News Scan for Mar 07, 2016

Ebola response errors
More chikungunya in Americas
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AP says consulting firm likely mishandled Ebola response

An Associated Press (AP) investigation into Metabiota Inc.'s role in Sierra Leone's response to Ebola found that the San Francisco-based epidemic consultant was likely responsible for errors that led to poor understanding of the situation, the AP said today.

Metabiota worked with the World Health Organization (WHO) and the government of Sierra Leone in 2014 to carry out diagnostic tests in a laboratory shared with Tulane University and conduct epidemic tracking and case management.

By July 2014, several WHO experts, along with US and Canadian response teams, had expressed concern with misdiagnoses, specimen mismanagement, and potential for cross-contamination at the shared lab. A representative from the Public Health Agency of Canada found discrepancies in half of the eight Ebola tests analyzed and evidence that five people had been incorrectly diagnosed with Ebola, the AP said.

Evaluation by US health officials found that diagnostic tests were wrong as often as 30% of the time, though the analysis found that Metabiota's tests were often more accurate than Tulane's. Poor safety practices were noted at the lab itself, including used needles left in the open, the lack of an ultraviolet light for decontamination, and insufficient space for safely processing blood samples.

In other misstpes in Sierra Leone, the AP said, Metabiota staff members entered the homes of suspected Ebola patients without protective gear, obstructed attempts to improve disease surveillance, misinterpreted epidemic data, and told a government Ebola task force that the epidemic had stabilized 3 days after the WHO declared it a global emergency.

Metabiota founder and Chief Executive Officer Nathan Wolfe, PhD, said there was no evidence that Metabiota mishandled the situation and that some problems were planted by the company's rivals, the AP said.

Many experts interviewed by the AP acknowledged that some errors are likely in fast-paced epidemic responses but said that Metabiota’s actions made aspects of the situation worse. Sylvia Blyden, special executive assistant to the president of Sierra Leone when the epidemic began, said, "They messed up the entire region."
Mar 7 AP story


PAHO reports more than 8,000 new chikungunya cases

In its Mar 4 update, the Pan American Health Organization (PAHO) has added 3,291 new chikungunya cases to 2016's totals and has modified its 2015 report to include an additional 5,387 infections in Brazil.

The 2016 outbreak total is now 21,763 confirmed and suspected cases, and the 2015 number has risen to 731,920 confirmed and suspected cases. The outbreak total since 2012 has now reached 1,901,309 cases.

Most of the 2016 increase can be attributed to Honduras's 1,923 new cases; the country has 5,271 total for the year thus far. (Honduras had not given a chikungunya reports since 5 weeks ago.) Colombia reported 698 new cases for a 2016 total of 7,253, and Venezuela had 300 new cases, reaching 1,653 cases for the year. Mexico, the only country in North America reporting any cases of chikungunya this year, noted 60 new cases last week, bringing its 2016 total to 140.

The newest update of PAHO's 2015 report was in Brazil, which now has 23,630 suspected and confirmed cases on record for that year. Both the Mar 4 and Feb 26 update indicated that Brazil had been up-to-date for 2015; PAHO does not cite the cause of the increase.

No chikungunya-related deaths have yet been reported for 2016. The outbreak began in December 2013 on St. Martin in the Caribbean with the first recorded cases of the disease in the Americas.
March 4 PAHO update 
Latest PAHO 2015 cumulative case numbers

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