Ebola news 10/30

[Buster's Uncle]

New York unveils incentives for workers in West Africa Ebola fight
Reuters
By Ellen Wulfhorst  26 minutes ago



A health worker in protective equipment holds on to equipment used to take swabs for laboratory testing near Rokupa Hospital, Freetown October 6, 2014. REUTERS/Christopher Black/WHO/Handout via Reuters



NEW YORK (Reuters) - New York officials on Thursday announced a program to encourage healthcare professionals to work in Ebola-hit West Africa, an effort to deflect criticism that the state's mandatory quarantine could hamper the battle against the disease.

The program will provide financial incentives and employment protections similar to the benefits and rights provided to military reservists, New York Governor Andrew Cuomo and New York City Mayor Bill de Blasio said in a joint statement.

The 21-day mandatory quarantines instituted by New York and New Jersey for health workers returning from countries with Ebola epidemics have sparked criticism that the measures would discourage doctors and nurses from traveling to West Africa.

“We believe that public health in West Africa and the public health in New York are interconnected and both must be addressed,” Cuomo said in the statement.

Key to containing Ebola is "encouraging and incentivizing medical personnel to go to West Africa," he said.

Under the New York program, health workers who go to West Africa will have their pay, healthcare and employment status continued while they are away.

Also, they will be provided financial reimbursement if they are placed in quarantine upon their return.

Cuomo first mentioned such an incentive program at a news conference on Sunday when he was seeking to quell perceptions that the quarantine policy was unduly harsh and said quarantines could be served at home.

In support of the incentive program, New York City Health Commissioner Mary Bassett said in the statement that doctors treating Ebola patients in West Africa "are performing a service for us all by tackling the epidemic at its source."

"We should do everything we can to honor these heroes," she said.

New York City and New York state are coordinating the program with New Jersey; the Greater New York Hospital Association, which represents some 250 area hospitals; Local 1199 of the Service Employees International Union of healthcare workers; the New York State Nurses Association; and the Medical Society of the State of New York, an organization of about 30,000 physicians, medical residents and medical students.

(Reporting by Ellen Wulfhorst; Editing by Eric Beech)


http://news.yahoo.com/york-unveils-incentives-workers-west-africa-ebola-fight-183444872.html

[Buster's Uncle]

Individual genetic differences may affect Ebola survival: study
Reuters
By Julie Steenhuysen  4 minutes ago



CHICAGO (Reuters) - Scientists have been puzzling for years over why some people survive Ebola while many others perish. A new study provides strong evidence that individual genetic differences play a major role in whether people die from the disease.

Researchers at the University of Washington in Seattle reported their findings on Thursday in the journal Science.

They compared conventional lab mice, which typically just die when infected with a mouse version of Ebola, with genetically diverse lab mice that developed a wide range of symptoms in much the same way that people infected with the virus do.

Mice used in the study were generated from eight different strains of the animal and were bred to represent human genetic diversity. Symptoms in these genetically diverse mice ranged from mild weight loss to full, hemorrhagic fever, including internal bleeding, swollen spleens and changes in liver color and texture.

"We infected these mice with a mouse-adopted strain of Ebola virus," said Angela Rasmussen, a microbiologist at the University of Washington who helped lead the study.

"In classical lab mice, this strain of Ebola kills the animals but it doesn't produce hemorrhagic disease," she said.

Researchers think the findings may help answer some questions about the Ebola outbreak in Guinea, Sierra Leone and Liberia, which has killed about 5,000 people.

A major question has been whether Ebola survivors have had some prior viral exposure that enables their immune systems to fight the infection or whether there is something genetically unique about survivors that makes them resistant.

The mouse study cannot address the issue of prior immunity but makes a strong case for the idea that an individual's genetic code plays a role in surviving Ebola.

"There is definitely a genetic component," Rasmussen said.

The study shows that host genes influence which cells become infected and how much the virus replicates, said Professor Andrew Easton, a virologist at the University of Warwick, who was not part of the study.

"Most of these genes are involved in the very earliest stages of our immune response to infection," something that has also been seen with other viruses, he said in a statement.

Study co-author Michael Katze of the University of Washington said he hopes the study will quell some of the debate over the role of genetics in disease progression.

"These mice were infected with exactly the same dose by exactly the same route by the same investigator. The only thing that was different was the genetic background," he said.

One thing that has hindered Ebola research has been the lack of a mouse model to study the disease. Rasmussen hopes her work now makes it easier for scientists to study drugs and vaccines that fight Ebola.

Most such studies are done in monkeys, but they can be hard to work with.

Genetically altered mice are easier to control, especially in the strict confines of a highly secure biocontainment laboratory where such work must be done.

Rasmussen doesn't expect mice to replace monkeys, but they may be useful for earlier-stage work.

(Reporting by Julie Steenhuysen; Editing by Jonathan Oatis)


http://news.yahoo.com/individual-genetic-differences-may-affect-ebola-survival-study-190039303.html

[Buster's Uncle]

Liberians fast, pray for three days to break Ebola "curse"
Reuters  12 hours ago



MONROVIA (Reuters) - Liberians began three days of fasting and prayers on Wednesday to seek salvation from the "curse" of the Ebola epidemic, which has killed 2,705 people and infected 4,665 more in the West African country.

The National Christian Ebola Task Force, an organisation formed in September by different Christian denominations, urged Liberians to fast from dawn-to-dusk over the next three days.

"Ebola is a virus from the devil. It's killing us because we have turned our back to God," Reverend David G. Benitoe, a representative of the task force, told a news conference.

"We have traded the worship of God with the worship of demons and witchcraft, and evil stuff is now happening in this country," Benitoe said.

Liberia is the country hardest-hit by the worst outbreak on record of the viral haemorrhagic fever, which is transmitted through direct contact with bodily fluids of those infected.

In total, the epidemic has killed nearly 5,000 people and infected some 13,703 people since it was first reported in Guinea in March.

The disease has spread to Liberia, Sierra Leone, Senegal, and Nigeria, with Mali becoming this month the sixth West Africa nation touched by the outbreak. Nigeria and Sierra Leone have now been declared Ebola-free by the World Health Organization.

Isolated cases have also been reported in Spain and the United States.

This month, Liberian President Ellen Johnson Sirleaf told Reuters her government had detected the first signs of an easing in the epidemic as public awareness of the disease improved.

The WHO also said on Wednesday there were indications it was slowing, with falls in the number of burials, new admissions and a plateau in laboratory-confirmed cases.

About 85 percent of Liberia's 4 million people are Christians, while about 12 percent are Muslims. Since the beginning of the outbreak, Liberians have packed churches on Sunday, singing and praying for deliverance.

Thousands of mobile phone subscribers received text messages on their phones on Wednesday asking them to take part.

"I have the faith that after Friday things will not be the same in Liberia with Ebola," said Mary Freeman, who attends the Faith Healing Temple of Jesus Christ of Monrovia, adding that she had started fasting on Wednesday morning.

"The Lord has taken pre-eminence over our situation."

Benitoe said the fast and prayer will be concluded on Friday with prayers and communion services across the country, but because Ebola is highly infectious, people would have to avoid touching one another during the communion.

"No one is going to be serving the communion. You will have you buy your own communion elements. Bread and wine or biscuit and non-alcoholic wine or red juice," he said.

(Reporting by James Harding Giahyue in Monrovia and Bate Felix in Dakar; Editing by Daniel Flynn and Catherine Evans)


http://news.yahoo.com/liberians-fast-pray-three-days-break-ebola-curse-072108019.html

[Buster's Uncle]

Maine in standoff with nurse over Ebola safeguards
Associated Press
By ROBERT F. BUKATY  53 minutes ago



Kaci Hickox, who treated Ebola patients in West Africa, said she plans to end her voluntary quarantine and even stepped outside her home briefly on Wednesday.



FORT KENT, Maine (AP) — Maine health authorities struggled Thursday to reach a compromise with nurse Kaci Hickox that would require her to keep her distance from other people, in the nation's most closely watched clash between personal freedom and fear of Ebola.

Hickox, 33, stepped out of her home in remote northern Maine for the second day in a row and went on a morning bike ride with her boyfriend, practically daring authorities to go to court to have her confined against her will, as they threatened to do for days.

But by late afternoon, the legal showdown had yet to take place.

Hickox, who returned to the U.S. last week from treating Ebola victims in West Africa as a volunteer with Doctors Without Borders, has been under what Maine has called a voluntary quarantine at her home in this town of 4,300 people.

She has rebelled against the restrictions on her movements, saying that her rights are being violated and that she is no threat to others because she has no symptoms. She tested negative last weekend for Ebola, though it can take days for the virus to reach detectable levels.

Her 21-day quarantine — the incubation period for the Ebola virus — is scheduled to end on Nov. 10.

Gov. Paul LePage said a scaled-down quarantine that was discussed by Hickox's lawyer and state attorneys would have allowed her to go for walks, runs and bicycle rides while preventing her from going into public places or coming within 3 feet of others.

But around midday, LePage said that the hours of negotiations had gone nowhere, and that he was prepared to use the full extent of his authority to protect the public.



State troopers and a television reporter stand across from the home where Kaci Hickox, a nurse who treated Ebola patients in West Africa, is staying, Wednesday, Oct. 29, 2014, in Fort Kent, Maine. Hickox 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. She said she'll defy the state if the policy isn't changed by Thursday. (AP Photo/Robert F. Bukaty)


"I was ready and willing — and remain ready and willing — to reasonably address the needs of health care workers meeting guidelines to assure the public health is protected," he said.

Hickox stepped into the media glare when she returned from treating Ebola patients in Sierra Leone to become subject to a mandatory quarantine in New Jersey. After an uproar, she was released and traveled more than 600 miles to the small town close to the Canadian border where she lives with her boyfriend.

She said she is following the federal Centers for Disease Control and Prevention recommendation of daily monitoring for fever and other signs of the disease.

An unmarked state police cruiser followed Hickox on her hour-long bike ride on trails near her home, but police could not take action to detain her without a court order signed by a judge.

"I really hope that we can work things out amicably and continue to negotiate," she said.

States have broad authority under long-established law to quarantine people to prevent the spread of disease. But legal experts said there are differences here that could work in Hickox's favor in court: People infected with Ebola are not contagious until they have symptoms, and the virus is not spread through casual contact.

In other developments:



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)


— Ebola fears infected a medical conference on the subject. Louisiana state health officials told thousands of doctors planning to attend a tropical-diseases meeting this weekend in New Orleans to stay away if they have been to certain African countries or have had contact with an Ebola patient in the last 21 days.

— Liberia is making some progress in containing the outbreak, while Sierra Leone is "in a crisis situation which is going to get worse," the top anti-Ebola officials in the two countries said.

— The World Bank announced it will give an additional $100 million to help bring in more foreign health workers. That raises the money it has given to the fight to $500 million.

Some states like Maine, New York and New Jersey are going above and beyond the CDC guidelines to require quarantines. So is the U.S military.

President Barack Obama, the nation's top infectious-disease expert and humanitarian groups have warned that overly restrictive measures could cripple the fight against the disease at its source by discouraging volunteers like Hickox from going to West Africa, where the outbreak has sickened more than 13,000 people and killed nearly 5,000 of them.

"The volunteers are heroes to the people they help, and they are heroes to our own countries. They should be treated like heroes when they return," Samantha Power, U.S. ambassador to the United Nations, said in Brussels.

In Maine, state law allows a judge to confine someone if health officials demonstrate "a clear and immediate public health threat."

If a judge grants the request, Hickox will appeal on constitutional grounds, said Norman Siegel, one of her attorneys.

Siegel said the nurse hopes her fight against the quarantine will help bring an end to misinformation about how Ebola is spread.

"She wants to have her voice in the debate about how America handles the Ebola crisis. She has an important voice and perspective," he said.

Word spread quickly around the town about Hickox.

Priscilla Staples said that some are fearful of Hickox's presence, but Hickox "has done nothing wrong, and she has every right in the world to go for a bike ride."

___

Associated Press writer Patrick Whittle in Portland, Maine, contributed to this story.


http://news.yahoo.com/showdown-imminent-over-nurses-quarantine-maine-060038440.html

[Buster's Uncle]

Fearing Ebola? Doctors say get a flu shot
Associated Press
By LINDSEY TANNER  6 hours ago



In this Sept. 16, 2014 file photo, a sign lets customers know they can get a flu shot in a Walgreen store in Indianapolis. Fever? Headache? Muscle aches? Forget about Ebola, chances are astronomically higher that you have the flu or some other common bug. That message still hasn't reached many Americans, judging from stories ER doctors and nurses swapped this week at a Chicago medical conference. Misinformed patients with Ebola-like symptoms can take up time and resources in busy emergency rooms, and doctors fear the problem may worsen when flu season ramps up. . (AP Photo/Darron Cummings)



CHICAGO (AP) — Fever? Headache? Muscle aches? Forget about Ebola — chances are astronomically higher that you have the flu or some other common bug.

That message still hasn't reached many Americans, judging from stories ER doctors and nurses swapped this week at a Chicago medical conference. Misinformed patients with Ebola-like symptoms can take up time and resources in busy emergency rooms, and doctors fear the problem may worsen when flu season ramps up.

That's one reason why doctors say this year it's especially important for patients to get their flu shots: Fewer flu cases could mean fewer Ebola false alarms.

"The whole system gets bogged down, even if it's a false alarm," Dr. Kristi Koenig said during a break at the American College of Emergency Physicians' annual meeting.

Since the first Ebola diagnosis in the U.S., on Sept. 30 in a Liberian man treated in Dallas, doctors say they've had to reassure patients with many fears but none of the risk factors.

Examples shared by those attending the meeting include:

—An Ohio patient who thought she had Ebola because her husband had worked in Dallas, but not with the Ebola patient.

—A New Mexico woman who sought ER testing for Ebola because she had visited Africa two years ago.

—Two Alabama patients who worried they were infected after traveling through an airport in Atlanta, the same city where Ebola patients were treated.

Those Alabama patients had intestinal symptoms but no contact with Ebola patients nor recent travel to Ebola-plagued countries in West Africa, and they were sent home after doctors consulted with the federal Centers for Disease Control and Prevention, said Dr. David Pigott, an emergency medicine specialist at the University of Alabama at Birmingham.

Flu and other airborne diseases can be transmitted by indirect contact with infected people. By contrast, the only way to get Ebola is through direct contact with blood, vomit and other body fluids from Ebola patients, experts say.

While Ebola can be quickly ruled out for many patients by asking about recent travel to West Africa and contact with Ebola patients, "there's still some concern about anybody with symptoms that could be Ebola because it's so much in the news right now," said Koenig, director of public health preparedness at the University of California in Irvine.

That means a patient with the flu could trigger a full-court press in the ER, including isolating the patient and ER staff grabbing the hazmat suits until Ebola is ruled out.

Ebola was among hot topics at the meeting, and hundreds packed sessions on how to handle a disease they most likely will never have to treat.

Only four people have been diagnosed with Ebola in the United States, and experts doubt that Ebola will become widespread in this country. But if more Ebola cases do occur, getting vaccinated against the flu now "would make the screening process a lot easier," said Dr. Daniel Bachmann, an emergency medicine physician at Ohio State University's Wexner Medical Center.

So far, flu activity is low nationwide and only one death has been reported, in a child earlier this month.

But unlike Ebola, flu contributes to thousands of U.S. deaths each year and many more hospitalizations. And unlike Ebola, there's a vaccine to protect against the flu, recommended annually for adults, teens and children starting at 6 months of age.

So when patients express fears about Ebola, Bachmann tells them, "Go get your flu shot."

Flu vaccination rates are low; a little over half of eligible U.S. children and teens and just 42 percent of adults got vaccinated in the 2012-13 flu season, CDC data show.

While there have been reports of scattered flu vaccine shortages this fall due to delayed vaccine shipments, seven manufacturers have estimated that as many as 156 million doses — an adequate supply — will be available this flu season, said CDC spokeswoman Erin Burns.

"As of Oct. 17, 2014, manufacturers reported having shipped 117.8 million doses of flu vaccine," she said.

Flu season often begins in October, peaks between December and February and then tapers off.

___

Online:

CDC: http://www.cdc.gov

___


http://news.yahoo.com/fearing-ebola-doctors-flu-shot-152450517.html

[Buster's Uncle]

US envoy sees 'first tangible signs' Ebola will be beaten
AFP  2 hours ago



US Ambassador to the United Nations Samantha Power gives a press conference on the Ebola virus in Brussels on October 30, 2014 (AFP Photo/John Thys )



Brussels (AFP) - Ebola-hit west Africa is showing "the first tangible signs" that the deadly virus will be beaten, the US envoy to the UN said Thursday after touring the region.

Samantha Power said the international community must still do much more to fight a months-long epidemic that has claimed around 5,000 lives, almost all of them in Liberia, Sierra Leone and Guinea.

"We stand at a historic juncture. We face the greatest public health crisis ever," Power told a gathering in Brussels sponsored by the German Marshall Fund of the United States.

Though there were "still alarming gaps in our collective response," foreign aid and a stronger local response were beginning to make a difference, Power said.

She said Muslim clerics in Guinea, for example, were encouraging people to bury Ebola victims safely to help check the spread of the disease.

Power added that a US Navy Ebola testing lab in Liberia was giving those who might be infected their results within hours rather than days, reducing the chance of the virus spreading.

And she learned how a clinic run by Medecins Sans Frontieres in the Liberian capital Monrovia now had enough beds so that it no longer had to turn away patients.

The survival rate of infected people in a community in Guinea had gone up because the local authorities were making sure people received treatment faster, she said.

The international contributions that have been made, along with local efforts, have "begun to save lives and offer the first tangible signs that this virus can and will be beaten," Power said.

She had travelled to the region not expecting to find much cause for optimism but came away with a message of "profound hope."

Power nonetheless said she noticed fear, ignorance and lack of basic supplies like chlorine disinfectant and buckets were still hampering prevention and treatment.

There were still not enough doctors, nurses, plastic gloves, bleach and thermometres, she said.

"The international community is not yet doing enough to stem the tide of the epidemic," she said.

The US envoy hailed the work of non-government organisations "but they are maxed out. They cannot fill the remaining gaps without more support."

Power said that fear was the greatest obstacle to fighting Ebola, both in the countries worst hit by the disease and the western countries needing to respond to it.

"Ebola has no greater friend than fear. The virus thrives on it," she said.


http://news.yahoo.com/us-envoy-sees-first-tangible-signs-ebola-beaten-194949789.html

[Buster's Uncle]

World Bank funding for Ebola fight hits $500 million
Reuters  8 hours ago



People sit near a banner reading "The Ministry of Agriculture, Dixinn Commune, Together to defeat Ebola," in Conakry, Guinea October 26, 2014. REUTERS/Michelle Nichols



GENEVA (Reuters) - The World Bank pledged $100 million on Thursday to help recruit more foreign health workers in the fight against Ebola, taking its funding for the three worst-hit countries to more than half a billion dollars over the past three months.

The biggest recorded outbreak of the deadly virus has killed almost 5,000 people, according to the World Health Organization, mainly in Liberia, Sierra Leone and Guinea. Some aid groups have criticized the scale of the initial international response.

World Bank Group President Jim Yong Kim said the three states were still struggling to get enough health staff to areas with the highest infection rates.

“We must urgently find ways to break any barriers to the deployment of more health workers. It is our hope that this $100 million can help be a catalyst for a rapid surge of health workers to the communities in dire need,” Kim said in a statement.

The latest tranche will go towards setting up a coordination hub to recruit, train and deploy qualified foreign health workers and support the three countries' efforts to isolate Ebola patients and bury the dead safely, the bank said.

(Reporting by Tom Miles; Editing by Andrew Heavens)


http://news.yahoo.com/world-bank-funding-ebola-fight-hits-500-million-134808681.html

[Buster's Uncle]

Ebola puts Ghana's bush meat traders out of work
Associated Press
By RODNEY MUHUMUZA and OBED BOAFO  October 29, 2014 5:46 AM



In this photo taken on Wednesday, Oct. 22, 2014, Yaa Kyerewaa waits for clients as she stands next to her makeshift bush meat shop at one of the largest local markets in Accra, Ghana. This “bush meat” was once considered a delicacy and fetched premium prices but Ebola has frightened away customers and it has been many days since Kyerewaa sold anything, so she cuts a sullen figure as she stands beside a pile of animal parts including the jaws of giant rodents, the hooves of wild pigs and snails. (AP Photo/Christian Thompson)



ACCRA, Ghana (AP) — Yaa Kyerewaa cuts a lonely figure beside a pile of animal parts: the jaws of a giant rodent, the hooves of wild pigs, snails. This bush meat was once considered a delicacy and fetched premium prices. But Ebola has frightened away customers and Kyerewaa hasn't sold anything in days.

Accra's busy Agbogbloshie market used to have several bush meat vendors but now she is the only one.

The 53-year-old says her earnings from bush meat keep her four children in school and she laments the sudden loss of business as public health officials warn that bush meat may be contaminated with the dreaded Ebola virus.

"Bush meat is healthy. I usually eat it as a special food on Sundays," she said. "We have been consuming for years only for it to be made unpopular by these needless rumors flying around. No one wants to buy our products now. It is sad."

Many restaurants in Ghana's capital no longer serve bush meat, of which a large rodent known as a "grasscutter" was the most popular offering. Hunters trap them in the wild or rear them at home for their meat, which is said to taste like chicken.

Health experts believe the initial cases in many Ebola outbreaks start from people eating or handling Ebola-infected animals. Then they spread it to other people through contact with bodily fluids. Fruit bats, as well as primates such as chimpanzees, are frequently cited as potential reservoirs of the Ebola virus — animals many Africans hunt for their meat.



In this photo taken on Wednesday, Oct. 22, 2014, bush meat is displayed for sale at one of the largest local markets in Accra, Ghana. The “bush meat” sold at this market including the jaws of giant rodents and the hooves of wild pigs was considered a delicacy and fetched premium prices but Ebola has frightened away most customers. (AP Photo/Christian Thompson)


Human infections in Africa have been linked to hunting, butchering and processing meat from infected animals, although none from eating cooked bush meat, according to the U.S. Centers for Disease Control and Prevention.

Ebola first appeared in 1976 in Congo and has caused periodic outbreaks there and in other African countries. This is West Africa's first outbreak — and the most deadly ever — and the World Health Organization warns it could get worse before the situation improves. More than 4,500 people, mostly in Guinea, Sierra Leone and Liberia, have died.

While stemming human-to-human transmission is the main focus for governments and international health agencies, African communities that hunt wild animals for their meat "risk future spill-over from species that can carry the virus," including fruit bats, some primates, and small antelopes called duikers, the Food and Agriculture Organization warns. Hunting animals that are sick or behaving strangely, or collecting dead animals for sale, is risky, the U.N. agency says.

Despite the dangers, bush meat is a source of protein for many West Africans, and for some it is a special treat. The soup of a roasted fruit bat, for example, is highly sought after.

Kyerewaa said she once had clients from all walks of life. That has changed with Ebola sweeping through West Africa and health officials stepping up campaigns to educate the public about how to avoid catching it.



In this photo taken on Wednesday, Oct. 22, 2014, a view of one of the largest local markets that sell bush meat and other products found in the local jungles, in Accra, Ghana. The “bush meat” sold at this market including the jaws of giant rodents and the hooves of wild pigs was considered a delicacy and fetched premium prices but Ebola has frightened away most customers (AP Photo/Christian Thompson)


"I am the only surviving bush meat seller in this market," said Kyerewaa, who said she has been a bush meat trader for years. "I can't stop coming because I have to look for ways to support myself and my family."

At her stall the parts of the great cane rat —smoked and salted for preservation — fetch as much as $30. That's out of reach for many in Ghana, where many live on less than $2 a day.

Rebecca Ackwonu, a Ghana Health Service Commission official, said it's hard to enforce any kind of bush meat ban in a country where many people grew up on it.

"We have advised our people to suspend eating bush meat in the meantime because of the risks," she said.

Some have heeded the call.

Theodor Semi, who operates a popular downtown restaurant called Semi's Place, said he won't serve bush meat until all of West Africa is declared free of Ebola.

"It has affected business, of course," he said. "It has become slow because most Ghanaians like bush meat, especially grasscutter."


http://news.yahoo.com/ebola-puts-ghanas-bush-meat-traders-094459106.html

---

GOOD.  Screw those guys.

[Buster's Uncle]

Bike-riding US nurse defies Ebola quarantine, on collision course with governor
Reuters
By Steve Holland  9 minutes ago



Nurse Kaci Hickox (L) and her boyfriend Ted Wilbur address the media during an informal meeting with the news media outside their home in Fort Kent, Maine October 29, 2014. 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. Hickox, 33, tested negative for Ebola after returning from treating patients in West Africa. Picture taken October 29, 2014. REUTERS/Ashley L. Conti/Bdn



CAPE ELIZABETH Maine (Reuters) - A nurse who treated Ebola patients in Sierra Leone but has tested negative for the virus went for a bike ride on Thursday, defying Maine's order that she be quarantined in her home and setting up a legal collision with Governor Paul LePage.

Attorneys for Kaci Hickox, 33, said they had not yet been served with a court order to enforce the 21-day quarantine - matching the virus's maximum incubation period - but remained prepared to fight such an order if necessary.

LePage's office said negotiations with Hickox "have failed despite repeated efforts by state officials" and that he would "exercise the full extent of his authority allowable by law."

Hickox left her home in the small Maine town of Fort Kent, along the Canadian border, and television news images showed her taking a morning bicycle ride with her boyfriend, Ted Wilbur. Hickox has given the New England state a deadline of Thursday to lift an order that she remain at home until Nov. 10, or she will go to court.

“It’s a beautiful day for a bike ride,” said Hickox, wearing a helmet and other bike gear as she headed out for her three-mile (5-km) ride while police stationed outside her house stood by without trying to stop her, according to local media.

LePage's office said he was open to an arrangement in which she could go for walks, runs or bike rides but not go into public places or come within 3 feet (1 meter) of other people.

“I was ready and willing - and remain ready and willing - to reasonably address the needs of healthcare workers meeting guidelines to assure the public health is protected,” said LePage, a Republican locked in a tough three-way re-election battle.

President Barack Obama, who has criticized mandatory quarantine policies imposed by some states for returning medical workers like Hickox, flew to Maine on Thursday to campaign in the town of Cape Elizabeth for Democratic candidates, including Mike Michaud, who is trying to unseat LePage in Tuesday's midterm elections.

Asked for comment on Hickox's situation, White House spokesman Josh Earnest told reporters aboard Air Force One en route to Maine that U.S. Centers for Disease Control and Prevention officials have been in regular touch with the health authorities in the state.

"Ultimately, it is their decision," said Earnest, adding that Obama had no plans to see Hickox while in Maine. Cape Elizabeth is at the opposite end of the state, on its southeastern coast.

One of Hickox's attorneys, Norman Siegel, defended his client's decision to go for a bike ride but noted that she avoided the center of town so as not to “freak people out.”

“Since there’s no court order, she can be out in public,” Siegel said. “Even if people disagree with her position, I would hope they respect the fact that she’s taking into account the fear, which is based on misinformation about the way the disease is transmitted.”

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.

U.S. concern about the disease is high even though there is only one person in the country currently being treated for it, a New York doctor, Craig Spencer, who cared for patients in West Africa. Spencer, 33, remains in serious but stable condition, New York's Bellevue Hospital said on Thursday.

The quarantine showdown between Hickox and Maine highlights how states have been struggling to guard against Ebola without resorting to overzealous, useless precautions or violating civil rights.

The nurse says she is completely healthy and has been monitoring her condition and taking her temperature twice a day.

Hickox tested negative for Ebola after returning from working with the humanitarian group Doctors Without Borders in Sierra Leone, one of the three impoverished countries at the heart of the outbreak that has killed about 5,000 people there.

She previously blasted New Jersey Governor Chris Christie after she was taken from Newark's airport and put in isolation in a tent before being driven to Maine to spend the rest of her 21-day quarantine at home.

With elections coming Tuesday, Republicans aiming to take full control of the U.S. Congress have made criticism of Obama's response to Ebola - which they call inept and too weak - a part of their campaign message.

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. Obama and other critics say such steps may discourage American doctors and nurses who are desperately needed there from volunteering.

New York City and state officials on Thursday announced a program to encourage healthcare professionals to work in West Africa, an effort to deflect criticism of the state's mandatory quarantine.

The program will provide financial incentives and employment protections similar to the benefits and rights provided to military reservists, New York Governor Andrew Cuomo and New York City Mayor Bill de Blasio said jointly.

(Additional reporting by Joseph Ax, Scott Malone, Jeff Mason, Brendan O'Brien, Ellen Wulfhorst, Susan Heavey and Roberta Rampton; Writing by Will Dunham; Editing by Jonathan Oatis and Grant McCool)


http://news.yahoo.com/maine-nurse-fights-ebola-quarantine-says-not-bullied-004050831.html

[Buster's Uncle]

Ebola quarantines: Can states do that?
Associated Press
By NANCY BENAC  1 hour ago



A worker from the Centers for Disease Control leaves the home of nurse Kaci Hickox after a brief visit, Thursday, Oct. 30, 2014, in Fort Kent, Maine. State officials are going to court to keep Hickox in quarantine for the remainder of the 21-day incubation period for Ebola that ends on Nov. 10. Police are monitoring her, but can't detain her without a court order signed by a judge. (AP Photo/Robert F. Bukaty)



WASHINGTON (AP) — The quarantine of a nurse in Maine who recently returned from the Ebola hot zone in West Africa has touched off a battle between the authority of states to confine people to protect public health and the right of Americans to move about freely.

Kaci Hickox, who returned to the U.S. last week after treating Ebola patients in Sierra Leone, is defying Maine's efforts to quarantine her at home until the 21-day incubation period for developing the deadly disease has passed. Some questions and answers about Hickox and the legal underpinnings in this tug-of-war between public health and civil liberties.

Q: Why all the attention to Hickox, when so many U.S. medical workers have been helping out in West Africa?

A: Timing. The 33-year-old nurse was the first U.S. medical worker returning from West Africa to get caught up after several states went beyond federal Ebola guidelines and established quarantine rules covering all those who have had contact with Ebola victims in Africa. When Hickox's flight arrived in New Jersey, the state put her in mandatory quarantine in a tent, then released her after three days to complete her journey home to Maine by private car. In Maine, state officials said she should stay in quarantine at home for the rest of the 21-day incubation period.

Q: What's wrong with that?

A: Hickox says a quarantine is unnecessary and is no way to treat health-care workers who've been fighting a scourge. A preliminary test in New Jersey found no evidence she had Ebola, and she's exhibiting no symptoms of the disease. People infected with the virus are not contagious until they have symptoms.

Q: What's the argument in favor of quarantine?

A: Maine Health and Human Services Commissioner Mary Mayhew says the federal government's screening of travelers returning from West Africa has been of limited effectiveness, pointing to the New York doctor who developed symptoms several days after returning home. Mayhew says an in-home quarantine for those who have had direct contact with Ebola patients is a "reasonable, commonsense approach" to avoid a public health crisis.

Q: Can states do that?

A: In general, state and local health departments have broad authority to issue quarantine and isolation orders when needed to protect public health, although the specific rules vary from state to state. That quarantine authority predates the drafting of the Constitution, going all the way back to the colonies, and is part of what's known as the police powers that states have to protect public health and safety.

Q: That's an awesome power. What kind of limits are there on that quarantine authority?

A: The courts have said that imposing a quarantine is a massive deprivation of liberty that can only be done if there's an individual assessment that a person poses a significant risk to the public based on scientific evidence, according to Georgetown Law School Professor Lawrence Gostin, who wrote a textbook on public health law. "You can't simply deprive an American of their freedom for three weeks based upon an abundance of caution, or a political imperative or public reassurance," he says. "Liberty matters much more than that in the United States."

Q: How does that apply in the Maine case?

A: That will probably be left for the courts to sort out, and there are arguments on both sides. Peter Jacobson, a University of Michigan professor of health law and policy, says no state public health official wants to be in the position of not taking sufficient action to avoid the spread of Ebola, and judges will be loathe to overrule the judgment those medical officials. Gostin, for his part, thinks Maine over-reached by issuing a quarantine rule that covers a broad class of people, and says judges are likely to give strong weight to the looser guidance of the federal Centers for Disease Control and Prevention.

Q: What does CDC recommend?

A: It says mandatory quarantines of those without symptoms are unnecessarily severe and will discourage health workers from going to West Africa to fight the epidemic. It says people at the highest risk of contracting Ebola but who have no symptoms — such as those who came into direct contact with an Ebola patient's body fluids — should avoid public transportation and public places like shopping centers and movie theaters, even if they have no symptoms. Activities like jogging, in which the person maintains a 3-foot distance from others, are allowed. For health workers who wore appropriate protective equipment, the CDC recommends such steps be decided on a case-by-case basis.

Q: Back to Hickox: What exactly did she do in Sierra Leone?

A: She wrote in the Dallas Morning News that she "spent a month watching children die, alone. ... I tried to help when much of the world has looked on and done nothing." On her last night in an Ebola center, she wrote, "I was called in at midnight because a 10-year-old girl was having seizures. I coaxed crushed tablets of Tylenol and an anti-seizure medicine into her mouth as her body jolted in the bed. It was the hardest night of my life."

Q: With mandatory quarantine rules for Ebola health workers who've been in West Africa taking effect in a number of states, are more challenges likely?

A: You bet.

___

AP Medical Writer Lauran Neergaard contributed to this report.

___

Online:

CDC guidelines: http://www.cdc.gov/vhf/ebola/exposure/monitoring-and-movement-of-persons-with-exposure.html

___


http://news.yahoo.com/ebola-quarantines-states-201954973--politics.html

[Buster's Uncle]

Ebola: Danger in Sierra Leone, progress in Liberia
Associated Press
By CLARENCE ROY-MACAULAY and JONATHAN PAYE-LAYLEH  4 hours ago



The British ship RFA Argus docks at the port in Freetown, Sierra Leone, Thursday, Oct. 30, 2014. The Royal Fleet Auxiliary Argus docked at The Queen Elizabeth II quay in Freetown Thursday unloading 32 pickup trucks to be used in the Ebola response in Freetown. The ship is also equipped with three Merlin MK2 helicopters that will be used to transport resources and personnel to the remote regions of Sierra Leone. (AP Photo/ Michael Duff)



FREETOWN, Sierra Leone (AP) — Liberia is making some progress in containing the Ebola outbreak while the crisis in Sierra Leone is going to get worse, the top anti-Ebola officials in the two countries said.

International assistance is still desperately needed and the people of both countries must redouble efforts to stop the disease, which has infected more than 13,000 people and killed nearly 5,000, the officials said.

Their assessments underscore that Ebola remains a constant threat until the outbreak is wiped out. It can appear to be on the wane, only to re-emerge in the same place or balloon elsewhere if people don't avoid touching Ebola patients or the bodies of those who succumb to the disease.

To help respond to the growing crisis in Sierra Leone, a British naval ship, carrying hundreds of troops, medical supplies, helicopters and trucks, docked in the capital on Thursday.

"With all these facilities, they will go a long way in the ongoing fight against the Ebola disease," Alfred Palo Conteh, the new head of the country's National Ebola Response Center, said Thursday, as he greeted the arriving ship.

On Wednesday, Conteh had warned that more needed to be done.



The Royal Fleet Auxiliary Argus is seen unloading one of the 32 pickup trucks at The Queen Elizabeth II quay in Freetown, Sierra Leone, Thursday, Oct. 30, 2014. The Royal Fleet Auxiliary Argus docked at in Freetown Thursday unloading trucks to be used in the Ebola response in Freetown. The ship is also equipped with three Merlin MK2 helicopters that will be used to transport resources and personnel to the remote regions of Sierra Leone. (AP Photo/ Michael Duff)


"We are in a crisis situation which is going to get worse," Conteh told reporters. "What is happening now should have been done three months ago."

The stark warning and call to action were echoed by others, even in neighboring Liberia, where the World Health Organization has said the rate of infection appears to be slowing, perhaps by as much by 25 percent week over week.

"We need to re-galvanize our efforts, accelerate the interventions, remain vigilant," said Tolbert Nyenswah, the assistant minister of health who leads the Liberian government's Ebola response.

The WHO announcement has given Liberia a reason "to put our shoulders to the wheel so that Ebola can be something of the past," Deputy Information Minister Isaac Jackson told a news conference Thursday. "We are not going to relax."

World Health Organization officials also urged caution in giving the news, saying the gains could be reversed.



The Royal Fleet Auxiliary Argus is seen unloading one of the 32 pickup trucks at The Queen Elizabeth II quay in Freetown, Sierra Leone, Thursday, Oct. 30, 2014. The Royal Fleet Auxiliary Argus docked =in Freetown Thursday unloading pickup trucks to be used in the Ebola response in Freetown. The ship is also equipped with three Merlin MK2 helicopters that will be used to transport resources and personnel to the remote regions of Sierra Leone. (AP Photo/ Michael Duff)


But others went further. Alfred Brownell, an activist in Liberia, remembered the moment in the spring when Liberians thought the crisis was over, but then it got worse. Now he is bracing for another potential wave of cases, he said.

"The present epidemic is unpredictable: We have seen a lull in cases in one area only to see the numbers spike again later. More aid is needed on the ground. It's time now to step up contact tracing, safe body management practices and community surveillance," said Fasil Tezera, head of Doctors Without Border's mission in Liberia, even while noting that their 250-bed center in the capital has only about 80 beds occupied.

Liberia is the hardest hit country in the Ebola outbreak sweeping West Africa that has also ravaged Guinea and Sierra Leone.

Still, there are some signs of hope. In Liberia, there has been a decrease in the number of patients seeking Ebola treatment, the number of bodies collected and the number of lab-confirmed cases, according to Nyenswah.

In Sierra Leone, even though the outbreak is now hitting areas in and around the capital, the country's east has seen the disease wane. Conteh, the country's top anti-Ebola official, urged people to follow the example of Kailahun and Kenema Districts, by not touching the sick or dead.



Vehicles are seen aboard the British Royal Fleet Auxiliary (RFA) Argus as it is docked at the port in Freetown, Sierra Leone, Thursday, Oct. 30, 2014. The Argus docked at the Queen Elizabeth II quay in Freetown Thursday where it unloaded 32 pickup trucks to be used for the Ebola virus response in Freetown. The ship is also equipped with three helicopters that will be used to transport resources and personnel to remote regions of Sierra Leone. (AP Photo/ Michael Duff)


He added that international assistance is growing: Up to 700 beds will be set up in treatment centers and the United Nations has four helicopters in the country.

The British ship the Argus docked Thursday in the country carrying 300 military personnel, 32 pick-up trucks, three helicopters, and medical and other supplies. Although it has a hospital on board, it will not accept patients on this mission. Instead, it will serve as a hangar and take-off and landing zone for the helicopters. The helicopters will ferry supplies and people to hard-to-reach areas of the country, said Commanding Officer Ross Spooner.

The outbreak has taken a particularly high toll on health workers, sickening more than 520, and greatly reducing the health system's capacity to respond in the three most-affected countries.

The World Bank announced Thursday that it will give an additional $100 million to help bring in more foreign health workers. The new funds will be used to train, pay and house health workers while they're in the Ebola hot zone and provide medical care or evacuation for anyone infected.

If the virus continues to surge in the worst-affected countries and spreads to neighboring countries, the financial impact could reach $32.6 billion by the end of 2015, the bank has warned.

___

Paye-Layleh reported from Monrovia, Liberia. Associated Press writer Francis Kokutse in Accra, Ghana, contributed to this report.


http://news.yahoo.com/liberia-official-good-progress-against-ebola-081731249.html

[Buster's Uncle]

U.S. quarantines 'chilling' Ebola fight in West Africa: MSF
Reuters
By Jonathan Allen  6 minutes ago



NEW YORK (Reuters) - Mandatory quarantines ordered by some U.S. states on doctors and nurses returning from West Africa's Ebola outbreak are creating a "chilling effect" on Doctors Without Borders operations there, the humanitarian group said on Thursday.

In response to questions from Reuters, the group said it is discussing whether to shorten some assignments as a result of restrictions imposed by some states since one of its American doctors, Craig Spencer, was hospitalized in New York City last week with the virus.

"There is rising anxiety and confusion among MSF staff members in the field over what they may face when they return home upon completion of their assignments in West Africa," Sophie Delaunay, executive director of Doctors Without Borders, said in a statement emailed to Reuters. Doctors Without Borders is also known by its French name, Médecins Sans Frontières, or MSF.

Some MSF workers are delaying their return home after their assignments and staying in Europe for 21 days, Ebola's maximum incubation period, "in order to avoid facing rising stigmatization at home and possible quarantine," Delaunay said in her statement.

"Some people are being discouraged by their families from returning to the field," she said.

The governors of New York and New Jersey announced strict new screening rules at airports last Friday, including mandatory 21-day quarantines for any healthcare worker who had been treating Ebola patients in West Africa.

Only one person is known to have been quarantined as a result of the new rules, nurse Kaci Hickox, who was confined to a tent against her will for several days after arriving at Newark Liberty International Airport in New Jersey last Friday. Hickox, 33, was returning from Sierra Leone, where she had cared for Ebola patients as an MSF healthcare worker.

Hickox, who tested negative for Ebola and says she is completely healthy, has strongly criticized the quarantine policy in New Jersey and then in her home state of Maine, where she was taken to finish her 21-day quarantine at home.

She went for a bike ride on Thursday, putting her on a collision course with Maine Governor Paul LePage, whose office said he would exercise his legal authority to keep her quarantined.

(Reporting by Jonathan Allen; Editing by Jonathan Oatis)


http://news.yahoo.com/u-quarantines-chilling-ebola-fight-west-africa-msf-220107622.html

[Buster's Uncle]

Stopping Ebola: How Small Changes Make a Big Difference
LiveScience.com
By Rachael Rettner  8 hours ago


NEW YORK — Small changes in the way Ebola interventions are carried out in West Africa could make a big difference in curbing the growth of the epidemic, experts said this week.

"Modest changes of performance," could be the factor that determines whether there is an exponential rise in cases, or the epidemic becomes self-limiting, said Jeffrey Sachs, director of The Earth Institute at Columbia University, who spoke at a conference on Ebola here this week.

At the conference, Sachs showed graphs depicting what would happen in a given Ebola outbreak if the people who were sick with Ebola left their homes to get medical care on the third day that they had symptoms, compared with if they stayed home until the sixth day (and hence infected more members of their households).

With care on the third day, the outbreak would be contained; with care on the sixth day, the outbreak would continue to grow exponentially, according to the model Sachs showed.

"Slight changes to the rate at which an infected individual is picked up [and sent to the hospital leads to] quite dramatic changes in the dynamics of the epidemic," Sachs said.

Dr. Ranu Dhillon, a senior health advisor at the Earth Institute who is currently in Guinea, agreed. Speaking at the conference via a video call, Dhillon said it's important not to just have more hospital beds, but also to get people with symptoms to hospitals faster. "We can control [the] outbreak with fewer beds than we're talking about now," if people with Ebola are transported to the hospital more quickly, Dhillon said.

Other small changes, such as better identification of Ebola cases and safer burials, may also make a big difference, Sachs said. To stop the growth of the outbreak, health officials need to reduce the number of new people who a given person with Ebola infects (the so-called "reproduction number") to less than one, on average, Sachs said. (The reproduction number during the current Ebola outbreak is between 1.5 and 2.5, according to a recent study in the journal PLOS Currents: Outbreaks.)

As of Oct. 24, more than 10,000 people had become sick with Ebola, and 4,900 had died, in Guinea, Liberia and Sierra Leone, according to the Centers for Disease Control and Prevention.

Health officials have repeatedly said that they know how to stop Ebola outbreaks — by identifying people who have contact with Ebola patients, following them for 21 days, testing them if they develop symptoms, and ensuring safe burials, and repeating the cycle until the chain of transmission is stopped, said Anne Liu, associate director of Health Systems Development at the Earth Institute.

However, "this can become very complicated with many moving pieces, Liu said. "Any gap in the chain allows for Ebola transmission to continue."

An important step to help prevent those gaps would be to put in place stronger management systems to coordinate all of the people involved in stopping the chain of transmission, Liu said. "This is an urgent epidemic and we cannot afford to lose time."

There are a number of other challenges in addressing the Ebola outbreak. Dhillon said that in Guinea, there are just two laboratories capable of performing the tests for Ebola, which makes testing for the virus difficult.

In addition, people with Ebola are hesitant to come forward to health officials, because they see the treatment as a death sentence, Dhillon said. Care needs to improve, Dhillon said, because people will only come forward if they know there is hope for getting better.

Trust is also an issue, and building trust among people in the community would help health officials better understand where cases are occurring, Dhillon said.

Dhillon called for a greater sense of urgency in responding to the West African outbreak. "There are difficult steps that need to be taken, but we don’t have a choice," Dhillon said. "If what's happening here were happening across the state of New York, what would we do and how would we act?"


http://news.yahoo.com/stopping-ebola-small-changes-big-difference-135727790.html