EBOLA VIRUS DISEASE PREPAREDNESS IN COUNTRIES BORDERING DEMOCRATIC REPUBLIC OF CONGO: LESSONS FROM WEST AFRICAN OUTBREAK.

BACKGROUND: Ebola virus disease ravaged three West African countries in the wake of 2014 which was seen as the deadliest Ebola Virus Disease (EVD) outbreak in history. Several lessons were taken out of the West African outbreak one of which is the lack of preparedness by countries in the region. MATERIALS AND METHODS: This paper looked at the mistakes of the West African outbreak and reports how such mistakes were corrected in the current outbreak going on in the Democratic Republic of Congo (DRC). Preparedness efforts are currently taking place in countries bordering DRC which included quick detection and response to an eventual EVD event. RESULTS: This paid off on several occasions when cases from DRC to Uganda were quickly detected and response was as quick as possible. Preparedness carried out in Countries bordering DRC included setting up of Rapid Response Team (RRT) and training of these teams both at country and regional level. All members of the RRT were trained in all areas of readiness which included community engagement, laboratory, logistics, surveillance, case management, sample collection, packaging and shipment as well as Infection Prevention and Control (IPC). CONCLUSION: These trainings have led to readiness to an eventual EVD event. Countries now have the ability to respond quickly with better Emergency Operation Centre (EOC) for EVD.

Transplacental transmission: A rare case of Ebola virus transmission.

During the mid-transmission period of the Ebola virus disease (EVD) outbreak in Sierra Leone, a 19-year-old pregnant woman, who was a petty trader in a health facility in Freetown, noticing no fetal movement for the past 3 days, reported to a health facility. Medical history and laboratory testing showed no abnormalities except that she was positive for sickle cell. She was not known to any surveillance team of having any epidemiological link to EVD case. She was induced with oral medications as well as IV infusion. EVD test showed that the fetus was positive to EVD with a high threshold value of 21, while the woman was negative for EVD with a threshold value of 42. The woman was positive to EVD IgG but negative to EVD IgM by ELISA technique. This is a rare EVD case in the period of medium transmission. We conclude that the woman may have come into contact with a low dose of virus not enough to cause a full blown EVD and that her immune system was able to stop the virus from further replication.

Elevated serum ß2-microglobulin in individuals coinfected with hepatitis B and hepatitis D virus in a rural settings in Southwest Nigeria.

OBJECTIVE: Coinfection of hepatitis B virus (HBV) with hepatitis D virus (HDV) has being reported to increase severity of progression to hepatocellular carcinoma (HCC) and liver cirrhosis (LC). Beta microglobulin (2ßM) which is present on the surfaces of blood cells in acceptable levels is a tumor marker which may become elevated in disease conditions. This study hence observed the prevalence of HBV and HDV coinfection in a rural population and their 2ßM concentration. RESULTS: Of the 368 samples, 66 (17.9%) were positive to hepatitis B surface antigen (HBsAg) and 33 (50%) were coinfected with HDV, 8 (2.1%) were monoinfected with HDV. 2ßM concentration increased beyond the normal level in individuals coinfected with HBV and HDV as compared with the monoinfected individuals. Coinfection resulted in the increased concentration of 2ßM in HBV and HDV coinfection and the likelihood of progression to HCC and LC may not be ruled out. Monoinfection with HDV also had high 2ßM concentration but this is due to having being infected with a non-detected HBV or chronic infection in which HBV is clearing.

Rapid outbreak sequencing of Ebola virus in Sierra Leone identifies transmission chains linked to sporadic cases.

To end the largest known outbreak of Ebola virus disease (EVD) in West Africa and to prevent new transmissions, rapid epidemiological tracing of cases and contacts was required. The ability to quickly identify unknown sources and chains of transmission is key to ending the EVD epidemic and of even greater importance in the context of recent reports of Ebola virus (EBOV) persistence in survivors. Phylogenetic analysis of complete EBOV genomes can provide important information on the source of any new infection. A local deep sequencing facility was established at the Mateneh Ebola Treatment Centre in central Sierra Leone. The facility included all wetlab and computational resources to rapidly process EBOV diagnostic samples into full genome sequences. We produced 554 EBOV genomes from EVD cases across Sierra Leone. These genomes provided a detailed description of EBOV evolution and facilitated phylogenetic tracking of new EVD cases. Importantly, we show that linked genomic and epidemiological data can not only support contact tracing but also identify unconventional transmission chains involving body fluids, including semen. Rapid EBOV genome sequencing, when linked to epidemiological information and a comprehensive database of virus sequences across the outbreak, provided a powerful tool for public health epidemic control efforts.

Human immunodeficiency virus (HIV) seropositivity and hepatitis B surface antigenemia (HBSAG) among blood donors in Benin city, Edo state, Nigeria.

BACKGROUND: Human Immunodeficiency Virus and Hepatitis B virus are blood borne pathogens that can be transmitted through blood transfusion and could pose a huge problem in areas where mechanisms of ensuring blood safety are suspect. This study became necessary in a population where most of the blood for transfusion is from commercial blood donors. METHOD: A total of 130 donors comprising 120 commercial donors and 10 voluntary donors were tested for antibodies to human immunodeficiency virus and hepatitis B surface antigen in Benin city using Immunocomb HIV - 1 and 2 Biospot kit and Quimica Clinica Aplicada direct latex agglutination method respectively. RESULTS: Thirteen (10%) samples were HIV seropositive and 7(5.8%) were HBsAg positive. The age bracket 18 - 25years had the highest numbers of donors and also had the highest number of HBsAg positive cases (7.8%) while the age group 29 - 38years had highest number of HIV seropositive cases. CONCLUSION: High prevalence of HIV antibodies and Hepatitis B surface antigen was found among commercial blood donors. Appropriate and compulsory screening of blood donors using sensitive methods, must be ensured to prevent post transfusion hepatitis and HIV.

Increasing resistance to quinolones: A four-year prospective study of urinary tract infection pathogens.

A four-year prospective study was carried out to determine the incidence and rate of development of resistance by common urinary tract infection (UTI) pathogens to quinolone antimicrobial agents. Results show that there is high intrinsic resistance to the quinolones among strains of Pseudomonas aeruginosa (43.4%), Escherichia coli (26.3%), and Proteus spp. (17.1%). Over four years, rising rates of resistance were observed in P. aeruginosa (14.6% increase), Staphylococcus aureus (9.8%), and E. coli (9.7%). The highest potency was exhibited by ciprofloxacin (91.2%), levofloxacin (89.2%), and moxifloxacin (85.1%), while there were high rates of resistance to nalidixic acid (51.7%) and pefloxacin (29.0%). Coliforms, particularly E. coli (>45%), remain the most prevalent causative agents of UTI while females within the age range of 20-50 years were most vulnerable to UTI.