EBOLA Epidemic Spreading in West Africa

EMERGING & RE-EMERGING INFECTIOUS DISEASES
VIRAL HEMORRHAGIC FEVERS
DEADLY EBOLA HF EPIDEMIC
SCENARIO 011
.

Death toll from Ebola outbreak in West Africa climbs to 337

Death toll from an outbreak of Ebola in West Africa—Guinea, Liberia and Sierra Leone— has risen to 337 since February, this year, reported World Health organization (WHO).

The the epidemiological situation as of June 18, 2014 is as follows:

Some 47 new cases and 14 additional deaths were reported across the region last week. Guinea is currently the worst affected country with 264 Ebola-related deaths, while  the death tolls in Sierra Leone has climbed to 49, with  Liberia reporting 24 fatalities.

Guinea (from WHO report)

Between June 14 and 16, 2014 an additional f 7 new cases and 5 new deaths were reported in Guinea, Gueckedou (4 cases and 5 deaths) and Boffa (3 cases and 0 deaths). The cumulative number of cases and deaths reported from Guinea to 398 (254 confirmed, 88 probable and 56 suspected) and 264 deaths, according to WHO.

The geographical distribution of these cases and deaths is as follows: Conakry (70 cases and 33 deaths); Guéckédou (224 cases and 173 deaths); Macenta (41 cases and 28 deaths); Dabola, (4 cases and 4 deaths); Kissidougou (8 cases and 5 deaths); Dinguiraye (1 case and 1 death); Telimele (30 cases and 9 deaths); Bofa (19 cases and 10 deaths) and Kouroussa (1 case and 1 death). Twenty four (24) patients are currently in EVD Treatment Centres: Conakry (6), Guéckédou (9), Telimele (3) and Boffa (6).

The number of contacts currently being followed countrywide is 1,258 and distributed as follows: Conakry (252), Guéckédou (529), Macenta (52), Telimele (118), Dubreka (118) and Boffa (189). So far 69.4% (2,848 contacts being followed-up out of a 4,106 contacts registered since the beginning of the outbreak) have completed the mandatory 21 days observation period.

Possible Outbreak in Senegal and Gambia

News of a possible outbreak in Senegal may have been suppressed. As of early April, Gambia had placed at least two people with suspected EHF under quarantine.

Ebola Hemorrhagic Fever (EHF)

EHF is a highly contagious virus that spreads via close personal contact and kills up to 90% of the victims.

Five subspecies of Ebolavirus have so far been found. Four of those have caused disease in humans: Ebola virus (Zaire ebolavirus); Sudan virus (Sudan ebolavirus); Taï Forest virus (Taï Forest ebolavirus, formerly Côte d’Ivoire ebolavirus); and Bundibugyo virus (Bundibugyo ebolavirus). The fifth, Reston virus (Reston ebolavirus), has caused disease in nonhuman primates, but not in humans, according to CDC.

There are  no known cure or vaccine for the Ebola virus.

In Africa, confirmed cases of Ebola HF have previously been reported in the following countries:

• Democratic Republic of the Congo (DRC)
• Gabon
• South Sudan
• Ivory Coast
• Uganda
• Republic of the Congo (ROC)
• South Africa (imported)

The current outbreak  is the first known occurrence of Ebola HF in Guinea.

“The natural reservoir host of ebolaviruses, and the manner in which transmission of the virus to humans occurs, remain unknown. This makes risk assessment in endemic areas difficult. With the exception of several laboratory contamination cases (one in England and two in Russia), all cases of human illness or death have occurred in Africa; no case has been reported in the United States,” said CDC.

Ebola virions (image 2 colorized 1), diagnostic specimen from the first passage in Vero cells of a specimen from a human patient — this image is from the first isolation and visualization of Ebola virus, 1976. In this case, some of the filamentous virions are fused together, end-to-end, giving the appearance of a “bowl of spaghetti.” Negatively stained virions. Magnification: approximately x40,000.  Micrograph from F. A. Murphy, University of Texas Medical Branch, Galveston, Texas.

12 deadly pathogens could spread into new regions aided by climate change

A report by Wildlife Conservation Society released on October 7, 2008 lists 12 deadly pathogens that could spread globally as a result of climate change. “All have potential impacts to both human and wildlife health as well as global economies.” Report said.

Titled ‘The Deadly Dozen: Wildlife Diseases in the Age of Climate Change,’ the report illustrates examples of diseases that could spread due to temperatures changes and variations in regional precipitation levels.

The “Deadly Dozen” list [ABC order]

1. Avian influenza
2. Babesia
3. Cholera
4. Ebola
5. Intestinal and external parasites
6. Lyme disease
7. Plague
8. Red tides
9. Rift Valley fever
10. Sleeping sickness (trypanosomiasis)
11. Tuberculosis
12. Yellow fever

Situation in Conakry (Guinea) – from WHO report

The outbreak in Conakry, capital city of Guinea with total population of about 1.5 million, started on 3 March 2014. It is linked (epidemiologically) to the outbreak in Gueckedou.

• As at 15 June 2014, a total of 68 cases and 33 deaths were reported of which 31 cases recovered and discharged. The distribution of cases by location is shown in figure 3.

• Cumulatively, 1001 contacts were identified of which 668 completed their follow-up and currently 333 are under follow-up.

• The outbreak spread to the following districts: Telimele (30 cases including 9 deaths), Boffa (19 cases including 10 deaths) and Kouroussa (1 case including 1 deaths). The geographical distribution of cases in Telimele and Boffa is shown on the next page.

Situation in Gueckedou, Macenta and Kissidougou (Guinea)

Gueckedou

• The first cases of EVD outbreak in West Africa were reported from Gueckedou district which has a total population of 405,000.

•  The onset of the index case was on 2 December 2013.

•  A total number of 221 cases including 171 deaths were reported; 43 cases were recovered and discharged.

•  Cumulatively, 1911 contacts were identified of which 1366 completed their follow-up and currently 545 are under follow-up.

Macenta

• The outbreak in Macenta district started on 17 February 2014. The total population of the district is 296, 000.

•  A total of 41 cases and 28 deaths were reported of which 12 cases recovered and discharged.

•  Cumulatively, 359 contacts were identified of which 307 completed their follow-up and currently 52 are under follow-up.

Kissidougou

•  The outbreak in Kissidougou district started on 24 February . The total population of the district is 214,000.

• A total of 8 cases and 5 deaths reported of which 3 recovered and discharged.

• No new cases have been reported since 1 April 2014.

RELATED LINKS

• Sierra Leone “Quarantines” Ebola Affected Area June 14, 2014
• Ebola Kills 100 in West Africa April 5, 2014
• Ebola Spreads to Liberia, Senegal Shuts Border March 31, 2014
• Ebola Outbreak Kills Dozens March 23, 2014
• Marburg Hemorrhagic Fever Breaks Out in SW Uganda October 20, 2012
• Disaster Calendar – 28 July 2012 July 28, 2012
• Climate Change Spreads “Deadly Dozen” Diseases October 8, 2008