Guinea - Ebola: Thread documenting initial outbreak - March 2014 +

[Pathfinder]

Re: Guinea - A hemorrhagic disease killed 61 people including 8 health workers in Forest Guinea - Ebola lab confirmed in 13 cases

Translation Google

Health : the remains of a dead trader Ebola infects his relatives Dinguiraye

Written by Amadou Tour?.

The body of a dead trader of Ebola hemorrhagic fever in Conakry contaminated " his family " who provided transport into a small village located more Dinguiraye 545 km from the capital, do we learned health authorities.

" In Conakry, the first case of death due beyond Ebola hemorrhagic fever is a citizen , a merchant by trade, was received on March 17 at the hospital Kip? ( suburb of Conakry) and died on March 18 . His body was taken in a small village Dinguiraye for burial purposes " explains Guin?eTime there a few minutes, Dr. Sakoba Keita, Chief Prevention cell disease Guinean Ministry of public Health.

Doing " the point of the situation " on March 27 in a pool of local and foreign journalists , Dr. Keita continues that " persons accompanying the body, after a week, have developed similar symptoms " in case of hemorrhagic fever described since January by the health authorities .

Voluntarily , these citizens were "introduced" to Donka Hospital and " levies" were made. Unfortunately, "the results of these samples were positive . "

The doctor in charge of the unit to prevent stress today , "All these cases are confined to the level of a family." To stop this epidemic , medical teams and Dinguiraye Dabola are in this village Dinguiraye to the status of all those who attended the funeral in question and their contacts.

The Ebola epidemic raging in Guinea since January. Of 103 cases, there were 66 deaths until today . Gu?ck?dou , south of Guinea is the most affected with 47 deaths out of 69 cases detected .

In terms of organized response with the help of partners, Dr Sakoba Keita refers to " the systematic search for all contacts of different patients " above cases were positive tests beyond hemorrhagic fever .

Two accredited laboratories WHO are currently in Guinea . These teams from Lyon ( France ) and the Institut Pasteur in Dakar will " check all suspected cases ." For now, said Dr. Keita, 41 diagnosed cases , 15 are considered positive for Ebola .

http://www.guineetime.com/index.php/2-a-la-une/2384-sante-la-depouille-d-un-commrcant-mort-d-ebola-contamine-ses-proches-a-dinguiraye.html

[Pathfinder]

Re: Guinea - A hemorrhagic disease killed 61 people including 8 health workers in Forest Guinea - Ebola lab confirmed in 13 cases

UPDATE 2-

Deadly Ebola virus spreads from rural Guinea to capital

Fri Mar 28, 2014 2:00am IST

...
Guinean Health Minister Remy Lamah told Reuters that four cases of the haemorrhagic fever - one of the most lethal infectious diseases known to man - had been confirmed in the capital and the victims had been placed in quarantine.
...
Lamah said the virus appeared to have been transmitted by an old man who showed signs of haemorrhagic fever after visiting Dinguiraye in central Guinea, more than 150 km (90 miles) from the previously identified outbreaks of Ebola.

Four of the man's brothers started to show the same symptoms after attending his funeral in the central town of Dabola, 200 km (125 miles) from Conakry, and were tested for Ebola on their return to the coastal capital.

"The four tested positive," Lamah told Reuters. "They have been placed in an isolation ward in Donka hospital."

The old man's family has also been quarantined, the minister said.

Medical sources said two staff at the Kipe University Hospital in Conakry, where the victims had initially been treated, had also developed signs of the disease.
...

http://in.reuters.com/article/2014/03/27/guinea-ebola-idINL5N0MO51020140327

[Pathfinder]

Re: Guinea - A hemorrhagic disease killed 61 people including 8 health workers in Forest Guinea - Ebola lab confirmed in 13 cases

Translation Google

Thurs, March 27, 2014 , 8:50 p.m.
Posted By Amara Camara

Four cases of Ebola reported in Conakry : the details of the Minister of Health

Four cases of haemorrhagic fever have recently been detected in Conakry. Cases which are now said Minister of Health quarantined treatment center CHU Donka . To understand this latest evolution of the Ebola outbreak , Guin?enews joined Thursday the Minister of Health , Colonel R?my Lamah here are the explanations :

"There are members of the same family who have lost their big brother since March 18 . You know our customs , people like to bring the body to the village. Thus the family had designated four members to convey the body for burial in a small village Dinguiraye . So they sent it the body for burial. After their return , there is a conveyor that has developed the same signs as symptoms of hemorrhagic fever. So he went to Conakry for a consultation. Arrived there, the interrogation , he said his signs , immediately the doctors reported a case of hemorrhagic fever . Because we have fixed laboratory, they took sample and they found it was positive. The others , they were with family. Fortunately, they were not out and they were not in contact with anyone. Thus doctors went to seek them to lead directly to the hospital . There, the doctors took sample and after tests, three were positive . Immediately, they took to file . At the moment I speak, they are already isolated at the center there to be follow for 21 days. However , they have not yet developed the disease . And physicians who have received them in consultation, were also placed under observation at the hospital Kip? in a cabin to follow for 21 days. Then a medical team visited Gbessia Port in the family home of 4 patients tested positive and the doctors performed the disinfection of their housing and population. Another team should move this Thursday night to go to the village where the funeral took place in Dinguiraye . The information is already given , no person shall move, the villagers are in place until the arrival of the mission. These are not cases scattered everywhere , this is one family yet. "

Interview by Amara Camara Moro

http://guineenews.org/2014/03/quatre-cas-de-fievre-ebola-signales-a-conakry-les-precisions-du-ministre-de-la-sante/

[Emily]

Re: Guinea - A hemorrhagic disease killed 61 people including 8 health workers in Forest Guinea - Ebola lab confirmed in 13 cases

http://www.ch-aviation.com/portal/ne...virus-outbreak
Gambia Bird suspends Conakry launch over Ebola virus outbreak

[Ronan Kelly]

Re: Guinea - A hemorrhagic disease killed 61 people including 8 health workers in Forest Guinea - Ebola lab confirmed in 13 cases

Latest Government press release here; http://www.lexpressguinee.com/fichie...4154&langue=fr

[Ronan Kelly]

Re: Guinea - A hemorrhagic disease killed 61 people including 8 health workers in Forest Guinea - Ebola lab confirmed in 13 cases

h/t @Crof for finding a copyable version of this

Ebola - balance: Government invites the public to refrain from consuming any game (Official)

Category: Society
Published Thursday, March 27, 2014 9:54 p.m.
Written by Government
As part of the ongoing information on the evolution of populations of hemorrhagic fever and its management in our country, the situation is as follows date March 27, 2014.

1. Health Services supported by Development Partners Health Sector reported a total of 103 suspected cases of hemorrhagic fever combined with 66 deaths;
2. Contamination cases and deaths recorded are as follows:
1) Gueck?dou: 69 cases including 47 deaths
2) Macenta: 21 cases including 12 deaths
3) Kissidougou: 7 cases with 5 deaths
4) Conakry: 5 cases including 1 death of a person back from the trip. 4 other cases of contamination concern parents of the victim income of the deceased funeral which took place in a town near Dabola.
3. The suspected case of Kankan was negative examinations EBOLA
4. 3 new cases of deaths occurred Gueck?dou (02) and Conakry (1).
An investigation is underway in Conakry for additional information. Appropriate arrangements were immediately taken to identify cases, particularly in people who have been in contact with the deceased in Conakry and in the interior of the country.
Among the sources of contamination for this disease include consumption of bushmeat. Until this type of contamination is confirmed, the government invites the public to refrain from consuming any game.
The Government remains focused with all its partners in the health sector to break the chain of infection. In this important part human and material resources are mobilized including specialists from across to cover affected areas.
A mobile laboratory available (experts mobilized by the partners) is en route to Gueck?dou. This laboratory will be on-site testing for forest areas and also process samples from suspected cases in neighboring countries (Liberia and Sierra Leone).
Significant amounts of chlorine solution are en route to the affected areas.
Such an operation Major has a chance to succeed with the support of the people. To do this, we invite them to follow the instructions given by the health services for the management of suspected cases and deaths as well as for contact tracing. Among the activities are:
 Installation Centres isolation of patients in the Affected Prefectures;
 Routine disinfection of homes of suspected cases and deaths;
 The action response plan available;
 The personal protective equipment (MPI) and kits support in affected areas
 Strengthening epidemiological surveillance,
awareness  door to door distribution of hygiene in the villages or neighborhoods affected kits;
 The deployment of intervention teams WHO and MSF (epidemiologists, prevention and control of viral haemorrhagic fevers, logisticians, data managers, communication specialists and anthropologists) to join the Guinean health authorities for efficient management of the epidemic
 The last provision of a mobile laboratory
These instructions will be technical papers by the Ministry of Health and the Technical Committee involving the health sector partners.
The Government thanks the international community for its mobilization for the rapid control of the disease. Conakry March 27, 2014 The Government

http://www.lejourguinee.com/index.php/fr/societe/3120-ebola-bilan-le-gouvernement-invite-la-population-a-s-abstenir-de-consommer-tout-gibier-officiel

[Emily]

Re: Guinea - Hemorrhagic fever killed 66 people with 103 suspected cases - Ebola lab confirmed in 15 cases

This is from Trey's post#61:

A media report also stated that Sierra Leone?s Health Ministry said it was investigating two suspected cases of ebola.
The World Health Organisation said the infection had emerged through the handling of infected chimpanzees, gorillas, fruit bats, monkeys, forest antelopes and porcupines.
These were those found dead or ill in the rain forest.

(Emphasis added by me.)

I was wondering if that type of diversity in animal deaths had happened in previous ebola outbreaks and found this:

http://ucsdnews.ucsd.edu/archive/new...nce/sebola.asp

Pattern of Human Ebola Outbreaks
Linked to Wildlife and Climate

November 14, 2006

By Sherry Seethaler

A visiting biologist at the University of California, San Diego and her colleagues in Africa and Britain have shown that there are close linkages between outbreaks of Ebola hemorrhagic fever in human and wildlife populations, and that climate may influence the spread of the disease.

...

Despite the low probability of finding dead animals in the humid forests that cover most of the region, due to the scavenging by animals and insects and rapid decomposition, Lahm received and verified reports of 397 dead animals. The carcasses, which were found at 35 different sites in Gabon and RoC, included gorillas, chimpanzees, mandrills, bush pigs, porcupines and four species of antelope. Tests on 14 samples from the decomposed carcasses did not detect the Ebola virus, but at 12 sites, observers also saw sick or dying animals with symptoms consistent with Ebola infection. In addition, 16 reported wildlife mortality incidents coincided with known Ebola epidemics.

?The transmission of Ebola within animal populations is much more widespread than previously believed,? explained Lahm. ?Ebola appears to spread both within species and between different species of animals.?
...

However, according to the findings, the spread of Ebola also depends on climate factors. Illness and deaths among animals were most prevalent during periods of prolonged drought-like conditions in the rainforest, which indicates that severe environmental stress may facilitate disease transmission. ...

I can't find reports of a particularly bad drought currently in SE Guinea, but this is towards the end of the of their dry season. The big picture as seen in 2009 was that west Central Africa has had lessening rainfall over the past 50 yrs:

http://onlinelibrary.wiley.com/doi/1...11010/abstract

But this data doesn't show the outbreak area as being particularly stressed by drought this year:

Famine Early Warning Systems Network


Maybe there are other environmental stresses on wildlife there, (deforestation or mining pollution of water sources?).

[Emily]

Re: Guinea - Hemorrhagic fever killed 66 people with 103 suspected cases - Ebola lab confirmed in 15 cases

http://allafrica.com/stories/201403280323.html

Guinea: Development of Antibodies Rushed to Treat Ebola Outbreak in Guinea
By Jessica Berman, 27 March 2014
VOA News

Amid a deadly outbreak of Ebola virus in the western African country of Guinea, an international team of researchers has stepped up production of experimental antibodies that scientists say have the potential to cure people infected with the virus, which has a 90 percent fatality rate.

Twenty laboratories and research sites around the world, including in Canada, Japan, Israel, Uganda, and the United States are working simultaneously to develop manmade antibodies against Ebola virus. Antibodies are frontline immune system proteins the body makes naturally to fight illness when first exposed to an infection...

[Giuseppe]

Re: Guinea - Hemorrhagic fever killed 66 people with 103 suspected cases - Ebola lab confirmed in 15 cases

It would be the first time a specific treatment would be devised during a full-blown outbreak of Ebola. I think the risks would not be irrelevant.

It would be better to enforce a very strict quarantine and isolation centres for the affected people, the only known effective way to stop this virus from causing large damages in the stricken communities.

[Giuseppe]

Re: Guinea - Hemorrhagic fever killed 66 people with 103 suspected cases - Ebola lab confirmed in 15 cases

[Source: European Centre for Disease Prevention and Control (ECDC), full page: (LINK).]


Epidemiological update: Outbreak of Ebola haemorrhagic fever in Guinea

28 Mar 2014


Background

An outbreak of Ebola haemorrhagic fever in Guinea, West Africa, with onset in early February 2014 is rapidly evolving.

The first cases were reported from the Forested Region of south-eastern Guinea.

ECDC published a Rapid Risk Assessment of the outbreak on 23 March at which time 80 cases including 59 deaths (CFR: 74%) had been reported.

To date, fifteen cases have tested positive for Ebola virus by PCR.

Gene sequencing has demonstrated 98% homology with the Zaire Ebola virus last reported from an outbreak in 2009 in Kasai-Occidental Province of the Democratic Republic of Congo. The case fatality ratios in previously reported outbreaks caused by the Zaire Ebola virus have been high.


Update

On 27 March, fifteen new cases were reported to WHO, of which five were reported from Conakry, eight from Gu?ck?dou district and two from Macenta district.

Of the five cases reported from Conakry, four have been laboratory-confirmed and are isolated in a hospital while the fifth fatal case could not be tested. Investigations are underway to identify the source and route of transmission of these patients, record their travel histories before arrival in Conakry and determine their period of infectivity for the purpose of contact tracing.

The five cases in Conakry are unlikely to have been infected in the capital.

According to a media report quoting the Minister of Health in Guinea, the primary case in the Conakry cluster is an elderly man who developed haemorrhagic fever after visiting Dinguiraye in central Guinea and subsequently died. Four of the man?s brothers who attended his funeral in the central town of Dabola later developed symptoms and tested positive for Ebola on their return to Conakry.

The four patients have been placed in an isolation ward in Donka hospital. The elderly man's family has been quarantined.

In summary, as of 27 March, 103 cases (15 laboratory-confirmed and 88 suspected) including 66 deaths (CFR: 64%) have been reported from three districts in south-eastern Guinea, Gu?ck?dou, Macenta and Kissidougou, and from the capital, Conakry.

Four of the fatal cases were healthcare workers. All age groups have been affected but most of the cases are adults aged 15-59 years.

As of 27 March, Liberia has reported eight suspected cases, including six deaths, and Sierra Leone has reported six suspected cases, including five deaths. All cases reported from Sierra Leone and Liberia had travel history to the affected districts in Guinea.

Investigations and response activities are ongoing in Guinea, and isolation facilities have been set up in Gu?ck?dou district.

WHO and the Global Outbreak Alert and Response Network (GOARN) have deployed experts to support the operational response. Supplies and logistics required for supportive management of patients and all aspects of outbreak control are being mobilised.


Read More

• WHO/AFRO outbreak news
• ECDC Ebola health topic page
• ECDC Ebola and Marburg fact sheet
• ECDC Rapid Risk Assessment, 23 March 2014 (PDF)

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[Giuseppe]

Re: Guinea - Hemorrhagic fever killed 66 people with 103 suspected cases - Ebola lab confirmed in 15 cases

[Source: Yahoo!, full page: (LINK).]


8 cases of Ebola turn up in Guinea's capital

CONAKRY, Guinea (AP) ? Health officials in the West African nation of Guinea say they're now treating eight cases of Ebola in the capital.

(?)


-
------

[Pathfinder]

Re: Guinea - Hemorrhagic fever killed 66 people with 103 suspected cases - Ebola lab confirmed in 15 cases

Translation Google

Ebola fever in Guinea : Still new cases reported in Conakry and the interior !

Category: Society
Published Friday, March 28, 2014 8:08 p.m.
Written by Barry Diao

The results of viral haemorrhagic fever gets heavier overnight in Guinea. The numbers of suspected cases increased in Conakry and in the interior of the country. Dr Sakoba Keita Division prevention Ministry of Health , during a press briefing busy Friday evening , March 28 , said

" From January to now , our health services have identified 112 cases of viral haemorrhagic fever with seventy deaths . These cases are distributed among a number of prefectures. The most affected province is Gu?k?dou today recognizes 73 cases with 51 deaths , followed by Macenta : 22 cases and 12 deaths , Kissidougou : 7 cases and 5 deaths , the Dabola : 2 cases and 2 deaths and Conakry eight cases and zero . " And to clarify : "Unlike our previous releases, which had reported five cases in Conakry with death, we had preliminary information from the fact-finding mission that visited the family of the former died on March 18 .

It was a Guinean citizen about 45 years , resident in Dabola merchant who had previously received a commercial came Gu?ck?dou and died of fever, diarrhea and vomiting. Thereafter, the citizen has similar symptoms and radio messages, he realized that he is suspicious of this disease. He was evacuated by his family at the hospital Kip? . He arrived on March 17 and died the next day. The family decided to bring his body back to his village to Watagalah , 3 km from the sub-prefecture in the prefecture of Dialakoro Dinguiraye . Funeral ceremonies ended , the return of the delegation, we are left with about six family members of the deceased who were positive ( biological tests were made yesterday) of Ebola haemorrhagic fever. In addition , we have two health workers who received deceased patient hospital Kip? , which now have a positive outcome. "

Given that the medical staff is not spared by the disease , new measures have been taken: "We have convened an emergency meeting at all health facilities in Conakry so that we review the conditions of hygiene compliance individual and collective. I recall that this disease is transmitted mainly through dirty hands , that is to say , through patient secretions : sweat , blood , urine and even including sperm. Certainly , our medical colleagues have had contact with the sweat of the patient and were contaminated , hence the need to educate all health personnel to observe the rules of hygiene ...

We are in the process of identifying all persons who had contact with the different cases in order to isolate them until the expiration of the periods of twenty-one days of incubation and all those who will have symptoms of disease, going to take to know their status . Starting today , we will set up committees in all municipal health directorates for all these contacts are then followed by specific individuals. Those attending will get sick proper care and others will be released , "said the head of the Prevention Division .

Diao Barry

http://www.lejourguinee.com/index.php/fr/societe/3122-fievre-ebola-en-guinee-encore-des-nouveaux-cas-signales-a-conakry-et-a-l-interieur-du-pays

[Treyfish]

Re: Guinea - Hemorrhagic fever killed 66 people with 103 suspected cases - Ebola lab confirmed in 15 cases

SITREP #1 Ebola Haemorrhagic Fever, Guinea, 28 March 2014




Date of issue 28 March 2014
1. Summary of overall situation to date
Cases of an unknown disease presenting with an acute febrile illness characterised by diarrhoea, vomiting and bleeding in some individuals, were first reported from Guekedou district, Guinea, east Africa, in February 2014, presumed to be a viral haemorrhagic fever or other severe gastrointestinal disease. On 21 March, WHO was officially notified that the rapidly evolving outbreak was caused by Ebola Haemorrhagic Fever (EHF) in forested areas south eastern Guinea. This is the first reported outbreak of EHF in Guinea. The outbreak investigation subsequently retrospectively identified earlier suspected cases that fell ill and died in December 2013. The outbreak is now confirmed to be caused by a strain of ebolavirus with very close homology (98%) to the Zaire ebolavirus.
A small number of suspected cases and deaths have also been reported from Sierra Leone and Liberia in individuals who had travelled to Guinea. As of today, no locally acquired cases in Sierra Leone or Liberia have been reported to WHO. Investigations are ongoing and laboratory results pending.
On 25 March, the WHO Global Emergency Management Team graded the outbreak as a Level 2 emergency and has mobilised international resources to support the response. Accordingly, all 3 levels of WHO have activated their Strategic Health Operations Centres (Emergency Operations Centres).
On 27 March, WHO was informed of 4 laboratory confirmed cases and one suspected case who died without laboratory confirmation in the capital, Conakry.
As of 28 March 2014, 103 suspected and confirmed cases, including 66 deaths, (CFR 64%) have been reported from Guinea affecting mainly 3 districts (Guekedou, Macenta and Kissidougou). Four health care workers are among the deceased.
To date, 37 clinical samples have been tested by PCR of which 15 are positive for ebolavirus.
2. Actions to date
Coordination

• The AFRO Regional Director has informed all WHO Country Offices in the African Region of the strategy to be taken at country level in response to the Ebola outbreak.
• Daily conferencing is occurring among the MoH/WCO of Guinea, Sierra Leone, Liberia, IST West Africa, WHO HQ and AFRO for risk assessment and operational planning and review.
• The Global Outbreak Alert and Response Network (GOARN) Operational Support Team issued an alert to GOARN partners on 22 March and subsequent request for assistance to mobilise additional international expertise in clinical case management, surveillance and epidemiology, data management, infection prevention and control, outbreak logistics, social mobilisation, risk communications and medical anthropology among key disciplines to support response efforts.
• Cross-border collaboration and cooperation are being actively promoted among the affected countries, particularly at major transport corridors.
• Response partners in the field include:
  • M?decins Sans Fronti?res, Switzerland (MSF-CH) has established isolation facilities in Guekedou district and is planning a facility in Macenta.
  • International reference laboratory support is being coordinated through Emerging and Dangerous Pathogens Laboratory Network (EDPLN). EDPLN labs are working with Guinean VHF Laboratory in Donka and Kenema Lassa fever laboratory in Sierra Leone to build capacity in filovirus diagnostics. The following laboratories are currently providing support: Institut Pasteur (IP) Dakar, Senegal; the European Union Mobile Laboratory (EMLab) team (comprising the Centre International de Recherche en Infectiologie (CIRI), France; the Bernhard-Nocht Institute of Tropical Medicine Hamburg, Germany; the National Institute for Infectious Diseases, Rome, Italy); and the Centre International de Recherche en Infectiologie (CIRI), Lyon, France.

Technical cooperation ? Outbreak response

• Affected countries have activated their emergency management committees, prepared/adapted emergency management plans and are carrying out needs assessments for human, financial and material resources.
• Enhanced surveillance activities, including distributing case definitions for EHF and sensitising health care workers to report suspected cases immediately.
• Case and contact tracing efforts are being implemented through Rapid Response Teams.
• Harmonisation of data collection is being encouraged for the generation of the key epidemiological parameters.

Information and Communications

• Fact sheets on EHF have been developed and distributed.
• IEC materials adapted/developed and multimedia approaches are being used to raise public awareness and support community mobilisation efforts.
• Key technical areas for the response to viral haemorrhagic fevers include: case management, surveillance and epidemiology, infection prevention control and safe burials, prevention through risk and behaviour change communications and response logistics. Applied research needs include investigation of animal reservoirs of ebolavirus.
• The international community is informed through the Disease Outbreak News posted on the WHO HQ and the AFRO website as well as through the Event Information Site under the International Health Regulations.

Finance and administration

• Seed funds have been provided to Guinea, Sierra Leone and Liberia to initiate outbreak investigation and response activities.
• Response plans, including identifying HR needs into the future, have been submitted by the affected countries.
• A Flash Appeal has been submitted for 2M USD.
• Funding proposals have been submitted to the African Public Health Emergency Fund (APHEF) and to ECHO.
• Other financial resource mobilisation is ongoing.

Human resource management

• WHO AFRO and HQ have deployed 19 experts in case management, epidemiology, infection prevention and control (IPC), outbreak logistics and medical anthropology to Guinea in the first instance. A rotation plan is being developed for the coming weeks.
• See also GOARN Request for Assistance above.

Logistics and Supplies

• Supplies are being prepositioned in high risk areas. Personal protective equipment (PPE) and other viral haemorrhagic fever response materials prepositioned in Dubai and Ouagadougou have been shipped to Guinea. 3,000 PPE have already reached Guinea. Additional PPEs and materials should reach the neighbouring countries within 3-4 days.
• VHF prevention & control guidelines and IEC materials have been sent and disseminatedhttp://www.afro.who.int/en/clusters-...arch-2014.html

[Treyfish]

Re: Guinea - Hemorrhagic fever killed 66 people with 103 suspected cases - Ebola lab confirmed in 15 cases

SITREP #1 Ebola Haemorrhagic Fever, Guinea, 28 March 2014




Date of issue 28 March 2014
1. Summary of overall situation to date
Cases of an unknown disease presenting with an acute febrile illness characterised by diarrhoea, vomiting and bleeding in some individuals, were first reported from Guekedou district, Guinea, east Africa, in February 2014, presumed to be a viral haemorrhagic fever or other severe gastrointestinal disease. On 21 March, WHO was officially notified that the rapidly evolving outbreak was caused by Ebola Haemorrhagic Fever (EHF) in forested areas south eastern Guinea. This is the first reported outbreak of EHF in Guinea. The outbreak investigation subsequently retrospectively identified earlier suspected cases that fell ill and died in December 2013. The outbreak is now confirmed to be caused by a strain of ebolavirus with very close homology (98%) to the Zaire ebolavirus.
A small number of suspected cases and deaths have also been reported from Sierra Leone and Liberia in individuals who had travelled to Guinea. As of today, no locally acquired cases in Sierra Leone or Liberia have been reported to WHO. Investigations are ongoing and laboratory results pending.
On 25 March, the WHO Global Emergency Management Team graded the outbreak as a Level 2 emergency and has mobilised international resources to support the response. Accordingly, all 3 levels of WHO have activated their Strategic Health Operations Centres (Emergency Operations Centres).
On 27 March, WHO was informed of 4 laboratory confirmed cases and one suspected case who died without laboratory confirmation in the capital, Conakry.
As of 28 March 2014, 103 suspected and confirmed cases, including 66 deaths, (CFR 64%) have been reported from Guinea affecting mainly 3 districts (Guekedou, Macenta and Kissidougou). Four health care workers are among the deceased.
To date, 37 clinical samples have been tested by PCR of which 15 are positive for ebolavirus.
2. Actions to date
Coordination

• The AFRO Regional Director has informed all WHO Country Offices in the African Region of the strategy to be taken at country level in response to the Ebola outbreak.
• Daily conferencing is occurring among the MoH/WCO of Guinea, Sierra Leone, Liberia, IST West Africa, WHO HQ and AFRO for risk assessment and operational planning and review.
• The Global Outbreak Alert and Response Network (GOARN) Operational Support Team issued an alert to GOARN partners on 22 March and subsequent request for assistance to mobilise additional international expertise in clinical case management, surveillance and epidemiology, data management, infection prevention and control, outbreak logistics, social mobilisation, risk communications and medical anthropology among key disciplines to support response efforts.
• Cross-border collaboration and cooperation are being actively promoted among the affected countries, particularly at major transport corridors.
• Response partners in the field include:
  • M?decins Sans Fronti?res, Switzerland (MSF-CH) has established isolation facilities in Guekedou district and is planning a facility in Macenta.
  • International reference laboratory support is being coordinated through Emerging and Dangerous Pathogens Laboratory Network (EDPLN). EDPLN labs are working with Guinean VHF Laboratory in Donka and Kenema Lassa fever laboratory in Sierra Leone to build capacity in filovirus diagnostics. The following laboratories are currently providing support: Institut Pasteur (IP) Dakar, Senegal; the European Union Mobile Laboratory (EMLab) team (comprising the Centre International de Recherche en Infectiologie (CIRI), France; the Bernhard-Nocht Institute of Tropical Medicine Hamburg, Germany; the National Institute for Infectious Diseases, Rome, Italy); and the Centre International de Recherche en Infectiologie (CIRI), Lyon, France.

Technical cooperation ? Outbreak response

• Affected countries have activated their emergency management committees, prepared/adapted emergency management plans and are carrying out needs assessments for human, financial and material resources.
• Enhanced surveillance activities, including distributing case definitions for EHF and sensitising health care workers to report suspected cases immediately.
• Case and contact tracing efforts are being implemented through Rapid Response Teams.
• Harmonisation of data collection is being encouraged for the generation of the key epidemiological parameters.

Information and Communications

• Fact sheets on EHF have been developed and distributed.
• IEC materials adapted/developed and multimedia approaches are being used to raise public awareness and support community mobilisation efforts.
• Key technical areas for the response to viral haemorrhagic fevers include: case management, surveillance and epidemiology, infection prevention control and safe burials, prevention through risk and behaviour change communications and response logistics. Applied research needs include investigation of animal reservoirs of ebolavirus.
• The international community is informed through the Disease Outbreak News posted on the WHO HQ and the AFRO website as well as through the Event Information Site under the International Health Regulations.

Finance and administration

• Seed funds have been provided to Guinea, Sierra Leone and Liberia to initiate outbreak investigation and response activities.
• Response plans, including identifying HR needs into the future, have been submitted by the affected countries.
• A Flash Appeal has been submitted for 2M USD.
• Funding proposals have been submitted to the African Public Health Emergency Fund (APHEF) and to ECHO.
• Other financial resource mobilisation is ongoing.

Human resource management

• WHO AFRO and HQ have deployed 19 experts in case management, epidemiology, infection prevention and control (IPC), outbreak logistics and medical anthropology to Guinea in the first instance. A rotation plan is being developed for the coming weeks.
• See also GOARN Request for Assistance above.

Logistics and Supplies

• Supplies are being prepositioned in high risk areas. Personal protective equipment (PPE) and other viral haemorrhagic fever response materials prepositioned in Dubai and Ouagadougou have been shipped to Guinea. 3,000 PPE have already reached Guinea. Additional PPEs and materials should reach the neighbouring countries within 3-4 days.
• VHF prevention & control guidelines and IEC materials have been sent and disseminatedhttp://www.afro.who.int/en/clusters-...arch-2014.html

[Treyfish]

Re: Guinea - Hemorrhagic fever killed 66 people with 103 suspected cases - Ebola lab confirmed in 15 cases

UN agency urges vigilance amid Ebola outbreak in Guinea, Sierra Leone and Liberia

A nurse comforts a patient who has been diagnosed to have the Ebola virus. Photo: WHO/Chris Black


Print


28 March 2014 ? With a total of 103 suspected and confirmed cases of Ebola in Guinea, including 66 deaths, the outbreak must be watched very carefully, a spokesperson for the United Nations health agency said today, noting that there is no treatment or cure for the frequently fatal disease.
?A lot of those cases still are only suspect cases,? Gregory Hartl of the World Health Organization (WHO) told reporters in Geneva. ?Local health authorities will report any number of syndromic cases that resemble Ebola but turn out not to be. So we don?t expect all of these cases to end up confirmed in the end.
?However, on the other hand, there are probably other cases out there which we don?t know of yet. So this is an extremely fluid situation.?
Both Sierra Leone and Liberia have reported suspected cases and deaths consistent with Ebola to the UN health agency among people who had travelled to Guinea before the onset of symptoms. Mr. Hartl said the cases in Sierra Leone and Liberia that are known to WHO have an epidemiological link with Guinea. As of now, the agency does not recommend that any travel or trade restrictions be applied to any of the three countries.
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?It?s not a disease which normally causes a large number of cases,? said Mr. Hartl. ?It?s a disease which is very traumatic. It?s a disease which kills large percentages of the people it infects? there?s no treatment, there?s no medicine, there?s no vaccine. So you are very much at the whim of the disease and you can only just hope that your body is strong enough for its natural defences to fight off the disease.
?We need to watch this extremely carefully because there is no treatment, there is no cure, and the course of the disease is, more often than not, fatal.?http://www.un.org/apps/news/story.as...r=disease&Cr1=



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