Ebola news 9/26

[Buster's Uncle]

WHO sees small-scale use of experimental Ebola vaccines in January
Reuters
By Stephanie Nebehay  1 hour ago



Actors parade on a street after performing at Anono school, during an awareness campaign against Ebola in Abidjan September 25, 2014. The tag on one of the actors read: "Red card to Ebola". REUTERS/Luc Gnago



GENEVA (Reuters) - The World Health Organization (WHO) said on Friday it expected to begin small-scale use of two experimental Ebola vaccines in West Africa early next year and in the meantime, transfusions of survivors' blood may offer the best hope of treatment.

WHO is working with pharmaceutical companies and regulators to accelerate the use of a range of potential treatments to fight the disease that has no cure and which has killed 2,917 out of 6,263 people infected in West Africa since an outbreak began in March, a senior WHO official said.

GlaxoSmithKline has begun clinical trials of its vaccine in the United States and Britain, to be followed by a trial starting in Mali next week, while NewLink vaccine trials are about to start in the United States and Germany, said Dr. Marie-Paule Kieny, WHO assistant director-general.

"If everything goes well again we might be able to start to use some of these vaccines in affected countries at the very beginning of next year, in January. This will not be a mass vaccination campaign, let's be clear about that because the quantity which will be available doesn't make this possible," Kieny told a news briefing in Geneva.

She stressed however that the shots are experimental and have not yet been shown to work against Ebola: "They have given very promising results in monkeys, but monkeys are not humans.

"We could still face a situation where these vaccines would be unsafe in humans or where they would do nothing in terms of protection. So we need to be very prudent."

Data will be collected from clinical trials when the experimental vaccines are being given to healthy volunteers who are then monitored for adverse side effects and to see if the shot elicits an immune response in their blood.

Regulators at the European Medicines Agency (EMA) said on Friday they would begin reviewing data on experimental Ebola medicines to support any decisions made on whether to use them for treating patients.

And the global vaccines alliance GAVI - the world's biggest funder of immunizations for people in poor countries - said in a statement that it was exploring how it could help speed up the availability of any Ebola vaccines that prove effective.

Canada has given 800 vials of the NewLink candidate vaccine to WHO, expected to yield at least 1,500 doses, Kieny said, and the U.S.-based firm is "working very hard to produce a few more thousand doses in the coming months," she said.

GSK has said it hopes to have 10,000 doses of its experimental vaccine by the end of this year.

Kieny said an experimental Ebola vaccine being developed by Johnson & Johnson but not yet ready for trials in humans is also under consideration.


ZMAPP DOSES BY YEAR-END

Experimental Ebola drugs including compounds from Mapp Biopharmaceutical, Sarepta and Tekmira will be tested in affected states for the first time in a bid to fast-track trials, the Wellcome Trust said on Tuesday.

WHO is taking part in that effort, Kieny said. "We are starting to discuss with African sites to see which would be the most suitable to test these new drugs and establish as soon as possible which one gives an advantage for survival to patients."

ZMapp has been used to treat several Ebola patients who have since recovered, but doctors cannot say for sure whether the drug helped them or whether they would have recovered anyway.

"In terms of ZMapp, the best as we have known for a few weeks now, is that maybe a few hundred doses will be available by the end of the year. But clearly this is not the kind of scale that can have impact on the epidemic curve," Kieny said of the drug by the California-based private biotech firm.

The use of blood transfusion and infusion of human serum from Ebola survivors is recognized as a "safe treatment", but donated blood must be screened for infections including HIV and hepatitis, she said.

There was only anecdotal information on its use in Ebola-infected healthcare workers, as there is no system in place.

"Will it be efficacious? For the time being we don't know because there are not enough people who have been treated," Kieny said, adding that they could be counted on two hands.

"This is something where the African population doesn't have to wait for anybody else to develop it for them. This is why there is a lot of enthusiasm," Kieny said.

(Additional reporting by Tom Miles in Geneva and by Kate Kelland in London, editing by Kate Kelland and Susan Fenton)


http://news.yahoo.com/sees-small-scale-experimental-ebola-vaccines-january-134245154--finance.html

[Buster's Uncle]

"Collateral" death toll expected to soar in Africa's Ebola crisis
Reuters
5 hours ago



A pregnant woman suspected of contracting Ebola is lifted by stretcher into an ambulance in Freetown, Sierra Leone September 19, 2014 in a handout photo provided by UNICEF. REUTERS/Bindra/UNICEF/handout via Reuters



LONDON, Sept 26 - By Kate Kelland, Health and Science Correspondent

(Reuters) - Deaths from infectious diseases like malaria, diarrhoea and pneumonia are likely to soar in West African countries where a vast outbreak of Ebola has crushed health systems and killed nurses and doctors.

Specialists on deadly diseases say deaths from malaria alone, which even before the Ebola crisis killed around 100,000 a year in the West Africa region as a whole, could increase four-fold in Ebola-hit countries as people miss out on life-saving treatments.

Even at this point, said Professor Chris Whitty of the London School of Hygiene and Tropical Medicine in London, in countries facing the worst of the Ebola outbreak, "many more people are dying of other things that are not Ebola".

As the epidemic continues, these so-called "collateral" deaths -- including from complications in childbirth and chronic conditions such as heart disease -- will rise as the clinics and health workers that would normally treat them are overwhelmed.

Carolyn Miles, head of the international charity Save the Children, said children under five -- of which there are an estimated 2.5 million living in the affected areas -- are at great risk, both from Ebola and knock-on effects including the psychological stress caused by parents and relatives dying.

"The health services of West Africa have to a very large degree broken down," said Jeremy Farrar, director of the Wellcome Trust international health charity. "That means care of women in childbirth, of people with malaria, of people with conditions like diabetes and mental illness are all suffering.

"That will have huge secondary consequences way beyond Ebola, no matter how bad this epidemic becomes."


RIPPLE EFFECT

The World Health Organisation's (WHO) latest update says the Ebola virus has killed almost 3,000 people in the West Africa outbreak, which began early this year in Guinea and has spread to Liberia, Sierra Leone, Nigeria and Senegal.

The United Nations health agency says at least 208 health workers in the region have been killed by Ebola, from a total of 373 so far infected with the virus.

Jimmy Whitworth, the Wellcome Trust's head of population health, said the crisis might cause malaria deaths to quadruple to around 400,000 in the coming year, with patients too afraid to come to clinics for fear of contracting Ebola, and therefore not getting anti-malarial drugs and care.

Deaths from diarrhoea and pneumonia, some of the biggest killers of children in sub-Saharan Africa, will also rise, he predicted, as will deaths of women in childbirth. Routine immunisation programmes will grind to a halt, putting children at higher risk of diphtheria, polio and tuberculosis.

"The ripples from this crisis are very worrying," he told Reuters. "The hospitals are full of Ebola patients and there is not space for any other type of patient, and in health clinics, there are essentially no staff any more."

Sierra Leone - one of the countries worst hit by the Ebola epidemic - "even at the best of times had just about the worst maternal mortality ratios in the world," said Whitworth. "We're at a very low base, and now even that is being eroded away."

The WHO's director-general Margaret Chan said last week her agency was acutely aware that in the three hardest-hit countries there are high numbers of deaths from causes other than Ebola.

"The size of this 'emergency within the emergency' is not precisely known, as systems for monitoring health statistics, not good to begin with, have now broken down completely," she said.

She argued, however, that these deaths should not be classed as "collateral damage".

"They are all part of the central problem: No fundamental public health infrastructures were in place, and this is what allowed the virus to spiral out of control."


http://news.yahoo.com/collateral-death-toll-expected-soar-africas-ebola-crisis-100459824.html

[Buster's Uncle]

Canada says poor coordination bogging down Ebola vaccine shipment
Reuters
By Rod Nickel  9 hours ago



Canada's Industry Minister Christian Paradis speaks during Question Period in the House of Commons on Parliament Hill in Ottawa May 8, 2013. REUTERS/Chris Wattie



WINNIPEG Manitoba (Reuters) - Poor global coordination has bogged down Canada's efforts to deliver its Ebola vaccine to Africa, a Canadian minister said on Thursday, six weeks after Ottawa offered to make a donation to help fight the deadly outbreak.

The Canadian government said it would donate between 800 and 1,000 doses of its VSV-EBOV vaccine to the World Health Organization for use in Africa. The vaccine remains in a government lab as Canadian and WHO officials grapple with logistical and ethical issues.

Canada is "deeply concerned by the inadequate coordination efforts" on Ebola, International Development Minister Christian Paradis said in a speech to the United Nations in New York, adding that he was not singling out any country or organization for blame.

WHO could not be reached for comment.

The country's chief public health officer, Greg Taylor, said Canada hopes to deliver the vaccine to the WHO within two to three weeks for storage but that when affected people in West Africa would get access to it was unclear.

The vaccine has proven effective in tests on animals, but there is anecdotal evidence that other experimental treatments might not work on a person who first receives the vaccine, Taylor said.

"You want to make sure you're not doing harm," Taylor said in an interview. "We don’t know what the right dose is.

"We don’t know if this will actually work in humans."

According to WHO, Ebola has killed almost 3,000 people since March in five countries: Sierra Leone, Guinea, Liberia, Nigeria and Senegal.

Earlier on Thursday, U.S. President Barack Obama told a meeting on Ebola on the sidelines of the United Nations General Assembly in New York that there was a "significant gap between where we are and where we need to be."

"More nations need to contribute critical assets and capabilities, whether it's air transport, medical evacuation, healthcare workers, equipment or treatment," he said.

A WHO panel said last month it was ethical to offer unproven drugs to people in West Africa who are infected by Ebola, or at risk of infection, but it also said such use required informed consent.

Iowa-based NewLink Genetics Corp holds the commercial license for the Canadian vaccine and said in August that it would be able to produce tens of thousands of vaccine doses within a month or two. The U.S. Food and Drug Administration has allowed the company to start human testing of the vaccine.

Paradis also said Canada would commit C$30 million (US$27 million) more in humanitarian aid to people affected by the outbreak.

(1 US dollar = 1.1102 Canadian dollar)


http://news.yahoo.com/canada-says-poor-coordination-bogging-down-ebola-vaccine-063236934--finance.html

[Buster's Uncle]

Ebola virus: Why estimates run from 20,000 cases to more than a million
The projected impact of Ebola on West Africa differed radically between health agencies this week, owing to differences in method and models and over the use of factors like 'underreporting.' Some health officials say high estimates help bring needed attention.
Christian Science Monitor
By Ariel Zirulnick  1 hour ago



After a week of attention-grabbing Ebola headlines, including urgent calls for action from President Barack Obama, it’s clear the international community recognizes the virus as a serious threat.

But how serious a threat is unclear. The dizzying array of projections, including this week’s from the World Health Organization (WHO) and the Center for Disease Control (CDC), places projected cases anywhere between 151,000 and 1.4 million. The radically different estimates complicate everything from assessing the effectiveness of interventions to how to parcel out aid.

The gulf illustrates how small differences in methodology and approach can lead to radically different estimates – and underscores how much of a guessing game the outbreak is. These estimates, which can include a political calculation of how seriously the outbreak is being taken, are what the international community works with as it considers a response.

On Monday, the WHO released its latest projections: 20,600 cases by early November in Sierra Leone, Liberia, and Guinea. The next day, CDC released its own analysis for Sierra Leone and Liberia that includes a worst-case scenario of 21,000 cases by Sept. 30 and 1.4 million by Jan. 20. (Guinea was not included.)

But the 1.4 million CDC figure is the high end. The same report issued Tuesday includes lower estimates of some 8,000 cases by Sept. 30 and 550,000 cases by January.

For lead responders like Doctors Without Borders, the projections – whether 20,000 or 1.4 million – can sometimes seem like needless squabbling if not enough attention is being paid or action being taken.

"This is already an unprecedented Ebola outbreak, we are in unknown waters," argues Charles Gaudry, who heads Doctors Without Borders in Kenya, by e-mail. "We already know we need massive scale-up right now.... Whether the predicted infection level is 20,000 or 1.4 million does not change that.... We need more centers, we need more qualified staff, and we need them right now."


THE PROBLEM OF 'UNDERREPORTING'

The CDC’s highest projection is based on an assumption in its calculations that for every person listed with Ebola, there are 1.5 more people not listed. This is known as an underreporting factor.

The use of underreporting as a factor “is up for a lot of contention and it’s been widely debated,” says Maia Majumder, a computational epidemiology specialist at HealthMap, a disease research team run out of Boston Children’s Hospital. HealthMap does not include underreporting in its estimates, nor does the WHO. They estimate 14,000 Ebola cases by the end of October, and a maximum of 151,000 cases – even if the response to the crisis in West Africa completely collapses.

Most Ebola data projections work off only reported cases, though they include a caveat that numbers could be higher due to underreporting, says Stephane Helleringer, a professor of population health at Columbia University in New York. He is concerned that the way CDC uses underreporting to calculate numbers may be incautious.

To be sure, actual underreporting of the virus on the ground in West Africa, apart from debates about statistical methods, is a major concern. In the most affected African nations, people don’t always report cases due to distrust of the health system, the stigma of contraction, or fear of going to Ebola medical centers.

Yet experts say the trouble with including underreporting in projection models is that underreporting is known typically to decline as outbreaks go on.

“If the unreported cases occurred early on but we’ve gotten increasingly better at detecting … the growth becomes a much flatter one,” Dr. Helleringer says, noting that he would guess underreporting is declining in this outbreak. “Typically in the epidemics that’s what happening. Early on, you get a lot of cases undetected and then the surveillance system kind of springs into place.”

Another reason for discrepancies between the WHO and CDC figures are differing estimates of Ebola’s incubation period – the time from infection to showing symptoms.

The CDC’s model assumes this time is a six-day period. But WHO data collected in the past month in West Africa show a 12-day incubation period. In the CDC model, cases multiply much faster, Helleringer explains.


INCENTIVES AND ESTIMATES

Finally, disease projections numbers are part of a political context, and impact the success and funding of health agencies and programs. So there’s an incentive to estimate high.

“The effectiveness of your response probably will be much larger against the scenario of 1.4 million cases than the 20,000 we’ve predicted,” Helleringer says.

CDC Director Tom Frieden stated clearly this week that high projection rates like 1.4 million are designed to catch the world’s attention and urge greater action.

“Part of the point of having a projection of what might happen if we don't take urgent action is to make sure that it doesn't happen.  And that's what we hope and anticipate this will result in,” he said


http://news.yahoo.com/ebola-virus-why-estimates-run-20-000-cases-140925989.html

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Third U.S. Ebola survivor says may return to Liberia
Reuters
10 minutes ago



BOSTON (Reuters) - The third U.S. patient to be treated in the United States for Ebola, which he contracted while working in Liberia, said on Friday that he would like to return to Africa to continue to fight the outbreak.

The patient, Dr. Rick Sacra, spoke to reporters a day after his release from Nebraska Medical Center, where he had been treated for the disease for the past three weeks. He had fallen ill while working at a hospital in Liberia, where doctors have been fighting a historic outbreak of the deadly virus.

"The odds of my ending up back there are pretty high. I don't have any specific plans, but that's where my heart is," Sacra told reporters at the University of Massachusetts Medical School in Worcester, outside Boston. "It's heartbreaking for me to see Liberians suffering from Ebola and other diseases right now."

The world is currently experiencing its worst outbreak of Ebola in history, with the disease killing nearly 3,000 people in West Africa during the past six months. Medical experts estimate some 20,000 cases could be reported by November.

"Though my fight with Ebola is finished, unfortunately it appears that West Africa's fight with Ebola is continuing to increase in intensity and severity," Sacra said.

(Reporting by Scott Malone; Editing by Susan Heavey)


http://news.yahoo.com/third-u-ebola-survivor-says-may-return-liberia-155226296.html

[Buster's Uncle]

Massachusetts doctor cleared of Ebola is home
Associated Press
By DENISE LAVOIE  29 minutes ago



The third American aid worker who contracted Ebola in West Africa was released Thursday from a Nebraska hospital. Dr. Rick Sacra said he was still very weak but never felt like he wouldn't make it. (Sept. 25)



Dr. Richard Sacra peers out from the front seat of a car after arriving in Worcester, Mass., Thursday, Sept. 25, 2014. After three weeks in isolation, Sacra, an American doctor who contracted Ebola while working in West Africa says he's grateful for the specialized care that allowed him to recover and remains concerned about the people he was trying to help. (AP Photo/Worcester Telegram & Gazette, Christine Peterson)



Dr. Richard Sacra laughs with his wife Deborah, as they walk toward the terminal at Worcester Airport, Thursday, Sept. 25, 2014, in Worcester, Mass. After three weeks in isolation, Sacra, an American doctor who contracted Ebola while working in West Africa says he's grateful for the specialized care that allowed him to recover and remains concerned about the people he was trying to help. (AP Photo/Worcester Telegram & Gazette, Christine Peterson)



Dr. Richard Sacra, left, smiles after arriving at Worcester Airport with his wife Deborah, Thursday, Sept. 25, 2014. After three weeks in isolation, Sacra, an American doctor who contracted Ebola while working in West Africa says he's grateful for the specialized care that allowed him to recover and remains concerned about the people he was trying to help. The man at right is unidentified. (AP Photo/Worcester Telegram & Gazette, Christine Peterson)



Dr. Richard Sacra walks around the chartered plane after arriving in Worcester, Mass., Thursday, Sept. 25, 2014. After three weeks in isolation, Sacra, an American doctor who contracted Ebola while working in West Africa says he's grateful for the specialized care that allowed him to recover and remains concerned about the people he was trying to help. (AP Photo/Worcester Telegram & Gazette, Christine Peterson)



WORCESTER, Mass. (AP) — A Massachusetts doctor who is one of three American aid workers successfully treated after contracting the Ebola virus in West Africa said Friday that as soon as he came down with a fever and chills, he feared he had the disease.

"Of course I was concerned that I might die ... there's the human side of you that's afraid," Dr. Richard Sacra said during a news conference at the University of Massachusetts Medical School. "I had also thought this through before going and had counted the cost in my own mind a little bit and knew this was a possibility."

Sacra, with his wife, Debbie by his side, said he had no regrets about going to Liberia to help pregnant women deliver babies, and will almost certainly return in the future. He said he knew there was a possibility he might contract Ebola but went to Liberia anyway because he wanted to help the people in his adopted home country.

Sacra, 51, has spent much of the last 15 years working in Liberia as a missionary doctor. He said it's heartbreaking for him to see Liberians suffering from Ebola and called for more medical resources to be sent there and other West African countries.

Sacra, who lives in nearby Holden, said he's tired, his legs are wobbly, and he expects it to take two or three months for him to fully recover. He returned to Massachusetts after being treated a special hospital unit in Nebraska.


http://news.yahoo.com/massachusetts-doctor-cleared-ebola-home-164028701.html

[Buster's Uncle]

IMF approves $130 million in aid to three Ebola-hit countries
Reuters
9 minutes ago



WASHINGTON (Reuters) - The International Monetary Fund on Friday approved $130 million in aid to Guinea, Liberia and Sierra Leone to help them deal with the economic impact from the Ebola virus.

"The Ebola outbreak in Guinea, Liberia, and Sierra Leone has already cost too many lives," IMF Managing Director Christine Lagarde said in a statement. "This humanitarian crisis could also have deep economic consequences."

The IMF said the financial aid would become available immediately, and would be in addition to assistance the countries are receiving under existing IMF programs.

The Fund said its preliminary estimates indicated the crisis could shave at least 3 percentage points from economic growth in Liberia and Sierra Leone this year and about 1.5 percentage point off growth in Guinea.

It said the countries would need "additional and sizable" budgetary support from bilateral and multilateral sources to meet the challenges posed by the outbreak of the virus, which has cut into tax revenues and put demands on public spending. It has estimated the total needed to close their financing gaps at about $300 million.

The three countries are among the poorest in West Africa and the hardest-hit by the worst Ebola epidemic since 1976, which has killed nearly 3,000 people.

The funds represent an expansion of current IMF programs. Guinea already has a $200 million program from the IMF, while Liberia is getting about $80 million and Sierra Leone about $96 million.

(Reporting by Timothy Ahmann; Editing by Chizu Nomiyama and Dan Grebler)


http://news.yahoo.com/imf-approves-130-million-aid-three-ebola-hit-165850778.html

[Buster's Uncle]

'Collateral' death toll expected to soar in Africa's Ebola crisis
Reuters
By Kate Kelland, Health and Science Correspondent  8 hours ago


LONDON, Sept 26 (Reuters) - Deaths from infectious diseases like malaria, diarrhoea and pneumonia are likely to soar in West African countries where a vast outbreak of Ebola has crushed health systems and killed nurses and doctors.

Specialists on deadly diseases say deaths from malaria alone, which even before the Ebola crisis killed around 100,000 a year in the West Africa region as a whole, could increase four-fold in Ebola-hit countries as people miss out on life-saving treatments.

Even at this point, said Professor Chris Whitty of the London School of Hygiene and Tropical Medicine in London, in countries facing the worst of the Ebola outbreak, "many more people are dying of other things that are not Ebola".

As the epidemic continues, these so-called "collateral" deaths -- including from complications in childbirth and chronic conditions such as heart disease -- will rise as the clinics and health workers that would normally treat them are overwhelmed.

Carolyn Miles, head of the international charity Save the Children, said children under five -- of which there are an estimated 2.5 million living in the affected areas -- are at great risk, both from Ebola and knock-on effects including the psychological stress caused by parents and relatives dying.

"The health services of West Africa have to a very large degree broken down," said Jeremy Farrar, director of the Wellcome Trust international health charity. "That means care of women in childbirth, of people with malaria, of people with conditions like diabetes and mental illness are all suffering.

"That will have huge secondary consequences way beyond Ebola, no matter how bad this epidemic becomes."


RIPPLE EFFECT

The World Health Organization's (WHO) latest update says the Ebola virus has killed almost 3,000 people in the West Africa outbreak, which began early this year in Guinea and has spread to Liberia, Sierra Leone, Nigeria and Senegal.

The United Nations health agency says at least 208 health workers in the region have been killed by Ebola, from a total of 373 so far infected with the virus.

Jimmy Whitworth, the Wellcome Trust's head of population health, said the crisis might cause malaria deaths to quadruple to around 400,000 in the coming year, with patients too afraid to come to clinics for fear of contracting Ebola, and therefore not getting anti-malarial drugs and care.

Deaths from diarrhoea and pneumonia, some of the biggest killers of children in sub-Saharan Africa, will also rise, he predicted, as will deaths of women in childbirth. Routine immunisation programs will grind to a halt, putting children at higher risk of diphtheria, polio and tuberculosis.

"The ripples from this crisis are very worrying," he told Reuters. "The hospitals are full of Ebola patients and there is not space for any other type of patient, and in health clinics, there are essentially no staff any more."

Sierra Leone - one of the countries worst hit by the Ebola epidemic - "even at the best of times had just about the worst maternal mortality ratios in the world," said Whitworth. "We're at a very low base, and now even that is being eroded away."

The WHO's director-general Margaret Chan said last week her agency was acutely aware that in the three hardest-hit countries there are high numbers of deaths from causes other than Ebola.

"The size of this 'emergency within the emergency' is not precisely known, as systems for monitoring health statistics, not good to begin with, have now broken down completely," she said.

She argued, however, that these deaths should not be classed as "collateral damage".

"They are all part of the central problem: No fundamental public health infrastructures were in place, and this is what allowed the virus to spiral out of control."

(Additional reporting by Stephanie Nebehay and Tom Miles in Geneva; Editing by Crispian Balmer)


http://news.yahoo.com/collateral-death-toll-expected-soar-africas-ebola-crisis-094040904.html

[Buster's Uncle]

U.S. says diseases like Ebola should be viewed as security threats
Reuters
By David Morgan  10 minutes ago



Health workers carry buckets of disinfectant at the newly-constructed Island Clinic and Ebola treatment center in Monrovia, Liberia, September 25, 2014. REUTERS/James Giahyue



WASHINGTON (Reuters) - The Obama administration urged the international community Friday to view outbreaks of Ebola, MERS and other deadly diseases as global security threats that require broad and rapid responses to protect the safety of populations and economies.

Top U.S. officials from the White House, Pentagon and State Department met with representatives from 44 countries and multilateral agencies, including the United Nations and World Bank, to call for implementation of 7-year-old global standards for dealing with deadly epidemics and other health dangers, including biological attacks.

President Barack Obama, who this week urged members of the United Nations to do more against the Ebola outbreak in West Africa [ID:L6N0RQ3FE], told Friday's meeting that the current response to disease outbreaks often amounts to an ill-coordinated scramble with tragic consequences.

"With all the knowledge, all the medical talent, all the advanced technologies at our disposal, it is unacceptable if, because of lack of preparedness and planning and global coordination, people are dying when they don't have to," the president said.

The worst-ever outbreak of the deadly Ebola virus, which has killed nearly 3,000 people in West Africa over the past six months and could reach a total number of 20,000 cases by November, was front and center in the discussion.

"If left unaddressed, Ebola has the potential to cause instability the likes of which we haven't seen since Liberia's civil war," U.S. Secretary of State John Kerry told an audience that included health ministers and other officials from countries with a combined population of 4 billion people.

The international community is mobilizing thousands of personnel and pouring billions of dollars into an Americana-led effort to control the Ebola outbreak, which the U.S. Centers for Disease Control and Prevention (CDC) says could infect 550,000 to 1.4 million people by January if nothing is done.

Experts say the world's response to Ebola was months late and it now faces enormous challenges recruiting adequate numbers of volunteers and funding for a long-term initiative that needs to address pervasive economic and cultural issues if it is to contain the disease.

"This is probably the most difficult global health security challenge that we have faced in our lifetime," said Dr. Keiji Fukuda, assistant director-general for health security at the World Health Organization (WHO).

The centerpiece of the global health security initiative is a 2007 set of standards known as the International Health Regulations, which set procedures for responding to pandemics and bioterrorism. But this has been implemented by fewer than 20 percent of WHO's 194 member states.

U.S. officials say the ultimate aim is to equip every country with secure laboratory and health surveillance systems to detect pathogens and emergency operations that can quickly control outbreaks, including large-scale immunization programs.

(Editing by Bernadette Baum)


http://news.yahoo.com/u-says-diseases-ebola-viewed-security-threats-152130821.html

[Buster's Uncle]

A Primer on the Deadly Math of Ebola
BusinessWeek
By Peter Coy  September 26, 2014



Liberian Red Cross health workers wearing protective suits carry the body of a victim of the Ebola virus in Monrovia on Sept. 12  Photograph by Zoom Dosso/AFP via Getty Images



If the Ebola virus continued to tear through the world’s population at the rate it has done recently in West Africa, all hell would break loose. The U.S. Centers for Disease Control and Prevention estimated on Sept. 26 that cases in Liberia and Sierra Leone were doubling every 20 days. Hypothetically speaking, if the Ebola outbreak continued to spread at that same pace, which it won’t, the number of cases would surpass 1 million by January, 100 million by June, and 1 billion by August, before infecting the entire world population sometime next fall.

To repeat, this is not going to happen. The point of running out the figures on unconstrained growth is to shed light on what things will probably happen in the coming weeks and months that will constrain Ebola, bending its growth curve downward and eventually causing this outbreak to end. These range from better care to more effective isolation to the simple fact that people who are exposed but don’t die will build up immunity. “It’s going to stop growing. What we can’t say yet is when,” says Jeffrey Shaman, an associate professor of environmental health sciences at Columbia University’s Mailman School of Public Health.

Here’s the math behind Ebola: The critical variable is what epidemiologists call the basic reproductive number, which is the number of secondary infections that a single typical infection can be expected to produce, assuming a population in which everyone is susceptible to infection. It’s known as R-zero. An R-zero above 1 means the number of cases will grow, while an R-zero below 1 means the number of cases will shrink. Each current case produces less than one other case.

The R-zero for seasonal influenza is about 1.3, while the R-zero for measles before the invention of a vaccine for it was a sky-high 17, which meant that almost all children had measles at some point, according to Gerardo Chowell, a professor at Arizona State University’s School of Human Evolution and Social Change. Ebola’s reproductive number assuming no effective intervention is probably 1.4 to 3, with most estimates clustered around 1.8 or 2—high enough to be dangerous.

The reproductive number is a product of the duration of illness—assumed to be six days from symptoms to death or recovery in the case of Ebola—and the number of infectious contacts per day that victims have with susceptible people. Cutting the average number of infectious contacts per day in half would cut Ebola’s reproductive rate from 2 to a manageable 1, says Chowell.

This assumes, of course, that people can’t transmit the disease while it’s latent in them, which seems fair because there have been no confirmed reports of transmission by asymptomatic individuals. A complication with Ebola is that corpses are highly contagious, so even death doesn’t end the risk that the disease poses.

One last thing to know is that any disease’s reproductive number falls over time. (The time-sensitive number is called Rt.) People who are exposed but don’t die gain immunity, so they can’t be reinfected. Even in the absence of quarantine or effective treatment, eventually so many people have been exposed to a disease that the outbreak simply stops, like a forest fire that runs out of fuel.

This background helps explain a statement by CDC officials that probably struck some people as odd. In its Sept. 26 report, the agency said that in theoretical terms, “the epidemic begins to decrease and eventually end if approximately 70% of persons with Ebola are in medical care facilities or Ebola treatment units (ETUs) or, when these settings are at capacity, in a non-ETU setting such that there is a reduced risk for disease transmission (including safe burial when needed).”

Why is 70 percent enough? Because perfect isolation isn’t necessary. There just has to be good enough care and isolation that the reproductive number edges below 1—causing the number of cases to shrink over time. Thomas Gift, an economist at the Centers for Disease Control, says the CDC estimates a reproductive number of 0.12 for victims in hospitals and 0.19 for people in a controlled community setting, vs. 1.8 for no protective measures whatsoever.

The CDC’s Sept. 26 report said that there could be 1.4 million cases of Ebola in Liberia and Sierra Leone by Jan. 20, but Gift points out that the estimate assumed no additional interventions or changes in community behavior. “That was sort of a worst-case scenario,” he says. The CDC hasn’t updated its forecast to take account of the commitment of aid by the U.S. and other donors. The World Health Organization hasn’t made a forecast that far ahead. “In our judgment it’s not valid to go any further than four weeks ahead,” Chris Dye, the WHO’s director of strategy, told Bloomberg News. Arizona State’s Chowell says that since there’s a lag in data-gathering, it’s possible that interventions have already begun to reduce Ebola’s reproductive number.

There has been some speculation that the Ebola virus could mutate into one that can be transmitted through the air, rather than through direct contact. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, raised the possibility in a New York Times op-ed column on Sept. 12. But Chowell thinks that’s unlikely, precisely because of the current virus’s fairly high reproductive rate. A random mutation that made Ebola transmissible by air might result in other changes that would make it less transmissible overall, reducing its chance of displacing the existing strain, Chowell says.


http://www.businessweek.com/articles/2014-09-26/ebolas-deadly-math?campaign_id=yhoo

[Buster's Uncle]

Sierra Leone is forcing its citizens into isolation to fight Ebola
Vox
Updated by Julia Belluz on September 26, 2014, 10:27 a.m. ET@juliaoftorontojulia.belluz@voxmedia.com



During Sierra Leone's bloody 11-year civil war in the 1990s, there were no government-imposed lockdowns, even though people would often hide in their homes out of fear of reprisal from rebel fighters.


Sierra Leone is grinding to a halt because of the Ebola epidemic


But now, because of the ongoing Ebola epidemic, the government is effectively grinding the country to a halt by imposing mandatory lockdowns on its citizens. The first ran from September 19 to 21, when Sierra Leoneans were not be allowed to leave their homes in an attempt to stop the spread of the virus and isolate new cases. Some 350 people with Ebola were identified.

As the death toll in the country rises exponentially, Sierra Leone's President Ernest Bai Koroma announced this week that he would extend the quarantine to include another one million people in three districts and 12 tribal chiefdoms in the country. This is an unprecedented move in a country desperate to contain the outbreak.

To get a sense of just how dire the situation is, read parts of the president's recent address to the nation:

The isolation of districts and chiefdoms will definitely pose great difficulties for our people in those districts. But the life of everyone and the survival of our country take precedence over these difficulties...

These are trying moments for everyone in the country, but we are a resilient people, a people that have shown their ability to unite and stand up as one to overcome difficulties...

We will use these strengths to confront those tendencies that undermine the fight against the disease, we will utilize our better calling to end this outbreak, and by the grace of God Almighty, we shall overcome and free our land from this evil virus.

The districts where Ebola is believed to be moving fast — Port Loko, Bombali, Moyamba — are now under isolation. People can't leave their homes or go to school or work. During this period, government and public-health officials are going door to door, educating people about Ebola and trying to identify patients who should be brought to containment facilities.

Officials in Sierra Leone are worried that many Ebola victims are either going underground or simply unable to access care.

The New York Times recently reported that the government of Sierra Leone has acknowledged the death toll is "worse than what was being reflected in reports."





Under-reporting is a concern in all countries most affected by Ebola right now — Sierra Leone, Liberia and Guinea. They are reportedly dealing with 6,000 cases and 2,900 deaths at the moment but the WHO said these figures  "vastly underestimate the true scale of the epidemic."

In its latest update on Ebola, the agency said that this epidemic amounts to "the most severe acute public health emergency seen in modern times. Never before in recorded history has a biosafety level four pathogen infected so many people so quickly, over such a broad geographical area, for so long."


Not everyone's convinced the quarantine is a good idea

Still, not every agrees forceful measures like the quarantine in Sierra Leone are a good idea. Médecins sans Frontières has expressed the worry that mandatory isolation will "end up driving people underground and jeopardizing the trust between people and health providers."

Some were also concerned that, because the latest lockdown came without a warning, people were unprepared and could go hungry. There's also the very real possibility that quarantines will deal a tragic blow to Sierra Leone's already fragile economy.





Speaking at a United Nations special meeting of world leaders on the Ebola crisis, President Barack Obama said the world needed to wake up to the deadly threat.

"If this epidemic is not stopped, this disease could cause a humanitarian catastrophe across the region," Obama said, adding: "We are not moving fast enough. We are not doing enough. There is still a significant gap between where we are and where we need to be."

Dr. Joanne Liu, international president of Médecins Sans Frontières, said Ebola is killing more than just those infected by the virus. "Mounting numbers are dying of other diseases, like malaria, because health systems have collapsed," she said.

"The sick continue to be turned away, only to return home and spread the virus among loved ones and neighbors."


http://www.vox.com/2014/9/25/6845549/sierra-leone-is-forcing-its-citizens-into-isolation-to-fight-ebola-virus-quarantine

[Buster's Uncle]

West Africa awaits Ebola aid, vaccine trials
AFP
By Zoom Dosso  3 hours ago



A guard waits to greet potential Ebola patients at the JFK hospital in the Liberian capital Monrovia on September 25, 2014 (AFP Photo/Pascal Guyot)



Monrovia (AFP) - Ebola-hit west Africa's governments were desperately counting on promises of global aid to be effected Friday as the World Health Organization announced urgently awaited vaccines could be ready early next year.

Liberia, the hardest-hit nation with almost 1,700 deaths, welcomed pledges of help from world leaders gathered at the United Nations on Thursday but warned it was losing the trust of its people as the crisis escalated.

"We are happy to hear that the entire world now understands the urgency of the reaction to threat of Ebola," Liberian Information Minister Lewis Brown told AFP.

"We hope that the commitment will be quickly followed by action because, if this drags for long, the populations of the various countries will begin to lose patience and they will blame our governments."

Health systems in Liberia, Sierra Leone and Guinea have been overwhelmed by the epidemic, which has killed 3,000 people since the start of the year, and are in dire need of doctors, nurses, medical equipment and supplies.

The WHO told reporters in Geneva it was working with British company GlaxoSmithKline (GSK) and American group NewLink Genetics to accelerate clinical trials on two vaccines.



People walk past a wall with information about Ebola in Monrovia on September 25, 2014 (AFP Photo/Pascal Guyot)


Some trials of the GSK vaccine have begun in the United States and Britain, and others are expected to begin in Mali next week, said WHO assistant director general Marie-Paule Kieny.

Trials of the NewLink vaccine are also set to start "imminently" in the US, and others are planned in Germany and elsewhere.

"If everything goes well, we may be able to begin using some of these vaccines in some of the affected countries at the very beginning of next year," Kieny said.

The European Medicines Agency watchdog said it was gathering all available information on experimental Ebola treatments to help doctors and health authorities make decisions on what to offer patients.



A nurse draws blood from a volunteer taking part in an Ebola vaccine trial at the Oxford Vaccine Group Centre for Clinical Vaccinology and Tropical Medicine (CCVTM) on September 17, 2014 (AFP Photo/Steve Parsons)


- 'We're not doing enough' -

Currently, there is no licenced treatment or vaccine against Ebola, although drugs which have not been fully tested have already been given to a few infected health workers, with stocks extremely limited.

"This is not a vaccine, this is a candidate vaccine," Kieny stressed, pointing to the need for caution in rolling out the vaccines.

The two prototypes "have given very promising results in monkeys, but monkeys are not humans," she said, adding that people who receive them initially "should not consider themselves protected against Ebola".

WHO is trying to accelerate the development of around half a dozen treatments for Ebola, including the prototype ZMapp drug already given to US and Spanish aid workers.

Kieny said "a few hundred doses" should be available by the end of the year.



US President Barack Obama speaks about the Ebola epidemic during the UN General Assembly in New York, September 25, 2014 (AFP Photo/Saul Loeb)


US President Barack Obama led calls for a ramped up response to the Ebola epidemic at the UN in New York on Thursday, urging governments, businesses and international organisations to join the fight.

Officials could not provide an immediate tally of the total pledges made at the meeting but the UN's coordinator for Ebola, David Nabarro, said countries had "responded with generosity".

Canada announced a contribution of $27 million (21 million euros) while France said it had set aside 70 million euros in a battle that the United Nations estimates will require close to one billion dollars.


- 'Battlefront' -

The European Union said it would add 30 million euros to the current 150 million euros it has provided.



Residents sick from the Ebola virus wait on September 23, 2014 outside a treatment centre in Monrovia (AFP Photo/Zoom Dosso)


But Obama warned: "We are not doing enough."

UN officials said a 20-fold surge in assistance is needed to come to grips with the outbreak.

Sierra Leone took the drastic step on Thursday of putting another three of its 14 districts under quarantine, meaning that more than a third of the population of six million can no longer move freely.

"My country is at the battlefront of one of the biggest life and death challenges facing the global human community," Sierra Leone's President Ernest Bai Koroma warned the UN by video link from Freetown.

A UN mission on Ebola set up last week is due to deploy in west Africa on Sunday, bringing supplies and equipment including protective suits, trucks, and helicopters.

The United States has begun sending the first of a 3,000-strong military mission to Liberia to help battle the contagion and has mobilised its experts from the Centres for Disease Control and Prevention to help beat back the virus.

Cuba said on Friday it would send nearly 300 more doctors and nurses to help fight epidemic, raising to 461 the number of its medical personnel in the region.

Meanwhile British actor Idris Elba, whose parents are from Sierra Leone, has joined the UN campaign to ramp up the response.

Elba, who portrayed Nelson Mandela in "Long Walk to Freedom", told journalists in New York the world was "setting up" the fight against Ebola, but that it will take time.


http://news.yahoo.com/un-promises-action-over-raging-ebola-virus-110822287.html

[Buster's Uncle]

12 Alarming Numbers About The Ebola Crisis
Business Insider
By Erin Brodwin  21 hours ago



A Nigerian port health official wears protective gear



They come for the dead. They used to come for the living, but with little funding and far too few health care workers to treat the mushrooming number of the West African nation's sick, Liberia's government employees now arrive only to pick up the bodies of those who have succumbed to Ebola.

Finally, the West is recognizing the scale of the crisis. On Sept. 15, President Obama pledged to send 3,000 people to fight the epidemic in Liberia, Guinea, and Sierra Leone, the three West African nations hit hardest by the virus. Five days later, former President Bill Clinton sent a chartered jet packed with gloves, gowns, and other protective medical equipment — the largest single shipment of aid to the Ebola zone to date — from New York to West Africa.

But even now, it's hard to feel the full impact of this epidemic from millions of miles away. It can be easier to understand how terrifying it is when you look at the numbers.

1.4 million: The number of Ebola cases expected by Jan. 20, 2015, if nothing changes in the way patients are treated.



HealthMap Ebola cases in Liberia, Guinea and Sierra Leone. The dark color shows real cases and the light color shows projected.

71%: The death rate of this epidemic: The percentage of people who, after becoming infected with Ebola, die as a direct result of the virus.

718: Number of new Ebola cases between Sept. 8 and Sept. 14 in Liberia, Guinea, and Sierra Leone, as reported by the WHO.



Ebola Virus Disease in West Africa, WHO Ebola Response Team Report, New England Journal of Medicine Weekly incidence of confirmed, probable and suspected Ebola cases 14,607: The approximate number undetected Ebola cases.

The official case count is 5,843, including 2,803 deaths (according to the WHO), but the CDC predicts the actual number of cases is 2.5 times higher than the official figure.
15 days: The time it takes for Ebola cases to double in Liberia, according to CDC estimates. In Sierra Leone, cases are doubling every 30 days. 82%: The percentage of Ebola patients in Liberia who are being cared for outside hospitals or other isolated settings necessary to reduce the risk of transmission. To stop the epidemic from spreading further, this number needs to be 30% or lower.



CDC 21 days: The time it can take a person infected with the Ebola virus to develop physical symptoms.

While people are not infectious until they develop symptoms, the longer a virus has incubated in someone, the lower their chances of getting rapid treatment and recovering.



Ebola Virus Disease in West Africa, WHO Ebola Response Team Report, New England Journal of Medicine Exposure to disease onset 49 days: The number of days after recovery that a man previously infected with Ebola can still transmit the virus through his semen. 14x: The number of times larger the current Ebola eruption is than the last largest outbreak, which hit 425 cases in Uganda in 2000.

As of March 2014, the current flare-up was already eight times the size of that outbreak. As of Sept. 2014, more people have been infected and died of Ebola than as a result of all the previous outbreaks combined.



CDC 20x: The number of times more health personnel needed to beat back the epidemic, according to the WHO. That's 20,000 national and 1,000 international staff.


54.2%: The percentage of health care workers who have died after becoming infected with the virus, despite being well-informed and having full access to treatment.



CDC 2nd: Sierra Leone's global ranking in terms of real GDP growth rate in 2013,before the Ebola outbreak. Liberia held position 11.

For some perspective, the United States was 157th. This is significant when you think about how well the country was doing — in a pure economic sense — before Ebola hit. After the outbreak, this is likely to drop drastically and all the progress the country has been making will be lost.

CIA World Factbook


http://news.yahoo.com/11-alarming-numbers-ebola-crisis-204709007.html

[Buster's Uncle]

IMF fast-tracks $130 mn for Ebola fight in West Africa
AFP
14 minutes ago



Liberian boys sell coconut near the health ministry's Ebola Treatment Unit in Monrovia on September 26, 2014 (AFP Photo/Pascal Guyot)



Washington (AFP) - The International Monetary Fund fast-tracked $130 million in aid Friday to fight the Ebola epidemic in the worst-hit countries in West Africa.

The IMF executive board strongly approved the financial assistance, "in an expedited decision," to help Guinea, Liberia, and Sierra Leone respond to the rapidly spreading Ebola outbreak that has killed nearly 3,000 since December, it said in a statement.

The financing, requested by the three governments, will be made available immediately: Guinea, $41 million; Liberia, $49 million; and Sierra Leone, $40 million.

"The Ebola outbreak in Guinea, Liberia, and Sierra Leone has already cost too many lives," said IMF managing director Christine Lagarde in the statement.

"The IMF is working hard with the authorities of the affected countries and their development partners to ensure that the outbreak is quickly brought under control and to assist the economic rebuilding effort that must follow."

The 188-nation IMF said the emergency aid comes in addition to its existing programs in the three already-fragile countries. The new funds are aimed at helping the governments cover part of their immediate financing needs, estimated at $100 million for each country.

Lagarde called on other potential donors to move quickly to help cover the balance of the shortfalls.

"The rapidly deteriorating health situation underscores the urgency of this support," she said.

In addition to the emergency funds, the IMF board approved 25 percent increases of the quotas of the three countries, increasing their ability to access IMF financing.

With the viral epidemic still raging, the IMF said preliminary projections show growth could plunge by at least 3.0-3.5 percent in Liberia and Sierra Leone and by about 1.5 percent in Guinea.

"The Fund is closely monitoring the situation and stands ready to provide further assistance through this challenging period," Lagarde said.

World leaders at the United Nations General Assembly in New York have pledged fresh assistance in battling the growing crisis, which has overwhelmed the health systems in the worst-hit countries.

On Thursday, the World Bank raised its emergency aid in the anti-Ebola campaign by $170 million to $400 million.

The Bank said the fresh financing for Guinea, Liberia and Sierra Leone will go toward expanding the health-care workforce and buying needed supplies for care and treatment.


http://news.yahoo.com/imf-fast-tracks-130-mn-ebola-fight-west-184514828.html

[Buster's Uncle]

West Africa Ebola death toll passes 3,000 - WHO
Reuters
4 minutes ago



DAKAR (Reuters) - The death toll from an outbreak of Ebola in West Africa has risen to at least 3,091 out of 6,574 probable, suspected and confirmed cases, the World Health Organization said on Friday.

Liberia has recorded 1,830 deaths, around three times as many as in either Guinea or Sierra Leone, the two other most affected countries, according to WHO data received up to Sept. 23.

An outbreak that began in a remote corner of Guinea has taken hold of much of neighboring Liberia and Sierra Leone, prompting warnings that tens of thousands of people may die from the worst outbreak of the disease on record.

The WHO update said Liberia had reported six confirmed cases of Ebola and four deaths in the Grand Cru district, which is near the border with Ivory Coast and had not previously recorded any cases of Ebola.

The district of Kindia in Guinea also reported its first confirmed case, the WHO said, a day after it said the spread of Ebola appeared to have stabilized in that country.

Nigeria and Senegal, the two other nations that have had confirmed cases of Ebola in the region, have not recorded any new cases or deaths in the last few weeks.

(Reporting by David Lewis; Editing by Gareth Jones)


http://news.yahoo.com/west-africa-ebola-death-toll-passes-3-000-191303024--finance.html