March 23, 2015 - LIBERIA - A patient in Liberia has tested positive for the Ebola virus, health officials said Friday, more than two weeks after the last known case in the country had been discharged from the hospital.
The news deflated optimism that Liberia, one of the three West African countries hit by the Ebola epidemic that has killed more than 10,000 people since it began a year ago, would soon be officially declared free of the virus.
The patient, a 44-year-old woman from the Caldwell area near Monrovia, the capital, first developed symptoms around March 15, said Dr. Moses Massaquoi, leader of the Clinton Health Access Initiative in Liberia and national case manager of the Ebola response.
Health officials said it was unclear how the woman, a food seller, had been infected. She had not been on a monitoring list for possible exposure and she said she had not traveled outside Liberia. The Information Ministry issued a statement saying “initial suspicion is that it may be the result of possible sexual intercourse with an Ebola survivor.”
While that is only speculative, researchers have found evidence that Ebola may persist in semen for up to three months after recovery, and abstinence is recommended.
In part for this reason, the World Health Organization intends to release new guidelines for when an Ebola epidemic ends, a W.H.O. official said.
To be declared Ebola-free, countries must wait 42 days from when the last patient tests negative for a second time. The new guidelines would recommend “heightened surveillance” for an additional 90 days, to take into account the potential for sexual transmission and hidden transmission chains.
Two Liberian triage nurses employed by the International Rescue Committee, an American relief agency, recognized the patient’s symptoms when she arrived at Monrovia’s Redemption Hospital on Thursday, Liz Hamann, the agency’s project leader, said from Monrovia.
Acting on a well-rehearsed protocol, the nurses summoned a team from an adjacent Ebola isolation center run by Doctors Without Borders, who arrived in protective gear and took the patient for testing. The initial results came back positive on Friday. “We were all a little blindsided,” Ms. Hamann said.
Dr. David Nabarro, the United Nations secretary general’s special envoy on Ebola, was informed of the new case while traveling in Italy. He expressed disappointment but not surprise.
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| Liberians lay wreaths in memory of those cremated due to the deadly Ebola virus in Disco Hill, Margibi County, Liberia, earlier this month. Ahmed Jallanzo/EPA/Landov Add caption |
“We will have unfortunately some periods in which our hopes are dashed at this stage in the outbreak,” he said in a telephone interview. “That’s just the way it is. That’s why we’re going to have to keep going without any kind of letup until the very end.”
New cases have declined sharply since last fall, when hundreds were becoming infected every week in Liberia, Guinea and Sierra Leone. Liberia has made the most progress.
On March 5, what was thought to have been Liberia’s last patient was discharged, a celebratory moment.“We knew something like this could possibly happen, so we have all the necessary setup in place to address it,” Dr. Massaquoi said. Still, he said, “today has not been a good day for us.”
Liberia’s comeback has been considered a model of community organizing, which raised public awareness of the risks of transmission through physical contact and unsafe burials. Dr. Bruce Aylward, the World Health Organization’s top Ebola official, described the nurses who first suspected the new Liberia case as heroes.
“They may have protected the whole country by finding the needle in the haystack,” he said in a phone interview. “It was because they were searching that haystack for the needle.” - NY Times.
Measles replaces Ebola as deadly epidemic in Liberia
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| In this file photo, a child covers his face as he looks at a man
suspected of suffering from the Ebola virus. Experts say a new measles outbreak could be more deadly. Photo: Abbas Dulleh/AP |
The people of Monrovia's Peace Island ghetto, refugees of civil war who found themselves suddenly overwhelmed and outmanoeuvred by the deadly Ebola epidemic, are used to life under siege.
Yet with Liberia emerging from the worst outbreak in history a year to the day since Ebola was first identified in west Africa, the slum-dwellers of Liberia's capital city are facing an even deadlier threat - the measles virus.
Experts say Liberia and its neighbours Guinea and Sierra Leone are ripe for an outbreak that could infect hundreds of thousands, dwarfing the carnage wrought by Ebola.
Death once again stalks impoverished communities like Peace Island, a cramped spit of land surrounded by swamp where 30,000 people sought refuge behind the abandoned Ministry of Defence after Liberia's 1989-2003 civil wars.
By mid-March, coastal Liberia is already mercilessly hot and healthcare workers sweat as they pass through the slum in a mini-truck, calling out to mothers via a loudspeaker to bring out their babies.
"I am happy to have the opportunity to bring my child for the measles vaccine because in this community children are dying," Marie Bassa says after climbing down from the vehicle with her nine-month-old baby.
The government said on Friday a woman in Monrovia had tested positive for Ebola, but the case was the first in the country for more than a month and officials said they were not concerned that it would lead to a wider outbreak.
Despite the setback, Liberia is considered to be well on the road to recovery from an outbreak that brought the country to its knees, claiming more than 4000 of the 10,000 lives lost across west Africa.
One consequence of the crisis has been a dramatic drop in measles vaccinations, with overburdened hospitals unable to keep up, leaving millions of children potentially at risk, experts suggest.
Medical aid agency Doctors Without Borders - known by its French initials MSF - believes that of Monrovia's myriad slums, Peace Island faces the greatest risk.
"We did a survey and we found out that measles is becoming a serious threat to the Peace Island community... So we decided to launch this campaign in response," MSF vaccination supervisor Denis Besdevant said.
MSF's initial target is to get 700 children aged nine months to five years into its makeshift community vaccination centre, says Besdevant, adding that 250 infants were seen on the first day of the campaign last week.
Researchers estimate that measles immunisations in the region - typically ranging between 60 and 80 per cent of children - had fallen by 75 per cent because of the Ebola crisis.
As a result, 100,000 more children could get measles, in addition to the 127,000 cases already anticipated among children who have not been vaccinated in Guinea, Sierra Leone and Liberia.
Researchers forecast that on top of the 7000 measles deaths that the countries would normally anticipate, up to 16,000 additional children could die from measles thanks to Ebola-related disruptions to healthcare.
Rita Kpepka said around 10 children in her part of the slum had recently died of measles, many wrongly thought to have been struck down by Ebola.
"First I was afraid. My friend encouraged me to come. She explained to me that it is the real measles vaccine they are giving here, not an Ebola vaccine," said Kpepka, who has a three-year-old."I am happy because my kid took the vaccine and she is OK." - SMH.
