Transcript Pandemic and Epidemic Diseases department

Ebola Epidemic in Coastal West Africa –
Overall Situation
Report given at Caritas Internationalis Briefing
Meeting
05 November 2014
Dr and Deacon Timothy Flanigan MD
Professor of Medicine and Infectious Diseases
Brown University Medical School, USA
Volunteer in Monrovia, Liberia
Ebola in West Africa
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Transmission by direct contact with body fluids from a sick
person, soiled clothes, or a dead body
Population at risk:
and Epidemic Diseases department
3 | Pandemic
Patient's
family (home care, burial) and health staff
How Ebola Outbreaks Start
●First human cases start with infection by an animal
● Chimpanzes, gorillas, monkeys, forest antelopes, fruit bats, porcupine...
● How current outbreak started in unknown, but killing and preparing
bush meat can spread other viral illnesses
●Infection from person-to-person creates an outbreak
• Direct or indirect physical contact with body fluids of a sick
infected person (blood, saliva, vomitus, urine, stool, semen)
●Well known locations where transmission occurs
• Hospital:
• Health care workers, other patients, unsafe injections
• Houses and Communities:
• Family, friends, contacts caring for ill, through funeral
practices
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Ebola virus disease
● Incubation 2-21 days (usually 6-10 days)
● Deadly Disease: Case Fatality Ratio 24-89%
● Survivors recover completely
● Treatment is supportive
● rehydration, intensive care,
● Some potential specific treatment
● Blood or plasma from recovered persons
● Monoclonal antibodies (Zmap): Limited supply and little data
● Candidate drugs also in early stages of testing
● Vaccines look promising and in development
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Critical Issues
● First large Ebola outbreak in West Africa
● Serious national & global health security threat
● Underlying weakness in health systems
● Lack of preparedness
● Surveillance, health care, communications …
● Health worker infections & inadequate infection
control & prevention
● Effect of fear
● Strong community resistance in places ……..
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Update of Ebola Situation as of
27 October 2014
There have been 13 703 EVD
cases, with 4 920 deaths, up to
the end of 27 October.
All districts in Liberia and
Sierra Leone are now affected.
Cases/Deaths:
Guinea - 1906/997
Liberia: 6535/2413
Sierra Leone: 5235/1500
• Five countries (Mali, Nigeria,
Senegal, Spain, and the United
States of America) have now
reported a case or cases
imported from a country with
widespread and intense
transmission
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Controling the epidemic
To manage the patients: early diagnostic, symptomatic treatment
To stop the transmission in the community:
Identification and medical follow up of the contacts
Safe management of the patients
Safe management of the corpses
Control at the borders
Behavioral and social interventions
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Pandemic and Epidemic Diseases department
An informed and engaged population
to best protect individuals, families and communities
Population needs to know:
- What is Ebola, how does it spread
- What behaviors to change or adopt to best protect them selves and their families
- Where they can get additional information
Critical that communities receive these messages from local trusted leaders, in language and
voices they can relate to and understand
Without community involvement:
- People will continue to hide sick people and
treat them at home
- Dead bodies will be taken back to the
community for unsafe burials
- Social conflicts will severely impact control
efforts
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Pandemic and Epidemic Diseases department
Outbreaks in Communities can increase and decrease
Trend of daily total admissions in Foya Ebola Treatment and
Case Management Center from 27 June to 7 October 2014
160
140
120
100
80
60
40
20
0
10
Six Strategic Objectives (STEPP) and
Actions in Addressing
Ebola Virus Disease Outbreaks
• Stop the outbreak
– Identify and trace people with Ebola
– Safe and dignified burials
– Effective sanitation, hygiene and infection control
• Treat the infected
– Care for the persons with Ebola and Infection
Control
– Medical Care for Responders
Ebola Virus Disease Outbreak: Overview of Needs and Requirements, compiled by
OCHA, WHO, UN partner agencies, and other key responders, September 2014.
Six Strategic Objectives (STEPP) and Fifteen Mission
Critical Actions in Addressing
Ebola Virus Disease Outbreaks
• Ensure essential services
– Provision of food security and nutrition
– Access to basic (including non-Ebola Health) services
– Cash incentives for Workers
– Recovery and Economic Development
• Preserve stability
– Reliable supplies of materials and equipment
– Transport and fuel
– Social mobilization and community engagement
– Messaging
Six Strategic Objectives (STEPP) and Fifteen Mission
Critical Actions in Addressing
Ebola Virus Disease Outbreaks
• Prevent outbreaks in countries currently unaffected
– Multi-faceted approach to strengthen preparedness of all
countries for rapidly detect and response to an Ebola
exposure, especially those sharing land borders with areas
of active transmission and those with international
transportation hubs.
• Research into treatment and vaccines
– Research which makes available effective treatments for
and vaccines to prevent outbreaks and cases in most
affected areas.
•
'Complementary Strategies'
Massive scale-up of community
engagement is essential to reduce
the intensity of transmission
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Community Training in Dolotown which was hard hit by Ebola