 |
Discharged junior medical officer fine, says colleague
• Why we oppose trial drugs, by WHO
• Warns against salt therapy, others
• Declares air travel is low-risk for transmission
• Cameroun closes borders with Nigeria, suspends flights
• 17 patients flee centre in Liberia
• Reasons govt dumped nano silver for treatment
FOR stakeholders who have persistently called for the supply of experimental drugs to Ebola patients, a word of caution has come from the World Health Organisation (WHO).
While WHO noted that efforts were underway to accelerate the production and supply of experimental drugs on Ebola, it, however, cautioned against their use.
Besides, the First Consultant Medical Centre Ikoyi, Lagos yesterday confirmed to The Guardian that only one of the two female doctors that were quarantined at the Infectious Disease Unit of the Lagos Mainland Hospital for having primary contact with the index case, Mr. Patrick Sawyer, had been discharged.
The Medical Director of First Consultant Medical Centre, Dr. B. N. Ohiaeri, Sunday, in a telephone interview told The Guardian: “There were two female doctors. One of the female doctors has been discharged and she is clean, negative and fine. The other one is still there and still receiving treatment.”
Ohiaeri further explained: “There are two female doctors. One is the senior one and the other, the junior one, a medical officer, has been discharged.”
The Minister of Health, Prof. Onyebuchi Chukwu, told journalists on Saturday in Lagos that the first Nigerian Ebola patient had been declared fit and discharged from hospital.
Yesterday, the minister clarified that the infected doctor discharged from the hospital was not Dr. Adadevor as reported in some media (not The Guardian). The Special Assistant on Media and Communication to the Minister, Dan Nwomeh, said the name of the discharged doctor who had recovered was not Adadevor.
A statement issued by Nwomeh yesterday noted: “It has been brought to the attention of the Honourable Minister of Health, Professor Onyebuchi Chukwu, that the first Nigerian to be diagnosed of Ebola Virus Disease, a female doctor, who treated the index case and who was discharged home from the ward yesterday, is being reported in some section of the media to be one Dr. Adadevor.
“The Honourable Minister wishes to clarify that the name of the patient is not Dr. Adadevor. This should be noted. The minister’s statement yesterday while indicating that it was a female doctor did not indicate the name of the patient.”
Meanwhile, Tony Elumelu Foundation has donated N100 million towards Ebola containment across West Africa.
WHO said at the weekend that the supply of experimental drugs was limited and may not be augmented for several months to come.
“Even then, supplies will be too small to have a significant impact on the outbreak,” the organisation said.
WHO’s position was disclosed by the group’s Media Officer, Gregory Hartl, who stressed: “The scale, duration, and lethality of the Ebola outbreak have generated a high level of public fear and anxiety, which extends well beyond West Africa. Such reactions are understandable, given the high fatality rate and the absence of a vaccine or cure.
“Recent intense media coverage of experimental medicines and vaccines is creating some unrealistic expectations, especially in an emotional climate of intense fear. The public needs to understand that these medical products are under investigation. They have not yet been tested in humans and are not approved by regulatory authorities, beyond use for compassionate care.
“Evidence of their effectiveness is suggestive, but not based on solid scientific data from clinical trials. Safety is also unknown, raising the possibility of adverse side effects when administered to humans. For most, administration is difficult and demanding. Safe administration of some requires facilities for intensive care, which are rare in West Africa.”
He went on: “WHO has advised that the use of experimental medicines and vaccines under the exceptional circumstances of this outbreak is ethically acceptable. However, existing supplies of all experimental medicines are either extremely limited or exhausted.
“WHO welcomes the decision by the Canadian government to donate several hundred doses of an experimental vaccine to support the outbreak response. A fully tested and licensed vaccine is not expected before 2015.
“Another source of public misunderstanding, especially in affected areas, comes from rumours on social media claiming that certain products or practices can prevent or cure Ebola virus disease.
“Decades of scientific research have failed to find a curative or preventive agent of proven safety and effectiveness in humans, though a number of promising products are currently under development.”
On talks about other possible therapies for Ebola, the statement noted: “All rumours of any other effective products or practices are false. Their use can be dangerous. In Nigeria, for example, at least two people have died after drinking salt water, rumoured to be protective.
“The most effective personal behaviours are avoiding well-known high-risk situations, knowing the symptoms of infection, and reporting early for testing and care. Evidence suggests that early supportive care improves the prospects of survival.
“The Ebola virus is highly contagious but only under very specific conditions involving close contact with the bodily fluids of an infected person or corpse. Most infections have been linked to traditional funeral practices or the unprotected care, in homes or health facilities, of an infected person showing symptoms.
“Apart from these specific opportunities for exposure to the virus, the general public is not at high risk of infection.”
The WHO reiterated its position that the risk of transmission of Ebola virus disease during air travel remains low.
The Director of WHO Global Capacity Alert and Response, Dr Isabelle Nuttall, in a statement said: “Unlike infections such as influenza or tuberculosis, Ebola is not airborne. It can only be transmitted by direct contact with the body fluids of a person who is sick with the disease.”
On the small chance that someone on the plane is sick with Ebola, the likelihood of other passengers and crew having contact with their body fluids is even smaller. Usually when someone is sick with Ebola, they are so unwell that they cannot travel. WHO is therefore advising against travel bans to and from affected countries.
Nuttall said: “Because the risk of Ebola transmission on airplanes is so low, WHO does not consider air transport hubs at high risk for further spread of Ebola.”
In early August, after the meeting of the Ebola Emergency Committee under the International Health Regulations, WHO provided advice to countries to help contain the current Ebola outbreak and prevent it from spreading further.
The guidance recommended: No ban on international travel or trade; that countries be prepared to detect, investigate, and manage Ebola cases; including access to a qualified diagnostic laboratory for Ebola virus and, where appropriate, the capacity to identify and care for travellers originating from known Ebola-infected areas who arrive at international airports or major land crossing points with unexplained fever and other symptoms. Worldwide, countries should provide their citizens traveling to Ebola-affected countries with accurate and relevant information on the Ebola outbreak and measures to reduce the risk of exposure.
Despite the assurance from the WHO, Cameroun has closed its borders with Nigeria for a minimum of one month.
Cameroun, according to the Nigerian Immigration Service (NIS), has a boundary of over 2, 000 kilometres in Borno, Adamawa, Taraba and Cross Rivers states in the South-South sub-region of Nigeria.
During a special programme of the Hausa Service of British Broadcasting Corporation (BBC) monitored in Maiduguri, the spokesman of Cameroun Foreign Affairs, Chiroumma Boukkari, said the decision to close the borders with Nigeria had become inevitable, because of the fear of the spread of Ebola in the West African sub-region.
“This decision on border closure and suspension of all flights to and from Nigeria was to protect the lives of Camerounian citizens living within and outside from contracting Ebola, as Nigeria, our main trading partner in Africa has been facing since July 20, 2014 when Patrick Sawyer sneaked into the country aboard a flight with the
deadly virus.”
He, however, noted that the border closure and suspension of flights to and from Nigeria would be for a minimum of one month. He also advised Camerounian citizens to take the closure of borders and flight suspension seriously to protect their lives and property.
“The border closure with our main trading partner will be lifted, as soon as Nigeria contains the spread of the deadly viral disease. We also urge all border security agencies of the two countries to be vigilant by complying with this border closure made yesterday (Saturday) by the foreign office here in Ngaudore,” said Boukkari.
The affected border outposts in Borno State include Kirawa, Duji, Mallam Fatori, Gamboru, Banki, Damba/Masara, Baga, Danbaure, Sigal and
Jilbe, 145 kilometres northeast of Maiduguri, the state capital.
The Guardian learnt that the Federal and Lagos State governments dumped the use of nano silver in treating EVD because a 2013 study showed that it is toxic to human organs and increase microbial resistance to drugs of choice.
Recent review papers suggest that at the current level of exposure, nano silver may not be hazardous to humans and may result in low internal exposure. However, data is insufficient to carry out a full risk assessment.
Nano silver
Silver (Ag) nanomaterials (nano silver) are widely used today for their antibacterial activity. In medical care nano silver has been used, for example, as an antibacterial agent in wound dressings such as bandages to protect patients with severe burns against infections. It has also been used in catheters to prevent the formation of infectious biofilms. It can be expected that, with prices of medical applications of nano silver decreasing, their use will increase. Nano silver has also been used in consumer products such as sports textiles, other textiles, washing powder and deodorants, where nano silver should reduce undesired odours.
In addition, indirect adverse effects on human health may occur via an increasing resistance of micro-organisms against silver, including nano silver and silver-based compounds. This may limit the usefulness of nano silver in medical devices and other medical applications.
Silver can be present in different forms (metallic – nanosized or not – and salts), and it is not clear how these different forms of silver influence its antimicrobial properties, a possible increase of antimicrobial resistance (AMR) and the healing process of burn wounds. Recent reviews and publications proposed to use a combination of nano silver with usual antibiotics for the treatment of specific infectious diseases caused by resistant bacteria.
A broad array of consumer and medical products employ billionths-of-a-meter scale silver particles as embedded disinfectants. A study now suggests that if those nanoparticles get loose and into the body, they might wreak havoc on the human immune system. Documented effects occurred at very low concentrations — levels as minute as parts per trillion or even, sometimes, one-thousandth that much (i.e. parts per quadrillion).
Meanwhile, the Agence France Presse (AFP) yesterday disclosed that17 patients infected with Ebola were unaccounted for after they fled an armed raid on a quarantine centre in Monrovia by men who claimed the epidemic was a fiction.
“They broke down the door and looted the place. The patients have all gone,” said Rebecca Wesseh, who witnessed the attack on the outskirts of the Liberian capital.
Her report was confirmed by residents and the head of Health Workers Association of Liberia, George Williams.
Williams said the unit housed 29 patients who “had all tested positive for Ebola” and were receiving preliminary treatment before being taken to hospital.
“Of the 29 patients, 17 fled last night (after the assault). Nine died four days ago and three others were yesterday (Saturday) taken by force by their relatives” from the centre, he said.
The attackers, mostly young men armed with clubs, shouted that President Ellen Johnson Sirleaf “is broke” and “there’s no Ebola” in Liberia as they broke into the unit in a Monrovia suburb, Wesseh said.
Residents had opposed the creation of the centre, set up by health authorities in part of the city considered an epicentre of the Ebola outbreak in the Liberian capital.
“We told them not to (build) their camp here. They didn’t listen to us,” said a young resident, who declined to give his name.
“We don’t believe in this Ebola outbreak.”
The Ebola outbreak, the worst since the virus first appeared in 1976, has claimed 1,145 lives in five months, according to the United Nations World Health Organisation’s latest figures as of August 13: 413 in Liberia, 380 in Guinea, 348 in Sierra Leone and four in Nigeria.