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Ebola Re-Emerges In Liberia Near Monrovia

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After 7 weeks Ebola re-emerges In Liberia near Monrovia.

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SCIENCEINSIDER

Breaking news and analysis from the world of science policy

A billboard in Monrovia earlier this year.

UNMEER/FLICKR (CC BY-ND 2.0)

A billboard in Monrovia earlier this year.

 

Liberia's puzzle: How did the new Ebola patient become infected?
 

Kai is a contributing correspondent forScience magazine based in Berlin, Germany.

More than 7 weeks after Liberians took to the streets to celebrate that their country had been declared free of Ebola, the deadly virus has come back, raising fears of a resurgence. The body of a 17-year-old boy who died recently has tested positive for Ebola, Liberian deputy minister of health Tolbert Nyenswah announced yesterday. The big question now is how he became infected.

The World Health Organization (WHO) has sent a team to investigate the case and trace all contacts in collaboration with the Liberian health ministry. "Obviously this is not good news," says Tarik Jasarevic, a spokesman for WHO. But he also pointed out that a sample was taken from the body after death, an Ebola test was done, and when it came back positive, a team was dispatched immediately to conduct a safe burial. "This shows clearly that Liberia is in a much better position than it was a year ago," Jasarevic says.

"It is really important to understand how this person got infected," Jasarevic adds. The patient's hometown of Nedowian is close to Liberia’s capital Monrovia, and far away from the border regions with Sierra Leone (SL) and Guinea, the two countries where the virus is still spreading. At a meeting about the case held this morning at Liberia's ministry of health, some suggested that the boy might have traveled within Liberia the past 2 weeks, says Philippe Le Vaillant, a program manager for Liberia at Doctors without Borders currently working in Monrovia, who attended the meeting. Travel inside the country would not explain how he became infected, however, because Liberia is officially Ebola-free. "There is no known source of infection and there's no information about him traveling to Guinea or SL,” a spokesperson for the ministry of health wrote in an email. 

 

It's possible that the disease was recently reimported into the country and that the boy came in contact with patients who haven't been reported—a worrying scenario because it could lead to further spread. Interviews with his siblings will hopefully yield more information soon, Le Vaillant says.

 Health officials seem to have missed the case initially because the patient tested positive for malaria, says Le Vaillant, which may have kept them from doing an Ebola test. "Malaria cases are increasing here now and the symptoms can be very similar to an Ebola infection,” he says.

If more Ebola cases are found, they could be treated in the Ebola Treatment Units (ETUs) that are still running. Liberia was officially declared free of the disease on 9 May, 42 days after the last patient, a woman, fell ill. But some ETUs have remained open to take in the many suspect cases that are still being reported. Since the 9 May declaration, none of those had tested positive for the Ebola virus.

 

Posted in AfricaHealth

 

http://news.sciencemag.org/africa/2015/06/liberias-puzzle-how-did-new-ebola-patient-become-infected

Edited by niman

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Ebola Death in Liberia Sparks Fears of New Outbreak

Quarantine imposed after teenage boy dies of the disease

 
Health workers carry the body of a person that they suspected died from the Ebola virus on March 11, 2015, at a graveyard on the outskirts of Monrovia, Liberia. The corpse of a 17-year-old boy has tested positive for Ebola in Liberia, but no other cases have been reported, the country's deputy health minister said late Monday.ENLARGE
Health workers carry the body of a person that they suspected died from the Ebola virus on March 11, 2015, at a graveyard on the outskirts of Monrovia, Liberia. The corpse of a 17-year-old boy has tested positive for Ebola in Liberia, but no other cases have been reported, the country's deputy health minister said late Monday. PHOTO:ASSOCIATED PRESS

JOHANNESBURG—Liberian officials on Tuesday quarantined a neighborhood near the capital city where a 17-year-old boy died of Ebola, a grim setback for a poor African country that was declared free of the deadly virus in May.

Deputy Health Minister Tolbert Nyenswah said dozens of people were under observation after potentially coming into contact with a boy who died on Sunday. His body tested positive for the Ebola virus this week.

“There’s a single new case of Ebola confirmed,” Mr. Nyenswah said. “We will show the world this is something we are used to dealing with.”

The World Health Organization declared Liberia Ebola-free on May 9, after 42 days without a newly recorded infection. That was a major milestone for a country that lost nearly 5,000 people to a yearlong epidemic that was claiming more than 400 lives a week at its September peak.

Liberia’s government was slow to address the crisis and lost more citizens than Guinea and Sierra Leone, the other West African nations hardest hit by the most severe outbreak of the hemorrhagic fever on record.

The main concern here is: Did this man infect anybody else before he died?

—Ben Neuman, a virologist at the U.K.’s University of Reading

But an aggressive public-awareness campaign persuaded Liberians to embrace preventative measures that slowed Ebola’s spread, like washing their hands with chlorinated water and avoiding shaking hands. Groups like the Centers for Disease Control and Prevention helped Liberian officials stamp out the virus in villages hidden deep in the rain forest.

Liberia’s neighbors haven’t succeeded in beating Ebola back as far. Twelve new infections were recorded in Guinea and eight in Sierra Leone in the week through June 21, the World Health Organization said, the latest period for which data is available.

The outbreak has claimed more than 11,200 lives since it began in Guinea late in 2013.

Ebola’s latest Liberian victim died at his home near the country’s main airport outside the capital of Monrovia, many hours of arduous travel from regions in Sierra Leone or Guinea that are still fighting the disease.

Mr. Nyenswah said officials are still investigating whether he contracted the virus in his community or whether he may have carried it from elsewhere. “Things have moved very rapidly in the response. We are on top of this,” he said.

The new infection could be a major setback to the Liberia’s PresidentEllen Johnson Sirleaf, who is struggling to make up for what the World Bank says could be a $240 million blow to her country’s poor economy from the epidemic.

“Everything is broken and there is a need in every sector,” Ms. Johnson Sirleaf told The Wall Street Journal in March.

Write to Patrick McGroarty at patrick.mcgroarty@wsj.com

 

http://www.wsj.com/articles/ebola-death-in-liberia-sparks-fears-of-new-outbreak-1435683070

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Liberia reports first Ebola case in 3 months

Almost 2 months after it was declared free of Ebola and 3 months after its last case, Liberian health officials yesterday reported a new case involving a 17-year-old boy whose illness wasn't detected until he died, according to media reports.

Though global health officials have praised Liberia's progress against Ebola, they had warned that its Ebola-free status was fragile, given ongoing disease activity in neighboring Guinea and Sierra Leone.

Liberia's latest case, however, occurred in a part of the country that's not near the border with either country, raising concerns about where the virus came from and why it wasn't detected until the boy died.

Ebola deaths occurring in the community are always worrisome, because they reveal that the patient wasn't isolated and treated, posing a threat to the community. Also, Ebola patients are thought to be most infectious at the latest stages of illness, especially at death.

Case details

Tolbert Nyenswah, MPH, Liberia's deputy health minister and head of the country's Ebola response team, said the boy died at his home in the Margibi County village of Nedowein and was buried safety, the Associated Press (AP) reported today.

He told AllAfrica news that the boy got sick on Jun 21, and Nyenswah said in the AP report that the boy died on Jun 28. The report said the village is remote, but the AP report noted that the area is about 30 miles south of Monrovia, not far from its international airport.

So far 27 people are on the contact list, and officials have beefed up surveillance in the area, AllAfrica reported.

Authorities have quarantined two households and food is being sent to the residences, according to the AP.

Remaining Ebola threats

The World Health Organization declared Liberia free of Ebola on May 9, two incubation periods after the country's last case-patient was buried.

The country's last case was a Monrovia-area woman who died on Mar 28 and was thought to have contracted the disease from sexual contact with an Ebola survivor. Scientists suspect that after patients recover, the Ebola virus can persist much longer in semen and in immune-protected organs such as the eyes.

Progress against the virus in Guinea and Sierra Leone has stalled over the past several weeks, averaging about 20 to 27 cases per week. Responders are still seeing infections in people who aren't on known contact lists and in people who die in community settings, two markers that show the virus isn't under control.

The United Nations Mission for Ebola Emergency Response (UNMEER), in Twitter posts acknowledging Liberia's new case today, saying the country has the capacity to contain the new case, but it remains vulnerable until cases in all of the region's countries reach zero.

It added that responders are stepping up safety and surveillance activities in Liberia.

Liberia would be declared Ebola free again once two disease-free incubation periods pass—a total of 42 days—from the time its last confirmed case-patient was buried.

See also:

Jun 30 AP story

Jun 29 AllAfrica story

UNMEER Twitter feed

 

http://www.cidrap.umn.edu/news-perspective/2015/06/liberia-reports-first-ebola-case-3-months

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Liberia: Ebola Mystery - Dog Meat Story Eclipses Border Lapse Theory

 

The source of Liberia's new confirmed case of the deadly Ebola virus remains unknown with the professed strong surveillance network of the Ministry of Health unable to identify any clue since the death of patient zero on June 27, nearly a week ago. Liberia was officially declared Ebola free on May 9 by the World Health organization with assurances from officials of the Ministry of Health that the right system has now been put in place to quickly detect any new emergence of the killer virus.

More than 11,000 people have died of the disease since December 2013, the vast majority of them in Liberia, Guinea and Sierra Leone. But it has all turned out to be a hectic task for the country as the source of the virus which was confirmed positive in the specimen of a 17 year old boy who died before his status was known remains unknown.

 

According to Assistant Minister of Health for Curative and Preventive Services, Deputy Minister Designate of the Ministry of Health for Surveillance and Disease Control they are conducting investigation as there is no trace of the deceased travel outside Liberia prior to his death. "We know the community where the case came from but what we don't know is the epic link or chain of transmission and we don't also know the source of transmission. This is what we are investigating", said Neynswah.

Dog meat eating

While the Ministry of Health is still sweating over finding out the source of the new Ebola case, in the village of Nedowein in Margibi County, some 30 miles from the capital, Monrovia, villagers are confused same as health officials, as a team of health workers from the Ministry of Health, the African Union Ebola mission (ASEOWA) all gathered on the main motor road in front of the village.

Ebola Virus Disease Victim Burial

A team of FrontPageAfrica reporters visiting the area of the latest casualty noticed several jeeps and officials from the U.S. Center for Disease Control and the African Union monitors in chatters with residents as they sought to get to the bottom of how Ebola clawed its way back to Liberia. In the village, what appears to be the inability of the government to provide essential information on the source of the virus has now led to speculations with news that the deceased and others ate a rotten dog meat. According to sources in the village the 17-year old boy along with others exhumed the body of dead dog that had been buried and used it for meal.

Although animals to human transmission is one major source of the deadly virus but domestic animals such as dog are yet to be established as one of the modes of transmission of Ebola. In its effort to trace the source of the virus the Ministry of Health looks to be heavily relying on the dog eating news from villagers. Accordingly a friend to the deceased also a teenager has fallen sick after eating the dog meat along with his late friend and others. A pregnant woman who is believed to have cooked the dog is also said to be sick.

Fear grips C. H. Rennie Hospital

In Kakata, Margibi County at the C.H. Rennie Hospital, the only referral in the county, specimen from a suspected patient was transferred to the Bong County Ebola laboratory for testing, a senior nurse at the hospital confirmed to FrontPageAfrica Tuesday morning. On Tuesday, fear gripped workers at the hospital with Ebola preventive measures reintroduced especially thorough screening of people entering and leaving the hospital with nurses were suited in their Personal Protective Equipment.

Angeline Kollie, a 23 year-old practicing nurse expressed fear over the suspected case observed at the hospital and said she hopes it proves negative. "I pray to God for it to be negative because we know what Ebola did to this country, we don't want it to come back", she said. The practicing nurse said although they are aware of the preventive measures, but Ebola is normally very difficult to put under control.

"Of course we understand the preventive measures but you know this virus is hard to deal with, so all we need to do is to pray for it to not return", she said. Like Angeline, other nurses at the hospital expressed fear over the suspected case of Ebola. The C.H. Rennie hospital was one of the hardest hit medical facilities during the peak of the Ebola outbreak in Liberia in 2014 where several health workers contracted the virus and some died.

http://allafrica.com/stories/201507011303.html

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1 JULY 2015

Liberia: Govt Investigates New Ebola Source

 

Liberian authorities are investigating the source of a new Ebola victim, a 17 years old boy, who tested positive and subsequently died on June 24th in Margibi County.

The deceased is the first reported case since the World Health Organization declared Liberia Ebola-freed on May 9 and formally certificated the Government of Liberia.

Deputy Health and Social Welfare Minister, and head of the Incident Management System, Tolbert Nyenswah, told the VOA Tuesday, July 1 that the government hasn't been able to establish the source of the latest infection.

 

Nyenswah however clarified that the new case is not traceable to neighboring Guinea and Sierra Leone, two countries still battling the epidemic, respectively. News of the latest infection comes amidst recent rumor in Monrovia that there were new cases in Lofa County, northern Liberia, but the government denied.

He said tests confirmed that the 17 years old victim, who hailed from a town near the Roberts International Airport in Margibi, died of Ebola. "Officials are investigating how he contracted Ebola", the deputy minister of health added.

 
 

No one knows for sure many persons the deceased may have come in contact since he was infected and up to his death. Nyenswah's comments are no different from an earlier position held by the government in March this year just as the country was counting 42 days to become Ebola freed when a female resident of Caldwell Township, a Monrovia suburb, tested positive at the Redemption Hospital in New Kru Town and died on March 25.

Health officials at the time were not emphatic on how the 44-year-old victim might had contracted the virus, but multiple sources hinted the press that she got infected thru sexual intercourse with a boyfriend, an Ebola survivor said to have resided in the Borough of New Kru Town, on Bushrod Island.

 
 

That single case in 2014 reverted the government's gains, forcing it to start a recount of 42 days, which is two incubation periods (21 days each) for the virus to become fatal in an infected person.

The late Ruth Tugbeh was a cooked food seller, but became sick for some time and her health condition rapidly deteriorated, which led family members to have called in the response team to take her to Redemption Hospital where doctors diagnosed her Ebola positive.

 

She died subsequently while being catered to at a Chinese-run Ebola Treatment Unit at Samuel Kanyon Doe Sports Stadium in Paynesville. Liberia was declared Ebola freed about six weeks ago following the deadliest outbreak in the disease's history.

Meanwhile, more than 11,000 people have died of the disease since December 2013 majority of them from Liberia, Guinea and Sierra Leone. The three countries had largely restricted the spread of the disease, but the number of new cases in Guinea and Sierra Leone has risen recently, with the start of the rainy season in West Africa.

Fear has gripped many Liberians following news of a new case involving a 17years old boy, who tested positive died.

Nurses and doctors most of whom succumbed to the virus while on the frontline last year in fighting the deadly Ebola Virus Disease outbreak here, have reportedly begun rejecting patients at clinics and hospitals in and around Monrovia for fear of taking in unsuspected cases. By Ethel A. Tweh - Editing by Jonathan Browne

http://allafrica.com/stories/201507011277.html

 

Edited by Admin

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