Sunday, November 16, 2014

Mali 3 Weeks Behind Ebola Outbreak; Try To Look Shocked



From AP News, via Yahoo! and ABC:
BAMAKO, Mali (AP) — It all started with a sick nurse, whose positive test for Ebola came only after her death. In a busy clinic that treats Mali's elite as well as wounded U.N. peacekeepers, what patient transmitted the virus?
Soon hospital officials were taking a second look at the case of a 70-year-old man who died after being brought to the capital late at night from Guinea suffering from kidney failure. A friend who visited him later died under suspicious circumstances, too.
It wasn't renal disease, they then realized. The 70-year-old man had Ebola and all three of the relatives who brought him to the clinic that night had all since been admitted to an Ebola treatment center back home in Guinea.
On Friday, Malian health authorities went to disinfect the mosque where the 70-year-old's body was prepared for burial — nearly three weeks ago. Already some are criticizing the Malian government for being too slow to react when health authorities had announced his death as a suspected Ebola case earlier in the week.
"It's been 18 days since the Guinean man sick with Ebola died here. It's just too late," said Koumou Keita, his face full of worry.
For nearly a year, Mali had been spared the virus now blamed for killing more than 5,000 people across West Africa despite the fact the country shared a porous land border with Guinea, the country where the epidemic first erupted.
Now there are least three confirmed Ebola deaths, and two others suspected deaths in Mali's capital, Bamako. Residents here who have seen the horrific death tolls from Ebola in neighboring Guinea now fear the worst.
"I feel uneasy because I have the impression that our authorities are not giving us the whole truth," said Ibrahim Traore, who works at a supermarket in the capital. "There are a lot of things not being said about how the Ebola virus came to Bamako."
Health officials now must try to track down not only family and friends who visited the 70-year-old man at his hospital bed, but also the scores of people who prepared his body for burial and attended his funeral. Teams of investigators are also headed to the border community where authorities believe the Patient Zero in the Bamako cluster — the 70-year-old man — first fell ill.
"The future of Ebola in Mali will depend on the quality of the surveillance of these contacts. If they are rigorously followed, and any subsequent cases are quickly identified and isolated, the battle will be won. But if there are failures in the process, it will lead to further contamination and further problems," said Ibrahima-Soce Fall, Mali's WHO representative.
Among those placed under quarantine are about 20 members of the U.N. peacekeeping force who were treated for battlefield wounds at the Bamako hospital where the dead nurse had worked. The peacekeepers are based in the north of the country, where they are trying to stabilize a vast region where jihadists ruled until a French-led war in 2013.
In recent years Mali already has suffered a separatist rebel insurgency, a coup that overthrew its longtime leader and a war against jihadists. Now Ebola threatens to be another source of misery if it is not contained.
"Ebola could cause many deaths here in Mali, said Aminata Samake, who works at a bank in the capital. "We have a tradition of living closely together that could contribute to a huge contamination. Take the example of public transport — you find people crammed into a bus, one on top of the other. Large families share the same plates, even the same glasses for tea."

No worries, right? We'll just go disinfect the site where the infected imam was washed  three weeks ago , and try and find the 96 357 over 400 and climbing contacts, who've now potentially spread Ebola to 4000 other people in a capitol teeming with 2,000,000 people living in each others' laps, along with the 20 UN peacekeepers from other countries' military forces, and that should be just fine.

I mean, it's not like someone infected took the subway across town, got a sub sandwich, and went bowling, right?

And now, the Reuters version:
(Reuters) - The United Nations mission in Mali has canceled plans to renew a contract with a private clinic providing care to its peacekeepers after a case of Ebola was missed and spread from there.This second Ebola alarm in Mali, coming just as it seemed to have contained its first case last month, raised doubts about the country's ability to protect itself from the epidemic that is ravaging three other states in West Africa. More than 5,000 people have died, almost all in Liberia, Sierra Leone and in Guinea, which shares an 800 km (500 mile) border with Mali.
The U.N. mission in Mali, whose peacekeepers are helping to protect the nation against Islamist rebels, reversed on Saturday a decision taken earlier in the week to renew the contract with the Pasteur Clinic in Bamako to care for sick or injured troops.
A U.N spokesman said the decision was taken "due to prevailing circumstances" but gave no further details.
It followed the death in the clinic in late October of an elderly imam, or Muslim religious leader, from Guinea. The sick man was never tested, but his case directly led to a chain of confirmed deaths from Ebola, including a 25-year-old nurse who treated him and a woman who washed his dead body.
The clinic, one of Bamako's best known and used by expatriates and the country's elite, denies any wrongdoing. It says it followed all its procedures for treating Ebola and that the imam never showed any signs of the fever.
On Tuesday last week, Mali's health minister declared there were no more confirmed cases in the country after it appeared to have successfully contained its first Ebola case of an infant girl who died last month.
But by nightfall the same day, the 25-year-old nurse from the clinic had died of the disease and authorities are now trying to trace over 400 potential fresh contacts.
President Ibrahim Boubacar Keita has ordered an enquiry.
Ibrahima Fall, World Health Organisation representative in Mali, said the Pasteur Clinic - which has no connection to the Paris-based Institut Pasteur - made "a terrible mistake" by not alerting authorities to the case of the sick Guinean imam, who would have been showing Ebola-like symptoms.
He said it was WHO officials tracing reported deaths in Guinea who had discovered this case in Mali.
Mali's Ebola response leader, Samba Sow, said the clinic did not tell him of a second suspected Ebola case once he got there. "It is something we would like to have known," he said.
Aid workers and diplomats in Bamako cite delays and obstacles in setting up Sow's Ebola-response team and poor communication within government over the latest case.

Government cluelessness?
Medical stupidity?
Delays and obstacles in response?
Poor communication?

This would be understandable, if we hadn't seen the exact same chain of official stupidity in Monrovia, Freetown, Conkary, Geneva, Madrid, and Washington D.C., as well as in NYC and Dallas.

It's clinically significant that Ebola manifestly causes profound dementia, verbal psychosis, and severe retardation in those responsible for dealing with outbreaks.

10 comments:

Anonymous said...

Will Mali be a Nigeria (Ebola free) or a Liberia (mass death and dislocation)? My prayers are on the former. My gut says the latter.

geoffb said...

" [T]he imam never showed any signs of the fever" [...]
World Health Organisation representative in Mali, said the Pasteur Clinic ... made "a terrible mistake" by not alerting authorities to the case of the sick Guinean imam, who would have been showing Ebola-like symptoms.


This gets to one problem which is that the symptoms are of a nature which might be thought to be some other affliction especially by a clinic which is not handling or seeing Ebola cases on some regular basis. Even then they may not notice as was the case which ended up in Hamburg where a WHO epidemiologist in Sierra Leone shared meeting rooms and a bathroom with a co-worker until 3 days before the co-worker died of Ebola. Looking for fever as a marker is not always reliable and tests which are done often don't detect it until the disease is quite far along.

mike18xx said...

"Authorities are now trying to trace over 400 potential fresh contacts" = "We don't have the slightest fucking idea where these people are."

mike18xx said...

China shows up; unrolls giant-ass banners.

Anonymous said...

China-- "He said China is a true friend that is here to stay."


That is long term planning. When Libya had there little problem China was in the news for evac'ing a shit ton of people. Something like a 100 thousand.

They are committed to being in Africa in a big way.

nick

Anonymous said...

gahh, no edits. "Their" not "there".

nick

geoffb said...

"Amb. Zhang: “We are building ETUs that will be operated and managed by China. They are solid and not mere tents as you can see, and we will use them to treat other diseases in the future even if Ebola is eradicated from here in Liberia.”"

Long haul indeed.

Aesop said...

Right up until they introduce Ebola to Shanghai or Hong Kong.

A Texan said...

Yeah, Cia is playing with fire, esp. since they are a less genetically diverse nation than most. If it hits there, look out!

A Texan said...

China...not Cia.