Ebola news 10/15

[Buster's Uncle]

Ebola: Questions about a stealthy virus
AFP
By Mariette Le Roux  12 hours ago



A man hangs up a banner giving information on measures to avoid the Ebola virus with an image of Ivory-Coast's Health Minister Raymonde Goudou Coffie in Abidjan on October 14, 2014CA-HEALTH-EBOLA-ICOAST



Paris (AFP) - The Ebola virus species that has killed more than 4,000 people in west Africa caught everyone by surprise when it erupted thousands of kilometres from its historical hotbed.

The outbreak, experts say, revealed just how little we know about the deadly agent.

What is the virus' natural range? Are there limits? Can they shift?

"Previously we were under the impression that this problem would be predominantly restricted to central Africa. Clearly, that is not the case," University of Warwick virology professor Andrew Easton told AFP.

"This outbreak emphasises that viruses are no respecters of borders."

Prior to the west African outbreak, the Zaire species of Ebolavirus had killed just under 1,100 people, all of them in the Democratic Republic of Congo (DRC), Congo and Gabon, since the disease was first recorded in 1976.

Zaire is the deadliest of the four African species of Ebolavirus, part of a family of viruses that cause haemorrhagic fever. A fifth, the Reston Ebolavirus, has been recorded in Asia.

How the virus found its way into the human population of west Africa remains, for now, a mystery.

Fruit bats are believed to be the virus' natural reservoir in the wild -- they do not fall ill from it, but can infect apes and monkeys and small antelopes, even humans directly.

Humans become exposed to the virus if they kill and butcher infected animals for food, or bushmeat, a practice that is common in parts of west Africa's tropical forests.

What seems likely is that last December, a single human caught the virus this way, and then kicked off a transmission chain in Guinea, Liberia and Sierra Leone.


- Bats brought it? -

But why was a "central African virus" in west Africa?

One theory is it was brought by a migrating bat, or a colony of bats -- the animals can fly thousands of kilometres in pursuit of seasonal fruit.

It could also have been passed unnoticed from bat to bat to bat ever westward through the African forests and jungles over a period of time.

Another idea is that a human contracted the virus in central Africa and carried it west.

"However, it is not likely, as the outbreak was in a very isolated area where the local population have almost no access to travel across the distances required and travel over land is certainly unlikely due to the rapidity of the infection," said Easton.

In west Africa, the virus could have passed directly from bats to humans who hunt or eat them, or come into contact with the animals' excrement in caves, on fruit or under trees -- or via infected bushmeat.

Another possibility is that the virus already made its way to west Africa years ago and was simply waiting for conditions to become right for a human outbreak.

Or it might have been in west Africa just as long as in central Africa, just waiting for humans to move closer.

The European Centre for Disease Prevention and Control (ECDC) said the reasons for the outbreak are "not fully understood yet".

But "changes in land use and penetration into previously remote areas of rainforest bringing humans into contact with potential reservoirs might have played a role," the agency told AFP by email.

"These things are purely chance events," said University of Nottingham molecular virology professor Jonathan Ball.

"You need the right conditions: you need an infected animal source, you need humans to then come into contact with that animal source."

A genetic study published in September said the virus responsible for the west African outbreak was a member of the Zaire Ebolavirus family, and may have diverged from central African strains about 10 years ago.

Easton said the west African Zaire Ebolavirus species was "incredibly similar" to that found in central Africa.

"The appearance of a virus that appears to have travelled from central to west Africa demonstrates that we lack much important knowledge about the 'natural history' of this virus."

Despite all the unknowns, it would appear Zaire Ebolavirus is more widespread than previously believed, and more mobile.

"Studies published in 2010 and 2012 detected antibodies to the Zaire Ebolavirus in the blood of certain fruit bat species in Ghana," virologist Olivier Reynard of France's CIRI infectious diseases research centre told AFP.

Its "circulation zone may be a lot wider than we thought".

A study last month said more than 22 million people live in parts of Africa where conditions exist for the Ebola virus to jump from animals to humans.

"African states need to prepare a plan for dealing with this and similar viruses" as soon as they emerge, Easton said, urging wealthy nations to lend support.


http://news.yahoo.com/ebola-questions-stealthy-virus-061608001.html

[Buster's Uncle]

US Ebola patient re-emerges on Twitter
AFP
October 13, 2014 6:29 PM



Medical staff carry the body of an Ebola victim at the Medecins Sans Frontieres center in Monrovia on September 27, 2014 (AFP Photo/Pascal Guyot)



Washington (AFP) - A US photojournalist who was sickened with Ebola in Liberia and evacuated to Nebraska for treatment emerged on Twitter Monday saying he was feeling better and planned to blog about the experience.

Ashoka Mukpo, 33, was working as a freelance cameraman for NBC News in Monrovia when he fell ill with the virus that has killed more than 4,000 people in West Africa.

He arrived at Nebraska Medical Center on October 6, and his symptoms were "not extreme," his mother said at the time.

"Back on Twitter, feeling like I'm on the road to good health," he wrote on the popular microblogging site, under the Twitter handle @unkyoka.

"Will be posting some thoughts this week. Endless gratitude for the good vibes."

He said he was working on a blog called the "Ebola Diaries" that would "compile material from long-term reporter residents of Liberia."

Officials at the Nebraska Medical Center said Sunday that Mukpo's health was improving.

He has received an experimental drug as a blood transfusion from Ebola survivor Kent Brantly, a US missionary doctor who also fell ill in Liberia.

"Now that I've had first hand experience with this scourge of a disease, I'm even more pained at how little care sick west Africans are receiving," Mukpo wrote.

Mukpo is the fifth American evacuated from West Africa with the help of the US State Department since the world's largest outbreak began earlier this year.


http://news.yahoo.com/us-ebola-patient-emerges-twitter-222930556.html

[Buster's Uncle]

New Texas nurse with Ebola had fever on airliner
Reuters
By Lisa Maria Garza and Terry Wade  14 minutes ago



DALLAS (Reuters) - A second Texas nurse who has contracted Ebola flew on a commercial flight from Ohio to Dallas with a slight temperature the day before she was diagnosed, health officials said on Wednesday, raising new concerns about U.S. efforts to control the disease.

Chances that other passengers on the plane were infected were very low, but the nurse should not have been traveling on the flight, U.S. Centers for Disease Control and Prevention (CDC) Director Dr. Thomas Frieden told reporters.

The woman, Amber Vinson, 29, was isolated immediately after reporting a fever on Tuesday, Texas Department of State Health Services officials said. She had treated Liberian patient Thomas Eric Duncan, who died of Ebola and was the first patient diagnosed with the virus in the United States.

Vinson, a worker at Texas Health Presbyterian Hospital in Dallas, had taken a Frontier Airlines flight from Cleveland, Ohio to Dallas/Fort Worth International Airport on Monday, the officials said.

The latest revelation raised fresh questions about the handling of Duncan's case and its aftermath by both the hospital and the CDC.

The CDC said earlier that it was asking all of the more than 130 passengers who shared the Frontier flight to call a CDC hotline.

In Washington, the White House said President Barack Obama had abruptly postponed a political trip he was to make on Wednesday to convene a high-level meeting about the government's response to the Ebola outbreak.

The move suggested a higher level of concern at the White House after reports emerged about Vinson, who government officials said was being transferred for treatment to Emory University Hospital in Atlanta.

At least 4,493 people, predominantly in West Africa, have died in the worst Ebola outbreak since the disease was identified in 1976, but cases in the United States and Europe have been limited. The virus can cause fever, bleeding, vomiting and diarrhea, and spreads through contact with bodily fluids.

Frieden said Vinson had been monitoring herself for symptoms of Ebola and failed to report that her temperature had risen to 99.5 degrees before she departed for Dallas. Even so, Frieden said the risk to other passengers was "very low" because she did not vomit on the flight and was not bleeding.

He added that authorities had identified three people who had direct contact with her before she was isolated.

Dr. Mary DiOrio, interim chief of the Ohio Department of Health’s Division of Prevention and Health Promotion, told reporters Vinson visited family in Akron from Oct. 8 to Oct. 13 before she flew to Dallas on Frontier.

U.S. airline stocks tumbled again on Wednesday on renewed fears of a drop-off in air travel. Ebola fears also contributed to a nearly 2 percent drop in the Dow Jones Industrial Average, which was under pressure from global economic concerns.

Over the weekend, 26-year-old nurse Nina Pham became the first person to be infected with Ebola in the United States. She had cared for Duncan during much of his 11 days in the hospital. He died in an isolation ward on Oct. 8.

The hospital said on Tuesday that Pham was "in good condition."

National Nurses United, which is both a union and a professional association for U.S. nurses, said on Tuesday that the hospital lacked protocols to deal with an Ebola patient, offered no advance training and provided nurses with insufficient gear, including suits that left their necks exposed.


'PILED TO THE CEILING'

Basic principles of infection control were violated by both the hospital's Infectious Disease Department and CDC officials, the nurses said, with no one picking up hazardous waste "as it piled to the ceiling."

"The nurses strongly feel unsupported, unprepared, lied to, and deserted to handle the situation on their own," the statement said.

The hospital said in a statement it had instituted measures to create a safe working environment and it was reviewing and responding to the nurses' criticisms.

Speaking early Wednesday on CBS "This Morning," U.S. Health and Human Services Secretary Sylvia Burwell declined to comment on the nurses’ allegations.

Dallas Mayor Mike Rawlings said at a news conference Wednesday that the second infected nurse lived alone and had no pets.

He said local health officials moved quickly to clean affected areas and to alert her neighbors and friends. A decontamination could be seen taking place at her residence.


EARLY WAKEUP

Residents at The Bend East in the Village apartment complex were awoken early Wednesday by text messages from property managers saying a neighbor had tested positive for Ebola, and pamphlets had been stuffed beneath doors and left under doormats, said a resident, who asked not to be named.

Other residents were concerned enough that they were limiting time spent outdoors.

"Everybody thinks this won't happen because we are in the United States. But it is happening," said Esmeralda Lazalde, who lives about a mile from where the first nurse who contracted Ebola resides.

Texas Health Presbyterian Hospital is doing everything it can to contain the virus, said Dr. Daniel Varga of Texas Health Resources, which owns the hospital. "I don't think we have a systematic institutional problem," he said at a news conference on Wednesday.

At the same briefing, Dallas County Judge Clay Jenkins, the county's chief political officer, said authorities were anticipating additional possible Ebola cases.

"We are preparing contingencies for more, and that is a very real possibility," Jenkins said.

Frieden has come under pressure over the response and preparedness for Ebola, but White House spokesman Josh Earnest said U.S. President Barack Obama was confident of Frieden's ability to lead the public health effort.

Burwell, in a series of television interviews on Wednesday, said officials were adding staff to ensure the hospital in Dallas followed procedures to prevent transmission of the virus.

She said there would be round-the-clock site managers to oversee how healthcare workers put on and remove the protective gear used when treating Ebola patients.

In addition to extra CDC staff on site, two nurses from Emory University, in Atlanta, which has a specialized hospital that has treated other Ebola patients flown in from West Africa, were in Dallas to train staff.

Prospects for a quick end to the contagion diminished as the World Health Organization predicted that Liberia, Sierra Leone and Guinea, the three worst-hit countries, could produce as many as 10,000 new cases a week by early December.

(The story was refiled to correct the death toll in the ninth paragraph)

(Additional reporting by Jim Forsyth in San Antonio, Susan Heavey and Doina Chiacu in Washington D.C. and Jon Herskovitz in Austin, Texas; Writing by Jonathan Kaminsky and Curtis Skinner; Editing by Bernadette Baum, Jonathan Oatis and Tom Brown)


http://news.yahoo.com/second-texas-healthcare-worker-tests-positive-ebola-090736415.html

[Buster's Uncle]

Medical charity says has reached limit in fight against Ebola
Reuters
By Robert-Jan Bartunek  3 hours ago



Medical staff working with Medecins sans Frontieres prepare to bring food to patients kept in an isolation area at the MSF Ebola treatment center in Kailahun, Sierra Leone, July 20, 2014. REUTERS/Tommy Trenchard



BRUSSELS (Reuters) - Medecins Sans Frontieres, a medical charity that has been at the forefront in the fight against Ebola in West Africa, said it was reaching its limit and urgently needed other organizations to step up the efforts against the deadly disease.

The organization currently operates six centers in Guinea, Sierra Leone and Liberia, with a total of 600 beds. Its personnel on the ground have grown from about 650 at the start of August to about 3,000 currently.

"We have increased our capacity a lot," said Brice de le Vingne, director of operations for MSF, which is also known as Doctors Without Borders. "Now we have reached our ceiling."

De le Vingne called on other actors, such as governments and international organizations, to up their game.

"They are deploying as we speak, but we still don't see the results on the field," he said. "The speed of the deployment is still lower than the speed of the epidemic, and that is problematic."

The Ebola epidemic is still spreading, and projections show there could be 5,000 to 10,000 new cases a week in early December, the World Health Organization said on Tuesday.

De le Vingne coordinates missions for MSF and oversees a facility in Brussels that trains volunteers heading for the affected areas. It is the only such training center in Europe, although others, operated by different organizations, are set to open in Geneva and Berlin.

Medecins Sans Frontieres has been accumulating expertise in fighting Ebola outbreaks since 1995. Protocols have been developed on such crucial issues as disinfecting nurses and doctors after they've been in contact with the sick.

At the Brussels training center, a group of trainees were being taught on Wednesday how to enter an Ebola field hospital and how to leave without infecting themselves. They learned how to carefully remove layer after layer of a thick protective suit, repeatedly washing their gloves in a chlorine solution.

All the trainees, whether doctors, nurses or psychologists, have been on missions with MSF before. But working at an Ebola field hospital is particularly challenging.

Already sweating under rubber aprons and face masks on a relatively chilly afternoon, they were reminded by the trainers that Africa will be much hotter, with temperatures at 30 degrees Celsius (86 degrees Fahrenheit) or more.

"We limit the number of times that we suit up and go into that actual high-risk zone where the patients themselves are to just a couple of times a day, so as not to risk over-heating," said Paul Brockmann, one of the trainees who will head out to Sierra Leone on Friday.

The psychological and physical stress is one of the reasons training missions are limited to about six weeks per turn, though some have gone on more than one turn.

Even with the strict protocols, one of MSF's Norwegian staff members was diagnosed with the disease in early October. The organization said it was investigating the incident.

"I'm a bit scared of what I will be seeing, because I know that there's a lot of human suffering that I will be witnessing, and I'm also scared for out staff," said Carla Uriarte a psychologist who is set to leave for Sierra Leone in November.

"I know that some of our local staff died, not necessarily because they get infected in the center but because they are part of the community so that is the part that scares me the most."

(Reporting by Robert-Jan Bartunek; Additional reporting by Miranda Alexander-Webber; Editing by Larry King)


http://news.yahoo.com/medical-charity-says-reached-limit-fight-against-ebola-174412551.html