Monday Micro II – lockdowns, manslaughter and murder

By Siouxsie Wiles 22/09/2014

The Ebola outbreak in west Africa continues. According to the CDC’s website, as of the 14th September the number of reported cases was up to 5,347 including 2,630 deaths. The virus is now in five countries. Here’s the latest:

Guinea (942 cases/601 deaths)

A team of health care workers, journalists and local officials have been reported to have been killed by villagers while on a drive to raise awareness of the symptoms of Ebola and how to seek help. Clearly suspicion that health care workers are spreading the disease is still widespread.

Sierra Leone (1673 cases/562 deaths)

Sierra Leone has been in lockdown since Friday with a three day curfew in place so that officials could try to get to grips with the numbers of people infected. There are reports of burial teams being attacked.

Liberia (2710 cases/1459 deaths)

There are reports that Liberia has run out of beds for all but the sickest Ebola patients and the healthcare system is collapsing.

Senegal (1 case/0 deaths)

So far there has been just one case of disease in Senegal, a Guinean man who was under surveillance for having had contact with an Ebola patient but who escaped by road to Dakar to stay with relatives. He arrived on the 20th of August and sought medical treatment on the 23rd when he started to have fever, diarrhoea, and vomiting. He was treated for malaria and went back to stay with his relatives. He was hospitalised on the 26th August and finally diagnosed with Ebola. Question is, how many family members and healthcare workers did he infect? The incubation period is almost up so we should know soon.

Nigeria (21 cases/8 deaths)

Ebola spread to Nigeria via American-Liberian Patrick Sawyer, who contracted Ebola from his sister and then travelled by air to Nigeria. He collapsed at the airport and died 5 days later. For a little while it looked like Nigeria might have managed to put a lid on Ebola, but human nature appears to have thwarted that. Nigeria’s Daily Post reports that a diplomat who contracted Ebola from Mr Sawyer, and survived, may be facing manslaughter charges. He evaded quarantine and travelled from Lagos to the city of Port Harcourt where he was secretly treated in his hotel room. The doctor who treated him contracted Ebola and has now died, but not before having contact with a lot of people while symptomatic.

Reading the WHO report, it sounds like he either didn’t know the diplomat he was treating had Ebola, or was in complete denial. Read this and weep:

After onset of symptoms, on 11 August, and until 13 August, the physician continued to treat patients at his private clinic, and operated on at least two. On 13 August, his symptoms worsened; he stayed at home and was hospitalized on 16 August. Prior to hospitalization, the physician had numerous contacts with the community, as relatives and friends visited his home to celebrate the birth of a baby. Once hospitalized, he again had numerous contacts with the community, as members of his church visited to perform a healing ritual said to involve the laying on of hands. During his 6 day period of hospitalization, he was attended by the majority of the hospital’s health care staff. On 21 August, he was taken to an ultrasound clinic, where 2 physicians performed an abdominal scan. He died the next day.The additional 2 confirmed cases are his wife, also a doctor, and a patient at the same hospital where he was treated. Additional staff at the hospital are undergoing tests. Given these multiple high-risk exposure opportunities, the outbreak of Ebola virus disease in Port Harcourt has the potential to grow larger and spread faster than the one in Lagos.

Several hundred people are now under surveillance so it’s a case of ‘watch this space’. Judging by the number of close contacts the doctor had with people while symptomatic, it’ll be amazing if there aren’t many more cases.