H5N1

Outbreak Brief 4: Ebola virus disease (EVD) outbreak

Via Africa CDC and published on March 16: Outbreak Brief 4: Ebola virus disease (EVD) Outbreak.

Outbreak Update: Since the last brief (9 March 2021), one new probable case, two new deaths, and four new recoveries of Ebola virus disease (EVD) have been reported from the Democratic Republic of Congo (DR Congo) and Guinea. Cumulatively, 30 EVD cases, 15 deaths (CFR: 50%), and eight recoveries have been reported from DR Congo (12 cases; 6 deaths; 2 recoveries) and Guinea (18; 9; 6). Seven healthcare workers are amongst the confirmed cases: DR Congo (2) and Guinea (5). 

● DR Congo updates: Since the last brief, one new probable case, one new death, and no new recoveries from EVD have been reported. Cumulatively, 12 cases (11 confirmed and 1 probable) with six deaths (CFR: 50%), and two recoveries have been reported. See Table 1 for the breakdown by health zone. 

● Guinea updates: Since the last brief, no new confirmed cases or deaths have been reported. However, four new recoveries have been reported in Nzérékoré. Cumulatively, 18 cases (14 confirmed, 4 probable), nine deaths (CFR: 50%), and six recoveries have been reported. See Table 1 for the breakdown by region and sub-prefecture. 

● Cross-border updates: Between 15 February to 12 March 2021, 18 EVD-related alerts were reported in Sierra Leone. All alerts were investigated and tested negative for EVD by PCR. As of today no confirmed case has been reported from Sierra Leone.

COVID-19 in Moldova: 25 deaths and 1518 new cases confirmed

Via TRM.md: COVID-19 in Moldova: 25 deaths and 1518 new cases confirmed.

Another 1,518 new cases of COVID-19 infection were confirmed today in Moldova, and 25 people died as a result of complications caused by the new Coronavirus. 

Of the total number of cases, seven are imported. 

The total number of tests performed - 4,838, of which 4,503 primary and 305 repeated. 

The balance of COVID-19 cases in Moldova reached 184,856. 

Of the total number of cases, 69 are healthcare workers: 25 doctors, 34 nurses, 10 auxiliary staff. 

In all, 3,654 patients confirmed with COVID-19 infection are hospitalized in medical institutions, of which 317 are in an extremely serious health condition (57 patients are connected to assisted breathing). Another 601 people were healed. In all, 165,489 people were treated of COVID-19. 

9,381 people with mild and moderate forms of COVID-19 get treatment at home, and 17,273 are under home supervision. 

At the same time, the Ministry of Health, Labor and Social Protection announces about another 25 deaths caused by COVID-19, among those who died is an employee of the healthcare system. It is about the obstetrician-gynecologist from the Institute of Mother and Child, Anatolie Serbenco, aged 67. So far, 89 healthcare workers have died from COVID-19 infection. 

In all, 3.924 people in Moldova died from coronavirus in Moldova.  

WHO: Ebola virus disease – Guinea (17 February 2021)

Via ReliefWeb, WHO has published Disease outbreak news: Ebola virus disease – Guinea (17 February 2021). Excerpt:

On 14 February 2021, the Ministry of Health (MoH) of Guinea informed WHO of a cluster of Ebola Virus Disease (EVD) cases in the sub-prefecture of Gouécké, Nzérékoré Region, Guinea between 18 January and 13 February 2021. The cases showed symptoms of diarrhea, vomiting and bleeding after attending the burial of another relative (a 51 year-old nurse) on 1 February 2021. 

The index case of the cluster was a nurse who had originally presented at a health centre in Gouécké on 18 January 2021 with headache, physical weakness, nausea, vomiting, loss of appetite, abdominal pain, and fever. She was diagnosed with typhoid. She sought a second consultation at a health facility in Nzérékoré on 23 January 2021 for fever, vomiting, liquid stools, and physical weakness, and she was diagnosed with malaria. On 24 January she consulted a traditional practitioner in Nzérékoré, and she died on 28 January 2021. She was buried unsafely on 1 February in Gouécké. The other six cases are the five family members and the traditional practitioner she visited. 

Among the seven cases, five have died (4 probable and 1 confirmed). The other two confirmed cases are currently in isolation in dedicated health care facilities in Conakry and Gouécké, Nzérékoré region. 

The Ebolavirus species is not yet determined. Additional laboratory analyses are on-going to ascertain virus species. 

As of 15 February, one hundred and ninety-two (192) contacts have been identified, including 164 contacts in N’Zérékoré Health District and 28 in Ratoma Health District, Conakry. To date, no contacts have been reported to have travelled in neighboring countries. However, Nzérékoré is the second-largest city in Guinea and lies at the intersection of roads from Ganta (in Liberia), Danané (Côte d’Ivoire), and roads to other major hubs in Guinea like Kankan and Macenta in (Guinea). Therefore, there is concern about the exportation of EVD cases into the neighboring countries.

6 deaths from Ebola in Guinea: A serious mistake that costs money?

Via Guineematin.com: 6 deaths from Ebola in Guinea: a serious mistake that costs money? Now the question is: Where and how did the old woman, nurse Lucie Haba's stepmother, acquire Ebola? The Google translation:

A serious error by the agents of the Gouéké health center would have favored the spread of the Ebola virus, which reappeared recently in this sub-prefecture located more than 40 kilometers from the city of N'Zérékoré (in southern Guinea). The latter would have made a false diagnosis on a patient they received in December 2020 and who would be the first case of Ebola.

It was the health authorities of N'Zérékoré who announced the news on Wednesday, February 17, 2021, reports the correspondent of Guineematin.com on the spot. Contrary to what has been announced so far, the Ebola virus did not reappear at the end of January in Guinea, but long before. The nurse who died between January 27 and January 2021 is therefore not the first victim of this disease. 

Her stepmother, a 70-year-old who died in December 2020 at the Gouéké health center, is said to be patient zero (the first case). In any case, this is what the daily report of the Ebola hemorrhagic fever response teams published this Wednesday, February 17 in N'Zérékoré. 

According to this report, the old woman was hospitalized at the Gouéké health center after developing a vaginal hemorrhage. Health workers who diagnosed her concluded that she had "severe anemia". But, a few weeks after her death, the nurse who was caring for her and who happened to be her stepdaughter fell ill and also died. Several people who attended her funeral subsequently fell ill and three of them died. 

This is why, a few days after the tests which revealed the presence of the Ebola virus disease in Gouéké, the health authorities decided to count the old woman among the victims of Ebola. Which makes 6 deaths caused by the epidemic since its resurgence in Guinea. Deaths, most of which are believed to be due to the false diagnosis made by the health workers who received the first patient and which led to new contaminations. 

As for contacts, they went from 164 to 216 in N'Zérékoré, announce the health authorities.

More than 3 Ebola deaths in Guinea: here is the government's statement

Via Guineematin.com: More than 3 Ebola deaths in Guinea: here is the Government's statement. The Google translation:

In the afternoon of this Sunday, February 14, 2021, the Guinean Government declared "an epidemic of Ebola virus disease in the prefecture of N'Zérékoré, sub-prefecture of Gouecké", after examining the samples taken from sick people. According to the Guinean Ministry of Health, more than three people have already been killed by this disease which officially killed 2,536 people between the end of 2013 and the end of 2015. All the victims were said to have attended the funeral of a nurse at the center. of Goueké's health on February 01. 

Guineematin.com offers you, below, the Government's statement: 

Conakry, February 14, 2021.   

GOVERNMENT DECLARATION FOLLOWING THE DETECTION OF A CASE OF EBOLA FEVER IN THE GOUECKE SUB-PREFECTURE, N'ZEREKORE PREFECTURE 

The health authorities of the Ministry of Health were informed by the Prefectural Directorate of Health of N'Zérékoré of the detection of suspected cases of Ebola with symptoms of diarrhea, vomiting and bleeding in people who participated in the burial of 'a nurse from the Goueké health center. She died on January 28, 2021 and her burial took place on February 01 in Goueké. The first investigation carried out counted 7 cases, all over 25 years old (4 men and 3 women) including 3 cases of death (2 women and 1 man). All cases participated in the funeral of the nurse.   

The first three samples sent to the laboratories of Gueckedou and Conakry were POSITIVE for Ebola.   

Faced with this situation and in application of the international health regulations (IHR), the Guinean government declares an epidemic of Ebola virus disease in the prefecture of N'Zérékoré, sub-prefecture of Gouecké.   

A crisis meeting held on February 14, 2021 under the chairmanship of the Minister of Health, in the presence of technical and financial partners, international and national, at the ANSS recommended the following measures:   

• Isolation of all suspected cases at CTEPI N'Zérékoré and Conakry; 

• Case investigation to clarify data, identify other suspected cases and identify all contacts to be isolated;   

• Sending of an emergency investigation mission from the central level in support of the local teams in Gouecké;   

• Activation of the coordination and technical commissions of the response to Ebola;   

• Activation of intersectoral coordination through the One Health platform;   

• Supply of sensitization, prevention, diagnostic and care inputs;   

• Opening of a care center for cases detected in Gouecké;   

• Acceleration of procurement of Ebola vaccines from WHO;  

• Implementation of standard RSI procedures.   

The government thanks the technical and financial partners who quickly came forward to express their commitment to the response to this new outbreak of Ebola.   

The government reassures the population that all measures are being taken to stem this epidemic as quickly as possible. It invites the populations of the affected areas to respect hygiene and preventive measures and to report to the health authorities in the presence of suggestive signs (fever, diarrhea, vomiting and bleeding). 

Together we will win! 

The Minister of Health 

General practitioner Rémy LAMAH

North Kivu, DR Congo: A 4th case of Ebola notified in Butembo, it is a nurse

Via 7sur7.cd: North Kivu: A 4th case of Ebola notified in Butembo, it is a nurse. The Google translation:

A fourth case of the Ebola virus disease was notified in the Katwa health zone, in the town of Butembo, North Kivu province, it is in the east of the Democratic Republic of Congo this Sunday, February 14, 2021. 

This is a nurse, who has been in contact with one of the first three cases. She is 22 years old, living in the Musienene health zone, according to the provincial health minister who spoke to 7SUR7.CD. 

“Yes, we just registered a fourth case of Ebola. The patient is a nurse who showed symptoms a few days ago. She also has around 60 contacts who are already listed,” said Eugène Nzanzu Syalita. 

He announces the start of vaccination for this week which begins. More than 1,200 doses of vaccines are already on site in Butembo as well as teams from the World Health Organization (WHO) to try to cut the chain of contamination. 

The cumulative number of cases since the resurgence of the epidemic on February 7 in Biena (Lubero) is now 4 cases, including two deaths and two patients under treatment in the Katwa health zone in Butembo.

Suspected Ebola cases in Guinea rise to 8

Via GuineeNews.org: Suspected Ebola cases in Guinea: ANSS specifies! Every report I find seems to have a different number of cases; this one lists 8, all contracted at the February 1 funeral of an infected nurse. That would make 9, not counting whoever transmitted Ebola to her. The Google translation:

Information on suspected Ebola cases reported in N'Zérékoré prefecture. 

Following a burial, 8 cases of diarrhea, vomiting and bleeding were reported including 3 deaths in the sub-prefecture of Goueké, 45 km from N'Zérékoré. 

Samples were taken and sent to the Labs of Gueckedou and Conakry (haemorrhagic fever). 

4 patients have been isolated at the CTEPI in N'Zérékoré since February 11, and one in Conakry on February 12. 

The Gueckedou lab provided a first result revealing the presence of the EBOLA virus. A second confirmation is underway at the hemorrhagic fever laboratory in Conakry. 

Case history information: 

It was a nurse from the Goueké health center who fell ill, she was consulted by the head of the center and referred to N'Zérékoré center, she died between January 27 and 28, 2021. 

Her burial took place on February 01 in Goueké. 

It is among the people who took part in this funeral that these 08 cases were counted. 

Taken measures: 

Isolation of all suspected cases at CTEPI N'Zérékoré and Conakry. 

Case investigation to clarify data, identify other suspected cases, and identify and isolate all contacts. 

An investigative mission left for Goueke on February 13. 

Initiate steps to acquire vaccines against Ebola from WHO AND CDC with a view to possibly carrying out a belt vaccination in the affected areas. 

A declaration will be made upon re-confirmation. 

Next update Sunday February 14.

First deaths from Ebola in Guinea, a resurgence of the disease in West Africa

Thanks to Bojo Bodean for tweeting the link to the report in Le Monde: First deaths from Ebola in Guinea, a resurgence of the disease in West Africa. Excerpt from the Google translation:

Ebola hemorrhagic fever is back in Guinea, the first reported resurgence of the disease in West Africa, where the worst epidemic in the history of the virus started (2013-2016). 

"We are really concerned, there are already four deaths from Ebola hemorrhagic fever in the region of Nzérékoré [South-East] , including two in Nzérékoré itself and two in the sub-prefecture of Gouéké," in Forest Guinea, Guinean Minister of Health Rémy Lamah told Agence France-Presse (AFP) on Saturday (February 13). 

“There is a nurse from Gouéké who fell ill towards the end of January. She died between 27 and January 28 and was buried on 1st February in Gouéké,"  explained the head of the National Health Security Agency (ANSS), Dr. Sakoba Keïta, quoted by the GuineaMatin website. “Of those who attended the funeral, eight people showed signs: diarrhea, vomiting and bleeding. Three of them died and four others are hospitalized in Nzérékoré."

According to him, a patient had "escaped" but was found and was hospitalized in Conakry. Asked by AFP, Dr Keïta confirmed having made these comments. 

A crisis meeting on Sunday 

The boss of the ANSS and the Minister of Health have both indicated that the samples analyzed by a laboratory set up by the European Union in Guéckédou, in the region, had detected the presence of the Ebola virus. The results of additional analyzes were expected in the coming hours. 

"We have made all the arrangements, an alert team is on site to identify contact cases , " Minister Rémy Lamah told AFP. “I am worried as a human being, but I remain calm because we managed the first epidemic and vaccination is possible. There will be a crisis meeting tomorrow” Sunday. 

Causing a sudden fever, headaches, vomiting and diarrhea, the Ebola virus was first identified in 1976 in Zaire, now the Democratic Republic of Congo (DRC). Since then, this virus, for which there are two experimental vaccines but no cure, has spread terror in Africa several times.

The Guardian: Our key findings about US healthcare worker deaths to date

Via The Guardian: Our key findings about US healthcare worker deaths to date. Excerpt:

As of 10 February, Lost on the frontline has counted more than 3,400 healthcare worker deaths. The pandemic is not over, and this project is therefore a work in progress, with new names added weekly. 

These are our findings to date. 

More than half were younger than 60 

In the general population, the median age of death from Covid-19 is 78. Yet among health care workers in our database, it is only 59. The majority of people who died were under the age of 60. Hundreds of even younger people also died while working on the frontlines.

Two in three deceased health care workers identified as people of color 

Although white Americans account for about 76% of the US population, we found that almost as many black health care workers died as white health care workers.

Many of the cases involved concerns over inadequate PPE 

We learned that a large number of those who died were worried about not having enough personal protective equipment (PPE). (We only possess information about PPE concerns for a smaller subset of cases, based on interviews with family members, friends and colleagues, as well as text messages or online messages some victims sent before they died.) 

More than a third of the health care workers who died were born outside the United States 

And those from the Philippines accounted for a disproportionate number of deaths.

Nurses and support staff account for most deaths 

Roughly one in three were nurses, but the total also includes physicians, pharmacists, first responders and hospital technicians, among others.

Encouraging indicators are everywhere, but deaths remain high: This week in COVID-19 data, Jan 21

Via The COVID Tracking Project: Encouraging Indicators Are Everywhere, But Deaths Remain High: This Week in COVID-19 Data, Jan 21. Excerpt:

In last week’s update, we wrote that the United States had reported the worst weekly case, hospitalization, and death numbers of the pandemic. At the time, it wasn’t clear what proportion of the case and death increases were related to post-holiday reporting backlogs. This week brings some clarity: The backlogs appear to be largely behind us, and the underlying trends are moving in the right direction for most of the country. Even for the states experiencing the worst outbreaks, we are seeing early indications that the rates of cases, hospitalizations, and deaths are easing, though some areas are still reporting dangerously high case and hospitalization levels and wrenching death rates. 

Weekly new cases for the seven-day period beginning Thursday, January 14 were down 20 percent, the lowest number of new cases we’ve seen for a non-holiday week since mid-November. As importantly, after 16 straight weeks of increases, average weekly hospitalizations dropped 4 percent this week—a modest improvement, but a good sign. Reported tests reached a new weekly high, edging out last week by one percent—though the high test numbers this week probably reflect the fact that the testing backlog is still catching up.   

States reported 21,301 deaths this week, the second-highest number of deaths of the pandemic to date. Yesterday, states reported 4,409 COVID-19 deaths, the highest single-day number of deaths on record. For comparison, in the week of September 24, 2020, states reported fewer than 5,000 deaths for the entire week. 

Because of the way states report data for nursing homes, assisted living facilities, and other long-term-care facilities, our figures for COVID-19 in these facilities refer to the week beginning January 8. These numbers remain very alarming: For the second week in a row, LTC facilities reported the highest death toll since we started gathering long-term-care data last May—more than 7,000 residents and staff. The number of known deaths reported this week may include backlogged figures from the winter holidays, and they also got a boost from a change in Iowa’s death reporting that increased that state’s reported figure. 

There is also tentative good news from long-term-care facilities: The number of new cases was down by about 15,000 this week. It remains unclear whether case data has fully normalized from the reporting delays associated with the holidays, but next week’s data should confirm whether this case drop indicates a real improvement in the situation in long-term-care facilities.