Ebola news 10/29

[Buster's Uncle]

Ebola Recovery: How Did Dallas Nurses Get Well So Quickly?
LiveScience.com
By Rachael Rettner  20 hours ago



The two nurses in Dallas who became infected with Ebola this month may have recovered so quickly because of their youth, as well as the protective equipment they were wearing at the time of infection, according to a doctor who has treated Ebola patients.

Today (Oct. 28), nurse Amber Vinson, who was infected with Ebola earlier this month, was declared free of the virus, and was released from Emory University Hospital in Atlanta, where she was treated.

"I'm so grateful to be well," Vinson said at a news conference this afternoon. "While the skill and dedication of the doctors, nurses and others who have taken care of me have obviously led to my recovery, it has been God's love that has truly carried my family and me through this difficult time."

After thorough testing, "we have determined that Ms. Vinson has recovered from her infection with Ebola virus, and that she can return to her family, to the community and to her life, without any concerns about transmitting this virus to any other individuals," said Dr. Bruce Ribner, director of the Serious Communicable Disease Unit at Emory University Hospital.

Vinson's release comes less than a week after Nina Pham, a nurse who works with Vinson and was also infected with Ebola, was declared free of the virus and well enough to go home.

Ribner said that doctors are not entirely sure why the two nurses recovered so quickly. (Both developed their first symptoms about two weeks ago.) But he noted that they are two of the youngest patients to be treated for Ebola in developed countries — Vinson is 29, and Pham is 26.

"We know that younger patients do much better," Ribner said.

The first two Americans to develop Ebola, Dr. Kent Brantly and nurse Nancy Writebol, were infected in West Africa and were flown back to the U.S. to also be treated at Emory. Brantly, who is 33, was released from the hospital about a month after he developed symptoms, and Writebol, age 59, was released about five weeks after she developed symptoms.

In addition, because they were wearing personal protective equipment when they were treating an Ebola patient, the nurses were likely exposed to a low level of the virus.

"It's quite likely that the amount of virus that [Vinson] was exposed to was substantially less than what we see in patients who get infected in less-developed countries," Ribner said. "The higher the viral load that you get infected with, the more severe your disease is likely to be."

Emory University has now successfully treated four Ebola patients.

Vinson and Pham became infected with Ebola when they cared for Thomas Eric Duncan, the first person to be diagnosed with Ebola in the United States.

It's still not clear how the nurses became infected with 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 Oct. 20 that it had updated those guidelines to better protect workers.

Health care workers are at higher risk than the general public for Ebola infection because they often treat patients who have reached the stage of the infection with the most symptoms and the highest viral load in their bodily fluids.


http://news.yahoo.com/ebola-recovery-did-dallas-nurses-well-quickly-194906117.html

[Buster's Uncle]

In Ebola Crisis, New Vaccine Candidates Show Uncertain Promise
Forbes
F.D. Flam Contributor 10/28/2014 @ 3:31PM         




In the race for an Ebola vaccine, the clear front-runner is the virus, which is expected to spread to tens of thousands of people in the coming weeks. But new competitors are now gearing up for human trials, and eventually the tables could turn. In the long run a vaccine could prove extremely important if, as some predict, the virus causing the current outbreak in West Africa will remain in circulation as a low-level “endemic” disease indefinitely.

The latest entry to the race comes from the Maryland-based Novavax . On Sunday, a representative from the company told participants at a major vaccine meeting in Philadelphia that they’d achieved immunity in mice using a vaccine based on a synthetic delivery system called a nanoparticle.



Illustration showing the Ebola virus-encoded glycoprotein trimers (pink) embedded in the host cell's lipid bilayer (gray). Novavax Ebola virus vaccine is based on recombinant GP trimers separated from host cell lipids and other contaminants forming multi-GP trimer protein nanoparticles.


The big selling point the company emphasized is that the Novavax product is the only one designed to target the exact strain of Ebola that’s currently raging through West Africa. Experts disagree over whether this fact will make a difference because the parts of the virus that are relevant to vaccines are nearly identical across strains.

On the other hand, scientists working on the Ebola problem acknowledge they are in new territory and can’t be sure what will and won’t work until human trials are carried out.

The terminology describing strains and species of Ebola can cause some confusion. There are five species – the current outbreak being caused by a species known as Ebola Zaire. Within that species are several different strains. Biologists have analyzed genetic material from the strains and found that evolution has led to some variation. What that variation means and how it will influence the course of the outbreak is not well understood, partly because the process of biological evolution is unpredictable.

Some scientists at the conference – the 8th Vaccine and ISV Congress – were skeptical because the Novavax results came from mice. The company has begun trials in monkeys, however, which are considered much more relevant to humans.

Currently, several groups have tested vaccines in monkeys and found promising results. GlaxoSmithKline  has already started testing healthy human volunteers in Europe and the U.S. with a vaccine called ChAd3, based on a cold virus that’s been altered to produce Ebola proteins. The proteins are what should trigger a protective immune response.  The vaccine was developed by the National Institute of Allergy and Infectious Diseases – a branch of NIH. It worked in monkeys, but vaccine researchers readily admit that this may not translate to humans. That uncertainty clouds all research in the vaccine race.

Another vaccine candidate has been developed by Walter Reed Army Institute of Research collaborating with government scientists in Canada. Instead of a cold virus, it uses an altered cow virus called vesicular stromatitis virus, or VSV. This vaccine, too, has proven effective in monkeys.

Meanwhile, researchers at Thomas Jefferson University in Philadelphia have been working for the last four years on a modified rabies vaccine that in monkeys can protect against both diseases. Rabies kills more than 20,000 people every year in Africa, said lead researchers Matthias Schnell. He said they have proven their product works in monkeys and could be ready to start human safety trials by January. He has plans to partner with a major pharmaceutical company to scale up production of the vaccine, but as of this week, those plans are still being worked out.

Also in the race is Johnson & Johnson . Last week the company announced the development of a two-step Ebola vaccine that had shown promise  in monkeys and would be ready for safety testing in human volunteers in early 2015. The company is working together with Bavarian Nordic, based in Denmark.

The Novavax researchers were able to more precisely target the virus behind the current outbreak because they started with the known sequence that makes up its genetic material. “We never touch a living organism in terms of the pathogen,” said Greg Glenn, senior vice president for research and development, in a phone interview. Instead, they synthesize the relevant genetic material from the sequence data.  Then they use a cell culture made from worm eggs to create multiple copies of this genetic material and produce the Ebola proteins deemed most likely to prompt the immune system to mount protective action.

The delivery system is not an existing virus but a synthetic “nanoparticle”. “It looks like a virus from the immune system’s point of view,” said Glenn. He said that if the experiments in monkeys go well they could be ready to start safety testing in humans by January.

Schnell, who leads work on the combined Ebola and rabies vaccine, said that he doubts targeting the exact strain will matter for efficacy of the vaccine. “There’s no real benefit,” to targeting the genetic sequence of this outbreak, he said.

But biologist David Sanders, who has studied Ebola at Purdue University, said that it’s remotely possible the subtle difference between strains will make a difference. It’s true, he said, that the viral proteins that make up the key part of the vaccine are highly “conserved”, meaning they and the genetic material holding their blueprints have changed very little from one strain to another.

But there’s also part of the viral genetic material they call a “highly variable region” because it seems to evolve more rapidly. Its role is less clear but Sanders said it may help the virus protect itself from the immune system and therefore may affect the way vaccines work.

Considering how little the scientists know about this virus, Sanders said it’s worth pursuing a vaccine that targets the specific strain circulating in West Africa. Having multiple vaccine candidates increases the chances that something will work, he said. “You have to be thinking about what can potentially go wrong.”

As many acknowledge, the fact that some candidates work in monkeys is no guarantee they will work safely in humans – a lesson the research community learned in attempting to create a vaccine against HIV. And no one knows how long these vaccines are likely to last, or whether there’s any chance they could protect people already exposed to Ebola but not yet sick.

Even if a vaccine proves safe and effective there are enormous hurdles in scaling up production and transporting it to the places where it’s needed. Glenn said his company’s system may be easier to scale up quickly if the vaccine proves safe and efficacious.

The bad news is that disease modelers predict that the death toll will likely explode over the coming weeks, affecting hundreds of thousands of people before any of these vaccines could be put to widespread use.

That doesn’t mean vaccines won’t still prove crucially important. Many scientists say the outbreak will eventually subside as it runs out of vulnerable people, much as a fire runs out of fuel, and people in the affected countries may change aspects of their behavior – such as spreading the disease by the washing of dead bodies.

After this outbreak subsides, the virus probably won’t disappear completely, some say, but will remain at a lower level, flaring up on occasion. So looking ahead, even if these vaccines take two years to test and scale up, they could end up saving thousands or even hundreds of thousands of lives.


http://www.forbes.com/sites/fayeflam/2014/10/28/in-ebola-crisis-new-vaccine-candidates-show-uncertain-promise/?partner=yahootix

[Buster's Uncle]

Ebola nurse on defensive gets call from Obama
Associated Press
By RAY HENRY  23 hours ago


ATLANTA (AP) — A nurse who fueled Ebola fears by flying to Cleveland after being infected by her dying patient was released Tuesday from a hospital isolation unit, where doctors defended her as a courageous front-line caregiver.

Another nurse, held for days in a medical tent in New Jersey after volunteering in West Africa, was in an undisclosed location in Maine, objecting to quarantine rules as overly restrictive.

While world leaders appeal for more doctors and nurses on the front lines of the Ebola epidemic, health care workers in the United States are finding themselves on the defensive.

Lawyers now represent both Amber Vinson, who contracted the virus while caring for a Liberian visitor to Texas, and Kaci Hickox, who is challenging the mandatory quarantines some states are imposing on anyone who came into contact with Ebola victims.

The virus is still spreading faster than the response, killing nearly half of the more than 10,000 people it has infected in West Africa.

World Bank President Jim Yong Kim said Tuesday that at least 5,000 more health workers are urgently needed in Liberia, Sierra Leone and Guinea. U.N. Secretary-General Ban Ki-moon, traveling with him in Africa, said mandatory quarantines for health care workers, Ebola-related travel restrictions and border closings are not the answer.

The Pentagon announced Tuesday that the Joint Chiefs of Staff recommended to Defense Secretary Chuck Hagel that he require all U.S. troops returning from Ebola-fighting missions in West Africa to be kept in supervised isolation for 21 days. Balancing that and similar quarantines announced by several state governors, President Barack Obama said the Ebola response needs to be "based on science."

"We've got to make sure that those workers who are willing and able and dedicated to go over there in a really tough job, that they're applauded, thanked and supported. That should be our priority. And we can make sure that when they come back they are being monitored in a prudent fashion," Obama said after calling Vinson from the White House.

Vinson's trip home to join her bridesmaids for wedding preparations was one of several moves by doctors and nurses that could have exposed others in the United States. In Ohio alone, 163 people were still being monitored Tuesday because of contact or potential contact with Vinson in a bridal shop and on the airplanes she used. Vinson arrived in Dallas on Tuesday evening, after tests showed she is now free of the virus.

New Jersey Gov. Chris Christie said voluntary stay-at-home measures were obviously insufficient, since even doctors and nurses had moved around in public before getting sick. He was among the first to announce mandatory 21-day quarantines for anyone who had contact with possibly infected people.

Vinson, 29, was infected while caring for Thomas Eric Duncan, who died at Texas Health Presbyterian Hospital Dallas on Oct. 8. She inserted catheters, drew blood, and dealt with Duncan's body fluids, all while wearing protective gear.

Dr. Bruce Ribner, an infectious disease expert who oversaw Vinson's recovery at Emory University Hospital, said her doctors in Atlanta don't know how she got infected in Dallas. He released no details about her treatment and wouldn't say whether certain drugs are proving more effective. "The honest answer is we're not exactly sure," he said.

But Emory University Hospital spokeswoman Holly Korschun later confirmed that Vinson received blood plasma from Ebola survivor Kent Brantly, and said Ebola survivor Nancy Writebol also donated her plasma, but it wasn't ultimately needed.

Ebola is only contagious when people who carry the virus get sick, and Vinson didn't show symptoms before flying to Ohio on Oct. 10. She reported her temperature to the Centers for Disease Control and Prevention, as required, on Oct. 13, and was cleared to fly back to Dallas. The next day, she developed a temperature, and on Oct. 15, she tested positive for Ebola.

Another nurse, Nina Pham, also was infected by Duncan, and was released Oct. 24 from the National Institutes of Health.

Vinson didn't take any questions at Emory. Instead she read a statement thanking God, her relatives and her doctors, appealed for privacy as she returns home to Texas, and asked "that we not lose focus on the thousands of families who labor under the burden of this disease in West Africa."

Hickox, the Doctors Without Borders volunteer, was staying meanwhile in an "undisclosed location," said Steve Hyman, one of her lawyers. Maine health officials announced she will be quarantined at home for 21 days after the last possible exposure to the disease, following the state's health protocols.

But Hyman said he expected her to remain in seclusion for the "next day or so" while he discusses her situation with Maine health officials. Hyman said the state should follow the Centers for Disease Control and Prevention guidelines, which require only monitoring, not quarantine, for health care workers who show no symptoms after treating Ebola patients.

"She's a very good person who did very good work and deserves to be honored, not detained, for it," he said.

___

Contributors include Associated Press writers Elias Meseret in Addis Ababa, Ethiopia; Jeff Martin in Atlanta; Robert F. Bukaty in Fort Kent, Maine; and David Sharp in Portland, Maine.


http://news.yahoo.com/ebola-nurse-defensive-gets-call-obama-223238909.html

[Buster's Uncle]

Ebola nurse plans to end voluntary quarantine
Associated Press  55 minutes ago



This undated image provided by University of Texas at Arlington shows Kaci Hickox. In a Sunday, Oct. 26, 2014 telephone interview with CNN, Hickox, the nurse quarantined at a New Jersey hospital because she had contact with Ebola patients in West Africa, said the process of keeping her isolated is "inhumane." (AP Photo/University of Texas at Arlington)



FORT KENT, Maine (AP) — A nurse who treated Ebola patients in West Africa said Wednesday she plans to stop quarantining herself in rural Maine, signaling a potential showdown with state police monitoring her home and state officials preparing to legally enforce the quarantine.

Kaci Hickox, who has shown no symptoms of Ebola, told NBC's "Today" show and ABC's "Good Morning America" she was abiding by the state's voluntary quarantine by having no contact with people Tuesday and Wednesday. But she said she'll defy the state if the policy isn't changed by Thursday.

"I remain appalled by these home quarantine policies that have been forced upon me even though I am in perfectly good health," Hickox said on "Today."

Her lawyer Norman Siegel told The Associated Press she isn't willing to cooperate further unless the state lifts "all or most of the restrictions."

Gov. Paul LePage said he was seeking legal authority to keep her in isolation.

"We hoped that the health care worker would voluntarily comply with these protocols, but this individual has stated publicly she will not abide by the protocols. We are very concerned about her safety and health and that of the community," said LePage, who canceled his campaign events to follow the developments.

If the state goes to court, the case could serve as a test as to the legality of state quarantines during the Ebola scare.

Generally, states have broad authority when it comes to such matters, but Maine health officials could have a tough time convincing a judge that Hickox poses a threat, said attorney Jackie L. Caynon III, who specializes in health law in Worcester, Massachusetts.

"If somebody isn't showing signs of the infection, then it's kind of hard to say someone should be under mandatory quarantine," he said.

Ebola, which is spread through direct contact with the bodily fluids of an infected person, has killed thousands of people in Africa, but only four people have been diagnosed with it in the United States. People can't be infected just by being near someone who's sick, and people aren't contagious unless they're sick.

Hickox, who volunteered in Sierra Leone with Doctors Without Borders, was the first person forced into New Jersey's mandatory quarantine for people arriving at Newark Liberty International Airport from three West African countries.

New Jersey Gov. Chris Christie and New York Gov. Andrew Cuomo were criticized for ordering mandatory quarantines as Hickox spent the weekend in a tent.

Hickox arrived Tuesday in Maine at the home of her boyfriend, a senior nursing student at the University of Maine at Fort Kent. The 21-day incubation period from her last exposure to Ebola will end Nov. 10, but she doesn't want to wait that long.

"I am not going to sit around and be bullied by politicians and forced to stay in my home when I am not a risk to the American public," she said.

Fort Kent is in far northern Maine, across the river from Canada, and has 4,300 residents. About 1,000 students attend the university.

Across the country, litigation seems unavoidable as health officials grapple with how to manage Ebola public health concerns.

Some states, including Maine, are going above and beyond guidelines from the federal Centers for Disease Control and Prevention, which recommend only regular monitoring, not quarantine, for health care workers who have come into contact with Ebola patients.

LePage commended all health care workers who have volunteered in Africa to treat Ebola patients and said he had hoped Hickox would voluntarily comply with Maine's restrictions.

"While we certainly respect the rights of one individual, we must be vigilant in protecting 1.3 million Mainers as well as anyone who visits our great state," he said.

Siegel said he remained hopeful the state will ease its restrictions. If not, then the state would have to go to court, and Hickox would challenge the state's actions, he said.

"Our position is very simple: There's no justification for the state of Maine to quarantine her," he said. "She has no symptoms, and therefore she's not contagious. And she's not at a risk to the public or the health and welfare of people in the state of Maine."


http://news.yahoo.com/nurse-ill-court-maine-quarantines-115836883.html

[Buster's Uncle]

U.S. attends Ebola meeting in Cuba called by leftist bloc
Reuters
By Nelson Acosta  1 hour ago



HAVANA (Reuters) - U.S. government officials joined health experts from throughout the Americas at an Ebola conference in Cuba on Wednesday, the latest show of cooperation between the historic adversaries on fighting the disease.

The meeting organized by ALBA, a bloc of leftist-governed countries, aims to coordinate a regional strategy on the prevention and control of Ebola, which has killed about 5,000 people in West Africa but in the Americas has only reached the United States.

U.S. military personnel and Cuban medical specialists are already posted in West Africa and prepared to work side by side if needed, officials have said, and Washington has expressed appreciation to Cuba for committing hundreds of doctors and nurses to the region to treat Ebola patients.

"This is a world emergency and we all should work together and cooperate in this effort," said Nelson Arboleda, the U.S. Centers for Disease Control and Prevention's (CDC) director for Central America, one of two U.S. officials and among 254 specialists from 32 countries at the Havana meeting.

ALBA, a nine-nation bloc led by socialist allies Venezuela and Cuba, held a summit in Havana last week in which presidents and prime ministers pledged cooperation on Ebola, leading to Wednesday's follow-up meeting.

The Pan American Health Organization (PAHO), a regional arm of the World Health Organization, invited the United States to participate, White House spokesman Edward Price said.

"Consistent with our ongoing engagement in all meetings and events organized by PAHO, the director of the Central American region for the Centers for Disease Control and Prevention will attend this meeting," Price said.

Following one of the agreements from the summit, Cuba is preparing to train health professionals from around the Americas for treating the disease, Cuban Health Minister Roberto Morales said.

"We have offered our training center ... and our experts to prepare professionals who can become facilitators in each country in the region and help elaborate and implement Ebola prevention and control plans," Morales told reporters.

With help from the World Health Organization and the CDC, Cuba has trained 461 of its own doctors and nurses for treating Ebola patients, more than half of whom have already gone to Sierra Leone, Guinea and Liberia for six-month missions.

The United States and Cuba have been adversaries since the 1959 revolution that brought Fidel Castro to power, though in recent years the two countries have cooperated on issues such as immigration, illegal drug interdiction, weather forecasts and oil spill prevention.

On Tuesday, the United Nations General Assembly voted 188 to 2 to condemn the decades-long U.S. economic embargo against Cuba.

A Liberian man died Oct. 8 while visiting Dallas, Texas, the first Ebola case diagnosed in the United States, and two nurses who treated him were infected but later cleared of the virus. In addition a New York doctor was diagnosed last week. Craig Spencer, 33, had worked with the humanitarian group Doctors Without Borders treating Ebola patients in Guinea.

(Reporting by Nelson Acosta; Editing by Daniel Trotta and Grant McCool)


http://news.yahoo.com/u-attends-ebola-meeting-cuba-called-leftist-bloc-171305999.html

[Buster's Uncle]

WHO: Ebola decline in Liberia could be real trend
Associated Press
By SARAH DiLORENZO and MARIA CHENG  18 minutes ago



A Ebola health worker removes rubbish including plastic bottles from the Island Clinic Treatment center in Monrovia, Liberia, Wednesday, Oct. 29, 2014. The rate of new Ebola infections in Liberia appears to be declining and could represent a real trend, the World Health Organization said Wednesday, but the epidemic is far from over. (AP Photo/ Abbas Dulleh)



DAKAR, Senegal (AP) — The rate of new Ebola infections in Liberia appears to be declining and could represent a genuine trend, the World Health Organization said Wednesday, but the epidemic is far from over.

The disease is still raging in parts of Sierra Leone and there is still a risk that the decline in Liberia won't be sustained, Dr. Bruce Aylward, an assistant director-general for WHO, warned reporters.

Several times during the outbreak officials have thought the disease's spread was slowing, only to surge again later. Officials have often blamed those false lulls on cases hidden because people were too afraid to seek treatment, wanted to bury their relatives themselves or simply weren't in contact with authorities.

But now there are some positive signs: There are empty beds in treatment centers in Liberia and the number of burials has declined. There may be as much as a 25 percent week-on-week reduction in cases in Liberia, Aylward said.

Throughout the Ebola outbreak, WHO has warned that its figures have been incomplete and the number of cases are likely vastly underreported. That is still a concern, Aylward said, but the trend nonetheless appears to be real.

"The epidemic (in Liberia) may be slowing down," he said during a telephone press conference from Geneva. The slowdown could be attributable to a rapid increase in safe burials of Ebola victims, an uptick in the number of sick people being isolated and major public awareness campaigns on how to stop transmission.

So far, more than 13,700 people have been sickened in the outbreak, which has hit Liberia, Guinea and Sierra Leone hardest. That figure, released Wednesday by the World Health Organization, includes cases from earlier in the outbreak that were recently found in patient databases but had never been reported — another sign of the difficulty of providing real-time, accurate data. Nearly 5,000 people have died.



Ebola patients sit inside the Island Clinic Treatment center, were they are kept under quarantine, in Monrovia, Liberia, Wednesday, Oct. 29, 2014. The rate of new Ebola infections in Liberia appears to be declining and could represent a real trend, the World Health Organization said Wednesday, but the epidemic is far from over. (AP Photo/ Abbas Dulleh)


Liberia alone has recorded more than 6,500 cases. Aylward cautioned against reading too much into the decline there, saying that any let-up in the response could allow the disease to surge again.

"Am I hopeful? I'm terrified the information will be misinterpreted and people would start to think, oh great, this is under control," he said. "That's like saying your pet tiger is under control."

Liberia's Red Cross said Tuesday that teams collected 117 bodies last week from the county that includes Monrovia, down from the high of 315 in one week in September, and the government reported last week that only about half of the available beds in treatment centers were occupied.

Others were more reluctant to call the decline a trend.

Ebola outbreaks come in waves, warned Benoit Carpentier, a spokesman for the International Federation of the Red Cross. Red Cross figures show deaths are still increasing outside Monrovia, he noted.

It's possible that at least some of the decline is because cases are being hidden — a phenomenon that has plagued the response to the outbreak since the beginning, said Ella Watson-Stryker, a health promotion manager for Doctors Without Borders in Liberia.



Ebola patients sit inside the Island Clinic Treatment center, where they are kept under quarantine in Monrovia, Liberia, Wednesday, Oct. 29, 2014. The rate of new Ebola infections in Liberia appears to be declining and could represent a real trend, the World Health Organization said Wednesday, but the epidemic is far from over. (AP Photo/ Abbas Dulleh)


She said her team has heard of people doing their own burials in order to avoid a government order that Ebola victims in Monrovia be cremated; the government has also cited fear of cremation, a practice deeply at odds with Liberian tradition, as a reason beds are empty in treatment centers. Watson-Stryker added that people may be staying away from such centers because they are still confused about what kind of care is given at them.

However the decline is characterized, Aylward said the response must not relax.

"This hasn't dropped off a cliff. ... There's a huge risk it wouldn't be sustained," said Aylward. "It would be a huge mistake ... to think we can scale down the response."

Instead, experts should redouble their efforts to track all of the people with whom the sick have come into contact — a task that has been nearly impossible in many parts of the outbreak because of the sheer number of infections.

There's also tremendous work still to be done outside Liberia.

The western areas of Sierra Leone, near the capital, have seen a particularly steady increase in cases lately.

On Wednesday, the government numbers showed 10 new confirmed cases were reported in the country's western districts, which include Freetown, during the previous 24 hours. Recent days have seen those districts report more than two dozen new confirmed cases in a single day.

"We are in a crisis situation, which is going to get worse," said Palo Conteh, the newly appointed head of Sierra Leone's national Ebola Response Center. "Ebola is right ahead of us and it is running fast."

He urged areas of the country experiencing increases in cases to follow the example of areas where the disease's spread is declining: avoid contact with the sick, bury the dead properly and seek quick treatment for fevers.

The top U.N. official on Ebola, Anthony Banbury said Wednesday that the tremendous international response was beginning to pay off.

But Samantha Power, the American ambassador to the U.N., called on countries — especially those that had promised aid but not yet delivered — to do more. WHO said Wednesday it had received about half of the $260 million it needs to meet its objectives, and more had been pledged, leaving a gap of about 35 percent.

"The U.S. is not running away from Ebola but walking toward the burning building," she said, as she urged others to do the same. Power spoke alongside Banbury in Ghana, where the U.N. mission on Ebola has its headquarters.

___

Cheng reported from London. Associated Press writers Francis Kokutse in Accra, Ghana, and Clarence Roy-Macaulay in Freetown, Sierra Leone, contributed to this report.


http://news.yahoo.com/sierra-leone-prez-change-behavior-defeat-ebola-113321163.html

[Buster's Uncle]

AP IMPACT: US health care unprepared for Ebola
AP IMPACT: Even small clusters of Ebola cases could overwhelm parts of US medical care system
Associated Press
By Jeff Donn and Garance Burke, Associated Press  2 hours ago



In this Oct. 24, 2014, file photo, members of the Department of Defense's Ebola Military Medical Support Team dress with protective gear during training at San Antonio Military Medical Center in San Antonio. Even small clusters of Ebola cases could overwhelm parts of US medical care system, according to an Associated Press review of readiness at hospitals and other components of the emergency medical network. (AP Photo/Eric Gay, File)



The U.S. health care apparatus is so unprepared and short on resources to deal with the deadly Ebola virus that even small clusters of cases could overwhelm parts of the system, according to an Associated Press review of readiness at hospitals and other components of the emergency medical network.

Experts broadly agree that a widespread nationwide outbreak is extremely unlikely, but they also concur that it is impossible to predict with certainty, since previous Ebola epidemics have been confined to remote areas of Africa. And Ebola is not the only possible danger that causes concern; experts say other deadly infectious diseases — ranging from airborne viruses such as SARS, to an unforeseen new strain of the flu, to more exotic plagues like Lassa fever — could crash the health care system.

To assess America's ability to deal with a major outbreak, the AP examined multiple indicators of readiness: training, staffing, funding, emergency room shortcomings, supplies and protection for health care workers. AP reporters also interviewed dozens of top experts in those fields.

The results were worrisome. Supplies, training and funds are all limited, and there are concerns about whether health care workers would refuse to treat Ebola patients.

Following the death of a man suffering from Ebola in a Texas hospital and the subsequent infection of two of his nurses, medical officials and politicians are scurrying to fix preparedness shortcomings. But remedies cannot be implemented overnight. And fixes will be expensive.

AP reporters frequently heard assessments that the smaller the facility, the less prepared it is to fight Ebola and other deadly infectious diseases. The U.S. has many more medium-size and small medical centers than large hospitals.

"The place I worry is: Are most small hospitals adequately prepared?" said Dr. Ashish Jha, a Harvard University health care quality specialist. "It clearly depends."

Other findings:

— The emergency care system is already overextended, without the extra stress of a new infectious disease. In its 2014 national report card, the American College of Emergency Physicians gives the country a D-plus grade in emergency care, asserting the system is in "near-crisis."

— Federal data shows patients spend an average of 4 1/2 hours in emergency rooms at U.S. hospitals before being admitted, and 2 percent of patients leave before being seen. Add an influx of patients diagnosed with Ebola, or those who fear they have the disease, and the system's vulnerable segments could wobble.

— While most providers are willing to care for people infected with Ebola virus, an August study shows many feel unprepared. Health care research group Black Book Rankings sought opinions from hospital administrators and staff about Ebola readiness and nearly 1,000 personnel at 389 facilities, including 282 hospitals, participated. Personnel at almost all hospitals in the survey said their facilities were not capable of quarantining large numbers of people possibly exposed to Ebola. And 14 percent of isolation care doctors and nurses and one in four emergency and critical care staff said they'd call in sick if Ebola patients were admitted to their hospitals.

— There are only four specialized containment care facilities set up to isolate and treat patients with Ebola. In any sizable outbreak, those dozen or so beds would fill up quickly.

— Despite sizable federal investments in Ebola research, there is no Ebola vaccine. And as of last week, there were no national emergency stockpiles of the waterproof gowns, full face shields and boot covers recommended by the U.S. Centers for Disease Control and Prevention for treating Ebola patients. The CDC's $6.2 billion Strategic National Stockpile placed an order Thursday for some such equipment, but officials would not say when it could be distributed.

— Since 2002, CDC has given states and territories more than $10 billion to help public health care systems ramp up when facing a disease outbreak. The program has been cut by 30 percent since fiscal year 2007, which led to thousands of layoffs by state and local health departments, according to the National Association of County and City Health Officials.

— A recent survey of 2,500 members of the same association found that only one in three local health departments had participated in full-scale emergency preparedness drills.

Experts concur that training health care workers on safe Ebola treatment and education is one of the antidotes.

"We're really going to have to step up our game if we are going to deal with hemorrhagic fevers in this country," said Lawrence Gostin, a global health law expert at Georgetown University.

A high ranking official at the U.S. Department of Health and Human Services said Wednesday that the government does not expect every hospital in America to be able to treat an Ebola patient, but "every hospital has to be able to recognize, isolate and use the highest level of personal protective equipment until they can transfer that patient."

"The moment anyone has an Ebola patient, CDC will have a team on the ground within a matter of hours to help that hospital," Dr. Nicole Lurie, the HHS assistant secretary for preparedness and response, said Wednesday. She acknowledged "some spot shortages of personal protective equipment" but said many kinds "'are still pretty widely available" and that manufacturers are ramping up production.

___

AP national investigative reporters Holbrook Mohr in Jackson, Mississippi; Michael Kunzelman in Baton Rouge, Louisiana; and David B. Caruso in New York contributed to this story.


http://news.yahoo.com/ap-impact-us-health-care-unprepared-ebola-164830696.html

[Buster's Uncle]

Doctors Without Borders nurse Kaci Hickox will disobey Ebola quarantine
Vox
Updated by German Lopez on October 29, 2014, 11:30 a.m. ET



Doctors Without Borders nurse Kaci Hickox will disobey a 21-day quarantine meant to keep her isolated during Ebola's potential incubation period.

Hickox tested negative for Ebola when she arrived at Newark, New Jersey, airport and has since returned to her hometown in Maine. She told Today's Matt Lauer she won't follow Maine's guidelines to remain in self-quarantine because she hasn't shown any symptoms for the disease — not even a fever — since she returned from Sierra Leone.

"I truly believe that this policy is not scientifically nor constitutionally just," Hickox said. "I am not going to sit around and be bullied by politicians and forced to stay in my home when I am not a risk to the American public."

Hickox clarified that she would take steps to isolate herself if she began showing symptoms. Ebola patients are only contagious when they show symptoms, and they become more contagious as the disease progresses.





The concern with mandatory quarantines, as Vox's Sarah Kliff previously explained, is that they'll discourage sorely needed health workers from volunteering in West Africa. "If you make people lose 21 days of contact, with their family, with their work and with their pay, that's a huge barrier and discouragement for people to go abroad in the first place," Michael Klag, dean of Johns Hopkins University's Bloomberg School of Public Health, told Kliff.

Hickox agreed the quarantine policies will have a chilling effect on volunteers. But for her, it's a matter of when, not if, she'll return to the region. "I would go back," she said. "This has been a bit of a nightmare for me, but my work at Sierra Leone for four weeks was amazing. And I feel privileged to have been able to help fight this battle."


http://www.vox.com/xpress/2014/10/29/7089721/ebola-nurse-kaci-hickox-says-she-refuses-to-be-bullied-by-politicians

[Buster's Uncle]

Liberian president 'a little bit concerned' about U.S. Ebola quarantine 'overreaction'
The Week
Catherine Garcia  October 28
 


John Moore/Getty Images



Although Liberian President Ellen Johnson Sirleaf says she doesn't think American health workers are going to be dissuaded from coming to West Africa to treat Ebola patients, she is "a little bit concerned" over quarantines that are "an overreaction."

In an interview with NBC News' Chris Jansing on Tuesday, Johnson Sirleaf also said she understands the fears people have of the disease, but "fear can be overcome with the right messaging from leaders."

The World Health Organization says that more than 4,600 cases of Ebola have been recorded in Liberia, which is almost half of all worldwide cases. More than 2,700 of those patients have died.

Johnson Sirleaf told Jansing that her country is making progress in the fight against Ebola, with 7,000 Liberians who were in contact with an infected person now under the watch of "disease detectives." Currently, 17 specialized Ebola treatment units and 600 community care centers are under construction, Johnson Sirleaf said, adding, "We feel a little bit confident that we're now beating the disease, but we also remain cautious that it's still with us, and we have a long way to go."


http://theweek.com/article/index/270838/speedreads-liberian-president-a-little-bit-concerned-over-us-overreaction-to-quarantines

[Buster's Uncle]

Beijing recommends home quarantine for people coming from Ebola regions
Reuters  11 hours ago



People have their body temperatures tested for signs of Ebola before entering the Canton Fair in Guangzhou, Guangdong province, October 23, 2014. REUTERS/Stringer



BEIJING (Reuters) - China's capital will suggest to people returning from regions affected by Ebola to quarantine themselves at home for 21 days, and to undergo twice daily temperature checks if they have had contact with patients, state media said on Wednesday.

China has not reported any confirmed cases of the deadly virus, though several suspected cases have ended up in hospital for observation.

The Ebola outbreak that began in March has killed nearly 5,000 people, the vast majority in West Africa. The disease has an incubation period of about three weeks, and only becomes contagious when a victim shows symptoms.

People returning to Beijing from Ebola-affected regions will have to undergo temperature checks at the airport and will be sent to hospital for tests if their temperature exceeds 37.3 degrees Celsius, the official Xinhua news agency reported.

Those without a fever but who have had contact with Ebola patients will have to have their temperatures checked twice a day for 21 days, it added.

People who have had no contact with Ebola patients will be recommended to quarantine themselves at home for 21 days, the report said.



Workers make protective clothing at a factory of Lakeland Industries in Weifang, Shandong province, October 28, 2014. REUTERS/China Daily


Xinhua did not say what would happen if people refused to quarantine themselves.

"Beijing has experience with SARS and the H7N9 (bird flu) virus. Once there is a case of Ebola, we have the ability to control its spread," city health official Zhao Tao told Xinhua.

State media have said the country's border entry points have stepped up health checks, especially in the southern city of Guangzhou which is home to a large African community and has direct flights to the continent.

China's health ministry has identified the main airports in Beijing, Shanghai and Guangzhou as key in terms of risk, and has been focusing its initial health and temperature checks there.

However, the three African countries most affected by the outbreak - Liberia, Sierra Leone and Guinea - do not rank as major trading partners with China in Africa.

Ebola, which can cause fever, vomiting and diarrhea, spreads through contact with bodily fluids such as blood or saliva.

(Reporting by Ben Blanchard; Editing by Nick Macfie)


http://news.yahoo.com/beijing-recommends-home-quarantine-people-coming-ebola-regions-103541089.html

[Buster's Uncle]

Saying she will not be bullied, nurse fights Maine Ebola quarantine
Reuters
By Susan Heavey and Roberta Rampton  1 hour ago



Members of the media wait outside the home of Theodore Wilbur, boyfriend of Kaci Hickox, the nurse who was released from New Jersey's mandatory quarantine for certain travelers from Ebola-stricken West Africa, in Fort Kent, Maine, October 28, 2014. Hickox, who so far had not arrived at the house, said on Wednesday that she will challenge restrictions by the state of Maine and does not plan to follow guidelines to quarantine herself until November 10. Picture taken October 28, 2014. REUTERS/Joel Page (UNITED STATES - Tags: HEALTH POLITICS)



WASHINGTON (Reuters) - Saying she will not be bullied by politicians, a Maine nurse is giving the state an ultimatum: lift her Ebola quarantine by Thursday or she will disregard the restrictions and go to court.

The saga of nurse Kaci Hickox illustrates how U.S. states are struggling to protect against the virus without resorting to overzealous and useless precautions or violating civil rights.

Hickox, 33, tested negative for Ebola after returning from treating patients in West Africa. She previously blasted New Jersey Governor Chris Christie after she was taken from Newark's airport and put in quarantine in a tent before being driven to Maine to spend the rest of her 21-day quarantine at her home.

"I truly believe this policy is not scientifically nor constitutionally just, and so I am not going to sit around and be bullied around by politicians and be forced to stay in my home when I am not a risk to the American public," Hickox, speaking from her home in the small Maine town of Fort Kent along the Canadian border, told NBC's "Today" program.

"If the restrictions placed on me by the state of Maine are not lifted by Thursday morning, I will go to court to fight for my freedom," Hickox added.

Hickox's defiance did not sit well with Republican Governor Paul LePage, who said he would seek legal authority to keep her isolated at home until Nov. 10.

"While we certainly respect the rights of one individual, we must be vigilant in protecting 1.3 million Mainers, as well as anyone who visits our great state," LePage said in a statement.

At a White House event, President Barack Obama scolded politicians who have sought quarantines or strict travel bans for caving into fears, although he did not mention anyone by name.

"When I hear people talking about American leadership, and then are promoting policies that would avoid leadership and have us running in the opposite direction and hiding under the covers, it makes me a little frustrated," Obama said.

The president was flanked by three doctors in white lab coats and several other healthcare workers who have served in West Africa or will soon travel there. "When they come home, they deserve to be treated properly. They deserve to be treated like the heroes they are," Obama said.

Even people who did not treat Ebola patients but traveled to West Africa are facing restrictions.

A Connecticut school superintendent defended the decision to keep a 7-year-old girl out of class for three weeks over concerns the girl might have contracted Ebola while at a wedding in Nigeria. The World Health Organization declared Nigeria Ebola-free days after the girl's trip.

Hickox worked with the humanitarian group Doctors Without Borders in Sierra Leone, one of the three nations at the heart of an outbreak that has killed about 5,000 people in West Africa. Liberia, the country worst-hit by the epidemic, may be seeing a decline in the spread of the virus, the World Health Organization said on Wednesday.

In several media interviews, Hickox said she was in good health and had not had any symptoms of the virus that would indicate she had become contagious. Hickox said she had been monitoring her condition and taking her temperature twice a day.

Lawyers for Hickox said Maine officials would have to go to court to get an order to enforce a quarantine and that, if the state does, she would challenge it.


'ILLEGAL AND UNCONSTITUTIONAL'

Her lawyer Steven Hyman told Reuters that Maine has no basis to arrest or detain her. "Such action would be illegal and unconstitutional and we would seek to protect Kaci’s rights as an American citizen under the Constitution. There is no medical risk and we have to deal with fact and not hysteria," he said.

Medical professionals say Ebola is difficult to catch and is spread through direct contact with bodily fluids from an infected person and is not transmitted by asymptomatic people. Ebola is not airborne.

Hickox said her last contact with an Ebola patient was on Oct. 21. The maximum incubation period for Ebola is 21 days.

Some U.S. states have imposed automatic 21-day quarantines on doctors and nurses returning from treating Ebola patients in Liberia, Sierra Leone and Guinea. Republicans including Christie have accused Obama's administration of doing too little to protect Americans from Ebola.

California, the most populous U.S. state, announced on Wednesday that people returning from Ebola-affected countries who have had contact with infected patients will be quarantined for 21 days. The policy offers a degree of flexibility, with local health officials allowed to "establish limitations of quarantine on a case-by-case basis."

Public health experts, the United Nations and medical charities - and Obama - oppose such steps as scientifically unjustified. They say such policies may discourage badly needed American doctors and nurses from volunteering to help.

Also on Wednesday, another American nurse who returned home from working with Ebola patients in Sierra Leone agreed to quarantine herself at home in Texas with twice-daily monitoring by state health officials for 21 days, officials said. The nurse, who was not identified, is asymptomatic.

Setting himself apart from his counterparts in Maine and New Jersey, Texas Governor Rick Perry, a possible 2016 Republican U.S. presidential candidate along with Christie, telephoned the nurse, calling her a hero.

Four people have been diagnosed with Ebola in the United States, with one death, a Liberian man who flew to Texas. Two of his nurses were infected, but both have recovered and are virus-free. The only patient now being treated for Ebola in the United States is a New York doctor, Craig Spencer, who was diagnosed last Thursday after treating Ebola patients in Guinea.

Two U.S. health officials attended a meeting in Havana organized by ALBA, a bloc of leftist-governed countries, to coordinate a regional strategy on stopping Ebola. It was the latest show of cooperation between historic adversaries Cuba and the United States on fighting the disease.

U.S. military personnel and Cuban medical specialists are already posted in West Africa and prepared to work side by side. Washington has expressed appreciation to Cuba for committing hundreds of doctors and nurses to the region.

In another sign of alarm over Ebola felt in many U.S. communities, the University of North Carolina on Wednesday banned students from school-related travel to Sierra Leone, Guinea and Liberia. It said faculty and staff must seek prior approval to travel there for humanitarian or scientific reasons.

The Pentagon said Defense Secretary Chuck Hagel approved a strict, 21-day quarantine-like monitoring period for all U.S. troops returning from the Ebola relief mission in West Africa.

Hagel also called for a review of the decision in 45 days. The new policy expands one put in place on Monday for Army soldiers to all branches of the military.

(Additional reporting by Nelson Acosta in Havana, Jon Herskovitz in Texas, Colleen Jenkins in Winston-Salem, N.C., Frank McGurty in New York and David Alexander, Steve Holland and Roberta Rampton in Washington; Writing by Will Dunham; Editing by Jonathan Oatis, Grant McCool and Lisa Shumaker)


http://news.yahoo.com/maine-nurse-tested-negative-ebola-clash-over-quaratine-161101054.html