Archive for the ‘Ebola’ Category
** WHO announces the end of the Ebola public health emergency of international concern (PHEIC)
Wednesday, March 30th, 2016Statement on the 9th meeting of the IHR Emergency Committee regarding the Ebola outbreak in West Africa
The 9th meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (2005) (IHR) regarding the Ebola virus disease (EVD) outbreak in West Africa took place by teleconference on Tuesday, 29 March 2016 from 12:30 until 15:15 hr.
The Committee was requested to provide the Director-General with views and perspectives as to whether the event continues to constitute a Public Health Emergency of International Concern (PHEIC) and whether the current Temporary Recommendations should be extended, rescinded or revised.
Representatives of Guinea, Liberia and Sierra Leone presented the epidemiological situation, ongoing work to prevent Ebola re-emergence, and capacity to detect and respond rapidly to any new clusters of cases in each country.
The Committee noted that since its last meeting all three countries have met the criteria for confirming interruption of their original chains of Ebola virus transmission. Specifically, all three countries have now completed the 42 day observation period and additional 90 day enhanced surveillance period since their last case that was linked to the original chain of transmission twice tested negative. Guinea achieved this milestone on 27 March 2016.
The Committee observed that, as expected, new clusters of Ebola cases continue to occur due to reintroductions of virus as it is cleared from the survivor population, though at decreasing frequency. Twelve such clusters have been detected to date, the most recent of which was reported on 17 March 2016 in Guinea and is ongoing. The Committee was impressed that to date all of these clusters have been detected and responded to rapidly, limiting transmission to at most two generations of cases in the 11 clusters which have now been stopped.
The Committee provided its view that Ebola transmission in West Africa no longer constitutes an extraordinary event, that the risk of international spread is now low, and that countries currently have the capacity to respond rapidly to new virus emergences. Accordingly, in the Committee’s view the Ebola situation in West Africa no longer constitutes a Public Health Emergency of International Concern and the Temporary Recommendations adopted in response should now be terminated. The Committee emphasized that there should be no restrictions on travel and trade with Guinea, Liberia and Sierra Leone, and that any such measures should be lifted immediately.
As in other areas of sub-Saharan Africa where Ebola virus is present in the ecosystem, and recognizing that new clusters due to re-emergence may occur in the coming months, the Committee reinforced that these countries must maintain the capacity and readiness to prevent, detect and respond to any ongoing and/or new clusters in future. National and international efforts must be intensified to ensure that male survivors can have their semen tested for virus persistence and know their status. Work must continue on the use of Ebola vaccination for intimate and close contacts of those survivors who have persistent virus excretion. Particularly important will be to ensure that communities can rapidly and fully engage in any future response, cases are quickly isolated and managed, local population movement in the affected areas is managed, and appropriate contact lists are shared with border authorities.
The Committee further emphasized the crucial need for continued international donor and technical support to prevent, detect and respond rapidly to any new Ebola outbreak in West Africa. International support is required in particular to maintain and, where needed, expand diagnostic laboratory and surveillance capacity, sustain vaccination capacity for outbreak response, and continue relevant research and development activities (e.g. on therapeutic options to clear persistent virus excretion). The Committee gave special attention to the need to ensure that sufficient and appropriate clinical care, testing capacity and welfare services are available to all survivors of this extraordinary health crisis.
Based on the advice of the Emergency Committee, and her own assessment of the situation, the Director-General terminated the Public Health Emergency of International Concern (PHEIC) regarding the Ebola virus disease outbreak in West Africa, in accordance with the International Health Regulations (2005). The Director-General terminated the Temporary Recommendations that she had issued in relation to this event, supported the public health advice provided above by the Committee, and reinforced the importance of States Parties immediately lifting any restrictions on travel and trade with these countries. The Director-General thanked the Emergency Committee members and advisors for their service and expert advice, and requested their availability to reconvene if needed.
Ebola: “….we must not forget that many features of this tragic outbreak strongly reinforce the benefit of continued investment in global health security efforts….”
Thursday, March 10th, 2016Spengler JR, Ervin ED, Towner JS, Rollin PE, Nichol ST. Perspectives on West Africa Ebola virus disease outbreak, 2013–2016. Emerg Infect Dis. 2016 Jun [date cited]. http://dx.doi.org/10.32032/eid2206.150021
CDC-Emerging Infectious Diseases
Ebola virus outbreaks (red dots) and distribution of Eidolon helvum, Mops condylurus, Myonycteris torquata, Epomops franqueti, and Hypsignathus monstrosus bats.
Presence and Persistence of Ebola or Marburg Virus in Patients and Survivor
Tuesday, March 1st, 2016Brainard J, Pond K, Hooper L, Edmunds K, Hunter P (2016) Presence and Persistence of Ebola or Marburg Virus in Patients and Survivors: A Rapid Systematic Review. PLoS Negl Trop Dis 10(2): e0004475. doi:10.1371/journal.pntd.0004475
“…….Blood products were confirmed as likely to be highly infectious among actively ill cases. In actively ill patients, filovirus was often found in non-blood body fluids. However, (apart from in semen), it is rare for viable virus to be found in survivors…..”
Ebola: 84 Survivors reported musculoskeletal pain (70%), headache (48%), and ocular problems (14%).
Sunday, February 28th, 2016Scott JT, Sesay FR, Massaquoi TA, Idriss BR, Sahr F, Semple MG. Post-Ebola syndrome, Sierra Leone. Emerg Infect Dis. 2016 Apr [date cited]. http://dx.doi.org/10.32032/eid2204.151302
Table 5
Post-Ebola complaints other than headache, musculoskeletal pain, or ocular problems among 44 survivors, Sierra Leone
| Complaint | No. (%; 95% CI, %) |
|---|---|
| Cough | 5 (11; 4–25) |
| Abdominal pain | 4 (9; 3–22) |
| Chest pain | 4 (9; 3–22) |
| Itching | 4 (9; 3–22) |
| Insomnia | 3 (7; 1–19) |
| Fever | 3 (7; 1–19) |
| Loss of appetite | 3 (7; 1–19) |
| Labored speech | 2 (5; 1–15) |
| Epigastric pain | 2 (5; 1–15) |
| Rash | 2 (5; 1–5) |
| Other* | 1 (2; 0–12) |
*Weight loss, hiccups, increased appetite, chest pain, sneezing, diarrhea, vomiting, left sided weakness with facial nerve palsy, breathlessness, rash, dry flaky skin, earache, fever blister/cold sore, left scrotal swelling, nasal congestion, tremors.
Table 3
Musculoskeletal symptoms described by 31 patients with post-Ebola syndrome, Sierra Leone*
| Area of pain | Patient sex
|
Total | |
|---|---|---|---|
| M | F | ||
| Joints | |||
| Joint, unspecified | 5 | 9 | 14 |
| Knee, unspecified | 2 | 0 | 2 |
| Right knee joint | 0 | 1 | 1 |
| Shoulder joint
|
1
|
1
|
2
|
| Body | |||
| Generalized body | 4 | 4 | 8 |
| Upper back | 1 | 3 | 4 |
| Musculoskeletal, unspecified | 2 | 0 | 2 |
| Left thigh | 1 | 1 | 2 |
| Lower limb | 0 | 1 | 1 |
| Right thigh | 1 | 0 | 1 |
| Gluteal muscle | 1 | 0 | 1 |
*Values are no. patients. Some survivors reported >1 area of pain. The proportion of male and female survivors with musculoskeletal pain did not differ significantly (χ2, p = 0.7).
Table 4
Ocular symptoms described by 6 patients with post-Ebola syndrome, Sierra Leone
| Patient age, y/sex | Symptom |
|---|---|
| 8/F | Eye pain |
| 14/F | Clear eye discharge |
| 20/F | Clear eye discharge |
| 28/F | Red eyes and blurred vision on the left |
| 29/F | Red eyes |
| 46/M | Blurred vision |
Long-term Complications of Ebola Virus Disease (EVD)
Sunday, February 28th, 2016
For Immediate Release: Tuesday, Feb. 23, 2016
Other Findings May Have Implications for Potential Sexual Transmission of Ebola
Preliminary findings from PREVAIL III, a study of Ebola virus disease (EVD) survivors being conducted in Liberia, indicate that both Ebola survivors and their close contacts have a high burden of illness. However, the prevalence of eye, musculoskeletal, and neurological complications was greater among the individuals who survived EVD.
These findings were presented today at the 23rd Conference on Retroviruses and Opportunistic Infections at the John B. Hynes Veterans Memorial Convention Center in Boston.
Ebola survivors are still struggling with long-term neurological and psychiatric problems
Friday, February 26th, 201682 Ebola survivors in Liberia
Average age was 35
At least six months after they were first infected with the virus, most had some type of neurological issue.
Weakness
Headache
Memory loss
Depressed mood
Muscle pain
Tremors
Abnormal eye movements
Irregular reflexes
Pauline Cafferkey was transferred to the Royal Free Hospital due to a late complication from her previous infection by the Ebola virus.
Wednesday, February 24th, 2016
She had been hospitalized at the hospital’s isolation unit twice before—once for her initial infection and for Ebola-related meningitis.
WHO’s Ebola Situation Report – 17 February 2016: The deployment of rapid-response teams following the detection of a new confirmed case continues to be a cornerstone of the national response strategy in Guinea, Liberia, and Sierra Leone.
Thursday, February 18th, 2016Today (1/14/16), WHO declares the end of the most recent outbreak of Ebola virus disease in Liberia and says all known chains of transmission have been stopped in West Africa.
Thursday, January 14th, 2016** This date marks the first time since the start of the epidemic 2 years ago that all 3 of the hardest-hit countries—Guinea, Liberia and Sierra Leone—have reported 0 cases for at least 42 days.
** More flare-ups are expected
** Strong surveillance and response systems will be critical in the months to come.