COMMENTARY: Health workers need optimal respiratory protection for Ebola

Lisa M Brosseau, ScD, and Rachael Jones, PhD

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Sep 17, 2014

Editor's Note: Today's commentary was submitted to CIDRAP by the authors, who are national experts on respiratory protection and infectious disease transmission. In May they published a similar commentary on MERS-CoV. Dr Brosseau is a Professor and Dr Jones an Assistant Professor in the School of Public Health, Division of Environmental and Occupational Health Sciences, at the University of Illinois at Chicago.

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Healthcare workers play a very important role in the successful containment of outbreaks of infectious diseases like Ebola. The correct type and level of personal protective equipment (PPE) ensures that healthcare workers remain healthy throughout an outbreak—and with the current rapidly expanding Ebola outbreak in West Africa, it's imperative to favor more conservative measures.

 

The precautionary principle—that any action designed to reduce risk should not await scientific certainty—compels the use of respiratory protection for a pathogen like Ebola virus that has:

 

• No proven pre- or post-exposure treatment modalities
• A high case-fatality rate
• Unclear modes of transmission

We believe there is scientific and epidemiologic evidence that Ebola virus has the potential to be transmitted via infectious aerosol particles both near and at a distance from infected patients, which means that healthcare workers should be wearing respirators, not facemasks.¹
The minimum level of protection in high-risk settings should be a respirator with an assigned protection factor greater than 10. A powered air-purifying respirator (PAPR) with a hood or helmet offers many advantages over an N95 filtering facepiece or similar respirator, being more protective, comfortable, and cost-effective in the long run.
We strongly urge the US Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) to seek funds for the purchase and transport of PAPRs to all healthcare workers currently fighting the battle against Ebola throughout Africa—and beyond.
There has been a lot of on-line and published controversy about whether Ebola virus can be transmitted via aerosols. Most scientific and medical personnel, along with public health organizations, have been unequivocal in their statements that Ebola can be transmitted only by direct contact with virus-laden fluids^2,3 and that the only modes of transmission we should be concerned with are those termed "droplet" and "contact."
These statements are based on two lines of reasoning. The first is that no one located at a distance from an infected individual has contracted the disease, or the converse, every person infected has had (or must have had) "direct" contact with the body fluids of an infected person.
This reflects an incorrect and outmoded understanding of infectious aerosols, which has been institutionalized in policies, language, culture, and approaches to infection control. We will address this below. Briefly, however, the important points are that virus-laden bodily fluids may be aerosolized and inhaled while a person is in proximity to an infectious person and that a wide range of particle sizes can be inhaled and deposited throughout the respiratory tract.
The second line of reasoning is that respirators or other control measures for infectious aerosols cannot be recommended in developing countries because the resources, time, and/or understanding for such measures are lacking.⁴
Although there are some important barriers to the use of respirators, especially PAPRs, in developing countries, healthcare workers everywhere deserve and should be afforded the same best-practice types of protection, regardless of costs and resources. Every healthcare worker is a precious commodity whose well-being ensures everyone is protected.
If we are willing to offer infected US healthcare workers expensive treatments and experimental drugs free of charge when most of the world has no access to them, we wonder why we are unwilling to find the resources to provide appropriate levels of comparatively less expensive respiratory protection to every healthcare worker around the world.

How are infectious diseases transmitted via aerosols?

Medical and infection control professionals have relied for years on a paradigm for aerosol transmission of infectious diseases based on very outmoded research and an overly simplistic interpretation of the data. In the 1940s and 50s, William F. Wells and other "aerobiologists" employed now significantly out-of-date sampling methods (eg, settling plates) and very blunt analytic approaches (eg, cell culturing) to understand the movement of bacterial aerosols in healthcare and other settings. Their work, though groundbreaking at the time, provides a very incomplete picture.
Early aerobiologists were not able to measure small particles near an infectious person and thus assumed such particles existed only far from the source. They concluded that organisms capable of aerosol transmission (termed "airborne") can only do so at around 3 feet or more from the source. Because they thought that only larger particles would be present near the source, they believed people would be exposed only via large "droplets" on their face, eyes, or nose.
Modern research, using more sensitive instruments and analytic methods, has shown that aerosols emitted from the respiratory tract contain a wide distribution of particle sizes—including many that are small enough to be inhaled.^5,6 Thus, both small and large particles will be present near an infectious person.
The chance of large droplets reaching the facial mucous membranes is quite small, as the nasal openings are small and shielded by their external and internal structure. Although close contact may permit large-droplet exposure, it also maximizes the possibility of aerosol inhalation.
As noted by early aerobiologists, liquid in a spray aerosol, such as that generated during coughing or sneezing, will quickly evaporate,⁷ which increases the concentration of small particles in the aerosol. Because evaporation occurs in milliseconds, many of these particles are likely to be found near the infectious person.

The current paradigm also assumes that only "small" particles (less than 5 micrometers [mcm]) can be inhaled and deposited in the respiratory tract. This is not true. Particles as large as 100 mcm (and perhaps even larger) can be inhaled into the mouth and nose. Larger particles are deposited in the nasal passages, pharynx, and upper regions of the lungs, while smaller particles are more likely to deposit in the lower, alveolar regions. And for many pathogens, infection is possible regardless of the particle size or deposition site.

It's time to abandon the old paradigm of three mutually exclusive transmission routes for a new one that considers the full range of particle sizes both near and far from a source. In addition, we need to factor in other important features of infectivity, such as the ability of a pathogen to remain viable in air at room temperature and humidity and the likelihood that systemic disease can result from deposition of infectious particles in the respiratory system or their transfer to the gastrointestinal tract.
We recommend using "aerosol transmissible" rather than the outmoded terms "droplet" or "airborne" to describe pathogens that can transmit disease via infectious particles suspended in air.

Is Ebola an aerosol-transmissible disease?

We recently published a commentary on the CIDRAP site discussing whether Middle East respiratory syndrome (MERS) could be an aerosol-transmissible disease, especially in healthcare settings. We drew comparisons with a similar and more well-studied disease, severe acute respiratory syndrome (SARS).
For Ebola and other filoviruses, however, there is much less information and research on disease transmission and survival, especially in healthcare settings.
Being at first skeptical that Ebola virus could be an aerosol-transmissible disease, we are now persuaded by a review of experimental and epidemiologic data that this might be an important feature of disease transmission, particularly in healthcare settings.

What do we know about Ebola transmission?

No one knows for certain how Ebola virus is transmitted from one person to the next. The virus has been found in the saliva, stool, breast milk, semen, and blood of infected persons.^8,9 Studies of transmission in Ebola virus outbreaks have identified activities like caring for an infected person, sharing a bed, funeral activities, and contact with blood or other body fluids to be key risk factors for transmission.^10-12
On the basis of epidemiologic evidence, it has been presumed that Ebola viruses are transmitted by contaminated hands in contact with the mouth or eyes or broken skin or by splashes or sprays of body fluids into these areas. Ebola viruses appear to be capable of initiating infection in a variety of human cell types,^13,14 but the primary portal or portals of entry into susceptible hosts have not been identified.
Some pathogens are limited in the cell type and location they infect. Influenza, for example, is generally restricted to respiratory epithelial cells, which explains why flu is primarily a respiratory infection and is most likely aerosol transmissible. HIV infects T-helper cells in the lymphoid tissues and is primarily a bloodborne pathogen with low probability for transmission via aerosols.
Ebola virus, on the other hand, is a broader-acting and more non-specific pathogen that can impede the proper functioning of macrophages and dendritic cells—immune response cells located throughout the epithelium.^15,16 Epithelial tissues are found throughout the body, including in the respiratory tract. Ebola prevents these cells from carrying out their antiviral functions but does not interfere with the initial inflammatory response, which attracts additional cells to the infection site. The latter contribute to further dissemination of the virus and similar adverse consequences far beyond the initial infection site.

The potential for transmission via inhalation of aerosols, therefore, cannot be ruled out by the observed risk factors or our knowledge of the infection process. Many body fluids, such as vomit, diarrhea, blood, and saliva, are capable of creating inhalable aerosol particles in the immediate vicinity of an infected person. Cough was identified among some cases in a 1995 outbreak in Kikwit, Democratic Republic of the Congo,¹¹ and coughs are known to emit viruses in respirable particles.¹⁷ The act of vomiting produces an aerosol and has been implicated in airborne transmission of gastrointestinal viruses.^18,19 Regarding diarrhea, even when contained by toilets, toilet flushing emits a pathogen-laden aerosol that disperses in the air.^20-22
Experimental work has shown that Marburg and Ebola viruses can be isolated from sera and tissue culture medium at room temperature for up to 46 days, but at room temperature no virus was recovered from glass, metal, or plastic surfaces.²³ Aerosolized (1-3 mcm) Marburg, Ebola, and Reston viruses, at 50% to 55% relative humidity and 72°F, had biological decay rates of 3.04%, 3.06%. and 1.55% per minute, respectively. These rates indicate that 99% loss in aerosol infectivity would occur in 93, 104, and 162 minutes, respectively.²³
In still air, 3-mcm particles can take up to an hour to settle. With air currents, these and smaller particles can be transported considerable distances before they are deposited on a surface.

There is also some experimental evidence that Ebola and other filoviruses can be transmitted by the aerosol route. Jaax et al²⁴ reported the unexpected death of two rhesus monkeys housed approximately 3 meters from monkeys infected with Ebola virus, concluding that respiratory or eye exposure to aerosols was the only possible explanation.
Zaire Ebola viruses have also been transmitted in the absence of direct contact among pigs²⁵ and from pigs to non-human primates,²⁶ which experienced lung involvement in infection. Persons with no known direct contact with Ebola virus disease patients or their bodily fluids have become infected.¹²
Direct injection and exposure via a skin break or mucous membranes are the most efficient ways for Ebola to transmit. It may be that inhalation is a less efficient route of transmission for Ebola and other filoviruses, as lung involvement has not been reported in all non-human primate studies of Ebola aerosol infectivity.²⁷ However, the respiratory and gastrointestinal systems are not complete barriers to Ebola virus. Experimental studies have demonstrated that it is possible to infect non-human primates and other mammals with filovirus aerosols.^25-27

Altogether, these epidemiologic and experimental data offer enough evidence to suggest that Ebola and other filoviruses may be opportunistic with respect to aerosol transmission.²⁸ That is, other routes of entry may be more important and probable, but, given the right conditions, it is possible that transmission could also occur via aerosols.
Guidance from the CDC and WHO recommends the use of facemasks for healthcare workers providing routine care to patients with Ebola virus disease and respirators when aerosol-generating procedures are performed. (Interestingly, the 1998 WHO and CDC infection-control guidance for viral hemorrhagic fevers in Africa, still available on the CDC Web site, recommends the use of respirators.)
Facemasks, however, do not offer protection against inhalation of small infectious aerosols, because they lack adequate filters and do not fit tightly against the face.¹ Therefore, a higher level of protection is necessary.

Which respirator to wear?

As described in our earlier CIDRAP commentary, we can use a Canadian control-banding approach to select the most appropriate respirator for exposures to Ebola in healthcare settings.²⁹ (See this document for a detailed description of the Canadian control banding approach and the data used to select respirators in our examples below.)
The control banding method involves the following steps:

1. Identify the organism's risk group (1 to 4). Risk group reflects the toxicity of an organism, including the degree and type of disease and whether treatments are available. Ebola is in risk group 4, the most toxic organisms, because it can cause serious human or animal disease, is easily transmitted, directly or indirectly, and currently has no effective treatments or preventive measures.
2. Identify the generation rate. The rate of aerosol generation reflects the number of particles created per time (eg, particles per second). Some processes, such as coughing, create more aerosols than others, like normal breathing. Some processes, like intubation and toilet flushing, can rapidly generate very large quantities of aerosols. The control banding approach assigns a qualitative rank ranging from low (1) to high (4) (eg, normal breathing without coughing has a rank of 1).
3. Identify the level of control. Removing contaminated air and replacing it with clean air, as accomplished with a ventilation system, is effective for lowering the overall concentration of infectious aerosol particles in a space, although it may not be effective at lowering concentration in the immediate vicinity of a source. The number of air changes per hour (ACH) reflects the rate of air removal and replacement. This is a useful variable, because it is relatively easy to measure and, for hospitals, reflects building code requirements for different types of rooms. Again, a qualitative ranking is used to reflect low (1) versus high (4) ACH. Even if the true ventilation rate is not known, the examples can be used to select an appropriate air exchange rate.
4. Identify the respirator assigned protection factor. Respirators are designated by their "class," each of which has an assigned protection factor (APF) that reflects the degree of protection. The APF represents the outside, environmental concentration divided by the inside, facepiece concentration. An APF of 10 means that the outside concentration of a particular contaminant will be 10 times greater than that inside the respirator. If the concentration outside the respirator is very high, an assigned protection factor of 10 may not prevent the wearer from inhaling an infective dose of a highly toxic organism.

Practical examples

Two examples follow. These assume that infectious aerosols are generated only during vomiting, diarrhea, coughing, sneezing, or similar high-energy emissions such as some medical procedures. It is possible that Ebola virus may be shed as an aerosol in other manners not considered.
Caring for a patient in the early stages of disease (no bleeding, vomiting, diarrhea, coughing, sneezing, etc). In this case, the generation rate is 1. For any level of control (less than 3 to more than 12 ACH), the control banding wheel indicates a respirator protection level of 1 (APF of 10), which corresponds to an air purifying (negative pressure) half-facepiece respirator such as an N95 filtering facepiece respirator. This type of respirator requires fit testing.
Caring for a patient in the later stages of disease (bleeding, vomiting, diarrhea, etc). If we assume the highest generation rate (4) and a standard patient room (control level = 2, 3-6 ACH), a respirator with an APF of at least 50 is needed. In the United States, this would be equivalent to either a full-facepiece air-purifying (negative-pressure) respirator or a half-facepiece PAPR (positive pressure), but standards differ in other countries. Fit testing is required for these types of respirators.
The control level (room ventilation) can have a big effect on respirator selection. For the same patient housed in a negative-pressure airborne infection isolation room (6-12 ACH), a respirator with an assigned protection factor of 25 is required. This would correspond in the United States to a PAPR with a loose-fitting facepiece or with a helmet or hood. This type of respirator does not need fit testing.

Implications for protecting health workers in Africa

Healthcare workers have experienced very high rates of morbidity and mortality in the past and current Ebola virus outbreaks. A facemask, or surgical mask, offers no or very minimal protection from infectious aerosol particles. As our examples illustrate, for a risk group 4 organism like Ebola, the minimum level of protection should be an N95 filtering facepiece respirator.
This type of respirator, however, would only be appropriate only when the likelihood of aerosol exposure is very low.  
For healthcare workers caring for many patients in an epidemic situation, this type of respirator may not provide an adequate level of protection.
For a risk group 4 organism, any activity that has the potential for aerosolizing liquid body fluids, such as medical or disinfection procedures, should be avoided, if possible. Our risk assessment indicates that a PAPR with a full facepiece (APF = 50) or a hood or helmet (APF = 25) would be a better choice for patient care during epidemic conditions.
We recognize that PAPRs present some logistical and infection-control problems. Batteries require frequent charging (which requires a reliable source of electricity), and the entire ensemble requires careful handling and disinfection between uses. A PAPR is also more expensive to buy and maintain than other types of respirators.
On the other hand, a PAPR with a loose-fitting facepiece (hood or helmet) does not require fit testing. Wearing this type of respirator minimizes the need for other types of PPE, such as head coverings and goggles. And, most important, it is much more comfortable to wear than a negative-pressure respirator like an N95, especially in hot environments.
A recent report from a Medecins Sans Frontieres healthcare worker in Sierra Leone³⁰ notes that healthcare workers cannot tolerate the required PPE for more than 40 minutes. Exiting the workplace every 40 minutes requires removal and disinfection or disposal (burning) of all PPE. A PAPR would allow much longer work periods, use less PPE, require fewer doffing episodes, generate less infectious waste, and be more protective. In the long run, we suspect this type of protection could also be less expensive.

Adequate protection is essential

To summarize, for the following reasons we believe that Ebola could be an opportunistic aerosol-transmissible disease requiring adequate respiratory protection:

• Patients and procedures generate aerosols, and Ebola virus remains viable in aerosols for up to 90 minutes.
• All sizes of aerosol particles are easily inhaled both near to and far from the patient.
• Crowding, limited air exchange, and close interactions with patients all contribute to the probability that healthcare workers will be exposed to high concentrations of very toxic infectious aerosols.
• Ebola targets immune response cells found in all epithelial tissues, including in the respiratory and gastrointestinal system.
• Experimental data support aerosols as a mode of disease transmission in non-human primates.

Risk level and working conditions suggest that a PAPR will be more protective, cost-effective, and comfortable than an N95 filtering facepiece respirator.
Acknowledgements
We thank Kathleen Harriman, PhD, MPH, RN, Chief, Vaccine Preventable Diseases Epidemiology Section, Immunization Branch, California Department of Public Health, and Nicole Vars McCullough, PhD, CIH, Manager, Global Technical Services, Personal Safety Division, 3M Company, for their input and review.
References  http://www.cidrap.umn.edu/news-perspective/2014/09/commentary-health-workers-need-optimal-respiratory-protection-ebola

PRESIDENT KOROMA ADDRESSES NATION ON EVE OF LOCKDOWN

PRESIDENT KOROMA ADDRESSES NATION ON EVE OF LOCKDOWN
Fellow Sierra Leoneans
Our country is the midst of a big trial. But by the grace of God, we shall overcome this Ebola outbreak. Many of our people have fallen victims to this disease. It was not a disease that started in Sierra Leone; it came to us from our brothers and sisters in our neighboring countries. But no body, no region, no district wish this disease on themselves. Many people were doing very ordinary things when they contracted the disease. They were attending funerals, visiting the sick, and caring for the sick when they became victims of the disease. Many of our doctors and nurses and other health workers were doing what God has called them to do, when they contracted the disease. That is why this disease is one of the biggest tragedies that has befallen our nation. But we shall overcome this trial.
But to overcome it, all of us must play our part. This is because if just one person does not play his or her part to contain this disease, this trial will not end. That is why it is very important that every body must know what they can do to avoid getting the disease and prevent others from getting the disease.

My Government has declared a three-day stay at home Ose to Ose Ebola Tok campaign to get this message to every house and family in the country. Everybody in every house in every community in this country is very important in our fight against Ebola. Avoid touching each other, avoid eating bush meat, avoid visiting the sick, avoid attending funerals, report illnesses and deaths to the nearest health facility or call 117. We know some of the things we are asking you to do are difficult. But life is better than these difficulties.

Today the life of every one is at stake, but we will get over this difficulty if all do what we have been asked to do. Ebola is no respecter of persons. It is not an APC or SLPP disease. It is not a disease of any political party, or ethnic group or district. Anyone who is not careful can endanger themselves and others that they love. These are extra-ordinary times, and extra-ordinary times require extra-ordinary measures.

The Ose to Ose Ebola Tok campaign is one such extra ordinary measure. The three-day campaign will start tomorrow, Friday the 19th, and ends on Sunday the 21st of September 2014. During this ‘Ose to Ose Ebola Tok’ campaign, 7136 trained teams composed of health workers, community volunteers and other NGO partners will be going from house-to-house across Sierra Leone to raise awareness about the Ebola virus disease and enlist family/community support and participation to the response. It is necessary that all family members are met at home by the visiting team members who will provide correct information on the disease, advice family members on what to do if a family member is sick, promote hand washing with soap as an effective means of protection, share some information material on Ebola and mark their homes with a sticker

During this period all persons (except for authorised persons on essential services) should stay at home. During consultations with the inter-religious council of our country, we have agreed that our Muslim and Christian families should pray at home on Friday, Saturday and Sunday, while reflecting and planning on what to do to protect the family from Ebola.

 We are a nation of great faith, a nation that lifts up its hands in prayers to the Almighty for our actions to be blessed, our sick be cured, our bereaved be comforted and the healthy ones amongst us secured. We must not relent; we must bring unto this fight our faith, our prayers, and our resolve. But let us also remember it is part of faith to obey the laws of life; for without life, there can be no faith. The Ose to Ose Ebola Tok is about preserving our lives and securing the blessings of our prayers.

During the Ose-to-Ose Ebola tok’ campaign, it is important that the police maintain public order. In doing so, however, the security forces have a public duty to exercise maximum restraint so that peace is preserved and the rights and dignity of every Sierra Leonean are upheld to the extent possible. The police will urge anyone who is found on the street without good cause to go straight home. I ask you to comply so that we each play our part in making this campaign a success.
It is important also that you listen to radio stations during the stay at home campaign. Government and its partners are ensuring that radio stations around the country specifically broadcast messages relating to the fight against Ebola during the period.

To address some concerns expressed by the general public and partners regarding the increased demand for services that will result from this exercise; and also other welfare issues that may affect especially the most vulnerable members of our society, government has taken the following actions:
1. Make available hundreds of additional beds for holding centers spread across the nation with trained staff and required equipment for suspected cases while they await laboratory results
2. Increased laboratory capacity to test and report on specimens to facilitate time confirmation and burials
3. Procured additional ambulances and vehicles for increased logistics support
4. Procured additional supplies of personal protective equipment (PPE) and supportive medicines to Health facilities
5. Recruited and conducted Ebola specific training for different cadres of health workers including Doctors, medical students, nurses and other paramedical staff
6. Increased and expanded the readiness and capacity of #117 to prepare for an increase in phone calls
Similarly, in order to respond to non-Ebola related emergencies like very sick children, women in labour and other life threatening medical emergencies like accidental injuries, asthma, diabetic, heart attacks and the like, special ambulance services will be provided in each district

Government have also taken into account the plight of some special vulnerable members of our population like street children who will be provided with cooked food, while the physically challenged (disabled), and street beggars will be provided with dry rations

In addition, Government has also put in place modalities to address issues relating to burials of non-Ebola related deaths and international travellers in and out of Sierra Leone. 

Fellow citizens, Let me also state that the three-day Ose to Ose Ebola Tok by itself will not end the outbreak. But if everyone follows the messages given to you by the teams visiting your homes; the campaign will greatly help to reverse the increasing trend of disease transmission and become a very big boost to our collective efforts to stop the outbreak. The survival and dignity of each and every Sierra Leonean is at stake; all what we have toiled for as a people is at stake; this is a fight for each and every one of us; this is a fight for this land that we love. We have shown great resolve as a nation to overcome tragedy and become a symbol of recovery, democracy and peace in the world. Early this year the United Nations hailed us as a symbol of recovery; the world hailed us as an example of growth, democracy and great possibilities.
Like all countries, we have our challenges, we have our weaknesses, we have our differences, and we have accounts of efforts we could have exerted in a much better way. But we are also a nation with a proud inheritance of achievements, and we are a nation with a positive place in the story of the resurgence of Africa, we must not allow Ebola to remove us from this story of resurgence. We are country of faith, resilience, and a great resolve for life and growth. We have surprised many before who thought this country shall not rise again; we have collectively taken many strides which many countries affected by war would only dream about. We must do it again. Ebola is not this nation’s portion, we must stand together to root it out, and this campaign must give us greater strength to root it out.
God Bless our collective efforts.
God Bless Sierra Leone.  https://www.facebook.com/umaru.fofana.5/posts/10152324982591921

Eight bodies found after attack on Guinea Ebola education team

Thu, Sep 18 17:02 PM EDT

CONAKRY (Reuters) - Eight bodies, including those of three journalists, were found after an attack on a team trying to educate locals on the risks of the Ebola virus in a remote area of southeastern Guinea, a government spokesman said on Thursday.
"The eight bodies were found in the village latrine. Three of them had their throats slit," Damantang Albert Camara told Reuters.
(Reporting by Saliou Samb; Writing by Bate Felix; Editing by Robin Pomeroy) http://mobile.reuters.com/article/idUSKBN0HD2JE20140918?irpc=932

Ebola outbreak: Health team 'found dead' in Guinea

Some villagers in Guinea have been scared by the appearance of health workers trying to combat Ebola

Continue reading the main story

Ebola outbreak

• Five ways to tackle outbreak
• Virus in video
• 'Biological warfare'
• How bad can Ebola get?

Officials in Guinea searching for a team of health workers and journalists who went missing while trying to raise awareness of Ebola have found several bodies.

A spokesman for Guinea's government said the bodies included those of three journalists in the team.
They went missing after being attacked on Tuesday in a village near the southern city of Nzerekore.
More than 2,600 people have now died from the Ebola outbreak in West Africa.
It is the world's worst outbreak of the deadly disease, with officials warning that more than 20,000 people could ultimately be infected.

Last month, riots erupted in the area of Guinea where the health team went missing - near where the outbreak was first recorded - after rumours that medics who were disinfecting a market were contaminating people.
The three doctors and three journalists went missing on Tuesday after residents in the village of Wome pelted them with stones as they visited the village.
One of the journalists managed to escape and told reporters that she could hear the villagers looking for them while she was hiding.
The governor of Nzerekore told the BBC that the group were being held captive but on Thursday night a government spokesman said several bodies had been found.
He said the eight bodies found included those of three journalists, but it is unclear who the other victims are.
A government delegation, including the health minister and the communications minister, had been dispatched to the region but the BBC's Makeme Bamba, in the Guinean capital Conakry, said they were unable to reach the village by road because a main bridge had been blocked.
There have been many reports of people in the region saying they do not believe Ebola exists, or refusing to co-operate with health authorities, fearing that a diagnosis means certain death...... http://www.bbc.com/news/world-africa-29256443

N'Zérékoré: A government delegation arrived in Wome

September 18, 2014, 6:11 p.m. Posted By Guilana Fidel Momou Spot News, The One, 1190 News 0
N'Zérékoré: A government delegation arrived in Wome

We announced the inaccessibility of the Sub-Prefecture Wome where people had set up roadblocks with tree trunks to prevent access to sites civilian and military authorities after the violence that glazed session awareness of the disease Ebola.

 
The government delegation led by the Minister of Health, Col. Remy Lamah (left in photo) has finally arrived this afternoon in Wome, has-been learned.



A colleague that we could join 17h confirmed this information. However, he denies the presence in the hospital N'Zérékoré body from Wome, as did believe the rumors. "The hospital is very close and I wonder how the bodies could leave for Wome N'Zérékoré while access to this place was impossible.


The facts will be known only after the return of the government delegation whose members are yet unreachable.  http://guineenews.org/nzerekore-une-delegation-gouvernementale-estarrivee-a-wome/?utm_source=Guinee1&utm_medium=twitter



A N'Zérékoré, rural radio and radio Zaly Fm, whose reporters are still no new states, no longer broadcast from Thursday morning because of the shock that frape both stations.

#EBOLA Wome - The lifeless body found in a well

Wome - The lifeless body found in a wellNew elements have been recently registered in the case of violence that occurred in the town of Wome, in the prefecture of Nzerekore! Some bodies have just been found in the community, located about fifty kilometers from the capital of the prefecture of Nzerekore.

The government delegation composed of the Minister of Health, the physician Colonel Remy Lamah and his counterpart in the communication Alhousseine Makanera, accompanied by a military contingent, was finally able to access Wome. Reportedly, a body was found at the entrance of the village.

When we put this dispatch line (4:15 p.m. GMT), the bodies of some victims of the violence of last Tuesday, were being removed from a well located inside the village.

Already, a source present at the scene told our editorial arrested six people. These local residents Womé are suspected of involvement in the violence that claimed the lives of several people.http://www.actu224.com/wome-corps-vie-retrouves-puits/

8 bodies exhumed from a mass grave some slain womey (N'zérékoré)

Source: http://aminata.com/8-corps-exhumes-d...mey-nzerekore/

Google translation:

8 bodies exhumed from a mass grave some slain womey (N'zérékoré)

The information has just fallen on the desk 's Aminata com, bodies of victims of violence in the sub-prefecture of womey were found. To believe a reliable source, 8 whose body was no news have been exhumed from a mass grave in the capital of N'Zérékoré.

Some information announced that the bodies had been removed from a well. But all indications are that eight people were murdered in cold blood by the people of this sub-prefecture. The bodies were exhumed before the two emissaries government ministers, Colonel Remy Lamah and Alhousseiny Makanera Kake.

To believe a generally well-informed source, the victims were murdered in "very horrific" conditions. Some bodies were found completely butchered, we learn. Another source maintains that an investigation led by the Prosecutor of the Court of First Instance N'zérékoré was opened. The investigation should determine the circumstances of the killings.

On Tuesday, members of the administrative delegation came to womey to educate citizens about the Ebola virus have been taken to task. Part of the delegation including the governor of the city of N'zérékoré had reached out clashes. By against journalists and doctors who were in the delegation had been held hostage. At last count, six people suspected of involvement in the killings were arrested. We will return.

HATTIP TO SHILOH  http://aminata.com/8-corps-exhumes-d...mey-nzerekore/

#Ebola aid workers -8 dead

Thurs, September 18, 2014, 7:20 p.m. Posted By Abdoulaye Bah Spot News, The One, News, Health, Society 0 1518
Violence womey eight bodies exhumed, six arrests and a statement by PM expected

Now it's official, eight bodies were found after the incidents in Wome, a town in the forest region 50 kilometers from the County seat, N'zérékoré-center, it was learned Thursday according to the spokesman of the government, Damantang Albert Camara.




According to our source, the eight bodies found include: the sub-prefect of Wome, the prefectural health director of the regional hospital N'zérékoré, deputy director of the regional hospital center head health Womé, an evangelist pastor of the health center Zao, two trainee technicians rural radio journalist and a private radio Zali Fm.


In other news, the eight bodies found in a septic tank in primary school Womé were exhumed in the presence of the public prosecutor at the court N'zérékoré and medical examiner. Similarly, the five year old son of the Deputy Commissioner of Womé managed to escape. We do not know its destination.


Latest news, six suspects have been arrested and Prime Minister Mohamed Said Fofana is set to make a statement in the news 20 hours 30 The three press associations of Guinea will make a joint statement.


While the city is N'zérékoré in psychosis, the town of Wome, it is almost empty.

A recall that before last Tuesday a delegation led by the governor of Nzerekore was visited womey is to educate local people about Ebola. Awareness has gone wrong and the whole delegation was taken to task by the inhabitants of Wome. The governor of Nzerekore was able to escape by running away, but all three of his fellow journalists were not so lucky. http://guineenews.org/violences-a-womey-huit-corps-exhumes-six-interpellations-et-une-declaration-du-pm-attendue/

Soul Clinic Ebola Infected Residents Want Ebola Training

Tue, 09/16/2014 - 21:09 admin

Call on Alfalit-Liberia for Hand-washing Structures, Sanitation Materials

By: 

Edwin M. Fayia III

Soul Clinic Community residents in Paynesville have urgently appealed to charity entities and global health partners to initiate some sensitive hygiene trainings in their community.

The residents’ appeal comes in the wake of suspected, probable and confirmed cases of more than 23 Ebola virus deaths for the past three weeks in the densely populated Paynesville Community.
The citizens and residents through the community leadership headed by Mr. Jonathan Enders sounded the appeal in an official encounter with the executives of Alfalit-Liberia and the Liberia/Ghana Missions (LGM) last week.
During the one and half hours of interactive discussions with the leadership of Alfalit-Liberia and LGM, Mr. Enders pointed out that some initiatives have been put in place to sensitize the citizens and residents about the deadly Ebola virus plaguing the nation and its people.
He also underscored the need for building of solid structures such as hand washing reservoirs in densely concentrated entry points to the Soul Clinic Community in Paynesville last week.
Chairman Enders also intimated that the majority of citizens and residents of the Soul Clinic Community are very low income earners and are unable to buy the critical sanitation materials being recommended by health workers in the country.
The Soul Clinic Community also stressed the need for the citizens and residents to at all times observe and practice all rules and regulations regarding dead bodies of infected Ebola virus victims in the area.
He further called on Liberians and global partners to consider a program that will critically address the tracing and tracking steps of suspected,

Two American experts in Ivory Coast this week for the prevention of Ebola

Monday, 15 September 2014 17:05

 

ABIDJAN - The Embassy of the United States is pleased to announce that two health experts Control Centers and Disease Prevention (CDC), based in the United States arrived this week in Cote d'Ivoire to help the government in efforts to prevent the spread of the Ebola virus in the country.

Although there is to date no confirmed cases of Ebola Ivory Coast, the country remains at high risk because it borders the affected countries. CDC experts will help assess and strengthen plans put in place to prevent the spread of disease, reduction plans and treatment of the disease should it break out in the country and also provide technical assistance research contacts with infected people. The experts will stay in Côte d'Ivoire from 11 to 25 September.

"Although the Government of Côte d'Ivoire has taken most of the measures necessary to prevent the spread of the disease, the United States is pleased to help the country strengthen these efforts by visiting two health experts, "said the Ambassador of the United States in Côte d'Ivoire, HE Mr. Terence McCulley. "There is no complete assurance that the Ivory Coast will not be affected by the disease, but we can work so that if a case was reported, patients can be quickly isolated and treated for the disease does not spread.

The American government is committed to stem the Ebola virus since the outbreak in March, when the first cases were reported in the region, and increased its equity and its staff in the region in response to the worsening situation . The United States has so far about 100 specialists distributed across the affected countries working on activities such as the distribution of physical health and emergency supplies, support for public health messages and the provision of technical expertise to help on issues such as airport screening and contact tracing with the infected person.

In addition, the CDC now has over 70 staff members deployed in Guinea, Liberia, Nigeria and Sierra Leone to help in the implementation of the various measures of response, including monitoring and incident management related to Ebola, laboratory testing, monitoring, research contacts with infected people, managing databases and education in health. . All these actions are intended to support efforts to prevent, detect and control the spread of the Ebola virus in the affected countries.  https://translate.googleusercontent.com/translate_c?depth=1&hl=en&ie=UTF8&prev=_t&rurl=translate.google.com&sl=auto&tl=en&u=http://lintelligentdabidjan.ci/societe/799-2014-08-22-14-12-02/1971-deux-experts-americains-en-cote-d-ivoire-cette-semaine-pour-la-prevention-de-l-ebola&usg=ALkJrhi9sjjGXK8OJJ1SerbRp-CGf1YmaQ

Ebola - Staff MSF infected with Ebola

       Ebola - Staff MSF infected with Ebola - 17092014, 23 Kb

Paris / Brussels, 17 September 2014 - Médecins Sans Frontières (MSF) confirms that a person of his team in Liberia has been infected with the Ebola virus.

The French MSF volunteer, part of the team deployed to Monrovia, was placed in solitary confinement Tuesday, Sept. 16, at the onset of symptoms. Laboratory tests performed on the same day confirmed an Ebola infection.

According to the strict protocols established by medical evacuation MSF volunteer to be transferred to a specialized treatment center in France.

"MSF protocols apply very strict protection to staff before, during and after a mission in a country affected by the Ebola outbreak, says the Vingne Brice, director of operations for MSF. This reduces dramatically the risk of infection. However, that risk is part of this type of intervention, and our teams are not completely spared. "

Respecting the confidentiality of medical information, and to preserve the privacy of its voluntary and his entourage, MSF does not wish to provide any additional information about it for now.

Doctors Without Borders is in response to the Ebola outbreak underway in West Africa since March. More than 2,000 MSF are currently at work in the region, including about 200 international volunteers.http://www.msf.fr/presse/communiques/ebola-volontaire-francaise-msf-infectee-au-liberia

Bourse de Paris: A French MSF volunteer contaminated with Ebola in Liberia

Bourse de Paris: A French MSF volunteer contaminated with Ebola in Liberia
17.09.2014 | 8:16 p.m.


A French cooperating Doctors Without Borders (MSF) has been contaminated by the Ebola virus in Liberia, the humanitarian organization said on Wednesday.

"The French MSF volunteer, part of the team deployed to Monrovia, was placed in solitary confinement Tuesday, Sept. 16, at the onset of symptoms. Laboratory tests performed on the same day confirmed an Ebola infection "MSF said in a statement.

It must be transferred to a treatment center in France, says the organization does not wish to provide more information about the identity of the person affected. http://www.zonebourse.com/actualite-bourse/Une-volontaire-francaise-de-MSF-contaminee-par-Ebola-au-Liberia--19062851/

A French MSF infected with Ebola virus

 9/17/2014 8:18 p.m.

 Médecins Sans Frontières (MSF) confirms today that a French volunteer his team in Liberia has been infected with the Ebola virus.

Voluntary, part of the team deployed to Monrovia, was placed in solitary confinement at the onset of the first symptoms, the NGO says on its website. Laboratory tests have confirmed infection with the virus.

According to protocols established by medical evacuation MSF, the volunteer should be transferred to a center that specializes in treating France, according to the website.  https://translate.google.com/translate?sl=auto&tl=en&js=y&prev=_t&hl=en&ie=UTF-8&u=http%3A%2F%2Fwww.lefigaro.fr%2Fflash-actu%2F2014%2F09%2F17%2F97001-20140917FILWWW00357-une-francaise-de-msf-infectee-par-le-virus-ebola.php&edit-text=

Mercy Ships changes course due to Ebola outbreak

Mercy Ships

POSTED: Monday, September 15, 2014 - 6:44pm
UPDATED: Monday, September 15, 2014 - 7:02pm

Arp, Texas (KETK) — Four hundred volunteers from 40 different nations are preparing for a new journey this fall. Mercy Ships, for the first time in their 36 year history is changing course due to the widespread Ebola outbreak. The virus is very active in the West Africa region.
"Mercy Ships has had a presence in West Africa for the past 23 years. We have lots of friends, lots of acquaintances in that particular region. They are obviously suffering the effects of Ebola," said Russel Holmes, Director of Corporate Relations at Mercy Ships.
Last month, the United Nations World Health Organization declared the Ebola outbreak an international health emergency.
Mercy Ships says they are not equipped to treat the virus.
"We're not set up to handle an Ebola outbreak and if we went in there with our hospital ship, folks don't understand that so we would be like a magnet," said Jim Paterson, Vice President of Marine Operations at Mercy Ships. "So I think it's safer for everybody, for the local ministry of health, our own crew and volunteers, that we remove ourselves from that situation. I think we would compound the problem rather than helping it."
Mercy Ships says that although west africa is off limits for now, they are eager to return to Madagascar, after 18 years, to provide 8 months of medical care.
"92% of the population live on less than $2 a day, so you can imagine the needs are immense. so Mercy Ships feels privileged to go back to Madagascar and provide much needed services," said Holmes.  http://www.ketknbc.com/news/mercy-ships-changes-course-due-to-ebola-outbreak

Nancy Perez reiterated that they are waiting for pathological studies of other deceased.
 He insisted that the lethality of this virus is "low" and said that "at this time there are no foreign virus in the country"

YP / National Web September 17, 2014 - 24:16
As he left a meeting with epidemiologists, health minister, Nancy Perez said that patients who have had a febrile syndrome with complications that have led to deaths "have an underlying disease" and attributed to a "terrorist campaign" theories on the causes of deaths, infectious disease specialists in the country have been attributed to an atypical presentation of chikungunya virus.

"We are waiting for the anatamopatológicos studies" reported, while confirming that there are 398 cases of chikungunya so far this year with three deaths that had the virus, but insisted that all these people "had underlying diseases" because the lethality of the virus "is very low."
"Right now there are not any strange virus, when that disease need to know the town, the report will appear. Polítca State not hide anything," said

Regarding the case of deceased gentleman of 60 years in clinical Razetti Luis, explained: "I was five days duration and had a skin infection, this is not a rare disease. What is it you do not know? the infectious agent that caused that person having septic shock and has died. But it is not a rare disease. Every day there are cases of patients who, for whatever reason, will unfortunately die. Can I be sure, that if here is a case of being detected internationally, be the first to say, "he said.


Perez asked the public to channel their concerns about hemorrhagic fever that has caused deaths in Aragua and the Capital District.
"The recommendation is to wait what government spokesmen say, the government has some spokesmen, is not that people do not make complaints, it is valid that express and say" he said.


He denied that the country had a shortage of acetaminophen for fever and symptoms of these diseases, but told the couple that the government is buying and distributing the medicine in hospitals and CDI.https://translate.googleusercontent....iTviyn1cRDVydw




Health Minister said that there was "bleeding or rare diseases"


National September 17, 2014 - 12:01 am
The Health Minister Nancy Perez ruled on the complaint of the Medical College of Aragua and said, "No hemorrhagic or rare diseases, and are responsible for diagnosing laboratories." Perez stressed that "chikunguya not kill the person, there are low deaths from this virus. What can happen is that you have an underlying disease, such as problems in the immune system, and the patient is complicated. "
Sectoral Health Secretary Aragua state, Luis Lopez, said in a radio program that the Central Hospital of Maracay is operating normally.


https://translate.googleusercontent....zXPlK0sAgb4IVA

....Results of the assembly.
On Monday night there was a meeting at the Medical College of Aragua, where it was said that the analysis of cultures made ​​the first killed in the Central Hospital of Maracay was negative in dengue and meningococcemia. "It is possible that the virus has mutated chikungunya fever" was the assumption on which the medical profession agreed. During the meeting it was reiterated that the medical reports of the 9 patients who died in the HCM indicate death from acute hemorrhagic fever syndrome, a common box with the patient died Sunday in Caracas Razzetti Clinic.
Physicians requested a ruling from the Ministry of Health on the causes of the 9 deaths in Maracay Central Hospital, after pictures of patients presented hemorrhagic fever. Yesterday, at a press conference at the headquarters of the Venezuelan Medical Federation reiterated the call. "Cases like this could be in any state because the information is not clear epidemiological and health centers do not have the supplies to care for patients. The government's responsibility is to clarify things, "said Douglas León Natera, president of the federation..https://translate.googleusercontent....GA94tKBmfg-DAg

16 Sep 2014

Syrian opposition halts vaccinations after death reports

BEIRUT, September 16, 2014 (AFP) - The Syrian opposition said Tuesday it halted a measles vaccination campaign in the northeastern Idlib province following reports children had died after being innoculated.
The announcement was posted on the websites of the Syrian opposition National Coalition and the rebel interim government.
The "interim government's health ministry has instructed a halt to the second round of the measles vaccination campaign, which began Monday... following several fatalities and injuries among children in vaccination centres in the Idlib countryside," the statement said.
It stressed that a first round of vaccinations against measles, which began a month ago, had been carried out "without any problems."
They said the vaccines being used in the latest campaign had come from the same source as those in the previous round, without specifying what that was.
The Syrian Observatory for Human Rights, a Britain-based NGO, said "at least 12 children have died and dozens more are suffering from poisoning or allergic reactions after measles vaccinations."
The death toll was revised from an earlier figure of five, and the group said it could rise further because several children were in serious condition.
The group said medical sources had suggested that the vaccines could have been compromised, either because they were expired or poorly stored, but there was no confirmation.
Medical groups have rushed to head off the spread of measles, mumps, rubella and polio in Syria, where normal medical services have disintegrated because of the civil war, which erupted in 2011.
The United Nations said earlier this year that 1.6 million children were to be vaccinated in Syria against polio, measles, mumps and rubella.
rd-sah/al   http://reliefweb.int/report/syrian-arab-republic/syrian-opposition-halts-vaccinations-after-death-reports

 

Medical emergency requires reporting of Aragua

According to autopsy, there are several deaths from complications Syndrome

In the Central Hospital of Maracay awaiting results of samples sent to the National Institute of Hygiene COURTESY

Erika GUILLÉN | SPECIAL TO THE UNIVERSAL

Wednesday September 17, 2014 12:00 AM

Maracay -. Photos, medical reports and autopsy data gathered representatives of the College of Physicians in Aragua, where it says that in the last days have passed 10 people, nine of them in the state, by the so-called hemorrhagic fever syndrome.

So far not known whether the disease is caused by a virus or bacteria. Indeed, as indicated, that is what the tests reveal samples sent last week, the National Institute of Hygiene (INH) in Caracas, the only place in the country with the reagents for these samples.

"They is an emergency, we know not what we face and we must know the cause in order to provide appropriate treatment to prevent the collapse of the patient's organs. Three to five days are enough for testing and still have not said anything, "he said and warned union representatives to be done urgently epidemiological fence.

"This is a very aggressive disease and causes deterioration of the patient within 72 hours to cause death," said a doctor who attended the meeting called for Tuesday night at the headquarters of the College of Physicians in Aragua, and who declined to be identified under guard.

The health professionals at that meeting, the authorities insisted that the Executive must declare a health emergency in the aragüeña entity due to the serious situation. They handle the figure of 10 deaths from the syndrome, one of which was recorded in Caracas earlier this week.

It was learned that some samples of crops able to be sent to a private laboratory to verify that the disease is treated.

For professional ethics, doctors kept secret the names of the patients involved, cautioned, however mentioned details of the autopsy of one of the recently deceased, which reveals the aggressiveness of the disease.

A case

All medical reports indicate death from Acute Haemorrhagic Fever Syndrome in a patient a year, died 1 September, after seven hours hospitalized. Relatives said, according to the report, the baby began the disease on August 30 with fever to 39.5 ° degrees and rash on upper extremities. Two days later he developed fever to 40 ° degrees and rectal bleeding not yield multiple times. On admission to the Central Hospital of Maracay, was diagnosed with "severe dengue".

In the clinical history of the patient indicates that the infant showed a hypovolemic shock. After supplying the necessary drugs, the baby had complications. Increasing white blood cells and low platelets. He recorded a respiratory arrest that caused his death.

The situation was reported to health authorities in the state. He took samples (post mortem) of heart, liver, kidney, spleen, lung and intracardiac blood sent to the National Institute of Hygiene Rafael Rangel.

In the autopsy report states: "hepatomegaly, steatosis, congestive spleen, pale kidneys, hemorrhagic enterocolitis with rings granulomatous appearance, pleuritis erosive and petechiae in the upper limbs."

Representatives of the College of Physicians insist that the deceased had the same set of symptoms (fever 40 ° degrees unyielding, skin rashes and bleeding) that result in rapid deterioration.

Suspected Cases

It was learned that at the Hospital of Maracay two children, 12 and 5 years of age, who for days have the same symptoms of the disease and are treated as DHF.

Social Security In San Jose are hospitalized two men, one 39 years (from the coastal town of Choroní) and another 55 with disease characteristics.

The suspects in both cases health centers could not be confirmed with the policy of the College of Physicians of Aragua.

Furthermore, it emerged that doctors and nurses do not have Central Hospital biosecurity measures. Face shortages of inputs, especially gloves and face mask, to take care of the patients admitted.  https://translate.google.com/translate?sl=auto&tl=en&js=y&prev=_t&hl=en&ie=UTF-8&u=http%3A%2F%2Fwww.eluniversal.com%2Fnacional-y-politica%2F140917%2Fmedicos-de-aragua-exigen-declarar-la-emergencia&edit-text=

5 year old dies in Vargas with similar symptoms to victims of Maracay

Tuesday, September 16, 2014

 

5 year old dies in Vargas with similar symptoms to victims of Maracay

Physicians Maracay Central Hospital reported that another patient five months old with acute hemorrhagic fever syndrome. "His condition is stable," although high fever and spots on the skin. Last Sunday he died in this hospital Fossi Franklin, 40 years of age, acute respiratory failure, fever, bleeding and stains on the skin. Before he had been admitted to hospital with symptoms of chikungunya and was discharged.

Social Security In San Jose, in Maracay, Yordi Bracho, 28, from Choroní, entered Friday with leg pain. "At first I thought it was phlebitis, had a red stain, but now all swollen and purple blood bubbles leg," said his wife Carolina Gautier. He developed fever from Friday until Sunday. "The doctors tell me that the redness moved very fast, and do not know what you have." Last week, Bracho presented symptoms of chikungunya, but had improved.

In Vargas, where chikungunya has also been extended, died Sunday a child of 5 years with similar cases of Aragua box. Thomas War of Maternal Messenger pediatrician and president of the Medical College of Vargas reported child entered after more than 12 hours with vomiting. His parents reported that he had a week with high fever and skin rash. During that time they resorted to home treatment, they thought it was chikungunya, which together with the dengue has affected the whole family. Living in Montesano, where most are affected by febrile virus. "We assume it was a dengue chikungunya.'re Waiting for studies to determine the causes of death," Guerra said.

Last week, Miguel Carrillo died, 39 years old, in hospital Pariata half hour after entering with high fever and joint pains as those produced by chikungunya.  https://translate.google.com/translate?sl=auto&tl=en&js=y&prev=_t&hl=en&ie=UTF-8&u=http%3A%2F%2Fwww.noticensura.com%2F2014%2F09%2Fmuere-nino-de-5-anos-en-vargas-con.html&edit-text=

They interpelarán Angel Sarmiento

The Bolivarian Legislative Council (Cleba) of Aragua state passed the interpellation of the President of the College of Physicians of Aragua, Angel Sarmiento, for dissemination of information relating to health through social networks and media.

The main authority of the regional legislature, Sumiré Ferrara said that as soon as possible the principal representative of the medical profession in the state be notified about his interpellation which must appear in the morning hours of Thursday in the spaces of the legislature Aragua.

The governor of Aragua state, Tarek El Aissami, introduced last Friday before the Public Prosecutor a complaint against Sarmiento to be investigated by creating a campaign of anxiety by lying about alleged killings in the Central Hospital of Maracay (HCM) because of a Fake virus.

The Aissami confirmed that there is no type of virus that threatens the lives of the patients and staff of that hospital.

Also reported are false assumptions images HCM patients that circulated in various media and social networks and do not correspond to any patient of the medical center.  https://translate.google.com/translate?sl=auto&tl=en&js=y&prev=_t&hl=en&ie=UTF-8&u=http%3A%2F%2Fwww.elsiglo.com.ve%2Farticle%2F87516%2FInterpelaran-a-Angel-Sarmiento-&edit-text=

"Institute of Hygiene must have case results HCM"

Tuesday September 16, 2014 | 10:47:02 President announced the FMV, Douglas Natera "Institute of Hygiene must have case results HCM"

On Monday held the general assembly of the union of health for consolidated itself with Dr. Angel Sarmiento, president of the College of Physicians of Aragua, who is being investigated at the request of the regional government, for statements about eight people died in the Maracay Central Hospital (HCM). During the meeting which brought together national doctors, nurses, medical students and health workers, the focus was to support the union executive. They also urged the parliament to ask the aragüeño epidemiological surveillance service a detailed report of the most recent cases of deaths from "unknown illness." On the right word Dr. Douglas Natera, president of the Venezuelan Medical Federation (FMC), said cases by fever syndrome have increased, as reported responsibly that total are ten people dead, detailing the last two cases during this Weekend in HCM and private health center in Caracas. He criticized the secrecy national government has taken in relation to this and other cases and noted that "when someone tells the truth to this Government in relation to a disease or some economic or security problem, then that person is a terrorist." "What they have is to declare health emergency instead of saying that we are terrorists. What we do is work with the few resources that exist for the welfare of Venezuelans." Meanwhile, the National Health guild solidarity with the College of Aragua state and its president Angel Sarmiento, who has warned considered responsible and timely manner "so the government would not do." "We are supportive of public health, and asked the government not to politicize this delicate situation. Moreover we will follow in the coming days giving more information on these cases," remarked the doctor. In relation to the diagnosis presented by the deceased, from the medical point of view, Natera said "would not dare talk about the chikungunya virus or Ebola as major complications for the deceased. I looks more like Venezuela hemorrhagic fever. But this is the study by the National Institute of Hygiene " He also said the government maintains unrest in the Venezuelan population, and therefore are six days in the health and irregularity "in the Institute of Hygiene least five days could have the results," he stressed. Finally, health professionals urged aragüeña population demand that they report the reality of the disease that has caused, according to the federation medication about ten deaths in the country.

Medical profession urges the Government to report on deaths from hemorrhagic fever syndrome

Published: 16/09/2014 24:09

The Monday night meeting in Ottawa, where health professionals insisted that the government must promptly report on the status of the 9 people killed by this strange disease was conducted. "In total there are 8 and 1 in Aragua state in Caracas, but the examinations on the first victims and should be ready," said Douglas León Natera, president of the Venezuelan Medical Federation, also noting that such analyzes yield results in just five days.
Doctors reported that the government only seeks to hide the information, however have been charged with assaulting the guild, knowing that this is not the solution.https://translate.google.com/translate?sl=auto&tl=en&js=y&prev=_t&hl=en&ie=UTF-8&u=http%3A%2F%2Fdiariocontraste.com%2Fes%2Freportan-3-nuevos-fallecimientos-en-hospital-central-de-maracay%2F&edit-text=

To tackle #Ebola: 10,000 local health workers needed - WHO

Tuesday, 16 September 2014 02:22 ND

The UN health agency, World Health Organization or WHO says, it would need at least 500-600 experts with 10,000 local health workers to combat the deadly Ebola virus which has claimed over 2000 lives in the Mano River sub-region.
WHO director general Margaret Chan addressing a news conference in Geneva Friday said the key to beating the disease is people power. He said pledges of equipment and money are coming in, but 500-600 foreign experts and at least 10,000 local health workers are needed on the ground.
"The number of new patients is moving far faster than the capacity to manage them. We need to surge at least three to four times to catch up with the outbreaks," Chan said.

The WHO boss said the number of new Ebola cases in the region is growing faster than authorities here can manage, while renewing a call for health workers from around the world to come to the region to help....  http://www.thenewdawnliberia.com/index.php?option=com_content&view=article&id=12674:to-tackle-ebola-10000-local-health-workers-needed-who&catid=25:politics&Itemid=59

500 #Ebola suspects in Bong County

Tuesday, 16 September 2014 02:27 Winston W. Parley

TRANSLATE

Bong County health authorities say they are following “very closely” about 500 plus suspected Ebola cases that are shortlisted, along with a total of 44 confirmed cases across the county.
During President Ellen Johnson-Sirleaf’s “information gathering trip” to Bong County on Sunday, September 14, County Health Officer Dr. Sampson Arzoaquoi, reported that Gbarnga City and a few other places are declared “high risk zones.”

President Sirleaf visited three major hospitals in Bong, including the C.B. Dunbar Maternity Hospital; the Phebe Hospital, which offers general services, and the Bong Mines Concession Hospital as well as several clinics.
Dr. Arzoaquoi: “Additionally, we had a situation where we now have a total of about 500 and some more suspected cases in the county that we have shortlisted.”

He said the county has lost about 68 persons so far; and there are currently 44 confirmed cases, 10 of them, health workers mostly from Phebe Hospital, including an ambulance driver.

The county health officer said the Bong health team has been collaborating with the security sector and local leaders, and they have succeeded in having their presence felt almost in every village, town and district.

He boasted that people were now walking into the health facilities and reporting themselves for isolation. With assistance from Save the Children, he said an Ebola Treatment Unit or ETU has been established.

After meeting the demands of panicking nurses at the C.B. Dunbar Hospital, who had fled after some of their colleagues came in contact with Ebola patients, Dr. Arzoaquoi said they have returned to work, though some major concerns, including additional incentives and risk benefits are awaiting government’s response.

The CHO said nurses returned to work after an Ebola Treatment Unit was established, trainings conducted for staff and facilities were disinfected, while disclosing that construction is ongoing for a holding center that will serve as a transition between the community and the ETU.

But he warned that the health workers’ return was not “a reliable situation” as a major challenge now is motivating them in terms of increased incentives and risk benefits, which need to be addressed. Dr. Arzoaquoi said they are getting technical support from the World Health Organization while UNICEF is providing tents and other materials.

But President Sirleaf said, addressing incentives and risk benefits are taking a while here because the government is working with international partners to have a harmonized support for doctors in Liberia, Guinea and Sierra Leone.

She said there special circumstances for people working in the ETU because they are at greater risk, and added that everyone working in even small clinics is being considered. Families of the deceased are being listed, she said, to help their children and spouses.

President Sirleaf finally said Liberia does not want to see progress made in handling other health situations such as maternity, malaria, among others, disappear because of Ebola while appreciating health workers for the level of progress.

Earlier, Bong County Superintendent Selena P. Mappy, said the county task force has been succeeding in the fight to kick Ebola out; and lauded Save the Children for providing 150 pieces of mattresses.

But Superintendent Mappy said the lack of ambulance remains a challenge in the county, telling President Sirleaf that the only available ambulance that’s supposed to be for C.B. Dunbar Hospital is now transporting Ebola cases across the entire county. http://www.thenewdawnliberia.com/index.php?option=com_content&view=article&id=12676:500-ebola-suspects-in-bong-county&catid=25:politics&Itemid=59

Sierra Leone News: Ose to Ose Ebola Talk…15-20% surge of cases expected

The Deputy Minister of Political and Public Affairs Karamoh Kabba has said in the daily press briefing at the SLAJ hall said that government has projected a 15 to 20% surge in the EVD suspected cases from communities across the country during the “Ose to Ose Ebola tok.”
The Minister went further to say that in preparedness for the three days Ose to Ose talk the emergency operation centre in collaboration with its partners has completed the training of the national supervisors for the three days. Training of the district supervisors has commenced and has completed yesterday while cascading training of national and districts supervisors to the bulk of the 21,000 volunteers will start today at local level.
The Minister added that in response, the EOC has expanded the number of holding centres and trained more staff to mann them as well as increased logistical support at district level to enable local authorities to adequately respond to the anticipated spike in EVD suspected cases.
He also added that there is an increased level of compliance with government policy to report all cases of deaths for certificate before burial thus the increased demand on the burial team to respond to dead bodies. In response government has increased the number of burial teams in Freetown to nine from four. The burial team coordinator has trained 26 dispatch riders to respond and collect samples from bodies for same day testing and provided eighteen burial vehicles to the Western Area teams where the demand for burial is most prevalent....  http://awoko.org/2014/09/16/sierra-leone-news-ose-to-ose-ebola-talk15-20-surge-of-cases-expected/