H5N1

West Africa COVID-19 deaths surge amid Ebola and other outbreaks

A news release from WHO AFRO: West Africa COVID-19 deaths surge amid Ebola and other outbreaks. Excerpt:

Brazzaville, 20 August 2021 – West Africa has recorded its highest number of COVID-19 deaths since the pandemic began as several countries grapple with outbreaks of cholera, Ebola Virus Disease and Marburg Virus Disease that threaten to further strain the already stretched emergency response capacity in the region. 

COVID-19 fatalities in West Africa over the past four weeks increased by 193% from 348 in the previous four weeks to 1018 in the week ending on 15 August. Although the case fatality ratio, or the proportion of people diagnosed with the disease who have died, stands at 1.4%—below the continental average of 2.5%—it is higher than the previous two waves in the sub-region, a sign that health systems are feeling the strain of a heavy caseload. While new cases in West Africa have dropped this week, they were surging for eight consecutive weeks. 

Overall Africa recorded over 244 000 new cases in the week ending on 15 August, an 11% drop from the week before and a second straight week of declining cases. However, nine out of 23 countries experiencing a resurgence are in West Africa. Cote d’Ivoire, Guinea and Nigeria are experiencing a surge in cases and all three countries are tackling other outbreaks. 

West Africa health systems are even more fragile than those in other sub-regions. A World Health Organization (WHO) assessment of the functionality of health systems in West Africa found that they were 21% lower than in Southern Africa, 

“We are particularly concerned about West Africa and we can expect the pressure of COVID-19 to hit health services harder and faster,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “In addition to the strain of COVID-19, comes Ebola and other outbreaks. Fighting multiple outbreaks is a complex challenge.” 

COVID-19 vaccines deliveries 

West Africa has to date received around 29 million vaccine doses—almost the same amount as East and Southern Africa. However, the rollout has been slow, with 38% of the doses administered compared with 76% in East and Southern Africa and 95% in North Africa. West Africa has delivered 2.4 doses per 100 people. In East and Southern Africa, the figure stands at 4.8 doses per 100 people. 

Vaccine shipments to Africa have picked up with the COVAX Facility delivering almost 10 million doses to Africa so far in August, that is nine times what was delivered in the same period in July. The African Union has so far delivered 1.5 million doses to nine countries. Since June, the number of doses administered per 100 people in sub-Saharan Africa has almost tripled from 1.2 per 100 people to 3.4 per 100 people. 

“While COVID-19 vaccine shipments seem to be taking off, Africa is encountering headwinds. Moves by some countries globally to introduce booster shots threaten the promise of a brighter tomorrow for Africa. As some richer countries hoard vaccines, they make a mockery of vaccine equity,” said Dr Moeti.

WHO says 49 Ebola contact cases identified in Ivory Coast

Via wionews.com, an AFP report: WHO says 49 Ebola contact cases identified in Ivory Coast.

Forty-nine individuals have been identified who were in contact with a young Guinean woman who tested positive for the Ebola virus in Ivory Coast's biggest city Abidjan, the UN health agency said Thursday. 

The 18-year-old had travelled to Abidjan by bus from Labe in northern Guinea, a journey of some 1,500 kilometres (950 miles) that traverses a densely-forested region where Ebola epidemics broke out earlier this year and 2013-16. 

It is Ivory Coast's first known case of the disease since 1994. 

Ebola, which is transmitted through close contact with bodily fluids, causes severe fever and, in the worst cases, unstoppable bleeding. 

Contact cases were identified from among fellow bus passengers as well as "among families at the starting point in Labe," WHO specialist Georges Ki-Zerbo told an online press conference of the World Health Organization's Africa branch. 

A senior health official in Labe, Elhadj Mamadou Houdy Bah, on Wednesday had said 58 contact cases had been identified there, and none had any sign of the disease. 

An Ivorian doctor told the WHO press conference that 70 people were aboard the bus, of whom 33 arrived in Abidjan, while the others are scattered across Ivory Coast. 

The bus made stops in the western towns of Duekoue and Guezabo and in the administrative capital Yamoussoukro, he said. 

"Through networking, we were able to home in on the communities" where the fellow passengers live, Health Minister Pierre Demba added. 

"We are stressing the need for vigilance" by all health structures to spot any further cases, he said. 

Three suspected cases have tested negative, according to Ivorian health authorities. 

Demba travelled Wednesday to the Ivorian-Guinean border to raise awareness of the need for vigilance. 

Matshidiso Moeti, the director of WHO-Africa, praised the two countries' "remarkable solidarity" over the Ebola situation and the swiftness of the Ivorian response. 

'Doubts' over diagnosis 

Guinea, with aid from the WHO, sent 5,000 doses of the Ebola vaccine to Ivory Coast two days after the young woman's infection emerged. 

Vaccinations began in the country on Monday. 

However, Guinean authorities on Thursday asked for a review of the initial diagnosis of the Guinean woman.  

"The improvement in symptoms... in 48 hours raises questions, given the typical course of the disease," Guinean Health Minister Remy Lamah wrote in a letter to the WHO seen by AFP. 

The minister also said that a Guinean medical team sent to Abidjan could not gain access to the patient. 

The city of Labe, where the young woman is from, recorded no cases of Ebola during the previous outbreaks in Guinea, Lamah wrote. 

He requested a "reconfirmation" of her infection by the Pasteur Institute in the Senegalese capital Dakar, which is a reference lab for West Africa, "and if possible by another accredited laboratory." 

The 2013-16 Ebola epidemic left 11,300 people dead in Guinea, Liberia and Sierra Leone, including 2,300 people in Guinea. 

A four-month outbreak in Guinea claimed 12 lives in Guinea this year before being declared over on June 19.

Ebola outbreak in Côte d'Ivoire: WHO worries about high risk of spread (updated)

Via L'infodrome: Ebola outbreak in Côte d'Ivoire: WHO worries about high risk of spread. I can't find the WHO report mentioned, but I'll keep looking. The Google translation:

The World Health Organization (WHO) fears a high risk of the spread of Ebola virus disease in Côte d'Ivoire. In a report that Linfodrome was able to consult, this Wednesday, August 18, 2021, this organization evokes a significant dispersion of people who have had contact with the confirmed case. 

In a report on the epidemiological situation of the Ebola virus disease, WHO is concerned about the high risk of the spread of this disease in Côte d'Ivoire. The rating is 3 plus (+++). With a potentially large number of contacts. Worse, this report mentions a significant dispersion of people who have had contact with an Ebola patient (+++). With continuous cross-border movements (+++). 

In addition, without wanting to push the population to panic, the world health specialist observed that the strain of virus currently circulating in Côte d'Ivoire is "unknown".

Another L'infodrome story has this to say:

According to a report from the World Health Organization (Oms-N ° 001 of August 17, 2021) that Linfodrome.ci was able to consult, there are 2 new suspected cases with no known link to the confirmed case. “The samples are being analyzed with the Institut Pasteur de Côte d'Ivoire,” the report said. Who mentions the presence of a case at the University Hospital Center (Chu) of Bouaké and another at the Chu of Treichville. Worse, "6 people who have been in contact with these patients are in quarantine at Vitib, in Grand Bassam", adds our source.

Côte d'Ivoire has recorded one confirmed case of Ebola virus patient and 0 deaths.

Update: I've now found the WHO report mentioned in the story. While it's dated August 17, the internal date in the 14th, so I don't know how much of this information is really current. Here's the Google translation of the key pints:

August 14, 2021: confirmation of an EVD case in Abidjan by the IPCI,
Case: 18-year-old patient, domiciled in Labé, Guinea, who came to CI,
Residence: 2 Plateaux, common courtyard, overcrowded shanty town
Symptoms: Fever + Headache, bleeding (gums, genitals)
Evolution: Hospitalized and alive
Ebolavirus species: not yet determined.
Beginning of vaccination of contacts around the case after receiving 5,000 doses of vaccine (3000 Johnson & Johnson, 2000 Merck).

Ebola in Côte d'Ivoire: WHO reports one new suspected case and nine contact cases

Via Africa Radio, an AFP report: Ebola in Côte d'Ivoire: WHO reports one new suspected case and nine contact cases. If I understand this report, the young woman may have been healthy when she left Labé and was infected somewhere along the 1,600-km road to Abidjan. The Google translation:

The World Health Organization (WHO) said on Tuesday that in addition to the confirmed case of Ebola contamination detected in Côte d'Ivoire, one suspected case and nine contact cases had been identified and were being followed up. 

"We are continuing the investigations to identify the contacts," explained to AFP the prefectural director of health (DPS) of Labé, Dr. Mamadou Hady Diallo. 

"We do not know where the contamination took place. If it is here in Labé, if it is outside Labé, in particular during the journey which took her to Ivory Coast via Forest Guinea," to N'Zérékoré, he said. 

"It was precisely in Forest Guinea that the 2021 epidemic was triggered, but also the one that struck West Africa between the end of 2013 and 2016 and which killed more than 11,300 people, mainly in Guinea (2,500 dead), Liberia and Sierra Leone, three of the poorest countries in the world. An undervalued assessment by the WHO itself. - Zaire strain - WHO has ruled."

Cote d'Ivoire starts Ebola vaccination of frontline workers

Via ReliefWeb, a WHO news release: Cote d'Ivoire starts Ebola vaccination of frontline workers. In addition to the young woman in hospital, another case is suspected. Excerpt:

Abidjan/Brazzaville, 17 August 2021 – Cote d’Ivoire has launched Ebola vaccination of high-risk populations, including health workers and first responders in Abidjan, where an Ebola outbreak was declared on 14 August. 

The country was able to swiftly begin the vaccination on 16 August with the rVSV-ZEBOV Ebola vaccine manufactured by Merck as the vaccine doses that the World Health Organization (WHO) helped secure to fight a four-month long outbreak in Guinea were sent quickly by Guinea to Cote d’Ivoire. 

The vaccine deployment from Guinea included 2,000 doses from Merck that are being used under the “ring strategy” where people who have come into contact with a confirmed Ebola patient are given the vaccine, as well as first responders and health workers. In addition, Guinea sent around 3,000 vaccine doses manufactured by Johnson & Johnson which are to be used to boost the vaccination in areas not experiencing active transmission. 

Guinea has also deployed five vaccination experts and provided monoclonal antibody treatments to Cote d’Ivoire, which declared an outbreak after confirming the Ebola virus in a patient who travelled to Abidjan by road from Guinea. The patient is currently receiving treatment at a hospital in Abidjan. Effective early treatment, which currently exists, and supportive care can significantly improve chances of surviving Ebola. 

“The Ebola vaccine is a critical tool in the fight against the virus and so it’s a top priority to move rapidly and start protecting people at high risk of the disease,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “The speed with which Cote d’Ivoire has ramped up vaccination is remarkable and shows that with effective sub-regional solidarity we can quickly take measures to extinguish lethal infections that can potentially flare up into large outbreaks.” 

In addition to the confirmed case, one suspected case and nine contacts have been identified and are being monitored. No deaths have been reported. There is no indication yet that the current outbreak in Cote d’Ivoire is linked with the one that was in Guinea. Further analysis and genomic sequencing will help determine any connection.

Ebola in West Africa: Ivory Coast reports first infection in 25 years

Via The Washington Post: Ebola in West Africa: Ivory Coast reports first infection in 25 years. 

DAKAR, Senegal — Ebola has resurfaced in Ivory Coast for the first time in 25 years, health officials said, after an 18-year-old woman from neighboring Guinea tested positive for the hemorrhagic fever in the nation’s bustling commercial capital, Abidjan. 

It is the first Ebola case in a major West African city since 2016. It comes about two months after Guinea declared the end of an outbreak that killed 12 people this year in the country and as third waves of the coronavirus pummel hospitals across the region. 

“It is of immense concern that this outbreak has been declared in Abidjan, a metropolis of more than 4 million people,” Matshidiso Moeti, the World Health Organization’s regional director for Africa, said in a statement. “However, much of the world’s expertise in tackling Ebola is here on the continent.” 

It’s unclear whether the Ivory Coast case is linked to the last epidemic, which started in February in Guinea’s forested southeast — the same region where the deadliest wave of Ebola on record erupted. That 2014-2016 outbreak killed more than 11,300 people, mostly across Guinea, Liberia and Sierra Leone. 

Health leaders in West Africa say they know how to manage the menace. Thousands of Ebola vaccine doses are on the way from Guinea, officials said late Saturday, and health workers — as well as people suspected to have come into contact with Ebola cases — will receive the first shots. 

Ivory Coast’s Health Ministry said investigators are rushing to trace contracts but did not specify how many people are thought to have interacted with the young patient, who entered the country by road Wednesday from Labé, the second-largest city in Guinea, before seeking medical help the next day in Abidjan. 

“This is an isolated and imported case,” Health Minister Pierre Dimba said in a statement. 

Ebola’s origin remains a mystery, but researchers suspect it probably came from bats. One of the flying mammals in Liberia tested positive for the virus in 2019. 

Ivory Coast last faced Ebola in 1994, when a scientist investigating primate deaths in the Tai Forest caught the virus after conducting an autopsy on a chimpanzee, according to the U.S. Centers for Disease Control and Prevention. The patient received treatment in Switzerland and recovered. 

Scientists warn that the world will see more battles with lethal disease as deforestation pushes humans closer to animals. Another Ebola outbreak emerged this year in Congo. 

Up to 90 percent of Ebola patients died in previous outbreaks, but health officials say chances of survival are better than ever with the rise of effective treatments. The scourge spreads mainly through body fluids. 

Guinea has yet to uncover other Ebola cases. Last week, the nation reported the region’s first brush with Marburg virus — another hemorrhagic fever with fatality rates of up to 88 percent, depending on the strain. 

The government has ordered 155 people into three weeks of quarantine.

Ebola in Abidjan: Here is the statement of the Ivorian Government

Via GuineeMatin.com: Ebola in Abidjan: here is the statement of the Ivorian Government. The Google translation:

The health authorities of the Ministry of Health, Public Hygiene and Universal Health Coverage were informed today, August 14, 2021, by the Pasteur Institute of Côte d'Ivoire, of a POSITIVE case of Virus Disease EBOLA after the examination of a sample taken on August 13, 2021 in the medical emergencies of the CHU of Cocody, on a young girl aged 18, of Guinean nationality. 

This young girl left Labé in Guinea for Abidjan by road. She arrived in Côte d'Ivoire on August 11 and was immediately diagnosed and taken care of by our health services on August 12, 2021 at 8 p.m. 

This is an isolated and imported case. 

The patient is currently in isolation and cared for at the treatment center for Highly Epidemic Diseases at the University Hospital of Treichville. 

Côte d'Ivoire has vaccines against Ebola. The Government will vaccinate target groups (front-line health personnel, immediate patient contact, security forces at points of entry, etc.). 

On receipt of the results of the analyzes today at 7 a.m., an emergency meeting of the health monitoring committee was held today at 10 a.m., chaired by the Minister in charge of Health and Public health. 

That same day, at 6 p.m., an emergency interministerial meeting was held at the Prime Minister's office under the chairmanship of the Prime Minister.

At the end of this working session, the following measures were adopted: 

• Reactivation of community surveillance of the Ebola response; 

• Organization of the follow-up of all identified contacts; 

• Awareness, prevention, diagnosis and management of confirmed cases; 

• Immediate vaccination of target groups; 

• Compliance with guidelines for the diagnosis and management of hemorrhagic fevers; 

• Continuation of strict compliance with the barrier measures enacted against COVID-19 which remain valid for Ebola virus disease; 

• Intense cross-border collaboration with Guinea; 

• Implementation of the standard procedures of the International Sanitary Regulations (IHR). 

The Government thanks the technical and financial partners who quickly came forward to express their support for the health response. 

It reassures the population and invites them to serenity. All arrangements are being made to deal with the situation. The sanitary device for the control of the disease exists and has been proven with success in the past. The Government invites the populations to respect hygiene and preventive measures.

Ivory Coast: A case of Ebola detected, 'immediately taken care of,' assures the Minister of Health

Via Fratmat.info: Ivory Coast: A case of Ebola detected, 'immediately taken care of,' assures the Minister of Health. The Google translation:

The Minister of Health, Public Hygiene and Universal Health Coverage, Mr. Pierre N'gou Dimba said this Saturday, August 14, 2021, that a case of Ebola was detected in Côte d'Ivoire.

In the press release he read on the 8 p.m. set of the public television channel, he also reassured Ivorians about the immediate care of the patient. 

This is a case imported from Guinea. The concerned is a young Guinean who arrived in Abidjan to see her fiancé. She would have arrived by road at the same time that the borders are closed because of the Covid-19 pandemic. Once the case was detected, she was also taken care of and isolated at the Chu de Cocody (Pasteur Institute). 

 According to the minister Pierre N'gou Dimba, her first contacts were isolated. The minister in charge of health reassured that Côte d'Ivoire has an Ebola vaccine. Thus the first contacts and the medical personnel involved in this case will be vaccinated. 

It should be noted that as part of the prevention of Ebola virus disease in Côte d'Ivoire, WHO has strengthened the capacities of front-line health workers in the Tonpki health region, in the West. And this, through two training workshops for health workers, on April 27, 2021, on case management and epidemiological surveillance of Ebola virus disease. 

Note that the Ebola virus disease epidemic resurfaced in Guinea on February 14, 2021, in the Prefecture of N'Zérékoré. A region located 133 kilometers from Danané to the south and 105 kilometers from Sipilou to the north. 

According to WHO, this geographical and health situation constitutes a real threat for the population of this zone which has twelve (12) regions and 34 health districts but also for the whole of Côte d'Ivoire, in a context where challenges related to the monitoring are obvious.

Cote d'Ivoire: More on the new Ebola case

Via linfodrome.com: Ebola : la Côte d'Ivoire records its first case. The Google translation:

The rumor about the registration of a first case of ebola has been confirmed by the Minister of Health. Côte d'Ivoire has just registered its first imported case. 

It is an 18-year-old Guinean girl who was diagnosed in whom ebola was detected. 

The young Guinean crossed the Ivorian territory by the land border. As soon as seized, a sample was taken on August 13 at Cocody University Hospital on the latter. 

The minister reassures that the young girl has been taken care of since August 12 by the epidemic disease department of the University Hospital of Treichville.  In order to prevent the spread of the disease, the girl was isolated. 

There is therefore no panic in the remainder.

Cote d’Ivoire declares first Ebola outbreak in more than 25 years

Google Maps

Thanks to Krutika Kuppalli for alerting me to this WHO AFRO report: Cote d’Ivoire declares first Ebola outbreak in more than 25 years | WHO | Regional Office for Africa.

Abidjan/Brazzaville – The Ministry of Health of Cote d’Ivoire today confirmed the country’s first case of Ebola since 1994. This came after the Institut Pasteur in Cote d’Ivoire confirmed the Ebola Virus Disease in samples collected from a patient, who was hospitalized in the commercial capital of Abidjan, after arriving from Guinea. 

Initial investigations found that the patient had travelled to Cote d’Ivoire by road and arrived in Abidjan on 12 August. The patient was admitted to a hospital after experiencing a fever and is currently receiving treatment. 

Guinea experienced a four-month long Ebola outbreak, which was declared over on the 19 June 2021. There is no indication that the current case in Cote d’Ivoire is linked to the earlier outbreak in Guinea. Further investigation and genomic sequencing will identify the strain and determine if there is a connection between the two outbreaks. 

This year Ebola outbreaks have been declared in the Democratic Republic of the Congo and Guinea, but it is the first time an outbreak has occurred in a large capital city such as Abidjan since the 2014–2016 West Ebola outbreak. 

“It is of immense concern that this outbreak has been declared in Abidjan, a metropolis of more than 4 million people,” said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa. “However, much of the world’s expertise in tackling Ebola is here on the continent and Cote d’Ivoire can tap into this experience and bring the response to full speed. The country is one of the six that WHO has supported recently to beef up their Ebola readiness and this quick diagnosis shows preparedness is paying off.” 

WHO is helping to coordinate cross-border Ebola response activities and 5000 Ebola vaccines doses which the organization helped secure to fight the outbreak in Guinea are now being transferred to Cote d’Ivoire, following an agreement between the ministries of health of Cote d’Ivoire and Guinea. An aircraft is departing Abidjan soon to collect the vaccines which will be used to vaccinate people at high risk, including health workers, first responders and contacts of confirmed cases. 

WHO staff based in Cote d’Ivoire are supporting the investigation into the case. In addition, a multidisciplinary team of WHO experts covering all key response areas will be deployed rapidly to the field. They will help with ramping up infection prevention and control of health facilities, diagnostics, contact tracing, treatment and reaching out to communities to ensure they take a key role in the response.  

Cote d’Ivoire declared the outbreak in line with International Health Regulations and WHO does not advise any travel restrictions to and from the country. 

While countries are focused on the COVID-19 response, they should strengthen their preparedness for potential Ebola cases.   

While Cote d’Ivoire borders Guinea and Liberia which were struck hard by the 2014–2016 West Africa Ebola outbreak, the country has had no confirmed cases reported since 1994, when an outbreak among chimpanzees infected a scientist.  

Ebola is a severe, often fatal illness affecting humans and other primates. Case fatality rates have varied from 25% to 90% in past outbreaks. There is now effective treatment available and if patients receive treatment early, as well as supportive care, their chances of survival improve significantly.