Suomen Huvudstadsbladet kirjoitaa ruotsinkielellä:
WHO antaa varoituksia:
Mali confirms its first case of Ebola
Ebola situation assessment - 24 October 2014
Mali’s Ministry of Health has confirmed the country’s first
case of Ebola virus disease. The Ministry received positive laboratory
results, from PCR testing, on Thursday and informed WHO immediately. In
line with standard procedures, samples are being sent to a WHO-approved
laboratory for further testing and diagnostic work.
Details about the case
In telephone conversation on Thursday night, health officials
gave WHO the following details about the case, which is currently
undergoing intense investigation.
The patient is a two-year-old girl, who recently
arrived from
Guinea accompanied by her grandmother. The child’s first contact with
the country’s health services occurred on
20 October, when she was
examined by a health care worker at Quartier Plateau in Kayes, a city in
western Mali on the Senegal River.
Kayes has a population of around 128 000 people. It is located
about 600 kilometres from the capital city of Bamako and lies near the
border between Mali and Senegal.
The health-care worker referred the grandmother and child to
the Fousseyni Daou Hospital, in the same city, where she was admitted to
the paediatric ward on the following day, on
21 October. Symptoms on
admission included a fever of 39°C, cough, bleeding from the nose, and
blood in the stools.
Test results were
negative for malaria, but
positive for
typhoid fever. The child received paracetamol, but did not improve.
Further testing at the country’s SEREFO laboratory confirmed
Ebola virus
as the causative agent on
23 October.
Initial investigation of this case – the first confirmed in
Mali – has revealed
the extensive travel history of
the child and her
grandmother. The grandmother travelled from her home in Mali to attend a
funeral in the town of Kissidougou, in southern Guinea.
WHO is seeking confirmation of media reports that
the funeral
was for the child’s mother, who is said to have shown Ebola-like
symptoms before her death. These and other facts will be communicated as
they are confirmed.
Additional facts communicated to WHO
On 19 October, the grandmother left Guinea to return to Mali,
taking the child with her. The case history revealed that
bleeding from
the nose began while both were still in Guinea, meaning that the
child
was symptomatic during their travels through Mali.
Travel was by
public transport through Keweni, Kankan,
Sigouri, and Kouremale to Bamako. The two stayed in Bamako for two hours
before travelling on to Kayes. Multiple opportunities for exposure
occurred when the child was visibly symptomatic.
Prompt emergency response
WHO is treating the situation in Mali as an emergency. The
child’s symptomatic state during the bus journey is especially
concerning, as it presented multiple opportunities for exposures –
including high-risk exposures - involving many people.
Continued high-level vigilance is essential, as the government is fully aware.
The child is being treated in isolation and staff have
received training in appropriate procedures for safe management. The
initial investigation identified
43 close and unprotected contacts,
including 10 health-care workers, who are also being monitored in
isolation.
The authorities in Mali have acted swiftly, also in
communicating their immediate needs to WHO. These needs include training
in infection prevention and control, adequate supplies of personal
protective equipment, and assistance with contact tracing and overall
investigation of the event.
Fortunately, key staff from WHO and the US Centers for Disease
Control and Prevention (CDC) were already in Mali assisting with the
country’s preparedness measures, should an imported case occur.
The WHO team already on the ground includes an infection
control expert and a logistician. These and other staff are now being
repurposed to assist in a surge response to the outbreak. WHO is
urgently deploying a rapid response team comprising experts in clinical
management, epidemiology, contact tracing, logistics and social
mobilization.
WHO and the Ministry of Health see a need to accelerate the
completion of an isolation facility in Bamako, and WHO has offered its
support. In addition, the public needs to be informed of the situation
as it evolves, including facts about the emergency actions already under
way.
Outbreaks in other parts of West Africa have demonstrated how
fear and anxiety, fuelled by misinformation and disinformation, if left
unchecked, can be a major barrier to even the best-orchestrated
containment efforts.
Both
Senegal and Nigeria, two countries now declared free of
Ebola virus transmission, used effective community information and
education initiatives, often conducted as house-to-house campaigns, as
an integral component of the outbreak response.