Ebola news 9/20

[Buster's Uncle]

New Ebola clinics useless without more trained staff
Reuters
By Stella Dawson  5 hours ago



Health workers bring a woman suspected of having contracted Ebola virus to an ambulance in front of a crowd in Monrovia, Liberia, September 15, 2014. REUTERS/James Giahyue



WASHINGTON (Thomson Reuters Foundation) - A shortage of volunteers to staff the new Ebola clinics and hospitals the international community is building in West Africa threatens efforts to bring the deadly virus rapidly under control, aid agencies have warned.

“The missing link is staff,” Athalia Christie, deputy for global health at the Centers for Disease Control and Prevention, who has just returned from Liberia, told the Thomson Reuters Foundation.

The United States this week announced it will send in its military to build 17 Ebola treatment centers in Liberia. Army engineers from Britain are building a 200-bed hospital in Sierra Leone, while the United Nations has formed a special mission to lead efforts.

This marks a dramatic scaling up of the global response to the Ebola crisis, which has claimed over 2,500 lives this year - mostly in Liberia, Sierra Leone and Guinea where infections are spiraling out of control as healthcare systems collapse.

When world leaders meet for the United Nations General Assembly in New York next week, their sessions will include a two-day summit on the Ebola crisis.

Many questions remain over how to handle the deadly virus. Medical experts have yet to agree on a basic method of treatment, which shapes the types of aid that will be delivered. More money is needed, as well as more people to work in the region and more training.

Experts at a poverty conference run by the U.S. development agency USAID in Washington on Friday said recruiting staff must be a top priority.

Each 100-bed Ebola treatment center under construction needs 230 trained staff, including 12 medical experts, to operate, U.S. officials said. That would mean nearly 4,000 personnel for the Liberian facilities due to start opening in October, and it is unclear where they will come from.

“Building hospitals and equipping them is great. But unless you have trained personnel to work in them, that is not going to help,” said Rabih Torbay, senior vice president at the global healthcare nonprofit International Medical Corps (IMC).

“Seventeen thousand beds, but who is going to staff them?" asked Torbay, who leads IMC’s Ebola response.


'TERRIFIED'

Usually humanitarian groups are inundated with volunteers ready to fly into disaster zones after earthquakes or floods. But Ebola has terrified people, he said.

It spreads rapidly through contact with sweat, saliva, blood and other bodily fluids of an infected person, and the average death rate is over 50 percent.

The epidemic has overwhelmed Liberia, Sierra Leone and Guinea, which had a critical shortage of doctors and nurses even before the Ebola outbreak, which began earlier this year. Infections are estimated at 5,000, though the actual rate may be two or three times larger since many people are hiding in their homes.

The World Health Organization says the infection rate is doubling every 10 to 21 days, which means hospitals and clinics may not be built and staffed fast enough to meet demand.

U.S. officials are recruiting healthcare personnel from universities and hospitals, said Torbay. China has pledged doctors and nurses, and the African Union is sending a team of 30 health workers and specialists to the region.

But the task of training them is huge, said Christie. They require seven to 10 days of classroom and practical work before they can enter hospitals and clinics. Relief staff must replace them every four to six weeks because workers get exhausted - emotionally from the high death toll and physically from wearing five layers of protective gear in extreme heat.

Nancy Lindborg, USAID assistant administrator, said international agencies have drawn up a detailed matrix, specifying what each country and organization can contribute to addressing the Ebola crisis.

“Health workers is the key gap,” she said.

(Reporting By Stella Dawson; Editing by Megan Rowling)


http://news.yahoo.com/ebola-clinics-useless-without-more-trained-staff-091111074.html

[Buster's Uncle]

Sierra Leone marathoner joins race against Ebola
Associated Press
By ROBBIE COREY-BOULET and CLARENCE ROY-MACAULAY  10 minutes ago



Police guard a roadblock as Sierra Leone government enforces a three day lock down on movement of all people in an attempt to fight the Ebola virus in Freetown, Sierra Leone, Friday, Sept. 19, 2014. Thousands of health workers began knocking on doors across Sierra Leone on Friday in search of hidden Ebola cases with the entire West African nation locked down in their homes for three days in an unprecedented effort to combat the deadly disease. (AP Photo/Michael Duff)



FREETOWN, Sierra Leone (AP) — As a boy, marathon runner Idrissa Kargbo sprinted through the villages of Sierra Leone on errands for his grandmother and later as a coffee courier. Now at 23 years old, his times have qualified him for races on three continents.

This weekend he is back home helping his country try to catch up with the worst Ebola outbreak in history.

Kargbo joined nearly 30,000 volunteers and health care workers who fanned out across the country on Friday to distribute soap and information on how to prevent Ebola, which the World Health Organization says has killed more than 560 people in Sierra Leone and more than 2,600 in the region. The outreach campaign coincided with a sweeping three-day lockdown that confined most of the country's 6 million people to their homes.

Despite the late delivery of some supply kits, officials said Saturday the campaign got off to a smooth start, with little evidence of the resistance that plagued the early Ebola response and still lingers in pockets of the hardest-hit countries: Sierra Leone, Guinea and Liberia. Distribution, screening and education continued through the lockdown.

In an interview with The Associated Press on Saturday, Kargbo said the Freetown residents he'd visited were grateful for whatever information they could get.

"Some people are still denying, but now when you go to almost any house they say, 'Come inside, come and teach us what we need to do to prevent,'" Kargbo said. "Nobody is annoyed by us."



In this Sept. 19, 2014 photo, Idrissa Kargbo, Sierra Leone's National marathon champion who took part in the New York marathon, in recent years, joins Ebola volunteers going from house to house to look for Ebola virus patients in Freetown, Sierra Leone, Thousands of health workers began knocking on doors across Sierra Leone on Friday in search of hidden Ebola cases with the entire West African nation locked down in their homes for three days in an unprecedented effort to combat the deadly disease. (AP Photo/ Michael Duff)


For Kargbo, spreading Ebola awareness was a welcome break from idleness after the outbreak cut off all opportunities for him to train and compete. He had been planning to run the Liberia Marathon in August, having placed second in the race last year, but it was postponed until at least early 2015 as the outbreak in that country spiraled out of control.

The stadium where he normally trains in Freetown has also been closed, he said, and his work as a coffee courier was put on hold because most of the clients — international NGO workers — have fled the country.

"Most of those NGO people are going out," Kargbo said. "Right now, I don't have the chance to go anywhere. I don't have the chance to train."

Sierra Leone's government is clearly hoping the lockdown will help turn the tide against the disease. In a speech before it began, President Ernest Bai Koroma said "the survival and dignity of each and every Sierra Leonean" was at stake.

The strategy is controversial, however. After it was announced earlier this month, Doctors Without Borders warned it would be "extremely difficult for health workers to accurately identify cases through door-to-door screening."



Health worker volunteers talk to a resident to distribute bars of soap and information about Ebola in Freetown, Sierra Leone, Saturday, Sept. 20, 2014. Thousands of health workers began knocking on doors across Sierra Leone on Friday in search of hidden Ebola cases with the entire West African nation locked down in their homes for three days in an unprecedented effort to combat the deadly disease. (AP Photo/Michael Duff)


Even if suspected cases are identified during the lockdown, the group said Sierra Leone wouldn't have enough beds for them.

In northern Sierra Leone, health worker Lamin Unisa Camara said Saturday he had received some reports that residents had run away from their homes to avoid being trapped during the lockdown.

"I was informed that people were running from their houses to the bush. Without wasting time, I informed the chief in charge of the area to call his people," said Camara, who was working in the town of Kambia.

Several health care workers and volunteers complained that supply kits were delivered late, preventing their teams from starting on time. The kits contain bars of soap, cards listing Ebola symptoms, stickers to mark houses visited and a tally sheet to record suspected cases.

Kargbo, however, said his team got to work on time and was on track to meet its goal of visiting 60 households by the end of the lockdown Sunday.

He said the effort would be worth it if the outbreak is shortened even a little. Once it's over, he is looking forward to getting back to a running career that has taken him to races in London and New York in the last year.

"I want this to be finished so I can have the chance to train and go to other countries," he said. "That's why I volunteered to do it."

__

Corey-Boulet reported from Abidjan, Ivory Coast. Youssouf Bah in Kambia, Sierra Leone, and Michael Duff in Freetown, Sierra Leone, contributed to this report.


http://news.yahoo.com/sierra-leone-complies-ebola-lockdown-120924475.html

[Buster's Uncle]

Why Ebola is very unlikely to go airborne
Vox
Updated by Brad Plumer on September 19, 2014, 1:53 p.m. ET@bradplumerbrad@vox.com



Not likely to spread Ebola.  Media for Medical/Getty Images



Ebola is not currently an airborne disease. You can't catch Ebola by sitting across the room from someone who has it. Ebola generally spreads through direct contact with bodily fluids. Everyone agrees on this.


Fears that Ebola will mutate and spread through the air are overblown, experts say
 

But recently, an op-ed in the New York Times raised a disturbing possibility — what if the Ebola epidemic in West Africa goes on long enough and the virus keeps mutating? Could Ebola somehow become airborne then? And wouldn't that allow the disease to spread even faster around the world?

That's a scary scenario. But fortunately for the world, most infectious disease experts remain very skeptical that Ebola will ever become airborne. "This is way down on the list of possible futures for Ebola and in all probability will never happen," said Ian Jones, a virologist with the University of Reading, in an interview with Reuters on this exact topic.


'We've never seen a human virus change the way it is transmitted'

But why are experts so confident Ebola won't become airborne? It's worth reading this long post by Vincent Racaniello, a virologist at the College of Physicians and Surgeons at Columbia University. He goes into detail about how viruses mutate, but here's his bottom line:

When it comes to viruses, it is always difficult to predict what they can or cannot do. It is instructive, however, to see what viruses have done in the past, and use that information to guide our thinking. Therefore we can ask: has any human virus ever changed its mode of transmission?

The answer is no. We have been studying viruses for over 100 years, and we've never seen a human virus change the way it is transmitted.

HIV-1 has infected millions of humans since the early 1900s. It is still transmitted among humans by introduction of the virus into the body by sex, contaminated needles, or during childbirth.

Hepatitis C virus has infected millions of humans since its discovery in the 1980s. It is still transmitted among humans by introduction of the virus into the body by contaminated needles, blood, and during birth.

There is no reason to believe that Ebola virus is any different from any of the viruses that infect humans and have not changed the way that they are spread.

I am fully aware that we can never rule out what a virus might or might not do. But the likelihood that Ebola virus will go airborne is so remote that we should not use it to frighten people. We need to focus on stopping the epidemic, which in itself is a huge job.

This jibes with what Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, told the Senate earlier this week: "Very, very rarely does [a virus] completely change the way it's transmitted."

Further reading: For more on the science of Ebola transmission, check out this previous post by Susannah Locke. She notes that, yes, some pigs infected with Ebola may be able to transmit the disease by coughing and sneezing large droplets. But there's a huge caveat here: Ebola affects pigs in a completely different manner than it does humans (in pigs, Ebola shows up as an infection of the lungs; in humans, it mainly targets the liver).


http://www.vox.com/2014/9/19/6543157/ebola-is-unlikely-to-go-airborne

[Buster's Uncle]

The Dire Need For A Rapid Diagnostic Ebola Test In West Africa
Forbes
Guest post written by William Frist, M.D.  9/18/2014 @ 10:56PM



Dr. Frist represented Tennessee in the U.S. Senate from 1995 to 2007. He served as Senate Majority Leader from 2003 to 2007.

The size and spread of this Ebola epidemic is simply unprecedented. The largest previous Ebola outbreak occurred in 1976 in Zaire: 318 confirmed cases and 280 deaths, but the current outbreak in West Africa has exceeded 4,400 cases with 2,300 deaths and growing. According to WHO estimates more than 20,000 more cases will occur before containment is achieved.

I, and many others, have written about the need for more resources and healthcare infrastructure. Hopefully the U.S. commitment of 1700 beds, training of 500 healthcare workers and 400,000 home treatment kits will offer much needed help and reduce the mortality rate from 50%.

But stemming the tide of this epidemic will not happen with only the commitment the President has made. Treating the sick is imperative, but as the number of cases grows exponentially, we have to take a closer look at why – we are failing at contact mapping and containment, and for three very good reasons.

First, there are cultural barriers to containment such as distrust of Western medicine, commitment to local burial practices, and a lingering disbelief that the virus exists. These barriers prevent containment procedures from being implemented and sanitary burials from being practiced.

Second, there is fear of the disease and what identification and isolation means. “Virus hunters,” public health workers skilled in contact mapping of exposures, are having a difficult time finding the sick because of the fear. People hide, change their address, and have even thrown rocks at aid workers. People do not want to be isolated and taken away from their families to wait out the incubation period and possibly die alone in makeshift clinic far from home.

Finally, we do not have a way of rapidly identifying the virus in the field. Current practice for fever in countries like West Africa is to rule out and treat the things that are more common, easily identified and more easily treated with the assumption that if the patient does not improve, a viral hemorrhagic fever is the diagnosis of exclusion. In West Africa, malaria or bacterial infections are the more likely more treatable diseases, so the practice is to rule out malaria and possibly use empiric antibiotics before assuming Ebola.

We have rapid detection tests (RDTs) for malaria that can and are being used in the field. The problem is the sensitivity and specificity are not adequate to definitively diagnose malaria. And even given this practice of diagnostic rule out, the truth remains that a negative test for malaria does not necessarily mean a positive test for Ebola and visa versa. We need diagnostics that are more definitive.

There are many types of tests for Ebola. Isolating the virus provides the most sensitive and specific diagnosis, but requires transport of biohazard material to a BSL-4 lab, of which there are few in the world. Alternatively there are reverse transcription polymerase chain reaction (RT-PCR) and quantitative PCR, which are both very sensitive and specific, but again require a lab. Newer tests include antigen and antibody identification using ELISA, and a nanoparticle microscopy system termed the Single Particle Interferometric Reflectance Imaging Sensor (SP-IRIS), which can digitally identify virons based on size. (ACS Nano. 2014 Jun 24;8(6):6047-55.)

There have been improvements in diagnostic ability in Sierra Leone that have improved care immensely, but all of these tests must be performed in a lab and that lab may not be local. It could take days to get results back. We need a test we can deploy rapidly in the field and have results in under an hour.

A very rapid test would be game-changing for Ebola. Let’s look at triage in a clinic. Everyone comes in the front door together and waits together. Most people have a fever, but they aren’t sure why. Most likely, it’s another endemic infection like malaria, typhoid or shigella. An RDT could quickly identify patients needing quarantine from those who do not. The benefit here is threefold: fast and early quarantine to separate patients at risk for infecting others making the rest of the hospital safer; replacing fear and anticipation with knowledge; and a more efficient use of quarantine resources because they are saved for people with known Ebola infections.

An RDT would also allow healthcare workers to confidently come to work knowing they are not infected. It would also prevent unnecessary quarantine of these most-needed personnel for the 21 day incubation period.

The same would hold true for exposed individuals. Given the lack of clinics and isolation units, public health workers are offering more home-based care. This requires isolation of people in their homes for up to three weeks.  A RDT would allow appropriate use of those resources.

An RTD could also be used at borders and airports for health officials to safely allow or restrict access from a country with a known outbreak, enabling the delivery of much-needed supplies, workers, and resources safely.

Finally, when this outbreak is contained, having an RDT would help more quickly identify new outbreaks in the future, facilitating early containment and guiding the use of prophylactic drugs, like Zmab, if available.

I want to impress upon you this is not conjecture. The reasons above make logical sense, but experts can also use mathematical modeling studies to show the effect of adequate containment versus rapid detection. Containment is certainly effective and has worked during all outbreaks in the past, but diagnostics either on site, off site, for all febrile patients or even just healthcare works can make a significant impact on the size of an outbreak.

An RDT—a new test or an adaptation of what we have—would not only be a massive step towards controlling this outbreak, I think it is the only step that will ultimately prevent this tragic epidemic from becoming a pandemic.

Avik Roy on Obama's Response to the Ebola Outbreak 2014-09-16

http://www.forbes.com/sites/theapothecary/2014/09/18/the-dire-need-for-a-rapid-diagnostic-ebola-test-in-west-africa/?partner=yahootix

[Buster's Uncle]

Pet animals become victims of Ebola scare in Ivory Coast
AFP
By Joris Fioriti  12 hours ago



A monkey, who was abandoned by its owner at the zoo in Abidjan, is seen in a cage in the quarantine ward of the zoo on September 9, 2014 (AFP Photo/Sia Kambou)



Abidjan (AFP) - From monkeys to big cats, people in Ivory Coast like to keep wild animals as pets but are now rethinking the custom with the deadly Ebola virus sweeping neighbouring countries.

A visit to the zoo in the economic capital Abidjan quickly demonstrated the concerns. The institution has begun to take in animals abandoned by owners, aware that wild beasts can be vectors of the highly contagious haemorrhagic fever.

The green cages in one section of the zoo have filled up with abandoned or donated animals, but nobody is allowed to visit them since the area is a quarantine zone.

Behind the bars of one cage, monkeys chattered, grunted and gesticulated with excitement. A sign makes it clear that none carry the virus, but they have nonetheless been isolated to prevent possible contamination.

Julie, a two-year-old chimpanzee, showed off and scampered around, asking to be petted. Charlotte, a red baboon, leapt frantically around the cage. Louise, a medium-sized monkey with a white belly and nose, sat stoically on a bar amid the racket. The two males sharing the cage were new and had yet to be named.


- 'An animal spreading panic' -

The youngest arrival, a small red monkey about 30 centimetres (almost one foot) tall, came to the zoo at the beginning of September in circumstances that highlight the fear of Ebola.



A baboon, named Charlotte, is seen in a cage painted in green next to a sign reading "access forbidden to people outside the quarantine" in the quarantine ward of the zoo in Abidjan on September 9, 2014 (AFP Photo/Sia Kambou)


The disease has killed almost 1,800 people across closed borders in neighbouring Liberia and Guinea alone and a total 2,600 in the four countries where the disease has hit, including Sierra Leone and Nigeria.

The zoo's vet, Daouda Soro, said that he had been summoned in haste to Abidjan's military hospital to deal with "an animal who was spreading panic". When he got there, he found a "very small (monkey) who was sleepy but shivering with hunger".

"It was above all Ebola that caused the panic," Soro told AFP.

As for Charlotte, she was abandoned on the street by her owner. Informed of her endangered state by passersby, Soro sped to the scene to find the baboon surrounded by people armed with "stones and clubs (who) wanted to kill her", he said.

Three weeks later, the three-year-old female was clearly doing much better. Whenever her caretaker Charles Aby Yapi turned his back, Charlotte confidently set about normal primate behaviour trying to pick fleas and ticks off him.

The newcomers "are not aggressive," Yapi said with a smile. The only employee authorised to look after quarantined animals, he wears gloves in the cages and systematically washes his boots in disinfectant.



An employee of the zoo of Abidjan looks at a monkey sitting in cage of the quarantine ward after it was abandoned by its owner at the zoo, on September 9, 2014 (AFP Photo/Sia Kambou)


Even if they are not carrying the Ebola virus, the beasts taken in by the zoo could be infected with a range of diseases, and at risk of contaminating other animals.

"As soon as we can, we'll put the (isolated arrivals) in the zoo" with their own kind, said deputy director Richard Champion, who specified that "the length of quarantine depends on the species."

Strident howls suddenly erupted during the visit. Julie was calling for help. The chilly chimpanzee took fright when Yapi vanished out of sight after putting her in a more comfortable cage so that she could spend the night in a blanket.

Julie's owner sadly relinquished his pet monkey to the zoo under pressure from his neighbours, who began to hassle him constantly on account of the Ebola scare.


- 'Ebola doesn't hide in bushes' -

"We have already had to turn down about 10 animals" for lack of space in the quarantine zone and in compliance with strict regulations, Soro said.

Instead, advice is being made available to pet owners so that they can go on looking after their monkeys until there is more room in quarantine and places become free.

However, the situation could rapidly worsen if a case of Ebola is diagnosed in Ivory Coast. "That would certainly create panic. So people will abandon their animals," zoo director Samouka Kane said.

The number of beasts people might then want to drop off at the zoo would grow exponentially because domesticating wild animals for company is a widely established practice.

Most animals in the zoo, apart from the elephant but including the leopard, have already been donated by people who no longer wanted to keep such pets at home once they were full-grown, Champion said.

Visitors benefit from the range of wildlife, but ever fewer people have been coming to the zoo since there is widespread but mistaken concern that any wild beast might be a carrier of Ebola.

Researchers worldwide have postulated that the fruit bat is a primary vector that may have passed on the disease to forest antelopes and primates, popularly eaten in many African countries as "bush meat", but there are no certainties.

Kane recalled how one woman who entered the zoo "on tiptoe" panicked and told him how she was "looking everywhere" to try to spot the virus.

"I told her that Ebola doesn't hide in the bushes," he said with a laugh. "Nor in the eyes of an animal."


http://news.yahoo.com/pet-animals-become-victims-ebola-scare-ivory-coast-040447897.html

[Buster's Uncle]

Sierra Leone faces criticism over Ebola shutdown
AFP
By Rod MacJohnson  1 hour ago



A health worker, wearing Personal Protective Equipment, stands inside the high-risk area at Elwa hospital in Monrovia on September 7, 2014 (AFP Photo/Dominique Faget)



Freetown (AFP) - Sierra Leone began the second day of a 72-hour nationwide shutdown aimed at containing the spread of the deadly Ebola virus on Saturday amid criticism that the action was a poorly planned publicity stunt.

Most of Sierra Leone's six million people have been confined to their homes from midnight (0000 GMT) on Friday, with only essential workers such as health professionals and security forces exempt.

Almost 30,000 volunteers are going door-to-door to educate locals and hand out soap, in an exercise expected to lead to scores more patients and bodies being discovered in homes.

But independent observers have voiced concerns over the quality of advice being given out, deeming the shutdown a "mixed success" in the Western Area, the region that includes the capital Freetown.

"While the supervisors were well trained, the visiting teams to families in some parts in the Western Area had poor training and could not deliver the information properly," said Abubakarr Kamara, from the Health for All Coalition, a local charity.

"From my observation, many of them were too young to be involved in the exercise and in one or two households where I witnessed their intervention, there were hardly messages given to the families which were beneficial to the households."

Ebola fever can fell its victims within days, causing severe muscle pain, vomiting, diarrhoea and -- in some cases -- unstoppable internal and external bleeding.

The outbreak has killed more than 2,600 people in Guinea, Liberia and Sierra Leone this year, cutting a swathe through entire villages at the epicentre and prompting warnings over possible economic catastrophe from the World Bank.

"Ose to Ose Ebola Tok" -- "House-to-House Ebola Talk" in the widely-spoken Krio language -- will see more than 7,000 volunteer teams of four attempting to reach the country's 1.5 million homes before the end of Sunday.



A sign warning of the dangers of Ebola outside a government hospital in the Sierra Leonean capital Freetown on August 13, 2014 (AFP Photo/Carl De Souza)


- 'Publicity stunt' -

Joe Amon, health and human rights director at New York-based advocacy organisation Human Rights Watch, described the shutdown as "more of a publicity stunt than a health intervention".

"Publicity -- or really crisis communication -- is what is urgently needed in this epidemic, but it should focus on spreading information and building trust with the government. The shutdown is the wrong approach," he told AFP.

Steven Gaoja, head of the government's emergency Ebola operation centre, admitted the first day was "really very rocky" at the start, but said organisation had improved throughout the day.

"On the whole we came out successful. We feel confident that the initial problems we encountered have been slashed," he said.

He said the centre had received 886 calls on a variety of Ebola-related issues by 3:00 pm, 102 reporting suspected cases but 238 of which were pranks.

"We have a target to reach every household in the country and the goal is to ensure that families have the right information about Ebola," said ministry of health spokesman Sidi Yahya Tunis.

"We are certain we will reach the target so people have to be a little patient."

Some complaints continued into Saturday, although there was also praise for the campaign.

"The campaign teams are not being rapid in their calls. They kept my family of six sitting the whole of yesterday and didn't show up," said Ghanaian fisherman Kwaku Adophy in Goderich, an affluent seaside suburb of 3,000 in the west end of Freetown.

"When they came this morning, nobody entered the compound but one member stood at the gate and shouted for us to come out and receive a bar of soap. No other information was given to us. We are very disappointed."

Isatu Koroma, a resident of Hill Station some six kilometres (four miles) away, said however that a door-to-door team had spent "a useful 30 minutes giving my family much needed information".

A spokesman for the World Health Organization said on Friday a contingent of Cuban doctors and nurses from a 165-strong delegation expected in Sierra Leone would be arriving over the weekend.

From the first week of October, the doctors and nurses would remain for six months.


http://news.yahoo.com/sierra-leone-faces-criticism-over-ebola-shutdown-093419949.html

[Buster's Uncle]

Sierra Leone staggers in Ebola isolation effort
AP - Sports
By CLARENCE ROY-MACAULAY (Associated Press) 3 hours ago



FREETOWN, Sierra Leone (AP) -- Some in Sierra Leone ran away from their homes Saturday and others clashed with health workers trying to bury dead Ebola victims as the country struggled through the second day of an unprecedented lockdown to combat the deadly disease.

Despite these setbacks, officials said most of Sierra Leone's 6 million people were complying with orders to stay at home as nearly 30,000 volunteers and health care workers fanned out across the country to distribute soap and information on how to prevent Ebola.

The virus, spread by contact with bodily fluids, has killed than 560 people in Sierra Leone and more than 2,600 in West Africa since the outbreak began last December, according to the World Health Organization. It is killing about half of the people it infects.

The streets of the capital, Freetown, were empty Saturday except for the four-person teams going door to door with kits bearing soap, cards listing Ebola symptoms, stickers to mark houses visited and a tally to record suspected cases.

Among the volunteers was Idrissa Kargbo, a well-known marathoner who has qualified for races on three continents but whose training and career have been stymied by the outbreak.

Although early responses to the disease have been marred by suspicion of health workers, Freetown residents on Saturday seemed grateful for any information they could get, Kargbo told The Associated Press.

''Some people are still denying, but now when you go to almost any house they say, 'Come inside, come and teach us what we need to do to prevent,''' Kargbo said. ''Nobody is annoyed by us.''

Sierra Leone's government is clearly hoping the lockdown will help turn the tide against the disease which the U.N. health agency estimates will take many months to eradicate in the country. In a speech before the lockdown, President Ernest Bai Koroma said ''the survival and dignity of each and every Sierra Leonean'' was at stake.

The strategy has drawn criticism, however. The charity group Doctors Without Borders warned it would be ''extremely difficult for health workers to accurately identify cases through door-to-door screening.''

Even if suspected cases are identified during the lockdown, the group said Sierra Leone doesn't have enough beds to treat them.

In a district 20 kilometers (12 miles) east of Freetown, police were called in Saturday to help a burial team that came under attack by residents as they were trying to bury the bodies of five Ebola victims, Sgt. Edward Momoh Brima Lahai said.

A witness told state television the burial team initially had to abandon the five bodies in the street and flee. Lahai said later the burials were successfully completed after police reinforcements arrived. The bodies of Ebola victims are very contagious and must be buried by special teams.

In northern Sierra Leone, health worker Lamin Unisa Camara said Saturday he had received reports that some residents had run away from their homes to avoid being trapped inside during the lockdown.

''People were running from their houses to the bush. Without wasting time, I informed the chief in charge of the area,'' said Camara, who was working in the town of Kambia.

Several health care workers and volunteers complained that supply kits were delivered late, preventing their teams from starting on time.

But Kargbo, the marathoner, said his team was on track to meet its goal of visiting 60 households by the end of the lockdown Sunday. He said the effort would be worth it if the outbreak is shortened even a little.

Other Freetown residents, however, were having trouble making it through the three days.

''The fact is that we were not happy with the three days, but the president declared that we must sit home,'' said Abdul Koroma, the father of nine children in Freetown.

''I want to go and find (something) for my children eat, but I do not have the chance,'' he said.

--

Youssouf Bah in Kambia, Sierra Leone, Michael Duff and Kabba Kargbo in Freetown, Sierra Leone, and Robbie Corey-Boulet in Abidjan, Ivory Coast, contributed to this report.


http://news.yahoo.com/sierra-leone-marathoner-joins-race-144210196--spt.html

[Buster's Uncle]

Spain to fly back missionary with Ebola from S.Leone
AFP
2 hours ago



Madrid (AFP) - Spain is sending a plane to fly a Catholic missionary infected with the deadly Ebola virus home from Sierra Leone, officials said Saturday.

Brother Manuel Garcia Viejo, 69, director of a hospital in the Sierra Leonean town of Lunsar, "has tested positive (for Ebola) and has expressed his desire to be transferred to Spain", the health ministry said in a statement.

He is the second Spaniard to contract Ebola in the current outbreak.

"In the coming hours a medical plane from the defence ministry will set off for Sierra Leone, carrying two doctors and three nurses with all the equipment necessary to protect the personnel and maintain the treatment of the patient," it said.

It said the risk to public health in Spain from the patient was "practically nil".

Garcia is a member of the Hospital Order of San Juan de Dios, a Roman Catholic group that runs Juan Ciudad, a charity working with Ebola victims.

On Saturday he was being treated in an Ebola unit in the Sierra Leone capital Freetown, the order said in a statement.

Garcia, a specialist in internal medicine, is also qualified in tropical medicine. He has worked in Africa for 30 years and has been director of the hospital in Lunsar for the past 12 years, it said.

Sierra Leone on Saturday began the second day of a 72-hour nationwide shutdown aimed at containing the spread of the deadly virus.

Most of the country's six million people were confined to their homes from midnight (0000 GMT) on Friday, with only essential workers such as health professionals and security forces exempt.

Spanish health officials did not expect the curfew to impede their efforts to fly Garcia out of the country, however.

The ministry said late Saturday that his repatriation would take place "in the coming hours" and he would be taken straight to Madrid's La Paz-Carlos III hospital.

In August a 75-year-old Spanish priest became the first European to die from Ebola during the current outbreak in west Africa, the worst since the disease was first discovered four decades ago.

That missionary, Miguel Pajares, was infected in Liberia, where he worked with Ebola patients.

The epidemic has so far killed more than 2,600 people in west Africa, the UN World Health Organization said Thursday.

No vaccine or medicine is available for treating Ebola. Pajares was treated with an experimental US serum, ZMapp, while in isolation in La Paz-Carlos III.

The virus causes severe muscle pain, vomiting, diarrhoea and -- in some cases -- unstoppable internal and external bleeding.

British nurse William Pooley, 29, who was infected with Ebola while working in Sierra Leone, recovered this month following treatment with ZMapp.

France on Friday authorised "experimental treatments" for a French nurse with Ebola who was flown back from Liberia.


http://news.yahoo.com/spain-fly-back-missionary-ebola-leone-202952954.html

[Buster's Uncle]

Sierra Leone begins 3-day Ebola lockdown
Sierra Leone begins 3-day Ebola lockdown; 1st US military aid lands in Liberia
Associated Press
By Clarence Roy-Macaulay, Associated Press  September 19, 2014 10:51 AM



A charity worker, center, from the GOAL Ireland humanitarian agency, educates children on how to prevent and identify the Ebola virus in their communities at Freetown, Sierra Leone, Thursday, Sept. 18, 2014. Shoppers crowded streets and markets in Sierra Leone's capital on Thursday stocking up for a three-day shutdown that authorities will hope will slow the spread of the Ebola outbreak that is accelerating across West Africa. (AP Photo/ Michael Duff)



FREETOWN, Sierra Leone (AP) -- Thousands of health workers began knocking on doors across Sierra Leone on Friday in search of hidden Ebola cases as the entire West African nation was locked down in their homes in an unprecedented effort to combat the deadly disease.

Authorities hope to find and isolate Ebola patients who have resisted going to health centers, often seen only as places to die. Some international health experts have warned that such a strategy could backfire especially if there are not enough beds at treatment centers for all the new patients found during the three-day lockdown which began Friday.

UNICEF said the measure provides an opportunity to tell people how to protect themselves.

"If people don't have access to the right information, we need to bring life-saving messages to them, where they live, at their doorsteps," said Roeland Monasch, UNICEF Representative in Sierra Leone. In a statement, the U.N. children's fund said the operation needs to be carried out "in a sensitive and respectful manner."

During this first-ever Ebola outbreak in West Africans, some people have lashed out at health workers, accusing them of bringing the dreaded disease. Others don't believe it exists. Many villagers have reacted with fear and panic when outsiders have come to conduct awareness campaigns, and this week such an encounter resulted in deaths.

Six people have been arrested in the killings of eight people in Guinea who had been on an Ebola awareness campaign there, the Guinean government said Friday. The team, accompanied by journalists, had gone to the village of Womey on Tuesday. Another team dispatched to look for nine missing members discovered eight bodies, including those of three local journalists, a hospital administrator and several health officials, the government said.

Only one of the missing, the son of a Womey deputy administrative leader, was found alive, hiding in the area, the government statement said.

In an address to the nation late Thursday, Sierra Leone President Ernest Bai Koroma said health workers would be handing out soap and that once a house had been visited it would be marked with a sticker. He urged Sierra Leoneans to abide by the order.

"The survival and dignity of each and every Sierra Leonean is at stake; all what we have toiled for as a people is at stake; this is a fight for each and every one of us; this is a fight for this land that we love," he said.

More than 2,600 people have died across West Africa, with more than half the fatalities recorded in Liberia.

Earlier this week, President Barack Obama pledged 3,000 troops and the first increased American military aid arrived in Liberia on Thursday, according to the U.S. Embassy there.

The C-17 U.S. military aircraft brought a team of seven military personnel along with some equipment on Thursday. An embassy statement said more supplies and personnel are expected in the coming days.

___

Associated Press writer Jonathan Paye-Layleh in Monrovia, Liberia, and Boubacar Diallo in Conakry, Guinea, contributed to this report.


http://news.yahoo.com/sierra-leone-begins-3-day-145136976.html

[Buster's Uncle]

Ebola health team found dead
Vox
Updated by Julia Belluz on September 19, 2014, 6:27 a.m. ET@juliaoftorontojulia.belluz@voxmedia.com


Eight people, including health workers and three journalists, have been found dead in Guinea, where they were distributing health information about Ebola.

"The eight bodies were found in the village latrine. Three of them had their throats slit," a Guinean government spokesperson told Reuters.

The team was allegedly attacked while working near the city of Nzérékoré. The group had been stoned on Tuesday and then went missing, according to the Guardian. They were believed to be held captive.

The Guardian reported that their messages about Ebola had been met by hostile residents:

The meeting started off well; the traditional chiefs welcomed the delegation with 10 kola nuts as a traditional greeting," said a local resident who was present at the meeting earlier this week and gave only his first name, Yves. "It was afterwards that some youths came out and started stoning them. They dragged some of them away, and damaged their vehicles.

Some believed they were actually in Guinea to spread the disease.

This isn't the first time public health workers have been attacked during the epidemic. Aid workers, including members of Doctors without Borders and the Red Cross, have reported that fear of the virus or the belief foreigners are giving people the illness have spurred locals to attack health teams or run away at their sight.

Part of this reaction is the result of the fact that this is the first time the virus has surfaced in West Africa, where many people had no idea about Ebola before this year. Spreading public health messages has been extremely challenging in an environment with low health literacy and public trust in officials.

In Liberia, distrust in the government led some people to think Ebola is a government scam to attract international aid.

But the killing of Ebola workers in Guinea takes this hostility to a new and disturbing level.

This year, Ebola has killed more people than sum total of all the previous outbreaks since the virus was first identified in 1976.

Further reading: Here are the seven reasons why this outbreak got so bad and a list of aid groups working on the Ebola crisis and how to donate.


http://www.vox.com/2014/9/18/6430563/ebola-virus-health-team-found-dead-in-guinea

[Buster's Uncle]

Sierra Leone burial team attacked despite lockdown
Reuters
By Umaru Fofana  56 minutes ago



An empty street is seen at the start of a three-day national lockdown in Freetown September 19, 2014.REUTERS/Umaru Fofana



FREETOWN (Reuters) - A team burying Ebola victims was attacked in Sierra Leone's capital on Saturday, a member of parliament said, as a small group defied a three-day lockdown aimed at halting the worst outbreak of the disease on record.

In one of the most extreme measures since the epidemic began, Sierra Leone has ordered its population of 6 million to stay indoors as volunteers circulate to educate residents about the disease as well as isolate the sick and remove the dead.

Residents have mostly complied with the measures announced by President Ernest Bai Koroma earlier this week. On the second day of the lockdown, the streets were mostly deserted, except for ambulances and police vehicles.

The attack on the burial team on Saturday occurred in the village of Matainkay, some three miles from the Waterloo district of Freetown.

Claude Kamanda, MP for the Waterloo district, said that armed policemen accompanying the burial team quickly arrived, causing the attackers to flee.

The police Local Unit Commander in the area, Superintendent Mustapha Kamara said he sent reinforcement to the village "after some youths attempted to disrupt the burial". He told Reuters that he has now instructed that the burial team must inform them to provide a stronger presence.

Ebola has infected at least 5,357 people in West Africa this year, mainly in Sierra Leone, Guinea and Liberia, killing 2,630 of those, according to the World Health Organization. More than 562 people have died in Sierra Leone.

Neighboring Liberia had put in place temporary community quarantine measures and curfews last month, but lifted them after street protests.

Some have criticized Sierra Leone's lockdown measures, warning of food shortages and saying it might cause people to go to extra lengths to conceal highly contagious bodies.

But volunteers said they were bombarded with calls on an Ebola hotline over the last two days, receiving hundreds of requests for help.

Stephen Gaojia, head of an emergency services operation, said the ability of his teams to respond to the calls was limited by shortages of staffing and equipment.

"We need about 14 burial teams, as we speak we have about nine", he said. "So if we have more number of people that will be able to improve our response time".

The leader of the United Democratic Movement party, Mohamed Bangura, told Reuters that his team buried 11 Ebola victims on Saturday.


U.N. DEPLOYMENT

The outbreak of the hemorrhagic fever is the worst since it was identified in 1976 in the forests of central Africa. The first victim of the current epidemic is thought to have caught the disease from a fruit bat in the forests of Guinea last December.

Western nations, led by the United States, have pledged in recent days to ramp up their aid efforts, and the United Nations said it would begin deploying an advanced team of its special mission to a regional headquarters in Ghana by Monday.

A chartered 747 jet, carrying the largest single shipment of aid, including protective gear and medications, to the Ebola zone to date and coordinated by the Clinton Global Initiative and other U.S. aid organizations, departed New York's John F. Kennedy International Airport on Saturday afternoon bound for West Africa.

Former President Bill Clinton praised new efforts from the United States, Britain, France and other countries to fight the epidemic. "We're still a little behind the curve but we're getting there," Clinton said on Saturday.

Volunteers and healthcare workers are often viewed with suspicion by locals who blame them for infecting the communities they are meant to be healing, slowing the ability of authorities to contain the disease.

Friday Kiyee, head of a Monrovia Ebola burial team, said that earlier this week locals placed a roadblock to prevent the collection of the decomposing body of a 29-year-old victim.

"Sometime we go into a community people will tell us they need an autopsy, and at the final stages you will see them blocking road. We don't expect for our own brothers to behave this way," she said.

Bans on Guinea, Liberia and Sierra Leone hosting any international football because of fears of spreading Ebola were kept in place by the Confederation of African Football, its executive committee decided on Saturday.

(Additional reporting by James Harding in Monrovia, Michelle Nichols in New York, Caren Bohan in Washington; Writing by Emma Farge; Editing by Leslie Adler)


http://news.yahoo.com/sierra-leone-burial-team-attacked-despite-lockdown-221015211--finance.html

[Buster's Uncle]

Bill Clinton says must 'do whatever it takes' to fight Ebola
Reuters
By Caren Bohan and Sharon Begley  1 hour ago



Former U.S. President Bill Clinton leads a panel discussion during the U.S.-Africa Business Forum in Washington August 5, 2014. REUTERS/Jonathan Ernst



WASHINGTON/NEW YORK (Reuters) - New initiatives from the United States, Britain, France and other countries to help fight the Ebola epidemic that has been spreading exponentially in West Africa marked a "good beginning," former President Bill Clinton said on Saturday, but said the world will need to do more.

"We're still a little behind the curve but we're getting there," Clinton told reporters in a conference call, a day before his charity, the Clinton Global Initiative, was set to begin its 10th annual meeting in New York.

A chartered 747 jet, carrying the largest single shipment of aid to the Ebola zone to date and coordinated by CGI and other U.S. aid organizations, departed New York's John F. Kennedy International Airport on Saturday afternoon bound for West Africa.

After refueling in Cape Verde, the Kalitta Air charter is scheduled to land in Freetown, Sierra Leone, on Sunday morning.

The shipment of 170 pallets containing gloves, gowns and other protective equipment for medical workers will be met by government officials and local aid workers, and distributed to some 200 healthcare facilities on Monday, said Thomas Tighe, chief executive of the California-based aid group Direct Relief, which collected the 100 tons of emergency medical aid.

Because Sierra Leone on Friday started a three-day government-ordered lockdown that prohibits most people from leaving their homes as health workers and others go door-to-door to educate people about Ebola and isolate the sick, the volunteers who will off-load the Direct Relief supplies have been staying at the airport for days.

The plane will continue on to Monrovia, Liberia, to deliver the rest of its cargo: 2.8 million gloves, 170,000 protective gowns, 120,000 masks, 40,000 liters of pre-mixed oral hydration solution, and 9.8 million doses of medications. The protective equipment can supply 280 healthcare workers treating Ebola patients for one year.

Since the outbreak was detected in March, Ebola has infected at least 5,357 people, according to the World Health Organization, mostly in Guinea, Sierra Leone and Liberia, and killed an estimated 2,630. It has also spread to Senegal and Nigeria.

In a major expansion of the U.S. effort against Ebola, President Barack Obama this week announced that the United States would send 3,000 troops to West Africa help tackle the outbreak, including a major deployment in Liberia.

"We're going to have to do whatever it takes to contain the epidemic," Clinton said.

"It's a sprawling, growing thing. But at least they're putting the infrastructure in and have shown a willingness to put some money behind it, and I think it's a good beginning."

In a brief ceremony before the 747 taxied down the runway at JFK, Liberia's minister of foreign affairs, Augustine Kpehe Ngafuan, said the aid shipment "will translate into saving lives." He added, "We have been able to place men on the moon. Let us do a similar thing for mankind. I appeal to the international community."

(Reporting by Caren Bohan and Sharon Begley; Editing by Leslie Adler)


http://news.yahoo.com/bill-clinton-says-must-whatever-takes-fight-ebola-183750051.html

[Buster's Uncle]

India postpones Africa summit over Ebola outbreak
AFP
8 hours ago



Liberian Red Cross health workers, wearing protective suits, carry the body of a 18-old-month baby, victim of the Ebola virus in a district of Monrovia on September 12, 2014 (AFP Photo/Zoom Dosso)



The deadly Ebola outbreak in west Africa has forced India to postpone plans for a December summit in New Delhi attended by representatives of more than 50 African nations, officials said on Saturday.

The spread of the virus, which has killed more than 2,600 people in Guinea, Liberia and Sierra Leone this year, made it "logistically difficult given the public health guidelines to manage" the Third India-Africa Forum Summit, a foreign ministry official said.

India had been expecting nearly 1,000 delegates including ministers, government officials and business leaders for the meeting on December 4, expected to be one of the biggest international events in the country in years.

The government will work with the African Union on rescheduling the trade-focused summit for 2015, foreign ministry spokesman Syed Akbaruddin told a media briefing.

The Ebola outbreak has cut a swathe through entire villages at the epicentre and prompted warnings from the World Bank of possible economic catastrophe.

Ebola fever can fell its victims within days, causing severe muscle pain, vomiting, diarrhoea and -- in some cases -- unstoppable internal and external bleeding.

India's airports went on alert in August to screen arrivals from west Africa as part of measures to prevent an outbreak of Ebola in the country of 1.25 billion people.

India's Health Minister Harsh Vardhan has said the country has "put in operation the most advanced surveillance and tracking systems" for the virus.

But health experts have voiced worries that India's already overburdened health services could not cope with an Ebola outbreak.

They say setting up adequate isolation and containment facilities and equipping medical personnel with protective gear would be beyond the country's capacity.

US President Barack Obama announced the deployment of troops to west Africa earlier this week, appealing for urgent global action to prevent the virus from spreading "exponentially".


http://news.yahoo.com/india-postpones-africa-summit-over-ebola-outbreak-153428285.html

[Buster's Uncle]

Sierra Leone Ebola burial team attacked despite lockdown
Reuters
3 hours ago



FREETOWN (Reuters) - A team burying Ebola victims was attacked in Sierra Leone's capital on Saturday, a member of parliament said, as some residents defied a three-day lockdown aimed at halting the worst outbreak of the disease on record.

Claude Kamanda, MP for the Waterloo district of Freetown, said that armed policemen accompanying the burial team quickly arrived, causing the attackers to flee.

Sierra Leone has asked its population of 6 million to stay indoors for three days as volunteers circulate to educate people about the disease as well as isolate the sick and remove the dead.

Ebola has infected at least 5,357 people in West Africa this year, mainly in Sierra Leone, Guinea and Liberia, killing 2,630 of those, according to the World Health Organization.

(Reporting by Umaru Fofana; Writing by Emma Farge; Editing by Leslie Adler)


http://news.yahoo.com/sierra-leone-ebola-burial-team-attacked-despite-lockdown-193304501.html