Random Analytica

Charts, Infographics & Analysis without the spin

Category: Health

A Memory: @WHO, 8th August 1989

I never read this when it was issued by the World Health Organisation. I should have but I don’t. I’m getting my final paperwork ready for the Army. I’m failing school. The Army accepts Year 10 and I have good grades to that point. School seems so pointless. Something is kicking off in the Middle East. We are going to smash Saddam Hussein in the fucking teeth. I don’t want to miss out on any action. I’m still too young in 1989 but I am slotted in for Basic Training early next year. I am 16-years old. I am so Green.

I’m good judoka. I’m not interested in black belts, I just love the training. I train twice during the week and on weekends if we get enough interest. My Sensei is amazing. He is a psychiatric nurse. He is tough. We laugh as he tells us the story of the bloke who tried to jump him in the supermarket. It supposed to be a joke but W* throws him. The checkout chick is terrified. It’s a great story. I meet him a year or two later. I’m home on leave. I’ve put on 15kg and I’m Army tough. As we train one of the kids clumsily kicks me in the balls as we practice sacrifice throws. It’s an accident but I’m in agony. W* tells the story to the other bouncers at the nightclub he is working at part-time that night. I’m still tender. We laugh. I get free entry and a drink voucher. I feel like a God in the early 90s but that hasn’t happened yet.

I’m working in a greasy Indian restaurant on weekends. The Indian family who own it treat me like one of their own. I get paid $10 per hour cash-in-hand (which is big money back then). I smell like sauce as I go to school on Mondays. The smell lingers till Wednesday. Indian food smells when you do the dishes. It takes me years to get coached into an Indian restaurant with my best friend and his girl. The food is amazing. I’m catching up with another friend and her man next week. We are eating Indian.

I’m so busy. I’ve been training for years to get this far. I’m an accomplished Venturer. I teach others how to abseil, orient a map or whatever. My Venturer leader is an amazing soldier. He is old but still fit. He smokes constantly. Under the stars one night he tells me how he started smoking. He is on patrol in Malaysia back in the day when his best mate cops the full blast of something. He is covered in his blood. Bits of flesh drip off him. When he gets in front of a medic they think he might be damaged. His mate cops the full blast, he walks away without a scratch. The medic puts a cigarette in his mouth and lights it. That was his first smoke. I’m sixteen and this amazing man is sharing his real story. We have a moment. I’ll meet other amazing soldiers in the future. Men and Women. We will share moments. I’ll forget it all.

It’s been 30-years since the World Health Organisation issued their warning.

1989_WHO_Mefloquine

I wonder why they never followed up on it?


WHO~Mefloquine

 

A memory…

 

If you or anyone you know of a veteran who needs help I would strongly suggest you reach out to Open Arms 1800 011 046.

Mefloquine and Tafenoquine use by the Australian Defence Force 1990 – 2017

Mefloquine and Tafenoquine are two different types of anti-malarial drugs that have been in use potentially as far back as 1990 but trialled extensively by the Australian Defence Force at the turn of the century. From 2016 via the Australian Broadcasting Corporation. Defence force admits soldier shouldn’t have been included in East Timor anti-malaria drug trial. Excerpt:

The Australian Defence Force has acknowledged it accidentally exposed one of its soldiers to controversial anti-malarial drugs during trials in East Timor, despite the soldier having a medical history of mental illness which should have precluded his involvement.

The soldier, Chris Salter, developed chronic depression and psychosis after inclusion in the Timor trials of psychoactive drugs mefloquine and tafenoquine.His illness has led to repeated suicide attempts and more than a dozen stays in psychiatric hospitals. He is unable to work or care for his family.

Since the trials, which included thousands of Australian soldiers between 2001 and 2003, a small group of veterans have developed severe mental illnesses. They believe the ADF erred by giving them the drugs even though there was a significant body of research which pointed to the drugs’ side effects, which in some cases are permanent.

I just wanted to get a chart posted which highlighted the use of Mefloquine and Tafenoquine in Australian soldiers over the past 30-years. Currently most of the documentation concentrates on the trials conducted between 1998 – 2002, however there is some evidence that groups of soldiers were subjected to trials of mefloquine as far back as 1992 during Operation SOLACE (Somalia). I’ll update the chart as new information comes to hand.

Mefloquine~TafenoquineUsebyADF1990-2017

Explanatory Notes:

1992-93: Somalia – Awaiting more information
1993: Cambodia – Awaiting more information
1994-96: Rwanda – One confirmed mefloquine dosage. Awaiting more info
1997: PNG – One confirmed mefloquine dosage. Awaiting more info
1998: Bougainville – Peace Monitoring Group – 201 troops given Tafenoquine (note: Stuart McCarthy’s notes state 374 troops were given Tafenoquine).
2000: East Timor – 639 troops given Tafenoquine during trials.
2000: East Timor – 162 troops given Mefloquine during the Double-Blind trial
2000: East Timor – 492 troops given Tafenoquine during the Double-Blind trial
2001: Australia – 31 troops given Tafenoquine to test for Relapse Prevention
2001: East Timor – 1,157 troops given Mefloquine during the last major trial of the drug

An excellent resource for understanding the trial intensity of both anti-malarial drugs is Stuart McCarthy’s Summary of ADF Mefloquine and Tafenoquine Clinical Trials 1998 – 2002. See attached:

150724_Summary_SMcCarthy_ClinicalTrials

Data Sources

  1. Mefloquine http://www.defence.gov.au/Health/HealthPortal/Malaria/Anti-malarial_medications/Mefloquine/default.asp
  2. Randomized, double-blind study of the safety, tolerability, and efficacy of tafenoquine versus mefloquine for malaria prophylaxis in nonimmune subjects https://www.ncbi.nlm.nih.gov/pubmed/19995933
  3. Summary of ADF Mefloquine and Tafenoquine Clinical Trials 1998 – 2002 https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Foreign_Affairs_Defence_and_Trade/Mefloquine/Submissions
  4. TGA Approvals for Australian Defence Force Use of Mefloquine in Townsville (Queensland) and Somalia, 1992-93 https://www.righttoknow.org.au/request/tga_approvals_for_australian_def

Measles in Australia (as at 18th April 2019)

I’ve been watching the news about various measles outbreaks across the globe and wondered how badly Australia had been impacted (or infected). After reading a few articles it dawned on me that no single entity looked after the data as it was a state or territory issue and each state reported infectious diseases differently. Not best practice for highly infectious diseases.

In terms of the measles numbers for Australia. I have put a tentative number of 109 across all states and territories. That eclipses last year’s total of 103 cases and the 81 cases recorded in 2017.

190418_Infographic_Measles_Australia

The State by State breakdown with links

If we have broken the measles record for recent years in the first four months one can only guess at the eventual total. One to watch…

Ebola in the Democratic Republic of Congo 4 April – 22 May 2018

The World Health Organisation updated its Ebola virus disease – Democratic Republic of the Congo Disease Outbreak News on Wednesday with numbers to Tuesday. The DR Congo Ministry of Health updated its numbers today with data to Wednesday presenting some new numbers including the invalidation of eight previously reported community deaths which occurred pre-outbreak.

Ian Mackay has broken down the numbers for us in an easy tweet. They are:

#Ebola numbers for 22MAY2018 from DRC MOH…

  • total: 58 (+0 from last report)
  • confirmed: 30 (+2)
  • suspect: 14 (+5)
  • probable: 14 (-7)
  • fatal: 22 (38%; -5)
  • Wangata: 10 (+3 suspect; +2 deaths)
  • Iboko: 24 (+6 suspect)
  • Bikoro: 24 (+3 suspect)

Those numbers in a infographic which details the cases/fatalities by territory (rather than Health Zone). Iboko Health Zone lies within Bikoro Territory:

180524_Infographic_EbolaInDRC

The World Health Organisation data via its latest Disease Outbreak News. Ebola virus disease – Democratic Republic of the Congo. Excerpt:

On 8 May 2018, the Ministry of Health (MoH) of the Democratic Republic of the Congo declared an outbreak of Ebola virus disease (EVD). This is the ninth outbreak of Ebola virus disease over the last four decades in the country, with the most recent outbreak occurring in May 2017.

Since the last Disease Outbreak News on 17 May 2018, an additional fourteen cases with four deaths have been reported. On 21 May 2018, eight new suspected cases were reported, including six cases in Iboko Health Zone and two cases in Wangata Health Zone. On 20 May, seven cases (reported previously) in Iboko Health Zone have been confirmed. Recently available information has enabled the classification of some cases to be updated.

As of 21 May 2018, a cumulative total of 58 Ebola virus disease (EVD) cases, including 27 deaths (case fatality rate = 47%), have been reported from three health zones in Equateur Province. The total includes 28 confirmed, 21 probable and 9 suspected cases from the three health zones: Bikoro (n=29; ten confirmed and 19 probable), Iboko (n=22; fourteen confirmed, two probable and six suspected cases) and Wangata (n=7; four confirmed and three suspected case). Of the four confirmed cases in Wangata, two have an epidemiological link with a probable case in Bikoro from April 2018. As of 21 May, over 600 contacts have been identified and are being followed-up and monitored field investigations are ongoing to determine the index case. Three health care workers were among the 58 cases reported.

Ebola in the Democratic Republic of Congo 4 April – 15 May 2018

The World Health Organisation has updated its Ebola virus disease – Democratic Republic of the Congo Disease Outbreak News which include Epidemic Curve chart and a map illustrating the Health Zones impacted.

Currently there are 40-cases in Bikoro Territory (2-confirmed, 20-probable & 18-suspect) and I’ve assumed that all 23 reported fatalities have occurred in that territory based on the most recent reporting although this has not been confirmed by the WHO in this update.

Note: If all the 23 fatalities have occurred in Bikoro Territory that puts the CFR at 57.5%. However, if all the fatalities have occurred in the smaller Bikoro Health Zone the CFR then spikes to 65.7%. There have also been four cases reported in Wangata Territory including two brothers who travelled to Bikoro for a wedding. This places those four within the environs of Mbandaka, a city of 1.2 to 1.5-million.

WHO are also reporting three Health Care Workers among the 44 infected without providing any further information.

All the cases to date have occurred in Equateur Province which is represented in the infographic below:

180515_Infographic_EbolaInDRC

The World Health Organisation data via Ebola virus disease – Democratic Republic of the Congo. Excerpt:

Since the last Disease Outbreak News on 14 May 2018, an additional five cases, including one laboratory-confirmed case from the city of Mbandaka, Wangata health zone, have been notified by the country’s Ministry of Health. Wangata health zone is one of three health zones in Mbandaka City, which has a population of approximately 1.5 million people. Recently available information has enabled the classification of some cases to be updated1.

From 4 April through 15 May 2018, a cumulative total of 44 Ebola virus disease (EVD) cases including 23 deaths (CFR = 52%) have been reported from three health zones in Equateur Province. The total includes three confirmed, 20 probable and 21 suspected cases from the three health zones, Bikoro (n=35; two confirmed, 18 probable and 15 suspected cases), Iboko (n=5; two probable and three suspect cases) and Wangata (n=4; one confirmed, and three suspect cases). Of the four cases in Wangata, two have an epidemiological link with a probable case in Bikoro from April 2018. As of 15 May, 527 contacts have been identified and are being followed-up and monitored. Three health care workers were among the 44 cases reported. Figure 1 shows the date of notification (date of illness onset not yet available for most cases) for 27 cases with available data from 5 May through 15 May 2018. Figure 2 shows the location of cases by health zone.

Ebola in the Democratic Republic of Congo 4 April – 13 May 2018

The World Health Organization has updated its Disease Outbreak News (DON) on the Ebola outbreak which has data updated to the 13th May 2018. I missed the initial DON but the most recent news is both good and bad. Good in that WHO has immediately ramped up efforts to stem this latest outbreak including deploying the Ebola vaccine but also bad because the two probable cases in the Wangata territory are on the outskirts of a large population centre (Mbandaka – population 1.2-million).

The DON breaks down the cases by Health Zones. Currently those cases listed in Bikoro and Ikoko Health Zones lie within Bikoro Territory while the Wangata Territory encompasses the city of Mbandaka and surrounds. The Case Fatality Rate for Bikoro Territory is 51.3%. All the cases so far have occurred in Equateur Province. Infographic below:

180513_Infographic_EbolaInDRC

The data for this infographic was supplied by the World Health Organization via Disease Outbreak News 14 May 2018 – Ebola virus disease – Democratic Republic of the Congo. Excerpt:

Since the publication of the first Disease Outbreak News on the Ebola outbreak in Equateur province, Democratic Republic of the Congo on 10 May 2018, an additional seven suspected cases have been notified by the country’s Ministry of Health. Importantly, since the last update, cases have been reviewed and reclassified, and some discarded.

From 4 April through 13 May 2018, a total of 39 Ebola virus disease cases have been reported, including 19 deaths (case fatality rate = 49%) and three health care workers. Cases were reported from the Bikoro health zone (n=29; two confirmed, 20 probable and 7 suspected cases), Iboko health zone (n=8; three probable and five suspected cases) and Wangata health zone (n=2; two probable cases). To date, 393 contacts have been identified and are being followed-up. Wangata health zone is adjacent to the provincial port city of Mbandaka (population 1.2 million). Response teams on the ground are in the process of verifying information on reported cases. Case numbers will be revised as further information becomes available.

Random Analytica: Rift Valley Fever 2000 to January 21, 2018

Over the African summer there have been several small outbreaks of Rift Valley Fever in both South Sudan and Uganda. In Yirol East, Eastern Lakes District in South Sudan an outbreak has resulted in six confirmed cases with three deaths. In Uganda there have been five cases spread over a wide area in that countries cattle corridor resulting in five cases and four deaths.

Here are the key facts about Rift Valley Fever via the World Health Organisation (updated July 2017).

  • • Rift Valley fever (RVF) is a viral zoonosis that primarily affects animals but can also infect humans.
  • • The majority of human infections result from contact with the blood or organs of infected animals.
  • • Human infections have also resulted from the bites of infected mosquitoes.
  • • To date, no human-to-human transmission of RVF virus has been documented.
  • • The incubation period (the interval from infection to onset of symptoms) for RVF varies from 2 to 6 days.
  • • Outbreaks of RVF in animals can be prevented by a sustained programme of animal vaccination.

While most human cases are relatively mild, a small percentage of patients develop a much more severe form of the disease. This usually appears as 1 or more of 3 distinct syndromes: ocular (eye) disease (0.5–2% of patients), meningoencephalitis (less than 1% of patients) or haemorrhagic fever (less than 1% of patients).

According to WHO, since 2000 there have been 15 significant outbreaks of Rift Valley Fever which have impacted 13-countries and at least one case was exported to China.

Here is a look at the Rift Valley Fever outbreaks by country since 2000.

RiftValleyFever - 180121

NOTE: The 2007 Sudan outbreak occurred prior to the creation of South Sudan but the outbreak was limited to districts within modern day Sudan.

The latest South Sudan update via the World Health Organisation. Integrated Disease Surveillance and Response (IDSR). Epidemiological Update W2 2018 (Jan 8-Jan 14). Excerpt (from page 14):

Epidemics – Update (RVF, Yirol East)

A Rift Valley Fever (RVF) outbreak reported in Thonabutkok village, Yali Payam, Yirol East county with the initial case dating back to 7 December 2017.

As of 21 January 2018, a total of 15 suspect RVF human cases have been reported in Eastern Lakes State. Out of the 15 suspect human cases reported since 7 December 2017, three human cases have been confirmed, three died and were classified as probable cases with epidemiological linkage to the three confirmed cases, four were classified as none-cases following negative laboratory results for RVF, and laboratory testing is pending for the other five suspect cases.

At the moment – field investigation (human, animal, entomological) are ongoing; supportive care to suspect cases; and social mobilisation and risk communication. Discussions on a joint Ministry of Health and Ministry of Livestock and Fisheries outbreak declaration are ongoing at the highest levels of Government.

The latest Uganda update again via the World Health Organisation. Government of Uganda confirms outbreak of Crimean-Congo hemorrhagic and Rift Valley fevers. Excerpt:

The Ministry of Health in Uganda confirmed an outbreak of the Crimean-Congo Hemorrhagic Fever and Rift Valley Fever in Nakasseke and Luwero respectively.

Regarding RVF, a total of five patients including four deaths have been confirmed in this outbreak. Cases have been sporadic, with no epidemiological link, and are spread out in diverse geographical areas in the cattle corridor. This is the second time RVF cases are confirmed in Uganda.

During a press conference at the Uganda Media Centre, the Minister of Health, Dr Jane Ruth Aceng informed the media that the government has employed rapid interventions to manage and control the outbreaks. She also revealed that a National Rapid Response Team of expert epidemiologists, clinicians, veterinarians, communicators and laboratory specialists was deployed in the affected districts to establish and support the response structures.

 

Random Analytics: Top 10 Ebola Outbreaks and West Africa

After a six month sabbatical I’m dipping my toe back into Random Analytics (and by default my passion for amateur epidemiology).

Last week the World Health Organisation released its latest Ebola Situation Report – 15 July 2015 which has demonstrated that although the disease has stopped it momentous attrition within West Africa it hasn’t entirely gone away. As we learnt from the initial outbreak in late 2013 one case can turn into many hundreds, then many thousands and finally some tens of thousands in a very short space of time.

The WHO notes:

There were 30 confirmed cases of Ebola virus disease (EVD) reported in the week to 12 July: 13 in Guinea, 3 in Liberia, and 14 in Sierra Leone. Although the total number of confirmed cases is the same as the previous week, there has been a shift in the foci of transmission. For the first time in several months, most cases were reported from Conakry and Freetown, the capitals of Guinea and Sierra Leone, respectively. All 9 of the cases reported from Conakry and all 10 of the cases reported from Freetown were either registered contacts of a previous case or have an established epidemiological link to a known chain of transmission. One of the 30 cases reported in the week to 12 July arose from a yet unknown source of infection. However, a substantial proportion of cases (7 of 30: 23%) continue to be identified as EVD-positive only after post-mortem testing. This suggests that although improvements to case investigation are increasing our understanding of chains of transmission, contact tracing, which aims to minimise transmission by identifying symptoms among contacts at the earliest stage of infection, is still a challenge in several areas.

As the following chart demonstrates the 2013-15 West African Ebola Zaire outbreak has eclipsed all previous Ebola events.

1 - Ebola_Top10Outbreaks_150717

Even as the disease has left the pages of most Western newspapers and television screens the scale of the event and the ongoing transmission is still frightening. Consider just these three data points:

  1. Based on current Case Numbers alone the West African outbreak is 65-times greater than the next largest outbreak (the Ebola Sudan outbreak in Uganda in 2000);
  2. The West African outbreak currently is 11-times greater than ALL previous outbreaks combined (total cases prior to the West African plus the 2014 DRC outbreak totalled 2470 while the current outbreak cases total 27,678);
  3. In the past week of reporting the total case count (30) was just under half of the 10th worst outbreak of Ebola recorded in Gabon back in 2001 and greater than the 13 of the 30 historical outbreaks/events across the world to date.

Not all of us have forgotten West Africa.

 

Data Sources

[1] WHO. Ebola Situation Report – 15 July 2015. Accessed 17 July 2015.

Random Analytics: West African Ebola Outbreak (to 5 Nov 2014)

The World Health Organisation (WHO) has updated it latest advice on the Ebola Outbreak. Ebola Response Roadmap Situation Report 7 November 2014. Summary:

A total of 13 268 confirmed, probable and suspected cases of Ebola virus disease (EVD) have been reported in six currently affected countries (Guinea, Liberia, Mali, Sierra Leone, Spain, the United States of America) and two previously affected countries (Nigeria, Senegal) up to the end of 4 November 2014. There have been 4960 reported deaths.

Following the WHO Ebola Response Roadmap structure, country reports fall into two categories: 1) those with widespread and intense transmission (Guinea, Liberia, and Sierra Leone); and 2) those with or that have had an initial case or cases, or with localized transmission (Mali, Nigeria, Senegal, Spain, and the United States of America).

Here are three charts/infographics of the West African Outbreak with data confirmed by WHO to 5 November 2014.

01 - Ebola_WAfricaOutbreakTableau_141108

The West African Ebola Outbreak (2013-2014) infographic details the cases, fatalities, provisional Case Fatality Rate (CFR) and health spend per capita in 2012 $USD.

The data point of interest for me in the past fortnight has been the revision in numbers that WHO has provided. In the most recent update case numbers in Sierra Leone have been significantly revised down, while in Liberia where cases are on the apparent wane the numbers were revised upwards. Data for Mali has been included in this update.

02 - Ebola_WAfricaOutbreakChart_141108

The West African Ebola Outbreak (by Nation) chart looks at the split between those recovered or still in treatment (highlighted by flag) and those deceased (in red).

A data point of interest here is the case difference between Sierra Leone and Guinea yet a similar amount of deaths. Provisional CFR is Sierra Leone is 23.2% compared to Guinea which is a much higher 59.9%. Surely that can’t be correct?

03 - WestAfrica_Cases~FatalitiesMonth_141108

The West African EVD Outbreak – All Cases/Fatalities by month details the epidemiological curve of the outbreak from March 2014 when the first cases and deaths became apparent. Each column is visualised by the flag of the eight impacted countries. Note: Due to revisions in late October as provided by WHO I have finalised the October numbers as at 2 November.

The data point of interest in the last chart is the epidemic curve differences between cases (still rising) and deaths (decreasing). I would have expected that both should increase or decrease in tandem. I suspect missing data would account for the anomaly.

Summary

I’ll update and post my charts again when the data becomes available for the entirety of November. In the meantime if you want to keep across the West African outbreak detail via some alternate sources then I would recommend Crawford Kilian and for more regular epidemiological posts Maia Majumder, MPH and Ian Mackay, PhD.

 

Data Sources

[1] World Bank. Health expenditure per capita (current US$). Accessed 8 November 2014.
[2] World Health Organisation. WHO: Ebola Response Roadmap Situation Report 7 November 2014. Accessed 8 November 2014.

Random Analytics: West African Ebola Outbreak (to 18/19 Oct 2014)

The World Health Organisation (WHO) has updated it latest advice on the Ebola Outbreak. Ebola Response Roadmap Situation Report 22 October 2014. Summary:

Summary

A total of 9936 confirmed, probably, and suspected cases of Ebola virus disease (EVD) have been reported in five affected countries (Guinea, Liberia, Sierra Leone, Spain, and the United States of America) and two previously affected countries (Nigeria and Senegal) up to the end of 19 October. A total of 4877 deaths have been reported.

The outbreaks of EVD in Senegal and Nigeria were declared over on 17 October and 19 October 2014, respectively.

EVD transmission remains persistent and widespread in Guinea, Liberia, and Sierra Leone. All but one administrative district in Liberia and all administrative districts in Sierra Leone have now reported at least one confirmed or probably case of EVD since the outbreak began. Cases of EVD transmission remain lowest in Guinea, but case numbers are still very high in absolute terms. Transmission remains intense in the capital cities of the three most affected countries. Case numbers continue to be under-reported, especially from the Liberian capital Monrovia.

Of the countries with localized transmission, both Spain and the United States continue to monitor potential contacts. On 21 October the single patient with EVD in Spain tested negative for the disease for a second time. Spain will be declared free of EVD 42 days after the date of the second negative test unless a new case arises during that period.

On 22 October 2014, WHO convened the third Emergency Committee on Ebola under the International Health Regulations (2005).

Here are three charts or infographics of the West African Outbreak with data confirmed by WHO to 18/19 October 2014.

01 - Ebola_WAfricaOutbreakTableau_141023

 

The West African Ebola Outbreak (2013-2014) infographic details the cases, fatalities, the provisional Case Fatality Rate (CFR) and health spend per capita in 2012 $USD.

Midway through October the biggest data find for me has been the difference between the index cases in Senegal and the United States. Lots of similarities but IMO four very important differences:

  1. Both cases entered the country without disclosing the possibility that they may have been exposed to Ebola;
  2. Both cases presented to hospital shortly after arrival in the destination country;
  3. Difference One: In the case of Thomas Eric Duncan who travelled to the USA he presented at hospital but was released back into the community. He presented again three days later (interestingly a key and important fact left out of the official CDC Overview) with more extreme symptoms. In the Senegal case the patient sought treatment in Dakar giving no indication he may have Ebola but was not released and a day later Senegalese authorities linked him to other cases. He was subsequently quarantined;
  4. Difference Two: In the USA contract tracing was slow to be implemented while PPE protocols were inadequate which resulted in the spread of the disease amongst Health Care Workers (HCW). In Senegal no HCW were infected.
  5. Difference Three: The USA index case died of the disease; potentially due to those critical days where he was without care while in Senegal the patient recovered and has returned to Guinea.
  6. Difference Four (and this is the key one which you can see in the infographic): The average health spend per capita in the USA is $8,895 (in 2012 $USD money) while Senegal makes do with just $51 per person. That’s 174 times less than the USA.

02 - Ebola_WAfricaOutbreakChart_141023

The West African Ebola Outbreak (by Nation) chart looks at the split between those recovered or still in treatment and those deceased. As per the latest update from WHO there is an element of underreporting going on in the worst impacted countries (Liberia, Sierra Leone and Guinea).

03 - WestAfrica_Cases~FatalitiesMonth_141023

The West African EVD Outbreak – All Cases/Fatalities by month details the epidemiological curve of the outbreak from March 2014 when the first cases and deaths became apparent. Each column is visualised by the flags of the seven impacted countries.

The mid-month data-find from this chart is that the epidemic curve in relation to deaths continues to increase month on month yet the case load seems to be pulling back. All the anecdotal evidence coming out of West Africa points to an increasing, rather than a decreasing case load as individuals, families and population centres avoid health care facilities. In past months, the case load mid-month would be approximately equal to the previous month. Best case scenario would be that West Africa is getting on top of the disease but the facts-on-the-ground don’t support this. I’d expect to see some revisions to the data in coming weeks and months.

Summary

I’ll update and post my charts again when the data becomes available for the entirety of October. In the meantime if you want to keep across the West African outbreak detail via some alternate sources then I would recommend Crawford Kilian and for more regular epidemiological posts Maia Majumder, MPH and Ian Mackay, PhD.

 

Data Sources

[1] World Bank. Health expenditure per capita (current US$). Accessed 23 October 2014.
[2] World Health Organisation. WHO: Ebola Response Roadmap Situation Report 22 October 2014. Accessed 23 October 2014.