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Ebola Begins With A 2-Year-Old African Boy In Guinea- Tracing The Breakout Tags: News Guinea Liberia Sierra Leone Health

Patient Zero in the Ebola outbreak, researchers suspect, was a 2-year-old boy who died on Dec. 6, just a few days after falling ill in a village in Guéckédou, in southeastern Guinea. Bordering Sierra Leone and Liberia, Guéckédou is at the intersection of three nations, where the disease found an easy entry point to the region.

A week later, it killed the boy’s mother, then his 3-year-old sister, then his grandmother. All had fever, vomiting and diarrhea, but no one knew what had sickened them.

Two mourners at the grandmother’s funeral took the virus home to their village. A health worker carried it to still another, where he died, as did his doctor. They both infected relatives from other towns. By the time Ebola was recognized, in March, dozens of people had died in eight Guinean communities, and suspected cases were popping up in Liberia and Sierra Leone — three of the world’s poorest countries, recovering from years of political dysfunction and civil war.

In Guéckédou, where it all began, “the feeling was fright,” said Dr. Kalissa N’fansoumane, the hospital director. He had to persuade his employees to come to work.

On March 31, Doctors Without Borders, which has intervened in many Ebola outbreaks, called this one “unprecedented,” and warned that the disease had erupted in so many locations that fighting it would be enormously difficult.

Now, with 1,779 cases, including 961 deaths and a small cluster in Nigeria, the outbreak is out of control and still getting worse. Not only is it the largest ever, but it also seems likely to surpass all two dozen previous known Ebola outbreaks combined. Epidemiologists predict it will take months to control, perhaps many months, and a spokesman for the World Health Organization said thousands more health workers were needed to fight it.

Some experts warn that the outbreak could destabilize governments in the region. It is already causing widespread panic and disruption. On Saturday, Guinea announced that it had closed its borders with Sierra Leone and Liberia in a bid to halt the virus’s spread. Doctors worry that deaths from malaria, dysentery and other diseases could shoot up as Ebola drains resources from weak health systems. Health care workers, already in short supply, have been hit hard by the outbreak: 145 have been infected, and 80 of them have died.

Past Ebola outbreaks have been snuffed out, often within a few months. How, then, did this one spin so far out of control? It is partly a consequence of modernization in Africa, and perhaps a warning that future outbreaks, which are inevitable, will pose tougher challenges. Unlike most previous outbreaks, which occurred in remote, localized spots, this one began in a border region where roads have been improved and people travel a lot. In this case, the disease was on the move before health officials even knew it had struck.

Also, this part of Africa had never seen Ebola before. Health workers did not recognize it and had neither the training nor the equipment to avoid infecting themselves or other patients. Hospitals in the region often lack running water and gloves, and can be fertile ground for epidemics.

Public health experts acknowledge that the initial response, both locally and internationally, was inadequate.

“That’s obviously the case,” said Dr. Thomas R. Frieden, director of the Centers for Disease Control and Prevention. “Look at what’s happening now.”

He added, “A couple of months ago, there was a false sense of confidence that it was controlled, a stepping back, and then it flared up worse than before.”

Health experts have grown increasingly confident in recent years that they can control Ebola, Dr. Frieden said, based on success in places like Uganda.

But those successes hinged on huge education campaigns to teach people about the disease and persuade them to go to treatment centers. Much work also went into getting people to change funeral practices that involve touching corpses, which are highly infectious.

But in West Africa, Ebola was unknown.

How Ebola Spread

A report in The New England Journal of Medicine traces the spread of the recent Ebola outbreak from Guéckédou, Guinea, to towns nearby.

In some areas, frightened and angry people have attacked health workers and even accused them of bringing in disease.

“Early on in the outbreak, we had at least 26 villages or little towns that would not cooperate with responders in terms of letting people into the village, even,” said Gregory Hartl, a spokesman for the World Health Organization.

The outbreak has occurred in three waves: The first two were relatively small, and the third, starting about a month ago, was much larger, Mr. Hartl said. “That third wave was a clarion call,” he said.

At a House subcommittee hearing on Thursday, Ken Isaacs, a vice president of Samaritan’s Purse, said his aid group and Doctors Without Borders were doing much of the work on the outbreak.

“That the world would allow two relief agencies to shoulder this burden along with the overwhelmed Ministries of Health in these countries testifies to the lack of serious attention the epidemic was given,” he said.

Guinea’s Monumental Task

In mid-March, Guinea’s Ministry of Health asked Doctors Without Borders for help in Guéckédou.

At first, the group’s experts suspected Lassa fever, a viral disease endemic in West Africa. But this illness was worse. Isolation units were set up, and tests confirmed Ebola.

Like many African cities and towns, this region hums with motorcycle taxis and minivans crammed with passengers.

The mobility, and now the sheer numbers, make the basic work of containing the disease a monumental task. The only way to stop an outbreak is to isolate infected patients, trace all their contacts, isolate the ones who get sick and repeat the process until, finally, there are no more cases.

But how do you do that when there can easily be 500 names on the list of contacts who are supposed to be tracked down and checked for fever every day for 21 days?

“They go to the field to work their crops,” said Monia Sayah, a nurse sent in by Doctors Without Borders. “Some have phones, but the networks don’t always work. Some will say, ‘I’m fine; you don’t have to come,’ but we really have to see them and take their temperature. But if someone wants to lie and take Tylenol, they won’t have a temperature.”

What You Need to Know About the Ebola Outbreak

At Donka Hospital in Guinea’s capital, Dr. Simon Mardel, a British emergency physician who has worked in seven previous hemorrhagic fever outbreaks and was sent to Guinea by the World Health Organization, realized this outbreak was the worst he had seen. A man had arrived late one night, panting and with abdominal pain. During the previous few days, he had been treated at two private clinics, given intravenous fluids and sent home. The staff did not suspect Ebola because he had no fever. But fever can diminish at the end stage of the disease.

The treatment room at Donka was poorly lit and had no sink. There were few buckets of chlorine solution, and the staff found it impossible to clean their hands between patients.

The man died two hours after arriving. Tests later showed he had been positive for Ebola. Untold numbers of health care workers and their subsequent patients had been exposed to the disease.

Gloves, in short supply at the hospitals, were selling for 50 cents a pair on the open market, a huge sum for people who often live on less than a dollar a day. At homes where families cared for patients, even plastic buckets to hold water and bleach for washing hands and disinfecting linens were lacking.

Workers were failing to trace all patients’ contacts. The resulting unsuspected cases, appearing at hospitals without standard infection control measures, worsened the spread in a “vicious circle,” Dr. Mardel said.

Tracing an Epidemic’s Origins

As is often the case in Ebola outbreaks, no one knows how the first person got the disease or how the virus found its way to the region. The virus infects monkeys and apes, and some previous epidemics are thought to have begun when someone was exposed to blood while killing or butchering an infected animal. Cooking will destroy the virus, so the risk is not in eating the meat, but in handling it raw. Ebola is also thought to infect fruit bats without harming them, so the same risks apply to butchering bats. Some researchers also think that people might become infected by eating fruit or other uncooked foods contaminated by droppings from infected bats.

Once people become ill, their bodily fluids can infect others, and they become more infectious as the illness progresses. The disease does not spread through the air like the flu; contact with fluids is necessary, usually through the eyes, nose, mouth or cuts in the skin. One drop of blood can harbor millions of viruses, and corpses become like virus bombs.

A research team that studied the Guinea outbreak traced the disease back to the 2-year-old who died in Guéckédou and published a report in The New England Journal of Medicine. He and his relatives were never tested to confirm Ebola, but their symptoms matched it and they fit into a pattern of transmission that included other cases confirmed by blood tests.

But no one can explain how such a small child could have become the first person infected. Contaminated fruit is one possibility. An injection with a contaminated needle is another.

Sylvain Baize, part of the team that studied the Guinea outbreak and head of the national reference center for viral hemorrhagic fevers at the Pasteur Institute in Lyon, France, said there might have been an earlier case that went undiscovered, before the 2-year-old.

“We suppose that the first case was infected following contact with bats,” he said. “Maybe, but we are not sure.”

Roaring Back in Liberia

Dr. Fazlul Haque, deputy representative of Unicef in Liberia, said that after a few cases there in March and April, health workers thought the disease had gone away. But it came roaring back about a month later.

“It reappeared, and this time, it came in a very big way,” he said. “The rate of increase is very high now.”

From July 30 to Aug. 6, Liberia’s government reported more than 170 new cases and over 90 deaths.

“Currently, our efforts are not enough to stop the virus,” Dr. Haque said.

He added that most health agencies believed the true case numbers to be far higher, in part because locals were not coming forward when relatives fell ill, and because detection by the health authorities has been weak. Rukshan Ratnam, a spokesman for Unicef in Liberia, said some families had hidden their sick to avoid sending them to isolation wards, or out of shame stemming from traditional beliefs that illness is a punishment for doing something wrong.

Dr. Haque said that the tracing of cases, crucial for the containment of the disease, was moving too slowly to keep up with new infections. Seven counties have confirmed cases, and the government has deployed security forces in Lofa County, where Liberia’s first case was detected, he said. But the government has given leave to nonessential employees in those areas, so it is not clear how they will have the staffing to isolate the sick. Some hospitals have closed because so many health workers have fallen ill.

Liberia has closed markets and many border crossings. It has said testing and screening will be done at immigration checkpoints.

But on Thursday, at a checkpoint staffed by at least 30 soldiers in Klay, Bomi County, there was no screening — just a blockade and a line of trucks loaded with bags of charcoal, plantains and potato greens.

Hilary Wesseh, a truck driver who was sucking the last drops of juice out of a small lime, said he had been stuck there for two days.

“They are holding us hostage,” he said.

A Desperate Call for Help

By June and July, Sierra Leone was becoming the center of the outbreak. At the government hospital in Kenema, Dr. Sheik Umar Khan was leading the efforts to treat patients and control the epidemic.

But he was desperate for supplies: chlorine for disinfection, gloves, goggles, protective suits, rudimentary sugar and salt solutions to fight dehydration and give patients a chance to survive. Early in July, he emailed friends and former medical school classmates in the United States, asking for their help and sending a spreadsheet listing what he needed, and what he had. Many of the lines in the “available” column were empty. One of his requests was for body bags: 3,000 adult, 2,000 child.

Before his friends could send the supplies, Dr. Khan contracted Ebola himself. He died on July 29.

Source: NYtimes

South Sudan Introduces Pentavalent Vaccine For Infants Tags: South Sudan News Children Vaccine

The Ministry of Health in South Sudan and its partners have introduced the "Pentavalent" vaccine for infants against preventable diseases. According to Health Minister Riek Gai Kok, the new vaccine will help save the lives of hundreds of thousands of South Sudanese children. "The 'five-in-one,' or 'Pentavalent' vaccine… will replace the three-in-one Trivalent vaccine which is currently being used to protect against diphtheria, whooping cough, tetanus, liver diseases and pneumonia, meningitis and septicaemia," Kok told Anadolu Agency on Friday.

"More than 451,500 infants under one year of age are expected to be reached in the first year," Kok added.

"When we look at the household survey of 2010, close to 234,000 children under the age of five die every year due to preventable diseases, such as pneumonia, meningitis and septicaemia," Kok said.
"And we hope that the number of vaccine-preventable deaths in children under the age of five will significantly reduce following the introduction of the new vaccine in South Sudan," he added.

Kok said the South Sudanese government would share the cost of the new vaccine with the Global Alliance for Vaccines and Immunisation (GAVI) Alliance, a global public-private partnership that aims to provide poor countries with vaccine programs.

"The government is proud and grateful in launching this life-saving vaccine, even as our country continues to face challenges because of the ongoing political crisis," he added.

"We are grateful to our donors and partners for the support in helping us to save the lives of children in this young nation; we hope that they will continue to support us to introduce other vaccines which are already in use in other countries," the minister asserted.

According to the World Health Organisation, the number of deaths among children under five years old due to vaccine-preventable diseases in South Sudan has fallen – from 135 per 1000 live births in 2006 to 108 per 1000 live births in 2010 – due to increased vaccination, while adding that the trend still remains a concern.

According to the Millennium Development Goal Four, the number of deaths among children under five years of age globally has been greatly reduced, from more than 12 million in 1990 to seven million in 2011.

Source: 

Sierra Leone and Liberia Announce States Of Emergency, Army Enforced Quarantine Zones And House To House Searches To Round Up Suspected Victims Tags: Sierra Leone Liberia Health Ebola West Africa

The Ebola virus outbreak has led both Sierra Leone and Liberia to declare states of public emergency, meaning the army can now move in to enforce quarantine zones.

It is a major escalation of both governments’ responses to the disease, which has killed more than 670 people across four West African countries since February.

The measures in Sierra Leone were announced in a statement late last night by President Ernest Bai Koroma, and came just hours after a similar declaration from neighbouring Liberia.

Top health officials have repeatedly criticised the lack of national and international organisation in response to the Ebola outbreak, which has seen fears in Britain and the rest of the world that the virus could be transmitted globally.

In Sierra Leone, poor infection control systems and chaos sparked by mistrust in the health service have allowed the virus to reach from remote jungle epicentres right to the heart of the coastal capital Freetown.

As a result the West African airline Asky has suspended its flights to both the capitals of Liberia and Sierra Leone, and said passengers departing from Guinea would be carefully screened.

It is the same airline that was used by the US citizen Patrick Sawyer who flew to Lagos, Nigeria before he died from Ebola.

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  • President Koroma has now cancelled a planned visit to Washington for the US-Africa summit next week.

Speaking late on Wednesday, he said: “I hereby proclaim a State of Public Emergency to enable us take a more robust approach to deal with the Ebola outbreak.”

The measures will be in place initially between 60 and 90 days and “all epicentres of the disease will be quarantined,” President Koroma said.

Following a number of attacks on health workers by local communities – some of whom blame the authorities for causing the disease – security forces will be used to protect NGO officers and health officials, and house-to-house searches will be carried out to track Ebola victims.

Liberia said on Wednesday it will close schools and consider quarantining some communities, while all non-essential government workers will be required to take 30 days of compulsory leave.

While Britain has brought in measures to protect its borders from the threat of an Ebola victim arriving here on a plane, the Foreign Secretary Philip Hammond said the most effective contribution the UK can make is with helping fight the outbreak on the ground in West Africa.

By the end of the week at least five officials from Public Health England will have joined teams of experts from all over the world to help coordinate the systems of infection control, quarantine and contact tracing required to slow and ultimately end the outbreak.

International efforts are being coordinated by Medicins San Frontieres and the World Health Organisation, which said in its last Ebola updated that it continues to “scale up and strengthen all aspects of the response” across Sierra Leone, Liberia and Guinea.

Source: Independent

Winnie Mandela Contests Nelson Mandela’s Will Tags: Nelson Mandela News South Africa

Nelson Mandela’s ex-wife Winnie Madikizela-Mandela is contesting the will of the late anti-apartheid hero in a bid to claim the country estate where he is buried reports the Daily Mail.

Relatives of the South African political icon have been bickering over his estate since his death in December 2013, and Mandela’s second wife is now insisting ownership of his country home should pass to her family.

Madikizela-Mandela, who married the civil rights activist in 1958 and divorced him in 1996, claims the property in Qunu should belong to her and her children because she bought it in 1989, during her then husband’s imprisonment on Robben Island.
Her lawyer has addressed her claim in a letter to South Africa’s Deputy Chief Justice Dikgang Moseneke.


Madikizela-Mandela was left nothing in her ex-husband’s will and his $4.1 million estate is to be split between his family, the African National Congress party, former staff and a number of schools.

Source:  Eurweb

Ellen Johnson Sirleaf Apologises For High Toll For Ebola Health Workers Tags: News Liberia Ebola Ellen Johnson Sirleaf HealthWest Africa

Liberia's President Ellen Johnson Sirleaf apologised on Saturday for the high death toll among the country's healthcare workers who have fought an Ebola outbreak, which has killed nearly 1,000 people in three countries.

Johnson Sirleaf pledged up to $18 million for the Ebola fight, part of which will be given to health workers to help with insurance and death benefits, to fund more ambulances and to increase the number of treatment centres.

"If we haven't done enough so far, I have come to apologise to you," she told hundreds of health workers who gathered at Monrovia's City Hall for a meeting with her government.

The West African Ebola outbreak, centred on Guinea, Sierra Leone and Liberia, is the worst in history. The World Health Organization (WHO) said on Friday it is an international health emergency that will likely continue spreading for months.

The disease has put a severe strain on the health systems of affected states and governments have responded with a range of measures, including the declaration of national emergencies in Sierra Leone, Liberia and Nigeria, which confirmed seven cases of Ebola in Lagos.

Ebola has reaped a high toll on health workers who have acted as first responders. Liberia alone has lost at least three doctors to the virus and 32 health workers.

Sierra Leone's Health Ministry said a senior physician had contracted the disease at the Connaught referral hospital in the capital, Freetown.

Dr. Modupeh Cole contracted the disease "after treating a patient ... who was later proved to have the virus and died," said ministry spokesman Sidi Yahya Tunis.

Cole was taken to an Ebola treatment centre in eastern Kailahun district, run by medical charity Medecins Sans Frontieres, Tunis said.

He is the latest Sierra Leonean medical practitioner to contract the virus. The country's leading Ebola doctor, Shek Umar Khan, died of the disease last month and several nurses have died.

GUINEA BORDERS TO STAY OPEN

Guinea said earlier on Saturday at a news conference attended by four government ministers that it had closed its borders with Sierra Leone and Liberia to halt the spread of Ebola.

Authorities said the decision was taken primarily to prevent infected people crossing into Guinea, where at least 367 people have died of Ebola since March and 18 others are being treated in isolation.

However, state television later said the borders remained open, in an about-face that appeared to highlight the difficulties governments face in coordinating policy in the face of the fast-moving outbreak.

"Guinea has not closed its borders with Sierra Leone or with Liberia. It's rather that we have taken health measures at the border posts," the television channel said.

A government source said the minister who made the original announcement had not been in possession of accurate information.

Ebola is one of the deadliest diseases known to humanity. It has no proven cure and there is no vaccine to prevent infection. The most effective treatment involves alleviating symptoms that include fever, vomiting and diarrhoea.

The rigorous use of quarantine is needed to prevent its spread, as well as high standards of hygiene for anyone who might come into contact with the disease.

These measures have proved hard to enforce given that Ebola has spread in rural parts of some of the world's poorest countries. The task is made harder because of mistrust of health workers in areas with inadequate public health services.

FRESH EBOLA TESTS

The WHO said on Friday 961 people have died during the outbreak and 1,779 have been infected. The infections and deaths have led to tests on suspected Ebola cases around the world.

Authorities in Ghana said they were testing samples from a man from Burkina Faso who died while being transported to hospital in the Upper East region.

"He had fever and was bleeding from the nose so we are testing him for Ebola because we don't want to take chances," Yaw Manu, medical head at Bawku Presbyterian Hospital, said by telephone. Ghana has previously conducted about 20 Ebola tests, though none has proved positive.

Test results for a patient being treated in a Toronto-area hospital for a suspected case of Ebola are due within 24 hours, Ontario's health ministry said on Saturday. The patient recently came to Canada from Nigeria.

Authorities in Benin also said they were testing a patient for Ebola, the second suspected case in the country, while Saudi Arabia's Health Ministry said initial tests on a dead Saudi citizen suspected of having Ebola were negative.

International alarm over the spread of the disease increased last month when a U.S. citizen died in Nigeria after travelling there by plane from Liberia. Since then, other countries with no cases of the disease have taken measures as a precaution.

Zambia said it would restrict the entry of travellers from countries affected by the virus and would ban Zambians from travelling to those countries, in one of the strictest actions by any nation outside of West Africa.

Zambia's Health Ministry also advised against holding any "international events" such as conferences and other gatherings, citing concerns about controlling potential outbreaks.

Gambia's Ministry of Transport said any planes flying to the capital, Banjul, should not pick up passengers at airports in Conakry, Freetown or Monrovia. 

Source: Reuters

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"WHY ALL OF THIS ARE HAPPENING IN AFRICA.IS THIS A CASE OF END..."
In: African woman Naked Her Self For RICHES (PHOTOS, Cameroon)
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