Wednesday, November 12, 2014

Ebola Kills at Least Two People in Mali, Threatening Spread

Nov 12, 2014 1:12 PM ET
Ebola killed at least two more people in Mali and many more may have been infected, threatening to spark an outbreak in a fourth West African nation.
A 25-year-old nurse died from Ebola yesterday at the Pasteur Clinic in Bamako, Mali’s capital, the World Health Organization and Mali health authorities said today. She had treated a 70-year-old grand imam from Guinea, who was hospitalized for kidney failure and wasn’t tested for Ebola.
The man died Oct. 27 and may have infected four family members who drove him to Mali for treatment, as well as a daughter who died two days ago and a friend who visited him at the clinic and “died abruptly of an undiagnosed disease,” according to the WHO. The imam’s body was taken to a mosque in Bamako for ritual washing before being returned to the border village of Kouremale in Guinea for burial, and the WHO said it assumes “many mourners” attended both ceremonies.
“Six months plus into what’s been recognized as a major outbreak, we still have these kinds of behaviors, which are making this an extra-challenging disease to get under control,” Tom Solomon, director of the Institute of Infection and Global Health at the University of Liverpool, said by phone today. “This is why the disease is continuing to spread.”

Almost Free

The death of the nurse at the Mali clinic comes just four days after Doctors Without Borders said it appeared that the country may have prevented the spread of the disease. A diagnosis that the imam’s son has the virus “further increases the likelihood that deaths in other family members were caused by Ebola,” the WHO said.
The man’s first wife died of an undiagnosed disease last week, while his son tested positive for Ebola yesterday and is being treated in Guinea, where the man’s brother and second wife are also “being managed” at an Ebola center. A daughter died two days ago from an undiagnosed illness, and the family declined an offer for a safe burial, the WHO said.
“Intensive contact tracing is under way in both countries,” the agency said, with support from the U.S. Centers for Disease Control and Prevention, Doctors Without Borders and other groups.
Mali is now monitoring more than 60 people for possible exposure to the virus, including 28 health care workers who are in quarantine at the Pasteur Clinic, Markatie Daou, a spokesman for the Health Ministry, said by phone.
There are 20 United Nations military personnel under quarantine at the same clinic, where they were being treated for injuries sustained on a peacekeeping mission in northern Mali, the organization said today. They work for Minusma, the United Nations Multidimensional Integrated Stabilization Mission in Mali. The personnel have shown no signs of Ebola infection, the U.N. said in a statement.

No Signs

The imam from Guinea “was identified at the border but he did not present any sign of temperature or vomiting,” Daou said. Kidney failure is “often seen” in the late stages of Ebola, the WHO said today. Both the imam and the friend who visited him at the clinic are being regarded as probable Ebola cases, though no samples are available for testing, the WHO said. Patients are most infectious in the late stages of the disease and immediately after death.
The clinic in Bamako is a private facility established in 2000, according to its website. It has 32 hospital beds and an emergency room, and offers “innovative and unique care” in areas including internal medicine, surgery, neurology, cardiology and pediatrics. The imam had previously been admitted to two clinics -- one in Guinea and one in Mali, according to the WHO....