Evening Ebola Update, Sun, 10/12: Caseload drops in Liberia after brothers/nuns engage villages   Leave a comment

10/12/2014

Dear Colleagues:

1.  Yahoo.com and other media reported that a nurse caring for Mr. Duncan at Texas Presbyterian Hospital in Dallas developed fever today, sought medical attention, and was isolated with EBOV in 90 minutes.  She has 10 known contacts; one contact has been isolated for observation; 9 other contacts are being monitored.  Dr. Frieden stated there was a ‘breach of protocol’ but has not specified the specific breach.  No announcement on which hospital will treat the infected nurse.

2.  Science Magazine October 3rd has quotes from three recovered EBOV caregivers working in Liberia in July.  Dr. Brantly says: ‘It is my opinion that during an Ebola outbreak, the safest health care job is working in the Ebola treatment unit.   …It is in clinics and emergency rooms and hospitals where you have to look at every patient and ask yourself ‘Should I be concerned that this patients might have Ebloa?”  Dr. Omeonga says: ‘A lot of them (EBOV patients) were lying when they came to the hospital.  …They didn’t even tell you they were having fevers.’

3.  In the Science Magazine article Dr. Brausch of Tulane University, who was also in West Africa, says that sicker EBOV patients have higher viral titers.  Corpses have the highest titers of all. and the virus ‘will seep into other tissues to saliva and sweat.’  He notes that EBOV was present in semen of a recovered EBOV patient 40 days after discharge.

4.  Dr. Timothy Flanigan’s Blog from Monrovia, Liberia, last night presented a summary of his Partners experience in Liberia.  Flanigan found that once the brothers/sisters of the Catholic Hospital engaged the family members, prayer women, and burial preparation women of affected villages and taught them about EBOV and precautions, the case load of EBOV patients dropped significantly and survival increased.  The villagers trusted the brothers/sisters because they have been there for a long time caring for villagers.  I have copied and pasted Dr. Flanigan’s summary of the Partners experience below.

I believe that if we can reduce infection opportunities in specialized isolation units for EBOV patients in the U.S. and in EBOV treatment units in West Africa, we can reduce the infection rate in HCW.  So I have written to the Emory team which cared for Brantly and Writebol at Emory to ask them which specific full body suit they had HCW wear in the isolation units.  The less steps in donning and doffing PPEs, the less the infection opportunities.

RGL,MD

SEE DR. FLANIGAN’S PARTNERS SUMMARY BELOW:

A presentation that sparked great discussion and hope …

Today at the partners’ meeting there was a presentation that sparked great discussion and hope.

Lofa County has been hard hit by the Ebola Epidemic—it is in the north right near Sierra Leone and Guinea. As you can see from the first slide below, there has been a remarkable decrease in cases. The first slide shows the probable and confirmed cases and the second slide shows the number of cases admitted to the Ebola Treatment Unit. This is extraordinary!!!

lofastats

map

The control of the epidemic is attributed primarily to community action.

In the beginning the response was: Panic! Run! Fear!

Then the community realized they had to control this terrible epidemic themselves. Community advocates/educators/outreach spread the word quickly that touching the sick and dead bodies was disastrous. Prayer mothers in prayer houses stopped gathering around the sick and dying. It was good to pray, but NOT TO TOUCH! This can be very difficult for many Muslim communities who prepare the body and even clean the mouth for the dead person because they will speak to God.

The community mobilized and the results were dramatic. All newcomers to the community were checked for 21 days to be sure that they did not get sick. All sick persons were taken to an Ebola Treatment Unit. Youth and woman’s group took up the call.

I’m also very hopeful because the awareness and community mobilization in Monrovia is much better. There has been room in all the ETUs this week. We will see if the numbers will also decrease in Monrovia.

(Link to full presentation)

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Posted October 13, 2014 by levittrg in Ebola

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