Ebola in West Africa

Friday, 5 September, 2014

No sign of the epidemic abating. The cumulative case curve contnues to climb exponentially. Cases in Nigeria continue to increase (now 21) with cases now occurring outside Lagos in Port Harcourt.

This second focus was started by a person who escaped quarantine in Lagos after being infected by the Liberian man who died in Lagos. Unfortunately, the first case in Port Harcourt was a doctor, who while ill had many social and professional contacts, including performing surgery. The doctor died on 22 August. The doctor's wife (a physician herself) and a patient at the hospital where the doctor was treated make up the epidmic at the moment. This focus would be expected to rapidly expand owing to the multiple contacts of the cases. WHO has a detailed report at http://www.who.int/mediacentre/news/ebola/3-september-2014/en/. Interestingly, the case fatality rate in Nigeria is lower at 37% (compared to 50% overall). Is the virus being selected for lower virulence already?

The first case of Ebola has occurred in Senegal: a 21 year old man who travelled by road from Guinea to stay with relatives in Dakar. The diagnosis was only made after Senegal was alerted through contact tracing. Prior to that the patient was being treated for malaria. WHO's Senegal report is at http://www.who.int/csr/don/2014_08_30_ebola/en/.

A comprehensive report on the West African outbreak is available at WHO.

The impact of Ebola on health services is illustrated by the story of a Spanish Catholic priest, Fr Miguel Pajares, who died in Madrid on 12 August. His hospital, Saint Joseph Hospital in Monrovia, Liberia, had four staff die in 10 days in early August. The hospital has now been closed.

Image: Epidemic curve of cumulative cases (black line) and deaths (red line) in West Africa.

Posted by Rick Speare