31 Oct 2014

#Massachusetts, Collaborative #System for #Ebola #Treatment Announced (DoH, October 31 2014)

[Source: State of Massachusetts Department of health, full page: (LINK).]

For Immediate Release - October 31, 2014

Department Of Public Health, Hospitals Announce Collaborative System for Ebola Treatment in the Commonwealth [      ]

BOSTON — The Department of Public Health (DPH) announced today that while the risk of Ebola in Massachusetts remains extremely low, six hospitals in Massachusetts have formed a collaborative system and are prepared to treat a limited number of cases, should the need arise.

The six hospitals — Baystate Medical Center, Beth Israel Deaconess Medical Center, Boston Medical Center, Brigham and Women’s Hospital, Massachusetts General Hospital, and Tufts Medical Center – would accept transfers from other hospitals in Massachusetts based on existing referral relationships and capacity.

“While there are no cases of Ebola in Massachusetts and the risk remains extremely low, this collaborative system shows that Massachusetts health care providers are well prepared,” said Public Health Commissioner Cheryl Bartlett, RN. “I thank these six hospitals, their leadership, and staff for their dedication and commitment to ensuring that Massachusetts is ready. It’s important to note that other states in the region are also prepared for any suspect cases, and would not need to transfer cases to Massachusetts.”

“Massachusetts hospitals have been working diligently with appropriate staff to ensure that there are comprehensive internal procedures and policies in place in the event of a confirmed Ebola case within the Commonwealth,” said Tim Gens, executive vice president of the Massachusetts Hospital Association. “Hospitals also remain committed to ensuring nurses, physicians, and other frontline health care providers have the proper training, equipment and protocols to remain safe and provide the highest quality care for our patients. Hospitals are partnering with DPH to continually evaluate the specific needs and requirements to ensure an appropriate and coordinated system of care is available throughout the state.”

Each of the state’s hospitals and their emergency departments are able to screen, identify, and isolate any suspect cases, and will coordinate with DPH on risk assessment and patient transfers as needed. Community hospitals will continue to identify and rule out low-risk individuals.

"Thanks to the guidance of Commissioner Bartlett and her team, Massachusetts hospitals have an emergency Ebola treatment plan that takes into account the resources of our providers while maintaining the highest level of safety for patients and staff,” said Steven Walsh, Executive Director of the Massachusetts Council of Community Hospitals. “DPH has been an invaluable partner in building a collaborative system to prepare all Massachusetts hospitals, while ensuring that any high risk or confirmed Ebola cases will be treated in the most appropriate hospital setting."

Ebola is not transmitted through air, water or food. It is only transmitted through direct contact with the bodily fluids of an infected person who has travelled within the past 21 days to one of the West African counties of Guinea, Liberia or Sierra Leone. More information is available on www.mass.gov/Ebola.

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Middle East respiratory syndrome #coronavirus (#MERS-CoV) – #Qatar (@WHO, October 31 2014)

[Source: World Health Organization, full page: (LINK).]

Middle East respiratory syndrome coronavirus (MERS-CoV) – Qatar [      ]

Disease outbreak news / 31 October 2014

On 12 and 23 October 2014, WHO was notified by the National IHR Focal Point of Qatar of 2 cases of Middle East respiratory syndrome coronavirus (MERS-CoV). These are the first cases reported to WHO by Qatar in 2014.

 

Details of the case are as follows:

A 71-year-old male from Doha, Qatar developed symptoms on 1 October while traveling with three family members by car from Qatar to the Al-Hasa Region of Saudi Arabia.

On 7 October, as his symptoms worsened, the case visited a private health facility in Al-Hasa, whereupon he was transferred to the Hamad General Hospital in Doha.

On 11 October, laboratory tests conducted on the patient confirmed MERS-CoV infection.

The case owns a camel barn and is known to have consumed raw camel milk.

The patient has comorbidities and is currently in critical condition.

A 43-year-old male from Doha developed symptoms on 14 October.

On 17 and 18 October, he sought care at a health care facility but was not admitted.

On 20 October, his condition deteriorated, he was admitted to hospital, and was confirmed positive for MERS-CoV infection on the same day.

The patient presented with no comorbidities but he had frequently visited a camel barn in the 14 days that preceded the onset of symptoms.

There is no history of exposure to other known risk factors. Currently, the patient is in stable condition.

 

Public health response

Household and healthcare contacts of the two cases have been identified and are being followed up.

Currently, none of these contacts is symptomatic.

Health education messages about appropriate preventive measures have been shared with the household contacts of the two patients.

Infection prevention and control measures in all health facilities have been re-enforced by Qatar’s Supreme Council of Health (SCH).

Furthermore, the SCH, in collaboration with the Ministry of Environment, is investigating the camels in the two barns.

Globally, WHO has received notification of 885 laboratory-confirmed cases of infection with MERS-CoV, including at least 319 related deaths.

 

WHO advice

Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for acute respiratory infections and to carefully review any unusual patterns.

Infection prevention and control measures are critical to prevent the possible spread of MERS-CoV in health care facilities. It is not always possible to identify patients with MERS-CoV early because like other respiratory infections, the early symptoms of MERS-CoV are non-specific. Therefore, health-care workers should always apply standard precautions consistently with all patients, regardless of their diagnosis. Droplet precautions should be added to the standard precautions when providing care to patients with symptoms of acute respiratory infection; contact precautions and eye protection should be added when caring for probable or confirmed cases of MERS-CoV infection; airborne precautions should be applied when performing aerosol generating procedures.

Until more is understood about MERS-CoV, people with diabetes, renal failure, chronic lung disease, and immunocompromised persons are considered to be at high risk of severe disease from MERS‐CoV infection. Therefore, these people should avoid close contact with animals, particularly camels, when visiting farms, markets, or barn areas where the virus is known to be potentially circulating. General hygiene measures, such as regular hand washing before and after touching animals and avoiding contact with sick animals, should be adhered to.

Food hygiene practices should be observed. People should avoid drinking raw camel milk or camel urine, or eating meat that has not been properly cooked.

WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions.

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#Ebola virus disease – #Mali (@WHO, October 31 2014)

[Source: World Health Organization, full page: (LINK).]

Ebola virus disease – Mali [      ]

Disease outbreak news / 31 October 2014

On 23 October 2014, WHO was notified by Mali's Ministry of Health of a laboratory-confirmed case of infection with Ebola Virus Disease (EVD). This is the first EVD case in Mali.

 

Details of the case are as follows:

The case is a 2-year-old female who developed symptoms, presumably on 19 October 2014, while in Beuila, Guinea and then travelled across by road to Mali.

On 20 October 2014, the patient was admitted to a healthcare facility in Kayes, Mali.

On 21 October 2014, she was referred to the Fousseyni Daou Hospital in Kayes.

On 22 October 2014, samples for EVD were taken and analysed at the Center for TB and AIDS Research in Mali.

Samples came back positive for EVD.

Confirmation of test results is being carried out at the Centers for Disease Control and Prevention (CDC) in Atlanta and at Institute Pasteur de Dakar Senegal.

The case died on 24 October 2014.

To date, 85 contacts have been identified and are under follow-up.

 

Public health response

  1. Under the leadership of the Government of Mali, WHO, Médecins Sans Frontières, the Alliance for International Medical Action, International Medical Corps, Project Muso, Save the Children and Plan Mali, national and international specialists have been deployed in Bamako and Kayes.
  2. In collaboration with WHO, the Ministry of Health is putting in place an incident command structure in order to:
    • (i) mount a coordinated response including surveillance and contact tracing, case management, safe burials, social mobilization and logistics;
    • (ii) accelerate the completion of the isolation facility at the Center for Vaccine Development in Bamako, Mali; and
    • (iii) provide regular communication to the public.
  3. WHO convened an EVD Task Force meeting to prioritize actions and to discuss roles and responsibilities with partners.
  4. Local authorities are carrying out training activities for the personnel working in the healthcare facilities where the patient was admitted; furthermore, these facilities are undergoing disinfection and equipment replacement. A management plan for EVD cases has been drafted at the Fousseyni Daou Hospital.

WHO and other partners are mobilizing and deploying additional experts to provide support to the Ministry of Health. The necessary supplies and logistics required for supportive management of patients and all aspects of outbreak control are also being mobilized.

Future WHO updates on EVD in Mali will not be posted on the Disease Outbreak News. Further information will be available in WHO’s Ebola Situation Reports which provide regular updates on the WHO response: Ebola situation reports

WHO does not recommend any travel or trade restrictions be applied by countries except in cases where individuals have been confirmed or are suspected of being infected with EVD or where individuals have had contact with cases of EVD. Contacts do not include properly-protected health-care workers and laboratory staff.

Temporary recommendations from the Emergency Committee with regard to actions to be taken by countries can be found at: WHO Statement on the Meeting of the International Health Regulations Emergency Committee Regarding the 2014 Ebola Outbreak in West Africa

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#Finland, HUS: #Ebola scare unfounded, more tests to be conducted (Yle Uutiset, October 31 2014)

[Source: YLE, full page: (LINK).]

News 31.10.2014 19:05 | updated 31.10.2014 19:05

HUS: Ebola scare unfounded, more tests to be conducted [   !   ]

Fears of Finland’s first Ebola infection have turned out to be unfounded, according to officials from the Helsinki and Uusimaa Hospital District (HUS). HUS said in a statement Friday evening that preliminary tests results show that a man suspected of having the disease was not, in fact, infected with the virus.

In a release issued early Friday evening HUS said that reports that a man admitted to a Helsinki hospital had been infected with the Ebola virus proved to be unfounded.

(…)

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#WHO #updates personal #protective #equipment #guidelines for #Ebola response (@WHO, October 31 2014)

[Source: World Health Organization, full page: (LINK).]

WHO updates personal protective equipment guidelines for Ebola response [      ]

News release / 31 October 2014 ¦ GENEVA

As part of WHO’s commitment to safety and protection of healthcare workers and patients from transmission of Ebola virus disease, WHO has conducted a formal review of personal protective equipment (PPE) guidelines for healthcare workers and is updating its guidelines in context of the current outbreak.

 

About the PPE guidelines

These updated guidelines aim to clarify and standardize safe and effective PPE options to protect health care workers and patients, as well as provide information for procurement of PPE stock in the current Ebola outbreak. The guidelines are based on a review of evidence of PPE use during care of suspected and confirmed Ebola virus disease patients.

The Guidelines Development Group convened by WHO included participation of a wide range of experts from developed and developing countries, and international organizations including the United States Centers for Disease Control and Prevention, Médecins Sans Frontières, the Infection Control Africa Network and others.

“These guidelines hold an important role in clarifying effective personal protective equipment options that protect the safety of healthcare workers and patients from Ebola virus disease transmission,” says Edward Kelley, WHO Director for Service Delivery and Safety. “Paramount to the guidelines’ effectiveness is the inclusion of mandatory training on the putting on, taking off and decontaminating of PPE, followed by mentoring for all users before engaging in any clinical care.”

Guidelines were developed from an accelerated development process that meets WHO’s standards for scientific rigour and serves as a complement to the Interim infection prevention and control guidance for care of patients with suspected or confirmed filovirus haemorrhagic fever in health-care settings, with focus on Ebola, published by WHO in August 2014.

 

Use of the personal protective equipment

Experts agreed that it was most important to have PPE that protects the mucosae – mouth, nose and eyes – from contaminated droplets and fluids. Given that hands are known to transmit pathogens to other parts of the body, as well as to other individuals, hand hygiene and gloves are essential, both to protect the health worker and to prevent transmission to others. Face cover, protective foot wear, gowns or coveralls, and head cover were also considered essential to prevent transmission to healthcare workers.

"Although PPE is the most visible control used to prevent transmission, it is effective only if applied together with other controls including facilities for barrier nursing and work organization, water and sanitation, hand hygiene, and waste management," says Marie-Paule Kieny, Assistant Director-General of Health Systems and Innovation. Benefits derived from PPE depend not only on choice of PPE, but also adherence to protocol on use of the equipment.

A fundamental principle guiding the selection of different types of PPE was the effort to strike a balance between the best possible protection against infection while allowing health workers to provide the best possible care to patients with maximum ease, dexterity, comfort and minimal heat-associated stress.

In this situation where evidence is still being collected, to see what works best and on an effective sustainable basis, it was considered prudent to provide options for selecting PPE. In most cases, there was no evidence to show that any one of the options recommended is superior to other options available for healthcare worker safety.

Further work is needed to gather scientific experience and data from the field in systematic studies, in order to understand why some health workers are infected in the current outbreak and to increase effective clinical care. WHO is committed to working with international partners on these issues to build this evidence base.

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WHO media contacts: Tarik Jasarevic, Communications Officer, Telephone: +41 22 791 50 99, Mobile: +41 79 367 62 14, Email: jasarevict@who.int

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#Epidemiological #update: #outbreak of #Ebola virus disease in West #Africa (@ECDC_EU, October 31 2014, edited)

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

Epidemiological update: outbreak of Ebola virus disease in West Africa [      ]

31 Oct 2014

​Since December 2013 and as of 27 October 2014, WHO has reported 13 703 cases of EVD including 4 920 deaths.

Countries with widespread and intense transmission:

  • Guinea: 1 906 cases and 997 deaths as of 27 October 2014;
  • Liberia: 6 535 cases and 2 413 deaths as of 25 October 2014;
  • Sierra Leone: 5 235 cases and 1 500 deaths as of 27 October 2014;

Countries with an initial case or cases, or with localised transmission:

  • Mali: one imported confirmed case from Guinea was reported in Kayes, Mali on 23 October; the case died on 24 October;
  • United States: four cases including one death. The last confirmed case occurred in New York on 23 October 2014;
  • Spain: one case, no deaths. The case is the result of secondary transmission in Spain to a nurse who cared for an EVD patient who had been evacuated from Liberia. The nurse was isolated on 6 October 2014;
  • Nigeria: 20 cases and 8 deaths. Nigeria was declared Ebola free on 19 October 2014;
  • Senegal: 1 confirmed imported case, no deaths. Senegal was declared Ebola free on 17 October 2014.

(…)

 

Situation in Guinea, Sierra Leone and Liberia

According to WHO, EVD transmission remains persistent and widespread in Guinea, Liberia, and Sierra Leone, especially in the capital cities. All administrative districts in Liberia and Sierra Leone reported at least one confirmed or probable case of EVD since the epidemic began. Case numbers continue to be under-reported.

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Distribution of cases of EVD by week of reporting in the three countries with widespread and intense transmission as of week 44/2014*

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* The bar for week 44/2014 does not represent a complete calendar week; the marked increase in the number of cases reported in weeksd 43 and 44 results from a more comprehensive assessment of patient databases. The additional 3 792 cases have occurred throughout the epidemic period.

(Source: Data are based on official information reported by ministries of health up to the end of 27 October for Guinea and Sierra Leone and 25 October for Liberia)

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Distribution of cases of EVD by week of reporting in Guinea, Sierra Leone and Liberia (as of week 43/2014)

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Source: Data from ministry of health reports (probable and confirmed cases)

 

Situation among healthcare workers in West Africa

As of 27 October 2014, WHO reported 551 healthcare workers infected with EVD of whom 272 died.

[Country  - Healthcare worker cases (% of reported cases)  - Healthcare worker deaths (% of reported deaths)]

  • Guinea  - 80 (4.2)  - 43 (4.3)
  • Liberia  - 299 (4.8)  - 123 (5.1)
  • Sierra Leone  - 127 (2.4)  - 101 (6.7)
  • Nigeria  - 11 (55.0)  - 5 (62.5)
  • Spain - 1 (100) – 0
  • United States of America - 3 (75.0) – 0
  • Total  - 521 (3.8)  - 272 (5.5)

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Source: data are based on official information reported by Ministries of Health

 

Situation outside of West Africa

USA

No new cases have been reported since 23 October.

The last case is a medical aid worker who volunteered in Guinea and recently returned to the United States. 

According to WHO, as of 29 October, two healthcare workers who became infected with Ebola have tested negative twice and have now been released from hospital [1].

On 20 October, Texas Health Department confirmed that 43 persons in Texas who had contact with the state's first Ebola patient have been cleared from twice-daily monitoring after reaching the 21-day mark.

 

Spain

No new cases have been reported since 6 October.

On 29 October, Spain notified that the confirmed secondary case of EVD isolated in Spain tested negative for the disease for a second time on 21 October, and according to protocols is now considered free of Ebola infection.

As of 27 October, out of 83 contacts identified, 15 high-risk contacts have reached the 21-day period and have been discharged; six low-risk contacts are currently being followed-up; all others have been discharged. None of the contacts are asymptomatic.

 

Mali

On 29 October WHO reports that 84 persons, of whom 11 are healthcare workers, are currently being followed-up in the region of Kayes and in Bamako District as contacts of the of the two-year-old girl from Guinea who recently died of Ebola.

 

Related information

Event background

Medical evacuations from EVD-affected countries

 

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Vesicular Stomatitis Virus–based #Vaccines against #Lassa and #Ebola Viruses (@CDC_EIDjournal, abstract, edited)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract.]

Volume 21, Number 2—February 2015  / Dispatch

Vesicular Stomatitis Virus–based Vaccines against Lassa and Ebola Viruses [      ]

Andrea Marzi, Friederike Feldmann, Thomas W. Geisbert, Heinz Feldmann, and David Safronetz

Author affiliations: National Institutes of Health, Hamilton, Montana, USA (A. Marzi, F. Feldmann, H. Feldmann, D. Safronetz); University of Texas Medical Branch, Galveston Texas, USA (T.W. Geisbert)


Abstract

We demonstrated that previous vaccination with a vesicular stomatitis virus (VSV)–based Lassa virus vaccine does not alter protective efficacy of subsequent vaccination with a VSV-based Ebola virus vaccine. These findings demonstrate the utility of VSV-based vaccines against divergent viral pathogens, even when preexisting immunity to the vaccine vector is present.

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#OHIO DAILY #EBOLA #CONTACT #REPORT, 10-31-14, 11 a.m. (DoH, edited)

[Source: State of Ohio Department of Health, full PDF document: (LINK).]

FOR IMMEDIATE RELEASE / October 31, 2014 / Contact: State Joint Information Center, (614) 644-8562

OHIO DAILY EBOLA CONTACT REPORT, 10-31-14, 11 a.m. [      ]

COLUMBUS – The Ohio Department of Health reported this morning in its Daily Ebola Contact Report that there are currently:

  • 0 confirmed cases of Ebola in Ohio;
  • 3 people under quarantine;
  • 164 contacts statewide;

ODH’s Daily Ebola Contact Report is issued at approximately 11 a.m. and is compiled from the local health districts, ODH officials and Centers for Disease Control and Prevention (CDC) Ohio team members who are working together to identify anyone who may have had contact of some type with the Dallas nurse who was in Northeast Ohio, Oct. 10-13.

Symptoms may appear anywhere from 2-21 days after exposure to Ebola, but the average is 8-10 days.

It is anticipated that contacts will be removed from the contact list between October 31, and November 4, 2014.

The figures may change daily based on the information officials learn from contacts and the type of exposure they may have had.

The report is below and also found on ODH’s website here: http://www.odh.ohio.gov/odhprograms/dis/orbitdis/ebola/Ebola.aspx

 

OHIO EBOLA DAILY CONTACT REPORT 10/31/14 (as of 11 AM, EST of date of issuance)

SUMMARY

  • CONFIRMED EBOLA CASES – 0
  • QUARANTINED OHIOANS – 3
  • TOTAL OHIO CONTACTS – 164

 

CONTACTS BY COUNTY AND TYPE

[QUARANTINE - ACTIVE MONITORING - VERIFIED SELF (PHONE) MONITORING - SELF-MONITORING – PENDING – TOTAL]

  • Cuyahoga – 1 – 3 – 35 – 17 – 0 – 56
  • Medina – 0 – 1 – 4 – 5 – 0 – 10
  • Portage – 0 – 0 – 4 – 5 – 0 – 9
  • Summit – 2 – 8 – 15 – 16 – 0 – 41
  • All Other Counties * – 0 – 5 – 36 – 7 – 0 – 48
  • TOTAL – 3 – 17 – 94 – 50 – 0 – 164

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*15 counties have 7 or fewer contacts and those figures are not being broken out by county in order to protect the privacy of individual contacts. (Belmont, Erie, Franklin, Geauga, Hamilton, Hardin, Lake, Lorain, Mahoning, Putnam, Seneca, Stark, Trumbull, Tuscarawas, and Wayne)

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#Ebola: #OHIO ISSUES NEW, STRONGER #HEALTH #MONITORING AND #QUARANTINE #PROTOCOLS FOR #TRAVELERS RETURNING FROM WEST #AFRICA (DoH, October 31 2014)

[Source: State of Ohio Department of Health, full PDF document: (LINK).]

FOR IMMEDIATE RELEASE / October 31, 2014 / Contact: Office of Public Affairs 614-644-8562

OHIO ISSUES NEW, STRONGER HEALTH MONITORING AND QUARANTINE PROTOCOLS FOR TRAVELERS RETURNING FROM WEST AFRICA [      ]

COLUMBUS – Today the Ohio Department of Health (ODH) strengthened its protocols for managing travelers returning from West African nations that have Ebola outbreaks.

The new protocols are stronger than those recommended by the Centers for Disease Control and Prevention (CDC) while still being respectful of travelers and informed by the latest medical considerations for risk and exposure.

Highlights of the new protocols include:

  • Returning travelers who had no exposure to a potentially infected person are to:
    • Undergo daily health checks by a public health official for the 21 days of the Ebola incubation period;
    • Record any trips outside their homes;
    • Avoid public places;
    • Remain within their health district unless they can make arrangements for public health officials in the district to which they are traveling to assume their daily monitoring, and;
    • Remain within the United States for their safety and the safety of other travelers.
  • Returning travelers who did have exposure to a potentially infected person are to:
    • Be quarantined at home with daily health checks by a public health official for 21 days, and;
    • Possibly be allowed trips outside their homes in some cases, away from public places, if public health officials determine they are at a low risk.

If public health officials have any doubt about a travelers’ history or exposure, they should always default to a stronger, safer protocol level.

“Our goal is to keep Ohioans safe, period—both those who travel to West Africa and those who don’t. We’re considering a lot of different needs with these new protocols, landing on the side of protecting Ohioans’ health while still working hard to respect the rights of travelers,” said ODH Director Richard Hodges.

“We don’t want to build counterproductive barriers to those who have a desire to volunteer for medical relief efforts. We believe these new protocols are the right approach—strong, common sense, and informed by science—but we’re also continuing to monitor the situation to keep our protocols in the right place to protect Ohioans.”

ODH will work with local health departments to implement the new monitoring and quarantine protocols, and also meet whatever needs arise from those people who might be placed under a 21-day quarantine.

To help protect the privacy of individuals under quarantine or monitoring, ODH and local health departments do not release their names or other information that could potentially lead to their identification.

Traditionally the number of travelers returning to Ohio from West Africa is very low, averaging out to approximately two per day. For the safety of first responders, local health departments will verify a quarantined individual’s identity and status in the event first responders must respond to a request for help at the home.

Ohio’s stronger health monitoring and quarantine protocols for travelers returning from West Africa can be viewed here.

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OHIO EBOLA INCIDENT RESPONSE CHRONOLOGY

  • Oct. 23 - ODH and the Ohio Hospital Association announced that 100% of Ohio hospitals have completed Ebola preparedness and response drills.
  • Oct. 22 - Representatives from ODH, CDC, Ohio Hospital Association and local health departments provided a briefing to media providing an update of the situation and summarizing the first week’s response efforts.
  • Oct. 21 - ODH evaluated new CDC guidance for personal protective equipment (PPE) when treating potential cases of Ebola to determine what, if any, additional PPE the Department should acquire to add to its stockpile.
    • Nearly 100 percent of Ohio hospitals reported completing recommended drills to practice how to manage suspected cases of Ebola and put on and remove PPE.
  • Oct. 20 - ODH voiced support for new steps by Summit County to protect first responders and health care workers required to respond to a request for help from someone currently quarantined or monitored for possible Ebola exposure.
    • The state Controlling Board approved ODH’s request to purchase up to $300,000 in new personal protective equipment and spend up to $500,000 for any cleanup and disposal of any contaminated linens and other items that may be generated by suspected or confirmed Ebola patients
  • Oct. 19 - ODH began issuing a daily report summarizing the number of individuals who have been found to have contact of some type with the Dallas nurse who was in Northeast Ohio, Oct. 10-13.
  • Oct. 18 - Press conference held in Akron with Gov. John R. Kasich, Lt. Gov. Mary Taylor and several federal, state and local doctors, health care professionals and elected officials to update the public on the status of Ohio’s Ebola response.
  • Oct. 17 - ODH announced it is adding to current stockpiles of health care protective equipment for frontline health care workers.
  • Oct. 16 - ODH participates in a media briefing in Summit County with state, local and federal partners.
    • State Health Director Rick Hodges notified Ohio hospitals asking that they conduct a series of training and practice drills within two days to ensure Ohio hospitals are prepared to handle a potential Ebola patient.
    • Gov. Kasich talked with President Barack Obama, thanking him for the CDC support staff, and informing him of Ohio’s new, more aggressive quarantine measures. The President is supportive.
    • State officials briefed CDC on Ohio’s Ebola response before travelling with the CDC to Summit County to assist with local efforts.
    • ODH updated infectious disease experts in Ohio and issued enhanced quarantine protocols for individuals with possible Ebola exposure.
  • Oct. 15 - Gov. Kasich spoke with U.S. Secretary of Health and Human Services Sylvia Burwell and CDC Director Dr. Tom Frieden, requesting CDC staff to support regional response efforts. As a result, CDC staff arrived in Ohio overnight.
    • The state of Ohio activated its Emergency Operation Center to manage Ohio’s response, and initiated a 24-hour-a-day call center to answer Ohioans’ questions about Ebola and the recent events.
    • ODH deployed state epidemiologist Dr. Mary DiOrio and other staff to Summit County to assist Ebola response efforts.
    • CDC notified ODH that Dallas nurse who tested positive for Ebola was in Summit County Oct. 10-13.
  • Oct. 14 - State conducted an Ebola-specific tabletop exercise and preparedness seminar with stakeholders including hospitals, physicians, nurses, EMS responders and local health departments.
  • July-Present - ODH shares Ebola preparedness guidance with health care providers and local health departments.

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#EBOLA RESPONSE ROADMAP #SITUATION #REPORT, 31 OCTOBER 2014 (@WHO, edited)

[Source: World Health Organization, full PDF document: (LINK). Edite.]

EBOLA RESPONSE ROADMAP SITUATION REPORT, 31 OCTOBER 2014 [      ]


SUMMARY

A total of 13 567 confirmed, probable, and suspected cases of Ebola virus disease (EVD) have been reported in six affected countries (Guinea, Liberia, Mali, Sierra Leone, Spain, and the United States of America) and two previously affected countries (Nigeria, Senegal) up to the end of 29 October.

There have been 4951 reported deaths.

The cases reported are fewer than those reported in the Situation Report of 29 October, due mainly to suspected cases in Guinea being discarded.

Following the WHO Ebola Response Roadmap structure, country reports fall into two categories:

  • 1) those with widespread and intense transmission (Guinea, Liberia, and Sierra Leone); and
  • 2) those with or that have had an initial case or cases, or with localized transmission (Mali, Nigeria, Senegal, Spain, and the United States of America).

An overview of the situation in the Democratic Republic of the Congo, where a separate, unrelated outbreak of EVD is occurring, is also provided (see Annex 2).

 

1. COUNTRIES WITH WIDESPREAD AND INTENSE TRANSMISSION

A total of 13 540 confirmed, probable, and suspected cases of EVD and 4941 deaths have been reported up to the end of the 29 October 2014 by the ministries of health of Guinea and Sierra Leone, and 25 October by the Ministry of Health of Liberia (table 1).

All districts in Liberia and Sierra Leone have now reported at least one case of EVD since the start of the outbreak (figure 1).

Of the eight Guinean and Liberian districts that share a border with Cote d’Ivoire, only one in Guinea is yet to report a confirmed or probable case of EVD.

A total of 523 health-care workers (HCWs) are known to have been infected with EVD up to the end of 29 October: 82 in Guinea; 299 in Liberia; 11 in Nigeria; 127 in Sierra Leone; one in Spain; and three in the United States of America (two were infected in the USA and one in Guinea). A total of 269 HCWs have died.

WHO is undertaking extensive investigations to determine the cause of infection in each case.

Early indications are that a substantial proportion of infections occurred outside the context of Ebola treatment and care.

Infection prevention and control quality assurance checks are now underway at every Ebola treatment unit in the three intense-transmission countries.

At the same time, exhaustive efforts are ongoing to ensure an ample supply of optimal personal protective equipment to all Ebola treatment facilities, along with the provision of training and relevant guidelines to ensure that all HCWs are exposed to the minimum possible level of risk.

 

Table 1: Confirmed, probable, and suspected cases in Guinea, Liberia, and Sierra Leone

[Country - Case definition - Cumulative Cases – Deaths]

  • Guinea
    • Confirmed – 1409 – *
    • Probable – 204 – *
    • Suspected – 54 – *
      • All – 1667 – 1018
  • Liberia
    • Confirmed – 2515 – *
    • Probable – 1540 – *
    • Suspected – 2480 – *
      • All – 6535 – 2413
  • Sierra Leone
    • Confirmed – 3778 – *
    • Probable – 322 – *
    • Suspected – 1238 – *
      • All – 5338 – 1510
  • Total - 13 540 – 4941

____

*N/A.

Data are based on official information reported by Ministries of Health. These numbers are subject to change due to ongoing reclassification, retrospective investigation and availability of laboratory results.

 

2. COUNTRIES WITH AN INITIAL CASE OR CASES, OR WITH LOCALIZED TRANSMISSION

Five countries (Mali, Nigeria, Senegal, Spain, and the United States of America) have now reported a case or cases imported from a country with widespread and intense transmission.

In Nigeria, there were 20 cases and eight deaths.

In Senegal, there was one case and no deaths.

However, following a successful response in both countries, the outbreaks of EVD in Senegal and Nigeria were declared over on 17 October and 19 October 2014, respectively.

On 23 October, Mali reported its first confirmed case of EVD (table 2). The patient was a 2-year old girl who travelled from Guinea with her grandmother to Mali. The patient was symptomatic for much of the journey. On 22 October the patient was admitted to Fousseyni Daou hospital in Kayes. Samples for laboratory confirmation were sent to SERAFO in Bamako and were positive for EVD. The patient died on 24 October.

Three suspect cases were identified and have been discarded.

To date, 85 contacts have been identified and are being followed up.

A WHO preparedness team was already in Mali to assess the country s state of readiness for an initial case.

It was immediately repurposed to provide expertise and support to Malian health authorities in infection prevention and control, contact tracing and in the training of health-care workers. A WHO team and key partners remain in Mali and continue to provide support.

In Spain, the single patient, who was infected in Madrid, tested negative for EVD on 19 October. A second negative test was obtained on 21 October. Spain will therefore be declared free of EVD 42 days after the date of the second negative test if no new cases are reported.

All 83 contacts of the HCW infected in Spain have completed the 21-day follow-up period.

(…)

There have been four cases and one death (table 2) in the United States of America.

The most recent case is a medical aid worker who volunteered in Guinea and returned to New York City on 17 October.

The patient was screened and was asymptomatic on arrival, but reported a fever on 23 October, and tested positive for EVD.

The patient is currently in isolation at Bellevue Hospital in New York City, one of eight New York State hospitals that have been designated to treat patients with EVD.

Two HCWs who became infected after treating an EVD-positive patient at the Texas Presbyterian Hospital of Dallas, Texas, have twice tested negative for EVD and have been discharged from hospital.

Of 176 possible contacts, 99 are being monitored and 77 have completed 21-day follow-up.

 

Table 2: Ebola virus disease cases and deaths in Mali, Spain, and the United States of America

[Country - Case definition – Cases – Deaths]

  • Mali
    • Confirmed – 1 – 1
    • Probable – 0 – 0
    • Suspected – 0 – 0
      • All – 1 – 1
  • Spain
    • Confirmed – 1 – 0
    • Probable – 0 – 0
    • Suspected – 0 – 0
      • All – 1 – 0
  • United States of America
    • Confirmed – 4 – 1
    • Probable – 0 – 0
    • Suspected – 0 – 0
      • All - 4* – 1
  • Total – 6 – 2

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*Includes two HCWs infected in the USA while treating an Ebola patient from Liberia, and a HCW infected in Guinea.

Data are based on official information reported by Ministries of Health. These numbers are subject to change due to ongoing reclassification, retrospective investigation and availability of laboratory results.

(…)

 

ANNEX 2: EBOLA OUTBREAK IN DEMOCRATIC REPUBLIC OF THE CONGO

As of 28 October 2014, there have been 66 cases (38 confirmed, 28 probable) of Ebola virus disease (EVD) reported in the Democratic Republic of the Congo, including eight among health-care workers (HCWs). In total, 49 deaths have been reported, including eight among HCWs. All suspected cases have now been discarded.

No new reported contacts are being followed.

Twenty days have passed since the last reported case tested negative for the second time and was discharged. The Democratic Republic of the Congo will therefore be declared free of EVD 42 days after the date of the second negative test if no new cases are reported. This outbreak is unrelated to the outbreak that originated in West Africa.

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