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[stem-ebola] PRO/AH/EDR> Ebola virus disease - West Africa (190): Liberia, Sierra Leone, China monitoring

A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases

In this update:
[1] Re: Comment in WHO Roadmap 8 Oct 2014
[2] Liberia: 1332 Nigerian soldiers quarantined
[3] Sierra Leone: Chinese holding center
[4] China: arrivals monitoring

[1] Re: Comment in WHO Roadmap 8 Oct 2014

[ProMED Moderator Emeritus Charlie Calisher has pointed out that
mortality rates are not expressed as percentages but as rates, say per
1000 or more cases per unit of time. What I actually inserted in this
WHO report was a CFR or case fatality rate of 48 percent since the
start of the epidemic. But in any case a CFR derived from reported
numbers is pretty meaningless, given that neither all the cases nor
all the deaths have been lab confirmed, because not all samples are in
fit condition to be tested after a long trip to a lab, and I
understand the labs have been pretty overwhelmed up to now. Many new
fully staffed labs are now arriving, but they will be hard pressed to
keep up with the influx of ever more cases. - Mod.JW]

[2] Liberia: 1332 Nigerian soldiers quarantined
Date: Fri 10 Oct 2014
Source: AllAfrica, Leadership report [edited]

The Nigerian Army has revealed that about 1332 of its peace-keeping
troops in Liberia have been placed under surveillance following their
contact with a Sudanese who later died of the Ebola virus disease
(EVD). The director of the Nigerian Army Medical Corps, Major-General
Obashina Ogunbiyi stated this in Abuja yesterday [9 Oct 2014].
According to the Army medical officer, the incident followed the death
of a Sudanese Muslim man who had come to the camp of the soldiers to
lead them in prayer during the Eid-el Fitri celebration, but developed
Ebola symptoms the following day and later died.

Ogunbuyi noted that the country remained at risk as any of the
soldiers could choose to travel home anytime, saying "that is why the
military had to be totally involved in the fight against the Ebola

[Byline: Abiodun Oluwarotimi, Winifred Ogbebo and Victor Okeke]

Communicated by:
Ryan McGinnis

[It is difficult to imagine how over 1000 troops can have has skin
contact with a single case. - Mod.JW]

[3] Sierra Leone: Chinese holding center
Date: Thu 9 Oct 2014
Source: Awoko [edited]

The 30 man Chinese medical team working at the Jui holding center
[near Freetown, Sierra Leone] started working on 1 Oct 2014 and on
that day they received 6 patients. In an exclusive interview with Dr
Jinsong Mu, who is the leader of the medical group, they have received
42 suspected cases -- 13 were confirmed positive and 7 died -- during
the 8 days they have worked.

He explained that when the cases are received they are taken to Area 1
where all of them are kept together until the results are out. After
the results are released, the confirmed cases are then moved to Area 2
where they are isolated before being transferred to the treatment
center. He complained that "these confirmed cases are told strictly to
stay in their room, but these people refuse and will come out of the
room walking around which is not good for other patients." Dr Mu
explained that after the confirmed cases are taken to the isolation
ward, the team then contacts the Command Center who will then send an
ambulance to collect and take them to the treatment center.

When asked how they receive patients, Dr Mu said every morning, they
hold discussions with the Command Center, which calls them at 8am to
know how many patients the holding center will receive. After both
parties agree, the Command Center will then send the required number
to them for testing.

Dr Mu said because they are working in the same compound with the lab,
it is easy for them to receive the results. Most of the cases in the
holding centre, he disclosed, will take a maximum of 3 days before
they are sent for treatment.

The Chinese head of the medical team said they have 4 doctors and 22
nurses, and currently they have 42 patients. This works out at one
doctor for at least 10 patients. He said when a doctor goes into the
isolation ward, he is there for about one hour dressed in the
protective suits. "I tell you, it is not easy to be in that suit for
so long, as it is very inconvenient."

One problem he says they have is people just walking into the hospital
without any report from community hospitals or from the central
Command. This, he said, is not correct because they need to have prior
knowledge of these victims. However, he said, they cannot turn them
away and have to accept and check them. While there, 8 patients walked
into the hospital complaining that they are infected, so they were
taken into the holding center for further tests.

Dr Mu disclosed that they are now training some of their other doctors
in the hope that they will be able to assist them in the fight. He
also revealed plans to train local doctors if and when they have them.
For now, however, they are only working with Sierra Leonean nurses.

Dr Mu said the local nurses are very hard working and he is very proud
of them because they are complementing their effort in winning this
battle. "I am very happy for them and Dr Alex Kanu as they are really
working with us to end this fight."

During the interview, a 7th patient died Wednesday morning [8 Oct
2014] and the burial team arrived 3 hours later, headed by Mr Deen,
who Dr Mu said has been very active, and doing his work well because
he has collected all the dead patients from the Jui hospital.... Dr Mu
said he wants to advise all Sierra Leoneans that Ebola can be cured if
they go to the hospital early. He said many people have been cured
because they went to the hospital on time.

He complimented the Sierra Leone military for their good job at the
treatment center as he heard that 49 patients were [discharged] on
Monday [6 Oct 2014]. "I hope more patients will be able to make it out
alive so that it will give more confidence to others."

Communicated by:
Ryan McGinnis

[4] China: arrivals monitoring
Date: 10 Oct 2015
Source: Sohu News [in Chinese, transl. DS, edited]

An article in Chinese media today [10 Oct 2015] reports the case of a
patient in Wuhan, a 29-year old worker, returned to China from Nigeria
in mid-August [2014].  Experienced fever, muscle aches, vomiting,
diarrhoea on day 2 after returning home.  Went to hospital in Wuhan
where Ebola was ruled out and patient was diagnosed with malaria.

Date: 10 Oct 2014
From: Dan Silver

Here's a partial translation of an article from Chengdu,  Sichuan
describing monitoring of people returning from West  Africa.  It
states that about 60 people have returned to  Chengdu from countries
with Ebola outbreaks since mid-August [2014].  Looking at Chengdu's
ratio to China's total population, we can estimate that maybe 5800
people  have returned from those countries to any part of China.   For
sure, this is an oversimplification (among other things, Chengdu is a
major metropolis unlike the vast majority of China).  But it gives
some idea of how Chinese returnees  from West Africa might fit into
the global picture.  This  article also talks a little about China's
policies on  monitoring of returnees. [see below]

Date: 10 Oct 2014
Source: Sichuan

Young African man from Ebola outbreak zone coming to Chengdu  for PhD:
1st class is 17 days of isolation
 "I well understand."   [the] 29 year old Nigerian is a new PhD
student at Southwest  Jiaotong University.  Though he says "boring,
dry" to describe these 17 days,  he still expresses understanding for
the isolation.  It was learned yesterday that in mid August [2014],
Chengdu  launched health monitoring of people coming to Chengdu from
countries with outbreaks.  Now, more than 30 people are  undergoing
monitoring with a total of 70 having been through it so far  ...In
fact, "isolation" like [this PhD student] is called  "health
monitoring" in medical terms and isn't actual  medical isolation.
From the National Health and Family  Planning Commission's "Notice
Regarding Ebola Prevention  & Control Program (3rd Version)" how
medical  monitoring for ordinary people merely visiting (returning) to
China from outbreak zones, versus those who have had close  contact
with Ebola cases, is different requires a close look at the details.
 ...[of the 70] the number of foreigners is less than 10.  The
majority are Chinese nationals returning from countries  with Ebola
outbreaks, such as citizens working in West  Africa."

Communicated by:
Dan Silver

[Luckily, not a single case had been reported as imported, so far. -

[A HealthMap/ProMED-mail map of Liberia can be accessed at:

A HealthMap/ProMED-mail map can be accessed at:

[See Also:
Ebola virus disease - West Africa (189): Sierra Leone, Liberia, OIE
Ebola virus disease - West Africa (188): international cases, Liberia,
clinical 20141007.2837773
Ebola virus disease - West Africa (187): UN, aid, Sierra Leone, ECDC,
Liberia 20141005.2834551
Ebola virus disease - West Africa (186): WHO, Cuban HCWs arrive,
prevention 20141004.2832637
Ebola virus disease - West Africa (185): WHO, CDC, Liberia, vaccine
Ebola virus disease - West Africa (184): USA (TX) first case ex
Liberia 20140930.2819341
Ebola virus disease - West Africa (183): great apes as sentinels
Ebola virus disease - West Africa (182): vaccine, orphans, S.Leone,
prevention 20140930.2817719
Ebola virus disease - West Africa (181): Liberia, Europe, Senegal, sea
law 20140929.2816072
Ebola virus disease - West Africa (180): S. Leone, Liberia, USA,
drugs, Guinea 20140928.2813292
Ebola virus disease - West Africa (179): Liberia, protection, aerosol,
prevention 20140927.2811394
Ebola virus disease - West Africa (178): WHO Roadmap Update
Ebola virus disease - West Africa (177): WHO, quarantine, vaccine,
Liberia, surv. 20140926.2808526
Ebola virus disease - West Africa (176): Sierra Leone, USA, Nigeria
Ebola virus disease - West Africa (175): CDC, Sierra Leone, drugs,
survivors RFI 20140924.2802601
Ebola virus disease - West Africa (174): WHO, UNMEER, AU, Sierra
Leone, Liberia 20140924.2799482
Ebola virus disease - West Africa (173): WHO, Sierra Leone,
respirators, aid 20140922.2792415
Ebola virus disease - West Africa (172): Sierra Leone, volunteers,
Senegal free 20140921.2790986
Ebola virus disease - West Africa (171): lockdown, serum, aerosol,
team killed 20140920.278947
Ebola virus disease - West Africa (170): WHO, volunteers, risk,
training 20140919.2788195
Ebola virus disease - West Africa (169): MSF, aircraft, blood donation
Ebola virus disease - West Africa (168): MSF, volunteers, hiccups,
vaccine 20140917.2780781
Ebola virus disease - West Africa (167): WHO, UN, UNICEF volunteers,
more aid 20140916.2779112
Ebola virus disease - West Africa (166): USA aid, hospitals, donations
Ebola virus disease - West Africa (165): Liberia, Sierra Leone, China
aid 20140915.2775948
Ebola virus disease - West Africa (164): Sierra Leone, infect.
control, susp. 20140914.2773490
Ebola virus disease - West Africa (163): volunteers, Sierra Leone,
Liberia 20140914.2772161
Ebola virus disease - West Africa (162): WHO, volunteering, protection
Ebola virus disease - West Africa (161): hospital ships, military
medical aid 20140911.2767249
Ebola virus disease - West Africa (160): Senegal, Liberia, tests,
media 20140911.2766294
Undiagnosed viral hemorrhagic fever - Guinea: (NZ) RFI
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