Ebola news 10/21

[Buster's Uncle]

Ebola: Why virus kills some, other people survive
Associated Press
By LAURAN NEERGAARD  39 minutes ago



In this Oct. 12, 2014, file photo, Dr. Tom Frieden, head of the Centers for Disease Control and Prevention, speaks at a news conference in Atlanta. People who shared an apartment with the country's first Ebola patient are emerging from quarantine healthy. And while Thomas Eric Duncan died and two U.S. nurses were infected caring for him, there are successes, too: A nurse infected in Spain has recovered, as have four American aid workers infected in West Africa. Even there, not everyone dies. (AP Photo/John Amis, File)



WASHINGTON (AP) — People who shared an apartment with the country's first Ebola patient are emerging from quarantine healthy. And while Thomas Eric Duncan died and two U.S. nurses were infected caring for him, there are successes, too: A nurse infected in Spain has recovered, as have four American aid workers infected in West Africa. Even there, not everyone dies.

So why do some people escape Ebola, and not others?

The end of quarantine for 43 people in Dallas who had contact with Duncan "simply supports what most of us who know something about the disease have been saying all along: It's not that easily spread," said Dr. Joseph McCormick of the University of Texas School of Public Health. Formerly with the Centers for Disease Control and Prevention, McCormick worked on the first known Ebola outbreak in 1976 and numerous other outbreaks of Ebola and related hemorrhagic viruses.

Ebola spreads by contact with bodily fluids, such as through a break in the skin or someone with contaminated hands touching the eyes or nose. Once inside the body, Ebola establishes a foothold by targeting the immune system's first line of defense, essentially disabling its alarms. The virus rapidly reproduces, infecting multiple kinds of cells before the immune system recognizes the threat and starts to fight back.

Only after enough virus is produced do symptoms appear, starting with fever, muscle pain, headache and sore throat. And only then is someone contagious.

It's not clear why Ebola runs a different course in different people. But how rapidly symptoms appear depends partly on how much virus a patient was initially exposed to, McCormick said.



This 2011 photo provided by Wilmot Chayee shows Thomas Eric Duncan at a wedding in Ghana. People who shared an apartment with the country's first Ebola patient are emerging from quarantine healthy. And while Thomas Eric Duncan died and two U.S. nurses were infected caring for him, there are successes, too: A nurse infected in Spain has recovered, as have four American aid workers infected in West Africa. Even there, not everyone dies. (AP Photo/Wilmot Chayee)


The World Health Organization has made clear that there's far more virus in blood, vomit and feces than in other bodily fluids.

There is no specific treatment for Ebola but specialists say basic supportive care — providing intravenous fluids and nutrients, and maintaining blood pressure — is crucial to give the body time to fight off the virus.

Profuse vomiting and diarrhea can cause dehydration. Worse, in the most severe cases, patients' blood vessels start to leak, causing blood pressure to drop to dangerous levels and fluid to build up in the lungs.

"The key issue is balance between keeping their blood pressure up by giving them fluids, and not pushing them into pulmonary edema where they're literally going to drown," McCormick said.

Death usually is due to shock and organ failure.

"We depend on the body's defenses to control the virus," said Dr. Bruce Ribner, who runs the infectious disease unit at Atlanta's Emory University Hospital, which successfully treated three aid workers with Ebola and now is treating one of the Dallas nurses.

"We just have to keep the patient alive long enough in order for the body to control this infection," he said.

What about experimental treatments? Doctors at Emory and Nebraska Medical Center, which successfully treated another aid worker and now is treating a video journalist infected in West Africa, say there's no way to know if those treatment really helped. Options include a plasma transfusion, donated by Ebola survivors who have antibodies in their blood able to fight Ebola, or a handful of experimental drugs that are in short supply.

But survival also can depend on how rapidly someone gets care. It also may be affected by factors beyond anyone's control: McCormick's research suggests it partly depends on how the immune system reacts early on — whether too many white blood cells die before they can fight the virus. Other research has linked genetic immune factors to increased survival.


http://news.yahoo.com/ebola-providing-time-fight-virus-070538377--politics.html

[Buster's Uncle]

How a Liberian Rubber Plant Prevented Ebola Spread
LiveScience.com
By Rachael Rettner  41 minutes ago


The rate of Ebola cases in one part of Liberia, where a certain rubber tree plantation operates, is far lower than in other parts of the country, suggesting that the strategies the company uses to reduce transmission of the virus could be useful elsewhere, according to a new report from the Centers for Disease Control and Prevention.

The company, Firestone Liberia, Inc., has operated the planation since 1926, and the company-run hospital provides health services to plant's employees and their family members, a total of about 80,000 people.

Between Aug. 1 and Sept. 23, there were 71 Ebola cases in the Firestone community, a rate of 0.09 percent, which is much lower than the rate of 0.23 percent in the rest of Margibi County, Liberia, where Firestone is located.

"I went to see the Firestone hospital in Liberia at the end of August," Dr. Tom Frieden, director of the CDC, said in a statement. "I saw how careful and meticulous the staff is and how compassionately they care for Ebola patients and their families. This shows that it's possible to contain Ebola with meticulous attention to detail and care for patients."

Some of the company's response strategies may have helped limit the spread of the virus in the community, researchers say.

The company rapidly established a system to manage the outbreak, and immediately isolated people with Ebola in a dedicated part of the company hospital, the CDC said.

In addition, people who had high-risk contact with Ebola patients were offered a voluntary quarantine in schools that served as centers for this purpose, where each quarantined family stayed in a separate classroom. People who had low-risk contact with patients were also monitored, but not quarantined. This monitoring of contacts likely facilitated prompt identification of new Ebola cases, the CDC said.

While in quarantine, families received personal protective equipment, sanitary supplies and education on how to prevent Ebola transmission.

In the rest of Liberia, such education and supplies could limit Ebola transmission among family members who are caring for Ebola patients in their homes, the CDC said. The country does not have enough Ebola treatment units to care for everyone with the virus, so many families are caring for Ebola patients at home.

The Firestone hospital also screened for Ebola among all patients who entered the hospital, even those who came to the hospital for another reason. As a result of this screening, three patients were sent to the hospital's Ebola treatment unit between Aug. 1 and Sep. 23, and one turned out to have Ebola.

This screening practice, as well as the establishment of a separate unit to treat Ebola patients "might serve as a model for infection control practices to other county health care facilities providing both non-Ebola and Ebola-related care," the report said.


http://news.yahoo.com/liberian-rubber-plant-prevented-ebola-spread-214400448.html

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NBC cameraman recovers from Ebola: US hospital
AFP  27 minutes ago



Liberian health workers are seen at the MSF Ebola treatment center in Monrovia, on October 18, 2014 (AFP Photo/Zoom Dosso)



Washington (AFP) - A US photojournalist who was infected with Ebola in Liberia is now free of the deadly virus and will go home on Wednesday, the Nebraska hospital treating him said.

"Recovering from Ebola is a truly humbling feeling," Ashoka Mukpo, who was working as a freelance cameraman for NBC News in Monrovia when he fell ill, said in a hospital statement Tuesday.

"Too many are not as fortunate and lucky as I've been. I'm very happy to be alive."

The virus has killed more than 4,500 people in West Africa this year, and stoked fears that it could spread beyond the three worst-hit countries Liberia, Sierra Leone and Guinea, and become a global threat.

Eight people including Mukpo have or are being treated for Ebola in the United States, one of whom, a man from Liberia, has died.

Mukpo added in the statement that he was not sure how he contracted the disease.

"I was around a lot of sick people the week before I got sick," he said. "I thought I was keeping a good distance and wish I knew exactly what went wrong."

A Centers for Disease Control and Prevention blood test showed that Mukpo no longer had the virus in his bloodstream, the Nebraska Medicine statement said.

Mukpo arrived at Nebraska Medical Center on October 6, and was able to walk off the plane that evacuated him from West Africa.


http://news.yahoo.com/nbc-cameraman-recovers-ebola-us-hospital-230439178.html

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Hospital: American video journalist free of Ebola
Associated Press  17 minutes ago



The parents of Ashoka Mukpo, the fifth American to contract Ebola in West Africa say their son is relieved to be back in the U.S. to be treated for the deadly virus



OMAHA, Neb. (AP) — An American video journalist being treated for Ebola is now free of the virus and will be released soon, the Omaha hospital where he is being treated said Tuesday.

A recent test showed Ashoka Mukpo's blood is negative for the virus, according to the Nebraska Medical Center. The test was confirmed by the Centers for Disease Control and Prevention. Mukpo will be allowed to leave the hospital's biocontainment unit Wednesday.

"Recovering from Ebola is a truly humbling feeling," Mukpo said in a statement. "Too many are not as fortunate and lucky as I've been. I'm very happy to be alive."

Mukpo, of Providence, Rhode Island, contracted the virus while working in Liberia as a freelance cameraman for NBC and other media outlets. He has been at the Nebraska Medical Center since Oct. 6 and was the second Ebola patient to be treated there.

"Our staff was confident it would be able to successfully care for another patient," Dr. Phil Smith, medical director of the biocontainment unit, said in a statement. "We've learned firsthand that caring for a patient with the Ebola virus presents challenges you don't face in the regular hospital environment. But our years of training on protocol in the unit and gaining familiarity with all the personal protective equipment was certainly an advantage for us."

Mukpo has tweeted that he's still not sure exactly how he caught the virus, but that he doesn't regret returning to Liberia in September to "help raise the alarm."

American aid worker Dr. Rick Sacra also was treated for Ebola at the Nebraska hospital.


http://news.yahoo.com/omaha-hospital-says-american-video-journalist-free-ebola-225917604.html

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Study shows exit screening vital to halting global Ebola spread
Reuters
By Kate Kelland  October 20, 2014 7:08 PM



Travellers walk past the stop red line as passengers arrive from Conakry at Charles de Gaulle International Airport in Roissy, near Paris October 18, 2014. REUTERS/Gonzalo Fuentes



LONDON (Reuters) - Three Ebola-infected travelers a month would be expected to get on international flights from the West African countries suffering epidemics of the deadly virus if there were no effective exit screening, scientists said on Tuesday.

The three countries, Guinea, Liberia and Sierra Leone, do all check departing air passengers for fever, although the test cannot spot sufferers in the period before they show symptoms, which can be up to 21 days.

The researchers, whose work was published in The Lancet medical journal on Tuesday, said exit screening was nevertheless one of the most effective ways of limiting Ebola's spread.

Using modeling based on 2014 global flight schedules and 2013 passenger itineraries, as well as current epidemic conditions and flight restrictions, the analysis showed that, on average, just under three (2. Ebola-infected travelers are projected to travel on an international flight every month.

Dr Kamran Khan of St Michael's Hospital in Toronto, Canada, who led the research, said the study showed it was far more effective and less disruptive to screen travelers from the affected countries in West Africa as they leave, rather than when they land, as the United States, Britain, France and some other countries have begun to do.



Paris airport doctor Philippe Bargain (R) demonstrates on a plain cloth policeman how airport medical staff will check the body temperature of a passenger arriving from Ebola infected zones during a press visit at the Charles de Gaulle International Airport in Roissy, near Paris October 17, 2014. REUTERS/Philippe Wojazer


"While screening travelers arriving at airports outside of West Africa may offer a sense of security, this would have at best marginal benefits, and could draw valuable resources away from more effective public health interventions," Khan said.

Ebola is known to have killed more than 4,500 people in Liberia, Sierra Leone and Guinea. But with at least half the cases going unreported and a 70 percent fatality rate, by World Health Organization (WHO) estimates, the true toll in what is by far the worst outbreak on record is probably more than 12,000.

Cases of the hemorrhagic fever have already been imported into Nigeria, Senegal, Spain and the United States, and WHO officials have said it is "unavoidable" that Ebola cases will be seen in more countries.

Many medical experts have argued that the best place to prevent the spread of Ebola is at its source.

Khan said excessive constraints on air travel could have "severe economic consequences that could destabilize the region and possibly disrupt critical supplies of essential health and humanitarian services".

The study found that, of the almost 500,000 travelers who flew on commercial flights out of Conakry, Monrovia and Freetown international airports in 2013, more than half were destined for one of five countries: Ghana (17.5 percent), Senegal (14.4 percent), Britain (8.7 percent), France (7.1 percent) or Gambia (6.8 percent).

It also found that more than 60 percent of travelers in 2014 were likely to be heading for poor or middle-income countries, where the medical and public health resources to prevent a wider outbreak are likely to be more limited.

(Reporting by Kate Kelland; Editing by Kevin Liffey)


http://news.yahoo.com/study-shows-exit-screening-vital-halting-global-ebola-230823104.html

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Nurse Nina Pham's Condition Is Improved
LiveScience.com
By Rachael Rettner  43 minutes ago


Nina Pham, the first Dallas nurse to contract Ebola, has had her health status upgraded from "fair" to "good," according to a statement released on Tuesday evening by the National Institutes of Health.

Pham was transfered last Thursday to the NIH Clinical Center in Bethesda, Maryland, from Texas Health Presbyterian Hospital, where she had contracted the disease. The NIH center is one of four hospitals in the coutnry with high-level containment rooms, and the staff there is trained to prevent the spread of diseases such as Ebola.

In late September, Pham helped care for Thomas Eric Duncan, the first person to be diagnosed with Ebola in the United States. Pham tested positive for Ebola on Oct. 12. A second nurse at the hospital tested positive for the disease a few days later.

It's still not clear how the nurses contracted the virus. However, some people have questioned the original guidelines from the Centers for Disease Control and Prevention on how to use personal protective equipment when treating Ebola patients. The agency announced on Monday (Oct. 20) that it had updated those guidelines to better protect workers.

Ebola is spread through direct contact with the bodily fluids, such as blood or secretions, of an infected person, or by contact with contaminated objects, such as needles and syringes, according to the CDC. People with Ebola are contagious only after they start showing symptoms.


http://news.yahoo.com/nurse-nina-phams-condition-improved-230455364.html

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How 1 doctor saved Nigeria from Ebola catastrophe
Yahoo News
By Dylan Stableford  11 hours ago



A campaigner of "#Bring Back Our Girls" shows an image of Ameyo Stella Adadevoh during a candlelight vigil for Adadevoh and other Ebola victims in Abuja August 26, 2014. Adadevoh, a consultant physician and endocrinologist, died after contracting the deadly Ebola virus while treating a Liberian-American, Patrick Sawyer, and other victims of the disease in Nigeria. REUTERS/Afolabi Sotunde



A day after the World Health Organization declared Nigeria free of Ebola, the doctor who treated the country's first case of the deadly virus and later died from the disease herself is being hailed as a hero for helping stop the outbreak.

Dr. Stella Ameyo Adadevoh, a doctor at First Consultant Hospital, oversaw treatment of Patrick Sawyer, Nigeria's Ebola patient zero, when he arrived sick in Lagos, Nigeria's former capital and Africa's largest city, on a flight from Liberia in July.

Adadevoh fought to isolate Sawyer, a top official in the Liberian Ministry of Finance who did not take kindly to isolation and lied about his symptoms, officials said.

"Immediately, he was very aggressive," Dr. Benjamin Ohiaeri, the hospital's director, told the BBC. "He was more intent on leaving the hospital than anything else. He was screaming. He pulled his intravenous [tubes] and spilled the blood everywhere."

Adadevoh, the Telegraph writes, "effectively saved the country from disaster by spotting that its first Ebola patient was lying about his condition, and then stopped him leaving her clinic."

Sawyer, who had been caring for his Ebola-stricken sister, was reportedly set on visiting one of Nigeria's Pentecostal churches "in search of a cure from one of the so-called miracle pastors," the BBC said.

"The Liberian ambassador started calling Dr. Adadevoh, putting pressure on her and the institution," Ohiaeri said. "He felt we were kidnapping the gentleman and said it was a denial of his fundamental rights and we could face further actions. ... The only way we could be sure and live up to our responsibility to our people, the state and nation — this is all about patriotism at the end of the day — was to keep him here."

Sawyer, 40, collapsed in Lagos on July 20 after getting off a plane from Liberia. He died just five days later. Adadevo and 11 colleagues were infected with Ebola.

"She was fine all along and then suddenly it became apparent," Adadevoh's son Bankole Cardoso told the news service.

She died on Aug. 19.

"We lost some of our best staff," Ohiaeri said. "Dr. Adadevoh had been working with us for 21 years and was perhaps one of the most brilliant physicians. I worked with her. I know that she was sheer genius."

Thanks to patient isolation and aggressive contact tracing (including 18,500 visits to 894 people), Nigeria had just 20 Ebola cases, including eight deaths — a far lower death rate than the 70 percent seen elsewhere.

Cardoso, still mourning the loss of his mother, says it's become "more and more apparent exactly what she had done" in identifying Sawyer as patient zero.

"It really helped Nigeria to prepare and get ready to trace everybody," Cardoso said. "And I think that's the difference between us and our West African neighbors — Guinea, Liberia and Sierra Leone."

Rui Gama Vaz, WHO director for Nigeria, called the containment of Ebola in the most populous country in Africa a "spectacular success story."

"But we must be clear that we only won a battle," Vaz added. "The war will only end when West Africa is also declared free of Ebola."

[Buster's Uncle]

Doctor gets emotional recounting Ebola patient Thomas Eric Duncan's final days, efforts to save him
Yahoo News
By Jason Sickles, 3 hours ago



Dr. Gary Weinstein in his interview with WFAA-TV. The doctor has treated three Ebola patients at Texas Health Presbyterian. (Screen shot)



DALLAS — It’s been popular in the court of public opinion to condemn West African Thomas Eric Duncan for delivering Ebola to America’s doorstep.

But a Texas doctor who tried to save the Ebola patient’s life doesn't see it that way.

“I don’t think about it in terms of blame,” said Dr. Gary Weinstein, a Dallas critical care physician who was with Duncan when he died earlier this month.

Duncan was living in Ebola-ravaged Liberia before arriving in Texas, but relatives have repeatedly said the 42-year-old had no idea he was infected before leaving his homeland — even after aiding a sick neighbor four days before his Sept. 19 flight. His neighbors and employer in Liberia have reported that Duncan received his visa to travel to the U.S. in early September.

Either way, Weinstein — in a lengthy interview with Dallas’ WFAA-TV — said it would be difficult to second-guess Duncan for leaving West Africa, where the World Health Organization says the outbreak has killed 4,546 out of 9,191 known cases in Guinea, Liberia and Sierra Leone since March.



Duncan died in Dallas on Oct. 8 (AP)


“It’s hard for me to imagine being in a country, being sharp enough to know that if I get this disease in the location where I am that I’m going to die, and then do nothing about it,” said Weinstein, 55. “So I think that many, many people might act in a similar way to do whatever they needed to do to get somewhere safe.”

Family and friends said love, not Ebola, drove Duncan to Dallas, where he had plans to marry Louise Troh, a long-lost love and the mother of his 19-year-old son, both of whom are now American citizens. On his fifth day here, Troh took Duncan to Texas Health Presbyterian Hospital where he told emergency room workers that he had just come from West Africa. But according to the hospital, he answered no when asked if had recently came in contact with any sick people.

“I can image that if I was in a situation like that from another country that I might be pretty frightened to say something like that for fear of what would happen,” said Weinstein, who did not see Duncan in the ER. “What if they send me back from the place I just escaped from? I don’t know.”

Weinstein, Texas Health Presbyterian’s chief of critical care medicine, was making his rounds three Sundays ago when Duncan returned to the hospital a second time and in worse condition. A nurse told him that the ER had a patient with a suspected case of Ebola, which had never been diagnosed in the United States.

“That can’t be right,” Weinstein recalls thinking. “Doesn’t seem right, that’s not likely, find out what the real story is.”

The hospital cleared an entire 24-bed intensive-care unit to isolate Duncan. Weinstein wasn’t on duty during Duncan’s first days in ICU, but drew the assignment by the time the patient took a turn for the worse.

“He had already deteriorated significantly, was critically ill, and was on a ventilator, asleep, pharmacologically — medically — in a coma,” Weinstein told WFAA.

In addition to the ventilator, Duncan also underwent dialysis during the last four days of his life due to kidney failure.

These were two surprising life-saving measures for an Ebola patient, Dr. Tom Frieden, director of the Centers for Disease Control, said during a news conference on Oct. 12.



.The CDC's Dr. Tom Frieden said he didn't know of an Ebola patient who had undergone intubation or dialysis, but Weinstein says both had been done at Emory. (John Amis/AP)


“I don't know the details of the other patients cared for in other parts of the world, but I’m not familiar with any prior patient with Ebola who has undergone either intubation or dialysis,” Frieden told reporters. “Certainly it would be very unusual if it has happened before.”

However, Weinstein said Texas Health Presbyterian’s doctors compared notes daily with experts from the CDC, Emory University Hospital and Nebraska Medical Center, which is also among the four hospitals designated to handle Ebola cases by the U.S.

“There was in fact an [Ebola] patient at Emory who had been intubated and been on the ventilator who did develop renal failure and required dialysis,” said Weinstein, adding that the measures helped stabilize Duncan.

WFAA published the unedited 45-minute interview online.

At one point, Weinstein gets emotional when asked about detractors who said the hospital shorted Duncan’s care because he was black and uninsured.

“I find that remarkably insulting, I don’t know how better to describe that,” he said.

“The team here,” he said, his lip quivering as tears welled up, “worked their tails off trying to save his life.”

Once they got approval, an experimental medication was tried, but Weinstein said he ultimately knew Duncan might be too sick to survive.

That moment came at 7:51 a.m. on Oct. 8.

“It was very, very quick,” Weinstein said. “He was critically ill and unstable, and over a period of minutes, he lost his pulse and was dead.”

The doctor said that Duncan, coherent in the early days of isolation, had discussions with Weinstein’s colleagues and instructed them not to resuscitate him or restart his heart in any way.

“He knew he had a bad problem, and he knew from his experience in Africa what happens to people with Ebola,” Weinstein said. “And I presume that all factored into his decision.”

Weinstein never had the opportunity to have a conversation with his patient.

“I’m told that he was a thoughtful, intelligent, kind man,” Weinstein said. “The nurses spent a lot of time speaking with him and trying to comfort him.”

Because he treated Duncan, Nina Pham and Amber Vinson — the nurses who contracted Ebola from Duncan — Weinstein is being monitored for symptoms until Nov. 7 and has agreed not to use public transportation or go to public places. That meant missing his son’s final home football game last Friday night.

He said he can’t say for sure, but the doctor figures Duncan felt sorry for creating such a crisis.

“If those are the kinds of thoughts that a thoughtful, kind man would have, then he probably did,” Weinstein said.


http://news.yahoo.com/dallas-doctor-gets-emotional-recounting-ebola-patient-thomas-eric-duncans-final-days-efforts-to-save-him-195701003.html

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Ebola cases rise sharply in western Sierra Leone
Associated Press
By CLARENCE ROY-MACAULAY  3 hours ago



Health workers bury the body of a woman who is suspected of having died of the Ebola virus in Bomi county, on the outskirts of Monrovia, Liberia, Monday, Oct. 20, 2014. Liberian President Ellen Johnson Sirleaf said Ebola has killed more than 2,000 people in her country and has brought it to "a standstill," noting that Liberia and two other badly hit countries were already weakened by years of war. (AP Photo/Abbas Dulleh)



FREETOWN, Sierra Leone (AP) — After emerging months ago in eastern Sierra Leone, Ebola is now hitting the western edges of the country where the capital is located with dozens of people falling sick each day, the government said Tuesday. So many people are dying that removing bodies is reportedly a problem.

Forty-nine confirmed cases of Ebola emerged in just one day, Monday, in two Ebola zones in and around the capital, the National Ebola Response Center, or NERC, said. Lawmaker Claude Kamanda who represents a western area said more than 20 deaths are being reported daily.

Kamanda told the local Politico newspaper that authorities are experiencing challenges collecting corpses from both quarantined and non-quarantined homes.

Authorities say the uncontrolled movement of people from the interior to Waterloo which is the gateway to Freetown, the capital, has fueled the increase of Ebola cases in the west. There is a strong feeling that people are violating the quarantines elsewhere and coming to Freetown through Waterloo.

There are 851 total confirmed Ebola cases in the two zones, called Western Area Urban and Western Area Rural, the NERC said. In numbers of cases, they may soon surpass a former epicenter of the outbreak in the country, the eastern districts of Kenema and Kailahun where there have been a total of 1,012 confirmed cases.

No new cases were reported Monday in Kenema and Kailahun but a World Health Organization spokeswoman said it is too early to declare that the epidemic has burned itself out in the east.

"There was a drop in new cases in Kenema and Kailahun and fingers were crossed but there has been a bit of a flare up thanks to a couple of unsafe burials," said Margaret Harris, WHO's spokeswoman in Sierra Leone. "So it's too early to say we have a real decline ... definitely too early to say it's been beaten there."

A local newspaper suggested Tuesday that authorities quarantine Waterloo. The World Food Program over the weekend delivered emergency food rations to people there.

"The growing fear has left the public with no choice but to call on the Government for Waterloo to be quarantined as was done to other places including Kailahun, Kenema, Bombali, Port Loko and Moyamba Districts," the Exclusive newspaper said.

Many residents of the capital note that Ebola has followed the same route across the country as rebels who in 1991 started a savage war in Kailahun district. The war ended in Freetown a decade later where the final battle was fought. Now the enemy is a disease, and the president is putting in place a more military-style response.

President Ernest Bai Koroma last week appointed Defense Minister Alfred Palo Conteh as CEO of the National Ebola Response Center, whose headquarters are being placed at the former War Crimes Tribunal for Sierra Leone in the west end of Freetown together with the United Nations Mission for Ebola Emergency Response.

The West African nations of Sierra Leone, Liberia and Guinea — where the outbreak first emerged 10 months ago — have been hit hard by Ebola with more than 4,500 deaths, according to WHO estimates. A few cases have also emerged in the United States and Spain.

In Guinea on Tuesday, hundreds of residents in the Conakry suburban neighborhood of Kaporo Rail protested the construction of an Ebola treatment center nearby.

"We don't want the hospital here. They want to infect our neighborhood," said Binta Sow, the spokesman of the group. Kaporo Rail has a thriving market for ice cream and milk that employs hundreds of women and youth. There were worries this could harm the local economy.

"No one will buy anything here if they erect the center," said a local ice cream vendor.

On Tuesday the East African nation of Rwanda was singling out travelers from the U.S. and Spain for special screening. A Rwandan Ministry of Health document says all passengers from the U.S. and Spain will have their temperatures taken upon arrival. If the passenger has a fever he or she is denied entry. If there is no fever, the visitors still must report their health condition daily to authorities.

The U.S. Embassy in Rwanda on Tuesday urged Americans who may have a fever or who have traveled to Ebola countries "to weigh carefully whether travel to Rwanda at this time is prudent."

"Please note neither the Department of State's Bureau of Consular Affairs nor the U.S. Embassy have authority over quarantine issues and cannot prevent a U.S. citizen from being quarantined should local health authorities require it," the embassy said.

No Ebola cases have emerged in Rwanda.


http://news.yahoo.com/ebola-cases-rise-sharply-western-sierra-leone-113359272.html

[Buster's Uncle]

Ebola: Keeping patients alive as body fights back
Associated Press
By LAURAN NEERGAARD  October 20, 2014 5:04 PM



This 2011 photo provided by Wilmot Chayee shows Thomas Eric Duncan at a wedding in Ghana. People who shared an apartment with the country's first Ebola patient are emerging from quarantine healthy. And while Thomas Eric Duncan died and two U.S. nurses were infected caring for him, there are successes, too: A nurse infected in Spain has recovered, as have four American aid workers infected in West Africa. Even there, not everyone dies. (AP Photo/Wilmot Chayee)



WASHINGTON (AP) — People who shared an apartment with the country's first Ebola patient are emerging from quarantine healthy. And while Thomas Eric Duncan died and two U.S. nurses were infected caring for him, there are successes, too: A nurse infected in Spain has recovered, as have four American aid workers infected in West Africa. Even there, not everyone dies.

So why do some people escape Ebola, and not others?

The end of quarantine for 43 people in Dallas who had contact with Duncan "simply supports what most of us who know something about the disease have been saying all along: It's not that easily spread," said Dr. Joseph McCormick of the University of Texas School of Public Health. Formerly with the Centers for Disease Control and Prevention, McCormick worked on the first known Ebola outbreak in 1976 and numerous other outbreaks of Ebola and related hemorrhagic viruses.

Ebola spreads by contact with bodily fluids, such as through a break in the skin or someone with contaminated hands touching the eyes or nose. Once inside the body, Ebola establishes a foothold by targeting the immune system's first line of defense, essentially disabling its alarms. The virus rapidly reproduces, infecting multiple kinds of cells before the immune system recognizes the threat and starts to fight back.

Only after enough virus is produced do symptoms appear, starting with fever, muscle pain, headache and sore throat. And only then is someone contagious.

It's not clear why Ebola runs a different course in different people. But how rapidly symptoms appear depends partly on how much virus a patient was initially exposed to, McCormick said.



In this Oct. 12, 2014, file photo, Dr. Tom Frieden, head of the Centers for Disease Control and Prevention, speaks at a news conference in Atlanta. People who shared an apartment with the country's first Ebola patient are emerging from quarantine healthy. And while Thomas Eric Duncan died and two U.S. nurses were infected caring for him, there are successes, too: A nurse infected in Spain has recovered, as have four American aid workers infected in West Africa. Even there, not everyone dies. (AP Photo/John Amis, File)


The World Health Organization has made clear that there's far more virus in blood, vomit and feces than in other bodily fluids.

There is no specific treatment for Ebola but specialists say basic supportive care — providing intravenous fluids and nutrients, and maintaining blood pressure — is crucial to give the body time to fight off the virus.

Profuse vomiting and diarrhea can cause dehydration. Worse, in the most severe cases, patients' blood vessels start to leak, causing blood pressure to drop to dangerous levels and fluid to build up in the lungs.

"The key issue is balance between keeping their blood pressure up by giving them fluids, and not pushing them into pulmonary edema where they're literally going to drown," McCormick said.

Death usually is due to shock and organ failure.

"We depend on the body's defenses to control the virus," said Dr. Bruce Ribner, who runs the infectious disease unit at Atlanta's Emory University Hospital, which successfully treated three aid workers with Ebola and now is treating one of the Dallas nurses.

"We just have to keep the patient alive long enough in order for the body to control this infection," he said.

What about experimental treatments? Doctors at Emory and Nebraska Medical Center, which successfully treated another aid worker and now is treating a video journalist infected in West Africa, say there's no way to know if those treatment really helped. Options include a plasma transfusion, donated by Ebola survivors who have antibodies in their blood able to fight Ebola, or a handful of experimental drugs that are in short supply.

But survival also can depend on how rapidly someone gets care. It also may be affected by factors beyond anyone's control: McCormick's research suggests it partly depends on how the immune system reacts early on — whether too many white blood cells die before they can fight the virus. Other research has linked genetic immune factors to increased survival.


http://news.yahoo.com/ebola-keeping-patients-alive-body-fights-back-205026638--politics.html

[Buster's Uncle]

U.S. to funnel travelers from Ebola-hit region through five airports
Reuters
By Jeffrey Dastin  26 minutes ago



The government announced Tuesday that everyone traveling to the United States from Ebola-afflicted African nations will have to be screened at one of five airports, as officials took to the road with new guidelines to promote head-to-toe protection for health workers who might be at risk of contracting the disease.



NEW YORK (Reuters) - The United States ratcheted up its safeguards against Ebola on Tuesday, requiring travelers from three countries at the center of an epidemic in West Africa to fly into one of five major airports conducting enhanced screening for the virus.

Restrictions on passengers whose trips originated in Liberia, Sierra Leone or Guinea were announced by the U.S. Department of Homeland Security and due to go into effect on Wednesday. The precautions stop well short of the travel ban sought by some U.S. lawmakers to prevent more Ebola cases in the United States.

Affected travelers will have their temperatures checked for signs of a fever that may indicate Ebola infection, among other protocols, at New York's John F. Kennedy, New Jersey's Newark, Washington Dulles, Atlanta, and Chicago's O'Hare international airports, officials said.

"We are working closely with the airlines to implement these restrictions with minimal travel disruption," Homeland Security Secretary Jeh Johnson said in a statement. "If not already handled by the airlines, the few impacted travelers should contact the airlines for rebooking, as needed."

Johnson said those airports account for about 94 percent of travelers flying to the United States from the three countries, noting that there are no direct, nonstop commercial flights from Liberia, Sierra Leone or Guinea to the United States.

"We currently have in place measures to identify and screen anyone at all land, sea and air ports of entry into the United States who we have reason to believe has been present in Liberia, Sierra Leone or Guinea in the preceding 21 days," Johnson said.

Washington-based trade group Airlines for America, or A4A, noted that under 150 people per day travel to the United States from those three countries and about 6 percent of them, some nine people daily, have been arriving at airports other than the five airports with enhanced Ebola screening.

The group's member airlines are "cooperating fully" with the U.S. Customs and Border Protection agency to reroute that 6 percent of travelers to the five designated airports, A4A spokeswoman Jean Medina said.

The group's members include Delta Air Lines, United Airlines and American Airlines, none of which fly to the affected countries. However, they may carry passengers from these countries on a connecting flight.

The worst Ebola outbreak on record has killed more than 4,500 people, mostly in Liberia, Sierra Leone and Guinea. Only three Ebola cases have been diagnosed in the United States: Liberian Thomas Eric Duncan, who died on October 8 at Texas Health Presbyterian Hospital in Dallas, and two nurses who treated him.



Protestor Jeff Hulbert of Annapolis, Maryland holds a sign reading "Stop the Flights" as he demonstrates in favor of a travel ban to stop the spread of the Ebola virus, in front of the White House in Washington October 16, 2014. REUTERS/Jim Bourg


On Tuesday, the U.S. National Institutes of Health outside Washington, D.C., upgraded the medical condition of one of the nurses, Nina Pham, to good from fair. She entered a special NIH facility in Bethesda, Maryland, for treatment last Thursday.

The other nurse, Amber Vinson, is being treated at Emory University Hospital in Atlanta. Vinson's mother, Debra Berry, told ABC's "Good Morning America" program her daughter is weak but recovering.

NBC freelance cameraman Ashoka Mukpo, who contracted Ebola while working in West Africa, is free of the virus and will leave the Nebraska Medical Center on Wednesday, the hospital said. Mukpo arrived in the United States on Oct. 6 for treatment.

He is the second patient to be successfully treated for Ebola at the Nebraska Medical Center, the hospital said on Tuesday, and the fifth treated in the United States to fully recover.

“Recovering from Ebola is a truly humbling feeling,” Mukpo said in a statement. “Too many are not as fortunate and lucky as I've been. I'm very happy to be alive.”

“I was around a lot of sick people the week before I got sick,” said Mukpo, the first U.S. journalist known to have contracted Ebola. “I thought I was keeping a good distance and wish I knew exactly what went wrong.”

He said his illness had not changed his feelings about Liberia. “I don't regret going to Liberia to cover the crisis. That country was a second home to me and I had to help raise the alarm.”


SUPPORT FOR TRAVEL BAN

A Reuters/Ipsos online poll released on Tuesday showed that nearly three-fourths of 1,602 Americans surveyed favored a U.S. ban on civilian air travel in and out of Liberia, Sierra Leone and Guinea.

In Washington, some lawmakers welcomed the government's new steps while others said more needed to be done.

Democratic U.S. Senator Charles Schumer of New York called the Department of Homeland Security move "a good and effective step towards tightening the net and further protecting our citizens."

Republican Representative Bob Goodlatte of Virginia, who heads the House of Representatives Judiciary Committee, said Obama needs to impose a travel ban.

“President Obama has a real solution at his disposal under current law and can use it at any time to temporarily ban foreign nationals from entering the United States from Ebola-ravaged countries," Goodlatte said.

White House spokesman Josh Earnest told reporters Obama is "not philosophically opposed to a travel ban" and remains "open to it" if the scientists and public health experts advising him say it would help protect Americans. Earnest said those advising the president currently oppose such a ban.

Airlines for America official Vaughn Jennings said the group opposes a travel ban. "We agree with the White House that discussions of flight bans are not necessary and actually impede efforts to stop the disease in its tracks in West Africa," Jennings said.

On Tuesday, the Dominican Republic became the latest country to impose a travel ban on foreigners who have visited Ebola-affected countries in the previous 30 days.

Concerns that Americans might fall victim to scams because of fear about Ebola prompted a warning from New York state Attorney General Eric Schneiderman about bogus Ebola preparedness kits and preventative medications.

There are no U.S. government-approved vaccines, medications or dietary supplements to prevent or treat Ebola.

In Texas, 60 people have been removed from watch lists after showing no Ebola symptoms in 21 days of monitoring, with 112 more people still being monitored for possible exposure, federal health officials said.

(Additional reporting by Gabriel Debenedetti and Susan Heavey in Washington, Sharon Begley and Michele Gershberg in New York, Jon Herskovitz in Dallas, Manuel Jimenez in Santo Domingo, Domican Republic; Writing by Will Dunham, Steve Gorman; Editing by Jonathan Oatis, Toni Reinhold)


http://news.yahoo.com/u-restricts-entrants-ebola-hit-nations-five-airports-162420664--finance.html