EBOLA Outbreak Thread

[morningfog]

I want to organize a thread of facts and information about the current Ebola outbreak in Western Africa.

My intention with this thread is to follow the timeline and what is known. I would greatly appreciate anyone adding links on the virus and its spread. This outbreak has had a fatality rate of approximately 60 percent. In this outbreak alone, more than 100 health workers have been infected and at least 50 of them have died, according to the WHO.

So far this strain of Ebola has spread (from one person to another) in three countries: Sierra Leone, Guinea and Liberia.



The virus traveled by way of Patrick Sawyer to Nigeria on July 20, when he collapsed in the Lagos airport. He died 5 days later. That was almost two weeks ago a no new cases have been reported in Nigeria, yet. However, the incubation period is up to 21 days. 59 people were identified as coming into contact with Sawyer on his travel from Liberia to Nigeria. As of July 29, 20 of those 59 had been tested for Ebola and all were negative.

http://www.reuters.com/article/2014/07/28/us-health-ebola-nigeria-idUSKBN0FX15420140728

http://www.reuters.com/article/2014/07/31/health-ebola-transport-idUSL6N0Q570N20140731

http://abcnews.go.com/Health/fullpage/ebola-virus-24809270


Two US citizens are en route, or will be shortly to the Emory campus quarantine for treatment. These two would be the only other confirmed cases outside of the four countries previously listed. Their transport is controlled and intentional, though.

Please feel free to add questions, links and discussions to this thread. I find this epidemic tragic and interesting to follow, if slightly terrifying.

[Aerows]

1. Thank you for an informative thread.

If not contained, many more could be infected.

It spreads through blood, urine, feces, saliva and sweat with a long incubation period. It's a cocktail for disaster if we don't get on this.

[morningfog]

2. Unfamiliar (to me) sources from Lagos: 2 of Sawyer's contacts with fever, negative

The Lagos State Government on Friday said two persons out of those who had contacts with Mr. Patrick Sawyer, the dead Liberian Ebola victim, had manifested symptoms of fever.

The Commissioner for Health, Dr Jide Idris, made the disclosure when he addressed newsmen on the update of the country‘s first Ebola case in Ikeja.

Idris said the two persons were among the 70 contacts being monitored and investigated for any symptoms of the disease by the state government and other partners.

The commissioner, who said the two cases were under observation, however stressed that they did not test positive to the virus.

http://thenationonlineng.net/new/ebola-two-down-with-fever-in-lagos-after-contact-with-victim/

Lagos State commissioner for health, Dr. JideIdris, in conjunction with federal health officials tackling the challenge of Ebola Virus Disease (EVD) have declared that the two people suspected of infection have tested negative to the virus.

Idris said yesterday that an official statement on the matter became necessary as result of the rumours being spread in Lagos and beyond that one of the 59 contacts of the late Liberian Patrick Sawyerr, who was physically screened, has been confirmed positive to the virus.
“The contact tracing team is following 70 contacts by now and linking them to clinical support when needed. Suspected cases will continue to be monitored until the end of the incubation period of 21 days, from their exposure to the late Sawyer who had EVD.”

http://dailytrust.com.ng/weekly/index.php/new-news/17211-ebola-critical-contacts-report-negative-lasg

[defacto7]

3. I wish some of these reports

showed the actual number of survivors of the disease. We see the 60% mortality rate but the numbers I have read are 60% under the best care and up to 90% without care. The graphs show the number of cases, the number of deaths but that does not relay the number of survivors. That would be an indicator that holds some important value.

[laundry_queen]

9. I know. I heard

on CNN the number was 60% without care so they were assuming it would be much lower with good care (this is when they were talking about the Americans being flown out...trying to make us feel better about their survival maybe? I don't know). It would be nice to actually see the data.

[magical thyme]

16. Ebola Zaire has a mortality rate of 90% without care; 60% with care

and this is the Zaire strain. There are 3 other strains with a lower mortality rate without care.

[laundry_queen]

18. I had not heard this was Zaire. Thanks. nt

[defacto7]

26. a belated thank you. n/t

[msongs]

4. timeline? this week: US deliberately brings ebola infected people into the country

[cwydro]

13. Those two

are American citizens, and they have the right to come home for treatment.

[magical thyme]

17. they had every right and deserve the best we can give them

Dr. Brantly was brought here under tightly controlled circumstances, as will the other patient.

The facility where they are being treated was specifically set up to treat researchers who have accidental exposures to the highly infectious pathogens that they work with while developing treatments and vaccines. The portable isolation unit they are traveling in was designed by the CDC and the DOD specifically to transport those patients.

Here in the US, their chances of survival will be better. Furthermore, it will give US doctors and researchers valuable information for the future. They will also have available experiemental treatments, should they choose.

[Katashi_itto]

22. What a soft people we Americans have become.

[snooper2]

31. Is it time to call Dustin Hoffman in yet?

[hootinholler]

32. As we should! n/t

[jberryhill]

58. US citizens.

How do you propose to keep US citizens out of the country?

This I want to hear.

You do know that their return to the US was privately financed. Yes?

[ProdigalJunkMail]

65. the gov't absolutely can deny return

of persons suspected to be infected with dangerous pathogens... the catch is they have to know if the person might be infected.

sP

[jberryhill]

66. Show me the statute

We don't do "banishment".

A US citizen has an unqualified right to enter the US.

[ProdigalJunkMail]

67. you are correct...

however, it is my understanding that they can detain you at the border crossing and then quarantine you for health concerns... so, while you are technically correct, might be a little tough to get home.

sP

[jberryhill]

69. And that's pretty much what happened here

There seems to be this notion that the "US" brought them back.

As I understand it, a private organization managed to raise money to get the equipment needed to bring them back, and the patients were taken immediately into isolation on arrival.

There are a number of circumstances where one can be detained on entry, but at the end of the day if you are a US citizen, you're coming in eventually.

[ProdigalJunkMail]

70. i should have been more careful in my assumptions

i think what most people are concerned with is that the US allowed them to continue on their way once within the US. i know they are essentially quarantined, but it blew my mind that they traveled down I-75 with just a little escort. i know the chance was remote, but if there had been an accident, who knows if some good samaritan might have tried to help... i suspect some might and would possibly then pay with their lives.

am i a worry-wart? kind of...

sP

[magical thyme]

74. "a little escort" included the FBI

Every part of the trip was carefully planned and controlled, with assistance by the CDC and DOD. The portable isolation tent they traveled in is the property of the CDC and was developed by the DOC, the CDC and a private company.

The patients both were in biohazard suits. Their care takers were in biohazard suits.

If their ambulance broke down or was in an accident, their escorts were there to render immediate assistance and prevent "good samaritans" from interfering or coming in contact.

The isolation ward they are staying in was designed for the CDC in the event of a researcher being accidentally exposed.

And their transport and care is being paid for completely by the two aid agencies that they work for, Samaritan's Purse and SIM.

[ProdigalJunkMail]

75. and no one has ever made a mistake

you can 'facepalm' all you want... but there are always unforeseen possibilities... as far as control, not so much. they traveled down a heavily utilized corridor in ATL during regular traffic flow. much could have gone wrong... hell, they were passed at one point by an 18 wheeler...

sP

[morningfog]

5. Two workers who helped Sawyer into wheelchair had fever, not yet positive for Ebola.

Lagos also got lucky: Mr. Sawyer, a consultant at the Liberian Finance Ministry, collapsed on arrival in the city and was put in isolation at a hospital. Had he spent even a few hours outside the airport, he might have spread his illness to exponentially more people, many of them impossible to trace in the city's endless sprawl of tin-roof shacks and walk-up apartments.

More than 1,323 people have been sickened, about 60% of them fatally, in West Africa since Ebola erupted from the forested interior of Guinea, according to the World Health Organization. The hundreds dead include a top Sierra Leonean doctor and another from Liberia, while two U.S. health-care workers are ill.

* * *

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

[LisaL]

29. Not so lucky after all.

Doctor who treated Mr. Saywer was just diagnosed with Ebola.

[morningfog]

6. National Geographic: Why Deadly Ebola Virus Is Likely to Hit the U.S. But Not Spread

http://news.nationalgeographic.com/news/2014/07/140729-ebola-america-disease-epidemic-africa-medicine-science/

[Puzzledtraveller]

7. Scary.

[Warren DeMontague]

8. CNN opinion: What Obama can do about Ebola

http://www.cnn.com/2014/07/31/opinion/garrett-ebola-obama-africa-summit/

[CoffeeCat]

10. Here are some numbers that show how Ebola has spread (number of dead)

Here are some numbers, according to an article from The Wire (link at bottom of post). Interesting to see these numbers.

Maybe a statistician, or someone with a medical background, can shed some insight into what these numbers mean, thus far.

Numbers of Ebola victims who have died in 2014 from this recent outbreak in west Africa:

April 7, 100
April 30 150
May 27 200
June 18 300
July 8 500
July 23 672
August 1 750*
*final number reported by multiple sources

http://www.thewire.com/global/2014/07/how-the-ebola-outbreak-spread-across-west-africa/375231/

[Squinch]

14. So the rate of spread is increasing quickly, which is not good news.

That's an important list. Thanks for it.

[840high]

57. It is scary.

[DeSwiss]

11. K&R

RSOE EDIS - Emergency and Disaster Information Service (Africa)

[dembotoz]

12. kick

[morningfog]

15. Aug. 2:American Doctor With Ebola Able to Walk Into Georgia Hospital

http://abcnews.go.com/Health/american-patient-ebola-en-route-us/story?id=24818577

Officially in US now.

[KamaAina]

36. Looks like he may make it

If he does, he will have one hell of a book deal waiting for him! The obligatory appearance on Colbert would, of course, feature The Greatest Living American jogging across the stage to greet him, wearing a hazmat suit.

[morningfog]

19. Bayesian methods to judge expectations in the coming months for 3 countries:

As the two sets of basis functions give similar answers in the near future, it seems likely that the epidemic will continue at a steady or slightly increasing rate for at least the next few weeks, though we must still be careful projecting too far into the future. Unfortunately, the most recent data had a fairly pronounced effect on the variability of these estimates. From early July through the data released on the 23rd, the models predicted a temporary continuation of epidemic activity followed by a decrease into the fall. While these predictions are still encompased by the observed variability, the situation on the ground is clearly evolving quickly. The current evidence is not inconsistent with the possibility that the disease will soon start the slow process of dying out, but our best predictions no longer place a high weight on such a possibility. The next few weeks are likely to be highly dynamic, and will hopefully narrow down the large space of probable epidemic patterns. In the meantime, we may hope for the best for the people of West Africa, and support the efforts of governmental and non-governmental organizations like the WHO and MSF

That wraps up the analyses for now. This document will continue to be updated as the epidemic progresses, reflecting new data and perhaps additional analysis techniques. As the document is tracked via source control it will be easy to see how well past predictions held up and how they change in response to new information.


http://grantbrown.github.io/libspatialSEIR/doc/tutorials/Ebola2014/Ebola2014.html#analysis-2-prediction-sect

[morningfog]

20. (very good interactive) Mapping the Ebola epidemic

http://www.aljazeera.com/indepth/interactive/2014/07/mapping-world-worst-ebola-epidemic-2014730134429708222.html

[Zorra]

21. Between July 27 and July 30, an average of almost 40 new cases per day

were reported.

http://en.wikipedia.org/wiki/2014_West_Africa_Ebola_outbreak

[Zorra]

43. Between July 30 and Aug 1, an average of 82 new cases per day

were reported.

http://en.wikipedia.org/wiki/2014_West_Africa_Ebola_outbreak#Timeline_of_the_outbreak

[morningfog]

23. Where ebola is gaining momentum (Liberia and Sierra Leone):

[MrMickeysMom]

24. Transmission of this virus, as understood by the CDC...

When an infection does occur in humans, there are several ways in which the virus can be transmitted to others. These include:
direct contact with the blood or secretions of an infected person
exposure to objects (such as needles) that have been contaminated with infected secretions

As someone who has worked as a respiratory therapist within environments where universal precautions must be observed (you have to treat everyone as if they are infected, even if they are not, to be safe), we have the means to contain it.

Link:

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

[Avalux]

25. Important clarification - it's an epidemic, not a pandemic.

Pandemics are global - everywhere. Unless Ebola mutates so as to allow for airborne transmission (highly unlikely), Ebola burns itself out before a pandemic can occur. So what we see are limited epidemics in the poorest parts of Africa where inadequate medical infrastructure and lack of infection control make it easy for the virus to spread. Ebola can live for several days in a deceased victim and on surfaces. If the people don't know this and don't take precautions, they'll be exposed unknowingly. That's a lot of what's happening now.

The epidemic IS tragic, all we can do is hope that the capable experts get it contained sooner than later, and not waste energy being scared about it.


The World Health Organization (WHO) Fact Sheet on Ebola Virus Disease:

Transmission

Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals. In Africa, infection has been documented through the handling of infected chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest.

Ebola then spreads in the community through human-to-human transmission, with infection resulting from direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and indirect contact with environments contaminated with such fluids. Burial ceremonies in which mourners have direct contact with the body of the deceased person can also play a role in the transmission of Ebola. Men who have recovered from the disease can still transmit the virus through their semen for up to 7 weeks after recovery from illness.

Health-care workers have frequently been infected while treating patients with suspected or confirmed EVD. This has occurred through close contact with patients when infection control precautions are not strictly practiced.

http://www.who.int/mediacentre/factsheets/fs103/en/

[morningfog]

27. Thanks for the clarification.

[LisaL]

28. It's spreading.

"A second case of Ebola has been recorded in Lagos. The Nigerian Health Minister said it was the doctor who treated US victim Patrick Sawyer."

http://www.itv.com/news/story/2014-08-04/doctor-becomes-second-ebola-case-in-lagos/

[mnhtnbb]

30. The second American--woman missionary--is expected to fly to the US tomorrow (Tuesday, 8/5)

http://www.vindy.com/news/2014/aug/04/woman-with-ebola-to-head-to-us-on-tuesda/?newswatch

[Hugabear]

33. It's a serious outbreak to be sure, but the media isn't helping with their scaremongering tactics

Last edited Mon Aug 4, 2014, 12:37 PM - Edit history (1)

I think we need to look at this from another perspective. When the media reports that several hundred people have died, we need to remember that these are also densely populated areas. Guinea's capital city Conakry, which has been hit pretty hard, has a population of several million people. If the Ebola virus were as easily spread as the flu, then we'd be looking at a truly horrific pandemic.

Fact of the matter is that the virus just doesn't spread that easily, it requires direct contact with the bodily fluids from an infected person. If someone is carrying the virus but not showing any symptoms, they're not going to be contagious. You can't catch the virus from simply being in close proximity, or touching something that they have touched.

[LisaL]

34. If it was so hard to get, how did the doctors get it?

Including the one in Nigeria, who treated Mr. Saywer, and was just diagnosed with it?
Especially considering doctors were using protective equipment, and yet still somehow managed to get it.
Two of the doctors died, the American doctor got some secret experimental treatment (which is presumably why he is alive) and now the one in Nigeria.

[Hugabear]

35. Because they're working in close proximity to bodily fluids

It's possible that they may have come into contact with the bodily fluids prior to using the protective equipment, or there may have been some sort of breach.

Simple logic should apply here. Conakry is a city of over a million people, with a very high population density.

As of July 2014, 91 cases of Ebola were confirmed in Conakry. Given the population density of Conakry, if Ebola was that easy to spread, then there should be MUCH higher numbers of infected people in just that one city alone.

[WinkyDink]

40. Because we are not being told the entire story, which is: THEY DON'T KNOW HOW. And victims are said

to be fleeing hospitals to die in the wilderness.

[Hugabear]

41. I think scientists do have a fairly good grasp on how the virus spreads

I don't think there's some sort of international conspiracy going on to hide the truth.

Will the virus spread? Absolutely, especially in areas as you mentioned where people aren't educated about the virus and they may lack the proper methods of dealing with the virus.

But fact of the matter is that we KNOW how the virus spreads. Again - if the Ebola virus were able to be spread through the air - then we would be seeing tens of thousands - or even hundreds of thousands - of cases, with a lot more deaths. Think about how easily the flu virus spreads, and how many people die each year from the flu.

If you read any article quoting actual medical scientists, while they are very concerned about the outbreak, they also say there's very little chance of this turning into a global pandemic.

[MrMickeysMom]

47. I agree… It's a matter of how it's transmitted...

The CDC describes it (my upthread post), so I think we have to understand the "universal precautions" taken to contain it.

[KamaAina]

38. Conakry is the capital of Guinea

So far as I know, Ghana (capital: Accra) does not have Ebola cases, nor did it get out of the Group of Death at the World Cup.

[Hugabear]

39. Thanks, I've edited to correct that

Not sure why I was thinking Ghana, but I've fixed it in my post.

[WinkyDink]

37. Patrick Sawyer's doctor just diagnosed with Ebola (What---Me Worry?):

http://www.dailymail.co.uk/news/article-2715745/Doctor-treated-U-S-businessman-died-Ebola-second-person-contract-virus-Nigeria.html
"A doctor has become the second confirmed case of Ebola in Nigeria after helping to treat a U.S. businessman who died from the disease, it emerged today.

Nigerian authorities said tests were also being carried out on three other people who treated Patrick Sawyer after they reported similar symptoms.

The second case of Ebola in Africa's most populous country is an alarming setback as officials across the region battle to stop the spread of a disease that has killed nearly 900 people."
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

THE NUMBER WENT UP BY 200 WITH NO NOTICE OR ANNOUNCEMENT WHATSOEVER.

[morningfog]

42. Once the news focused on the US doc, it ignored the toll.

[morningfog]

44. UPDATE from Nigeria: 2nd case confirmed, "hope to have 8" quarantined by Monday.

In Nigeria, Health Minister Onyebuchi Chukwu said Monday 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 from Liberia.

Test samples are pending for three other people who also treated Sawyer and now have shown symptoms of Ebola, he said. Authorities are trying to trace and quarantine others.

"Hopefully by the end of today we should have the results of their own test," Chukwu said.

The emergence of a second case raises serious concerns about the infection control practices in Nigeria, and also raises the specter that more cases could emerge. It can take up to 21 days after exposure to the virus for symptoms to appear. They include fever, sore throat, muscle pains and headaches. Often nausea, vomiting and diarrhea follow, along with severe internal and external bleeding in advanced stages of the disease.

* * *

Sawyer, who was traveling to Nigeria on business, became ill while aboard a flight and Nigerian authorities immediately took him into isolation upon arrival in Lagos. They did not quarantine his fellow passengers, and have insisted that the risk of additional cases was minimal.

Nigerian authorities said a total of 70 people are under surveillance and that they hoped to have eight people in quarantine by the end of Monday in an isolation ward in Lagos. The emergence there is particularly worrisome because Lagos is the largest city in Africa with some 21 million people.

http://www.usnews.com/news/world/articles/2014/08/04/nigeria-confirms-doctor-as-2nd-ebola-case

[morningfog]

49. 21 days from Aug. 4 (doctor's confirmed infection) is Aug. 25.

Hopefully no further spread will follow from this doctor's infection.

[morningfog]

45. Sierra Leone, Liberia deploy troops as Ebola toll hits 887 (3 new suspected cases in Nigeria)

Hundreds of troops deployed in Sierra Leone and Liberia on Monday to quarantine communities hit by the deadly Ebola virus, as the death toll from the worst-ever outbreak reached 887 and three new cases were reported in Nigeria.

With healthcare systems in the West Africa nations overrun by the epidemic, the African Development Bank and World Bank said they would immediately disburse $260 million to the three countries worst affected - Sierra Leone, Liberia and Guinea.

The World Health Organization, which warned last week of catastrophic consequences if the disease were not controlled, reported 61 new deaths in the two days to Aug. 1 as the disease continues to spread.

The outbreak began in February in the forests of Guinea. The toll there continues to rise, but the epicentre has since shifted to neighbouring Liberia and Sierra Leone.

In Nigeria, where U.S. citizen Patrick Sawyer became the first person to die of the virus after arriving from Liberia in late July, the WHO reported three new cases, two of them probable and one suspected.

http://in.reuters.com/article/2014/08/05/healh-ebola-africa-idINL6N0QA4M020140805

[morningfog]

46. Charting the spread:

[morningfog]

48. "can only be declared over after two successive incubation periods, or six weeks, have passed"

The outbreak can only be declared over after two successive incubation periods, or six weeks, have passed without incident. Yet when we could see such a period remains hard to pin down. “You can get lulled into thinking the epidemic is under control because the numbers will go down and then it’ll turn out that you missed [one infected person] and now it’s spreading to other people,” Fischer says. “I don’t think we are anywhere near the end” The NIAID's Fauci agrees. “I think it will go on for awhile,” he says.

http://www.scientificamerican.com/article/cross-border-ebola-outbreak-a-first-for-deadly-virus/?utm_content=buffer8eac6&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer

[morningfog]

50. Aug. 10 will be 21 days after Saywer's July 20 collapse.

As of Aug. 5, one new case has been confirmed in Nigeria by someone treating Sawyer.

[morningfog]

51. British Airways suspends flights to Liberia and Sierra Leone, citing Ebola concerns

British Airways announced Tuesday that it has temporarily suspended flights to and from Liberia and Sierra Leone, two of the West African nations afflicted with the Ebola outbreak.

The suspension will remain in place until the end of August, “due to the deteriorating public health situation in both countries,” the airline said in a statement. “The safety of our customers, crew and ground teams is always our top priority and we will keep the route under constant review in the coming weeks.”

http://www.washingtonpost.com/news/world/wp/2014/08/05/british-airways-suspends-flights-to-liberia-and-sierra-leone-citing-ebola-concerns/?Post+generic=%3Ftid%3Dsm_twitter_washingtonpost

[slipslidingaway]

52. Thanks and glad to hear, still no word on the Mount Sinai patient. n/t

[morningfog]

53. The hospital said it will take up to 48 hours for testing to be completed.

http://time.com/3080189/ebola-mt-sinai-new-york/

He arrived Monday, so we should hear the test results by tomorrow.

[slipslidingaway]

56. Thank you for the link and also for the thread ...

initially I had heard results by latest today.

[morningfog]

76. Mount Sinai Hospital: Patient In Isolation Does Not Have Ebola

The Mount Sinai Hospital patient who has been in isolation since Monday does not have the Ebola virus, hospital officials said Wednesday afternoon.

“We would like to report that the Centers for Disease Control and Prevention have determined that the patient kept in isolation since Monday, August 4, 2014 at The Mount Sinai Hospital has tested negative for Ebola Virus Disease (EVD),” the hospital said in a statement. “The patient is in stable condition, is improving, and remains in the care of our physicians and nurses.”

http://newyork.cbslocal.com/2014/08/06/mount-sinai-hospital-president-patient-in-good-spirits-ebola-test-results-could-come-wednesday/

[slipslidingaway]

77. Many thanks for the update :))) n/t

[Puzzledtraveller]

55. Thanks for the updates.

This is one of those things that people are prone to dismissing because we are so inoculated against the real harsh realities that this disease is responsible for in the parts of he world Ebola wreaks havoc. We see it as a fictional horror story when we think about it's possible spread here and scoff at the notion. The truth is it is a real horror story for the people and nations that experience it and borders and distance are a weak guarantee if you can call it that , that this horror story will remain mostly something we read about happening somewhere else.

[davidpdx]

54. Wow, thank you all for the information

I know some countries have reacted strongly to outbreaks of illnesses in the past. I live in South Korea and during the bird flu outbreak some foreigners were taken from the airport and essentially locked in a hospital. The thing the authorities didn't realize is the people had laptops and started blogging about it. Soon word got out and people saw the gross overreaction for what it was.

I'm headed back from the US to South Korea. While I'm not worried about getting sick, I am wondering if they are going to try to quarantine people.

[emsimon33]

59. Very helpful and well researched--thank you

[morningfog]

60. Nigeria confirms 5 new cases, second death

A Nigerian nurse has become the second person to die of the Ebola virus in Africa’s most populous nation, Health Minister Onyebuchi Chukwu said.

The nurse had helped treat Liberian government worker Patrick Sawyer, who fell ill from the virus after arriving on a flight to the commercial capital, Lagos. He was taken to a hospital in the city and died five days later on July 25.

Nigeria has five other confirmed cases of Ebola in Lagos, Chukwu said in a statement handed to reporters today in Abuja, the capital of Africa’s biggest economy.

http://www.bloomberg.com/news/2014-08-06/nigerian-nurse-dies-of-ebola-as-5-others-confirmed-with-disease.html

Assuming one of the five is the doctor who treated Sawyer that we knew about, it is not clear whether the other 4 were Sawyer contacts or not. Nor is it clear at this moment if they were already under observation.

[morningfog]

61. Spain sends plane to evacuate missionary with Ebola

Spain's government said Wednesday it will send an air force plane to Liberia to fly an elderly Spanish missionary infected with Ebola back home for treatment.

"This news lifts my spirits, it's great, I am very happy, it is worth fighting," the 75-year-old Roman Catholic priest, Miguel Pajares, told the online edition of daily Spanish newspaper ABC by telephone.

Pajares tested positive for Ebola at the Saint Joseph Hospital in Monrovia were he has worked for the past seven years, Spanish aid organisation Juan Ciudad ONG said Tuesday.

http://news.yahoo.com/spain-sends-plane-evacuate-missionary-ebola-113810956.html

[morningfog]

62. Saudi being tested for Ebola dies in hospital

A Saudi national, who fell ill after returning from Sierra Leone, died early Wednesday in his hospital isolation ward where he was being tested for the Ebola virus, said the Saudi Health Ministry.

The 40-year-old returned on Sunday from Sierra Leone, where there has been an Ebola outbreak, and was then hospitalized in Jiddah after showing symptoms of the viral hemorrhagic fever.

The patient’s samples are being tested in an international reference lab on the advice of the World Health Organization. He had already tested negative for dengue fever.

http://www.washingtonpost.com/world/middle_east/saudi-man-being-tested-for-ebola-dies-in-hospital/2014/08/06/177890d6-1d60-11e4-9b6c-12e30cbe86a3_story.html

[morningfog]

63. Nigeria details, good info here:

Nigerian health authorities acknowledged Tuesday that they did not immediately quarantine a sick airline passenger who later died of Ebola, announcing that eight health workers who had direct contact with him were now in isolation with symptoms of the disease.

* * *

Initially authorities told reporters that the risk of any exposure to others was minimal because Sawyer was whisked into isolation after arriving at the airport with symptoms of Ebola.

But Lagos state health commissioner Jide Idris said Tuesday that the nature of his disease "was not known" the first day, and only after further investigation did they suspect Ebola. Sawyer's sister had died in Liberia from the disease, which has no proven cure or treatment.

"They went back to the history and they were like 'Oh, this is Liberia,' and that's why he was put into isolation," he told reporters. "So even in that window period it was possible that some of these people got infected."

A doctor who cared for Sawyer has tested positive for the disease, and seven other health workers are now showing symptoms so have been placed in isolation. They are among 14 people who had "serious direct contact" with Sawyer, most of them at the hospital, Idris said. Authorities say they are also following the conditions of 56 other people who had "primary contact" with Sawyer — presumably less at risk than those in the first group.

http://www.usnews.com/news/world/articles/2014/08/05/nigeria-acknowledges-slow-response-in-ebola-case

[B2G]

64. New WHO numbers out

As of 4 August 2014, the cumulative number of cases attributed to EVD in the four countries stands at 1 711, including 932 deaths.

http://www.who.int/csr/don/2014_08_06_ebola/en/

[Zorra]

71. 107 reported new cases between Aug 1 and Aug 4. Hopefully the fewer avg. # reported cases per day

since the last report is a sign that the epidemic is being brought under control.

[B2G]

72. Doesn't look like it to me

[suffragette]

79. Hope that is the case. Still, with hospitals closing, people dying at homes and reports that people

are moving dead bodies to the streets rather than facing quarantines of their homes, I wonder how many new cases are not being identified.

http://www.nytimes.com/2014/08/08/world/africa/dont-touch-the-walls-ebola-fears-infect-hospital.html?

Some Ebola patients still die at the hospital, perhaps four per day, in the tentlike temporary isolation ward at the back of the muddy grounds. But just as many, if not more, are dying in the city and neighboring villages, greatly increasing the risk of spreading the disease and undermining international efforts to halt the epidemic.

“People don’t die here now,” said the deputy chief of the hospital’s burying team, Albert J. Mattia, exasperated after a long day of Ebola burials. “They are dying in the community, five, six a day.” Mr. Mattia was particularly disturbed that many of the bodies his team were putting in the ground had come from outside the hospital, thwarting attempts to isolate patients and prevent them from passing the disease to others.

~~~
Dead bodies have been appearing on the streets and in houses throughout Monrovia, with people staging roadblocks to ensure that health workers remove them. But with hospitals closed in the capital, it was unclear how many of the victims had died of Ebola, or from other causes. A health worker said his burial team, one of twelve, picked up seven bodies in Monrovia and surrounding areas on Thursday alone.
“Only two of the bodies were in houses, and the others were on the street,” the health worker said.



Compounding this is that people with other diseases are avoiding the hospitals.

http://www.bloomberg.com/news/2014-08-06/malaria-cases-mix-with-ebola-amid-slow-motion-disaster-.html#disqus_thread

It’s a widening challenge complicated by the fact that Ebola, malaria and cholera share common symptoms early on, including fever and vomiting, which can cause confusion among patients, said Cyprien Fabre, head of the West Africa office of the European Commission’s humanitarian aid department.

“We now have increased mortality for these other diseases” as well, Fabre said by telephone from Freetown, the country’s capital, after visiting Ebola treatment centers in Kenema and Kailahun near the eastern border. “This is a slow-motion disaster.”

The issue threatens to further undermine health and welfare in Sierra Leone, which has the world’s highest rate of child and maternal mortality, Fabre said.

[WorseBeforeBetter]

68. Thanks for this thread. (n/t)

[morningfog]

73. U.S. allows use of Ebola test overseas as crisis deepens

U.S. health regulators on Wednesday authorized the use of an Ebola diagnostic test developed by the Pentagon to help contain the world's worst outbreak of the deadly virus.

The move was one of a number of steps taken by the U.S. government this week to address the highly contagious disease that has killed more than 930 people in Africa and sickened hundreds more, including two Americans being treated in Atlanta.

The diagnostic test was authorized for use abroad on military personnel, aid workers and emergency responders in laboratories designated by the Department of Defense to respond to the Ebola outbreak, the U.S. Food and Drug Administration said.

The test, called DoD EZ1 Real-time RT-PCR Assay, is designed for use on individuals who have symptoms of Ebola infection, who are at risk for exposure or who may have been exposed. It can take as long as 21 days for symptoms to appear after infections.

http://www.reuters.com/article/2014/08/06/us-health-ebola-testing-idUSKBN0G61YK20140806

[morningfog]

78. Liberia, Sierra Leone Impose Ebola Quarantines (of entire districts and counties)

Liberia and Sierra Leone trucked in soldiers to quarantine whole sections of their respective nations on Thursday in response to the collapse of hospitals and clinics in the most Ebola-infected zones.

In Liberia, soldiers and police at checkpoints began halting all road travel entering and leaving eight of the nation's 15 counties, said Information Minister Lewis Brown.

President Ellen Johnson Sirleaf had declared a state of emergency late Wednesday for the coming 90 days, saying her government "will institute extraordinary measures, including, if need be, the suspensions of certain rights and privileges."

A similar effort was under way in Sierra Leone on Thursday, where soldiers in riot gear blocked the roads leading to the country's two most infected districts, said Abdulai Baratay, a government spokesman. Only first responders and officials on public-health-related trips were exempt from the restrictions, he added.

"The broad plan is to keep unaffected areas unaffected," said Mr. Brown. "We cannot do that as long as people are moving."

http://online.wsj.com/news/articles/SB20001424052702304070304580077651039836696?mg=reno64-wsj&url=http%3A%2F%2Fonline.wsj.com%2Farticle%2FSB20001424052702304070304580077651039836696.html