Ebola reported in Lagos, Nigeria, Megacity of 21 Million People

It's a new strain - and unstudied. It is known not to present with the same early symptoms as other Ebola strains, and has a much lower fatality rate (60% compared to 90%).

The Ebola virus strain responsible for Guinea's outbreak—now at 197 suspected or confirmed cases—is a new strain that has been sickening and killing people at least as far back as December, researchers reported yesterday.

The results of full genetic sequencing suggest that the outbreak in Guinea isn't related to others that have occurred elsewhere in Africa, according to an international team that published its findings online in the New England Journal of Medicine (NEJM).

www.nejm.org... - New England Journal of Medicine

Virologic investigation identified Zaire ebolavirus (EBOV) as the causative agent. Full-length genome sequencing and phylogenetic analysis showed that EBOV from Guinea forms a separate clade in relationship to the known EBOV strains from the Democratic Republic of Congo and Gabon. Epidemiologic investigation linked the laboratory-confirmed cases with the presumed first fatality of the outbreak in December 2013. This study demonstrates the emergence of a new EBOV strain in Guinea.

a reply to: GogoVicMorrow

Given the patient died so quickly, it's likely this new Ebola strain is in Lagos - which is a gamechanger.

What do you think?

originally posted by: CloudsTasteMetallic
a reply to: soficrow

Not looking good, is it? Had an eye on this since March.

The hop to Nigeria is shocking in the distance traveled from the previous 3 countries with confirmed cases.

I think a lot of the problem with the healthcare professionals contracting it lies in the fact that they're under-staffed, ill-equipped, and over-worked.

No - it's not looking good. Especially now that the man Sawyer has died - and his rapid death clearly indicates Ebola.

Yes - West Africa's medical system is "under-staffed, ill-equipped, and over-worked" - early transmissions to health workers were blamed on the fact that the epidemic was not identified and Ebola wasn't diagnosed. Then, for sure the problem was lack of protective gear and proper equipment - not to mention cultural resistance to diagnosis, quarantine and (non)treatment. [...Just occurred to me this is a helluva test run for identifying pitfalls of pandemic quarantines in developed nations.]

I'm also thinking back to the earlier stages of this epidemic - as I recall, there were reports of cases in Sierra Leone and Liberia, as well as Senegal and Mali - which were denied outright. Seems most likely the virus spread widely across borders in rural areas and jumped with travellers, but political-economic concerns kept it all quiet with the assumption it would burn out quickly like other Ebola outbreaks in other areas.

It's official:

Sawyer Confirmed to Have Ebola

Looks like a gamechanger - but how bad is it, really?

Ebola Reported in Africa's Most Populous City Lagos [POP. 21 Million]

A man has died of ebola in Lagos, the first confirmed case of the highly contagious and deadly virus in Africa's most populous metropolis.

Patrick Sawyer, a 40-year-old Liberian civil servant, collapsed on arrival in Nigeria's main airport on Sunday, health officials said. His condition rapidly deteriorated before he died, said Abdulsalami Nasidi, project director at the Nigeria Centre for Disease Control, who attributed his death to ebola.

...Lagos state authorities said they had requested the flight's manifest to contact the other passengers, and began distributing protective clothing to health workers, state health advisor Yewande Adeshina said. Sawyer flew from Liberia's capital of Monrovia, with a brief flight stopover in nearby Togo. His sister is believed to have died of ebola in the last month, a Liberian official told the Guardian.

...The death marks a new and alarming cross-border development in a disease that has spiralled into the world's biggest epidemic, spread across three west African countries. At least 660 people have died in Guinea, Liberia and Sierra Leone since ebola was first diagnosed in February.

Liberian Man Diagnosed With Ebola Disease Dies In Lagos

The Lagos State Government on Thursday evening confirmed the presence of the Ebola Virus in the state, following the admission of a Liberian, Mr. Patrick Sawyer, at a private hospital in the Obalende area of the state.

However, Mr. Sawyer’s death was confirmed on Friday afternoon, although a medical source who spoke with SaharaReporters under condition of anonymity said the death occurred on Thursday night.

News reports are rife with conflicting information. Most claim all of Sawyer's fellow travellers have been found and are being monitored for signs of Ebola. The following bit says no, they're still looking - and is the most believable.

Nigeria reports first Ebola virus death, hunts for other suspects

….With the victim’s death, the Lagos government is now desperately searching for Sawyer’s co-travellers from Lome, Togo. The co-travellers were believed to be in Calabar, in south-south Nigeria.

At a news conference on Friday evening, Lagos Commissioner for Health, Dr. Jide Idris said the government is trying to get the contact of those who were in the plane with the victim en-route from Lome to Lagos.
...we need to deal with those he got in contact with,” he said.

Idris said the government was still trying to get the manifest and ensure that co-travellers with the victim were properly screened and observed for at least 21 days to ensure that they were not carrying the trace of the disease in order to check its spread.

….“people should not panic, there is no need to panic. One thing is clear, the hospital in Obalende did the right thing by contacting us. We are taking everything necessary to curtail this from spreading. The committee set up will hold meeting daily on this issue. So far, we are lucky the man went to the health facility immediately.”

MORE

Nigeria government confirms Ebola case in megacity of Lagos

.....Nigeria has some of the continent's least adequate healthcare infrastructure, despite access to billions of dollars of oil money as Africa's biggest producer of crude.

Some officials think the disease is easier to contain in cities than in remote rural areas.

"The fear of spread within a dense population would be offset by better healthcare and a willingness to use it, easier contact tracing and, I assume for an urban population, less risky funerary and family rites," Ian Jones, a professor of virology at the University of Reading in Britain, said.

"It would be contained more easily than in rural populations."

There have been 1,093 Ebola cases to date in West Africa's first outbreak, including the 660 who have died, according to the WHO.

a reply to: R0CR13

Not unique, not new. As deadly as always.

CDC

originally posted by: GogoVicMorrow

originally posted by: CloudsTasteMetallic

originally posted by: GogoVicMorrow
a reply to: soficrow

Without good ventilation it can spreas through the air. Thats what happened at the monkey house in virginia.

That was a very specific strain, which was only pathogenic in primates, not humans.

Humans are Primates and Ebola Reston is pathogenic in Humans it was just asymptomatic. The other strains likely spread the same way.

Ah, thanks for the clarification.

originally posted by: intrptr
a reply to: R0CR13

Not unique, not new. As deadly as always.

CDC

Guess you missed it - genetic testing shows this is a new clade. Also, infection presents differently, and the fatality rate is closer to 60% than 90%.

The Ebola virus strain responsible for Guinea's outbreak—now at 197 suspected or confirmed cases—is a new strain that has been sickening and killing people at least as far back as December, researchers reported yesterday.

The results of full genetic sequencing suggest that the outbreak in Guinea isn't related to others that have occurred elsewhere in Africa, according to an international team that published its findings online in the New England Journal of Medicine (NEJM).

www.nejm.org... - New England Journal of Medicine

Virologic investigation identified Zaire ebolavirus (EBOV) as the causative agent. Full-length genome sequencing and phylogenetic analysis showed that EBOV from Guinea forms a separate clade in relationship to the known EBOV strains from the Democratic Republic of Congo and Gabon. Epidemiologic investigation linked the laboratory-confirmed cases with the presumed first fatality of the outbreak in December 2013. This study demonstrates the emergence of a new EBOV strain in Guinea.

a reply to: soficrow

Thanks for the link. Not sure why we differ , Ebola is Ebola is Ebola. They name the particular strain every time there is another outbreak. There are subtle differences between them, but it is ebola.

Seems you were right about Nigeria. New case there. People run from quarantine. If a panic sets in thats how it further spreads. People can hike around road blocks.

originally posted by: intrptr
a reply to: soficrow

Thanks for the link. Not sure why we differ , Ebola is Ebola is Ebola. They name the particular strain every time there is another outbreak. There are subtle differences between them, but it is ebola.

Seems you were right about Nigeria. New case there. People run from quarantine. If a panic sets in thats how it further spreads. People can hike around road blocks.

I suspect the differences with this new clade are not so subtle - whatever new mutations this Ebola has picked up have dropped its fatality rate by 30% and allowed it to spread over a huge geographic area. For starters. Unprecedented and not insignificant, even if local governments indulged in denials and cover-ups, hoping it would just burn out like other Ebola outbreaks.

So now, it's likely in Nigeria, maybe Togo and who knows where else. Logged in to post this:

UPDATE and WAKE-UP CALL

Sawyer's case and death in Nigeria shows that Ebola can spread by air travel. There are conflicting reports about Sawyer's contacts after landing. Original reports said he attended a conference before becoming ill, but current reports claim he became sick on the plane and went directly into quarantine upon landing. Reports also conflict regarding whether or not Sawyer's fellow travellers have all been traced, contacted and monitored. In addition, the plane stopped over in Lome, Togo - no reports on tracing those who might have been exposed in that country.

From ndtv: "West African hospital systems have weak and "often paralyzed" health care systems, he (Plyler) added, and are not usually equipped to handle Ebola outbreaks. International aid organizations like his and Doctors Without Borders have stepped in, but they also lack enough funding and manpower. "We need more humanitarian workers," he said. "We need resources." "

NOTE: Due to Ebola's varying incubation period (2 - 21 days), atypical presentation and the fact that it can't be diagnosed "on the spot," screening at ports and airports etc. should not be considered very effective.

American Doctor in Africa Tests Positive for Ebola

…North Carolina-based Samaritan's Purse issued a news release Saturday saying that Dr. Kent Brantly tested positive for the disease and was being treated at a hospital in Monrovia, Liberia. Brantly had been serving as medical director for the aid organization's case management center in the city.

….(Samaritan's Purse spokeswoman Melissa Strickland) says that Brantly began serving in Africa as part of a post-residency program before the Ebola outbreak began. The deadly disease has already killed 672 in several countries since the outbreak began earlier this year.

Nigeria Death Shows Ebola Can Spread by Air Travel

Nigerian health authorities raced to stop the spread of Ebola on Saturday after a man sick with one of the world's deadliest diseases brought it by plane to Lagos, Africa's largest city with 21 million people.

The fact that the traveler from Liberia could board an international flight also raised new fears that other passengers could take the disease beyond Africa due to weak inspection of passengers and the fact Ebola's symptoms are similar to other diseases.

….Screening people as they enter the country may help slow the spread of the disease, but it is no guarantee Ebola won't travel by airplane, according to Dr. Lance Plyler, who heads Ebola medical efforts in Liberia for aid organization Samaritan's Purse.

….Doctors say health screens could be effective, but Ebola has a variable incubation period of between two and 21 days and cannot be diagnosed on the spot.

……West African hospital systems have weak and "often paralyzed" health care systems, he added, and are not usually equipped to handle Ebola outbreaks. International aid organizations like his and Doctors Without Borders have stepped in, but they also lack enough funding and manpower. "We need more humanitarian workers," he said. "We need resources."

PS. An "unnamed source" says Sawyer's contacts from the plane have been contacted but are NOT being isolated for monitoring. Dumb and dumber.

This is being dealt with as a political-economic nightmare - so it's just going to get worse.

a reply to: soficrow

Due to Ebola's varying incubation period (2 - 21 days)

Especially that. For 21 days before first symptoms, then for x number of days with symptoms, lots of time to spread the disease. It lives outside the body on surfaces for some time, too.

If he was showing symptoms on the plane he already had it before he got on. Modern jet aircraft add antiseptic of some sort to their air supply for that reason. Was his plane a jet liner or a short hop twin prop passenger, do you know?

originally posted by: intrptr
a reply to: soficrow

....If he was showing symptoms on the plane he already had it before he got on.

Sawyer definitely had Ebola before he got on the plane - the question is, did he go straight into quarantine or attend his conference? Original reports said he went to his conference - later ones denied it. Sound like damage control to me. This pic, published by reportingnigeria, seems to show Sawyer at the conference. Note the pic ID he's wearing, and the dark bags under his eyes...

Was his plane a jet liner or a short hop twin prop passenger, do you know?

I recall reading it was a 3 hour plane ride - so likely a small plane but I don't know. But 3 hours is plenty of time to share bodily fluids - and I doubt the plane was disinfected before taking on more passengers. Even big airlines and hospitals cut back on cleaning staff to cut costs and bump profits....

a reply to: soficrow

If that is a pic of him at the conference…

imagine having Ebola, feeling sick and not knowing its Ebola?

Wonder how many people he shook hands with?

originally posted by: intrptr
a reply to: soficrow

If that is a pic of him at the conference…

Wonder how many people he shook hands with?

And what he touched - on the plane, in the airport, at his hotel, in taxis, at the conference....

That's a lot of potential sharing.

a reply to: soficrow

Well the newest strain, as far as I understand, is actually a weaker strain of the older strain Ebola Zaire.
Ebola Zaire was thought to have a mortality rate of up to 90 percent. However that could have been sensationalistic and since outbreaks were rare then it could have always really had a mortality rate similar to Sudan (at around 60 percent).

So until they say otherwise I'm under the impression it's a mutation of Ebola Zaire. Though I have read that it's a new unrelated strain. So I really don't know.

Time will tell. We could make a betting game of the name? I'm calling Ebola Conakry, but it will probably be a much lamer Ebola Guinea.

a reply to: soficrow

EDIT: Wait is this a different Ebola doctor?

Given that they knew he was exposed before he started showing symptoms my guess is that he knew exactly when he got infected.

Have they said? My guess would be an infected person coughed on him or he pricked himself with a needle because he tested himself and test positive. They didn't find out he had it because he was sick.

So i'd say something happened, he thought damn, and quarantined and tested himself.

a reply to: soficrow

I personally don't think it will ever spread in first world countries like it does in Africa, but it's definitely a game changer for Africa.

I thought they said it was a mutation of Zaire though. I'm kinda confused on that.

Considering most Africans think Ebola is b.s. I would say Lagos is potentially a game changer for Africa. That's if it's confirmed and if he spread it before infecting others.

Ebola is just one of those that I don't fear as a world wide pandemic even though I find it horrifying and super interesting. Now If it made it to a place like Iraq, or Syria, or other unstable countries their could be problems, but as far as the modern first world goes, i think we are okay.

originally posted by: GogoVicMorrow
a reply to: soficrow

Well the newest strain, as far as I understand, is actually a weaker strain of the older strain Ebola Zaire.
Ebola Zaire was thought to have a mortality rate of up to 90 percent. ...So until they say otherwise I'm under the impression it's a mutation of Ebola Zaire. Though I have read that it's a new unrelated strain. So I really don't know.

Time will tell. We could make a betting game of the name? I'm calling Ebola Conakry, but it will probably be a much lamer Ebola Guinea.

Hmmm. I gave you the link on the genetic sequencing, but here it is again (below). Based on the genetics, the New England Journal of Medicine says it's a "new EBOV strain." ....ZEBOV (Zaire Ebola Virus) has a fatality rate of 90-99% - this one weighs in around 60%. While this may be a "weaker" strain, the fact is that lower fatality rates are linked to a greater ability to spread.

Other differences between the 2 strains will become evident when epidemiological studies are done, but we already know that this strain presents differently.

www.nejm.org... - New England Journal of Medicine

Virologic investigation identified Zaire ebolavirus (EBOV) as the causative agent. Full-length genome sequencing and phylogenetic analysis showed that EBOV from Guinea forms a separate clade in relationship to the known EBOV strains from the Democratic Republic of Congo and Gabon. Epidemiologic investigation linked the laboratory-confirmed cases with the presumed first fatality of the outbreak in December 2013. This study demonstrates the emergence of a new EBOV strain in Guinea.

a reply to: soficrow

It's fatality rate is similar to Ebola Sudan, I believe, and higher than others (excluding Zaire - even though I think Zaire may have been inflated due to bad healthcare and fewer outbreaks to study.

EDIT: The current outbreak is NOT a new Ebola strain, but is Ebola Zaire. Initial reports was wrong.

American doctor in Liberia infected with Ebola

(CNN) -- An American doctor trying to quell the Ebola outbreak in Liberia is now infected with the virus, the organization for which he works said.

Dr. Kent Brantly is now hospitalized and undergoing treatment at an isolation center, the Christian humanitarian group Samaritan's Purse said.

The 33-year-old doctor had been treating Ebola patients and started feeling ill, Samaritan's Purse spokeswoman Melissa Strickland said. Once he started noticing the symptoms last week, Brantly isolated himself.

CNN

It seems to be spreading and getting much worst.