l. Ebola Deeply reports today that Dr. Salia did not arrive at University of Nebraska Medical Center until Day #13 of his symptoms. Other sources earlier reported that his symptoms began November 6th so that he would have arrived in Nebraska on Day #5.
2. The Lancet 18 November has a Comment by Danache, et. al. reporting that the definition of fever varies by country so that some cases of EBOV might be missed depending on the temperature chosen as indicating fever. For the 5 EBOV patients whose temperature course during their hospital treatment is known, the authors found the median temperature on Day #5 was 38.2 degrees C. and on Day #7 was 38.7 degrees C. The Comment says that in the U.S. the definition of fever is 38.6 degrees C. (101.5 degrees F.). This in not true. The U.S. definition of fever is 38.0 degrees C. (100.4 degrees F.). Moreover, the CDC does not specify a specific temperature for fever in its guidelines for EBOV diagnosis; the CDC says ‘elevation of body temperature’ only. See the Comment at: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61787-6/fulltext
3. WHO issued today a Situational Assessment regarding PCR testing for EBOV. In West Africa now it requires a tube of blood, 2-6 hours to run the PCR test, $100 to run the PCR test, and worst of all, transport time over rough roads to a testing facility during which time the specimen must be preserved in the West African heat. So WHO has initiated two action plans to find a fast, reliable, and local means of testing for EBOV. One action plan states to vendors what the test should do: take 3 steps to process, take 30 min to process, require only 1/2 day of instruction to teach the test, and be inexpensive. The other action plan is evaluation of 16 such test kits submitted by vendors which approximate these requirements. See: http://who.int/mediacentre/news/ebola/18-november-2014-diagnostics/en/ for this positive news.
4. ABC News and other media report that an Indian treated for EBOV in Liberia has been quarantined at the New Dehli airport because he has EBOV in his semen. CDC has reported that EBOV may remain in the semen for 101 days after successfully elimination of EBOV from blood specimens. So abstaining from sexual relations or use of condoms is the treatment of choice for the former patient. But New Delhi officials have had him quarantined since November 10th.
5. CDC Morbidity and Mortality Report for November 18th reports cumulative caseloads and new cases for Liberia, Sierra Leone, and Guinea up to November Graphics show that the caseloads for Sierra Leone and Liberia continue to climb exponentially, but the caseload for Guinea not so much. See: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm63e1118a1.htm?s_cid=mm63e1118a1_e for the complete CDC report.
6. Note in Figure 3 of the CDC M&M report cited above that the Yamou county in Guinea had no cases of EBOV for the last 3 reported weeks; yet this county is surrounded by counties in two countries with many reported cases. WHO needs to determine why Yamou county has been spared EBOV recently.