“Risk of Ebola spreading in Europe is very low” say World Health Authority


Ebola Crisis

Ebola Crisis

We have covered the Ebola virus before but with recent developments in the USA and the European Union we think it would be useful to extend our coverage during the crisis.

We would also be very interested in finding out what your ideas are to stop the spread of the virus. That being said the World Health Organisation shared the following with us yesterday. “Sporadic cases of Ebola virus disease in Europe are unavoidable. This is due to travel between Europe and affected countries.

However, the risk of spread of Ebola in Europe is avoidable and extremely low. European countries are among the best prepared in the world to respond to viral haemorrhagic fever (VHF) including Ebola.

There is a risk of accidental contamination for people exposed to Ebola patients: this risk can be and must be mitigated with strict infection control measures. Health care workers are on the frontline of the Ebola fight and they are those most at risk of infection. They need to be protected and supported by all means.

All countries have protocols and procedures that must be implemented when a case is suspected and it is important that these are followed diligently. WHO is, as always, ready to provide help and support where requested.”

The latest edition of the Ebola Response Roadmap Situation Report was published yesterday. You can read it here.


Study warns swift action needed to curb exponential climb in Ebola outbreak – says New England Journal of Medicine


Ebola Outbreak News

Ebola Outbreak News

Like many of my readers I have been following the recent Ebola outbreak with some concern. I was send the following information this morning which I thought would be useful to share.

Unless Ebola control measures in West Africa are enhanced quickly, experts from the World Health Organization (WHO) and Imperial College, London, predict numbers will continue to climb exponentially, and more than 20,000 people will have been infected by early November, according to a new article in the New England Journal of Medicine released six months after WHO was first notified of the outbreak in West Africa.

In the article, public health epidemiologists and statisticians reviewed data since the beginning of the outbreak in December 2013 to determine the scale of the epidemic, better understand the spread of the disease, and what it will take to reverse the trend of infections.

Scale of epidemic

Although WHO was first notified of the outbreak on 23 March 2014, investigations retroactively revealed the outbreak started in December 2013. Between 30 December 2013 and 14 September 2014, a total of 4507 cases were reported to WHO.


The data in the study help clarify some details of who is most affected by this outbreak. For example, there have been mixed reports on whether women might be harder hit because they are more likely to care for sick, or whether it would be men who might be more likely to bury the highly-infectious dead bodies.

“This study gave us some real insight into how this outbreak was working, for example, we learned there is no significant difference among the different countries in the total numbers of male and female case patients,” says Dr Christopher Dye, Director of Strategy for WHO, and co-author of the study. “There may be differences in some communities, but when we actually looked at all the data combined, we saw it was really almost split 50-50.”

The extensive review of data also allowed for a closer look at case fatality rate.

“Assessing the case fatality rate during this epidemic is complicated by incomplete information on the clinical outcomes of many cases, both detected and undetected,” says Dye. “This analysis shows that by 14 September, a total of 70.8% of patients with definitive outcomes have died. This rate was consistent among Guinea, Liberia and Sierra Leone.”

But the case fatality rate was lower when only hospitalized patients were considered, supporting evidence that getting patients to good, supportive health care quickly makes a difference.

Spread of infection

The examination of the data also showed the spread more clearly. In late December, the first cases were reported in the forest areas of Guinea. By March, when the government sounded the alarm to WHO, cases had already spread from the forest area to the capital of Conakry. In May, the focus of the outbreak in Guinea expanded strongly to Sierra Leone and in June it really took hold in Liberia. From July onward, there were sharp increases in case numbers in all three countries.

Projections

Although the current epidemic in West Africa is unprecedented in scale, the clinical course of infection and the transmissibility of the virus are similar to those in previous Ebola outbreaks.
“We infer that the present epidemic is exceptionally large, not primarily because of biologic characteristics of the virus, but in part because of the attributes of the affected populations, the condition of the health systems, and because control efforts have been insufficient to halt the spread of infection,” says Dye.

There are challenges in this region that exacerbate the struggles to contain the virus quickly. Most importantly the health systems in all three countries were shattered after years of conflict and there was a significant shortage of health workers, leaving the system weaker than in other countries with Ebola outbreaks. In addition, certain characteristics of the population may have led to the rapid spread of the disease, for example, the populations of Guinea, Liberia, and Sierra Leone are highly interconnected, with extensive cross-border traffic at the epicentre and relatively easy connections by road between rural towns and villages and the densely populated capital cities.
“The large intermixing population has facilitated the spread of infection, but a large outbreak was not inevitable,” says Professor Christl Donnelly, Professor of Statistical Epidemiology, Imperial College and the MRC Centre for Outbreak Analysis and Modelling. “In Nigeria, for example, where health systems are stronger, the number of cases has so far been limited, despite the introduction of infection into the large cities of Lagos and Port Harcourt.“

The critical determinant of outbreak size appears to be the speed of implementation of rigorous control measures.

“Forward projections suggest that unless control measures – including improvements in contract tracing, adequate case isolation, increased quality of care and capacity for clinical management, greater community engagement, and support from international partners – improve quickly, these three countries will soon be reporting thousands of cases and deaths each week,” says Dye.
Experimental therapeutics and vaccines offer promise for the future, but are unlikely to be available in the quantities needed to make a substantial difference in control efforts for many months, even if they are proved to be safe and effective.

The risk of continued expansion of the Ebola outbreak is real. This study provides the evidence needed for an urgent wakeup call requiring intensive scaling up of control measures while working towards rapid development and deployment of new medicines and vaccines.

British Red Cross launch Ebola Outbreak Appeal

We would like to share this recent news from the Red Cross website and hope you will share with your family and friends.

Due to constraints of time we are quoting directly from the Red Cross site:

Red Cross Ebola Appeal

Red Cross Ebola Appeal

Red Cross workers are “stretched to the limit” as the Ebola outbreak gets worse.

More than 1,900 people have now died from the virulent disease, according to the World Health Organisation.

The International Federation of Red Cross and Red Crescent Societies (IFRC), which is working across West Africa, is increasing its relief effort, but it has only 62 per cent of the funds needed to fight the epidemic.

The British Red Cross has launched an emergency Ebola Outbreak Appeal.

Together with the IFRC, we are completing construction of an isolation facility in Kenema, Sierra Leone. The new facility will ease overcrowding in other health facilities and help save lives.

Funding shortfall

The outbreak, which is the worst in history, has hit five countries in West Africa: Guinea, Liberia, Sierra Leone, Nigeria and Senegal.

Ben Webster, British Red Cross disaster response manager, said: “It is not an overstatement to say that this outbreak is stretching our capacity in terms of funding and personnel.

“We are seeking as much support as possible from the international community, the corporate world and the public.”

National Red Cross Societies in Guinea, Sierra Leone and Liberia have trained 1,800 volunteers to help fight the Ebola outbreak.

Urgent action

Elhadj As Sy, the new secretary general of the IFRC, recently visited Sierra Leone and Guinea.

“In recent months, Red Cross volunteers have been working hard, assisting with dead body management, tracing those who had been in contact with patients, providing psychological support and conducting preventive education at community level.

“Their capacity is stretched to the limit, and they are literally exhausted.

“Fear, misconceptions and stigmatization fuel a vicious cycle that hampers an effective response at community level. This cycle can only be broken with a sustained mobilization from us all, in close collaboration with affected communities.”

Mr Sy also supported calls for greater intervention from the international community.

“The IFRC fully supports – and echoes – the call from Médecins Sans Frontières (Doctors Without Borders) for the international community to urgently deploy bio-disaster facilities to the region to respond effectively to the epidemic,” he said.

The Ebola outbreak began in Guinea in March. It has a fatality rate of about 50 per cent.

Please donate if you can to this important cause!