 |
| Sierra Leone Ebola
Truth - Transmission INTENSE, WIDESPREAD |
By Patricia
Doyle |
| Hello Jeff - The real situation in Sierra Leone is not
as reported by the Obama administration or some researchers, the situation
is Ebola is WIDESPREAD AND INTENSE TRANSMISSION. This does
not sound like people are spending a week or two in hospital and walking
out cured. People, especially health care workers are dying. The truth is too hard for some to handle, so they feel lying about conditions on the ground in Sierra Leone and other hard hit countries in W Africa is going to sugar coat the situation. Remember sugar has its own dangers and too much will cause bad health effects especially for diabetics. So, too, lying about the Ebola situation will bring with it its own grief. People will let their guard down and that is when there is a big risk of infection. So, there cycle of transmission has been labeled INTENSE. That tells me we are no closer to containing this virus in W Africa then we were back in the late Summer and early Fall. Why are patients, who have been called 'HCWs', being flown to the US, at least 3 a week for the past couple of Weeks? What is the purpose? Why are these particular patients not being identified? We don't know if they are Americans or simply residents of the US which could even be some are non citizens who may or may not be legally in the US. What is the big secret? Are these patients - very ill and dying - or are they not yet sick? That would brings up a new list of questions. Questions like why is the US spending almost a quarter of a million dollars to bring in patients not yet infected? According to the CDC talking points, a patient exposed to Ebola is not contagious until symptoms are evident. That is if, IF, you believe the CDC. I don't particularly believe that line with this strain of Ebola. In any event, this report does show a very different Ebola outbreak in Sierra Leone than we are being told. Follow the planes, which is following the money...taxpayer money! Patty All areas of Sierra Leone have been impacted by Ebola CASES Total: 8,201 clinical cases as of 12 December Confirmed: 6,592 | Probable: 79 | Suspected: 1,530 Deaths: 2,318 (1,952 confirmed) (Source: Ministry of Health 12 December) --Sierra Leone Last Updated: December 14, 2014 07:40 GMT STATUS: WIDESPREAD AND INTENSE TRANSMISSION ISOLATION / TREATMENT CENTRES (ETCs) As at 30 November, the country had 553 beds in ETCs, up from 356 the week prior. The World Health Organization (WHO) estimates that 1,460 beds are required in total, which has been revised up since mid-November in response to the intense transmission. The number of operational Community Care Centre (CCC) beds increased to 262 (as at 27 November), up from 32 the week before, with the WHO predicting 1,208 CCC beds will be required. See the World Health Organization interactive map of Ebola Treatment Centres for details on location, status and number of beds. Kenema is part of a "unified sector", together with Foya, Liberia, and Gueckedou, Guinea. Public health measures restricting movement in and out of the sector. For more information information on Screening and Closures click here UPDATES 14 December A new Ebola treatment unit has opened at Hastings Airfield, near Freetown. The unit was constructed by the United Kingdom, and is managed by Australia. The capacity of the unit will gradually increase to 100 beds. 13 December Over 40 new cases were reported from Kailahun, Kambia, Bombali, Port Loko, Tonkolili, Western Area Urban and Western Area Rural. 12 December At least 100 new cases were reported for 11-12 December affecting Kailahun (1), Bombali (16), Kambia (6), Koinadugu (2), Port Loko (18), Tonkolili (4), Bo (8), Western Area Urban (28) and Western Area Rural (17). Sierra Leone's rate of new cases has not declined as quickly as neighbouring Liberia which appears to be stabilising. Médecins Sans Frontières (MSF) together with the Ministry of Health as part of its ongoing emergency response to Ebola in West Africa have distributed more than a million anti-malarial medications in the country. These were given to residents of Freetown and five districts in the surrounding Western Area. Authorities said, “In the context of Ebola, malaria is a major concern, because people who are sick with malaria have the same symptoms as people sick with Ebola. As a result, most people turn up at Ebola treatment centres thinking that they have Ebola, when actually they have malaria. It’s a huge load on the system, as well as being a huge stress on patients and their families.” News sources report that public Christmas and New Year celebrations have been banned. 11 December The Ministry of Health confirmed 37 new cases in its latest situation update. The cases were in Kono (4), Tonkolili (1), Port Loko (6), Bo (7), Moyamba (1), Western Area Urban (11) and Western Area Rural (7). 10 December Case incidence is still increasing, with almost 400 new confirmed cases in the first week of December. Freetown reported about 1/3 of those cases. Transmission is intense across the country except in the south, in Kenema and Kailahun. As of 9 December, the Ministry of Health has reported 45 new cases, from Kailahun (1), Koinadugu (1), Bo (3), Bombali (4), Port Loko (5), Kono (7), Western Area Rural (10) and Western Area Urban (14). WHO reports that there is sufficient ETU bed capacity nationally, however distribution is "uneven". As at 30 November, there were 553 ETU beds available, 38% of the required 1460. Over 260 Community Care Centre (CCC) beds are operational, 22% of the estimated number required. Authorities are concerned that the outbreak in Kono may be far greater than officially reported cases. Unverified information indicates that dozens of people have died at a local hospital, with outbreaks evident in many villages. A team from Kenema will travel to Kono to support the Ebola response there. A "lock-down" restricting movement into and out of the district has been implemented and is expected to be in place until 23 December. Cases of Lassa fever have been reported in the hospital in Kenema further aggravating the situation. An article published in Morbidity and Mortality Weekly Report, indicates the rate of Ebola infection in health care workers (HCW) was 100 times that seen in the average adult population in Sierra Leone. An analysis of the data from May to October, revealed a number of gaps - including in infection prevention and control; staff, equipment and infrastructure shortage; diagnosis and protocols regarding patient movement or high risk zones. Cases in health care workers were reported from almost all the districts mostly from employees in government health care centres. The Ministry of Health and Sanitation and its international partners have launched interventions to reduce the high rate of infection in HCWs. Another CDC-MMWR report states that rapid needs assessments have been conducted in six districts of Sierra Leone: Bombali, Moyamba, Port Loko, Pujehun, Tonkolili, and Western districts between 1 October and 5 October. The team, which included international health professionals from CDC, conducted interviews based on WHO Ebola prevention recommendations. They found gaps in current infection prevention and control practices, patient transport and health facilities. The experts have highlighted the urgent need for "An increasingly coordinated and comprehensive IPC [infection prevention and control] program with district and health facility level support". 9 December Media reports say members of the nation's Junior Doctors Association are on "partial strike". They are protesting a perceived lack of care for locally-based medical staff who are infected with Ebola, compared to international staff who are sometimes evacuated for treatment. Most of the local doctors who are working to control the outbreak in the country are from this Association. 8 December The Ministry of Health reported 25 confirmed cases for 7 December; Moyamba (4), Bombali (3), Port Loko (2), Tonkolili (3), Bo (1), Western Area Urban (9) and Western Area Rural (3). For 8 December they reported 58 confirmed cases Bombali (6), Port Loko (6), Tonkolili (1), Bo(4), Western Urban Area (25) and Western Area Rural (10). 7 December Media reports say at least two doctors in Sierra Leone have died of Ebola in the past few days. This is a devastating loss in a country where medical personnel is in short supply and the Ebola remains intense. There are also reports that Red Cross burial teams have been attacked by community members in several areas. Dissatisfaction with Ebola response, fear and misunderstanding all play a role in the cultural challenge of implementing health interventions in local communities. 5 December The Ministry of Health announced 25 deaths and 69 newly confirmed cases for 4 December. These are from Bo, Bombali, Bonthe, Kambia, Port Loko, Tonkolili and Western Area districts. 4 December The Ministry of Health report 26 deaths and 93 confirmed cases for 3 December, from: Bo, Bombali, Moyamba, Port Loko, Tonkolili and Western Area. The World Health Organization states in the latest situation report that transmission remains intense in Sierra Leone. 537 newly confirmed cases were reported for 23-30 November, up from 385 the previous week. Freetown is still the worst affected area and transmission remains intense and persistent in all districts except the south-west. Treatment and isolation capacity is stretched in Port Loko and Freetown by the large numbers of new cases. Eight Ebola treatment centres are currently under construction around the country. 3 December An additional 26 confirmed deaths and 61 confirmed cases have been reported by the Ministry of Health, from: Kono, Bombali, Koinadugu, Port Loko, Tonkolili and Western Area districts. 2 December The Ministry of Health has announced 27 confirmed deaths and 72 confirmed cases for 1 December, from the districts of Bo, Bombali, Kambia, Moyamba, Port Loko and Western Area. On 1 December, the government began preventing people from entering or leaving Tonkolili district (Northern province) in an effort to control the spread of Ebola. The measure will remain in place until 15 December. During this period, the borders of the district will be sealed and the authorities will conduct a door-to-door awareness-raising campaign within the area. Visitors will not be allowed into the district, though vehicles passing through it will be allowed to enter, provided they do not stop anywhere in Tonkolili. 1 December There are 75 more confirmed cases in the Ministry of Health report for 30 November in Kambia (2), Western Area (51), Tonkolili (10) and Bombali (12). In total, 138 health workers have been infected, with 106 deaths. 30 November The Ministry of Health reports an additional 64 confirmed cases for 29 November from; Kailahun, Kambia, Bo, Western Area, Kono, Tonkolili and Bombali. There have been several new infections of healthcare workers in Tonkolili district. The World Health Organization states that a lockdown began in Koinadugu district on 28 November. 28 November The government has announced a three-day shutdown of all businesses in the capital Freetown from 28 November. Only pharmacies will be allowed to remain open during the shutdown which is being implemented to control the spread of ongoing Ebola outbreak. The authorities have also called upon residents to wear long-sleeved clothing. There have been 110 cases identified in the last day - with confirmed cases in Port Loko, Bo, Koinadugu, Tonkolili, Bombali and Pujehun. The World Health Organisation daily situation report advises there are a number of hotspot areas in Tonkolili, including Mile 91. A community health officer who is infected with Ebola has "contributed to a high incidence in Mile 91". 27 November There are an additional 71 confirmed cases for 26 November reported by the Ministry of Health; Bombali (14), Koinadugu (4), Port Loko (3), Tonkolili (10), Bo (3), Western Area Urban (22) and Western Area Rural (15). In the latest World Health Organization situation report, Ebola transmission remains intense in Sierra Leone, particularly in the western and northern areas. There were 385 newly confirmed cases reported in the week up to 23 November. Freetown, the capital, remains the worst affected area, accounting for 118 of the new cases. Transmission appears to be slowing in the south-eastern districts of Bonthe, Kailahun, Kenema and Pujehun. 26 November The Ministry of Health has announced 83 additional confirmed cases for 25 November: Bobmali (10), Kambia (6), Port Loko (13), Tonkolili (4), Bo (8), Moyamba (1), Western Area Urban (31), Western Area Rural (10). There is a continuing lack of safe disposal of bodies, with burial teams striking in several areas due to non-payment of hazard pay. News sources are reporting that bodies of Ebola victims are being left unburied in Kenema. Another doctor is reported to have contracted Ebola and is being treated in Hastings Ebola Treatment Center. An Ebola Treatment Centre in Lunsar, Port Loko, will begin admitting patients today. The centre is run by International Medical Corps and will be scaled up to 50-beds before the end of the year. 25 November There are additional 39 confirmed cases reported by the Ministry of Health as of 24 November; Kono (1), Moyamba (1), Kambia (2), Tonkolili (3), Western Area Rural (8), Western Area Urban (11), Port Loko (13). The Italian Ministry of Health have confirmed that an Italian doctor, who was working in Sierra Leone for the non-governmental organization "Emergency", has been diagnosed with Ebola. The doctor has been evacuated for treatment at the Lazzaro Spallanzani National Institute for Infectious Diseases in Rome. 24 November The Ministry of Health has reported 47 newly confirmed cases for 23 November: Bombali (4), Port Loko (3), Tonkolili (5), Bo (1), Moyamba (1), Western Area Urban (26) and Western Area Rural (7). 22 November Today's World Health Organisation country report advises a three-day lock-down is being proposed for Kumala in Koinadugu. The district is difficult to access and was the last in the country to have Ebola cases. It is currently one of the hotspots for new cases. Specimens and supplies are being transported by helicopter. Two of the three holding centres in Bombali are full (137 patients). There have been 69 new cases in the previous day, 51 confirmed (Kailahun 2, Port Loko 5, Kambia 1, Bo 6, Western Area 17, Tonkolili 5, Bombali 14, Moyamba 1) with 21 deaths. 21 November An additional 58 confirmed cases are reported by the Ministry of Health; Kenema (1), Bombali (14), Kambia (1), Port Loko (8), Tonkolili (5), Bo (1), Western Area Urban (15) and Western Area Rural (13). Over 580 new contacts have been identified and will be monitored. Unrestricted movement in Moyamba is contributing to an escalation in case numbers. 20 November The Ministry of Health has announced 43 confirmed cases for 19 November: Bombali (2), Koinadugu (1), Tonkolili (11), Bo (1), Moyamba (2), Pujehun (2) Western Area Urban (17) and Western Area Rural (7). The latest Ebola response roadmap Situation Report by the World Health Organization states that transmission remains widespread and intense in Sierra Leone, except in the south east. Freetown, the capital, remains the worst affected area. The districts of Bo, Bombali, Koinadugu, Kono, Moyamba, Port Loko, Tonkolili and Western Area have reported high numbers of cases recently. The decrease in the number of cases in the south east where the outbreak began indicates that the response efforts have been effective. 19 November An additional 53 confirmed cases have been reported by the Ministry of Health; Kono (5), Bombali (2), Koinadugu (2), Port Loko (18), Bo (3), Moyamba (2), Western Area Urban (15) and Western Area Rural (6). Media sources are reporting that another physician has passed away in Freetown from Ebola. Investigations into how he became infected are ongoing as he was reportedly not involved with frontline treatment of Ebola patients. All seven Sierra Leonean doctors who have become infected with Ebola have died. The Cuban Ministry of Health has confirmed that a doctor who tested positive for Ebola on 17 November is currently in a stable condition. He will be transferred to University Hospital of Geneva in Switzerland for treatment. 18 November There are 89 additional confirmed cases reported by the Ministry of Health in; Kailahun (1), Bombali (12), Kambia (1), Port Loko (9), Tonkolili (2), Bo (2), Moyamba (3), Western Area Urban (35), Western Area Rural (24). 17 November The Ministry of Health report 54 newly confirmed cases for 16 November in; Bombali (4), Koinadugu (1), Port Loko (14), Bo (8), Bonthe (1), Moyamba (2), Western Area Urban (2) and Western Area Rural (8). Koinadugu district continues to be a hotspot for transmission, with an increase in paediatric cases and absence of safe burial practices reported in some areas. 15 November The WHO situation report of 14 November records steep increases in the transmission of Ebola nationally in Sierra Leone, echoed at district level with consistently high transmission in the western and northern areas of the country. New cases appear to be slowing in Kenema and Kailahun. New cases were reported by the Ministry of Health in Kono (8), Bombali (8), Koinadugu (13), Port Loko (19), Tonkolili (9) Bo (4), Western Area Urban (15), and Western Area Rural (8). The United Nations Children's Fund (UNICEF) has announced its plans to open ten Ebola Community Care Centers in Bombali district of Sierra Leone this week. These centers will have eight beds each and will cater to Ebola patients. The UNICEF also has plans to set up about 30 such centers in other districts. 14 November An additional 9 deaths and 61 confirmed cases have been reported by the Ministry of Health for 13 November; Bombali (19), Bo (1), Port Loko (15), Western Area Urban (15) and Western Area Rural (11). 13 November In the latest WHO Ebola response roadmap situation report, the Ebola activity in Sierra Leone has been described as intense. Over 420 new cases were reported last week. Bombali, Freetown, Port Loko, Tonkolili and Western rural area are heavily affected. Other areas of concern are Koinadugu and Kambia whereas Kenema and Kailahun have recorded a sharp decline in new cases. Around 30 percent of the planned Ebola treatment centres are functional in the country. At least 66 new cases have been confirmed by the Ministry of Health as of 12 November. These are in Kambia (3), Moyamba (4), Port Loko (5), Tonkolili (7), Bo (9), Western Area Rural (13) and Western Area Urban (25). 12 November The Ministry of Health reports 94 confirmed cases for 11 November. These are Bombali (2), Kambia (1), Koinadugu (7), Port Loko (19), Tonkolili (8), Bo (4), Western Area Urban (31) and Western Area Rural (22). 11 November The Ministry of Health reports 90 newly confirmed cases for 10 November in; Bombali (9), Port Loko (29), Tonkolili (12), Bo (1), Moyamba (2), Western Area Urban (29) and Western Area Rural (8). The National Ebola Response Centre (NERC) announced that the Government of Sierra Leone has approved a one-time death benefit payment of US$5,000 to all health care workers who die from Ebola in the line of duty. The NERC is also working with payment teams to ensure hazard incentives are paid to all frontline staff by 14 November and continue on a bi-weekly basis. The latest UN Mission for Ebola Emergency Response (UNMEER) report (PDF) states that the district of Koinadugu, the last unaffected district in the country, has seen 50 deaths from Ebola since mid-October. More than two hundred people have been placed in quaratine to try to stop transmission. Reports from the Ministry of Social Welfare, Gender and Children's Affairs and UNICEF estimate that between 2,600 and 7,000 children have been orphaned by the outbreak, with orphans facing harsher conditions that during the civil war. 10 November There are 111 additional confirmed cases on 9 November as reported by the Ministry of Health and Sanitation in; Western Area Rural (22), Port Loko (21), Tonkolili (20), Western Area Urban (18), Moyamba (14), Bombali (10), Kono (3), Kambia (2) and Kailahun (1). 9 November The Ministry of Health has reported 45 confirmed cases for 8 November in Kailahun (2), Bombali (6), Koinadugu (4), Port Loko (2), Bo (4), Moyamba (3), Western Area Urban (12) and Western Area Rural (12). According to the World Health Organisation daily update of 8 November, the last case admitted to the holding centres in Kailahun was 30 October. 8 November The World Health Organization states in their recent SitRep (PDF) that intense transmission is continuing nationwide, except in Bonthe, Kailahun, Kono and Pujehun districts which each have less than five new cases identified in the previous 21 days. The Ministry of Health reports 41 confirmed cases for 7 November; Bombali (6), Koinadugu (6), Port Loko (2), Tonkolili (12), Western Area Urban (10) and Western Area Rural (5). A total of 247 confirmed cases are currently in treatment centres and 857 people have survived to date. 6 November WHO: Ebola transmission continues to be a major concern, according to the WHO’s latest Ebola Response Roadmap Situation Report. More than 110 new confirmed cases were recorded in the capital city, Freetown. Bombali, Port Loko, western rural areas, Tonkolili and Koinadugu also continue to be majorly affected. However, Kenema and Kailahun recorded a decline in cases. The Ministry of Health report 36 confirmed cases for 5 November; Bombali (2), Kambia (4), Koinadugu (15), Bo (4) and Western Area Rural (7). 814 people have survived Ebola to date. A 92-bed Ebola treatment facility at Kerry Town has opened. The centre will have an 80-bed treatment centre for the public, run by Save the Children, as well as a 12-bed treatment centre dedicated to health care workers and international aid staff, run by British Army medics. The Australian Government will assist with staffing of the facility. 5 November There are 56 additional confirmed cases for 4 November as reported by the Ministry of Health and Sanitation in; Bombali (24), Port Loko (2), Tonkolili (3), Bo (3), Moyamba (3), Western Area Urban (8) and Western Area Rural (13). 4 November The Ministry of Health has reported 61 confirmed cases for 3 November; Bombali (7), Port Loko (2), Kailahun (1), Western Area Urban (35) and Western Area Rural (16). Over 820 patients have been treated and discharged. 2 November The Sierra Leone WHO Country Office situation report for today advises there are 196 cases admitted in treatment units - 18 in Kenema, 44 in Kailahun, 25 in Bo and 109 in Western Area. Over the past 24 hours that have been 75 new cases, of which 60 are confirmed (Western Area 24, Bombali 10, Koinadugu 8, Kambia 7, Tonkolili 7, Bo 2, Port Loko 2). There are about 14,000 contacts under follow up. Food is being supplied to homes under quarantine across the nation. There remains a significant shortfall in the number of people to implement thorough surveillance, contact tracing, and case management. A report from the Africa Governance Initiative indicates that Ebola is now spreading even faster than it was in September. According to news sources, about 6 more cases a day are reported in Freetown compared to two months ago. The only region where there has been a slowing of new cases is in Bombali. 1 November Norway is sending equipment and deploying up to 200 healthcare staff to work at the United Kingdom's Treatment Centre in Moyamba. 31 October There are 31 newly confirmed cases reported by the Ministry of Health. These are from; Port Loko (15), Bombali (7), Bo (3), Kambia (2) and Western Area (4). The World Health Organisation advises that "Lowere Nieni chiefdom in Koinadugu District remains the hotspot where majority of EVD cases are being reported from." 30 October The Ministry of Health reports 47 confirmed cases for 29 October; Kenema (4), Bombali (11), Kambia (5), Koinadugu (2), Port Loko (4), Tonkolili (6), Moyamba (3), Pujehun (2), Western Area Urban (6) and Western Area Rural (4). The World Health Organization state in their situation report for 28 October that analysis of exposure in Port Loko reveals more than 40% of infected pepole attended a funeral ceremony before becoming ill. 29 October In the latest WHO Ebola response roadmap situation report, the situation in Sierra Leone has been described as intense. The Western rural region has continually reported increased activity with over 80 confirmed cases in the last week. The following districts; capital Freetown, Bombali and Port Loko are heavily affected. Other areas of concern are Tonkolili, Kailahun and Kenema. Over a hundred healthcare workers have died of the infection in the country. There are 91 newly confirmed cases reported by the Ministry of Health. These are from; Bo (7), Bombali (32), Kambia (1), Kenema (1), Kono (1), Port Loko (17), Tonkolili (6), Western Area Urban (13) and Western Area Rural (13). 28 October The latest Ministry of Health report states there are 62 new confirmed cases from Western Area Urban (23), Western Area Rural (19), Tonkolili (7), Koinadugu (4), Port Loko (6) and Moyamba (3). At least 737 patients have been treated and discharged. 27 October There have been 130 newly confirmed cases identified over the weekend, according to the latest reports from the Ministry of Health and Sanitation. These cases are from; Kailahun (1), Kenema (4), Kono (4), Bombali (13), Port Loko (6), Tonkolili (8), Bo (3), Moyamba (2), Western Area Urban (42), Western Area Rural (47). 25 October The Ministry Of Health reports 41 new cases, again with many occurring in the Western areas and none new in Kailahun. The new cases were reported in Bombali (14), Western Area Urban (8), Tonkolili (7), Western Area Rural (4), Koinadugu (4), Kenema (2) and Moyamba (2). Almost 200 confirmed cases are admitted in designated treatment units - Kenema (24), Kailahun (39), Bo (28) and Western area (105). The number of patients being treated in the community in Western Area in Freetown is "high", according to the WHO daily country situation report. BACKGROUND Although several suspected cases were reported in March and April, they proved to be Lassa fever and other more common illnesses. Sierra Leone’s first Ebola case occurred in late May, on the border of Guinea. (That nation had been experiencing an outbreak for several months already.) Sierra Leone’s first affected area was Kailahun district. All confirmed cases were confined to that district until 10 June, when Port Loko district became the second district with confirmed cases. By mid-June, cases had also been confirmed in Kenema, Kono and the Western Area. Kenema and Kaliahun remained the most affected areas throughout June. Bo reported cases in July, as did Port Loko. The first case in Freetown was reported in late July. Dr Shiekh Khan, the country's only virologist, was infected while treating Ebola patients and died at the treatment centre in Kailahun on 29 July. A public health emergency was declared on 31 July. Quarantine of houses with confirmed cases and outbreak areas, restrictions on public meetings and gatherings, screening of passengers at airports, active surveillance and house-to-house searches were enforced. The government set aside 4 August as ‘Ebola Day’ in order to inspect houses, trace contacts and quarantine suspected cases. By early August all districts, except Koinadugu in the north, had confirmed cases. Throughout August and September several Ebola Treatment Centres were built around the country by Medecins Sans Frontieres, Red Cross and International Medical Corps. In early September the British Military began building a treatment centre in Freetown to serve the local population as well as having a special ward dedicated to treating infected health care workers. A 165-person medical team from Cuba and a 59-person medical team from China arrived to staff some of the new treatment centres and laboratories. A British nurse, who became infected whilst working in an Ebola treatment centre, was expatriated for treatment at the Royal Free Hospital London on 24 August. https://www.internationalsos.com/ebola/index.cfm?content_id=397&language_id=ENG |
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