Ebola news 11/3

[Buster's Uncle]

U.S. Ebola nurse, Maine settle quarantine suit
Reuters
By Dave Sherwood and Colleen Jenkins  1 hour ago



Nurse Kaci Hickox speaks to reporters outside their home, Friday, Oct. 31, 2014, in Fort Kent, Maine. A Maine judge gave Hickox the OK to go wherever she pleases, handing state officials a defeat Friday in their bid to restrict her movements as a precaution against Ebola.( AP Photo/Robert F. Bukaty)



BRUNSWICK Maine/WINSTON-SALEM N.C. (Reuters) - The state of Maine and a nurse who had treated victims of the Ebola virus in West Africa reached a settlement deal on Monday, allowing her to travel freely in public but requiring her to monitor her health closely and report any symptoms.

The settlement, filed in nurse Kaci Hickox's home town of Fort Kent, in northern Maine, where she returned after being briefly quarantined in New Jersey, keeps in effect through Nov. 10 the terms of an order issued by a Maine judge on Friday.

Hickox returned to the United States last month after treating Ebola patients in Sierra Leone and was quarantined in a tent outside a hospital in New Jersey for four days despite showing no symptoms.

She sharply criticized the way both New Jersey Governor Chris Christie and Maine Governor Paul LePage responded to her case. Christie and LePage have defended their handling of the case.

A handful of states have imposed mandatory quarantines on health workers returning from three Ebola-ravaged West African countries, Guinea, Liberia and Sierra Leone, while the federal government is wary of discouraging potential medical volunteers.



Nurse Kaci Hickox (L) joined by her boyfriend Ted Wilbur, speaks with the media outside of their home in Fort Kent, Maine in this October 31, 2014 file photo. Hickox, who challenged quarantines of health care workers returning from treating West African Ebola patients said November 2, 2014 she thought "an abundance of politics" lurked behind them. (REUTERS/Joel Page)


The most deadly outbreak of Ebola on record has killed nearly 5,000 people, all but a handful of them in Liberia, Guinea and Sierra Leone.

A separate patient being monitored in North Carolina for Ebola after arriving in the United States last week from Liberia has so far tested negative for the disease, state health officials said on Monday, adding that the results still need to be confirmed.

The patient, who arrived at New Jersey's Newark Liberty International Airport on Oct. 31 and developed a fever on Sunday morning in North Carolina, will continue to be monitored in isolation at Duke University Hospital in Durham, officials said.

Additional testing to confirm the preliminary negative result will be conducted 72 hours after the fever began, the state's Department of Health and Human Services said in a statement.

The person, who was not identified, had no symptoms upon arrival in the United States and had no known exposure to Ebola in Liberia, the department said. It said the patient also would be evaluated for other possible causes of fever.

U.S. health care providers have been on heightened alert for potential Ebola cases, and officials in North Carolina said they had been working since the summer to prepare for the possibility of the virus being diagnosed in the state.

In the United States, some states have restricted the movements of people returning from those West African nations beyond guidelines from the U.S. Centers for Disease Control and Prevention.

Only one person in the United States is currently being treated for Ebola, a New York doctor in stable condition.

(Additional reporting by Chris Michaud and Laila Kearney in New York; Writing by Scott Malone; Editing by Susan Heavey and James Dalgleish)


http://news.yahoo.com/u-nurse-treated-ebola-patients-maine-reach-deal-155326338.html

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After botching Ebola, WHO to pick new Africa boss
Associated Press
By MARIA CHENG  20 minutes ago



In this Sunday, Oct. 19, 2014 file photo, Margaret Chan, Director General of the World Health Organization (WHO), addresses the media during a media conference in Gammarth, northeastern Tunisia. In a speech on Monday Nov. 3, 2014, Chan stayed away from any critical remarks about outgoing director of WHO Africa, Dr. Luis Sambo, and instead thanked him for his “years of dedication”. (AP Photo/Adel Ben Salah, File)



LONDON (AP) — After acknowledging that it bungled the response to the biggest Ebola outbreak in history, the World Health Organization is electing a new regional director for its Africa office this week. Critics say it's about time.

WHO Africa is widely acknowledged to be the U.N. health agency's weakest regional office. In an internal draft document obtained by the Associated Press last month, WHO blamed its staff in Africa for initially botching the response to Ebola, describing many of its regional staff as "politically-motivated appointments" and noted numerous complaints about WHO officials in West Africa.

WHO has six regional offices including Africa — all of them are largely autonomous and do not answer to the Geneva headquarters. The U.N. agency was intentionally set up as a fragmented organization in 1948 because it was feared existing regional health organizations wouldn't want to join WHO unless they had a high degree of independence.

Whoever is chosen as Africa's new WHO head probably won't have a big role in ending Ebola since the U.N. has already taken charge of control efforts, but the new director could be key to preventing similar disasters in the future.

First, its structure must be overhauled, experts say.

"Everyone working in global health knows that if you want anything done in the African region, the last people you go to is (WHO) Africa," said Kelley Lee, an associate dean in health sciences at Simon Fraser University in Canada, who has studied the governance of public health agencies. She said the WHO Africa office is plagued by a profound lack of transparency and said many top jobs are doled out as political favors.

The outgoing director of WHO Africa, Dr. Luis Sambo, rejected the need for major change when he was elected in 2005, vowing that "there will be no radical shake-up." Sambo oversaw the WHO Africa response to Ebola and has declined numerous interview requests.

Having already served two terms as regional director, he is ineligible to run again in the elections held at a committee meeting in Benin this week.

There are five candidates jostling to be the new Africa director: Jean-Marie Okwo-Bele, a Congolese doctor in charge of the vaccination program at WHO Geneva, Mali's Dr. Fatoumata Nafo Traore, director of the Roll Back Malaria partnership, Dorothee Akoko Kinde-Gazard, Benin's health minister, Therese N'Dri Yoman of Cote d'Ivoire, a past health minister, and Dr. Matshidiso Moeti of Botswana, who previously ran the country's epidemiology department.

In a report on lessons learned from Ebola released ahead of this week's meeting, the WHO Africa office said the explosive spread of the lethal virus was due to issues including poor awareness and badly trained health workers. It didn't mention several problems detailed in the internal WHO document written in Geneva, which observed that WHO staff in Africa refused to help get visas for outbreak experts to fly to Guinea and were compromising Ebola containment efforts.

Lee said WHO headquarters in Geneva should have jumped in sooner to seize control of Ebola from its Africa office, but that agency politics likely complicated that.

"There were enough voices raising the alarm outside of WHO to suggest that something exceptional was going on," she said. "Serious questions need to be asked within WHO Geneva about why these other sources were ignored for so long."

In a speech at the Benin meeting on Monday, WHO chief Dr. Margaret Chan stayed away from any critical remarks and instead thanked Sambo for his "years of dedication to WHO and to the health of the African people."

Some experts doubted that whoever is elected as new WHO Africa head would do much to change the stagnant culture there.

"There is no appetite for reform among senior WHO leaders," said Dr. Donald A. Henderson, who headed the agency's smallpox eradication efforts. He called the WHO Africa office "completely out of touch" and said it was so bereft of competent people when Ebola in Guinea was identified in March that "there was no one left to raise the alarm."

Others said the fumbled response to the Ebola epidemic has further undermined WHO's credibility.

"This Ebola outbreak should have justified WHO's existence but it has become completely sidelined and irrelevant," said Lawrence Gostin, a professor of global health law at Georgetown University. He said regional directors, including the one in Africa, should be more accountable to Geneva but couldn't see them willingly relinquishing power.

"Seeing thousands of Africans die of a preventable disease should teach us to make sure the right systems are in place to avoid a similar outbreak in the future," he said. "But if history is any guide, then crises will come and go and nothing will change."

___

Virgile Ahissou in Cotonou, Benin, contributed to this report.


http://news.yahoo.com/botching-ebola-pick-africa-boss-200518529.html

[Buster's Uncle]

Soccer-Sierra Leone again concede home advantage in Nations Cup
Reuters  5 hours ago



Nov 3 (Reuters) - Sierra Leone have again conceded home advantage in the African Nations Cup but Guinea, who are also banned from playing at home due to the Ebola virus, are not sure where they will play their last qualifying tie.

Guinea were able to move their two previous home fixtures to neutral Casablanca but now Morocco has expressed fears over the possible spread of Ebola and want to postpone the 2015 finals, the venue for their last home game against Uganda on Nov. 19 is uncertain.

It could be a decisive tie as they bid to finish in the top two in Group E and qualify for the 16-team final in Morocco.

Sierra Leone were unable to find a country willing to host their last two home games in Group D and conceded territorial advantage to Democratic Republic of Congo and Cameroon.

Now they have done the same for the match with Ivory Coast on Nov. 14.

Sierra Leone's inability to play in the capital of Freetown has meant they are virtually eliminated, with one point from four group games.

Guinea still have a chance to qualify. They visit Togo on Nov. 15, four days before meeting Uganda.

The most deadly outbreak of Ebola on record has killed nearly 5,000 people, all but a handful of them in Liberia, Guinea and Sierra Leone. (Reporting by Mark Gleeson in Cape Town, editing by Tony Jimenez; mark.gleeson@thomsonreuters.com +27828257807 Messaging mark.gleeson.thomsonreuters.com@reuters.net)


http://news.yahoo.com/soccer-sierra-leone-again-concede-home-advantage-nations-144009601--sow.html

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WHO says currently no Ebola cases in Mali, 39 contacts sought
Reuters
By Tom Miles  3 hours ago



A health worker checks the temperature of a baby entering Mali from Guinea at the border in Kouremale, October 2, 2014. REUTERS/Joe Penney



GENEVA (Reuters) - Thirty-nine people who traveled on buses with a toddler who died from Ebola in Mali are still being sought for checks, although the country is believed to be free of the disease, the World Health Organization said on Monday.

A WHO spokeswoman said 108 contacts were being followed up, including 33 health workers, but epidemiologists believe those who have not been traced are at low risk, as they are unlikely to have had physical contact with the sick two-year-old.

The girl's five-year-old sister had a fever but was suffering from malaria, not Ebola, tests showed. Other family members are under observation in the same hospital and doing well, with no fever or other symptoms, the WHO said.

Last week an epidemiological presentation showed Mali had two suspected cases of the disease, which has killed at least 4,951 people, mostly in Liberia, Sierra Leone and Guinea in the worst outbreak of the virus since it was identified in 1976.

WHO experts say that the best way to tackle the disease is to stop it in its tracks before it can spread, and finding contacts of the initial patient is crucial.

Ebola is contagious when a patient has symptoms, meaning the girl who died may have been infectious throughout her long and broken journey from Guinea, where controls are supposed to be in place to screen people for Ebola symptoms before they cross the border.

If other travelers caught the disease, their onward journeys risk spreading it in the capital Bamako or deeper into Mali, which borders Niger, Algeria, Senegal, Mauritania, Burkina Faso and Ivory Coast. None of them currently have Ebola cases.

The toddler's family - including her grandmother, uncle, great aunt and sister, will remain in quarantine for one more week before reaching the 21 days which is the maximum incubation period of the virus. If they do not develop Ebola, they will be allowed to leave the hospital.

Of the 108 contacts being followed, 79, including the 33 health workers, are in Kayes, where the girl died. The other 29 are in the capital Bamako, where she changed buses on her way from the Guinean border to Kayes.

(Reporting by Tom Miles; editing by Robert Evans and Crispian Balmer)


http://news.yahoo.com/says-currently-no-ebola-cases-mali-39-contacts-162252069.html

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Sierra Leone doctor tests positive for Ebola
Associated Press
By CLARENCE ROY-MACAULAY  November 2, 2014 11:29 AM



FREETOWN, Sierra Leone (AP) — Authorities in Sierra Leone said Sunday that another doctor there has tested positive for Ebola, marking a setback for efforts to keep desperately needed health care workers safe in the West African country ravaged by the deadly virus.

Government Chief Medical Officer Dr. Brima Kargbo confirmed on Sunday that a fifth doctor in Sierra Leone had tested positive. The other four all have died from the virus that has killed nearly 5,000 across West Africa.

The sick physician has been identified as Dr. Godfrey George, medical superintendent of Kambia Government Hospital in northern Sierra Leone. He was driven to the capital, Freetown, after reporting he wasn't feeling well.

Doctors and nurses have been the most vulnerable to contracting Ebola, as the virus is spread through bodily fluids. Some 523 health workers have contracted Ebola, and about half of them have died.

France said it was treating a U.N. employee who had contracted Ebola while working in Sierra Leone.

France's government announced in a statement late Saturday that a U.N. employee had been evacuated there by a special flight and was undergoing treatment in "high-security isolation" in the Begin Army Training Hospital in Saint-Mande, near Paris.

It didn't identify the patient or the U.N. agency where the patient works.

France previously had taken in a French medic with Doctors Without Borders in September who had Ebola. She later recovered from the infection.

___

Associated Press writer Jamey Keaten in Paris contributed to this report.


http://news.yahoo.com/sierra-leone-doctor-tests-positive-ebola-141306537.html

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U.S. scientists say uncertainties loom about Ebola's transmission, other key facts
Reuters
By Sharon Begley  32 minutes ago



(Reuters) - Even as government officials express confidence that researchers know the key facts about Ebola, many questions crucial to preventing an outbreak in the United States remain unanswered, scientists told a workshop at the National Academy's Institute of Medicine in Washington on Monday.

Virtually all the unknowns have practical consequences, participants emphasized, making it foolish and perhaps dangerous to base policy on weak science.

For instance, virologists believe that Ebola is spread when people come in contact with the virus-laden bodily fluids of those who are already sick and then touch their eyes, nose or mouth, allowing the virus to pass through mucous membranes and enter the bloodstream.

But penetration through intact skin has not been definitively ruled out, said hemorrhagic-fever expert Thomas Ksiarek of the University of Texas Medical Branch (UTMB), who co-led a session on Ebola's transmission routes.

"Does bleach or hand sanitizer," which people in West Africa are using to protect themselves from Ebola, "make the skin more susceptible" to being penetrated by the virus?, Peters wondered. "It's a question that has to be asked."



A worker in a hazardous material suit is sprayed down by a co-worker after coming out of an apartment unit where a man diagnosed with the Ebola virus was staying in Dallas, Texas, October 5, 2014. REUTERS/Jim Young


Another crucial question is whether the virus can be spread by people who do not show symptoms. For months public health officials in the United States and elsewhere have insisted it cannot.

But the possibility of such "subclinical transmission" remains very much open, said Dr. Andrew Pavia, chief of pediatric infectious diseases at the University of Utah.

Nor do experts know whether the infectious dose of virus depends on how it enters the body, Pavia said.

Also unknown is whether the time between exposure to Ebola and the appearance of symptoms depends on which bodily fluids someone contacted. If it does, then someone exposed through, say, saliva rather than blood might incubate the virus for longer than the 21 days officials have repeatedly said is the outer limit of the incubation period.

That was the longest incubation time during the 1976 Ebola outbreak, said Dr. C.J. Peters, a field virologist at UTMB. But "I would guess that 5 percent of people" can transmit the virus after incubating it for more than three weeks, said Peters, whose battle against the Ebola outbreak in a monkey colony in Virginia was recounted in Richard Preston's 1994 book "The Hot Zone."

Health officials emphasize the importance of taking the temperature of those exposed to Ebola, since people are not thought to be infectious until they run a fever of 100.4 F. (38 C). But at what temperature patients start shedding virus is not definitively known, said Dr. Michael Hodgson, chief medical officer of the Occupational Safety and Health Administration.

Environmental mysteries also remain. Scientists do not know whether foam, gas, or liquid decontaminants are most effective for cleaning surfaces that might harbor Ebola. Nor do they know whether it can survive in sewers where, said Paul Lemieux of the National Homeland Security Research Center at the Environmental Protection Agency, rats "might pick it up."

(Reporting by Sharon Begley; Editing by Cynthia Osterman)


http://news.yahoo.com/u-scientists-uncertainties-loom-ebolas-transmission-other-key-003751718--finance.html

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Fifth Sierra Leone doctor dies after contracting Ebola
Reuters  10 hours ago



A health worker prepares protective equipment near Rokupa Hospital, Freetown October 6, 2014. REUTERS/Christopher Black/WHO/Handout via Reuters



FREETOWN (Reuters) - A Sierra Leone doctor died on Monday from Ebola, making him the fifth local doctor in the West African state to have succumbed to the hemorrhagic fever that has taken a heavy toll on the country's medical personnel.

Dr Godffrey George, a medical superintendent at the Kambia Government Hospital in the north of the country, died after he tested positive for Ebola on Saturday, according to Sierra Leone's Chief Medical Officer Brima Kargbo.

"He drove himself from Kambia on Friday after he started feeling unwell and checked himself into the Chinese hospital at Jui outside Freetown," Kargbo said.

He added that George did not treat Ebola patients and might have contracted the virus through a patient he treated for another illness.

Sierra Leone is one of the countries worst affected by the largest outbreak of Ebola on record. The disease has killed 4,951 people out of 13,567 infected in eight countries.

Some 120 health workers - including nurses and other medical staff - have tested positive for the disease in Sierra Leone, with about 100 dead.

With its healthcare system still reeling from a 1991-2002 civil war, Sierra Leone had only just over 100 doctors for its 6 million people before the outbreak struck.

Many rural clinics lacked even basic medical supplies, such as plastic gloves, leaving medical staff vulnerable to infection by Ebola, whose early symptoms resemble cholera and malaria, common diseases in the region.

With international help gradually arriving, Britain was due to inaugurate on Wednesday an Ebola treatment center in Kerry Town just outside Freetown with some 100 beds. It was built by British army engineers to be run by the non-governmental organization Save the Children.

(Reporting by Umaru Fofana; Writing by Bate Felix; Editing by Daniel Flynn and Tom Heneghan)


http://news.yahoo.com/fifth-sierra-leone-doctor-dies-contracting-ebola-151242767--business.html

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We have military research to thank for Ebola vaccines
Shortly after Ebola first broke out in 1976, the Pentagon began looking into countermeasures
The Week
By Frank L. Smith III,  War is Boring | 8:38am ET   



If experimental Ebola vaccines prove usable, we could partly have the military to thank.  (Steve Parsons-WPA Pool/Getty Images) 



Tragically, the Ebola outbreak in West Africa painfully reminds us of the fragile state of health infrastructure in poor countries — as well as of the seemingly limited impact of global health governance.

Though cold comfort, many of the experimental drugs that could help defeat Ebola also remind us of the benefits of military and civilian biodefense R&D.

Biodefense efforts try to limit the damage from biological weapons. The Soviet Union investigated Ebola as a biological weapon during the Cold War, although the Soviets didn't mass produce the virus as a weapon — in contrast to smallpox and other pathogens.

Reportedly, the Japanese cult Aum Shinrikyo also tried to acquire samples of Ebola in 1993 as part of its doomed bioterrorism campaign. Shortly after the first natural cases of Ebola occurred in 1976, the U.S. Army Medical Research Institute for Infectious Diseases — USAMRIID, the military's main biodefense research facility — started to look into countermeasures to this viral hemorrhagic fever.

One important question about biodefense is whether R&D to combat biological warfare and bioterrorism can help to combat naturally occurring outbreaks, as well. It's not uncommon for military technologies to spin off into commercial applications.

Not surprisingly, this "synergy thesis" has its critics. They argue that biodefense distorts public health priorities and may even allow the military to hide an offensive biological weapons program, since some of the knowledge and technology involved is dual use.

It's doubtful that the U.S. military is building biological weapons, given its preference for kinetic warfare. Plus, some investments in biodefense may pay future dividends in the fight against Ebola.

For instance, USAMRIID and the Defense Threat Reduction Agency, along with the Public Health Agency of Canada, supported development of the experimental Ebola drug Zmapp. Granted, Zmapp might not actually work and, even if it does, we just ran out of it for the time being.

But if we were to manufacture this drug in bulk, mass production may involve the Centers for Innovation in Advanced Development and Manufacturing that the U.S. Department of Health and Human Services recently established to help build capacity for biodefense.

Currently, most funding for biodefense comes from civilian sponsors in the United States, not the military. Aside from Zmapp, most of their therapies for other dangerous pathogens — like Marburg virus and Staphylococcal enterotoxin B — get funding from the U.S. National Institutes of Allergy and Infectious Diseases.

Again, Zmapp may fail. Most experimental drugs do. But other medical countermeasures for Ebola relate directly to investments in biodefense, as well. For example, research into one Ebola vaccine began when the U.S. National Institutes of Health asked a Canadian company to reapply technology it had developed for anthrax to also fight Ebola.

Several other potential therapies for Ebola — such as TKM-Ebola and AVI-7537 — also resulted from private collaboration with USAMRIID. So did the GSK/NIAID Ebola vaccine that authorities have just approved for human trials.

Therefore, what little hope there is for vaccines and therapies against naturally occurring Ebola depends in part on research and development for biodefense.

We should welcome these synergies and spinoffs. That being said, new drugs are unlikely to provide quick or easy solutions to the current outbreak.

Instead, the current fight against Ebola now depends on contact tracing, quarantine, and similar public health strategies that date back to the 19th century.


http://theweek.com/article/index/270346/we-have-military-research-to-thank-for-ebola-vaccines

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Health workers miss Louisiana medical conference over Ebola warning
Reuters
By Jonathan Kaminsky  35 minutes ago



NEW ORLEANS (Reuters) - A healthcare worker in Liberia is among those staying away from a tropical medicine conference in New Orleans after the state of Louisiana warned of quarantining attendees potentially exposed to Ebola, Doctors Without Borders said on Monday.

Amanda Tiffany, an epidemiologist with the humanitarian aid group, was one of at least 10 people blocked from attending the annual meeting of the American Society of Tropical Medicine and Hygiene (ASTMH) on threat of quarantine, conference officials said, adding that they oppose the policy.

"Unfortunately my colleague, Amanda Tiffany, was not allowed to travel to ASTMH due to fear of quarantine upon arrival," said Carrie Teicher, a doctor with Doctors Without Borders, also known by its French name, Médecins Sans Frontières, or MSF, speaking at the conference."She hopes these regulations get changed quickly as the stigma American and other colleagues are now facing is great," Teicher added.

Those planning to attend the Nov. 2-6 conference, expected to number more than 4,000, were warned in a letter sent last week by Louisiana's Department of Health and Hospitals to stay away if they had been in Sierra Leone, Liberia or Guinea within the past 21 days or had been in contact with Ebola patients.

The worst Ebola outbreak on record, centered in those three West African countries, has killed nearly 5,000 people.

"We see no utility in you traveling to New Orleans to simply be confined to your room," the state health department said.

Conference organizers, calling the state's quarantine policy "outside of the scientific understanding of Ebola transmission," said it disagreed with Louisiana's rules.

Louisiana Governor Bobby Jindal, a Republican widely seen as holding 2016 presidential ambitions, has been among those calling for a travel ban to the United States from countries affected by Ebola.

Mandatory quarantines issued by some U.S. states for doctors and nurses returning from West Africa's Ebola outbreak have created a chilling effect on aid work there, MSF has said.

(Additional reporting by Jonathan Allen in New York; Editing by Eric Walsh)


http://news.yahoo.com/health-workers-miss-louisiana-medical-conference-over-ebola-023613836.html