - Ebola: Liberian man in Lagos dies- testing incomplete for ebola; 2nd suspected case reported

Re: Nigeria - Ebola: Liberian man in Lagos dies- testing incomplete for ebola; 2nd suspected case reported

Apologies - couldnt find it, need to look harder!

 

[sharon sanders]

Re: Nigeria - Ebola: Liberian man in Lagos dies- testing incomplete for ebola; 2nd suspected case reported

Re: Nigeria - Ebola: Liberian man in Lagos dies- testing incomplete for ebola; 2nd suspected case reported

Apologies - couldnt find it, need to look harder!

No apologies! I made the forum this morning. Thanks for the idea!

 

[Emily]

Re: Nigeria - Ebola: Liberian man in Lagos dies- tested positive for filovirus; 2nd suspected case reported

Re: Nigeria - Ebola: Liberian man in Lagos dies- tested positive for filovirus; 2nd suspected case reported

Thanks for finding that article, Nika! So there is quite a bit of data about Ebola and pregnancy.

 

[Nordica]

Re: Nigeria - Ebola: Liberian man in Lagos dies- tested positive for filovirus; 2nd suspected case reported

Re: Nigeria - Ebola: Liberian man in Lagos dies- tested positive for filovirus; 2nd suspected case reported

At the end of the article ....

"By Friday, only two had developed a fever?the handlers who helped Mr. Sawyer into a wheelchair. Their blood tested negative, and they are still under close watch."


http://online.wsj.com/articles/ebolas-threat-forced-nigerias-lagos-to-scramble-1406940469

 

[alert]

Re: Nigeria - Ebola: Liberian man in Lagos dies- tested positive for filovirus; 2nd suspected case reported

Re: Nigeria - Ebola: Liberian man in Lagos dies- tested positive for filovirus; 2nd suspected case reported

Could he have had a more transmissible co-infection (such as flu or norovirus) that he transmitted to the two handlers, while not transmitting Ebola? Or did the two of them contract an unrelated illness? Or have they been infected with Ebola and the testing is bad?

Only time will tell.

 

[Nordica]

Re: Nigeria - Ebola: Liberian man in Lagos dies- tested positive for filovirus; 2nd suspected case reported

Re: Nigeria - Ebola: Liberian man in Lagos dies- tested positive for filovirus; 2nd suspected case reported

In MERS cases early testing often show negative result but a new test a few days later gives positive result. It may be the same with ebola. The page below says test can be made a few days after first symptom.


http://www.cdc.gov/vhf/ebola/diagnosis/index.html

Maybe one of the experts online can explain the situation.

 

[JimO]

Re: Nigeria - Ebola: Liberian man in Lagos dies- tested positive for filovirus; 2nd suspected case reported

Re: Nigeria - Ebola: Liberian man in Lagos dies- tested positive for filovirus; 2nd suspected case reported

I don't think anyone knows. Due to the nature of the outbreaks, it sounds like they don't have a lot of data on the virus, how it behaves, how it might mutate, etc.

In MERS cases early testing often show negative result but a new test a few days later gives positive result. It may be the same with ebola. The page below says test can be made a few days after first symptom.


http://www.cdc.gov/vhf/ebola/diagnosis/index.html

Maybe one of the experts online can explain the situation.

 

[alert]

Re: Nigeria - Ebola: Liberian man in Lagos dies- tested positive for filovirus; 2nd suspected case reported

Re: Nigeria - Ebola: Liberian man in Lagos dies- tested positive for filovirus; 2nd suspected case reported

We have a report that one of these cases has been confirmed, and also of several more suspects:

http://www.channelstv.com/2014/08/04/eight-persons-suspected-contracted-ebola-virus-quarantined/

Eight Persons Suspected To Have Contracted Ebola Virus Quarantined

A Lagos doctor who treated the Liberian man that died few days ago of Ebola Virus has tested positive to the Virus, Nigeria?s Minister of Health said on Monday.

[snip]

 

[alert]

Re: Nigeria - Ebola: Liberian man in Lagos dies- tested positive for filovirus; 2nd suspected case reported

Re: Nigeria - Ebola: Liberian man in Lagos dies- tested positive for filovirus; 2nd suspected case reported

http://abcnews.go.com/Health/wireStory/liberia-orders-cremation-ebola-victims-24830289



Nigeria Confirms Doctor as 2nd Ebola Case



ABUJA, Nigeria ? Aug 4, 2014, 9:23 AM ET

By BASHIR ADIGUN Associated Press

Nigerian authorities on Monday confirmed a second case of Ebola in Africa's most populous country, an alarming setback as officials across the region battle to stop the spread of a disease that has killed more than 700 people.

Nigerian Health Minister Onyebuchi Chukwu also said test samples were pending for three other people who had shown symptoms of Ebola.

The confirmed second case is a doctor who had helped treat Patrick Sawyer, the Liberian-American man who died July 25 days after arriving in Nigeria amid the unprecedented outbreak in West Africa.

"Three others who participated in that treatment who are currently symptomatic have had their samples taken and hopefully by the end of today we should have the results of their own test," Chukwu said.

[snip]