News Scan for Aug 31, 2015

Sierra Leone Ebola death
More chikungunya cases
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Sierra Leone woman dies from Ebola; lab study shows clinical patterns

Sierra Leone health officials said yesterday that tests on a 67-year-old woman who died in Kambia district were positive for Ebola, but further testing is under way to confirm the findings, Reuters reported yesterday. The positive test is the country's first since its countdown to Ebola-free status began on Aug 24.

Brima Kargbo, MD, Sierra Leone's chief medical officer, told Reuters that two samples from the woman were positive in tests in Kambia district, but further tests are being conducted in Makeni and Freetown to rule out a potential error in initial tests, given that Kambia district has gone 50 days without a confirmed Ebola case.

The woman died on Aug 29. She had worked as a trader and apparently had not traveled recently, according to the report.  Sierra Leone's last known Ebola patient was discharged from the hospital on Aug 24, signaling the start of its 42-day countdown.
Aug 30 Reuters story

In other Ebola developments, a Chinese mobile lab team that served in Sierra Leone last fall reported today on clinical patterns they saw during their experience, including fever in three fourth of patients. They reported findings from cases at the Sierra Leone-China Friendship Hospital in Western Area district, about 19 miles west of Freetown, from late September to mid November 2014 in Emerging Infectious Diseases.

Of 1,635 samples from suspected Ebola patients, 824 (50.4%) were positive, constituting about a third of all cases reported in Sierra Leone during the study period. The team found that 84.6% of the patients who tested positive lived near main roads connecting rural towns to highly populated urban areas.

At the time of testing, 75.7% of patients had fever and 94.1% reported at least one gastrointestinal symptom. Viral loads were higher in those with fever, diarrhea, fatigue, or headache. The investigators also found that the case-fatality rate was lower in patients ages 15 to 44 years old and in people with lower viral loads.
Aug 31 Emerg Infect Dis report


Americas chikungunya cases rise by nearly 28,000

In its latest update on chikungunya in the Caribbean and the Americas, the Pan American Health Organization (PAHO) on Aug 28 reported 27,867 new cases, bringing the outbreak total to 1,707,090.

The number of new cases was down a bit from the 34,866 new cases reported the previous week.

The new total includes 541,468 suspected, 18,039 confirmed, and 814 imported cases, bringing the total for 2015 to 560,321 so far. Earlier reported death dropped from 63 to 60 during the most recent reporting week, likely because of ongoing lab testing and case confirmation.

Colombia, which now has 320,891 cases in 2015, has reported the region's most cases by far this year. PAHO's latest update reflects 2,280 new suspected cases for that nation. Honduras, however, reported the biggest jump, with 22,673 new cases in the most recent 7 weeks, bringing its total for the year to 71,840. Other countries reporting increases are Ecuador with 1,009 suspected cases over a 3-week period, and Venezuela, with 450 more.

The epidemic started in December 2013 with the detection of the Americas' first locally acquired chikungunya cases on St. Martin in the Caribbean.
Aug 28 PAHO update

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