Ebola news 9/23

[Buster's Uncle]

Ever-present endemic Ebola now major concern for disease experts
Reuters
By, Kate, Kelland, 29 minutes ago



LONDON, Sept 23 (Reuters) -

West Africa's Ebola epidemic is the largest the world has ever seen, but infectious disease experts are almost as fearful of a long-term legacy in humans as they are about the deaths it is causing right now.

While the current outbreak is vast and out of control, even pessimistic forecasts suggest it will eventually recede.

But if the virus continues to transmit from person to person for a year or more, the risk is that Ebola will become endemic in humans and constitute an ever-present threat to people in the region and the rest of the world.

"The big question here for me is, will this virus become endemic -- meaning it's being transmitted at low levels (in humans all the time)?" said Peter Piot, director of the London School of Hygiene and Tropical Medicine and one of the scientists who identified the Ebola virus almost 40 years ago.

Jeremy Farrar, director of the Wellcome Trust and an expert in infectious diseases, said all the signs are that this Ebola outbreak will run for many months yet, increasing the risk that West Africans could become a reservoir for the virus's spread to other parts of the continent and the rest of the world.

"The concern is that if it keeps going, it will turn from an epidemic disease, which is terrible, to becoming endemic in humans, which means would no longer require an overspill from animals to cause an outbreak," he told reporters at a briefing.

"Then it would also increase the possibility of spread beyond the region."

The West Africa Ebola epidemic has killed more than 2,800 people since it began in Guinea earlier this year, and the World Health Organisation (WHO) has said up to 20,000 people could be affected before it is brought under control.

The virus, which can have a human mortality rate of up to 90 percent, is thought to be carried by bats or other wild animals and crosses into humans through contact with blood, meat or other infected fluids.


BAD HOSTS

Farrar said that if Ebola were to become endemic, it would almost inevitably simultaneously become less virulent.

This would mean that while the risk of wide regional and even global spread was far higher, the disease would be likely to kill a smaller proportion of the people it infected.

Ebola infection is caused by a virus whose raison d'etre is to survive for as long as possible so that it can replicate and multiply, Piot explained.

Because so many humans are killed so quickly, they are in fact a very ineffective "host" for the Ebola virus. A mortality rate of up to 90 percent may be frightening, but at least it means the outbreaks eventually kill themselves off.

"We (humans) are a very bad host from the virus' point of view," said Piot. "A host that's killed by a virus in a week or so is absolutely useless.

"So in all other outbreaks it eventually just disappeared from the human host and retreated into animals."

If it were to adapt to humans, perhaps becoming less deadly and allowing them to survive and become better hosts, the virus could settle and pool into a human reservoir.

"The time you really start to worry is when mortality rate drops -- because that suggests the probability that the disease is adapting to humans and risks becoming endemic," said Farrar.

A panel of more than 60 World Health Organisation (WHO) experts conducted an analysis of the first nine months of the West Africa outbreak and calculated its case fatality rate at between 69 and 73 percent, according to a study in the New England Journal of Medicine.

But epidemiologists have cautioned that data collection is understandably lagging behind as the disease wreaks havoc in Guinea, Liberia and Sierra Leone - suggesting current case numbers and death rates are likely to be underestimates.


http://news.yahoo.com/ever-present-endemic-ebola-now-major-concern-disease-152655370--finance.html

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Ebola cases could reach 550,000 to 1.4 million by late January: CDC
Reuters
By Sharon Begley  7 minutes ago



A U.N. convoy of soldiers passes a screen displaying a message on Ebola on a street in Abidjan August 14, 2014. REUTERS/Luc Gnago



(Reuters) - Between 550,000 and 1.4 million people in West Africa could be infected with the Ebola virus by January 20, 2015, according to a study published on Tuesday by researchers at the U.S. Centers for Disease Control and Prevention (CDC).

The top range of the estimate, 1.4 million, assumes that the number of cases, 5,864 according to the count kept by the World Health Organization, is significantly underreported, and that it is likely that 2.5 times as many cases, or about 15,000, have in fact occurred.

CDC emphasized that the projections, based on an epidemiological model that takes into account how many people each Ebola patient eventually infects as well as other factors, are based on data from late August. They, therefore, do not account for the recently announced U.S. government Ebola relief effort, which includes sending 3,000 members of the armed forces to the stricken region and training 500 healthcare workers per week.

"Extensive, immediate actions – such as those already started – can bring the epidemic to a tipping point to start a rapid decline in cases," CDC said in a statement.

"A surge now can break the back of the epidemic," CDC director Dr. Thomas Frieden told reporters. "If you get enough people effectively isolated, the epidemic can be stopped," he said, adding, "I am confident the most dire projections will not come to pass" now that the international community has begun to respond.

Also on Tuesday, experts from the World Health Organization projected that Ebola outbreak could infect 20,000 people as soon as early November unless rigorous infection control measures are implemented, and might become a constant, endemic disease in the region rather than being completely eradicated.

In contrast, the WHO in late August predicted that the virus could strike 20,000 people by the middle of 2015. The current death toll is at least 2,811 out of the reported 5,864 cases, the U.N. agency said.

According to the CDC analysis, published in the journal Morbidity and Mortality Weekly Report, reported cases in Liberia are doubling every 15 to 20 days, while those in Sierra Leone are doubling every 30 to 40 days.

The essence of the CDC analysis is a mathematical model, called EbolaResponse, that allows researchers to see how different actions affect the course of the epidemic.

For instance, it shows that if by late December 70 percent of Ebola patients have received treatment - or safe burial, if medical efforts fail - thereby slashing transmission rates, the epidemic begins to decrease and eventually end by late January 2015.

The model also projects that every 30-day delay in reaching that 70 percent tipping point would triple the number of daily cases at the peak of the epidemic.

The Excel 2010-based model is available at http://stacks.cdc.gov/view/cdc/24900.

(Reporting by Sharon Begley; Editing by Chizu Nomiyama and Gunna Dickson)


http://news.yahoo.com/ebola-cases-could-reach-between-550-000-1-143355195.html

[Buster's Uncle]

Ever-present endemic Ebola now major concern for disease experts
Reuters
By Kate Kelland  1 hour ago



Students of Goverment Secondary School Garki wash their hands, as school resumes in Abuja September 22, 2014. REUTERS/Stringer



LONDON, Sept 23 (Reuters) - West Africa's Ebola epidemic is the largest the world has ever seen, but infectious disease experts are almost as fearful of a long-term legacy in humans as they are about the deaths it is causing right now.

While the current outbreak is vast and out of control, even pessimistic forecasts suggest it will eventually recede.

But if the virus continues to transmit from person to person for a year or more, the risk is that Ebola will become endemic in humans and constitute an ever-present threat to people in the region and the rest of the world.

"The big question here for me is, will this virus become endemic -- meaning it's being transmitted at low levels (in humans all the time)?" said Peter Piot, director of the London School of Hygiene and Tropical Medicine and one of the scientists who identified the Ebola virus almost 40 years ago.

Jeremy Farrar, director of the Wellcome Trust and an expert in infectious diseases, said all the signs are that this Ebola outbreak will run for many months yet, increasing the risk that West Africans could become a reservoir for the virus's spread to other parts of the continent and the rest of the world.

"The concern is that if it keeps going, it will turn from an epidemic disease, which is terrible, to becoming endemic in humans, which means would no longer require an overspill from animals to cause an outbreak," he told reporters at a briefing.

"Then it would also increase the possibility of spread beyond the region."

The West Africa Ebola epidemic has killed more than 2,800 people since it began in Guinea earlier this year, and the World Health Organization (WHO) has said up to 20,000 people could be affected before it is brought under control.

The virus, which can have a human mortality rate of up to 90 percent, is thought to be carried by bats or other wild animals and crosses into humans through contact with blood, meat or other infected fluids.


BAD HOSTS

Farrar said that if Ebola were to become endemic, it would almost inevitably simultaneously become less virulent.

This would mean that while the risk of wide regional and even global spread was far higher, the disease would be likely to kill a smaller proportion of the people it infected.

Ebola infection is caused by a virus whose raison d'etre is to survive for as long as possible so that it can replicate and multiply, Piot explained.

Because so many humans are killed so quickly, they are in fact a very ineffective "host" for the Ebola virus. A mortality rate of up to 90 percent may be frightening, but at least it means the outbreaks eventually kill themselves off.

"We (humans) are a very bad host from the virus' point of view," said Piot. "A host that's killed by a virus in a week or so is absolutely useless.

"So in all other outbreaks it eventually just disappeared from the human host and retreated into animals."

If it were to adapt to humans, perhaps becoming less deadly and allowing them to survive and become better hosts, the virus could settle and pool into a human reservoir.

"The time you really start to worry is when mortality rate drops -- because that suggests the probability that the disease is adapting to humans and risks becoming endemic," said Farrar.

A panel of more than 60 World Health Organization (WHO) experts conducted an analysis of the first nine months of the West Africa outbreak and calculated its case fatality rate at between 69 and 73 percent, according to a study in the New England Journal of Medicine.

But epidemiologists have cautioned that data collection is understandably lagging behind as the disease wreaks havoc in Guinea, Liberia and Sierra Leone - suggesting current case numbers and death rates are likely to be underestimates.

(Reporting by Kate Kelland; Editing by Sonya Hepinstall)


http://news.yahoo.com/ever-present-endemic-ebola-now-major-concern-disease-151625325--finance.html

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Ebola could strike 20,000 in six weeks, "rumble on for years" - study
Reuters
By Stephanie Nebehay and Tom Miles  10 hours ago






GENEVA (Reuters) - The Ebola outbreak in West Africa could infect 20,000 people as soon as early November unless rigorous infection control measures are implemented, and might "rumble on" for years in a holding pattern, researchers said on Tuesday.

In an article in the New England Journal of Medicine, experts from the World Health Organization and Imperial College said that infections will continue climbing exponentially unless patients are isolated, contacts traced and communities enlisted.

The WHO, in an initial roadmap issued on Aug 28, predicted that the virus could strike 20,000 people within the next nine months. The current death toll is at least 2,811 out of 5,864 cases, the U.N. agency says.

The latest study, marking six months from March 23, when the WHO says it was informed of the Ebola outbreak in southeastern Guinea, reflects projections based on the data from a third wave of the virus in Guinea, Sierra Leone and worst-hit Liberia.

"With exponential growth, you'll see that the case numbers per week go up so that by the second of November, over these three countries our best estimate is over 20,000 cases, confirmed and suspected cases," Dr. Christopher Dye, the WHO director of strategy, and co-author of article, told a briefing.

Nearly 10,000 of those would be in Liberia, 5,000 in Sierra Leone and nearly 6,000 in Guinea, he said. But those numbers would only come about with no enhanced infection control.

"Everyone is certainly working very hard to make sure this is a not the reality that we will be seeing," Dye said. "I will be surprised if we hit 20,000 by then," he later added.

U.N. Secretary-General Ban Ki-moon said last week that under a $1 billion plan, he will create a special mission to combat the disease and deployed staff to the region.



Boxes of aid for Ebola patients donated by Ghana's President and chairman of the Economic Community Of West African States (ECOWAS), seen at Conakry airport, on September 15, 2014. (AFP Photo/Cellou Binani)


"If control is completely successful in the way that we know it can be, then Ebola will disappear from the human population of West Africa and probably return to its animal reservoir," Dye said, noting that fruit bats were probably the reservoir.

But if control efforts are only partly successful, Ebola viral disease in the human population could become "a permanent feature of life in West Africa", Dye said.

"The alternative possibility that we're talking about is that the epidemic simply rumbles on as it has for the last few months for the next few years, on the order of years, rather than months.

"Under those circumstances, the fear is that Ebola will be more or less a permanent feature of the human population. Of course it could be extinguished later on."

In the three hardest-hit countries there was a "mixed pattern", Dye said.

"We see for example in the border areas of Guinea, Sierra Leone and Liberia, some areas where there has been no increase in cases for some weeks now. That's true in Sierra Leone, it's true in Lofa in northern Liberia, and it's true in one of the provinces of Guinea.

"So the question that arises is whether we're actually seeing the beginning of a stationary pattern in this epidemic.

In two badly affected districts of Sierra Leone, Kenema and Kailahun, close to border areas with Guinea and Liberia, there has been a stationary pattern, he said.

"What we've seen in the past weeks there, maybe eight, nine, 10 weeks now, is a pattern of incidence, numbers of cases per week, which has not significantly changed.



The disease is still spreading elsewhere and has now killed over 2,811 people in the region. (Yahoo News/Who)


"And indeed there are signs that it's going down. And I say that cautiously, because we're prepared to be surprised again. That is what I mean by stationary pattern. A steady incidence week on week."

There are other reassuring signs about the efficacy of infection control measures, he said, but whether the disease's spread was stabilising would become clear in the next few weeks.

No new cases have been recorded in either Nigeria or Senegal in the last three weeks, corresponding to the 21-day incubation period for developing the virulent virus, whose symptoms include fever, vomiting and diarrhoea.

"It is reassuring in many ways that a disease like Ebola can enter a city of 20 million, namely Lagos, and we are able to stop transmission, or rather the people of Nigeria are able to stop transmission," Dye said.

But the Liberian capital Monrovia, where the disease has recently spread fastest, was "uncharted territory", he said.

"Quite honestly if you ask 'can we stamp Ebola out of Liberia?' I'm not sure. In principle we know how to do it, but can we do it on the ground? It remains to be seen."


http://news.yahoo.com/ebola-could-strike-20-000-six-weeks-rumble-063552235.html

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Ebola cases could reach between 550,000 and 1.4 mln by late Jan-CDC
Reuters
2 hours ago



A student of Goverment Secondary School Garki washes her hands, as school resumes in Abuja September 22, 2014. Nigeria and Senegal, two of the five countries affected by the world's worst ever Ebola outbreak are managing to halt the spread of the disease, the World Health Organization said on Monday, although the overall death toll rose to 2,793 out of 5,762 cases. REUTERS/Stringer



(Reuters) - Between 550,000 and 1.4 million people in West Africa could be infected with the Ebola virus by January 20, 2015, according to a report issued on Tuesday by the U.S. Centers for Disease Control and Prevention (CDC).

The top range of the estimate, 1.4 million, assumes that the number of cases officially cited so far, 5,864 according to the count kept by the World Health Organization, is significantly underreported, and that it is likely that 2.5 times as many cases, or nearly 20,000, have in fact occurred.

CDC emphasized that the projections, based on an epidemiological model that takes into account how many people each Ebola patient eventually infects as well as other factors, is based on data available in August. They therefore do not account for the recently announced U.S. government Ebola relief effort, which includes sending 3,000 members of the armed forces to the Ebola-stricken region.

"Extensive, immediate actions – such as those already started – can bring the epidemic to a tipping point to start a rapid decline in cases," CDC said in a statement.


http://news.yahoo.com/ebola-cases-could-reach-between-550-000-1-144829039.html

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Here's A Terrifying Chart Of Projected Ebola Cases
Business Insider
By Lauren F Friedman  2 hours ago



Warnings about the current Ebola epidemic in West Africa, which has sickened more people than all previous outbreaks combined, have been dire for a while now.

In March, a Doctors Without Borders official called it "an epidemic of a magnitude never before seen." By June, the organization was already warning that it was "totally out of control." In early September, the director of the Centers for Disease Control and Prevention said we still had a chance to stop the outbreak, but that the "window of opportunity [was] closing."

Soon after, President Obama called for action in a press conference, saying the epidemic was "spiraling out of control," and the World Bank called the potential economic impacts of the outbreak "catastrophic."

Predicting the future of events like disease outbreaks, with so many variables and moving targets, is difficult. Estimates may be far off base. But projections about the worst that could happen if the international community does not step up its efforts to contain the Ebola epidemic have become increasingly alarming.

A new paper in the New England Journal of Medicine by a team of World Health Organization researchers estimates that if current trends continue, the number of confirmed and probable cases will rise to 20,000 by November 1, with almost half of those cases in Liberia:



Observed (triangles) and projected (dotted line) cases of Ebola in the three hardest-hit countries. WHO Ebola Response Team / NEJM


The Centers for Disease Control and Prevention also released projections on Tuesday, using a new modeling tool that ended up with different numbers than the predictions published in the NEJM.

They estimated that reported cases in Sierra Leone and Liberia could rise to 8,000 by the end of September. But the CDC also noted that cases seem to be vastly underreported, perhaps by a factor of 2.5. According to the new projections, the true number of cases by the end of September could — worst case scenario — rise to 21,000.

By January 20, 2015, the number of Ebola cases in Liberia and Sierra Leone could be as high as 550,000, the CDC report said. Correcting for underreporting, the number would be vastly higher: 1.4 million cases.



CDC


"If conditions continue without scale-up of interventions," the CDC researchers warned, "cases will continue to double approximately every 20 days, and the number of cases in West Africa will rapidly reach extraordinary levels."

The projection of over 1 million cases by the end of January is not the likeliest scenario, but it is entirely possible. "My gut feeling is, the actions we're taking now are going to make that worst-case scenario not come to pass," CDC director Tom Frieden told The New York Times. "But it’s important to understand that it could happen."

The are reasons to think that the tide may be turning against Ebola. "The findings... indicate that the epidemic can be controlled," the CDC researchers wrote, and the international community has already begun mobilizing to help avoid the worst-case-scenario predictions. (The CDC's best-case-scenario projections show that the epidemic could be almost over — rather than infecting more than a million people — by January 20.)

Ebola is spread via bodily fluids, and isolating patients and their contacts is the most effective way to contain it. More beds set up for Ebola treatment are desperately needed.

The CDC projections — based on data from August — "reflect a moment in time before recent significant increases in efforts to improve treatment and isolation," said Frieden in a statement. "They do not account for actions taken or planned since August by the United States and the international community. We anticipate that these actions will slow the spread of the epidemic."

This post was updated with additional information from the CDC.


http://news.yahoo.com/heres-terrifying-chart-projected-ebola-153600517.html

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CDC Predicts As Many As 1.4 Million Ebola Cases by Early 2015
The Atlantic Wire
By Adam Chandler  2 hours ago






A new and particularly grim CDC projection estimates that Ebola cases in western Africa could easily breach the million mark in just four months. The agency warned that without an effective intervention or a slowdown in the transmission of the virus, the world's biggest outbreak on record could extend from 550,000 to as many as 1.4 million cases by January 20. From the Washington Post:

Researchers say the total number of cases is vastly underreported by a factor of 2.5 in Sierra Leone and Liberia, two of the three hardest-hit countries. Using this correction factor, researchers estimate that approximately 21,000 total cases will have occurred in Liberia and Sierra Leone by Sept. 30. Reported cases in those two countries are doubling approximately every 20 days, researchers said.

As Denise Grady pointed out, the new projections don't account for the recent efforts taken by the United States and the international community into account, but instead reflect a "worst-case scenario." That said, the figures also don't include cases reported in Guinea, which are said to be unreliable.

With international health workers and groups working to limit the exposure and treat the ill, countries have taken drastic action to stem the spread of the virus. As CNN reported, Sierra Leone finished a three-day national lockdown on Monday in which citizens were not allowed to leave their homes as health workers sought to make contact with 1.5 million homes to explain how the virus is contracted.

According to the country's health ministry, 75 percents of the households were reached.

This article was originally published at http://www.thewire.com/global/2014/09/officials-predict-there-could-be-14-million-ebola-cases-by-early-2015/380654/

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Sime Darby delays Liberia palm oil mill construction over Ebola
Reuters
By Alphonso Toweh  5 hours ago



WASHINGTON (Reuters) - Malaysian palm oil firm Sime Darby has delayed construction of a mill for its Liberia plantation and has suspended talks to expand its planted acreage there due to the Ebola outbreak, it said on Tuesday.

More than 2,811 people have died from the disease in West Africa since the initial outbreak was identified in March, according to World Health Organization figures. Liberia has been the country hardest hit with 1,578 deaths.

"Right now, we are maintaining. Anything in addition needs to be put on hold," said Carl Dagenhar, Sime Darby's head of sustainability and external relations for Africa and Europe.   

Sime Darby has one of the largest palm oil plantations in the West African country, with a planned total investment of more than $2 billion.

A contractor for Sime Darby Plantation Liberia's (SDPL) palm oil mill has been chosen and preparations for construction - initially due to be completed in mid-2015 - had already begun when the outbreak began.

Dagenhar said it would resume work when the disease was under control.

The company had planted 10,035 hectares of oil palm and 107 hectares of rubber as of early this year.

Though it has signed an agreement with the government to develop about 220,000 hectares of land for 63 years, it must negotiate with local communities before planting on undeveloped areas of the concession. Those talks have now been put on hold.

"Of course we would like to develop more. But I think the most important thing is to survive Ebola first," Dagenhar said, adding that all 2,881 workers will continue to receive their salaries and benefits, including two 50 kilogram bags of rice each month.

Sime Darby began planting at its Liberia concession in 2011, and only a small part of its acreage is currently in production, so Ebola crisis will have little effect on output.

Western nations, led by the United States, have pledged to ramp up their efforts to stop the epidemic, which has also reached Sierra Leone, Guinea, Nigeria and Senegal. Washington is planning to deploy around 3,000 military personnel to the region to aid the relief response.

"Our only hope now is Sime Darby. They give us food by the end of the month. We are praying by the day for the Americans and others to help us bring this virus under control,” plantation worker Henry Passawee said.

Sime Darby has donated one million Malaysian ringgit ($308,309) to the Liberian Red Cross and to pay for rubber gloves for health workers.

(1 US dollar = 3.2435 Malaysian ringgit)

(Writing and additional reporting by Joe Bavier in Abidjan, editing by Louise Heavens)


http://news.yahoo.com/sime-darby-delays-liberia-palm-oil-mill-construction-122047484--sector.html

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Australian patient tests negative for Ebola
Associated Press
3 hours ago



SYDNEY (AP) — A patient who was being treated as a suspected Ebola case at an Australian hospital tested negative for the disease on Tuesday, the hospital said.

The patient, who had recently traveled to West Africa, was released from quarantine at Sir Charles Gairdner Hospital in the Western Australia city of Perth, the hospital said in a statement. A spokeswoman declined to release further details about the patient due to confidentiality rules.

There have been no confirmed Ebola cases in Australia from the recent outbreak in West Africa, which has been blamed for more than 2,800 deaths and sickened more than 5,800 people.

Two weeks ago, a hospital in Queensland state said it was treating a patient for suspected Ebola, but later determined the man did not have the virus.

Australia announced last week that it was providing an additional 7 million Australian dollars ($6.4 million) to help the international response to the outbreak. The country had previously committed AU$1 million.


http://news.yahoo.com/australian-hospital-treats-suspected-ebola-case-010259562.html

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Sierra Leone: 130 Ebola cases found in lockdown
Associated Press
By CLARENCE ROY-MACAULAY  18 minutes ago



FILE - In this Aug. 4, 2014, file photo, a Nigerian health official wearing a protective suit waits to screen passengers for the Ebola virus at the arrivals hall of Murtala Muhammed International Airport in Lagos, Nigeria. Six months into the biggest-ever Ebola outbreak, scientists say they’ve learned more about how the potentially lethal virus behaves and how future outbreaks might be stopped. The first cases of Ebola were reported in Guinea by the World Health Organization on March 23 before spreading to Sierra Leone, Liberia and elsewhere. (AP Photo/Sunday Alamba, File)



Sierra Leone says 130 confirmed cases of Ebola were found during a three-day nationwide lockdown to slow the spread of the disease. Officials are awaiting tests on about 70 more suspected cases.

Deputy Minister for Political and Public Affairs Karamoh Kabba told a press briefing Tuesday that 92 bodies were also recovered during the shutdown.

The Ebola outbreak in West Africa is believed to have sickened more than 5,800 people and killed more than 2,800, primarily in Liberia, Sierra Leone and Guinea. The unprecedented size and sweep of the outbreak has led to dramatic measures, like the shutdown in Sierra Leone.

The outbreak has overwhelmed already weak health systems in the West African countries and there are concerns about whether Sierra Leone will be able to handle the new cases discovered during the lockdown.


http://news.yahoo.com/sierra-leone-considers-repeating-ebola-shutdown-122447760.html

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Ebola cases to explode without drastic action: WHO
AFP
By Nina Larson with Zoom Dosso in Monrovia  17 minutes ago



Patients arrive on September 21, 2014 at the "Island Clinic", a new Ebola treatment centre in Monrovia (AFP Photo/Zoom Dosso)



Geneva (AFP) - The Ebola epidemic is set to explode unless the response is radically intensified, the WHO said Tuesday, warning that hundreds of thousands could be infected by the end of the year.

The UN agency said in a report that new cases would surge from hundreds each week to thousands without "drastic improvements in control measures", with the number of infections set to more than triple to 20,000 by November.

"We've rather modestly only extended the projections to November 2, but if you go to... January 2, you're into hundreds of thousands," said Christopher Dye, the head of strategy at the World Health Organization and a co-author of the study.

The research paper warns that the outbreak could drag out for years and become entrenched in west Africa, which has already seen almost 3,000 deaths.

The epidemic might simply "rumble on as it has for the last few months for the next few years," Dye said, adding that "the fear is that Ebola will become more or less a permanent feature of the human population".

Liberia, the hardest-hit nation, has seen 3,000 cases of Ebola and almost 1,600 deaths, with health workers turning people away from treatment units due to chronic shortages of beds and staff.



The World Health Organisation logo is displayed at their office in Beijing on April 19, 2013 (AFP Photo/Ed Jones)


The country has some 150 foreign specialised medical workers on the ground but the UN has said they need at least 600, and health authorities are aiming to scale its current 400 Ebola beds up to around 2,000 within weeks.

Its response has been bolstered by a US military mission, already being deployed, which will see 3,000 troops providing training and logistics.


- Threat of civil war -

But Antonio Vigilante, UN deputy special representative for recovery and governance in Liberia, likened the struggle to "trying to remedy an earthquake when it is happening".

Liberia said Tuesday the slow international response risked allowing the country to slide back into civil war alongside neighbouring Sierra Leone, and could reignite civil unrest in Guinea.



A Medecins Sans Frontieres medical worker wearing protective clothing throws contaminated items to be incinerated into a pit at a facility in Kailahun, Sierra Leone, on August 14, 2014 (AFP Photo/Carl de Souza)


"The world cannot wait for Liberia, Sierra Leone and Guinea to slip back into conflict, which could be the result of this slowness in response," Information Minister Lewis Brown told AFP late Monday.

Sierra Leone, where more than 1,800 have been infected and nearly 600 have died, reported "an overflow of bodies" after a nationwide curfew helped uncover more than 200 new cases.

The WHO study, carried out with Imperial College London and published in the New England Journal of Medicine, forecast the number of cases would rise to around 6,000 in Guinea, 10,000 in Liberia and 5,000 in Sierra Leone by November 2 without action.

And it warned that the fatality rate in the current outbreak was likely more than 70 percent rather than the current estimate of one in two, based on recovery rates rather than cases where the outcome was still unknown.

"We are seeing exponential growth and we need to act now," Dye said.



A student washes her hands at Government Secondary School in Abuja on September 22, 2014 (AFP Photo/)


The United Nations is seeking to raise nearly $1 billion (778 million euros) to defeat the Ebola outbreak, the worst ever recorded, which the Security Council has declared a threat to world peace.

The UN has also produced a list of urgent "in kind" requirements, including helicopters, mobile laboratories, 3.3 million items of protective clothing and Ebola treatment centres.


- Weak health systems -

Ebola fever is one of the deadliest viruses known to man.

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

The current crisis, which quietly began in southern Guinea last December, has killed far more than all other known Ebola outbreaks combined.

Dye said that while the virus ravaging west Africa was speading similarly to previous outbreaks, what has changed is the density and mobility of the affected populations.

Cultural practices like washing and touching dead bodies have compounded the problem, as has the very slow response in affected countries, which have never before seen the virus, and the international community, he said.

Weak health systems in the hardest-hit countries are also largely to blame, said Christl Donnelly, a professor of statistical epidemiology at the Imperial College and a co-author of the study.

"In Nigeria, for example, where health systems are stronger, the number of cases has so far been limited, despite the introduction of infection into the large cities of Lagos and Port Harcourt," she said.

Ebola is only transmitted through contact with body fluids, so halting its spread is usually relatively simple.

Even in this epidemic, each Ebola patient on average infects only 1.7 people in Guinea, 1.8 in Liberia and two in Sierra Leone, the study showed.


http://news.yahoo.com/ebola-cases-explode-without-drastic-action-174534587.html

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U.S., Canada allow emergency use of Tekmira's Ebola treatment
Reuters
19 hours ago



Tekmira Pharmaceuticals Corporation's head office is pictured in Burnaby, British Columbia August 5, 2014. REUTERS/Ben Nelms



(Reuters) - Canadian drugmaker Tekmira Pharmaceuticals Corp said on Monday that U.S. and Canadian regulators have authorized the use of its Ebola treatment in patients who have confirmed or suspected infections from the deadly virus.

The Vancouver-based company said its treatment, TKM-Ebola, has been administered to patients on an emergency basis and the repeat infusions have been well-tolerated.

The drug was administered to Rick Sacra, a doctor who contracted the virus in West Africa, and who has shown promising signs, the Nebraska Medical Center said in a statement.

TKM-Ebola, an RNAi therapeutic, works by preventing the virus from replicating.

Expanded access protocols, authorized by the U.S. Food and Drug Administration and Health Canada, allow drug developers to offer experimental therapies to patients with serious diseases who cannot participate in controlled clinical trials.

Tekmira Chief Executive Officer Mark Murray said the company's supplies of the treatment are limited.

The company is developing TKM-Ebola under a contract with the U.S. Department of Defense.

Tekmira's shares closed 15 percent up at C$26.01 in Toronto and up 17 percent at $23.61 on the Nasdaq.

(Reporting By Amrutha Penumudi in Bangalore and Rod Nickel in Winnipeg, Manitoba; Editing by Simon Jennings and Jeffrey Benkoe)


http://news.yahoo.com/fda-authorizes-emergency-tekmiras-ebola-treatment-134111316--finance.html

[Buster's Uncle]

Liberia facing massive shortage of foreign help against Ebola -UN
Reuters
By Tom Miles and Stephanie Nebehay  5 hours ago



The United Nations headquarters building is pictured though a window with the UN logo in the foreground in the Manhattan borough of New York August 15, 2014. REUTERS/Carlo Allegri



GENEVA (Reuters) - Liberia, the West African state hardest-hit by the worst Ebola outbreak in history, remains gravely short of foreign health care workers despite repeated pleas for help, a senior U.N. official said on Tuesday.

Efforts to tackle the Ebola outbreak, now six months old, have been too slow to stop the disease infecting more people than ever before and spreading from its origins in Guinea to Sierra Leone, Liberia, Nigeria and Senegal, killing over 2,800.

Without scaling up efforts to tackle the deadly haemorrhagic fever, there could be 20,000 cases in West Africa by early November, half of them in Liberia, according to a World Health Organization study published on Tuesday.

Antonio Vigilante, head of the U.N. Development Programme in Liberia, said 40,000 community workers needed to be trained and the country still had far too few foreign experts. The opening of a new clinic in Monrovia meant Liberia now had 350-400 Ebola bed spaces but this was still far below the target of 2,000.

"We have some 50-70 cases per day. Even net of the people that die, it's very, very difficult to keep adding 30 or 40 beds or day," Vigilante told a U.N. news briefing in Geneva by telephone from Monrovia.

"Even if we are at 2,000 beds two or three weeks from now, the cases we'll have in any single day may be more than that," he said, and adding new beds is of little use without the experts to manage them.

There are now some 150 foreign experts in Liberia, provided by Medecins sans Frontieres and U.N. staff, he said.


OVERWHELMED

But a further 600-700 are already needed and, with the number of cases in Liberia now at 3,100 and rapidly increasing, the requirements for foreign help are only growing in the small, impoverished country.

"We have announcements that more will come but very small numbers. The African Union sent a team of medical and non-medical staff, in that team there are some 15 doctors," Vigilante said.

"The American military are bringing in a camp hospital but it is for 25 beds with medical staff. And so there are still very few."

The WHO has repeatedly called for governments to send international medical teams, but the foreign effort remains largely in the hands of the charity Medecins Sans Frontieres, which has said it is overwhelmed and has pleaded for help.

A co-author of the WHO study, the U.N. agency's strategy chief Christopher Dye, spoke of international pledges falling woefully short of Liberia's health needs.

"You've probably heard the stories that are coming out of major donors that we'll build a hospital and we'll spend a million dollars but it will only be 25 beds," he told reporters.

"Well, great, thanks guys for the help but we need more than 25 beds here. So let's take the 25 but how are we going to talk about not tens of beds but hundreds of beds which is what we're going to need," Dye said, without naming the donor in question.

Vigilante said the Liberian effort was switching to training community volunteers to staff local care centres, since "we cannot invent doctors and nurses overnight.

"The American troops will certainly accelerate the availability of those beds but let's face it - the virus is running faster than us for the time being."


http://news.yahoo.com/liberia-facing-massive-shortage-foreign-help-against-ebola-122810943.html

[Buster's Uncle]

Sierra Leone: 130 Ebola cases found in lockdown
Associated Press
By CLARENCE ROY-MACAULAY and MARIA CHENG  9 minutes ago



FILE - In this Aug. 4, 2014, file photo, a Nigerian health official wearing a protective suit waits to screen passengers for the Ebola virus at the arrivals hall of Murtala Muhammed International Airport in Lagos, Nigeria. Six months into the biggest-ever Ebola outbreak, scientists say they’ve learned more about how the potentially lethal virus behaves and how future outbreaks might be stopped. The first cases of Ebola were reported in Guinea by the World Health Organization on March 23 before spreading to Sierra Leone, Liberia and elsewhere. (AP Photo/Sunday Alamba, File)



FREETOWN, Sierra Leone (AP) — Health teams that went door-to-door in Sierra Leone found 130 confirmed cases of Ebola during a nationwide shutdown to slow the spread of the disease, an official said Tuesday, as authorities consider repeating the unprecedented exercise.

About 70 more suspected cases are still being tested, said Deputy Minister for Political and Public Affairs Karamoh Kabba. In all, 92 bodies were found during the three-day campaign, during which teams handed out information about the disease to more than 1 million households.

The Ebola outbreak sweeping West Africa is believed to have sickened more than 5,800 people and killed more than 2,800, primarily Liberia, Sierra Leone and Guinea. The World Health Organization has warned that even those high tolls are likely underestimates. The unprecedented size and sweep of the outbreak has led to dramatic measures, like the cordoning off of entire communities in Liberia and the shutdown in Sierra Leone.

The outbreak has overwhelmed already weak health systems: A shortage of ambulances has stranded many of the sick at home, others have been turned away from teeming treatment centers and bodies have sometimes not been buried for days. In recent weeks, promises by Western countries to send in more health workers and build more treatment centers have been made and Sierra Leone said it prepared temporary treatment centers for whatever cases it found during the lockdown.

Though many experts initially raised doubts about the lockdown's ability to slow the outbreak, saying it would be hard to keep the country's 6 million people at home, the government has hailed it as a success, and it now considering doing it again.

President Ernest Bai Koroma said on the radio Tuesday that he is "mainly satisfied with the whole process, as it has helped reaching more homes and bringing to the fore many sick people and corpses."



In this Sept. 4, 2014, file photo, a health worker, right, sprays a man with disinfectant chemicals after he is suspected of dying due to the Ebola virus as people, rear, look on in Monrovia, Liberia. Six months into the biggest-ever Ebola outbreak, scientists say they’ve learned more about how the potentially lethal virus behaves and how future outbreaks might be stopped. The first cases of Ebola were reported in Guinea by the World Health Organization on March 23 before spreading to Sierra Leone, Liberia and elsewhere. (AP Photo/Abbas Dulleh, File)


The committee coordinating the Ebola response is still analyzing the results of the lockdown and Koroma said he will listen to the committee's advice about whether or not to have another lockdown.

Dr. David Heymann, an Ebola expert, said reaching so many people with information about Ebola could be crucial to stopping the outbreak. Six months into the world's largest-ever Ebola outbreak, confusion, fear and misunderstanding about the disease is still hindering efforts to control it.

"It's important for African governments to innovate and find new ways of getting messages out to the people," said Heymann, professor of infectious diseases at London School of Hygiene and Tropical Medicine. "(The lockdown) seemed to pass without violence and it went against much of international advice. Maybe it's the innovation that will make a difference."

In a sign of how much mistrust and misunderstanding still reigns, teams that were going door-to-door in Sierra Leone reported hearing rumors that the soap they were handing out was poisonous. People sent to treat patients, disinfect homes or provide information about Ebola have come under attack in some communities because of fears they are spreading the disease. One such team was killed last week in Guinea by villagers.

If more isn't done to control the outbreak, the case toll could hit 21,000 in the next six weeks, WHO predicted in a study published Tuesday. The U.S. Centers for Disease Control and Prevention also released its own, more dire predictions Tuesday, based partly on the assumption that Ebola cases are being underreported. The report says there could be up to 21,000 reported and unreported cases in Liberia and Sierra Leone alone by the end of this month and that cases could balloon to as many as 1.4 million by mid-January.

Experts caution that predictions don't take into account response efforts. In recent weeks, many countries have promised to set up new treatment clinics and send in doctors and nurses. Britain will train 164 health care workers to treat Ebola patients in Sierra Leone, the country's chief medical officer, Dr. Sally Davies, said Tuesday. Those being trained are members of the government's health staff and responded to a call for volunteers sent out last week.

Ebola, which is transmitted through bodily fluids, has no licensed treatment or vaccine. But some experimental drugs have been tried out in this outbreak. There are now plans for more organized trials in West Africa, possibly as soon as November.

Dr. Peter Horby, of Oxford University who is heading the effort, said he and colleagues will start assessing which clinics in the region might be able to conduct the trials. Horby said they are hoping to enroll 100 to 200 patients once they decide which treatment to test.

___

Cheng reported from London. AP medical writer Mike Stobbe in New York contributed to this report.


http://news.yahoo.com/sierra-leone-considers-repeating-ebola-shutdown-122447760.html

[Buster's Uncle]

Lessons learned 6 months into worst Ebola outbreak
Associated Press
By MARIA CHENG  2 hours ago



FILE - In this Sept. 18, 2014, file photo nurses are trained to use Ebola protective gear by World Health Organization, WHO, workers, in Freetown, Sierra Leone. Six months into the biggest-ever Ebola outbreak, scientists say they’ve learned more about how the potentially lethal virus behaves and how future outbreaks might be stopped. The first cases of Ebola were reported in Guinea by the World Health Organization on March 23 before spreading to Sierra Leone, Liberia and elsewhere. (AP Photo/Michael Duff, File)



LONDON (AP) — Six months into the biggest-ever Ebola outbreak, scientists say they know more about how the deadly virus behaves. The first cases were reported in Guinea by the World Health Organization on March 23 — before spreading to Sierra Leone, Liberia and elsewhere. Here's a look at what scientists have learned so far.


HOW DIFFERENT IS THIS OUTBREAK?

Past outbreaks have mostly been in remote, rural communities and have typically been snuffed out in weeks or months. But one main difference this time is that the virus has hit densely packed cities in West Africa, making the current outbreak an international threat.

"I always thought Ebola was really bad when it happens, but that it would kill 100 people in a remote part of Africa, and then it's over," said Dr. Peter Piot, the co-discoverer of Ebola. He said the severity of this outbreak could also be linked to the increased movement of people across borders and "more contact with whatever the primary source of Ebola is." The virus' reservoir is thought to be fruit bats, considered a delicacy in some parts of Africa.

In a study released Tuesday by the New England Journal of Medicine, the World Health Organization said there could be almost 21,000 Ebola cases by early November and that cases could continue to trickle out for years.



In this Aug. 22, 2014, file photo, a Liberian policeman, right, speaks with residents of the West Point area calling on calm, as they wait for a second consignment of food from the Liberian Government to be handed out, at the West Point area, near the central city area of Monrovia, Liberia. Six months into the biggest-ever Ebola outbreak, scientists say they’ve learned more about how the potentially lethal virus behaves and how future outbreaks might be stopped. The first cases of Ebola were reported in Guinea by the World Health Organization on March 23 before spreading to Sierra Leone, Liberia and elsewhere. (AP Photo/Abbas Dulleh, File)


WILL THIS OUTBREAK JUST BURN ITSELF OUT?

Yes, but that's a worst case scenario. If control measures don't work, at some point, Ebola will have infected everyone who hasn't already been killed or recovered from the virus and there won't be enough people to maintain the virus' spread, said Dr. Bruce Aylward, WHO assistant director-general in charge of emergencies. He said the next few months are crucial to curbing transmission.

"As this outbreak continues, the sheer caseload will make it much more difficult to get people isolated and into beds," he said.

"The way Ebola has spread so far, it's hard to believe it will just die out," added Dr. Heinz Feldmann, chief of virology at the U.S. National Institute of Allergy and Infectious Disease. "At some point it will, but how long is that going to take and how many people have to die for that to happen?"


IS EBOLA BECOMING MORE INFECTIOUS?

We don't know. Experts say it's difficult to assess that in the current outbreak since so many issues are involved. It's possible the virus has become more infectious than before — which might explain the spiraling caseload — but it's also possible health workers aren't properly protected or are so overworked they are making more mistakes. There has also been more physical violence involving patients, many of whom are suspicious of Western aid workers. This has led to risky situations that might increase the chances of getting infected, said Michael Osterholm, a professor at the University of Minnesota who advises the U.S. government on infectious diseases. Scientists have also noted hundreds of mutations in the virus so far but aren't sure what that means, since viruses evolve constantly.



In this Sept. 4, 2014, file photo, a health worker, right, sprays a man with disinfectant chemicals after he is suspected of dying due to the Ebola virus as people, rear, look on in Monrovia, Liberia. Six months into the biggest-ever Ebola outbreak, scientists say they’ve learned more about how the potentially lethal virus behaves and how future outbreaks might be stopped. The first cases of Ebola were reported in Guinea by the World Health Organization on March 23 before spreading to Sierra Leone, Liberia and elsewhere. (AP Photo/Abbas Dulleh, File)


CAN ANYTHING BE DONE FOR PATIENTS NOT IN A HOSPITAL?

Maybe. Given the scarcity of hospital beds, health officials say authorities shouldn't just focus on patients being treated in clinics. Some groups have started handing out basic protection kits they admit are woefully inadequate but better than nothing. Agencies including UNICEF, USAID and Doctors Without Borders have given out tens of thousands of Ebola kits, including gloves, aprons, face masks and garbage bags in Liberia, the worst-hit country. WHO notes that water and soap are still unavailable in some parts of West Africa.

"It's a tragic situation, so we are helping arm people with the best possible solution in a worst-case scenario," said Sarah Crowe, a UNICEF spokeswoman in Liberia. "So if they are going to have to use plastic bags to wipe up vomit of a sick person, then there is a correct method."

The American aid agency, USAID, says only about half of Ebola patients are seeking treatment, so the kits and information about the disease are indispensable to fighting the outbreak.

___

Associated Press Writer Sarah DiLorenzo in Dakar, Senegal, contributed to this report.


http://news.yahoo.com/lessons-learned-6-months-worst-ebola-outbreak-082554101.html