Ebola news 10/16

[Buster's Uncle]

Ebola Outbreak: Why It's So Important to Find Patient Zero
LiveScience.com
By Laura Geggel, Staff Writer  1 hour ago



Health care workers from the U.S. Centers for Disease Control and Prevention check the temperature of a man in Conakry, Guinea in West Africa to see whether he has Ebola symptoms.



The current Ebola virus outbreak in West Africa has killed more than 4,000 people, but it started with one person: a 2-year-old child who died on Dec. 6, 2013.

It's unclear how the child caught the virus, but by Jan. 1, 2014, the child's mother, 3-year-old sister and grandmother had all died of the disease, according to a study published in the Oct. 9 issue of the New England Journal of Medicine. Their town in the Guéckédou region of Guinea sits at the intersection of three nations, giving the virus easy access to Liberia and Sierra Leone.

In a disease outbreak, it's important to find the first person to become infected with the pathogen — called "patient zero" — because knowing that person's history can help researchers determine how and when the outbreak started, said Dr. William Schaffner, a professor of preventive medicine and infectious diseases at Vanderbilt University Medical Center in Nashville, Tennessee.

"From a medical and public health point of view, finding the first case is instructive because it first gives us a clue as to what the source was," said Schaffner, who was not involved in the research.

For instance, in the Guinea outbreak, the location of the first case also explained how the virus easily spread to three countries within a matter of months.

It's likely that Ebola is transmitted to humans when they hunt or eat infected bushmeat, Schaffner said. If a person contracts the Ebola virus after hunting for meat, epidemiologists might ask questions that could help them figure out how the virus jumped from animals to people.

In Guinea, a traditional healer who had contact with the 2-year-old got sick, and then gave the virus to a doctor, who, in turn, passed it on to his relatives, according to the New England Journal of Medicine study. The disease is not airborne, but spreads through contact with the bodily fluids, such as blood and vomit, of an infected individual.

In their study, the researchers mapped out the transmission of the virus, showing how it spread. First, the virus wound slowly through rural regions, and then spread rapidly as it moved into populated areas, they said.

Finding patient zero requires painstaking detective work.

"We call it shoe-leather epidemiology," Schaffner said. "Health care workers go out in the field and wear holes in their shoes, figuratively speaking, going from case to case."

It's like backtracking, said Lina Moses, an epidemiologist at Tulane University in New Orleans. "Every case has a point where [patients] can identify some type of exposure to someone who would be classified as a suspected case of Ebola," Moses said. "If you have the personnel and manpower to backtrack — if you have people who are still surviving — then you can trace it back."

When patient zero is identified, the next step is to figure out how the person got sick. "You'd like to know when this might have happened," Schaffner told Live Science. "What was the animal that you killed, or you found already dead? What activities did you do? Did you skin it in the field? Did you cut yourself while you were skinning? Exactly how exposed were you to the entrails or the blood of the animal?"


Tracking Ebola

After the 2-year-old's death in Guinea, the virus spread to Liberia in March, Sierra Leone in May and Nigeria by July. When researchers track the virus's transmission, it tells them how Ebola travels. For instance, in Guinea, the boy's family and caretakers caught it and passed it on to others. In Sierra Leone, the first cases arose after 13 women attended the funeral of a traditional healer who had treated Ebola patients in Guinea.

Tracking these routes of transmission "has been very illuminating, and just reinforces the notion that dealing with the sick directly, whether you're a family member or a traditional healer, are high-risk events for acquiring the infection and perpetuating the epidemic," Schaffner said.

The first case of Ebola in Nigeria started in Liberia. A man who had a fever and was under observation for the illness at a hospital in Monrovia decided to leave, even though doctors asked him to stay. On July 20, he flew by commercial airline from Liberia to Ghana, from Ghana to Togo and finally from Togo to Nigeria, according toan Oct. 3 report from the Centers for Disease Control and Prevention.

The man potentially exposed 72 people at the Nigerian airport and hospital, and died five days later, the report found. But Nigerian officials were largely able to contain the virus, by establishing an Ebola Incident Management Center supported by the state and federal Nigerian government in coordination with international partners. The center helped rapidly coordinate the response and take actions such as contacting people who had interacted with the man, isolating people with viral symptoms and decontaminating places the man had visited, the report found. As of Oct. 8, Nigeria had 20 cases of Ebola and eight deaths, the CDC reported.

Other countries have reported one or two cases. On Aug. 20, a 21-year-old man traveled by road from Guinea to visit relatives in Dakar, Senegal's capital and largest city, the World Health Organization (WHO) reported. He had a fever, diarrhea and vomiting, but doctors in Senegal initially diagnosed him with malaria. By Aug. 26, doctors referred him to infectious-disease experts, and he later recovered.

The United States has reported two cases, and Spain has reported one, in which a nurse caught it from a priest who was airlifted from Liberia and brought to Spain for treatment, the CDC reported. The Spanish priest, 75-year-old Miguel Pajares, died on Aug. 11.

The Democratic Republic of the Congo currently has a separate outbreak that is caused by another strain of the Ebola virus. Epidemiologists found patient zero in that outbreak was a pregnant woman who butchered a wild animal that her husband had killed and given to her for food. Ebola outbreaks are more common in the Democratic Republic of the Congo than they are in West Africa — this is the seventh to happen in the country since 1976, WHO reported.


Detective work

In addition to the backtracking method, researchers can verify the virus's trajectory with genetic analysis. For example, in a recent study published in the journal Science, researchers reported that they sequenced the genomes of 99 Ebola viruses found in samples taken from 78 patients in Sierra Leone.

They found that the virus was brought to West Africa within the past decade, likely by an animal. Moreover, the findings suggested the virus had made a single jump from an animal to a person, meaning that the outbreak was not being fueled by continuous exposure to infected animals.

"They discovered that [the genomes] were all tightly genetically related," Schaffner said, "indicating that there was a single introduction from the wild that then spread among the humans."

However, finding patient zero does little to help patients who already have the Ebola virus, Moses said.

Instead, trained health care workers are sorely needed to treat patients in West Africa, she said.


http://news.yahoo.com/ebola-outbreak-why-important-patient-zero-152143370.html

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Roche seeks fast-track approval for Ebola virus test
Reuters 2 hours ago



The logo of Swiss pharmaceutical company Roche is seen outside the Shanghai Roche Pharmaceutical Co. Ltd. headquarters in Shanghai May 22, 2014. REUTERS/Aly Song



ZURICH (Reuters) - Roche Holding AG has filed its Ebola virus test for emergency use approval in the United States, in response to the world's worst outbreak of the disease, the drugmaker's head of diagnostics said on Thursday.

Roland Diggelman said Roche has an Ebola test that can run on its polymerase chain reaction (PCR) systems, but said it was currently only labeled for use in research purposes.

"We are in discussions for emergency use application by the FDA (Food and Drug Administration)," Diggelman told an analyst call after the company's third-quarter results.

A spokesman for Roche said the company has also filed for so-called CE mark approval in the European Union. The CE mark is awarded to products that comply with European regulations.

He said it takes approximately two hours for the company's Ebola test to detect the virus. It is possible to run around 480 samples per day on a single Roche LightCycler 480 machine. Only laboratories that fulfil specific safety requirements would be able to handle Ebola samples.

A total of 4,493 people have died from the world's worst Ebola outbreak on record and the situation in Guinea, Liberia and Sierra Leone is deteriorating, the World Health Organization (WHO) said on Wednesday.

Public anxiety about the disease has grown in the United States after a second Texas healthcare worker became infected with the disease after treating Liberian national Thomas Duncan.

The WHO recommends testing for viral ribonucleic acid (RNA) or viral antigen in suspected or probable cases of Ebola.

(Reporting by Caroline Copley; Editing by David Holmes)


http://news.yahoo.com/roche-seeks-fast-track-approval-ebola-virus-test-143750525--finance.html

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University knocks down tweet that Ebola airborne
Associated Press  1 hour ago



Centers for Disease Control and Prevention (CDC) Director Dr. Tom Frieden, left, takes his seat on Capitol Hill in Washington, Thursday, Oct. 16, 2014, prior to testifying before the House Energy and Commerce Committee's subcommittee on Oversight and Investigations, to get answers about the Ebola outbreak from top U.S. health officials. (AP Photo/Pablo Martinez Monsivais)



University of Minnesota officials are knocking down a tweet claiming its researchers say Ebola is airborne.

University spokeswoman Caroline Marin told the Star Tribune in Minneapolis that the university never made such a claim.

In fact, the tweet refers to a commentary posted a month ago on a university website that was written by Chicago-based researchers who were debating Ebola's "potential to be transmitted" to health workers by aerosolized virus particles, and thus what protective gear they should wear.

World health authorities have been clear that Ebola is transmitted through direct contact with bodily fluids, and that blood, vomit and feces carry the most virus. Health workers are at particular risk because in the course of caring for patients, they draw blood and clean up diarrhea when the patients are most infectious. Likewise in the epidemic zone in West Africa, people involved with burials of highly infectious bodies are at high risk.

What if a sick person's wet sneeze hits your hand and then you absentmindedly rub your eyes? Asked about such scenarios recently, Dr. Tom Frieden, director of the Centers for Disease Control and Prevention, allowed that, theoretically, "it would not be impossible" to catch the virus that way. But it's considered highly unlikely. No such case has been documented.

"Should you be worried you might have gotten it by sitting next to someone?" he said Wednesday. "The answer to that is no."

Frieden said "what actually happens in the real world" — and he cited four decades of dealing with Ebola in Africa — is that the disease is spread through much more direct contact with a sick person.

The World Health Organization says the same thing and notes that few studies have found Ebola in an infected person's saliva, generally in patients who were severely ill.


http://news.yahoo.com/university-knocks-down-tweet-ebola-airborne-152323845.html

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Don't shun Ebola survivors: give them frontline roles, say officials
Reuters
By Bate Felix  28 minutes ago



DAKAR (Reuters) - Ebola survivors could play critical frontline roles as care givers and blood donors in the battle against the deadly virus - because of their built-in immunity to it, top charity and government officials in Sierra Leone said on Thursday.

Andrew Brooks, a senior U.N. Children's Fund (UNICEF) official, said developing a network of those who had survived the highly infectious disease and could be involved in the response against it would be a way of more effectively addressing the outbreak that has killed nearly 4,500 people.

That job is made tough however by preconceptions towards those who have contracted Ebola and not died: A recent UNICEF survey of 1,400 households across Sierra Leone found survivors face high levels of stigma and discrimination from communities that undermines their ability to rebuild their lives.

Children in particular are vulnerable when communities do not step in to help, the report found.

In an attempt to combat those prejudices and discuss ways to act, some 35 survivors met on Thursday in Kenema in eastern Sierra Leone - an epicentre of the outbreak - in a two-day gathering organised by the government in partnership with UNICEF and the U.S. Centers for Disease Control.

They will talk about their experience, learn how to deal with the psychological aftermath and look for ways to help others fight the disease.

"Sierra Leone is facing one of the biggest crises in its history, and to defeat Ebola we need the help of every citizen," Alhaji Moijue Kaikai, Sierra Leone's social welfare minister said on Thursday.

"People who have survived Ebola give hope to others who are still fighting the disease. We need to accept survivors and welcome them back to our families and our communities."


DONORS, CARERS

The World Health Organization (WHO) said in September that products and serum derived from the blood of survivors could be used to treat the disease until experimental drugs currently under development enter production. A British man and two U.S. health workers who survived the illness have already donated their blood to victims.

The head of a treatment centre in Liberia, the country worst-hit by the outbreak, has urged survivors to donate their blood for use in treating infected patients.

But Brooks, a UNICEF regional child protection adviser, said survivors could play an even larger role by acting as care givers and foster parents to children orphaned by the disease.

Their presence would also be invaluable inside Ebola treatment units, he said, to offer hope and emotional engagement to help sick people get through when the odds were really against them.

Health systems in Guinea, Liberia and Sierra Leone, the three most affected countries, have been severely strained by the worst outbreak on record of the viral haemorrhagic fever.

"The Kenema meeting is a landmark. It is the first focused meeting around survivors. Survivors will came up with ideas on what they can do," said Brooks.

"I think that we should see them as people who have a critical function in public service at a time when it is really needed."

(Editing by Sophie Walker)


http://news.yahoo.com/dont-shun-ebola-survivors-them-frontline-roles-officials-170140742--business.html

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Patient with 'Ebola-like symptoms' admitted to Connecticut hospital
Reuters
By Richard Weizel  56 minutes ago




NEW HAVEN Conn. (Reuters) - Yale-New Haven Hospital in Connecticut was evaluating a patient with "Ebola-like symptoms" on Thursday and will likely know within 24 hours whether the person has the deadly disease, a hospital official said.

The patient is one of two Yale University graduate epidemiology students who traveled to Liberia last month to advise the health ministry on using computers to track Ebola, according to Laurence Grotheer, a spokesman for New Haven Mayor Toni Harp.

"Yale-New Haven Hospital admitted a patient late Wednesday night for evaluation of Ebola-like symptoms. We have not confirmed or ruled out any diagnosis at this point," the hospital said in the statement on its website.

Dr. Thomas Balcezak, the hospital's chief medical officer, said at a press conference that fever was among the patient's symptoms and they were placed in isolation. Balcezak said the patient was in stable condition.

Balcezak said a specimen from the patient was sent to a state laboratory in Massachusetts Thursday and it would take up to 24 hours to confirm or rule out Ebola.

“We are treating this patient as though they do have Ebola and taking every precaution possible," Balcezak said.

The mayor, however, told the same press conference that it was doubtful the patient has Ebola.

When the two graduate students returned from Liberia, Yale officials earlier said they had not traveled into areas where Ebola was present. They initially asked the two to quarantine themselves for 21 days but last week rescinded that request, according to the university.

Liberia is among three impoverished West African countries - the others are Sierrra Leone and Guinea - where nearly 4,500 people have died in the worst Ebola outbreak on record. The virus can cause fever, bleeding, vomiting and diarrhea, and spreads through contact with bodily fluids. It is not airborne.

A wave of citizens experiencing flu-like symptoms have called New Haven authorities with concerns they may be infected with Ebola, said Harp, the mayor.

“I think it’s really important for folks to remember that we are in flu season," Harp said.

"If you haven’t come from Liberia, Sierra Leone or Guinea, then you are likely to have just the regular flu."

(Additional reporting by Scott Malone and Barbara Goldberg; Editing by Susan Heavey and Grant McCool)


http://news.yahoo.com/connecticut-hospital-says-evaluating-patient-ebola-symptoms-135830904.html

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Ebola escalation could trigger major food crisis
Associated Press
By EDITH M. LEDERER  14 hours ago



UNITED NATIONS (AP) — The global famine warning system is predicting a major food crisis if the Ebola outbreak continues to grow exponentially over the coming months, and the United Nations still hasn't reached over 750,000 people in need of food in West Africa as prices spiral and farms are abandoned.

On the eve of World Food Day on Thursday, U.N agencies and non-governmental organizations are scrambling to scale up efforts to avert widespread hunger.

"The world is mobilizing and we need to reach the smallest villages in the most remote locations," Denise Brown, the U.N. World Food Program's regional director for West Africa, said in a statement Wednesday. "Indications are that things will get worse before they improve. How much worse depends on us all."

WFP has said it needs to reach 1.3 million people in need in hardest-hit Liberia, Sierra Leone and Guinea.

So far, the U.N. agency has provided food to 534,000 people, and it expects to reach between 600,000 and 700,000 this month, Bettina Luescher, WFP's chief spokesperson in North America, told AP. "And we are working hard to reach and scale up to 1.3 million eventually."

WFP is providing food to patients in Ebola treatment centers, survivors of the virus who have been discharged, and communities which have been quarantined or have seen widespread transmission, including the families of those affected. It is also helping with logistics and is managing the U.N. Humanitarian Air Service between the three affected countries and nearby Dakar, Senegal and Accra, Ghana to help humanitarian workers rapidly deploy to the field.

"We are assessing how families are coping as the virus keeps spreading," Luescher said. "We expect to have a better understanding of the impact of the Ebola outbreak on food availability and farming activities by the end of October."

WFP said its first survey using mobile telephones showed that people living in the Kailahun and Kenema districts of Sierra Leone — where most Ebola cases have been reported — are finding it harder to feed their families than people in other parts of the country and are resorting to more desperate measures to cope. More than 80 percent of people in those areas said they ate less expensive food, and 75 percent reported that they have reduced the number of daily means and were serving smaller portions.

Kanayo Nwanze, president of the U.N. International Fund for Agricultural Development, said Monday that up to 40 percent of farms have been abandoned in the worst-affected areas of Sierra Leone and there are already food shortages in Senegal and other countries in West Africa because regional trade has been disrupted.

He said preliminary reports suggest that "trade volume in these markets is half of what it was at this time last year."

Andrea Tamburini, CEO of the non-governmental organization Action Against Hunger which operates in the hardest-hit West African countries, said in an interview Wednesday that his two main concerns are the spike in food costs and the shortage of manpower due to restrictions on movement. This has led to farmers abandoning their crops to seek refuge in locations considered less exposed to the Ebola virus, he said.

The U.N. Food and Agriculture Organization said that in Lofa County, the worst affected rural county in Liberia, the price of food and other commodities increased from 30 to 75 percent, just in August. Action Against Hunger said the price of cassava — a key staple — increased by almost 150 percent in the Liberian capital, Monrovia, during the first week in August.

Tamburini said his organization will be running a survey to watch malnutrition rates but giving farmers "seeds and tools will definitely be there as a first step."

The Famine Early Warning Network known as FEWS NET said in an Oct. 10 report that if the number of Ebola cases reaches 200,000-250,000 by mid-January, large numbers of people in the three worst-affected countries would face moderate to extreme food shortages.

FEWS NET said that in this scenario, traders' fears of contracting Ebola and restrictions on movement would severely disrupt the availability of food on local markets, contribute to a significant drop in household incomes, and lead to food shortages at local markets.

"Contingency planning for an expanded emergency food assistance response is urgently needed given that the size of the food insecure population could be two to three times higher than currently planned," it said.

FEWS NET was created in 1985 after devastating famines in East and West Africa by the U.S. Agency for International Development. It provides analysis to help government decision-makers and relief agencies plan for and respond to humanitarian crises.


http://news.yahoo.com/ebola-escalation-could-trigger-major-food-crisis-043927850.html

[Buster's Uncle]

AU asks African leaders to send doctors to Ebola-stricken states
Reuters  56 minutes ago



African Union Commission Chairperson Nkosazana Dlamini-Zuma addresses a news conference during the closing ceremony of the 22nd Ordinary Session of the African Union summit in Ethiopia's capital Addis Ababa January 31, 2014. REUTERS/Tiksa Negeri



ADDIS ABABA (Reuters) - The African Union has appealed to all leaders in the continent to contribute health workers and specialists to staff new Ebola clinics and hospitals being built in West Africa, its chairperson said on Thursday.

Global health authorities are struggling to contain the world's worst Ebola epidemic since the hemorrhagic disease was identified in 1976.

The virus - still spreading in West Africa - has killed nearly 4,500 people, with confirmed, probable and suspected cases reported in seven countries, including the United States.

Though hundreds of millions of dollars have been committed and new Ebola clinics and hospitals are being built, aid agencies say there too few volunteers.

The Addis Ababa-based bloc has already deployed around 100 volunteers in Liberia, where -- as in Sierra Leone and Guinea -- healthcare systems are collapsing.

"We have written to our members' heads of state to see if each country can give us maybe up to 10 or 20 each," Nkosazana Dlamini-Zuma, Chairperson of the African Union Commission, told reporters.

"Even if some give us one or others give us 20, if everyone gave, we can get some hundreds of health workers," she added.

The United States already has more than 350 troops on the ground in West Africa, part of a planned mission of up to 4,000.

They have set up headquarters in Liberia's capital, Monrovia, and hope to have a 25-bed field hospital ready this month. The U.S. military also aims to quickly build up to 17 Ebola treatment units.

Britain is setting up a 200-bed hospital in Sierra Leone and the United Nations has formed a special mission to lead efforts.

But aid agencies say hospitals for Ebola infections, which the World Health Organization says are doubling every 10 to 21 days, may not be built and staffed fast enough to meet demand.

"It is not just a fight for these three countries," Zuma said. "If we don't help them the disease will also come to everyone ... each member state cannot say it is immune."

(Reporting by Aaron Maasho; Editing by Drazen Jorgic/Ruth Pitchford)


http://news.yahoo.com/au-asks-african-leaders-send-doctors-ebola-stricken-175953418.html

[Buster's Uncle]

Your constitutional rights during an Ebola (or other) outbreak
National Constitution Center
By Scott Bomboy  3 hours ago



With rising concern nationally about Ebola haemorrhagic fever, the possibility of some very limited quarantines looms as efforts are underway to contain the disease. But what are your rights under such conditions?




 
In short, state governments, and not the federal government, have most of  the power to place people in isolation or quarantine under certain circumstances. Isolation separates people who are known to be ill from those who aren’t sick. Quarantine separates people suspected of being exposed to an illness or biological agent from the general population.

Your individual rights are very limited in these circumstances, unless you can prove the government action is arbitrary.

The topic of Ebola and the Constitution is starting to get some play in legal publications; however, the precedents over the government’s power to isolate citizens go back almost 200 years.

The Constitution doesn’t directly list the power to isolate or quarantine people as a power given to the federal government, so the power to take these severe measures is reserved to the states under the 10th Amendment.

In 1824, Supreme Court Chief Justice John Marshall’s opinion in Gibbons v. Ogden drew a clear line between the federal government and the state governments when it came to regulating activities within and between states.

Marshall’s reasoning set the precedent that police powers are reserved to states for activities within their borders (with some exceptions). Those police powers include the ability to impose isolation and quarantine conditions. He said that inspection laws “form a portion of that immense mass of legislation which embraces everything within the territory of a State not surrendered to the General Government,” and quarantine laws were part of that “mass.”

Marshall’s decision also helped to define the Commerce Clause, and it is under the Commerce Clause that the federal government can impose isolation and quarantine conditions on people who travel between states, and on people entering and leaving the United States.

Under section 361 of the Public Health Service Act, the U.S. Secretary of Health and Human Services has the power to take measures to contain communicable diseases from foreign countries into the United States and between states. The Centers for Disease Control and Prevention (or CDC) acts on behalf of the Secretary in these matters.

But also under the Constitution, individuals have rights even in quarantine and isolation conditions. Under the rights of Due Process, public health regulations used to impose such conditions cant’ be “arbitrary, oppressive and unreasonable.”

There are precedents where courts have ruled that states or local governments didn’t meet a burden of proof. For example, in 1900 courts ruled against the city of San Francisco when it tried to inoculate and then quarantine Chinese residents against the bubonic plague, when the courts had doubts that plague conditions existed.

And there also precedents that authorities should provide confined people with an explanation about why they are confined and notify them they have a right to counsel and other constitutional provisions.

Cornell Law professor Michael Dorf has argued that some type of judicial oversight is needed in quarantine cases. Dorf cites a 1979 Supreme Court decision that proof by “clear and convincing evidence” was needed for civil confinement.

“Quarantine amounts to an extraordinarily serious limitation on liberty. Moreover, even a quarantine that is justified for purposes of preventing the spread of a disease to the general population can put the individuals subject to the quarantine at greater risk of becoming sick themselves—by concentrating them among others with a higher risk of being infected,” Dorf argues.

“Accordingly, judicial review of government officials’ claims that a quarantine is necessary to protect public health should not be a mere rubber stamp.”

The federal government also has a seldom-used right to impose large-scale quarantines. The federal government last issued isolation and quarantine orders during the Spanish Flu pandemic in 1918 and 1919.

Federal public health and welfare statutes also give the federal government authority to isolate and quarantine persons with certain diseases, based on an executive order issued by President George W. Bush in 2003.

Executive Order 13295 lists Ebola as one of several diseases that if suspected, provide for “the apprehension, detention, or conditional release of individuals to prevent the introduction, transmission, or spread of suspected communicable diseases.” Breaking a federal quarantine order is punishable by a fine and imprisonment.

So far, the states have handled the quarantine and isolation incidents in the few Ebola cases reported in the United States.


http://news.yahoo.com/constitutional-rights-during-ebola-other-outbreak-154818524.html

[Buster's Uncle]

US officials defend Ebola response; nurse moved
Associated Press
By JIM KUHNHENN  16 minutes ago



A second Texas nurse who contracted the Ebola virus from a patient flew across the Midwest aboard an airliner the day before she was diagnosed. The nurse has now been transferred to a hospital in Atlanta. (Oct. 15)



WASHINGTON (AP) — In the face of skepticism in Congress, health officials tried to assure the nation Thursday that they can head off an Ebola outbreak in the U.S. despite mistakes that let the deadly virus spread to two nurses and cleared one of them to fly.

The revelation that one of the hospital nurses was allowed on a commercial airline the day before she was diagnosed raised new alarms about the U.S. response to the Ebola outbreak in West Africa. Some lawmakers pressed for a ban on travel to the U.S. from the region — a course President Barack Obama is resisting.

The death toll is expected to climb above 4,500 in Africa, all but a few within Liberia, Sierra Leone and New Guinea, the World Health Organization said.

Obama directed his administration to respond in a "much more aggressive way" to the threat and, for a second day in a row, canceled his out-of-town trips to stay in town and monitor the Ebola response. He was calling foreign leaders and U.S. lawmakers to discuss what more must be done, the White House said, and bringing his Cabinet members together on the matter.

But a ban on travel to the U.S. from the Ebola-stricken countries is not under consideration, spokesman Josh Earnest reiterated Thursday.

Obama believes the U.S. already is taking the necessary steps to protect the public by screening passengers as they depart West Africa and again when they enter the U.S., Earnest said.

In Sierra Leone, the government announced the virus had infected two people in the last part of the country that had been free of the disease, in the mountainous north, despite aggressive steps to keep it at bay.

The first nurse stricken in the U.S., Nina Pham, who contracted Ebola after treating a Liberian man at Texas Health Presbyterian Hospital in Dallas, was being flown to the National Institutes of Health outside Washington on Thursday, while a second nurse has already been transferred to a biohazard infectious disease center at Emory University Hospital in Atlanta.

The two nurses, Pham and Amber Joy Vinson, had been involved in providing care to Thomas Duncan, who died of Ebola last week.



President Barack Obama, right, next to Health and Human Services Secretary Sylvia Burwell, speaks to the media about Ebola during a meeting in the Cabinet Room of the White House in Washington, Wednesday, Oct. 15, 2014, with members of his team coordinating the government’s response to the Ebola outbreak. (AP Photo/Jacquelyn Martin)


In a hearing on Capitol Hill, the chairman of a House committee cited "demonstrated failures" in the government's response. Rep. Tim Murphy of Pennsylvania said the "trust and credibility of the administration and government are waning as the American public loses confidence each day." Seated before him were leaders of the Centers for Disease Control and Prevention and the NIH.

Dr. Tom Frieden, director of the CDC, testified that despite the latest incidents, "we remain confident that our public health and health care systems can prevent an Ebola outbreak here."

In his prepared testimony, the Texas hospital's chief clinical officer, Dr. Daniel Varga, admitted the facility had made mistakes in Duncan's initial treatment, he apologized for that.

"We did not correctly diagnose his symptoms as those of Ebola," Varga said. "We are deeply sorry." Duncan was initially sent home from the emergency room with antibiotics for his high fever, despite saying he'd come from Liberia.

Varga testified to the committee by video conference.

In Europe, Spain's government is wrestling with treatment questions, too. The condition of a nursing assistant infected at a Madrid hospital appeared to be improving, but a person who came in contact with her before she was hospitalized developed a fever and was being tested Thursday.

That second person is not a health care worker, a Spanish Health Ministry spokesman said.

To this point, only hospital workers — the Madrid nursing assistant and the two nurses in Dallas — had been known to have contracted Ebola outside West Africa during the outbreak that began in March.



An ambulance carrying Amber Vinson, the second health care worker to be diagnosed with Ebola in Texas, arrives at Emory University Hospital on Wednesday, Oct. 15, 2014 in Atlanta. A joint emergency isolation unit administered by Emory University Hospital and the Centers for Disease Control and Prevention has successfully treated two Americans and is currently treating a third. (AP Photo/David Tulis)


U.S. Secretary-General Ban Ki-moon said a trust fund he launched to fight Ebola, with a $1 billion goal, has a paltry $100,000 in the bank. He appealed to nations to do more about a "huge and urgent global problem that demands a huge and urgent global response." Some $20 million has been spent from the fund.

France said that on Saturday it will begin screening passengers who arrive at Paris' Charles de Gaulle airport on the once-daily flight from Guinea's capital.

In the U.S., Customs and health officials at airports in Chicago, Atlanta, suburban Washington and Newark, New Jersey, were to begin taking the temperatures of passengers from the three hardest-hit West African countries Thursday. The screenings, using no-touch thermometers, started Saturday at New York's Kennedy International Airport.

With hospitals and airports on heightened alert, Frieden said the CDC is receiving hundreds of requests for help in ruling out Ebola in travelers. So far 12 cases merited testing, he said.

Frieden said investigators are trying to figure out how the nurses caught the virus from that Liberian patient, Thomas Eric Duncan. In the meantime, he said, their cases show a need to strengthen the infection-control procedures that "allowed for exposure to the virus."

Duncan's death and the sick health care workers in the U.S. and Spain "intensify our concern about the global health threat," said Dr. Anthony Fauci, director of the Institute of Allergy and Infectious Diseases at the National Institutes of Health.

He said two Ebola vaccine candidates were undergoing a first phase of human clinical testing this fall. But he cautioned that scientists were still in the early stages of seeking new treatments or a vaccine.

A nurse at the Dallas hospital, Texas Health Presbyterian, on Thursday described a "chaotic scene" when the hospital faced Duncan, its first Ebola patient.

Briana Aguirre, who has helped treat the first nurse who was infected, told NBC's "Today" show she felt exposed in the protective gear the hospital provided.

"In the second week of an Ebola crisis at my hospital, the only gear they were offering us at that time, and up until that time, is gear that is allowing our necks to be uncovered?" Aguirre said, adding that she piled on gloves and booties in triplicate and wore a plastic suit up to her neck.

The hospital said it used the protective gear recommended by the CDC and updated the equipment as CDC guidelines changed. Because nurses complained that their necks were exposed, the hospital ordered hoods for them, according to a statement from Texas Health Presbyterian.

Frieden said nurse Amber Joy Vinson never should have been allowed to fly on a commercial jetliner because she had been exposed to the virus while caring for the first Ebola patient.

Still, a CDC official cleared Vinson to board the Frontier Airlines flight from Cleveland to the Dallas area. Her reported temperature — 99.5 degrees — was below the threshold set by the agency, according to agency spokesman David Daigle.

Ebola patients are not considered contagious until they have symptoms.

Vinson was diagnosed with Ebola a day after the flight, news that sent airline stocks falling amid fears it could dissuade people from flying.

Frontier has taken the aircraft out of service. The plane was flown Wednesday without passengers from Cleveland to Denver, where the airline said it would undergo a fourth cleaning, including replacement of seat covers, carpeting and air filters.

___

Associated Press writers Emily Schmall and Nomaan Merchant in Dallas and Connie Cass and Calvin Woodward in Washington contributed to the report.


http://news.yahoo.com/us-steps-domestic-response-ebola-crisis-070311017--politics.html

[Buster's Uncle]

Ebola must be stopped at source, not via travel bans: World Bank's Kim
Reuters
By Anna Yukhananov  1 hour ago



World Bank Group President Jim Yong Kim is interviewed at the Reuters Global Climate Change Summit in Washington October 16, 2014. REUTERS/Gary Cameron



WASHINGTON (Reuters) - Closing national borders to people from countries hit hardest by the Ebola outbreak is "not an effective strategy" for stopping the deadly disease, the president of the World Bank said on Thursday.

There is only one way to end the Ebola crisis, which is to stop the spread of disease in the three worst-hit countries of Liberia, Sierra Leone and Guinea, the World Bank's Jim Yong Kim told the Reuters Climate Change Summit.

"All this talk about closing our borders ... it's as if you were in a burning house, in your room, and you start putting wet towels under the door to keep the smoke from coming in," Kim said.

"That is not an effective strategy. We've got to get back to putting out the fire," he said. "You either put it out, or it spreads: that's the bottom line."

Several U.S. lawmakers, including House of Representatives Speaker John Boehner, have urged temporary travel bans to the United States from the countries hardest hit by Ebola.

The disease has killed at least 4,400 people, predominantly in West Africa, and the rate of outbreak continues to increase.

Thomas Eric Duncan, a visitor from Liberia diagnosed with from Ebola, died in a Dallas hospital this month. Two nurses involved in his treatment have since tested positive for the Ebola virus.

"If the fear evolves into closing our borders, we're going to take our eye off the ball," said Kim.

Kim said U.S. hospitals could increase their effectiveness in stopping the disease from spreading, but it would be impossible to prevent any person in contact with the disease from traveling, especially as cases have now spread to Spain.

"The most important thing to prevent more and more cases coming is to maintain our focus in getting the response right," he said at the summit, held in the Reuters Washington bureau. "And we’re not close yet, we’re not close."

(Reporting by Anna Yukhananov; Editing by Ros Krasny, Doina Chiacu and Eric Walsh)


http://news.yahoo.com/ebola-must-stopped-source-not-via-travel-bans-170505581.html

[Buster's Uncle]

1st Dallas nurse with Ebola to be sent to Maryland
Associated Press  1 hour ago



This Texas Christian University yearbook photo shows Nina Pham, 26, who became the first person to contract the disease within the United States. Records show that Pham and other health care workers wore protective gear, including gowns, gloves, masks and face shields and sometimes full-body suits when caring for Thomas Eric Duncan. (AP Photo/Courtesy of tcu360.com)



DALLAS (AP) — The first Dallas nurse to have contracted Ebola after treating an infected Liberian man is scheduled to be moved Thursday to a specialized medical facility in Maryland.

The National Institutes of Health said in a statement that Nina Pham, 26, will be taken from Texas Health Presbyterian Hospital in Dallas to the NIH center in Bethesda, Maryland. The NIH facility has one of four biocontainment units in the United States.

Texas Health Presbyterian officials said Wednesday that Pham was in good condition.

Hospital spokesman Wendell Watson said Thursday the move is necessary because numerous employees are being monitored for symptoms of the virus and aren't available to work.

"With so many of the medical professionals who normally staff our intensive care unit sidelined for the continuous monitoring, we felt it was in the best interest of the hospital's employees, the nurses, the physicians, the community, to give the hospital an opportunity to prepare for tomorrow ... for whatever comes next," Watson said.

Pham will receive care from an NIH staff that specializes in infectious disease and critical care, according to the NIH statement.

A second nurse who tested positive, 29-year-old Amber Joy Vinson, has been transferred to a biohazard infectious disease center at Emory University Hospital in Atlanta.

Pham and Vinson were involved in providing care to Thomas Duncan, who died of Ebola last week at Texas Health Presbyterian.

They wore protective gear including face shields, hazardous materials suits and protective footwear as they inserted catheters, drew blood and dealt with his body fluids. Still, the two somehow contracted Ebola.

Federal health officials said Thursday they still don't know how the nurses caught the virus from Duncan.

Pham will be flown to Frederick Municipal Airport in Frederick, Maryland, a small airport about 35 miles northwest of the NIH. State police, the city and the county are coordinating to ensure she has a quick trip to the hospital, Frederick City Police Lt. Clark Pennington said Thursday.


http://news.yahoo.com/1st-dallas-nurse-ebola-sent-maryland-175440445.html

[Buster's Uncle]

Medical worker in Denmark does not have Ebola: official
Reuters  2 hours ago



COPENHAGEN (Reuters) - A medical worker who had returned to Denmark from West Africa does not have the Ebola virus, a hospital official said on Thursday following tests after the person reported a "slight rise" in temperature.

The Danish branch of medical charity Medecins Sans Frontieres (MSF) said earlier one of its employees was being tested for the virus which has killed almost 4,500 people in an outbreak in West Africa.

"It's negative," the official said of the test.

A Spanish nurse became the first person to contract the disease outside West Africa earlier this month after treating Ebola patients. Two U.S. nurses also contracted the disease after treating a patient.

(Reporting by Ole Mikkelsen, Annabella Nielsen and Sabina Zawadzki; Editing by Janet Lawrence)


http://news.yahoo.com/denmark-tests-medical-worker-ebola-results-soon-health-113022664--finance.html

[Buster's Uncle]

EU may boost exit screening in Ebola-hit states
AFP
By Lachlan Carmichael  2 hours ago



Brussels (AFP) - European health ministers agreed Thursday to launch an immediate review of the screening of passengers departing Ebola-hit countries in West Africa and boost them if the measures are found to be failing.

The ministers also agreed at a meeting in Brussels to coordinate measures at entry points to the 28-nation European Union, although any decision on screening rests with individual countries, health commissioner Tonio Borg said.

Europe is increasingly jittery about the possible spread of a disease that has already killed nearly 4,500 people, even if there has only been one case of the disease being transmitted within its borders.

Borg said the European Commission, the EU executive, "will immediately undertake an audit of exit screening systems in place in the affected countries... to check their effectiveness and reinforce them as necessary".

The review of the exit screening in Liberia, Guinea and Sierre Leone will be conducted in coordination with the World Health Organization, he said.

It will also allow EU officials to set up a database to better trace people who may be carrying the deadly virus from those countries, he added.

Officials said the information sharing system, sought mainly by Spain, could be based on visas acquired by citizens from the three worst-hit countries.

Italian Health Minister Beatrice Lorenzin told the same news conference he wanted the database plan in place "as soon as possible because it will remain the best way for us to follow the movement of passengers".

The ministers also agreed to "coordinate national measures" at EU arrival points such as having common protocols and procedures on passenger questionaires.


- 'Narrow window of opportunity' -

Several health workers have been evacuated back to Europe from Africa with Ebola, but the only recorded case of transmission on the continent so far is a Spanish nurse in Madrid.

The EU needs to improve the distribution of information to travellers from the affected countries so they "know what to do and where to go if symptoms arise," commissioner Borg said.

With the decision up to member states to decide what measures to take, the meeting was focused on coordinating efforts to stop the spread of the worst-ever outbreak of the virus, whose victims have almost all been in west Africa.

Borg said experts will hold a "workshop" in Brussels on November 4 "to exchange best practices on infection control" but reiterated the European position that an epidemic on the continent is highly unlikely.

The EU has meanwhile struggled to get member states to join an air evacuation scheme.

But Borg said the commission is expected to sign a deal in the next few weeks with the US State Department to use planes operated by the American government to evacuate any infected EU health workers.

Natalia Alonso, an official with the British-based humanitarian group Oxfam, criticised the EU meeting which drew 21 health ministers at short notice.

"Europe was more concerned about its border controls rather than what it should be doing to contain the spread of the disease in West Africa," Alonso said.

She said the EU should deploy more medical staff and equipment as well as military personnel in the next two weeks.

"Otherwise the EU will miss a very narrow window of opportunity to halt this epidemic," Alonso said.

EU nations have contributed aid worth about 450 million euros ($575 million) to Ebola-hit countries, including 180 million euros from the Commission, officials said.


http://news.yahoo.com/eu-review-screening-passengers-ebola-hit-african-states-141437485.html

[Buster's Uncle]

U.S. nurse with Ebola moving hospitals; officials grilled
Reuters
By Terry Wade  48 minutes ago



DALLAS (Reuters) - The U.S. National Institutes of Health said it would take over the care of the first Texas nurse diagnosed with Ebola, as lawmakers blasted the government's response to the virus at home.

Nina Pham, the first nurse diagnosed with Ebola after treating a man who died of the disease, will be transferred late Thursday from Dallas to an isolation unit at the U.S. National Institutes of Health outside Washington for treatment, NIH's Dr. Anthony Fauci told lawmakers at a congressional hearing on the government's handling of the virus in the United States.

"We will be supplying her with state-of-the-art care in our high-level containment facilities," said Fauci, director of the National Institute of Allergy and Infectious Diseases at NIH.

He announced the decision to move Pham, whose condition was said to be stable, as lawmakers grilled federal officials about their response to the outbreak of Ebola on U.S. soil and flaws in efforts to check its spread within the country.

Pham was part of a team of healthcare workers who had tended to Thomas Eric Duncan, a Liberian man who was the first patient diagnosed with Ebola in the United States. Duncan died on Oct. 8.

Dr. Daniel Varga, chief clinical officer and senior vice president of Texas Health Resources, said at the hearing that mistakes were made in diagnosing Duncan and in giving inaccurate information to the public, and that he was "deeply sorry."

He said there had been no Ebola training for staff before the first patient was admitted. Texas Health operates hospitals and health facilities in North Texas including the facility where Duncan was treated.

Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention (CDC) in Atlanta, is the top doctor overseeing the U.S. response to Ebola and has faced pointed criticism and calls for his resignation over lapses in containing the virus on U.S. soil.

He stressed in his testimony before the congressional oversight panel that there was a lot of fear about the disease, which has killed nearly 4,500 people in Sierra Leone, Liberia and Guinea this year.

"As the director of CDC, one of the things I fear about Ebola is that it could spread more widely in Africa. If this were to happen, it could become a threat to our health system and the healthcare we give for a long time to come," Frieden said.

The spread of Ebola to Pham and Amber Vinson - another Dallas nurse who had cared for Duncan at Texas Health Presbyterian Hospital - and revelations that Vinson had subsequently traveled on an airplane while running a slight fever, prompted Frieden to backtrack on earlier statements about his confidence in the ability of American health officials to contain the disease.

"It would be an understatement to say that the response to the first U.S.-based patient with Ebola has been mismanaged, causing risk to scores of additional people," said Representative Diana DeGette, the top Democrat on the Energy and Commerce congressional subcommittee holding Thursday's hearing.

At least two lawmakers have called for Frieden's resignation. Others, including House Speaker John Boehner of Ohio, urged travel restrictions on the countries hardest hit by Ebola. The disease appeared in the United States last month.

Vinson was transferred to Emory University Hospital for treatment on Wednesday night.

In Ohio, where Vinson had visited family members, two schools in the Cleveland suburb of Solon were closed on Thursday because an employee may have traveled on the same plane as Vinson, though on a different flight.

The Ohio health department said the CDC was sending staff to help coordinate efforts to contain the spread of Ebola.

Frontier Airlines said it had placed six crew members on paid leave for 21 days "out of an abundance of caution." Florida Governor Rick Scott asked the CDC to expand the reach of its contacts to people who flew on the same plane after nurse Amber Vinson’s flight. The plane made a stop in Fort Lauderdale after Dallas.

Back in Texas, the Belton school district in central Texas said three schools were closed on Thursday because two students were on the same flight as the nurse.

Frieden has said it was unlikely passengers who flew with Vinson were infected because the nurse had not vomited or bled on the flight, but he said she should not have boarded the plane.

The virus, which also causes fever and diarrhea, is spread through direct contact with body fluids from an infected person.

A federal official said Wednesday Vinson had told the CDC her temperature was 99.5 degrees Fahrenheit (37.5 Celsius), but "was not told not to fly" because that was below the CDC's temperature threshold of 100.4 F (38 C).

One nurse who helped treat Pham came forward on Thursday to say the Dallas hospital was unprepared for the emergency and lacked proper protective gear.

    Nurses were not briefed or prepared for Ebola, Briana Aguirre told NBC's "Today" show, and no special precautions were taken when Duncan was admitted to the hospital.

"It was a total chaotic scene," she said.

(Additional reporting by Susan Heavey in Washington; Jon Herskovitz in Austin, Colleen Jenkins in North Carolina; Writing by Tom Brown; Editing by Bernadette Baum and Jonathan Oatis)


http://news.yahoo.com/second-texas-nurse-ebola-receiving-care-atlanta-hospital-105902200.html

[Buster's Uncle]

Seven in Ohio confirm contact with nurse Ebola patient, in quarantine
Reuters  2 hours ago



An emergency response team with Protect Environmental arrive at the Village Apartment complex where a second Texas nurse who tested positive for Ebola resides in Dallas, Texas, October 15, 2014. REUTERS/Jaime R. Carrero



CLEVELAND (Reuters) - Seven people who had confirmed contact with the second Texas nurse diagnosed with Ebola during her visit to Ohio over the weekend are in voluntary quarantine and have not shown symptoms of the virus, county public health officials said on Thursday.

Amber Vinson, 29, had limited contacts outside family after flying into the Cleveland area on Friday and returning to Dallas on Monday, a day before she was diagnosed with Ebola, though she did visit a retail establishment, officials said.

"All identified persons that had contact with the visiting nurse have been contacted, are being monitored, and have no symptoms," Dr. Marguerite Erme, medical director for Summit County, told a news conference.

(Reporting by Kim Palmer; Writing by David Bailey)


http://news.yahoo.com/seven-ohio-confirm-contact-nurse-ebola-patient-quarantine-171453866--finance.html