Tag: outbreak

Virus update

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And it’s not good news.

This from Dr Craig Spencer:

And he should know:

To be fair, this assumption means that I should be a bit of an authority on a lot of illnesses. And – because people do ask, my Top 3 worst ones from a personal experience point of view would be: Covid at number one, with Malaria and Influenza rather close behind. I’m guessing that if I managed to get it, Ebola might top the list quickly and (in all probability) finally.

Anyway…

The combined confirmed and suspected Ebola cases in DRC are now more than 1,000.
All signs are pointing to a very long and catastrophic outbreak in Central Africa:

  1. This is a vast undercount. We know this because the test positivity rate is hovering around 50%, only 20% of contacts are being traced (and in some areas, no contacts at all), and more cases keep popping up with no known connection. This all points to widespread and undetected community transmission.
  2. This is in only a week of detection. Compared to previous outbreaks, the growth is very fast, as the huge West Africa outbreak in 2016 was first detected at 49 cases and rose to 208 cases a month later. It took four months for that outbreak to reach the size of the current one in the DR Congo.
  3. The cases are spread out across 16 health zones. There are now multiple epicenters, making containment very difficult.

Next door in Uganda, the case count is seven. While this number is low compared to DRC, a concerning development is that two health care workers recently tested positive with uncertain exposure histories. If they weren’t treating known Ebola cases, this means it’s spreading undetected in Uganda as well.

As ever with outbreaks in less developed areas of the world, we’ll likely never know the true scale of this outbreak. And we definitely won’t have an accurate handle on what is going on day-to-day. That makes it very difficult to direct whatever resources might be available in order to help those on the ground. And all of this has been compounded by the withdrawal of USAID in the region. We can’t say for definite that this caused the outbreak to occur, but it’s fairly well accepted by those in the know that it will be playing a big part in not being able to control it more quickly and efficiently.

The US plan to bury their heads in the sand, and direct anyone from the affected region to a (as yet unbuilt) field hospital in Kenya is a worrying and bizarre decision (at least when compared with previous presidencies).

But whatever the causes and whatever the complications, it’s clear that this outbreak is – at the present time, at least – completely out of control.

Just saying (part 79 – the Hantavirus edition)

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Very soon after this post the other day:

I was accused by a couple of individuals on social media of being “dramatic”, and of “scaremongering”.
They took exception to my view that – coming from Argentina – this particular strain of Hantavirus (at that point only isolated in one patient, and not the other two seriously ill patients or the three individuals who died, including the one that collapsed in OR Tambo airport) could well have been passed from human to human.

But then a day later, the WHO agreed with me:

The World Health Organization says there may have been rare human-to-human transmission of hantavirus on the Dutch cruise ship where three passengers have died.

The virus is usually spread from rodents, but the WHO said in this instance it could have spread among “really close contacts” aboard the MV Hondius vessel. 

And today, our local NICD confirmed that:

And sure, that still doesn’t mean that we’re in any huge amount of danger from Hantavirus, but equally, it doesn’t mean that we’re in the clear, either.

Thankfully, there finally seems to have been some hard work done in contact tracing those on board the flight with the Dutch woman – which was almost certainly 4Z132 on April 25th:

Now we just need to know what she did (aside from collapsing) between this flight landing at 20:31 and her not getting onto KL592, which departed at 23:58 that evening.

That’s two confirmed cases so far, then. And it would be foolish not to assume that her husband also died from the virus. Given this new development of potential human to human transmission, they’re also going to medivac another close contact of his off the ship today.

Important work again by the NICD is confirming the strain of Hantavirus, and good that we’re now able to look at the outbreak and any potential consequences with fresh information. But I’m still sticking to the way that I ended that last post on this subject:

It’s going to be interesting couple of weeks ahead.

Don’t panic (but…)

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It reads like the script of some disaster movie. A luxury cruise ship, full of 91 posh people (and 61 crew) from 23 countries, taking in some of the most amazing sights (and sites) of the Southern Hemisphere.

And then a deadly viral outbreak onboard. “Ebola-lite”, as one news outlet inaccurately described it.
One guy dies, his wife tries to escape through the biggest airport in Africa, but collapses as she tries to fly home. She dies.
There’s then a third death on board.
And a British man is in ICU in Johannesburg (quite a long way from where the ship actually docked, which wasn’t actually in SA at all).

On board, stuck just off the coast of Cape Verde, the rest of the passengers and crew are forced to isolate as they wait out the incubation time of the virus, which has a mortality rate of 30-60%. More people are ill, but the local hospitals don’t have the facilities to treat them, and the local Health Minister isn’t allowing anyone from the ship near the islands.

Understandable.

There’s a travel blogger on board, and it’s said that there’s no such thing as bad publicity, perhaps being part of an as yet uncontrolled outbreak of severe, often fatal respiratory disease on a small, densely-packed ship might reasonably be seen as an exception to that rule.

So… anything to worry about in SA?

Nah. Surely not for us. The boat is in Cape Verde: way, way up the West Coast from here.

In a statement on Monday, the Health Department of South Africa said:

In our view, there is no need for the public to panic because only two patients from the cruise ship have been within our borders.

And of course the guy in the ICU in Joburg was brought there under very controlled conditions.

It’s just the woman that collapsed at the airport, then. The woman whose husband probably died of Hantavirus: the woman who collapsed at OR Tambo and who then died (probably of Hantavirus) in hospital soon afterwards.

Thankfully, no issues here, because it’s just a bit of contact tracing, which will obviously have been done quickly and efficiently and… I’m sorry? What?

The only challenge is that we need anyone who came in contact with the two patients to come forward for screening and testing to check if they are not infected yet.

Right.

It’s been a week, guys. This really isn’t great news at a major international airport and with a virus with an incubation period of 2-3 (but sometimes up to 8) weeks.

Mind you. When it comes to burying one’s head in the sand…

Three deaths from severe respiratory illness, one patient in ICU with severe respiratory symptoms – and who has tested positive from Hantavirus – and two crew members exhibiting severe respiratory symptoms, and the cruise company is still saying that the cases might not be linked:

Hantavirus has not currently been confirmed in the two persons still on board who require medical care. Nor has it been established that the virus is connected to the three deaths associated with this voyage. The exact cause and any possible connection are being investigated.

I’ve seen this approach before somewhere…

Ah yes:

Obviously, there’s not a microbiologist or an epidemiologist anywhere in the world that thinks that these cases might – just possibly – be connected. Obviously.

All perfectly normal. Obviously.

I mean, you hope that this is all done now. But there’s no reason why it should be. We’re still within one month of the ship’s departure from Argentina – a country which…

…reports approximately 100 cases of Hantavirus Pulmonary Syndrome annually, with notable risks of rare human-to-human transmission, distinct from other global hantaviruses.

It’s going to be interesting couple of weeks ahead.

Don’t panic about Anthrax

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Easy for me to say: I don’t have anthrax.

But as the Mail and Guardian dives in with this headline:

…I think it’s important to understand that anthrax – at least the bit of anthrax they’re talking about here – isn’t going to be the next Coronavirus, just like Monkeypox isn’t either. This is an unfortunate outbreak in the far North West corner of Sierra Leone.

Obviously, that’s bad news for the far North West corner of Sierra Leone, but it’s unlikely to adversely affect anyone outside that area.

This headline does highlight a couple of things regarding reporting of infectious diseases in the press though. Firstly, the tendency to sensationalise things a little. Anthrax can be a deadly pathogen, but a short course of really basic antibiotics will see it happily on its way. A vaccine for your herd of cattle will stop it before it’s even begun.

And “fray”:

a usually disorderly or protracted fight, struggle, or dispute

…does rather suggest that we are engaged in a constant fight against microbes, which yes, again, is kind of true, but then that always has been the case: that’s biology. There’s nothing exceptional about this particular outbreak. Anthrax has been around for millennia and so have we. It’s inevitable that our paths will cross every now and again. These things haven happened all the time and we never heard about them before. But we’re much more sensitive about bacteria and viruses now, because of what’s happened over the last couple of years.

Indeed, if the South African M&G (and yes, I recognise that this is an article originally from their pan-African partner) had taken just a moment to scoot around some high-quality local blogs, they’d find that we’ve had anthrax outbreaks right on our national doorstep very recently: In Zim in 2008 and in Lesotho in 2019. And we survived them.

With all the difficulties of obtaining decent data in deepest, darkest Africa – the continent upon which most of the global anthrax cases occur – it’s difficult to say how much anthrax there is around. But the generally accepted numbers are somewhere between 20,000 and 100,000 cases each year worldwide.

And yes, mostly in Africa, and yes, mostly in poorer, rural areas.

Just like the Port Loko District in the far North West corner of Sierra Leone.

All of which does rather make one wonder why the M&G is using that sort of language in a headline over a couple of hundred cows and sheep.

Day 66, Part 2 – Pigs

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We (humans) are not the only ones in South Africa struggling with a virus problem.

There are now outbreaks of African Swine Fever in three provinces: Eastern Cape, the Free State and Mpumalanga. And so the Department of Agriculture, Land Reform and Rural Development (broad portfolio, bru) are advising that pigs are subjected to some of the same restrictions as humans to avoid the further spread of the virus:

There you have it.

Socially distance and self-isolate your pigs. Disinfect their surroundings regularly.

Keep them off beaches and out of National Parks. Ensure they wash their trotters for at least 30 seconds at a time. Don’t (or do) (or don’t) allow them to go back to school. Cook their food thoroughly.

Ensure they wear a mask and only exercise between 6-9am. Quarantine them where necessary. Only allow them to buy alcohol on Level 3. Keep them away from warthogs.

NEVER LET THEM SMOKE CIGARETTES.

Do not get them wet or feed them after midnight.

 

Right. I think that covers everything. Bring on the next viral pandemic.