The battle against Ebola continues: More cases surface in Mali

United Nations Secretary General Ban Ki-moon and the Director General of the World Health Organization (WHO) Dr. Margaret Chan warned that the fight to contain and eradicate the largest outbreak of the Ebola Virus Disease (EVD) in history requires continuing and enhanced efforts.

Speaking at a recent meeting on the EVD crisis in Washington, D.C., along with officials from the WHO, World Bank and the International Monetary Fund (IMF), Ban said "If we continue to accelerate our response, we can contain and end the outbreak by the middle of next year."

Figures released by the WHO on Nov. 19 indicated that the total number of cases of EVD has reached 15, 145, with 5,420 resulting in death. The overwhelming numbers of cases have occurred in three West African states: Liberia, Sierra Leone and Guinea.

Three other African states, Senegal, Nigeria and the Democratic Republic of Congo (DRC) have been declared “Ebola Free.” In the United States there was the death of Liberian national Thomas Eric Duncan in Dallas where two nurses were infected after providing treatment to the patient at the Texas Health Presbyterian Hospital in late Sept. and early Oct.

The two nurses, Nina Pham and Amber Vinson, were treated successfully in specialized units in Atlanta’s Emory University and at the Bethesda Hospital near Washington, D.C. and released.

Secretary General Ban noted that outcomes in the global responses to effectively address EVD remained uneven, illustrating the needfor far more healthcare workers in the worst-hit countries in West Africa. "Our end game is not near. We must get to zero cases.” (BBC, Nov. 21)

The Director General of the WHO, Dr. Margaret Chan traveled to Mali on Nov. 22, amid the announcement of the creation of a special UN taskforce for the West African country to respond to the outbreak. Anthony Banbury, the chair of the UN Mission for Ebola Emergency Response (UNMEER), noted that "we are far, far away from ending this crisis. There is a long battle ahead of us.”

Mali Facing More Cases While EVD outbreaks in Sierra Leone are continuing at an alarming rate, additional cases in Mali linked to people who had traveled from neighboring Guinea was cause for concern. It has been reported that five people in Mali have died after contracting the disease where a French occupation of the north of the country is continuing in light of ongoing fighting between the Bamako-based government in the south and Islamic as well as separatist rebels.

At least one other case in Mali was confirmed in the capital Bamako after the friend of a nurse who died of EVD earlier in November tested positive for the dreaded disease, health and medical officials reported on Nov. 22. The healthcare workeris said to have contracted EVD after providing treatment for a Muslim clericwho traveled from neighboring Guinea.

The cleric later died after being falsely diagnosed as suffering from kidney ailments. Health officials surmise that this case allowed the disease to spread to five other people in the West African nation.

In addition there are two others suspected of harboring the potentially deadly strain of the Viral Hemorrhagic Fever (VHF) in Mali. "Of two suspected cases tested, one was negative and the other positive. The latter was placed in an isolation center for intensive treatment," a statement from the Malian health ministry reported, adding that an additional 310 contacts of the victims were being monitored. (Reuters, Nov. 22) Sierra Leone Doctor Dies From EVD in the U.S. A physician from Sierra Leone, Dr. Martin Salia, died in the United States on Nov. 17 at the University of Nebraska Medical Center Bio-containment Unit after being transported here where he was a resident for treatment. Reports indicate that the delay in travel to the U.S. for treatment was a major factor in his death.

According to Reuters press agency, “Dr. Martin Salia, a native of Sierra Leone and a permanent U.S. resident, had been in very critical condition when he arrived at the Nebraska Medical Center on Saturday afternoon (Nov. 15), Dr. Phil Smith, director of the bio-containment unit, said at a news conference. ‘He had no kidney function, he was working extremely hard to breathe and he was unresponsive,’ Dr. Daniel Johnson said.”

Dr. Salia was the third patient treated at the Nebraska specialized facility. The two other patients were treated successfully and released.

The Washington Post reported that “Salia was rushed onto emergency kidney dialysis and a ventilator and was given several medications to support his organs. Doctors administered the experimental drug ZMapp on Saturday (Nov. 15), and Salia also received a plasma transfusion from an Ebola survivor. That treatment is thought to offer antibodies to fight the virus, doctors said.” (Nov. 17)

This same article continues saying of the hospital staff that “We used every possible treatment available to give Dr. Salia every possible opportunity for survival,” noted Phil Smith, the medical director of the bio-containment unit. “As we have learned, early treatment with these patients is essential. In Dr. Salia’s case, his disease was already extremely advanced by the time he came here for treatment.”

Rate of Infection Declines in Liberia In one of the three most impacted states, Liberia, the rate of infection from EVD has declined. This has been reported for several weeks by the international media and these statistics were acknowledged by Dr. Thomas R.Frieden, the Director of the Centers for Disease Control and Prevention (C.D.C.) in the U.S.

By confirming what healthcare officials and news agencies have reported since early Nov., Dr. Frieden said that previous estimates by the C.D.C. that the Ebola epidemic could lead to 1.4 million cases by January 2015, were no longer valid, citing what he described as “good progress” in Liberia.

“There’s been a substantial change in the trend,” Dr. Frieden told a press conference with journalists. “There is no longer exponential increase, and in fact, there’s been a decrease in the rate of infections in Liberia.” (New York Times, Nov. 21)

Nonetheless, the New York Times did report that “Health officials are less certain of the rate of infections in Guinea, another of the three most affected countries. Dr. Frieden said that in the third country, Sierra Leone, ‘both their epidemic and their response are several weeks behind Liberia.’ He added that he hoped an increase in international aid to Sierra Leone, particularly from Britain, would help bring down the numbers there as well.”