Ebola 8/24

[Buster's Uncle]

Sierra Leone "hero" doctor's death exposes slow Ebola response
Reuters
By Umaru Fofana and Daniel Flynn  2 hours ago



Sheik Umar Khan, head doctor fighting the deadly tropical virus Ebola in Sierra Leone, poses for a picture in Freetown in this June 25, 2014 file photo. More than 100 health workers have been infected by the viral disease, which has no known cure, including two American medics working for charity Samaritan's Purse. More than half of those have died, among them Sierra Leone's leading doctor in the fight against Ebola, Khan, a national hero. REUTERS/Umaru Fofana/Files



FREETOWN/DAKAR (Reuters) - When two American aid workers recovered from Ebola after being treated with an experimental drug, the grieving family of Sierra Leone's most famous doctor wondered why he had been denied the same treatment before he died from the deadly virus.

Sheik Umar Khan was a hero in his small West African country for leading the fight against the worst ever outbreak of the highly contagious hemorrhagic fever, which has killed 1,427 people mostly in Sierra Leone, Liberia and Guinea.

When Khan fell sick in late July, he was rushed to a treatment unit run by Medecins Sans Frontieres (MSF) where doctors debated whether to give him ZMapp, a drug tested on laboratory animals but never before used on humans.

Staff agonised over the ethics of favouring one individual over hundreds of others and the risk of a popular backlash if the untried treatment was perceived as killing a national hero.

In the end, they decided against using ZMapp. Khan died on July 29, plunging his country into mourning.

A few days later, the California-manufactured pharmaceutical was administered to U.S. aid workers Kent Brantly and Nancy Writebol who contracted Ebola in Liberia and were flown home for treatment. It is not clear what role ZMapp played in their recovery but the two left hospital in Atlanta last week.

Khan is among nearly 100 African healthcare workers to have paid the ultimate price for fighting Ebola, as the region's medical systems have been overwhelmed by an epidemic which many say could have been contained if the world had acted quicker.

In their village of Mahera, in northern Sierra Leone, Khan's elderly parents and siblings asked why he did not get the treatment. Khan saved hundreds of lives during a decade battling Lassa fever - a disease similar to Ebola - at his clinic in Kenema and was Sierra Leone's only expert on haemorrhagic fever.

"If it was good enough for Americans, it should have been good enough for my brother," said C-Ray, his elder brother, as he sat on the porch of the family home. "It's not logical that it wasn't used. He had nothing to lose if it hadn't worked."

Doctors who knew Khan and who were involved in the difficult decision, however, said it was based on sound ethical reasoning.

Ebola, which is passed on by direct contact with the bodily fluids of infected persons, strikes hardest at healthcare providers and carers who work closely with patients.

Victims suffer vomiting, diarrhoea, internal and external bleeding in the final stages of the disease, leaving their bodies coated in the virus. To treat the sick, doctors require training and protective clothing, both of them scarce in Africa.

The outbreak - the first in West Africa - was detected five months ago deep in the forests of southeastern Guinea. But it was not until Aug. 8 that the World Health Organization declared an international health emergency and promised more resources.

By decimating healthcare staff in countries that had only a few hundred trained doctors before the outbreak, Ebola has now left millions vulnerable to the next crisis, experts say.

"Dr. Khan knew the risks better than anybody ... but if you work for months in overcrowded facilities, 18 hours a day, anyone will make a mistake," said Robert Garry, professor of microbiology and immunology at Tulane University in New Orleans, who worked with Khan for a decade.

"The whole international community needs to look back and say we dropped the ball. We should've reacted faster to this."


TENSE ATMOSPHERE

To many in his impoverished country, Khan was a saviour for his pioneering work with Lassa fever, a disease endemic to the jungles of eastern Sierra Leone that kills 5,000 people a year. When Ebola struck, he became a figurehead for that fight, too, hailed by President Ernest Bai Koroma as a "national hero".

Doctors involved in treating Khan were aware that - given sporadic violence against healthcare workers by a frightened local population - a misstep could prove costly.

"Now you can look back at that and say it was a mistake," said American doctor Daniel Bausch of Tulane University, who worked with Khan and advocated giving him ZMapp at the time.

"But there was a very tense atmosphere on the ground," he said. "If he had died from the drug, or even if it was perceived that he had, it could have had dangerous ramifications."

Doctors also had ethical concerns about giving Khan priority treatment that hundreds of other infected people could not receive, since only a few doses of ZMapp had been manufactured.

The president of Medecins San Frontieres - which has spearheaded the response to Ebola at clinics in Sierra Leone, Guinea and Liberia - said its doctors could not sanction use of a drug on Khan whose effects were unknown.

"We didn't know what the consequences would be. We didn't know how sick he was and we didn't know how efficient it would be," Joanne Liu told Reuters.

Khan, who had initially appeared to be recovering, was never told that the drug was available. Two weeks after his death, the World Health Organization approved the use of experimental drugs to tackle Ebola, on Aug. 12.     

However, the manufacturer of ZMapp, California-based Mapp Biopharmaceutical, said supplies of the drug are exhausted after the last doses were used in treating three African healthcare workers in Liberia last week. Like the two Americans, they are also recovering.

Supplies of trial vaccines to prevent people contracting the disease are also very limited. With only 1,590 deaths from Ebola in the four decades that have passed since the virus was first isolated, all of them in poor African countries, drug firms have had little incentive to pursue research into the disease.

Drug companies including GlaxoSmithKline are now fast-tracking vaccine trials in humans, amid fears that Ebola could be spread beyond Africa by air travel, after a U.S. citizen died in Nigeria after flying from Liberia.   

    "We need to get healthcare workers vaccines. They are in harm's way," said Robert Garry, the main investigator at Viral Hemorrhagic Fever Consortium, a partnership of research institutes. He said the outbreak would last at least six months.

"We need a lot more people to bring this under control. We haven’t seen the worst of this yet."


"WHO WILL FILL MY SHOES"

Khan knew from the first his work at the Kenema clinic would be dangerous. When he took over as head doctor there in 2004, his predecessor had bled to death from Lassa fever in the same ward.

But after 11 years of civil war, there were few others who could do the job. The last but one of 10 children from a humble background, Khan always wanted to be a physician like his childhood hero Dr. Kamara, who ran a clinic in Mahera.

Determined to enter Freetown's medical school COMAHS, Khan persisted despite being initially rejected. When he graduated, his father was too ashamed to visit this preserve of his country's elite and listened to the ceremony on the radio.

    "When the name Dr. Sheik Umar Khan was called out by the dean of the faculty, my father broke down in tears of joy," Khan's sister Mariama recalled.

An extrovert and joker, Khan threw himself into his work in Kenema, a diamond-trading hub home to 130,000 people. His wife divorced him, complaining he only had time for his patients.

    When Ebola struck, Khan converted the bungalows of the clinic into an Ebola treatment centre, erecting a makeshift tarpaulin ward outside with 50 beds in three rows. With no proven cure, doctors simply tried to keep patients hydrated and free from other diseases as Ebola attacked their immune system.

Though he feared for his life, he refused to abandon the understaffed clinic, even as nurses there began to fall sick.

    "If I leave, then who will come and fill my shoes," he told a friend from medical school, James Russel.

Outbreaks in Central Africa lasted six to eight weeks, so when infections ebbed early in the epidemic, many assumed the worst had passed. It turned out to be a lull as relatives hid victims rather than going to hospitals regarded as death traps and a massive second wave of infection caught governments and international aid donors off guard.

One of Khan's biggest challenges was resistance from local people, terrified of the medics in their white bodysuits and masks. A crowd attacked the Kenema facility, enraged by a rumour of cannibalism there. Several patients fled, spreading infection even wider.

"My biggest problem ... is getting people to accept the disease," a frustrated Khan told Reuters in June.

The first person infected in Sierra Leone was a "sowei" - a tribal healer. She claimed to have the power to treat Ebola and had attracted sick people to visit her from Guinea. Traditions of washing the dead helped spread the disease. Several women from neighbouring towns were infected at the sowei's burial.

    Already thinly staffed, the clinic was sapped by resignations and a strike after three senior nurses died. Khan was compulsive in checking his protective gear before entering the ward, using a mirror he called his "policeman".

"I'm afraid for my life because, I must say, I cherish my life," he said.

Bausch, sent by the WHO to Kenema in July to help train staff, said Khan had appeared worn down. Bausch had hired Khan to work at the Kenema clinic in 2004 but was so alarmed by the understaffing there, he had wondered if it should be shut down.

    "It's one thing for a foreign doctor who comes in for three weeks. But if you're Dr. Khan, head of the ward, it never stops," Bausch said. "Anyone would get infected."

Khan's death sent shockwaves through Sierra Leone's small medical community of less than 150 doctors for its 6 million people - one of the lowest ratios in the world. Sierra Leone has one doctor per 45,000 inhabitants, according to the WHO, compared to a doctor for every 410 people in the United States.

Other senior medical staff in the country have since died and the staff at Kenema has been decimated.

"Once this nightmare is over, who in these countries will want to work treating patients with hemorrhagic fever?" said Bausch. "If it was hard before to get healthcare workers to do it, it will be even harder now."


http://news.yahoo.com/sierra-leone-hero-doctors-death-exposes-slow-ebola-093731653.html

[Buster's Uncle]

UN vows central role in fighting 'exceptional' Ebola epidemic
AFP
By Zoom DOSSO with Selim SAHEB ETTABA in Dakar  9 hours ago



An MSF medical worker feeds  an Ebola child victim at an MSF facility in Kailahun, on August 15, 2014 (AFP Photo/Carl de Souza)



Monrovia (AFP) - The United Nations vowed Saturday to play a "strong role" in helping Liberia and its neighbours fight a deadly outbreak of Ebola in west Africa, which it said could take months to bring it under control.

Liberia has been particularly hard hit by the epidemic that has swept relentlessly across the region since March, accounting for almost half of the 1,427 deaths.

In recognition of the deteriorating situation, neighbouring Ivory Coast announced it had closed its borders with Liberia and Guinea in a bid to protect its citizens.

"Ebola in Liberia must be addressed to ensure a stable economy, future and society," said Karin Landgren, UN Secretary-General Ban Ki-Moon's special representative for the country.

"The magnitude of this outbreak requires a higher level of coordination than previous responses and the UN Mission in Liberia will play a strong role in this effort."

Her comments were echoed by David Nabarro, the UN's new pointman on Ebola, who arrived in the region on Thursday to tour the Ebola-hit countries of Liberia, Sierra Leone, Guinea and Nigeria.

Nabarro, a British physician tasked with coordinating the global response to the worst-ever outbreak of the deadly virus, said the UN would "ensure that adequate resources are given to sectors that need it most".



Government burial team members close the coffin of Dr Modupeh Cole at the MSF facility in Kailahun, Sierra Leone on August 14, 2014 (AFP Photo/Carl de Souza)


A day earlier, the World Health Organization (WHO) warned it could take "several months" to bring the epidemic under control.

"This is not something to turn around overnight, it is not going to be easy; we expect several months of hard work," said the UN agency's Assistant Director-General Keiji Fukuda, who is accompanying Nabarro on his tour.


- Death toll rises -

Their visit has coincided with a surge in new cases of Ebola in the region, as affected countries struggle to contain the spread of the killer virus.

The WHO said Friday that the death toll had risen to 1,427 out of more than 2,600 cases -- with 77 succumbing to the disease between August 18 and 20.

A British national who lives in Sierra Leone has tested positive for Ebola, the first British citizen to have contracted the disease, according to officials.



A man stands with the coffin at the MSF facility in Kailahun, Sierra Leone on August 14, 2014 (AFP Photo/Carl de Souza)


Britain's Mail on Sunday newspaper reported that the infected man was a medic working for a charity in Sierra Leone.

He was reportedly set to be flown back to Britain for treatment in the next couple of days. The Department of Health did not immediately respond to a request to confirm the report.

Nigeria, which has seen progress in battling the outbreak, has suffered five deaths to date. Officials said Friday that two more people had tested positive for Ebola.

Liberia remains the worst-affected country with 624 deaths. Guinea has seen 406 people die while in Sierra Leone, 392 have succumbed to the haemorrhagic fever.

Aid workers said crematoriums in the Liberian capital Monrovia were struggling to deal with dozens of bodies arriving every day, and earlier this week, violence erupted in an Ebola quarantine zone in the capital after soldiers opened fire on protesting crowds.

The failure of West African countries to bring the epidemic under control has worried its neighbours and nations further afield.



A girls suspected of being infected with the Ebola virus has her temperature checked at the government hospital in Kenema, Sierra Leone on August 16, 2014 (AFP Photo/Carl de Souza)


Many flights to the region have been cancelled, and authorities around the world have adopted measures to screen travellers arriving from affected nations.

A Canadian hospital said it had placed a patient who recently returned from Guinea in isolation as it awaits whether the individual tests positive for Ebola.

The patient was quarantined after experiencing a high fever, according to Montreal's Maisonneuve-Rosemont Hospital.

And in Bolivia, authorities said they were investigating a first potential case of Ebola after a patient, who is being treated for a fever, diarrhoea and vomiting, had made stopovers in several African cities.

The Ivory Coast closed its borders with Guinea and Liberia just days after Senegal did the same with Guinea, where the outbreak is thought to have begun.

It came in the wake of the first reported Ebola deaths in the southeast of Liberia, which borders the Ivory Coast.

Meanwhile, an official said Cameroon has suspended imports of meat and animals "sensitive" to the Ebola virus.


- 'Pariah states' -

The extreme measures taken against affected countries, especially by their neighbours, have caused friction in the region.

Ibrahim Ben Kargbo, the chairman of Sierra Leone's presidential task force on Ebola, said he was "surprised" by the lack of solidarity among African countries.

It "gives the impression that we are pariah states," Kargo said on state television, in reference to a South African ban on non-citizens travelling from Sierra Leone, Guinea and Liberia.

"The epidemic is not manmade but a natural phenomenon, we did not create it," said Kargbo, who is a presidential advisor and former information minister.

"Once we get over the epidemic, we will begin to look at ourselves to know who our friends are."

No cure or vaccine is currently available for the deadly virus, which is spread by close contact with body fluids, meaning patients must be isolated.


http://news.yahoo.com/un-vows-central-role-fighting-exceptional-ebola-epidemic-190628985.html

[Buster's Uncle]

American Ebola doc urges help fighting outbreak
Associated Press
By KATHLEEN FOODY  August 22, 2014 10:38 AM



After nearly three weeks of treatment, the two American aid workers who were infected with the deadly Ebola virus in Africa have been discharged from an Atlanta hospital. (Aug. 21)
 


ATLANTA (AP) — As one of few Ebola survivors with medical expertise, Dr. Kent Brantly seems keenly aware of the position his painful experience has put him in. He hasn't spoken yet about his plans, but spent much of his first public appearance pleading for help for countries still struggling with the virus.

"I am forever thankful to God for sparing my life and am glad for any attention my sickness has attracted to the plight of West Africa in the midst of this epidemic," Brantly said Thursday before leaving Emory University Hospital, where he and a medical missionary colleague spent three weeks in an isolation unit as they recovered.

"Please continue to pray for Liberia and the people of West Africa, and encourage those in positions of leadership and influence to do everything possible to bring this Ebola outbreak to an end," he added. Then he hugged all the doctors and nurses at the news conference, a very public display of affection telegraphing the message that Ebola survivors are not contagious.

With the world watching, Brantly could continue sending these messages from the United States or even return to Africa.

Dr. Bruce Ribner, who runs Emory's infectious disease unit, said he would not discourage an Ebola survivor from treating those with the disease, since they've effectively been vaccinated against this strain and there is no danger of a relapse.

"There would be no concerns and in fact the likelihood is we would anticipate immunity to this virus so that they would probably not be at risk for infection if they were caring for patients with Ebola virus disease during this outbreak," Ribner said.



Ebola victim Dr. Kent Brantly, right, hugs a member of the medical staff that treated him, after being released from Emory University Hospital Thursday, Aug. 21, 2014, in Atlanta. Another American aid worker, Nancy Writebol, who was also infected with the Ebola virus, was released from the hospital Tuesday. (AP Photo/John Bazemore)


The same goes for Nancy Writebol, Brantly's missionary colleague, who was quietly released Tuesday. They are effectively vaccinated against the current strain of the Ebola virus, should recover completely, and no one should fear being in contact with them, Ribner said.

"My family and I will now be going away for a period of time to reconnect, decompress and continue to recover physically and emotionally. After I have recovered a little more and regained some of my strength, we will look forward to sharing more of our story," said Brantly, visibly thinner than he appeared in an image circulated earlier by his charity organization, the North Carolina-based Samaritan's Purse.

Writebol's son, Jeremy Writebol, said in a telephone interview that his mother is able to move around, eat and drink normally. His parents are considering their next steps, he said.

Brantly's reappearance was celebratory, in contrast to his arrival in an ambulance under police escort three weeks earlier, when he shuffled into the hospital wearing a bulky white hazardous materials suit. Both patients were discharged after their blood tested clean of the virus, which is spread only through direct contact with the bodily fluids of sick people experiencing symptoms.

After Brantly, 33, and Writebol, 59, were infected while working with Ebola victims in Liberia, their charity organizations, Samaritan's Purse and SIM, reached out to top infectious disease experts for help.



Ebola victim Dr. Kent Brantly stands with his wife, Amber, during a news conference after being released from Emory University Hospital, Thursday, Aug. 21, 2014, in Atlanta. Another American aid worker, Nancy Writebol, who was also infected with the Ebola virus, was released from the hospital Tuesday. (AP Photo/John Bazemore)


Working connections, they obtained one of only five courses available worldwide of an experimental drug known as Zmapp, and Brantly and Writebol split the doses before being evacuated to Atlanta. The other four were later given to a Spanish priest, who died, and three doctors in Africa, who have been improving.

Brantly's doctors cautioned that it's unclear whether the drug or a blood transfusion he got from a young Ebola survivor in Africa helped, hurt or made no difference at all.

"They are the very first individuals to have received this treatment and frankly we do not know," Ribner said.

Brantly didn't take questions Thursday, but he did briefly describe his experience in Liberia, where they saw their first Ebola patient in June. Soon, many more arrived.

He said his team took all the precautions they could. Three days after his wife and children returned to the U.S., Brantly woke up feeling sick and was diagnosed with the disease. For nine days, he prayed for faith.



Ebola victim Dr. Kent Brantly, left, embraces Dr. Bruce Ribner, medical director of Emory’s Infectious Disease Unit, after being released from Emory University Hospital, Thursday, Aug. 21, 2014, in Atlanta. Another American aid worker, Nancy Writebol, who was also infected with the Ebola virus, was released from the hospital Tuesday. (AP Photo/John Bazemore)


"I serve a faithful God who answers prayers," he said.

There is a huge gap between the treatment these Americans got at Emory, where five infectious disease experts and 21 nurses provided rigorous care, and West Africa, where the virus has killed more than 1,300 people and counting, and even such basics as sterile fluids can be in short supply.

Ribner insisted that bringing them to Atlanta "was the right decision" and said the hospital could decide to take more Ebola patients on a case by case basis.

"We cannot let our fears dictate our actions," Ribner said.

The treatment of these two Americans may already lead to better care for Ebola patients anywhere. For example, their doctors now believe common fluid-replacement measures may need more nutrients to help patients recover. Emory's team has begun sharing its findings with other doctors, and hopes to publish in a medical journal.

At least 2,473 people have been sickened in this outbreak — more than the caseloads of all the previous two-dozen Ebola outbreaks combined, according to the World Health Organization.

___

Associated Press writers Jeff Martin in Atlanta and Roxana Hegeman in Wichita, Kansas, and AP Medical Writer Mike Stobbe in New York contributed to this report.


http://news.yahoo.com/american-ebola-doc-urges-help-fighting-outbreak-081912132.html

[Geo]

Both infected Americans recovered from a disease with a 96% casualty rate.
Talk about the wonders of being born in the right place.

[Buster's Uncle]

Minister: 2 people have died of Ebola in Congo
Minister says 2 people have died of Ebola in Congo, cases unrelated to West Africa outbreak
Associated Press
By Saleh Mwanamilongo, Associated Press  4 hours ago



KINSHASA, Congo (AP) -- Two Ebola-related deaths have been confirmed in Congo, the country's health minister said Sunday, though local officials believe the cases are unrelated to the outbreak in West Africa that has killed more than 1,400 people.

Eight samples were taken from Djera, located in the Boende region of Congo's northwest Equateur province, and two of them came back positive, Felix Kabange Numbi said on state television Sunday.

Congolese officials believe Ebola has killed 13 people in the region, including five health workers, Kabange said.

He said 11 people were sick and in isolation and that 80 contacts were being traced.

"This epidemic has nothing to do with the one in West Africa," Kabange said.

This is the seventh outbreak of Ebola in Congo. The disease was first discovered there in 1976.

"The experience acquired during the six previous epidemics of Ebola will contribute to the containing of this illness," Kabange said.

Boende is the region where the World Health Organization said an outbreak of hemorrhagic gastroenteritis has killed 70 people in recent weeks.

The WHO said last week those deaths were not Ebola-related, but WHO spokesman Gregory Hartl said by email Sunday that the information was the result of "miscommunication from the field."

Hartl said on Twitter that samples tested at a national laboratory were positive for Ebola and that the results of confirmation tests from a laboratory in Gabon would likely come back Monday.

He said it was possible the outbreak could be unrelated to the outbreak in West Africa, where a total of 2,615 infections and 1,427 deaths have been recorded in four countries -- Liberia, Guinea, Sierra Leone and Nigeria.

Djera, a collection of villages, is more than 1,200 kilometers (745 miles) from Congo's capital, Kinshasa. It is more than 600 kilometers from the provincial capital, Mbandaka.

Kabange said Djera would be placed under quarantine.


http://news.yahoo.com/minister-2-people-died-ebola-congo-180845511.html

[Buster's Uncle]

Ebola taking toll on west African economy
AFP
By Zoom Dosso  16 hours ago



People walks in a market in Kenema, Sierra Leone, on August 16, 2014 (AFP Photo/Carl De Souza)



Monrovia (AFP) - The worst-ever outbreak of the Ebola virus is taking a heavy toll on west Africa's economy as crops rot in the fields, mines are abandoned and goods cannot get to market.

The epidemic has ravaged the region since it erupted in the forests in the south of Guinea earlier this year, killing 1,427 people and infecting thousands more.

On Friday health officials said the fever had spread to every corner of Liberia, the worst-hit country in the grip of the epidemic where 624 people have died so far.

But beyond the mounting death toll, the disease is also undermining the region's economic growth and threatening the long-term development of some of the world's poorest countries.

"It is a total catastrophe. We are losing lots of money," said Alhaji Bamogo, who sells clothes in the market in the Liberian capital Monrovia.

"All those who are coming to the market come only to buy food or products for the disinfection of Ebola," he said.



A street market remains empty in Monrovia's West Point slum as part of quarantine measures to contain the spread of Ebola in Liberia on August 20, 2014 (AFP Photo/Zoom Dosso)


Across the resource-rich countries of Liberia, Sierra Leone, Guinea and Nigeria, companies are suspending operations due to fears of the haemorrhagic fever, which is spread through contact with bodily fluids.

Steel giant ArcelorMittal this month said the contractors at its expanding iron ore works in Liberia had suspended operations and were pulling out staff.

Several international airlines have halted their flights to west Africa in a move that Moody's ratings agency warns "will exact an economic toll" on the region.

And in Nigeria, Africa's top oil producer and most populous country where 15 cases have been identified and five people have died, experts warn that the impact for the regional economy could be dire if the disease takes hold.

"The Ebola epidemic is not just a public health crisis, but an economic crisis... affecting many sectors of activity," the president of the African Development Bank, Donald Kaberuka warned this month.



A medical worker from French NGO Doctors Without Borders wears protective clothing at an Ebola treatment facility in Kailahun, Sierra Leone, on August 15, 2014 (AFP Photo/Carl de Souza)


- Too dangerous to invest -

Philippe Hugon, Africa research director at the French think-tank IRIS, said the biggest threat for west Africa is a long-term pullout of global companies that the region relies on.

"Everything depends on whether this stays limited or whether the epidemic continues to spread in a prolonged way. The heads of foreign businesses on the ground are very concerned," he said.

The epidemic may "reinforce the idea that Guinea, Sierra Leone and Liberia are countries where it is dangerous to live -- because of diseases like Ebola and AIDS -- and thus to invest in," he said.

The disease is also exacting a direct economic toll on the countries where it is spreading by sapping already stretched government budgets.



Medicins Sans Frontieres (MSF) medical workers wearing protective clothing carry the body bag of an Ebola victim at the MSF facility in Kailahun, on August 14, 2014 (AFP Photo/Carl de Souza)


Moody's warned it will squeeze state coffers from all sides, by forcing both "increased health expenditures, and... an Ebola-induced economic slowdown on government revenue generation".

This month the African Development Bank pledged $60 million to support the over-stretched health systems of the four affected countries.

Critics have accused west Africa's governments of being slow to admit the extent of the problem because of the cost of deploying resources to fight the disease.

Amadou Soumah, a trade union official in Guinea, which only last week declared a national emergency despite being at the epicentre of the outbreak earlier this year, said the government had played down the crisis "to stop investors fleeing".

And now "Guinea is going to deploy its forces along the border to rack up even more spending," he added, referring to the closure of its frontiers with Liberia and Sierra Leone.



A doctor of the national public health institute controls the temperature of a woman at the airport, in Abidjan on August 13, 2014, as part of protective measures against the Ebola virus (AFP Photo/Sia Kambou)


- Food shortages -

For people on the ground, the epidemic has created an even more pressing problem: food shortages.

In the markets, supplies of staple commodities such as rice are already dwindling, with only the bravest traders willing to venture far afield to buy stocks.

In quarantined zones in Sierra Leone and Liberia, key cash crops such as cocoa and coffee have been left rotting in the fields as farmers fear to stray far from home.

"People are going to move around less and less," said Philippe De Vreyer, a specialist in west African economics and professor at the University of Paris.



A man rides his bicycle by a poster raising awareness on the Ebola virus reading "the risk Ebola is still there. Let us apply the protective measures together", on August 24, 2014 in Abidjian (AFP Photo/Sia Kambou)


"For instance, the man who usually goes to the local market to sell his vegetables will decide to stay home. People are not going to get their supplies, with all that entails."

In Nigeria, even though it is the least hit by the epidemic, Ebola fears are already keeping people indoors.

So far the epidemic has not threatened the economically vital oil industry, which is centred in the southern Niger Delta about 1,000 kilometres (600 miles) from Lagos, where the cases have been found.

The service industry is feeling the effects, however.

"Bookings to hotels have dropped by almost 30 percent so far this month, as have orders for food and drink for large social gatherings like weddings and funerals," said Bismarck Rewane, head of the Lagos-based Financial Derivatives Company.


http://news.yahoo.com/ebola-taking-toll-west-african-economy-104428978.html