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Old 08-08-2014, 01:54 PM   #1
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Default Ebola: Sierra Leone

Informative interview with a virologist on the ground in Sierra Leone.

Q&A: American Virus Expert in Africa’s Ebola Zone: ‘This is Like War’
Quote:
How are health care workers in the region coping? Dozens have died across the region since the outbreak began.

There's been a lot of abandoning ship, for lack of a better way of saying it.

It's hard to blame them for leaving.


Indeed. You are facing something very dangerous. This is just like a war. You have people who either run toward danger or run away from it. Both are understandable. And there's no shame in either.

...What is the infrastructure like in Sierra Leone? Can it handle the outbreak?

In a city of over 200,000 people, there's no power grid. Imagine a city being run off of a generator and trying to operate any kind of high-tech equipment, like a ventilator. It's just not possible.

...Are the newcomers not trained well enough?

Professionals go through years of training in how to be careful, what small mistakes not to make. Imagine rolling into a setting, taking on volunteers to help you fight the fight, giving them as much training as you can.

Combine that with working 12 to 14 hour shifts. You're now wearing full personal protective equipment in an environment where the average temp can [top 95ºF]. You're sweating. You probably haven't eaten, because there's been no chance to take a break to eat. Maybe you had a few weeks of training. Let's say you have an itch on your nose and instinctively you reach to scratch that itch—you've just exposed yourself...
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Old 08-11-2014, 08:11 AM   #2
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Quote:
Sierra Leone Ebola: 'We are two steps behind'

Possibly more than 1,700 people have been infected with Ebola
UPDATED 12:31 AM CDT Aug 11, 2014


SIERRA LEONE (CNN) —It's Monday, mid-morning as we drive east down rain-slicked roads. There are no cars, no trucks, and no people. Sierra Leone's government demanded a shutdown and its citizens are listening. The West African nation crippled by Ebola is responding to the outbreak through a day of prayer and reflection.

But that gives little comfort to us. Ebola is a disease that spreads fear faster than it infects. And the emptiness makes us uneasy.

We're headed to Doctors Without Borders or MSF's treatment facility in Kailahun, a border community in the middle of the Kissi triangle, linking the country with Liberia and Guinea. Simply put, it's the epicenter of this unprecedented epidemic.

Already more than 1,700 people have been infected across the three countries and now Nigeria and possibly more. Ebola can kill up to 90% of those infected and more than 930 people have already died in this epidemic, dwarfing all previous Ebola outbreaks.

The WHO has just declared it a public health emergency. But as we sit down with MSF's emergency coordinator at their makeshift headquarters, we realize, months since the first infection, no one yet truly knows the outbreak's full scope.

"We are too late. In an Ebola outbreak you need to be a step ahead. We are two steps behind," says Anja Wolz.

What MSF needs, says Wolz, isn't more doctors -- they have those. What's needed are more experts out in the communities, to trace the disease and help train local health workers, she says.

Wolz, a veteran responder to outbreaks, much of her staff's time is focused educating workers on how to respond safely to a virus that can infect with just one drop of bodily fluid. If mistakes are made, the results are deadly.
http://www.koco.com/national/sierra-...ehind/27375530
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Old 08-11-2014, 03:18 PM   #3
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The number of healthcare workers that continue to be infected is mind blowing.

Quote:
Eight Chinese quarantined in Ebola-hit Sierra Leone

FREETOWN: Eight Chinese medical workers who treated patients suffering from the deadly Ebola virus have been placed in quarantine in Sierra Leone, the Chinese ambassador in Freetown said on Monday (Aug 11).

Seven Chinese doctors and one nurse, as well as five local nurses who treated Ebola patients, have been placed in quarantine, said ambassador Zhao Yanbo.
http://www.channelnewsasia.com/news/.../1307530.html?
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Old 08-11-2014, 03:54 PM   #4
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Hi Exodia, I think I know how the HCWs are getting sick. At least I think I know.

Patrick Sawyer infected the healthcare workers associated with him. The HCWs did not get it from patients. I think a few HCWs are getting it from patients and then passing it along when they are out of their suits. A spot of blood may get in a HCWs eye causing the base infection. Days later, they are at the local bar with co-worker friends breathing spit on each other. Or maybe they are double-dippers. HCWs are the "amplification points", they ARE the amplifiers.

---------- Post added at 03:54 PM ---------- Previous post was at 03:53 PM ----------

Interestingly, the article did not say WHY they were put into quarantine.
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Old 08-11-2014, 04:53 PM   #5
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Asymptomatic so perhaps simply an excess of caution.
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Old 08-11-2014, 05:27 PM   #6
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It's possible, although maybe not likely, that they're being quarantined as part of preparing to go home to China.
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Old 08-12-2014, 03:08 PM   #7
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An excerpt from an excellent article about conditions in one village in Sierra Leone.


At Heart of Ebola Outbreak, a Village Frozen by Fear and Death

Quote:
...Even at the Doctors Without Borders treatment center outside Kailahun, the doctors say they are not keeping pace with the epidemic, despite a staff of over 300, 10 tents, more than 2,000 protective suits and a mathematically precise layout to reduce the risk of infection.

“I think we are two steps behind,” Dr. Wolz said.

“We are still discovering villages,” she said, where Ebola victims are dying at home, rather than in isolation, risking new infections. There have been up to 140 new cases at the treatment center over the last three weeks, she said.

At the Doctors Without Borders center, a medical assistant flipped cans of sardines to grateful Ebola patients behind a barrier, several of whom were eager to demonstrate their healthiness. But one patient, struggling to his feet, held his head in his hands. “Hurting, hurting, hurting,” said Mamou Samba, a 43-year-old mason, groaning and demanding painkillers.

Behind the tents, the morgue is full. A body arrived — a young man, his arm hanging limply from the stretcher, who appeared to have been in his prime. Most of the patients are breadwinners for their families, as one staff member put it. A team of five in full protective gear disinfected the corpse with a potent chlorine spray solution. Behind the morgue rose smoke from the latest incineration of protective gear, which is discarded after a single use.

Dr. Wolz said the outbreak would not end this year. “Everybody sends experts,” she said. “They sit in offices and go to meetings. We need people to go into the field.”
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Old 08-12-2014, 04:49 PM   #8
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That is a sombre read & the entire article is well worth reading as an example of the enormous struggle that lies ahead.
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Old 08-12-2014, 07:29 PM   #9
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Default Two patients died of Ebola at two Hospitals.

The Chinese ambassador in Freetown said Monday eight Chinese medical workers who treated patients suffering from the deadly Ebola virus have been placed in quarantine in Sierra Leone. Ambassador Zhao Yanbo said, "Six Chinese doctors and one nurse as well as five local nurses treated an Ebola patient at the Jui Hospital who later died of the virus."
=====
Zhao Yanbo, the Chinese ambassador to Sierra Leone, would not say if the seven doctors and one nurse were showing any symptoms.
=====


"Six Chinese doctors and one nurse as well as five local nurses treated an Ebola patient at the Jui Hospital who later died of the virus," said ambassador Zhao Yanbo.

"All of them who came in contact with the patient have been quarantined for the past two weeks under observation while the hospital has been fumigated and closed temporarily."

Yanbo said another Chinese doctor who treated an Ebola patient at the Kingharman Road Hospital had also been quarantined.

http://news.yahoo.com/eight-chinese-...184831106.html


---------- Post added at 07:29 PM ---------- Previous post was at 07:27 PM ----------

http://www.sierraexpressmedia.com/?p=69637
Ebola patient dies at Chinese Hospital






By: SEM Contributor on August 4, 2014.

The deadly Ebola virus has killed a 40 year-old woman only known as Aminata of Father Street, Lunsar at the Chinese Hospital, Jui on 1st August 2014.

This reporter gathered that the woman was first admitted at the Saint John of God Catholic Hospital, Mabesseneh, Lunsar in the Port Loko District two weeks ago due to failing health and her blood sample was taken to Kenema for testing but that by the time the result was brought back to the hospital, the woman escaped to the Magbinteh Hospital in Makeni.

Mabesseneh Hospital Head of Communication, Joshua Sandy disclosed that Aminata was admitted at the hospital for diarrhea and vomiting which caused her blood sample to be taken to Kenema for testing for Ebola but that by the time they knew the result she had disappeared only to later learn that she had been admitted at the Magbinteh Hospital in Makeni.

He continued that the management of Mabesseneh Hospital informed the Port Loko District Health Management Team (DHMT) and the Chiefdom Public Health Team about the development before he heard that she has died at the Chinese Friendship Hospital in Jui.

According to sources at Magbinteh, Aminata visited the hospital on business only for another person who had earlier seen her at Mabesseneh informing staff at Magbinteh Hospital that Aminata was earlier admitted at the Mabesseneh Hospital in Lunsar where she escaped and surfaced at the Chinese Friendship Hospital.

Sources at the Chinese Friendship Hospital revealed to this medium that three relatives of the late Aminata and the health workers who had contact with her have been quarantined to be observed for twenty-one days.

A relative of the late Aminata disclosed to this medium that she was complaining of chest pain that led to her admission at the Mabesseneh Hospital.

According to the World Health Organization (WHO), over 700 people have died of the virus in Sierra Leone, Guinea and Liberia including over 60 health workers.

The Chinese Friendship Hospital has been closed as investigations into the matter continue.
By Abdul R. Bedor Kamara

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Old 08-12-2014, 07:35 PM   #10
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Quote:
“We are still discovering villages,”
This area of Africa is like a two edged sword. There are densely populated areas and very remote areas, a bad combo for infections and then runners.

I've been helping out with some of the Red Cross mapping (trying to locate and tag villages/dwelling/roads/path using satellite imagery). There are some places that are literally in the middle of nowhere, only accessible by footpath through the bush. The chances of someone finding them with being directed there is zero. I'm sure there are entire small villages that could be decimated and nobody would ever know.
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Old 08-12-2014, 07:57 PM   #11
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Quote:
Originally Posted by Exodia View Post
This area of Africa is like a two edged sword. There are densely populated areas and very remote areas, a bad combo for infections and then runners.

I've been helping out with some of the Red Cross mapping (trying to locate and tag villages/dwelling/roads/path using satellite imagery). There are some places that are literally in the middle of nowhere, only accessible by footpath through the bush. The chances of someone finding them with being directed there is zero. I'm sure there are entire small villages that could be decimated and nobody would ever know.
Ex, how did you get the gig? what's it like?

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Old 08-12-2014, 08:14 PM   #12
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Exodia, thank you for this most valuable contribution to the control effort.
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Old 08-12-2014, 08:54 PM   #13
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Quote:
Originally Posted by Sonny View Post
Ex, how did you get the gig? what's it like?
Anyone can do it: http://abcnews.go.com/Health/red-cro...ry?id=24863778
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Old 08-12-2014, 10:39 PM   #14
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Quote:
Originally Posted by Sonny View Post




Ex, how did you get the gig? what's it like?

~
As others said, open to anyone. I have a "thing" for maps, I thought it was something I could contribute to. It can be a bit tedious, but there are also times when you find a building or trail that nobody else saw, and that's pretty cool. I'd be really pleased if this contributes to the effort in some small way.

I can imagine telling my dad that I create maps on overlays of photos Africa taken from space to help combat a killer illness. It's a world I doubt he could imagine.
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Old 08-13-2014, 11:36 AM   #15
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Quote:
Ebola kills leading Sierra Leone Dr. Modupeh Cole

An official in Sierra Leone says another of the country's leading physicians has died from Ebola.

Ebola has killed more than 1,000 people in a West African outbreak that has also hit Guinea, Liberia and Nigeria. Many of the dead are health workers, who are often working with inadequate supplies and protection.

Sidie Yayah Tunis, director of communications for the Ministry of Health and Sanitation, announced that Modupeh Cole died Wednesday. The U.S.-trained Cole was one of the lead doctors working in the Ebola isolation ward in Connaught Hospital in Freetown, the capital.

Cole's death comes on the heels of that of another physician who was leading Sierra Leone's fight against Ebola, Sheik Humarr Khan.
http://www.cbc.ca/news/health/ebola-...cole-1.2735161
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Old 08-13-2014, 01:59 PM   #16
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Quote:
Ebola Spreads Throughout Sierra Leone

Kim Lewis
Last updated on: August 13, 2014 10:51 AM


As Ebola virus outbreaks continue to spread in Sierra Leone, humanitarian agencies such as the International Rescue Committee (IRC) work to contain the disease and educate communities about how to prevent contamination.

IRC country director Saffea Senessie says the country urgently needs major technical and financial resources to contain the spread of the disease.

“The current rate of the transmission of the disease is faster than the efforts to contain it,” says Senessie. “The geographic spread of the outbreak in Sierra Leone is so fast we now have it in 12 of the 14 systems.”

“The challenge we have now is to contain the disease,” he says.

Resources are stretched too far

The IRC country director added the other challenge is obtaining the resources and materials to meet the medical needs of all of the affected districts before it spreads further. “If all stakeholders including the government had invested six weeks ago, less money would have been required now,” Senessie says.

“There needs to be strengthening of coordination between different organizations and delegate responsibilities between the international technical staff, non-governmental organizations, and the ministry of health,” he says. “Quality, clinical case management is the cornerstone of Ebola control.”

People fear they will contract Ebola at clinics

Another major problem is that many people are afraid to enter health facilities.

“We are observing significant drops in utilization of health services,” he says. “People are scared to go to health facilities because they are both worried about getting Ebola from health workers,” he says.

Health workers are being stigmatized. Senessie reports that some people have spread rumors that health workers are injecting people with Ebola.

Such misinformation makes it important, he says, that community leaders educate the public about the disease to restore public confidence in healthcare workers.
http://www.voanews.com/content/ebola.../2412006.html?
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Old 08-13-2014, 03:22 PM   #17
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I think we are at a point where the reported numbers are meaningless. The only way to gauge it is how many are dying per day, and there is so much stuff that kills people in that part of the world that we will never really know.
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Old 08-13-2014, 04:56 PM   #18
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Very true.
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Old 08-13-2014, 05:01 PM   #19
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The number of dead isn't accurate either. But the death rate does at least provide an indication of what's happening.
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Old 08-13-2014, 05:18 PM   #20
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I saw this raised elsewhere, sort of.

Has the government of SL overflown the affected areas? I appreciate if they're flying over deep jungle, it may be impossible to see anything but it can't all be thick jungle. We hear of people fleeing villages - they have to have gone somewhere. Other villages are rumoured to contain nothing but the dead. Surely at least a glimpse of... SOMETHING might be possible?

Might help to gain a better understanding of what's really going on away from where any aid is available.
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Old 08-14-2014, 02:33 PM   #21
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Finding confirmed cases of Ebola in police officers is as bad as the cases of HCW's. Given the amount of contact with the public, it might even be worse.

Sierra Leone: As Ebola Kills Two Police Officers - IG Munu Warns Citizens to Obey the Law


Quote:
Inspector General of Police Francis Munu has sternly warned Sierra Leoneans to understand the current reality on the ground and obey the law for the safety of all.

..."The time for denial is over and we should now take responsibility and be accountable for the decisions we take," he said and disclosed that two police officers have contracted the Ebola disease and that one of them got infected through his friend who is a medical practitioner. He however refused to name the officers.

He said they have provided protective gears for some of officers and that the duty of security officers is to restrict the movement of persons in quarantined locations, and not to have any contact with infected persons...
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Old 08-14-2014, 02:38 PM   #22
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If police officers are intelligent, somewhat trained, getting infected, and have no protective gear, they will soon disappear and will resist going near anybody, contributing to lawlessness contributing to collateral deaths.
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Old 08-14-2014, 02:54 PM   #23
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Then need to dismiss and drop the "Only by contact with Body Fluids" in the warning, That's wrong and it's getting people killed.

replace it with just, "Any unprotected Contact with an infected person".

That was appropriate with HIV AIDS, but this Ebola is way more infectious than AIDS.

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Old 08-14-2014, 05:45 PM   #24
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You're right Sonny - I fear many assume if you can't SEE a bodily fluid, there's none there. Often, that's just flat out wrong.

The police officers may have been the first to enter homes or other locations where there were victims; goodness, there are so many ways they could have come into contact with the disease.

As to intelligence & training, as much as we're used to that here, it may simply been a case of being well connected & able to handle a firearm better than the other local thugs.
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Old 08-14-2014, 07:05 PM   #25
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Hells bells CS, they could have shaken someone hand and then rub his eye, maybe he ate an apple without washing it after no telling how many people had handled it?? eh?

Please CS, tell us the story about the fomites you tell it so well.

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Last edited by Sonny; 08-14-2014 at 07:13 PM. Reason: add link for fomites,,
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