Monday Micro II – update on Ebola and MERS

By Siouxsie Wiles 28/04/2014

A quickie to point to a paper in the New England Journal of Medicine which summarises the ongoing outbreak of Ebola in Guinea (1). Sequencing of the virus from several patients points to a new strain of Ebola Zaire, related but distinct from the strains which have caused previous outbreaks in the Democratic Republic of Conga and Gabon.

Figure 2 demonstrates the suspected chain of transmission for some of the cases and makes for sad reading. The index case is thought to be a 2 year old child who got sick on the 2nd December 2013 and died on the 6th of December. Their mother died on the 13th of December, their 3 year old sibling on the 29th and their grandmother on the 1st January 2014. The nurse and village midwife also died as did relatives and friends who attended the grandmother’s funeral.

As of the 22nd April, the World Health Organisation put the number of cases in Guinea at 208, including 136 deaths, while there have been 6 confirmed cases, including 6 deaths, and 2 probable and 26 suspected cases in neighbouring Liberia.

The World Health Organisation is also worried about the number of cases of Middle Eastern Respiratory Syndrome (MERS). Since April 2012 there have been 254 lab‐confirmed cases, with 93 deaths. Cases are mainly in the Middle East but have been reported in Europe, North Africa and Asia. As much as 75% of the recently reported cases appear to be as a result of human to human transmission and there have been a number of healthcare associated outbreaks, which is a worry. The Canadian Press reported a few days ago that the number of known infections has skyrocketed in recent days, with Saudi Arabia alone reporting 48 cases over a two day period last week.

1. Baize et al. Emergence of Zaire Ebola Virus Disease in Guinea — Preliminary Report. NEJM. DOI: 10.1056/NEJMoa1404505

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