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Follow-up on the suspected Ebola virus disease case
Joint press release by the Ministry of National Health Services, Regulation and Coordination and the World Health Organization (WHO) on follow-up on the suspected Ebola virus disease case
2 December 2014, Islamabad – The Ministry of National Health Services, Regulation and Coordination in coordination with the National Institute of Health and WHO has sent a four member federal rapid response team consisting of an epidemiologist, laboratory technologist and infectious disease control consultant to undertake an investigation of the suspected Ebola case identified yesterday by Karachi airport authorities and transferred to an appropriate isolation ward at the Jinnah Postgraduate Medical Centre.
Although the clinical picture of the patient is much better than upon his arrival, federal and provincial health authorities together with WHO consider it imperative to pursue full compliance with anti-Ebola protocol. Having returned from the city of Monrovia, the capital of Liberia, less than 21 days ago, the patient remains epidemiologically linked with the disease until biologically proven otherwise.
Should the passenger have been identified without any symptoms, he would still have been taken care of by airport health authorities in order to track his travel and contact history, and to be properly informed and advised on the risks of Ebola, but would have been free to remain at home under strict medical supervision. In this case, the patient was symptomatic and his presence at the hospital remains justified.
In this regard, a blood sample has been obtained from the patient, in the presence of the federal rapid response team, under safe conditions, by a trained laboratory technician from the National Institute of Health, Islamabad, and has been safely packaged and shipped for laboratory testing. Results are expected to come back within a week at most.
The federal rapid response team has verified that all sanitary protocols for Ebola control have been adequately carried out, including disinfection of the ambulance and all areas and materials the patient has been in contact with since his arrival in Pakistan, along with the identification of all individuals he has been in contact with.
Provincial and federal health authorities wish to reaffirm the importance of not compromising on Ebola control standards operating procedures, and reiterate their appreciation for the measures and actions taken so far in Karachi by both airport and hospital personnel.
WHO also stresses the importance of pursuing evidence-based messaging, in order to avoid any surge of non-credible or unfounded rumours about the disease.
Finally, WHO wishes to reiterate that there is at the moment no other credible suspicion of Ebola anywhere in Pakistan, other than the case in Karachi.
In this respect, the passenger who entered Pakistan today at Islamabad with a clinical picture of respiratory infection is not considered to be a possible suspected Ebola case based on his travel or contact history.
It is important to remember that only passengers who initiated their travel less than 21 days ago from the four Ebola-prone countries (Guinea, Liberia, Mali, Sierra Leone) are subject to Ebola sanitary control measures.
Today’s rumour is therefore unfounded as the passenger came from Uganda, an Ebola-free country, more than three months ago. That person suffers from a severe chest infection, an occupational condition in this case.
Suspected case of Ebola at Jinnah Postgraduate Medical Centre, Karachi
World AIDS Day 2014: HIV treatment controls the virus. Treat for life. Prevent for life.
World AIDS Day is observed on 1 December every year. This year it is as an opportunity to harness the power of social change and close the gap between people who have access to HIV prevention, treatment, care and support services and people who are being left behind.
The WHO Eastern Mediterranean Region, comprising 22 countries including Pakistan, is celebrating the Day under the slogan "HIV treatment controls the virus. Treat for Life. Prevent for Life". This is a call for action so that every individual living with HIV can enjoy the highest attainable level of health through lifelong access to good quality HIV care and treatment.
Antiretroviral therapy (ART) has become less toxic and easier to administer, and people living with HIV who take it in the right combination of medicines can control the virus and bring it down to undetectable levels. This keeps the immune system sufficiently strong to fight opportunistic infections and cancers. Thus, people living with HIV can now live long, healthy and productive lives.
On this occasion, Dr Ala Alwan, WHO Regional Director for the Eastern Mediterranean has affirmed that "HIV treatment reduces the virus to undetectable levels, and protects people against diseases. Secondary to the preventive benefit to individuals of reducing the virus to undetectable levels, there is a benefit to public health in general. Implementing ART programmes reduces the likelihood of transmission from people living with HIV to others. This is a major public health gain that will eventually result in curbing the HIV epidemic".
"Effective HIV treatment will help people living with HIV to avoid the transmission of their infection to their uninfected partners. Similarly, once the level of their infection has become undetectable, pregnant women living with HIV can give birth without passing the virus on to their babies", he added. He has called for adapting Health systems to ensure that even the least privileged and most marginalized individuals are not excluded, while monitoring the treatment success in individuals.
The Government of Pakistan has been maintaining a sustained response to the HIV epidemic since the late-1980s/early 1990s through the national and provincial AIDS control programmes, with support from United Natioons (UN) agencies such as WHO, UNAIDS, UNICEF, UNESCO and UNFPA, as well as bilateral and multilateral donors, and a large number of nongovernmental and community service organizations. The Global Fund to Fight AIDS, Tuberculosis and Malaria has been financing a substantial portion of the HIV/AIDS response in Pakistan. Since June 2011, the provincial AIDS control programmes have been leading the implementation of their policies, strategies and guidelines.
Pakistan falls under the category of a high-risk but low prevalence country for HIV/AIDS with a concentrated epidemic level (meaning that the prevalence in traditional risk groups exceeds 5%). The national AIDS control programme estimates that there are around 100 000 HIV cases in Pakistan, with an overall general population prevalence ranging from 0.05% to less than 0.1% during the last decade. However, the epidemic is expanding among the country's estimated 150 000 injecting drug users.
According to Dr Michel Thieren, WHO Representative in Pakistan, Pakistan faces an elevated risk of HIV transmission as a result of poverty, low literacy, gender discrimination, ignorance about modes of transmission and the stigma that prohibits people with risky behaviours from seeking HIV testing or care. Dr Thieren noted that WHO had been supporting the programme since the early 1990s with a focus on enhancing the capacity of national and provincial HIV/AIDS programmes, supporting policy development, strengthening HIV testing and counselling, and HIV/AIDS treatment, monitoring the prevention of HIV transmission in health care settings alongside blood safety, and enhancing the diagnosis and treatment of other sexually transmitted infections. It also helps the programme in resource mobilization.
Dr Thieren stressed that while the multisectoral effort involving a large number of agencies belonging to different sectors was yielding good results in Pakistan, there was need for better monitoring, surveillance and coordination between other programmes including those for tuberculosis control, maternal and child health, and lady health workers. This would result in proper documentation and prevent duplication of efforts, he added. He emphasized the need to eliminate the barriers to the provision of antiretroviral drugs to patients in need through adequate privacy and counselling, while pursuing a gender-sensitive and human rights-based approach.
Suspected case of Ebola at Jinnah Postgraduate Medical Centre, Karachi
A joint Ministry of National Health Services, Regulation and Coordination, Health Department of the Government of Sindh, and World Health Organization (WHO) press release.
1 December 2014, Islamabad – This morning, a 45 year-old national of Pakistan arrived at Karachi airport from Liberia, after a two day-long journey, where he had been on a business trip. The passenger presented with a fever and general weakness, which he associated with journey fatigue.
The passenger was immediately identified by airport authorities through appropriate application of the Ebola response standard operating procedures at ports of entry, recently reviewed by the WHO Expert Assessment Mission deployed last week. The contact history related by the patient indicates no direct contact with anyone possibly affected by Ebola virus disease.
In response the following measures have been taken:
- Immediate isolation of the passenger at the Karachi airport and tracing of passenger travel and contact history undertaken by the airport health authorities.
- Secure transportation of the passenger to Jinnah Postgraduate Medical Centre, Karachi, the designated reference centre for any suspected Ebola case in Sindh province.
- Complete isolation of the patient in a dedicated ward at the medical centre.
- Deployment, in the afternoon, of a rapid Ebola response team with the task of applying proven Ebola protection measures, detailed patient travel and contact history confirmation, further contact tracking and subsequent protective measures, and case confirmation.
- A blood sample will be taken once all infection control measures are in place.
- Personal protective equipment type-B (compatible with Ebola patient care) are currently in stock at the WHO warehouse and will be dispatched immeditately to Karachi.
- Immediate official communication by this communiqué to the press, which will be followed-up by daily communiqués as appropriate.
The Ministry of National Health Services, Regulation and Coordination, the Health Department of the Government of Sindh,and WHO in Pakistan are in agreement with the measures taken, and wish to commend the airport authorities and their health officers for the action taken in full compliance with procedures.
WHO acknowledges the public concern with the disease, but reiterates that the likelihood of Ebola transmission without a history of direct contact with a patient symptomatically affected with Ebola is very low. WHO therefore calls for all communications on the subject to be strictly based on information derived from reliable and authorized sources.
