Ebola news 9/28

[Buster's Uncle]

Liberia's top doctor in quarantine after assistant dies of Ebola
Reuters
8 hours ago



Bernice Dahn, Liberia's chief medical officer and deputy health minister, attends the opening ceremony for the Island Ebola treatment center in Monrovia September 21, 2014. REUTERS/James Giahyue



MONROVIA (Reuters) - Liberia's chief medical officer, who is also a deputy health minister, has put herself in quarantine as a precaution against Ebola after one of her assistants died from the disease, the government said on Saturday.

Bernice Dahn is the latest senior West African medical official to be directly affected by an outbreak of Ebola, which has killed over 3,000 people as it spreads across most of Guinea, Liberia and Sierra Leone.

"She has placed herself under self observation due to the fact that her special assistant contracted the virus," Isaac Jackson, Liberia's deputy information minister, told Reuters.

Jackson said that the government praised Dahn's decision to come forward to be monitored after potentially coming into contact with the disease.

"If everyone were to do what Dr. Dahn has done, Liberia would be free of Ebola," he said.

The latest figures from the World Health Organisation show that the death toll from the worst outbreak of Ebola on record has killed at least 3,091 people, out of 6,574 probable, suspected and confirmed cases.

Liberia has recorded 1,830 deaths, around three times as many as Guinea or Sierra Leone, the two other most affected countries. Nigeria and Senegal have had confirmed cases of Ebola but appear to have prevented it from spreading.

Although relatively common in Central Africa, the haemorrhagic fever has taken West Africa by surprise, spreading into heavily populated areas and across borders before authorities were able to coordinate their response.

Already weak national health care systems have been over-run by the disease, which has infected 375 health care workers in the region, killing 211 of them.

Sheik Umar Khan, the doctor leading the fight against Ebola in Sierra Leone, contracted the disease himself and died in July.

Foreign governments and international organisations are dispatching funds, supplies and personnel to the region amid warnings that the disease could claims tens or hundreds of thousands of lives before it is halted.


http://news.yahoo.com/liberias-top-doctor-quarantine-assistant-dies-ebola-072627096--finance.html

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Maryland hospital to care for U.S. doctor exposed to Ebola in West Africa
Reuters
By Jon Herskovitz  5 hours ago



File photograph shows senior Matron Breda Athan demonstrates putting on the protective suit which would be used if it becomes necessary to treat patients suffering from Ebola. August 12, 2014. REUTERS/Suzanne Plunkett



(Reuters) - The U.S. National Institutes of Health plans to admit to one of its special observation wards an American physician exposed to the Ebola virus while volunteering in Sierra Leone, it said on Saturday.

The patient, who has not been identified, was expected to be admitted on Sunday to the NIH Clinical Center in Bethesda, Maryland, for observation and to enroll in a clinical study, the institute said.

"Out of an abundance of caution, the patient will be admitted to the NIH Clinical Center's special clinical studies unit that is specifically designed to provide high-level isolation capabilities and is staffed by infectious diseases and critical care specialists," it said.

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.

The 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 third U.S. patient to be treated in the United States for Ebola is now free of the virus, doctors at the Nebraska Medical Center, where the patient was being treated, said in a news conference earlier this week.


http://news.yahoo.com/maryland-hospital-care-u-doctor-exposed-ebola-west-105207279.html

[Buster's Uncle]

Liberia's top doctor under Ebola quarantine, deputy dead
AFP
1 hour ago



A nurse walks with a little girl suffering from Ebola, at a clinic in Monrovia on September 27, 2014 (AFP Photo/Pascal Guyot)



Monrovia (AFP) - Liberia's chief medical authority has placed herself in quarantine following the Ebola death of her deputy, health officials and humanitarian sources said on Sunday.

Dr Bernice Dahn, who is also a deputy health minister, opted to put herself in isolation after her assistant died of the infectious disease on Thursday.

Dahn and her assistant's staff, whom she also quarantined, will remain under observation for 21 days, the sources said, for the full incubation period of the tropical fever that has killed more than 3,000 people since the end of last year.

Of the four west African nations affected by the Ebola outbreak, Liberia has been hit the hardest, with 3,458 people infected, and 1,830 of killed by the disease, acording to a World Health Organization count released Saturday.

Healthcare workers, already in very short supply, have paid an especially heavy price, with 211 dead in the stricken nations, 89 of them in Liberia.

In Monrovia, "about 50 bodies are incinerated each day -- though we estimate that 20 to 30 percent of those did not have Ebola," a WHO official who requested anonymity said, suggesting an Ebola toll of 35 to 40 victims each day in the Liberian capital.

"This is a slow rise, and it only includes the cases that have been officially tallied. There are still people who continue to bury their dead secretly in their gardens," he said.

The US federal health body Centers for Disease Control and Prevention estimates that only about 40 percent of Ebola cases are being announced in Liberia and Sierra Leone, the worst-affected states.

The virus can fell its victims within days, causing rampant fever, severe muscle pain, vomiting, diarrhea and -- in many cases -- unstoppable internal and external bleeding.

Liberia's decrepit public health infrastructure, ruined by 14 years of civil war to 2003 and endemic poverty, has "totally collapsed" under the Ebola crisis, the WHO official said.


http://news.yahoo.com/liberias-top-doctor-under-ebola-quarantine-deputy-dead-142744318.html

[Buster's Uncle]

NIH to treat US doctor exposed to Ebola virus
Associated Press
By LAURAN NEERGAARD  7 hours ago



This Jan. 14, 2014 file photo shows Daniel Bennett quarantined in an isolation unit at the National Institute of Health (NIH) in Bethesda, Md., during research for a better flu vaccine. The NIH is preparing to care for an American doctor who was exposed to the Ebola virus while volunteering in Sierra Leone. As early as Sunday, Sept. 28, 2014, the physician is expected to be admitted to the same special isolation unit at NIH's hospital out of what the agency called "an abundance of caution," for observation. (AP Photo/Charles Dharapak, File)



WASHINGTON (AP) — The National Institutes of Health is preparing to care for an American doctor who was exposed to the Ebola virus while volunteering in Sierra Leone.

Out of what the agency called "an abundance of caution," the physician is expected to be admitted to the special isolation unit at the NIH's hospital near the nation's capital as early as Sunday, for observation.

NIH infectious disease chief Dr. Anthony Fauci wouldn't discuss details about the patient but said that in general, an exposure to Ebola doesn't necessarily mean someone will become sick.

"When someone is exposed, you want to put them into the best possible situation so if something happens you can take care of them," Fauci said.

"NIH is taking every precaution to ensure the safety of our patients, NIH staff and the public," said an agency statement.

Four other Americans aid workers who were infected with Ebola while volunteering in the West African outbreak have been treated at hospitals in Georgia and Nebraska. One remains hospitalized while the others have recovered.


http://news.yahoo.com/nih-treat-us-doctor-exposed-ebola-virus-084947768--politics.html

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Scientists grapple with ethics in rush to release Ebola vaccines
Reuters
By Kate Kelland, Health and Science Correspondent  3 hours ago



Professor Adrian Hill, Director of the Jenner Institute, and Chief Investigator of the trials, holds a phial containing the Ebola vaccine at the Oxford Vaccine Group Centre for Clinical Vaccinology and Tropical Medicine (CCVTM) in Oxford, southern England September 17, 2014. REUTERS/Steve Parsons



LONDON, Sept 28 (Reuters) - Normally it takes years to prove a new vaccine is both safe and effective before it can be used in the field. But with hundreds of people dying a day in the worst ever outbreak of Ebola, there is no time to wait.

In an effort to save lives, health authorities are determined to roll out potential vaccines within months, dispensing with some of the usual testing, and raising unprecedented ethical and practical questions.

"Nobody knows yet how we will do it. There are lots of tough real-world deployment issues and nobody has the full answers yet," said Adrian Hill, who is conducting safety trials on healthy volunteers of an experimental Ebola shot developed by GlaxoSmithKline.

Hill, a professor and director at the Jenner Institute at Britain's University of Oxford, says that if his results show no adverse side-effects, GSK's new shot could used in people in West Africa by the end of this year.

Even if a drug is shown to be safe, it takes longer to prove it is effective - time that is simply not available when cases of Ebola infection are doubling every few weeks and projected by the World Health Organization to reach 20,000 by November.

Among questions that scientists are grappling with: should an unproven vaccine be given to everybody, or just a few? Should it be offered to healthcare workers first? The young before the old? Should it be used first in Liberia where Ebola is spreading fastest, or Guinea where it is closer to being under control?

Should people be told to assume it will protect them from Ebola? Or should they take all the protective measures they would if they hadn't been vaccinated? And if so, how will anyone know whether the vaccine works?

GSK is one of several drug firms that have either started or announced plans for human trials of candidate Ebola vaccines. Others include Johnson & Johnson, NewLink, Inovio Pharmaceuticals and Profectus Biosciences.

The WHO says it hopes to see small-scale use of the first experimental Ebola vaccines in the West Africa outbreak by January next year.

It has convened vaccine specialists, epidemiologists, pharmaceutical companies and ethicists, for a meeting on Monday and Tuesday to discuss the moral and practical issues.

"Normally safety is the absolutely paramount thing when you're developing a new vaccine, but this time we're going to have to take more risks," said Brian Greenwood, a professor at the London School of Hygiene and Tropical Medicine who will take part in the WHO-led meeting.

"Quite how we do that, and what risks we take, hasn't really been thought through yet. That's what people are trying to figure out."


TWO THINGS AT THE SAME TIME

The chaos caused by the epidemic itself makes it even more difficult to deploy and track use of a new vaccine, said Hill.

"You're trying to do two things at the same time: you're trying to evaluate a vaccine and deploy it - when normally you would evaluate the vaccine first, by doing a randomised double blind controlled trial, and then you'd deploy it if it was shown to be safe and effective."

Because Ebola virus is so deadly, those who receive a trial vaccine must be told to take all other precautions and protect themselves fully. This could make it harder for researchers to decipher whether the protective clothing and safety protocols, or the new vaccine, is what kept them safe.

Normally researchers testing a vaccine would give some volunteers a placebo, or dummy, to create a "control" group to compare against those who get the real drug. That seems unthinkable in a situation where disease with a death rate of up to 90 percent is raging through villages.

"Would it be ethical to do a trial where some people don't get the vaccine because they are in the control group? Most people think it wouldn't be - especially if you have reasonable evidence that the vaccine might work," said Hill.

Jeremy Farrar, an infectious diseases expert and director of the Wellcome Trust medical charity, said limited supplies of any candidate vaccine could result in a form of natural control group being formed anyway. Researchers can compare populations where the vaccine is available with those where it isn't.

GSK has said it is aiming to have 10,000 doses of its experimental shot by the end of the year, while Canada has given 800 vials of the NewLink candidate vaccine to the WHO, expected to yield at least 1,500 doses.

Most experts interviewed by Reuters favour the idea of the first doses going to frontline healthcare workers, since their exposure to risk is so high. Researchers could then compare infection rates among health workers who receive the vaccine to those working in regions still waiting for it.

Peter Piot, a co-discoverer of the Ebola virus in 1976 and now director of the London School of Hygiene and Tropical Medicine said that however complicated the ethics, reverting to the traditional years-long process of testing vaccines, and withholding them from West Africa until then, is not an option.

"It may be that without a vaccine, we can't really stop this epidemic," he said.


http://news.yahoo.com/scientists-grapple-ethics-rush-release-ebola-vaccines-135816919--finance.html

[Buster's Uncle]

12 Terrifying Numbers That Show Just How Bad The Ebola Crisis Is
Business Insider
By Erin Brodwin  26 minutes ago



AP/Sunday Alamba 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.



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/12-terrifying-numbers-show-just-190100293.html

[Buster's Uncle]

Beds scarce, staff scarcer, in Liberia's overrun Ebola wards
AFP
By Marc Bastian  18 minutes ago

 

Mary, a Liberian mother, holds a photo of her son Emaya, who is being treated for Ebola at Island Hospital in Monrovia, on September 26, 2014 (AFP Photo/Pascal Guyot)



Monrovia (AFP) - They carry photos, bags of food -- and hope. But what the families idling at the gate of this Ebola centre in Monrovia lack is news of the fate of their sick loved ones inside.

George Williams brought his wife and daughter to the Island Clinic on Tuesday and since then has had "no news, no contact with my family".

"I trust the doctors and the government," he says.

But his faith draws hoots of laughter from the 40-odd others also waiting. For days, they say, no news of their family has ventured beyond the clinic's barbed-wire and high walls -- only cadavers.

The keeper of the clinic gate, in protective white gear from head to toe, looks like he is transported from outer space to this sweltering, misery-infected African city.

The crowd's noisy complaints fall silent as the gates open, and two Red Cross trucks, each carrying a dozen body bags, emerge.



People with relatives infected with the Ebola virus wait in front of the Island hospital, on September 28, 2014 in Monrovia (AFP Photo/Pascal Guyot)


A woman cries out, then two -- and then anger surges again.

"I want to see my son!" Janjay Geleplay, hard-faced, demands.

She brought 12-year-old Joshua on Sunday from the "72nd" district of Liberia's capital, where "there is a lot of Ebola".

"We get no record from the authorities. They always say we should wait. I come here every day. I want to see my son! Maybe he is already dead," she says, dry-eyed.

The Island clinic opened on Sunday. By the next day its 120 beds were full.



Beds sit inside the Island Clinic, an Ebola treatment centre in Monrovia, Liberia, on September 21, 2014 (AFP Photo/Zoom Dosso)


"As of Friday, we had 206 patients," a spokesman for the UN's World Health Organization, which runs the centre, told AFP.

Like all the NGO-run Ebola centres in Liberia, the Island is under-resourced and overrun by demand, forced to fill in for a public health infrastructure that has been decimated by 14 years of civil war and grinding poverty.

"There is supposed to be a system to allow the patients to talk to their families while keeping a distance of several metres (yards) -- but apparently it's not up and running yet," a clearly embarrassed WHO official there says.

Of the four west African nations affected by the Ebola outbreak, Liberia has been hit the hardest, with 3,458 people infected, and 1,830 killed by the disease.

A total of more than 6,500 infections, almost all in Guinea, Liberia and Sierra Leone, have been recorded since the beginning of the year according to a WHO count as of Saturday. Of those, 3,091 people have died so far.



A health worker lifts a girl at a Doctors Without Borders run Ebola centre in Monrovia, Liberia, on September 26, 2014 (AFP Photo/Pascal Guyot)


- More beds, few aid workers -

On the other side of Monrovia, a 160-bed Ebola clinic run by Doctors Without Borders (Medecins Sans Frontieres, MSF) had to turn away patients for days.

A Belgian aid worker, forced to act as a "bouncer" there, quit and returned home, traumatised by the need to turn away the sick and dying.

"A lot of people are saying this is the hardest mission they've ever had," an MSF colleague says, requesting anonymity.

But the colleague also pointed to progress, saying that "slightly fewer arrivals" since Thursday has meant no one needed to be turned away -- "perhaps because new centres have been opened".



A man dries disinfected boots for medical staff members taking care of patients suffering from Ebola, at a center run by Doctors Without Borders in Monrovia, September 27, 2014 (AFP Photo/Pascal Guyot)


International efforts are finally building speed to get critical supplies and staff to stricken nations, following a call for fresh aid by US President Barack Obama, and along with fast-track funding from the International Monetary Fund.

The UN has estimated that nearly one billion dollars will be required to effectively fight the disease.

"In the next two to three weeks, we'll have over a thousand beds available in Monrovia," Frank Mahoney, the representative of the US health body Centers for Disease Control and Prevention, says.

The WHO is planning on creating 500 new beds within the month, and MSF plans to have a total of 400 beds, while Obama has also charged the US army with setting up beds.

Jean-Pierre Veyrenche, in charge of the construction of clinics in Monrovia for the WHO, says the task is especially complicated in the dense Liberian capital.

"You need 5,000 square metres (5,400 square feet) for a 100-bed clinic -- not easy to find in a big city like Monrovia, with marshy terrain. And the heavy rains are an enormous obstacle, as is the high water table which makes it impossible to dig latrines and is forcing us to build septic tanks out of concrete."

Like all NGOs and political leaders, he appeals for more aid workers on the ground.

"I think people are scared," Veyrenche says, "No one knows how to deal with Ebola in an urban zone, and in such numbers.... But the international humanitarian community must act. There are ways of working here. You can't get Ebola from stepping down onto the runway."

A group of aid workers in Monrovia noted the same problem. "Supplies are coming in, but what we're still missing are healthcare personnel," one of them tells AFP.

After a devastating earthquake in Haiti in 2010, 820 NGOs mobilised with on-the-ground efforts, he says. In Liberia, there are fewer than 10.

Outside the Island clinic, 32-year-old Finley Freeman handed his homemade meals over to the gatekeeper to deliver to his mother.

He has not seen her for days but gets his news directly.

"I talked to her on the phone last night. She keeps praying," he says.


http://news.yahoo.com/beds-scarce-staff-scarcer-liberias-overrun-ebola-wards-192833372.html

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US doctor exposed to Ebola virus admitted to NIH
Associated Press
2 hours ago



This Jan. 14, 2014 file photo shows Daniel Bennett quarantined in an isolation unit at the National Institute of Health (NIH) in Bethesda, Md., during research for a better flu vaccine. The NIH is preparing to care for an American doctor who was exposed to the Ebola virus while volunteering in Sierra Leone. As early as Sunday, Sept. 28, 2014, the physician is expected to be admitted to the same special isolation unit at NIH's hospital out of what the agency called "an abundance of caution," for observation. (AP Photo/Charles Dharapak, File)



WASHINGTON (AP) — An American doctor who was exposed to the Ebola virus while volunteering in Sierra Leone was admitted Sunday to a hospital at the National Institutes of Health near the nation's capital.

The patient, who was not identified, arrived at NIH's Clinical Center about 4 p.m., NIH said in a statement on its website.

NIH said that out of "an abundance of caution," the physician was admitted to a special isolation unit. NIH infectious disease chief Dr. Anthony Fauci wouldn't discuss details about the patient but said that in general, an exposure to Ebola doesn't necessarily mean someone will become sick.

"When someone is exposed, you want to put them into the best possible situation so if something happens you can take care of them," Fauci said.

"NIH is taking every precaution to ensure the safety of our patients, NIH staff and the public," the agency said in a statement.

Four other American aid workers who were sickened by Ebola while volunteering in the West African outbreak have been treated at hospitals in Georgia and Nebraska. One remains hospitalized while the others have recovered.

An Associated Press photographer saw a person dressed in a white protective suit get off a plane and walk to a waiting ambulance at the Frederick Municipal Airport in Maryland about 3:30 p.m. Sunday.

The plane's tail number matched that of the aircraft that has been used previously to transport other Ebola patients to the United States from overseas.

NIH spokesman John Burklow confirmed that the plane carrying the patient landed at Frederick.


http://news.yahoo.com/nih-treat-us-doctor-exposed-ebola-virus-084947768--politics.html