Ebola: West African Nation Declared Free

Medic-ALL (01:18:2015) Healthcare News-

Ebola virus stopped in yet another West African Country

The Government of the West African nation, Mali today declared the country free of the deadly Ebola virus following a 42-day period without a new case of the disease.

Mali's Health Minister Ousmane Koné declared this in a statement in which he thanked the country's health workers and international partners for their work which helped to see a halt to the outbreak.

Countries must report no new cases for 42 days - or two incubation periods of 21 days - to be declared Ebola-free.

Mali recorded a total of seven deaths caused by the Ebola outbreak that began just over a year ago

According to World Health Organization (WHO) data the worst epidemic of the viral haemorrhagic fever on record has killed more than 8,400 people, mostly in neighbouring Guinea, Sierra Leone and Liberia.

At least 21,296 people have so far been infected with the virus worldwide.

Mali's last infected patient recovered and left hospital early last month. At one point health officials had been monitoring more than 300 contact cases.

Mali became the sixth West African country to record a case of Ebola when a two-year-old girlfrom Guinea died in October. It was close to being declared Ebola free in November before a second wave of infections.

The country now joins other West African countries Nigeria and Senegal who had been declared Ebola-free in the last couple of months.

Medic-ALL.Inc 2015

Ref: BBC, WHO

Ebola Response On Track -WHO

Medic-ALL (19:12:2014) Via MedPage Today

The response to the Ebola epidemic is on track to meet U.N. targets, the World Health Organization said in a mildly optimistic midweek situation report.
By New Year's Day, the agency said, the three hardest-hit countries will likely have the capacity to isolate and treat all cases and to bury all Ebola victims "safely and with dignity."

Guinea, Liberia, and Sierra Leone all now have more available beds than reported patients, the WHO said, although they are not distributed evenly and some regions still have "serious shortfalls." By the same token, each country has enough safe burial teams to handle all people known to have died from Ebola; however, some regions might lack enough capacity.

The U.N. goals are to have 100% of new patients under treatment by Jan. 1 and all known Ebola victims buried safely. Isolating patients breaks the chain of transmission, while safe burials -- avoiding unprotected contact with the highly infectious body of an Ebola victim -- avoid an important risk factor for new cases.
The agency also had a brighter picture of the incidence of cases, suggesting there are signs that the epidemic in Sierra Leone might be starting to slow -- even though the country reported 327 new confirmed cases in the week ending Dec. 14.
Most of the cases are in the western part of the country, with the capital, Freetown, accounting for 125 of the new cases. Teams began house-to-house searches in Freetown yesterday, seeking hidden Ebola patients, according to the BBC.
The searches are part of the so-called Western Area Surge, which aims to get Ebola patients into treatment and also to raise the number of available beds in the capital, the WHO said.

In Guinea, there has been no evident pattern in recent weeks, with the number of new confirmed cases each week fluctuating between 75 and 148. For the week ending Dec. 14, there were 76.
In Liberia, on the other hand, incidence is falling, with only six districts reporting new confirmed or probable cases in the week ending Dec. 14, although data are missing for much of the week.
The cumulative Ebola toll worldwide, to Dec. 14, is 18,603 confirmed, probable, and suspected cases in five affected countries (Guinea, Liberia, Mali, Sierra Leone, and the U.S.) and three previously affected countries (Nigeria, Senegal, and Spain), the agency said.

The U.S. has not had a new Ebola case since Craig Spencer, MD, was reported to be be cured Nov. 9; the country can be declared free of the disease Sunday, which will be 42 days after Spencer tested negative.
Mali also appears to have controlled the disease; all of the contacts of the country's eight confirmed and probable Ebola patients (six of whom died) have now passed the 21-day incubation period without developing the disease.


The last patient tested negative for the disease Dec. 6.

The WHO also reported, for the first time, population-based Ebola rates for Guinea, Liberia, and Sierra Leone:

In Guinea, there have been 22 reported cases and 14 deaths per 100,000 people, with a cumulative total of 2,416 cases and 1,525 fatalities.

Liberia has had 197 reported cases and 83 deaths per 100,000 population, with a total of 7,790 cases and 3,290 deaths.

And Sierra Leone has had 145 cases and 36 deaths per 100,000 people, for a total of 8,356 cases and 2085 deaths.

Meanwhile, researchers are reporting that laboratory tests show that 53 existing and approved drugs have the effect of blocking ebolavirus entry to target cells.

The list includes a wide range of drug classes: microtubule inhibitors, estrogen receptor modulators, antihistamines, antipsychotics, pump/channel antagonists, anticancer drugs, and antibiotics, according to Adolfo Garcia-Sastre, PhD, of the Icahn School of Medicine at Mount Sinai Hospital in New York City, and colleagues.
But more experiments will be needed to understand how useful any of the compounds might be, Garcia-Sastre and colleagues cautioned in Emerging Microbes and Infections.

The work is a positive step, commented Ben Neuman, PhD, of England's University of Reading, who was not part of the study.
The research "extends the list of drugs that are safe to use in people, and have been shown to interfere with Ebola in the lab," he said. But, he added, "it takes a lot to stop Ebola and none of the drugs identified in this study has been shown to protect an experimental animal yet."

"We now have a longer list of things that might work, but the list of things that definitely will work still unfortunately stands at zero," Neuman said.
Indeed, there is little evidence of efficacy even for the drugs that have been used experimentally during this current outbreak, according to the European Medicines Agency, which is conducting a continuing review of them.

The agency is looking at such medicines as brincidofovir, favipiravir, TKM-100802, and ZMapp -- all used to treat one or more patients -- but there is nothing to be said so far about their efficacy, according to an interim report.
"Treatments for patients infected with the Ebola virus are still in early stages of development," an agency spokesman said in a statement. "We encourage developers to generate more information on the use of these medicines in the treatment of Ebola patients."

Ref: World Health Organization
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Nigeria Declared Ebola-Free by WHO

Medic-ALL (20:10:2014) by Kayode Kuku

With no new cases of Ebola reported in Nigeria over the last 42 days, the World Health Organization (WHO) today declared the country "Ebola Free", a sign of how the deadly virus could have been easily contained had the other West African countries ravaged by the disease acted swiftly.

There haven’t been any cases of Ebola in 42 days, said WHO Country Representative Rui Gama Vaz in a news conference in Abuja, Nigeria’s capital.

“The last chain of transmission has been broken. The disease is gone,” said Dr. Vaz. “This is a spectacular story, that Ebola can be defeated.”

This is following an announcement that Senegal is also rid of the virus.

The entire world and health officials particularly were concerned of a possible worldwide outbreak  and wary of the spread throughout the world when a Liberian-American "transported" the virus into Nigeria when he flew into Lagos, the Country's most populous city with a population of about 21 million people late July.

A different story has been unfolding in Liberia, Sierra Leone, and Guinea, whose governments didn’t notice Ebola had arrived in their interiors until March, four months after the disease first erupted in rural Guinea late last year.

More than 4,500 people are known to have died from the disease in those countries, the WHO says. Thousands more are thought to have contracted it without ever being tallied in the United Nations health agency’s records.

Meanwhile the United States continue to put in place measures to ensure the diseses which has so far been confirmed in 3 persons in the U.S. 43 contacts of the country's first Ebola case, Thomas Eric Duncan have been cleared after not developing any symptoms following a 21-day period in quarantine, while 4 others are close to the end of the isolation period.

 Reports from Spain, reveal that the nurse's aide has also beaten Ebola after spending weeks hospitalized with the disease.

Ref : Wall Street Journal

Related posts: Yes!! Nigeria, Ebola Free

Fight Against Ebola: Grossly Unfunded!

•  MARKETS
•  SETTINGS

CNN (NewYork) 22:09:2014 -

The Ebola virus has already killed thousands in West Africa, an immeasurable loss for many families. As medical workers try to quell its spread, global organizations are calculating the economic impact of the disease.

"Their economies are basically being devastated," said Daniel Epstein, a spokesperson for the World Health Organization. "Economic activity has halted in many areas there. The harvest isn't going on. People can't fly in and fly out."

WHO workers even had difficulty flying into the Ebola-stricken nations of Liberia, Sierra Leone and Guinea, Epstein said. 

The Ebola virus has already killed thousands in West Africa, an immeasurable loss for many families. As medical workers try to quell its spread, global organizations are calculating the economic impact of the disease.

"Their economies are basically being devastated," said Daniel Epstein, a spokesperson for the World Health Organization. "Economic activity has halted in many areas there. The harvest isn't going on. People can't fly in and fly out."

WHO workers even had difficulty flying into the Ebola-stricken nations of Liberia, Sierra Leone and Guinea, Epstein said.

Over 2,600 people have died, according to the latest WHO count. If Ebola is not contained this year, the cost could increase by eight times its current estimate, according to a report published Wednesday by the World Bank Group. Ebola's toll in Liberia alone could affect almost 5% of the country's GDP this year, the World Bank said.

"Our findings make clear that the sooner we get an adequate containment response and decrease the level of fear and uncertainty, the faster we can blunt Ebola's economic impact," said World Bank president Jim Yong Kim in a statement.

In need of aid: The United Nations said this week that $1 billion in aid is needed to contain the Ebola outbreak. But a UN database tally of donations shows that many wealthy Western nations that verbally pledged support have donated paltry sums to fight the disease.

Total donations, including non-binding pledges, to fight Ebola are about $388 million, well under half of the United Nation's estimate, according to data from Financial Tracking Service, a database that tracks humanitarian aid and is managed by the United Nations. The Obama administration announced this week that it hopes to send an additional $500 million in humanitarian aid to the West African nations this fiscal year.

Even with the U.S. government's significant aid proposal, the total number would still fall short of the United Nations' estimate of a billion.

UN Secretary-General Ban Ki-moon went as far as saying "our best estimate is that we need a 20-fold increase in assistance" at a meeting this week.

Some private foundations have also stepped in. The Bill and Melinda Gates Foundation has donated over $8 million so far to various organizations to fight Ebola. That is more than the combined donations of Canada, Germany and Spain, according to FTS data.

Overall, the Gates Foundation has pledged $38 million, which eclipses many more countries.

Epstein noted that countries such as Canada contribute to the aid effort in non-monetary ways by sending aid workers and conducting medical research.

"We're also at the stage where people are seeing what the landscape is and figuring out, what's the best way to donate funds?" Epstein said. "In a humanitarian crisis, there are often delays between what people realize what they have to do and what they actually do.

WHO: Ebola Surging Beyond Control

Medic-ALL(13:09:2014) via CBC News:

Ebola virus cases in West Africa are rising faster than the ability to contain them, the World Health Organization says, as experts warn that the exponential rise could become a worldwide disaster.

The death toll has risen to more than 2,400 people out of 4,784 cases, WHO director general Margaret Chan told reporters at the UN health agency’s headquarters in in Geneva on Friday, noting the figures could be an underestimate.

In the three hardest hit countries, Guinea, Liberia and Sierra Leone, the number of new patients is moving far faster than the capacity to manage them. We need to surge at least three to four times to catch up with the outbreaks," Chan said.

She called for urgent international support in the form of doctors, nurses, medical supplies and aid to the worst-affected countries.

Health-care workers have been infected with Ebola while treating patients in West Africa. Almost half of the 301 health-care workers who have developed the disease have died.

Chan welcomed Cuba's announcement that it will send 165 health-workers to fight the outbreak , but added that at least 500 doctors from abroad are needed.

An infectious disease expert warned in Friday’s New York Times that "the Ebola epidemic in West Africa has the potential to alter history as much as any plague has ever done."

Michael Osterholm is the director of the Center for go backrian aid from countries and non-governmental groups. Disease Research and Policy at the University of Minnesota.

Ebola spreads through direct contact with bodily fluids, but Osterholm raised a possibility that he said virologists are loath to discuss openly but consider behind closed doors: the prospect that the Ebola virus could mutate to become transmissible through the air.

Osterholm cites a 2012 study by researchers at the National Microbiology Laboratory in Winnipeg that showed the Ebola Zaire strain behind West Africa’s outbreak could spread by the respiratory route between pigs and monkeys.

The key to containing the outbreak, Osterholm stressed, is to beef up efforts to stop the spread of the virus.

To that end, he suggested that the United Nations take over the position of "command and control" to direct the efforts of medical, public health and humanitarian aid from countries and non-governmental groups.

Culled from CBC News

Ebola Response: Slowed by a "Perfect Storm" of Setbacks

Via Medpage Today (09:09:2014)

WASHINGTON -- The world was taken by surprise by the West Africa Ebola outbreak and has been scrambling ever since to catch up, with many setbacks and only a few bright spots in the picture, international experts said at the Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC).

The Centre for Disease Control (CDC)'s initial response was based on years of experience with Ebola, according to Barbara Knust, DVM, of the agency's National Center for Emerging and Zoonotic Infectious Diseases.

In March, the agency dispatched 20 staff to do what the CDC has often done before -- help control an Ebola outbreak with such things as data management, contact tracing, and epidemiology, she told reporters.

It seemed to work, and in May the agency pulled its staff back, satisfied -- as was the World Health Organization (WHO) -- that the worst would soon be over.

But in the following months it became clear that a "perfect storm" of factors was at work, combining to push what had been a localized outbreak into a widespread and deadly epidemic, she said.

Those factors included a very mobile community that was sometimes angrily opposed to the outbreak control measures -- adequate infection control and safe burial practices, for instance -- that had always worked in the past.

The result was an outbreak that has grown so swiftly that "those measures still need to be put fully into effect," she said.

Currently, the CDC has some 90 people on the ground in the affected countries -- Guinea, Liberia, Sierra Leone, and Nigeria -- and is planning to send teams to nearby nations to help them get ready in case of further spread.

Knust was among three speakers added to the ICAAC program at the last minute to fill in the Ebola picture. The others were Aneesh Mehta, MD, of Emory University School of Medicine in Atlanta and Gary Kobinger, PhD, of Canada's National Microbiology Lab in Winnipeg, Manitoba.

Mehta was part of the 100-strong medical team that cared for two American medical missionaries who came down with the virus and were airlifted to Atlanta for treatment.

Both recovered and Mehta said he and colleagues gleaned some "clinical pearls" from their experience that might help future patients including those in West Africa.

Among them, he told MedPage Today, was the ability to swiftly correct specific electrolytes, to switch intravenous fluids quickly to match changing patient needs, and to give high-quality liquid nutrition to help repair the immune system.

"One of the things that we learned was the power of close monitoring and high-level nursing care," he added, something that both patients commented was absent in the African setting.

Although the caregivers initially had no idea what to expect, the two patients were very similar to other seriously ill people, Mehta said, and responded to similar interventions.

One advantage the American team had was daily on-site lab work which is not available to African doctors. But he said the American team also used point-of-care devices to monitor blood chemistry, which could also be used in the African setting.

The epidemic has now caused more than 3,700 cases and almost 1,850 deaths, according to WHO, and the treatment for Ebola is some form of the supportive care that Mehta discussed.

But several vaccines and therapeutics are in the pipeline and might be ready in time to have some impact on the epidemic, Kobinger said.

In particular, it's just possible that the two vaccines now entering phase I safety trials will pass that hurdle in time to be of some help.

But the process of getting such drugs into the clinic in a hurry is not an easy one, he said.

"It's easy to say let's do a clinical trial, but it's very complex, especially in the current situation where the focus is really on the outbreak response," he said.

On the other hand, if the vaccines are shown to be safe and effective, they could assist the public health response by persuading more healthcare workers to take part, Kobinger stated.

"If you could just protect them, you would have a tremendous impact on the response," he said, "because more people would go."

In the long run, the availability of drugs and vaccines might change the face of Ebola. "I'm hoping this will be the last large outbreak," he said.

Ebola Takes Toll on African Economy

Wall Street Journal (05:09:2014) by Matina Stevie, Nicholas Bariyo and Gbenga Akingbule:

Ebola's economic toll on Africa is starting to emerge.

The flow of goods across many African frontiers, from Congolese copper crossing the Botswana border to used cars driven into Nigeria, is seizing up on fears that traders could be carrying or catch the killer virus. The trade slowdown comes on top of a drop in tourismand the suspension of commercial flights to West African cities as well as Nairobi, a continental hub.

The upshot: An accelerating continental economy has hit a massive speed bump. The International Monetary Fund projected sub-Saharan Africa would grow by 5.4% this year, but it is now warning that Ebola is set to badly hit growth rates in the countries directly affected.

The Ebola outbreak began in Guinea eight months ago and has since spread to Sierra Leone, Liberia and Nigeria. A separate Ebola outbreak has surfaced in the Democratic Republic of Congo.

The World Health Organization has warned that the epidemic is likely to accelerate and more than 20,000 people could be infected. Already, more than 1,900 people have died.

Ebola's economic impact has become so severe that the IMF is now warning that stricken countries could need emergency assistance. Guinea, Liberia and Sierra Leone have all been burning holes in their finances trying to curb the outbreak, and a dramatic downturn in trade—specifically timber and rubber—will compound those troubles.

"What is already clear at this stage is that growth is likely to slow sharply," said Gerry Rice, a fund spokesman. "Significant financing needs are likely to rise."

The World Bank and the IMF said recently that the epidemic would shave a full percentage point off Guinea's growth rate, slowing it to 3.5%.

Sierra Leone's economy was set to grow by a breakneck 13.9% rate in 2014, and Liberia's by 5.9%, the IMF predicted earlier this year. While the fund still hasn't specified how it believes the outbreak will affect those growth rates, the impact is expected to be significant, setting back fragile economies that were beginning to stage convincing economic expansions.

The Washington-based institution is already funding assistance programs to the three West African nations affected by Ebola. Sierra Leone benefits from a roughly $96 million IMF program, while Guinea is drawing on a $200 million loan, and Liberia on an $80 million one. IMF rules allow it to enhance or extend such loan facilities.

Agriculture accounts for some 40% of the economic output in Liberia and Sierra Leone and a quarter in Guinea, and the sector is taking a hit in the three countries as farmers are forced to leave the fields and can't trade across borders because many have closed, according to Manji Cheto, vice president at the New York-based Teneo Intelligence consultancy. What could be worse is the jobs and vital income lost in the sector: In Sierra Leone, for example, about 70% of the workforce is occupied in the broader agricultural sector.

Nigeria, which this year surpassed South Africa as the continent's largest economy, is better positioned to absorb the impact of the Ebola epidemic, which at this point appears confined to two cities, Lagos and Port Harcourt.

Still, Ebola is deterring those who help drive trade with Nigeria. A Nigerian customs official said revenue from import duties of used vehicles has declined drastically. Part of the reason is that increased surveillance for the disease at land borders—including quarantines for those with high fevers—has slowed trade and potential customers to a trickle, the official, who declined to be identified because he wasn't authorized to speak to the media said.

And It isn't just cars. "Many of my customers from neighboring countries have stopped coming," said Yusuf Adamu, an electronics dealer in Nigeria. "When I try to reach out to them on the phone they complain of stringent Ebola screening measures."

Zambia's health ministry said Friday that it was reviewing travel regulations for people entering its borders from Congo, the latest country to be hit by Ebola. Since Aug. 25, Botswana's authorities have blocked the entry of more than 100 trucks carrying copper from Congo.

Traffic along the Rwanda-Congo border has dropped drastically, as travelers stay away due to long screening queues. According toFrançois Kahwerikula, a Congolese customs official at the Goma border crossing, known asGrande Barriere, daily collections have declined by 30% to 40% since Congo announced that it had confirmed the Ebola outbreak.

More than 10,000 people cross the Rwanda-Congo border every day for business, but a Congolese mineral dealer, Siraje Bigirimana, said he is booking a hotel room in Rwanda until the situation is safe. "It's very expensive to operate in such a situation," Mr. Bigirimana said.

Rwandan Health Minister Agness Binagahwo said that Kigali had deployed troops and civilian health workers to ensure that all people going through the borders are screened. All people with a fever of 37.5 degrees Celsius (99.5 degrees Fahrenheit) and above are being turned away at the busy cross points.

"No one passes without being screened," said Ms. Binagwaho said. "There is good coordination and everything is going in fine."

Breast is Best!

Medic-ALL (04:09:2014) by Kayode Kuku:

It has become increasingly common to hear young mothers express their objection to adopting exclusive breast feeding, moreso for  the medically prescribed duration.

The WHO recommends exclusive breastfeeding for 6 months as the optimal way of feeding infants.Thereafter infants are to receive complementary foods with continued breastfeeding up to 2 years of age or beyond.

Breast milk is the natural first food for babies, it provides all the energy and nutrients that the infant needs for the first months of life, and it continues to provide up to half or more of a child’s nutritional needs during the second half of the first year, and up to one-third during the second year of life.

Breast milk promotes sensory and cognitive development, and protects the infant against infectious and chronic diseases. Exclusive breastfeeding reduces infant mortality due to common childhood illnesses such as diarrhoea or pneumonia, and helps for a quicker recovery during illness.

To enable mothers to establish and sustain exclusive breastfeeding for 6 months, WHO and UNICEF recommend:

• Initiation of breastfeeding within the first hour of life
• Exclusive breastfeeding – that is the infant only receives breast milkmiwithout any additional food or drink, not even water
• Breastfeeding on demand – that is as often as the child wants, day and night
• No use of bottles, teats or pacifiers

Many women however  frown at the mere sound of exclusive breastfeeding for reasons such as cosmetics, talking about the sagging effect of breastfeeding on their breasts mainly. Does breastfeeding actually cause your breasts to sag, or affect the shape or firmness of the breast in any way?

The Fact is...

During pregnancy, the ligaments that support the breasts might stretch as the breasts get fuller and heavier. This stretching could contribute to sagging breasts after pregnancy — whether or not you breastfeed your baby. Sagging breasts may become more noticeable with subsequent pregnancies.

Other factors however also contribute to sagging breasts, including aging and smoking , both of which reduce skin elasticity. Being overweight and having large breasts can have a similar effect.

There are few medical reasons why a nursing mother could be adviced against breastfeeding, for example in ,retro-viral disease positive patients, in order to prevent Mother-Child transmission, even in such cases Mothers could still opt to adopt exclusive breastfeed and stop abruptly and completely when other foods are to be introduced. Most mothers on medications for chronic conditions can breastfeed safely. - Please check with your Obstetrician.

It is important to note that Mothers make healthy milk even if their own eating habits are not nutritious. Tattoos, piercings and breast surgery often do not affect breastfeeding.

Even though it has numerous benefits, breastfeeding can have it's challenges. A common problem faced by first timers is sore nipples. If after a minute of breastfeeding, pain is felt , the positionong of the baby's mouth should be checked. It should cover more of the areola below the nipple than above with the chin and nose of the baby touching the breast with the lips splayed out. Lotions should be avoided when attempting to relieve dryness, water and breast milk are best for healing the nipples.

A hard breast lump, soreness or redness may be the result of a clogged duct. Long stretches between feeding should be avoided to prevent clogging. Warm water compress or light massage could help stimulate milk flow. Unrelieved clogs can however lead to mastitis.

So do not let the fear of manageable problems or that of sagging breasts stop you from breast-feeding. To help maintain the appearance of your breasts at any stage of life, make healthy lifestyle choices. Include physical activity in your daily routine. Eat a healthy diet. If you smoke, ask your doctor to help you quit

Remember, breast is best for babies. Breastfeeding also contributes to the health and well-being of mothers; it indeed helps to space children, reduces the risk of ovarian cancer and breast cancer, increases family and national resources, is a secure way of feeding and is safe for the environment.

Ref: WHO Nutrition,

        Mission Breastfeeding Centre,

        Mayo Clinic 

Medic-ALL.inc 2014 

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WHO: Ebola Death Toll, over 1900

Medic-ALL (03:09:2014):

According to the World Health Organisation, over 1,900 people have now died in West Africa’s Ebola outbreak.

WHO Director-General,  Margaret Chan MD said there were 3,500 confirmed or probable cases of the deadly virus in Guinea, Sierra Leone and Liberia.

“The outbreaks are racing ahead of the control efforts in these countries,” she said.

On Thursday the WHO, will be holding a meeting to examine the most promising treatments and to discuss how to fast track their testing and production.

Disease control experts, medical researchers, officials from affected countries, and specialists in medical ethics will all be represented at the meeting in Geneva.

The WHO has previously warned that more than 20,000 people could be infected before the outbreak of the virus is brought under control.

Dr Chan described the outbreak as “the largest, most severe and most complex we have ever seen”.

“No one, even outbreak responders with experience dating back to 1976, to 1995, people that were directly involved with those outbreaks, none of them have ever seen anything like it,” she said.

Forty per cent of the deaths have occurred in three weeks leading up to September 3, the WHO says.

Ref: WHO media centre