Ebola news 9/10

[Buster's Uncle]

Ebola’s Terrifying Evolution
The Daily Beast
By Abby Haglage  28 minutes ago






In a paper released Wednesday afternoon titled Ebola Then and Now, two doctors on the frontlines of the 1976 outbreak in Zaire recall the meticulous procedures that kept the climax of the outbreak to 318 people. While the piece offers valuable information for those fighting the current Ebola outbreak, it underscores just how dangerous it has become. That was then, this is now. Here, juxtaposed with the New England Journal of Medicine’s report, is today’s response.


1. Delayed Response Time


1976

The study’s authors, Dr. Joel G. Breman and Karl M. Johnson, arrived in Zaire in 1976 equipped with new virologic and immunologic tests that helped them immediately identify the (then new) agent. “In Zaire, we became, respectively, the chief of surveillance, epidemiology, and control and the scientific director of the International Commission for the Investigation and Control of Ebola Hemorrhagic Fever in Zaire,” they write. Immediately upon arrival, five commission members were sent to the village of Yambuku—the original site of the outbreak—to map the extent of the outbreak. The other 70 members remained at the hospital base.


Now

On March 23, 2014, the World Health Organization (WHO) reported what they called a “rapidly evolving outbreak” of Ebola in West Africa, where 49 cases and 39 deaths had been recorded. One month later, the number of cases had quadrupled, with WHO showing more than 208 cases and 130 deaths. It wasn’t until August 6, with 1,779 cases and close to 1,000 deaths, that WHO began discussing whether or not the outbreak constituted an international health emergency. By the time it did a few days later, which made it nearly six months after the initial outbreak, it was too late.


2. Infective Quarantine


1976

When Breman and Johnson arrived on the scene, the government had already quarantined 275,000 people in the Bumba Zone. Planes, boats, cars, strangers—all were banned from entering the cordoned off area. At first, the doctors write, the villagers were “fearful and agitated,” lacking the basic necessities needed to survive. When members of the International Commission arrived to help, the community was wary. But with an electron micgrograph to illustrate what was fueling the outbreak, they were able to gain the trust of the people. “People along the road from the town …were relieved when we said we’d come to stop the disease’s spread, treat patients, and meet their families,” the paper reads. Inside the quarantine zone, even more specific procedures were outlined to keep those within the bounds of it safe.


Now

Attempts to quarantine during the current outbreak, led by the local armies and police, have been catastrophic. When the Liberian government attempted to contain the outbreak in Liberia through a quarantine in West Point—an exceptionally impoverished area near Monrovia—they did the opposite. With anywhere from 70K to 120K residents living in tiny shacks without running water, sanitation, or electricity, they left a struggling demographic without the means to protect themselves—many, without knowledge of what it was that necessitated protection. With people fighting for food, violent outbreaks between Liberians and the army began to heat up at the 10-day mark. When four were injured and one killed, President Ellen Johnson Sirleaf officially lifted the quarantine.


3. Mistrust from Communities

1976

For those outside of the quarantine zones, Drs. Breman and Johnson laid out specific guidelines to community members to help reduce the risk of the infection’s spread. Family members who became infected with the disease were placed in “huts outside their villages,” a procedure that allowed victims to be isolated outside of a hospital. The doctors then suggested one family member, “preferably someone who had recovered from the illness,” deliver food, water, and medicine to the patient each day until a medical professional could arrive on the scene. With the help of other community members, the doctors successfully educated the families of those who died about the dangers of handling the body in typical ritual fashion. “Credibility was gradually restored,” the authors write. “Especially when we began visiting villages accompanied by the three remaining nuns.” Bodies were covered with bleach and buried, and isolation huts burned. An already-local tradition of shaving one’s head in mourning for a lost family member became dual purpose—used to flag potential carriers of the disease.


Now

With the virus already widespread when international relief began pouring into West Africa, spending individual time in affected communities was not an option. Without this crucial period of trust building, many in the communities spent months under the impression that Ebola was either a hoax or a disease brought to West Africa by American nurses and doctors. The fallout of this loss of trust has had an enormous impact on the outbreak. Without a clear understanding of how Ebola is spread and when it is contagious, family members continued to bury their loved ones—who, at that point, are the most contagious—with typical burial rites such as washing, touching, and even kissing the corpses. While doctors in West Africa now report success educating the communities and persuading them not to perform burials, the amount of burials already performed have infected hundreds if not thousands.

***

At the end of the report, which highlights stirring images from the original 1976 outbreak, the authors offer suggestions for where the international community should focus their support. “We believe the main priorities should be adequate staff for rigorous identification, surveillance, and care of patients and primary contacts,” they write. “Strict isolation of patients; good clinical care; and rapid, culturally sensitive disposal of infectious cadavers.”

Breman, who got wind of the current outbreak when a CDC officer stationed in Guinea called him for advice in March, is still optimistic. Most of his positivity rests on the news that people in the villages have finally begun to trust that the outbreak is real, and that the health workers are there to stop it. And with the announcement that the U.S. plans to send a “surge” of workers into West Africa armed with $22 million from the Pentagon, America now looks poised to fight back against Ebola.

“These are the darkest days, they know what they’re doing,” Breman tells me of the health care workers in the field. “They know the dangers. There are dangers at the front lines. It’s a war zone, and Ebola is the enemy.”


http://news.yahoo.com/ebola-terrifying-evolution-234000111--politics.html

[Buster's Uncle]

Nebraska Ebola patient showing more progress : hospital
Reuters
35 minutes ago



International Christian mission organization SIM missionary doctor Rick Sacra is shown in this undated photo provided by SIM on September 4, 2014. REUTERS/SIM/Handout via Reuters



(Reuters) - A U.S. doctor infected with the Ebola virus in West Africa has continued to show progress at the Nebraska Medical Center where he was taken last week, the hospital said on Wednesday.

Dr. Rick Sacra, 51, who was working as a medical missionary at a hospital in Liberia when he contracted Ebola, has been reported to have made progress for several days since his arrival at the Omaha hospital on Friday.

Sacra is being cared for in a special isolation unit designed to treat patients with highly infectious diseases and has been communicating with family through a video link.

"Dr. Sacra's lab values continue to move in the right direction and doctors treating him in the Biocontainment Unit at The Nebraska Medical Center are pleased with the way things are trending," the hospital said in a statement.

Sacra's wife, Debbie Sacra, is expected to speak to reporters Thursday afternoon along with doctors caring for him. Sacra, who is from Massachusetts, was working in West Africa on behalf of the North Carolina-based Christian group SIM USA.

The virus kills about half of those who contract it. The outbreak has killed at least 2,296 people out of 4,293 cases in five West African countries, the World Health Organization said on Tuesday.



Debbie Sacra, wife of Dr. Rick Sacra, reads Bible verses to him (on screen) during a video conference at the Nebraska Medical Center in Omaha, Nebraska in this September 10, 2014 handout photo courtesy of the center. REUTERS/Nebraska Medical Center/Handout via Reuters


Sacra is one of four Ebola patients transported to the United States for treatment. Doctors have said they are using an unidentified experimental research drug to treat him.

Three patients have been treated for Ebola at Emory University Hospital in Atlanta, which has an isolation unit like one at the Omaha hospital.

An American doctor was admitted to Emory on Tuesday after being infected with Ebola in Sierra Leone. That doctor has not been identified and the hospital said on Wednesday it had no update on his condition.

The two other patients that had been at Emory, U.S. missionaries Nancy Writebol and Dr. Kent Brantly, recovered and were released in August.

An experimental drug, ZMapp, was given to Writebol and Brantly. No more doses of ZMapp are available, and doctors have said it is not clear whether it helped their recovery.

(Reporting by David Bailey in Minneapolis and Colleen Jenkins in Winston-Salem, North Carolina)


http://news.yahoo.com/nebraska-ebola-patient-showing-more-progress-hospital-001128751.html

[Buster's Uncle]

SLeone expects to uncover hundreds of hidden Ebola cases
AFP
8 hours ago



A girl walks past a sign warning of the dangers of ebola outside a government hospital in Freetown, Sierra Leone, on August 13, 2014 (AFP Photo/Carl de Souza)



Freetown (AFP) - Sierra Leone said on Wednesday it expected to uncover up to 20 percent more Ebola victims when it imposes a nationwide curfew to find the dead and sufferers who have yet to go to hospital.

The government has announced the shutdown, with the population of six million confined to their homes except for essential business, for 72 hours starting from September 19.

More than 20,000 volunteers will go door-to-door to remove bodies and take patients who have not yet gone to hospital into the care of medics.

The government's Ebola emergency operation centre said 10 areas of the capital Freetown had been designated as "hot spots" charged with dealing with the surge in cases expected.

"Isolation centres including schools equipped with beds will be set up as we envisage a five percent to 20 percent surge during the exercise, which is aimed at breaking the chain of transmission," Steven Ngaoja, head of the centre, told a news conference in Freetown.

The Ebola outbreak has killed almost 2,300 people in four west African nations.

Sierra Leone has reported some 500 deaths from almost 1,400 cases since it registered its first infection in May.

The government has set aside $1.3 million (1.0 million euros) to cover the costs of the shutdown, most of which has been donated by the United Nations Children's Fund, according to health ministry spokesman Yahya Tunis.

The health ministry has said it plans to distribute 1.2 million bars of soap -- enough for every household in the country.


http://news.yahoo.com/sleone-expects-uncover-hundreds-hidden-ebola-cases-164318892.html

[Buster's Uncle]

Australian man isolated in Ebola scare
AFP
15 minutes ago



An Australian was isolated in hospital Thursday after he displayed symptoms of the deadly Ebola virus following a trip to Africa, health officials said.

The man, in his 20s, was taken to Gold Coast University Hospital in Queensland state by paramedics wearing full protective gear.

Reports said he returned from West Africa two days ago and had been seriously ill since.

Gold Coast Hospital and Health Service chief executive Damian Green said more details about his condition would be released when they were known.

"Gold Coast Health can confirm a patient has been transferred to Gold Coast University Hospital after being identified by paramedics as having symptoms of Ebola virus," Green said in a statement.

"Gold Coast Health is taking necessary precautions and has isolated the patient, who is currently being assessed."

He added that the hospital had the necessary processes in place "to safely manage such circumstances".

More than 2,200 people have died in the Ebola outbreak gripping west Africa, with more than 4,200 cases in Liberia, Sierra Leone, Guinea and Nigeria leaving medical teams in those countries overwhelmed.

The World Health Organization has predicted an "exponential increase" in infections across west Africa, and warned that Liberia alone will face thousands of new cases in the coming weeks.


http://news.yahoo.com/australian-man-isolated-ebola-scare-011241483.html