Ebola news 10/6

[Buster's Uncle]

How Do Doctors Test for Ebola?
LiveScience.com
By Tanya Lewis, Staff Writer  1 hour ago



Scientists working with Ebola must work in Biosafety Level 4 conditions, like those this CDC scientist is working under.



Health officials are now monitoring 50 people in Texas for signs of Ebola, via twice-daily temperature checks, and in recent days, there have been reports that people in other areas of the country — most recently, Washington, D.C. — may be infected with the virus.

But why can't all these people just be tested for Ebola as soon as possible?

Ebola is difficult to diagnose when a person is first infected because the early symptoms, such as fever, are also symptoms of other diseases, such as malaria and typhoid fever.

"The symptoms are extremely nonspecific in the beginning — Ebola looks like almost anything," said Dr. Bruce Hirsch, an infectious-disease specialist at North Shore University Hospital in Manhasset, New York.


Who could have it?

The main question doctors consider is whether the person has been in one of the countries in West Africa experiencing the current Ebola outbreak (Guinea, Sierra Leone or Liberia) within the last 21 days, which is the incubation period of the virus, Hirsch told Live Science. Or, whether that person has been exposed to someone has been one of those places, he added.

Earlier this week, a man in Texas became the first person to be diagnosed with Ebola in the United States, after traveling to Dallas from Liberia. The patient sought medical care but was initially sent home, before being admitted to a hospital in Dallas and testing positive for the virus.

Ebola spreads via contact with the blood or bodily fluids of an infected person, objects contaminated with those fluids or contact with infected animals; it does not spread through the air. Symptoms of the disease include a fever greater than101.5 degrees Fahrenheit (38.6 degrees Celsius), severe headache, muscle pain, diarrhea, vomiting, abdominal pain or unexplained hemorrhage, according to the Centers for Disease Control and Prevention (CDC).

If a person shows these symptoms and has been in an area with Ebola within the past 21 days, they should be put in isolation and tested for Ebola, the CDC says.


Tests for Ebola

A number of tests can be used to diagnose Ebola within a few days of the onset of symptoms, which can detect the virus's genetic material or the presence of antibodies against the pathogen.

The most accurate of these is likely the polymerase chain reaction (PCR) test, a technique that looks for genetic material from the virus and creates enough copies of it that it can be detected, Hirsch said. "PCR is a really definitive test," Hirsch said. It can pick up very small amounts of the virus.

However, this test can be negative during the first three days an infected person has symptoms, said Dr. Sandro Cinti, an infectious-disease specialist at the University of Michigan Hospital System/Ann Arbor VA Health System.

"Somebody could be in the hospital for three to five days before a diagnosis [of Ebola] is confirmed," Cinti told Live Science. "The important thing is keeping the patient isolated until you can get to a diagnosis." Meanwhile, doctors will be running tests to rule out other diseases, such as malaria, which can be detected more quickly than Ebola, he said.

Another test for Ebola looks for antibodies produced by the body's immune system in response to the virus. Known as the antigen-capture enzyme-linked immunosorbent assay (ELISA), this test can take even longer than three days to give a positive result for an infected person, Cinti said. And antibodies can also be detected after a patient recovers, he added.

Once a patient is diagnosed with Ebola, scientists may attempt to isolate the virus — which is a type of filovirus, known for their filamentlike shape — by culturing it with living cells and examine it using electron microscopy. But culturing Ebola is very dangerous, and should only be done in a high-biosafety-level lab, Hirsch said. Culturing the virus is not a practical means of diagnosing infection, but may help researchers understand how the virus infects cells and test possible treatments.

So, given the severity of an Ebola infection, why wouldn't you test everybody with the remotest chance of having the disease?

A huge number of people come to the United States from Africa with fevers, Cinti said, and testing all of them for Ebola would drain hospital resources and raise unnecessary panic. "We really have to be clear and get good histories about exposure," he said. "It makes absolutely zero sense to test people who aren't from high-risk areas."


http://news.yahoo.com/doctors-test-ebola-144531104.html

[Buster's Uncle]

Hospital: Ebola virus survivor not infected again
Associated Press
13 hours ago



Former Ebola patient Dr. Richard Sacra participates in a news conference at the Nebraska Medical Center in Omaha, Neb., in this Thursday, Sept. 25, 2014 file photo. The Massachusetts doctor and missionary who was successfully treated for Ebola he contracted in Africa is back in the hospital Saturday Oct. 4, 2014 with what appears to be a respiratory infection, but doctors don't suspect a recurrence of the virus. (AP Photo/Nati Harnik, File)



WORCESTER, Mass. (AP) — A Massachusetts doctor who is back in the hospital after he was successfully treated for the Ebola virus last month isn't infected again with it, hospital officials said Sunday.

UMass Memorial Medical Center said test results for Dr. Rick Sacra came back negative for the virus, and the federal Centers for Disease Control and Prevention confirmed that Sacra's symptoms were not due to Ebola.

Sacra was admitted to the hospital for observation on Saturday after he came in complaining of a cough and low-grade fever. Doctors said he was in stable condition and they did not suspect he was suffering a recurrence of Ebola virus but put him in isolation as a precaution, while awaiting test results from the CDC.

The CDC informed the hospital Sunday evening that testing for Sacra came back negative, hospital spokeswoman Peggy Thrappas said in a news release. She said Sacra would be removed from isolation and would continue to receive routine care for an upper respiratory tract infection.

Sacra, of Holden, contracted the virus while working in Africa. He returned to Massachusetts on Sept. 25 after weeks of treatment at an Omaha, Nebraska, hospital.

Dr. Robert Finberg, who is leading Sacra's medical team, said at a news conference earlier Sunday that doctors were confident Sacra's symptoms were not related to the Ebola virus he contracted in Africa. Finberg and hospital President Patrick Muldoon also stressed there was no threat to the public.

"People are very concerned, that's why we're being extremely cautious," Finberg said. "We're not taking risks with Dr. Sacra and his caregivers."

Asked why doctors believe Sacra's symptoms were not related to Ebola, Finberg said he was not aware of any case of Ebola recurring in surviving patients, and Sacra was feeling better and eating.

"People with Ebola don't feel like eating. They feel like throwing up," Finberg said. "The fact that he's eating and he feels pretty good, I think is a very good sign."

Finberg said Sacra was just being responsible when he decided to go a hospital when he started feeling bad.

Sacra spent much of the last two decades in Liberia, working with a missionary group. He also works at Family Health Center of Worcester.


http://news.yahoo.com/hospital-monitoring-doctor-cleared-ebola-virus-065708436.html

[Buster's Uncle]

Nurse at Spain hospital contracts Ebola
AFP
34 minutes ago



A Spanish Defense Ministry photo shows aid workers and doctors transferring Catholic missionary Manuel Garcia Viejo, who contracted the deadly Ebola virus, upon his arrival in Spain on September 22, 2014 (AFP Photo/)



Madrid (AFP) - In what is believed to be the first infection outside of Africa, an assistant nurse at a Madrid hospital where two Ebola patients died has contracted the virus herself, health officials said Monday.

"Two tests were done and the two were positive," a spokesman for the health department of the regional government of Madrid told AFP.

The woman works at Madrid's La Paz-Carlos III hospital where two missionaries who were repatriated from Africa with Ebola died from the disease, a spokeswoman for the hospital said.

"We do not know yet if she treated any of the two missionaries," the spokeswoman told AFP.

Spanish priest Miguel Pajares, 75, was infected with Ebola in Liberia and died at the hospital on August 12.

Another Spanish missionary, Manuel Garcia viejo, 69, was repatriated from Sierra Leone and died at the hospital on September 25.

The Ebola epidemic that has been raging in west Africa has so far claimed almost 3,500 lives, with Liberia, Guinea and Sierra Leone worst hit.

There is no licensed treatment or vaccine for Ebola. Of several prototype treatments in the pipeline, one dubbed ZMapp has been fast-tracked for use, developed by Mapp Biopharmaceutical in California, in conjunction with the US Army.


http://news.yahoo.com/first-outside-africa-nurse-spain-hospital-contracts-ebola-174043185.html

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High risk Ebola could reach France and UK by end-October, scientists calculate
Reuters
By Kate Kelland  16 hours ago



Health workers, wearing head-to-toe protective gear, prepare for work outside an isolation unit in Foya District, Lofa County, Liberia, July 2014. REUTERS/Ahmed Jallanzo



LONDON, Oct 5 (Reuters) - Scientists have used Ebola disease spread patterns and airline traffic data to predict a 75 percent chance the virus could be imported to France by October 24, and a 50 percent chance it could hit Britain by that date.

Those numbers are based on air traffic remaining at full capacity. Assuming an 80 percent reduction in travel to reflect that many airlines are halting flights to affected regions, France's risk is still 25 percent, and Britain's is 15 percent.

"It's really a lottery," said Derek Gatherer of Britain's Lancaster University, an expert in viruses who has been tracking the epidemic - the worst Ebola outbreak in history.

The deadly epidemic has killed more than 3,400 people since it began in West Africa in March and has now started to spread faster, infecting almost 7,200 people so far. Nigeria, Senegal and now the United States - where the first case was diagnosed on Tuesday in a man who flew in from Liberia - have all seen people carrying the Ebola hemorrhagic fever virus, apparently unwittingly, arrive on their shores.

France is among countries most likely to be hit next because the worst affected countries include Guinea, alongside Sierra Leone and Liberia, which is a French-speaking country and has busy travel links back, while Britain's Heathrow airport is one of the world's biggest travel hubs.

France and Britain have each treated one national who was brought home with the disease and then cured. The scientists' study suggests that more may bring it to Europe not knowing they are infected.

"If this thing continues to rage on in West Africa and indeed gets worse, as some people have predicted, then it's only a matter of time before one of these cases ends up on a plane to Europe," said Gatherer.

Belgium has a 40 percent chance of seeing the disease arrive on its territory, while Spain and Switzerland have lower risks of 14 percent each, according to the study first published in the journal PLoS Current Outbreaks and now being regularly updated at http://www.mobs-lab.org/ebola.html.

The World Health Organization (WHO) has not placed any restrictions on travel and has encouraged airlines to keep flying to the worst-hit countries. British Airways and Emirates airlines have suspended some flights

But the risks change every day the epidemic continues, said Alex Vespignani, a professor at the Laboratory for the Modeling of Biological and Socio-Technical Systems at Northeastern University in Boston who led the research.

"This is not a deterministic list, it's about probabilities - but those probabilities are growing for everyone," Vespignani said in a telephone interview. "It's just a matter of who gets lucky and who gets unlucky."

The latest calculations used data from October 1.

"Air traffic is the driver," Vespignani said. "But there are also differences in connections with the affected countries (Guinea, Liberia and Sierra Leone), as well as different numbers of cases in these three countries - so depending on that, the probability numbers change."


PATIENTS UNAWARE

Patients are at their most contagious when Ebola is in its terminal stages, inducing both internal and external bleeding, and profuse vomiting and diarrhea - all of which contain high concentrations of infectious virus.

But the disease can also have a long incubation period of up to 21 days, meaning that people can be unaware for weeks that they are infected, and not feel or display any symptoms.

This, it seems, is what allowed the Liberian visitor Thomas Eric Duncanto to fly to the United States and spend several days there unaware that he was carrying the deadly virus, before being diagnosed and isolated.

In the European Union, free movement of people means someone unknowingly infected with Ebola could easily drive through several neighboring countries before feeling ill and seeking help, and spend weeks in contact with friends or strangers before becoming sick enough to show up on airport scanners.

Jonathan Ball, a professor of molecular virology at Britain's Nottingham University said that even with exit screening at airports of affected countries, the long, silent incubation period meant "cases can slip through the net".

"Whilst the risk of imported Ebola virus remains small, it's still a very real risk, and one that won't go away until this outbreak is stopped," he said. "Ebola virus isn't just an African problem."

However, the chance of the disease spreading widely or developing into an epidemic in a wealthy, developed country is extremely low, healthcare specialists say.

According to the latest Ebola risk assessment from the European Centers of Disease Prevention and Control, which monitors health and disease in the region, "the capacity to detect and confirm cases... is considered to be sufficient to interrupt any possible local transmission of the disease early."

Gatherer cited Nigeria as an example of how Ebola can be halted with swift and detailed action.

Despite being in West Africa and being home to one of the world's most crowded, chaotic cities, Nigeria has managed to contain Ebola's spread to a total of 20 cases and 8 deaths, and looks likely to be declared free of the virus in coming weeks.

"Even if we have a worse case scenario where someone doesn't present for medical treatment, or... it's not correctly identified as Ebola, and we get secondary transmission, it's not likely to be a very long secondary transmission chain," he said.

"People aren't living in very crowded conditions (in Europe), so the disease doesn't have the same environment it has in a shanty town in Monrovia, where the environment is perfect for it to spread. It's a different matter in modern western cities with the very sanitized, sterile lives that we live."

(Refiled to clarify paragraph five)

(Editing by Sophie Walker)


http://news.yahoo.com/high-risk-ebola-could-reach-france-uk-end-060511398.html

[Buster's Uncle]

New concern worldwide as nurse in Spain gets Ebola
Associated Press
By CONNIE CASS and LAURAN NEERGAARD  55 minutes ago



The parents of a U.S. video journalist who contracted Ebola in Liberia spoke at a press conference Monday after his arrival at the Nebraska Medical Center in Omaha. They said they tried to talk their son out of it be he couldn't be dissuaded. (Oct. 6)



WASHINGTON (AP) — Raising fresh concern around the world, a nurse in Spain on Monday became the first person known to catch Ebola outside the outbreak zone in West Africa. In the U.S., President Barack Obama said the government was considering ordering more careful screening of airline passengers arriving from the region.

In dealing with potential Ebola cases, Obama said, "we don't have a lot of margin for error."

Already hospitalized in the U.S., a critically ill Liberian man, Thomas Duncan, began receiving an experimental drug in Dallas. But there were encouraging signs for an American video journalist who returned from Liberia for treatment. Ashoka Mukpo, 33, was able to walk off the plane before being loaded on a stretcher and taken to an ambulance, and his father said his symptoms of fever and nausea appeared mild.

"It was really wonderful to see his face," said Dr. Mitchell Levy, who talked to his son over a video chat system at Nebraska Medical Center.

In Spain, the stricken nurse had been part of a team that treated two missionaries flown home to Spain after becoming infected with Ebola in West Africa. The nurse's only symptom was a fever, but the infection was confirmed by two tests, Spanish health officials said. She was being treated in isolation, while authorities drew up a list of people she had had contact with.

Medical workers in Texas were among Americans waiting to find out whether they had been infected by Duncan, the African traveler.



A plane carrying an American photojournalist who contracted Ebola while working in Liberia landed Monday in Nebraska, where he will undergo treatment for the deadly disease. (Oct. 6)


In Washington, the White House continued to rule out any blanket ban on travel from West Africa.

People leaving the outbreak zone are checked for fevers before they're allowed to board airplanes, but the disease's incubation period is 21 days and symptoms could arise later.

Airline crews and border agents already watch for obviously sick passengers, and in a high-level meeting at the White House, officials discussed potential options for screening passengers when they arrive in the U.S. as well.

Obama said the U.S. will be "working on protocols to do additional passenger screening both at the source and here in the United States." He did not outline any details or offer a timeline for when new measures might begin.

Additional screening would not have caught Duncan because he wasn't exhibiting any Ebola symptoms when he arrived in the U.S.



Vice President Joe Biden attends via teleconference, right through microphone booms, as President Barack Obama meets with members of his national security team and senior staff to receive an update on the Ebola outbreak in West Africa, Monday, Oct. 6, 2014, in the Roosevelt Room of the White House in Washington. Back row, from left are, Health and Human Services Secretary Sylvia Burwell, the president, and Assistant to the President for Homeland Security and Counterterrorism Lisa Monaco. Foreground, from left are, Defense Secretary Chuck Hagel, Secretary of State John Kerry, UN Ambassador Samantha Power and White House Chief of Staff Denis McDonough. (AP Photo/Jacquelyn Martin)


The Obama administration maintains that the best way to protect Americans is to end the outbreak in Africa. To that end, the U.S. military was working Monday on the first of 17 promised medical centers in Liberia and training up to 4,000 soldiers this week to help with the Ebola crisis.

The U.S. is equipped to stop any further cases that reach this country, said White House spokesman Josh Earnest.

"The tragedy of this situation is that Ebola is rapidly spreading among populations in West African who don't have that kind of medical infrastructure," Earnest said.

About 350 U.S. troops are already in Liberia, the Pentagon said, to begin building a 25-bed field hospital for medical workers infected with Ebola. A torrential rain delayed the start of the job on Monday.

The virus has taken an especially devastating toll on health care workers, sickening or killing more than 370 in the hardest-hit countries of Liberia, Guinea and Sierra Leone — places that already were short on doctors and nurses before Ebola.



Spain's Health Minister Ana Mato pauses during a news conference on the first reported incident of Ebola transmission outside Africa, in Madrid, Spain, Monday, Oct. 6, 2014. A Spanish nurse who treated a missionary for the disease at a Madrid hospital tested positive for the virus, Mato said Monday. The female nurse was part of the medical team that treated a 69-year-old Spanish priest who died in a hospital last month after being flown back from Sierra Leone, where he was posted. (AP Photo/Paul White)


Texas Gov. Rick Perry urged the U.S. government to begin screening air passengers arriving from Ebola-affected nations, including taking their temperatures.

Perry stopped short, however, of joining some conservatives who have backed bans on travel from those countries.

Federal health officials say a travel ban could make the desperate situation worse in the afflicted countries, and White House spokesman Earnest said it was not currently under consideration.

Southwest Airlines CEO Gary Kelly said he saw no need for additional screening at airports and noted that airlines already carefully clean planes.

Airlines have dealt with previous epidemics, such as the 2003 outbreak in Asia of SARS, or severe acute respiratory syndrome.



Diana Mukpo, mother of Ashoka Mukpo, speaks to the media Monday, Oct 6, 2014, on the treatment of her son, at a news conference in Omaha, Neb. Mukpo arrived at the Nebraska Medical Center's specialized isolation unit Monday, where he will be treated for the deadly disease. He is an American video journalist who was working in Liberia as a freelance cameraman for NBC News when he became ill last week. (AP Photo/Dave Weaver)


"Now it's Ebola," Kelly said. "We are always on the alert for any kind of infectious disease."

The U.S. didn't ban flights or impose extra screening on passengers during the SARS outbreak or the 2009 swine flu pandemic. Both of those were airborne diseases that spread more easily than the Ebola virus, which is spread by contact with bodily fluids.

The CDC did meet many direct flights arriving from SARS-affected countries, to distribute health notices advising travelers that they might have been exposed, how they could monitor their health and when to call a doctor.

Canadian health authorities attempted various methods of screening arriving passengers for SARS, including sometimes checking for fever. Authorities later reported that five SARS patients entered Canada in three months, but none had symptoms while traveling through airports.

General airport fever checks aren't very effective, especially as flu season begins, said Lawrence Gostin, a prominent health law professor at Georgetown University. But checking and questioning only passengers from the outbreak zone "might reassure the public. I don't think there would be a big downside."

The SARS death rate was about 10 percent, higher for older patients. Its new relative MERS, now spreading in the Middle East, appears to be more deadly, about 40 percent. About half of people infected with Ebola have died in this outbreak.

___

Associated Press writers Jorge Sainz in Spain, David Koenig in Dallas, Josh Funk in Omaha, Matthew Perrone, Lolita Baldor and Joan Lowy in Washington, and Krista Larson and Sarah DiLorenzo in Liberia contributed to this report.


http://news.yahoo.com/us-military-put-tent-liberia-ebola-clinic-113605302.html

[Buster's Uncle]

Texas Ebola patient gets experimental drug
AFP
4 hours ago



An American photojournalist who contracted Ebola while working in Liberia is expected to arrive Monday in Nebraska where he will be treated for the virus that has ravaged West Africa.



Washington (AFP) - A Liberian man diagnosed with Ebola in Texas was given an experimental drug for the first time, officials said Monday as the White House mulled tougher airport screening at home and abroad.

Thomas Eric Duncan was given the investigational medication, brincidofovir, on Saturday, the day his condition worsened from serious to critical, said Texas Health Presbyterian Hospital Dallas.

The medication is made by the North Carolina-based pharmaceutical company Chimerix, and until now had never been tried in humans with Ebola, the company said.

However, it has been tested in about 1,000 people against adenovirus and cytomegalovirus.

The drug "works by keeping viruses from creating additional copies of themselves," Chimerix said.

Duncan is the first person to be diagnosed with Ebola in the United States, and he is believed to have become infected while in Liberia.



A cameraman films the entrance of the Ebola treatment center in Liberia where NBC cameraman Ashoka Mukpo was being treated for Ebola (AFP Photo/Pascal Guyot)


West Africa is currently battling the largest outbreak of Ebola in history, with more than 3,400 dead from the hemorrhagic virus since the start of the year.

Meanwhile, President Barack Obama was briefed by senior health and security advisors about the situation in Texas and US preparedness against Ebola.

Obama said the chances of a US Ebola outbreak were "extraordinarily low" but vowed to press world leaders to step up the global fight against the deadly epidemic in West Africa.

"We have not seen other countries step up as aggressively as they need to," Obama said.

"I'm going to be putting a lot of pressure on my fellow heads of state and government around the world to make sure that they are doing everything that they can to join us in this effort."



Dr. Mitchell Levy, father of Ashoka Mukpo, an American freelance cameraman who is diagnosed with Ebola, talks with a reporter at his home in Providence, R.I., Friday, Oct. 3, 2014. Levy's son, Ashoka Mukpo is scheduled to fly to the Nebraska Medical Center in Omaha, when he leaves Liberia. (AP Photo/Stew Milne)


He said the United States is considering tougher airport screening to ward against the spread of cases by airline travelers.

"We're also going to be working on protocols to do additional passenger screening both at the source and here in the United States," Obama told reporters.

In Nebraska, a US photojournalist who tested positive for Ebola in Liberia arrived at a hospital and was able to walk off the airplane that carried him.

"We are really happy that his symptoms are not extreme yet," Ashoka Mukpo's mother, Diana, told reporters, adding that he was feverish and nauseous.

He is being treated at the Nebraska Medical Center, the same facility that treated American missionary doctor Rick Sacra last month.

Sacra also came down with Ebola in Liberia and was treated with the Canadian firm Tekmira's Ebola drug, TKM-Ebola, as well as serum from another doctor, Kent Brantly, who had Ebola and recovered.

Brantly was treated with a drug called ZMapp, which is hard to make, and there are no doses left.

There is no market-approved drug for treating Ebola yet, and no vaccine to prevent it.


http://news.yahoo.com/cameraman-ebola-arrives-us-treatment-100200967.html