Cote d'Ivoire has never been part a human Ebola epidemic. August 2021 has suddenly put Cote d'Ivoire in the middle of multiple contact tracing investigations. 1/n
In August 2021, a case was found in a traveler to Abidjan from Guinea, leading to investigation of contacts along route and in city. A new case is suspected in Burkina Faso and linked to an area as far as possible from Abidjan on northern Mali border
Hopefully the case in Burkina Faso is simply a suspected case which tests negative. This is quite possible. There are not enough characters to list here all the diagnoses that can look like Ebola - yellow fever, malaria, Lassa etc
Sometimes once Ebola is raised, lots of suspected rule outs pop up. This is a sign of good medicine. It's worth ruling out diagnoses that are dangerous to patients, health workers and communities.
Cote d'Ivoire has been a relative stranger to Ebola, despite its proximity to the 2014-16 epidemic. The only prior fully documented human Ebola case was in 1994, in a foreign ethnologist infected by a chimp cadaver.
That said, there were clearly cases before the 2014-16 outbreak. There was one case detected by MSF in Cote d'Ivoire during the Liberian civil war - in a fighter who fled across the border, tested by Pasteur Institute, 1995 pubmed.ncbi.nlm.nih.gov/9893379/
Transportation has likely made all the difference between isolated forest exposures and wider and urban spread. Extensive road and transport improvements have been made by and for extractive industries in the region, without concurrent clinical and diagnostic investments.
Yet throughout the 2014-16 epidemic, the long and often porous border with Guinea, Liberia, and Mali was not associated with any Ebola cases, though there were alerts at the time and suspected cases tested.
There remains the concern that travel plus recrudescence followed by sexual transmission from a man could spark unrecognized chains. It has been known for decades Ebola can become infectious again in semen. Although rare, given 10K survivors, can happen pubmed.ncbi.nlm.nih.gov/9988162/
Moreover, the traveler to Abidjan crossed over through western Cote d'Ivoire many hours drive away from where the current suspected case in Burkina Faso is reported to have come from.
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Starting in September, Germany will offer another dose of Pfizer or Moderna to older people, residents of care homes, and people with compromised immune systems — and also to anyone who was already fully vaccinated with the 2-dose AZ or single-dose J&J nytimes.com/2021/08/02/wor…
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This impacts not just HIV but COVID
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