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[stem-ebola] PRO/SOAS> Ebola virus disease - West Africa (22): UNMEER, WHO updates

EBOLA VIRUS DISEASE - WEST AFRICA (22): UNMEER, WHO UPDATES
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In this posting:
[1] UNMEER: External Situation Report 23 Oct 2014
[2] WHO: Ebola Response Roadmap Situation Report 25 Oct 2014

******
[1] UNMEER: External Situation Report 23 Oct 2014
Date: Thu 23 Oct 2014
Source: UN Mission for Ebola Emergency Response (UNMEER) [edited]
<http://www.un.org/ebolaresponse/pdf/Situation_Report-Ebola-23Oct14.pdf>


Highlights
----------
- A total of 9936 cases of Ebola virus disease (EVD) have been
reported and 4877 deaths [as of 25 Oct 2014 WHO has reported 10 141
EVD and 4922 deaths
<http://apps.who.int/iris/bitstream/10665/137185/1/roadmapupdate25Oct14_eng.pdf>]

- SRSG Banbury met with the President of Sierra Leone, Ernest Bai
Koroma, to discuss the
operational framework for the EVD crisis.
- Many WHO staff, including Assistant Director General for Health
Systems and Innovation,
Dr Marie-Paule Kieny, are volunteering to test experimental EVD
vaccines.

Key Political and Economic Developments
---------------------------------------
1. SRSG [UN Special Representative of the Secretary-General] Banbury
met with the President of Sierra Leone, Ernest Bai Koroma, to discuss
the operational framework for the EVD crisis response developed at a
recent UNMEER Meeting in Accra [15-18 Oct 2014]. The President
expressed his support for the framework that would continue to be
developed and tailored to the national context of Sierra Leone. SRSG
Banbury also met with the head of the National Ebola Response Centre,
the Development Group leaders, and the heads of UN agencies to discuss
the implementation of the National Response Plan.
2. Many WHO staff, including Assistant Director General for Health
Systems and Innovation, Dr Marie-Paule Kieny, are volunteering to test
experimental EVD vaccines. Human tests for safety and effectiveness of
2 promising vaccines have already begun in Mali, the UK, and the US
and are about to begin in Gabon, Germany, Kenya, and Switzerland. The
next phase of human testing will be in West Africa.

Medical
-------
3. [A total of 10 141 confirmed, probable, and suspected cases of EVD
have been reported in 6 affected countries (Guinea, Liberia, Mali,
Sierra Leone, Spain, and the USA) and 2 previously affected countries
(Nigeria, Senegal) up to the end of 23 Oct 2014. There have been 4922
reported deaths.
<http://apps.who.int/iris/bitstream/10665/137185/1/roadmapupdate25Oct14_eng.pdf>.]
4. All but one district in Liberia and all districts in Sierra Leone
have now reported at least one confirmed or probable case of EVD since
the outbreak began.
5. A total of 443 health-care workers [450 as of 23 Oct 2014] have
been infected with EVD and 244 have died.
6. The WHO reported that meeting the overall EVD crisis response
target of isolating 70 per cent of EVD cases by [1 Dec 2014], and 100
per cent of cases by [1 Jan 2015], requires effective case
identification, isolation, and treatment. In terms of case
identification, WHO estimates that 28 laboratories are required across
the 3 most affected countries. At present, 12 laboratories are
operational (3 in Guinea, 5 in Liberia, and 4 in Sierra Leone). Up to
20 000 contact tracing staff may also be needed. In regard to case
isolation and treatment, the WHO estimates that 4388 beds are required
in 50 Ebola treatment units (ETUs) across the three most affected
countries. At present, 1126 (25 per cent) are in place. In addition,
there remains a gap in the availability of foreign medical teams to
manage and staff ETUs -- there are firm commitments from teams for 30
of the planned 50 ETUs.
7. WHO reported that there are 140 teams trained in the management of
dead bodies currently operating -- 34 in Guinea, 56 in Liberia, and 50
in Sierra Leone. To meet the EVD response target that 70 per cent of
burials are carried out safely by properly trained and equipped teams
by [1 Dec 2014], WHO estimates 230 additional dead-body-management
teams will be required in these countries.
8. The Secretary-General of the International Federation of Red Cross
and Red Crescent Societies (IFRC), Elhadj As Sy, said the EVD outbreak
could be contained within 4 to 6 months if the right steps are
followed. The time frame is possible with good isolation and treatment
for those with confirmed cases of EVD, along with safe and dignified
burials for those who died. Mr Elhadj As Sy also argued that closing
borders would not effectively curb EVD infections.
9. The West Africa Health Organization reported that it would deploy
300 health workers to Guinea, Liberia, and Sierra Leone.
10. 83 health workers from Cuba arrived in Guinea and Liberia,
bringing to 256 the number of medical workers sent by Cuba so far to
the affected countries.
11. Burundi is to send a team of medical staff that will help control
the EVD outbreak in the 3 affected countries.
12. Johnson & Johnson is accelerating work on its experimental Ebola
vaccine and aims to produce 1 million doses next year [2015], 250 000
of which are expected to be available by May [2015].
13. The US Centers for Disease Control and Prevention (CDC) have
announced a new program of active monitoring of every person coming
back to the US from Guinea, Liberia, and Sierra Leone.
The travelers concerned will be asked to carry out daily self-checks
for fever and provide contact details of friends or family.
Temperatures are recommended to be taken twice per day and reported
once per day and these travellers will also receive a care kit that
includes a tracking log, instructions for monitoring temperature, and
a pictorial description of symptoms. There is also a phone number to
call if symptoms develop.

Logistics
---------
14. The IFRC reported on its efforts to stop EVD. Across the affected
countries this week [week of 23 Oct 2014] the IFRC traced 3907
contacts, reached 5600 households through social mobilization, and
conducted 701 safe and dignified burials.
15. The World Bank and UNFPA [UN Population Fund] donated 38
motorbikes and 13 computers and accessories to the Government of
Sierra Leone. UNICEF delivered 8 vehicles and 100 motorbikes to the
Government of Guinea.
16. The US Ebola 'czar' has commenced work and a 30-member
military-led EVD emergency team, including 5 doctors, 20 critical care
nurses, and 5 trainers who are experts in infectious disease
protocols, has begun its training. This team will be rapidly deployed
in response to any further EVD cases in the US.

Outreach and education
----------------------
17. The US Centers for Disease Control and Prevention is tracking the
approximate locations of cell phone users in Guinea, Liberia, and
Sierra Leone who dial emergency call centers in an effort to predict
the onset and spread of EVD.

Resource mobilisation
---------------------
18. The World Olympians Association and Oxfam have launched the
#TargetEbola campaign to help combat EVD.
19. All humanitarian partners, including donors and recipient
agencies, are encouraged to inform OCHA's Financial Tracking Service
(FTS (<http://fts.unocha.org>) of cash and in-kind contributions by
e-mailing <fts@xxxxxx>.)

Essential services
------------------
20. WFP [UN World Food Program], working in Guinea, Liberia, and
Sierra Leone, has delivered 13 125 metric tonnes of food to 776 000
people since April 2014, transported 1130 responders by UNHAS [United
Nations Humanitarian Air Service], with 2 planes and one helicopter in
operation, and provided 7718 m3 of medical cargo.
21. FAO is urgently calling for USD 30 million to support activities
linked to its Regional Response Programme to the EVD Outbreak over the
next 12 months. The FAO is aiming to provide immediate assistance to
90 000 vulnerable households to boost their food security.

The UNMEER report also provides links to a number of useful
resources:
- WHO Ebola response roadmap:
[<http://apps.who.int/iris/bitstream/10665/137185/1/roadmapupdate25Oct14_eng.pdf>]
- US Centres for Disease Control and Prevention EVD Outbreak and
Distribution Map:
<http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/distribution-map.html>
- OCHA Guinea EVD dashboard:
<http://www.humanitarianresponse.info/system/files/documents/files/Dashboard-Guinea%20as%20of%2020%20Oct%2014.pdf>
- OCHA Liberia EVD dashboard:
<http://www.humanitarianresponse.info/system/files/documents/files/Dashboard-Liberia%20as%20of%2020%20Oct%2014.pdf>
- OCHA Sierra Leone EVD dashboard:
<http://www.humanitarianresponse.info/system/files/documents/files/Dashboard-SierraLeone%20as%20of%2020%20Oct%2014.pdf>
- OCHA Guinea 3W [Who, What, Where]:
<http://www.humanitarianresponse.info/system/files/documents/files/GIN_A4_L_141020_Ebola_3W_Reponse.pdf>
- OCHA Sierra Leone 3W:
<http://www.humanitarianresponse.info/system/files/documents/files/SLE_A4_L_141020_Ebola_3W_Reponse.pdf>
[- OCHA Liberia 3W:
<http://www.humanitarianresponse.info/system/files/documents/files/LBR_A4_3W_Ebola_20141020.pdf>]

--
Communicated by:
ProMED-SoAs
<promed-SoAs@xxxxxxxxxxxxxx>

******
[2] WHO: Ebola Response Roadmap Situation Report 25 Oct 2014
Date: Sat 25 Oct 2014
Source: WHO Global Alert and Response (GAR), Pandemic and Epidemic
Diseases, Situation reports: Ebola response roadmap [summ., edited]
<http://apps.who.int/iris/bitstream/10665/137185/1/roadmapupdate25Oct14_eng.pdf?ua=1>


Situation report update -- 25 Oct 2014
--------------------------------------
Summary
-------
A total of 10 141 confirmed, probable, and suspected cases of Ebola
virus disease (EVD) have been reported in 6 affected countries
(Guinea, Liberia, Mali, Sierra Leone, Spain, and the United States of
America) and 2 previously affected countries (Nigeria, Senegal) up to
the end of [23 Oct 2014]. There have been 4922 reported deaths.

Following the WHO Ebola Response Roadmap structure, country reports
fall into 2 categories: 1) those with widespread and intense
transmission (Guinea, Liberia, and Sierra Leone); and 2) those with or
that have had an initial case or cases, or with localized transmission
(Mali, Nigeria, Senegal, Spain, and the United States of America).

Countries with widespread and intense transmission
--------------------------------------------------
A total of 10 114 confirmed, probable, and suspected cases of EVD and
4912 deaths have been reported up to the end of [18 Oct 2014] by the
Ministry of Health of Liberia, [21 Oct 2014] by the Ministry of Health
of Guinea, and [22 Oct 2014] by the Ministry of Health of Sierra Leone
All but one district in Liberia and all districts in Sierra Leone have
now reported at least one case of EVD since the start of the outbreak
Of the 8 Guinean and Liberian districts that share a border with Cote
d'Ivoire, only 2 are yet to report a confirmed or probable case of
EVD.

A total of 450 health-care workers (HCWs) are known to have been
infected with EVD up to the end of [23 Oct 2014]: 80 in Guinea; 228 in
Liberia; 11 in Nigeria; 127 in Sierra Leone; one in Spain; and 3 in
the United States of America. A total of 244 HCWs have died.

WHO is undertaking extensive investigations to determine the cause of
infection in each case. Early indications are that a substantial
proportion of infections occurred outside the context of Ebola
treatment and care. Infection prevention and control quality assurance
checks are now underway at every Ebola treatment unit in the 3
intense-transmission countries. At the same time, exhaustive efforts
are ongoing to ensure an ample supply of optimal personal protective
equipment to all Ebola treatment facilities, along with the provision
of training and relevant guidelines to ensure that all HCWs are
exposed to the minimum possible level of risk.

Country: cases (all) / deaths
Guinea: 1553 / 926
Liberia*: 4665 / 2705
Sierra Leone**: 3896 / 1281
Total: 10 114 / 4912

*For Liberia, 276 more confirmed deaths have been reported than have
confirmed cases. **For Sierra Leone, 127 more probable deaths have
been reported than have probable cases. Data are based on official
information reported by Ministries of Health. These numbers are
subject to change due to ongoing reclassification, retrospective
investigation and availability of laboratory results.

Countries with an initial case or cases, or with localized
transmission
-----------------------------------------------------------------------
5 countries (Mali, Nigeria, Senegal, Spain, and the United States of
America) have now reported a case or cases imported from a country
with widespread and intense transmission.

In Nigeria, there were 20 cases and 8 deaths. In Senegal, there was
one case and no deaths. However, following a successful response in
both countries, the outbreaks of EVD in Senegal and Nigeria were
declared over on [17 Oct and 19 Oct 2014], respectively.

On [23 Oct 2014], Mali reported its 1st confirmed case of EVD  The
patient was a 2-year old girl who travelled from the Guinean district
of Kissidougou with her grandmother to the city of Kayes in western
Mali, which is approximately 600 km [373 mi] from the Malian capital
Bamako and lies close to the border with Senegal. The patient was
symptomatic for much of the journey. On [22 Oct 2014] the patient was
taken to Fousseyni Daou hospital in Kayes, where she died on [24 Oct
2014]. At present, 43 contacts, of whom 10 are HCWs, are being
monitored; efforts to trace further contacts are ongoing. A WHO team
was already in Mali to assess the country s state of readiness for an
initial case. A rapid-response team will also arrive in the coming
days.

In Spain, the single case tested negative for EVD on [19 Oct 2014]. A
2nd negative test was obtained on [21 Oct 2014]. Spain will therefore
be declared free of EVD 42 days after the date of the 2nd negative
test if no new cases are reported. A total of 83 contacts are being
monitored.

There have now been 4 cases and one death in the United States of
America. The most recent case is a medical aid worker who volunteered
in Guinea and returned to New York City on [17 Oct 2014]. The patient
was screened and was asymptomatic on arrival, but reported a fever on
[23 Oct 2014], and tested positive for EVD. The patient is currently
in isolation at Bellevue Hospital in New York City, one of 8 New York
State hospitals that have been designated to treat patients with EVD.
Possible contacts are being identified and followed up. 2 HCWs who
became infected after treating an EVD-positive patient at the Texas
Presbyterian Hospital of Dallas, Texas, have now tested negative for
EVD. Of a total of 176 possible contacts linked with these cases, 109
are currently being monitored; 67 have completed 21-day follow-up. In
Ohio, 153 crew and passengers who shared a flight with one of the
infected HCWs (prior to the patient developing symptoms) are being
followed-up, though they are considered low-risk and are not
considered to be contacts.

Country: cases (all) / deaths
Mali: 1 / 1
Spain: 1 / 0
USA: 4 / 1
Total: 6 / 2

--
Communicated by:
ProMED-SoAs
<promed-SoAs@xxxxxxxxxxxxxx>

[The full update is available at the source URL above. It includes:
- Tables of confirmed, probable, and suspected cases in the 6
currently affected countries (Guinea, Liberia, Mali, Sierra Leone,
Spain, and the United States of America)
- Map of the geographical distribution of new cases and total cases in
Guinea, Liberia, and Sierra Leone.
- Annex 1: Categories used to classify Ebola cases (suspected,
probable, confirmed)
- Annex 2: overview of the situation in the Democratic Republic of the
Congo, where a separate, unrelated outbreak of EVD is occurring. -
Sr.Tech.Ed.MJ]

[The road to recovery is likely to be long and arduous, in addition to
the human cost. The lesson that gets reinforced is that we cannot
realistically expect the public health problems in developing
countries with limited and often inadequate health infrastructure to
resolve on their own. While efforts to curb the ongoing, now global
Ebola crisis, continue, support to improve long term efforts in health
surveillance and response should be the ultimate goal - Mod.UBA

A HealthMap showing the distribution of EVD cases and deaths can be
seen at <http://healthmap.org/ebola/>.]

[See Also:
Ebola virus disease - West Africa (21): WHO Senegal & Nigeria free,
preparedness 20141023.2881479
Ebola virus disease - West Africa (20): WHO 20141018.2869581
Ebola virus disease - West Africa (19): WHO update, OIE, animal
reservoirs 20141013.2853581
Ebola virus disease - West Africa (18): WHO, Senegal 20140918.2779772
Ebola virus disease - West Africa (17): WHO, outbreak tracker, mapping
20140911.2762699
Ebola virus disease - West Africa (16): WHO, UK vaccine trial, Sierra
Leone 20140906.2750459
Ebola virus disease - West Africa (15): WHO, Nigeria, costs, China
drug 20140904.2747465
Ebola virus disease - West Africa (14): WHO Ebola outbreak control
20140901.2740203
Ebola virus disease - West Africa (13): mutations, new drug options
0140831.2736334
Ebola virus disease - West Africa (12): WHO update, US/Canada vaccine
trials 20140830.2732520
Ebola virus disease - West Africa (11): Senegal ex Guinea, 1st case
conf. 20140829.2734739
Ebola virus disease - West Africa (10): personnel, expert infected,
therapies 20140827.2721269
Ebola virus disease - West Africa (09): WHO update, more female
deaths, hidden cases 20140824.2717652
Ebola virus disease - West Africa (08): WHO update 20140822.2709441
Ebola virus disease - West Africa (07): WHO update, exit screening
recommended 20140821.2706092
Ebola virus disease - West Africa (06): WHO, Liberia, FDA, media
reports 20140816.2695949
Ebola virus disease - West Africa (05): WHO update 20140814.2690501
Ebola virus disease - West Africa (04): WHO, experimental drugs, CDC
case def., media 20140813.2684947
Ebola virus disease - West Africa (03): WHO update 20140811.2674847
Ebola virus disease - West Africa (02): WHO, International health
emergency 20140810.2674775
Ebola virus disease - West Africa (01): WHO update 20140809.2670371

For additional background information on Ebola virus disease, the
following ProMED-mail posts can be found at
<http://www.promedmail.org>

Ebolavirus, animal reservoir (05): USA, dog, NOT 20141026.2901733
Ebola virus disease - ex Africa (24): USA nurse better, China, USA
troops 20141025.2899189
Ebola virus disease - ex Africa (23): USA (NYC) MSF doctor ex Guinea
Ebola virus disease - West Africa (196): WHO, Mali conf. case ex
Guinea, Liberia
Ebola virus disease - ex Africa (22): Canada, China, France, UK, USA,
guidelines
Ebola virus disease - West Africa (195): Liberia, Sierra Leone, drug
trials
Ebola virus disease - ex Africa (16): USA (TX) 2nd nurse case
Ebola virus disease - ex Africa (15): UN doctor dies, USA, prevention
Ebola virus disease - ex Africa (12): in hospital management
challenges
virus disease - West Africa (191): Liberia, Sierra Leone, volunteers,
vaccine testing
Ebola virus disease - ex Africa (11): Europe, threat to N. America,
recurrence
Ebola virus disease - West Africa (190): Liberia, Sierra Leone, China
monitoring
Ebola virus disease - ex Africa (09): WHO, Spain, Australia, Canada,
USA
Ebola virus disease - West Africa (189): Sierra Leone, Liberia, OIE
20141008.2841244
Ebola virus disease - West Africa (183): great apes as sentinels
20140930.2818170
Transboundary disease transmission - USA: risk from wildlife trade
20140831.2738382
Ebola virus disease - West Africa (116): Morocco NOT, Nigeria,
bushmeat, more 20140805.2663054
Ebola virus disease - West Africa (68): Liberia, One Health approach
20140619.2553035
Ebola virus disease - West Africa (23): Cote d'Ivoire, bushmeat ban
20140421.2419488
Ebola virus disease - Guinea (02): bat eating banned 20140326.2359281
and other items in the archives]
.................................................uba/mj/pkb
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