Ebola news 10/31

[Buster's Uncle]

Ebola 'Patient Zero': How Outbreak Started from Single Child
LiveScience.com
By Bahar Gholipour  1 hour ago


When Ebola virus came for the first time to a small village in Guinea, the victim was a toddler, who later became known to the world as Patient Zero. He died on Dec. 6, 2013, at age 2, and the domino effect of his illness has spiraled into the outbreak currently ravaging three nations in West Africa.

His name was Emile Ouamouno.

Emile's 3-year-old sister, his mother and his grandmother all died by January, leaving his father behind.

"Emile liked to listen to the radio, and his sister liked to carry babies on her back," Emile’s father, Etienne Ouamouno, told Suzanne Mary Beukes, a communication officer for the United Nations' children's agency, UNICEF. The siblings liked to dance and play ball near their house, he said.

The disease detectives who traced the Ebola outbreak back to the toddler still don't know how he got infected, according to their report published in the Oct. 9 issue of the New England Journal of Medicine.

The child may have contracted the disease through contact with a fruit bat, as the animals are reservoirs of the virus. Most likely, the outbreak started from only this toddler and no one else, the researchers said, because their genetic analysis of the viruses found in multiple patients' blood samples showed great similarities within the samples. This suggests that the outbreak started from a single introduction of the virus from animals into the human population, the researchers wrote in their report.


Exponential growth

Emile lived in the village of Meliandou in the Guéckédou region of Guinea, just a few miles away from the country's borders with Liberia and Sierra Leone. After Emile and his family members became sick, two health care workers in the village — a nurse and the village midwife — also contracted Ebola and died.

But the sick midwife was cared for by a family member who lived in nearby Dandou Pombo village, and then six additional deaths occurred in that location. The virus also spread to Gbandou and Dawa villages by family members who attended the funeral of Emile's grandmother.

The outbreak escalated from there: A health care worker who may have been infected in Dawa or Meliandou, went to a hospital in another town, Macenta, resulting in 15 additional cases there. The virus also reached people in two other districts in Guéckédou, as well as Kissidougou.

On March 10, hospitals in Guéckédou and Macenta alerted the Ministry of Health of Guinea and Doctors without Borders in Guinea about clusters of a mysterious disease. An epidemic of Ebola was declared on March 23.

By then, the virus had spread to people in Liberia and Sierra Leone. It likely traveled to Sierra Leone by a traditional healer who treated Ebola patients across the border in Guinea, said a study published Aug. 28 in the journal Science. Investigators found that 14 of the mourners who attended this healer's funeral contracted the virus.

Now, nearly a year later after Emile died, the three countries have seen more than 10,000 cases of Ebola, and more than 4,900 people have died of the disease, according to the World Health Organization.


Lingering fears

Since April, there have been no more Ebola cases in Emile's village, Meliandou authorities say. But the villagers are struggling with the financial consequences caused by social stigmas, as they are now unable to sell their produce, Beukes wrote. What's happening to the village is part of a bigger picture of what Guinea is facing. More than half of Guineans live below the national poverty line; about 20 percent live in extreme poverty. And with the Ebola outbreak, the situation may get even worse.

"The World Bank estimates the country could see a loss of up to 2.3 percent of its GDP as a result of the stigma now cast over Guinea by travelers, traders and potential investors," Beukes wrote. "The world has virtually quarantined a country in which 43 percent of people were already living on less than $1.25 a day prior to this health crisis."

[Buster's Uncle]

Death or Full Recovery? Ebola Outcome May Depend on Your Genes
LiveScience.com
By Bahar Gholipour  1 hour ago



A magnified view of the Ebola virus particles (in red) on the surface of a cell (in blue).



To study the relationship between genes and the virus, researchers used a group of mice that were bred to have high genetic diversity, as opposed to the typical laboratory mice, which are produced by many generations of inbreeding and are therefore extremely similar. Normally, classic lab mice don't develop the symptoms of Ebola that are seen in people, even though the animals do die from a lethal dose of the virus.

In the study, among the genetically diverse mice, the researchers saw a full range of Ebola symptoms when they infected the animals with the virus. Some mice were resistant to infection, some showed symptoms but survived, and some were similar to classical lab mice (they died without showing bleeding symptoms). About 40 percent of the animals developed blood and liver problems similar to the hemorrhagic disease that is seen in some Ebola patients, the researchers said.

The findings suggest that "the genetic background of the individual who is infected plays a really significant role in determining how serious their Ebola virus disease is going to be," said co-author Angela Rasmussen, a virologist at the University of Washington.

The research, which began well before the current Ebola outbreak in West Africa, was done in collaboration with the University of North Carolina at Chapel Hill and the National Institutes of Health (NIH). The researchers worked with Ebola virus in an NIH "level 4" lab in Hamilton, Montana, which was designed with all the safety measures required for working with highly dangerous infectious organisms.

The study was published today (Oct. 30) in the journal Science.


Genes and the virus

The interplay of the Ebola virus and the body's own genetic factors is not unique. In many diseases, scientists have found that the host's response to an infection early on is related to how the disease unfolds.

"We have been working with these mice for other infectious conditions, and we saw an expanded range of disease outcomes with influenza," Rasmussen said. Moreover, other scientists working on cancer and diabetes have reported broad ranges of disease in genetically diverse mice. "So we hypothesized that the same will be true for Ebola," Rasmussen said.

In the study, all the mice lost weight in the first few days after infection. Some of the mice fully recovered. Others developed liver inflammation without the classic symptoms of Ebola, but some had blood that took too long to clot, a hallmark of fatal Ebola hemorrhagic fever in humans. Those mice developed internal bleeding, swollen spleens and changes in liver color and texture.

The researchers found certain genetic differences appeared to be linked to disease outcome among the animals.

"Depending on what kind of disease outcome you have, different genes get turned off and turned on," Rasmussen said.

For example, genes involved in the health of the body's blood vessels were turned down in mice that developed hemorrhagic disease, she said. "We think that control of the inflammation within the vascular system may be important in terms of controlling the hemorrhagic disease that you see in Ebola patients sometimes."

The spectrum of the disease seen in the mice was similar to that observed in the current West African outbreak, the researchers said. In the outbreak, about 18 percent of patients are developing hemorrhagic syndrome, according to the Centers for Disease Control and Prevention. It's not known how commonly people may be resistant to Ebola, because those who might have developed mild or asymptomatic infections, that don't need medical care, wouldn't get documented.


Ebola patients

In the next steps, the scientists are planning to work to better identify the genes in mice that may be critically important in the disease outcome, and then eventually see if those same genes are at work in people with Ebola, Rasmussen said.

Right now, studying genetic differences between Ebola patients is difficult, especially without knowing where to look in the genome. "You'd really need a lot of people to start making really concrete conclusions about genes that may or may not be playing a role," Rasmussen said.

Genes may turn out to be important in determining the fate of Ebola patients, but they would be just one of the factors involved, Rasmussen noted. The mice in the study were all given the same dose of the virus, via the same route of infection, and they didn't receive treatment.

In human populations, people are infected with varying doses of virus, depending how they get infected, and they also vary in the supportive care and other treatment they receive. Presumably in humans a combination of these things will ultimately contribute to the outcome, Rasmussen said.


http://news.yahoo.com/death-full-recovery-ebola-outcome-may-depend-genes-144136480.html

[Buster's Uncle]

To stop Ebola's spread in West Africa, target funerals: study
Reuters
By Sharon Begley  9 hours ago



Volunteers lower a corpse, which is prepared with safe burial practices to ensure it does not pose a health risk to others and stop the chain of person-to-person transmission of Ebola, into a grave in Kailahun August 2, 2014. REUTERS/WHO/Tarik Jasarevic/Handout via Reuters



NEW YORK (Reuters) - As the global health community ramps up its efforts to treat Ebola patients and curb its spread in West Africa, a new analysis finds that the greatest impact would come from insuring safe burials for victims, scientists reported on Thursday.

The need for safe burials has been known from the beginning of the epidemic last spring, when people who attended the funeral of a faith healer in Guinea became infected.

U.S. guidelines call for workers wearing full protective gear to wrap the remains of Ebola victims, which have an extremely high concentration of the virus, in a plastic shroud and then place them in two body bags. The body should not be washed or handled in any way, something that has been a common practice in much of West Africa.

The new findings, published in the journal Science, are based on a mathematical model being developed by Ebola researchers at Yale School of Public Health.

It takes into account data from the current outbreak and previous ones, including how long people harbor the virus before becoming ill, how long they are infectious, and what percentage are isolated at home or in a treatment center.

Similar models have already informed public policy. A U.S. projection that there could be 1.4 million cases in Liberia and Sierra Leone by late January spurred some Western countries to commit more funds and personnel to curb the worst Ebola outbreak since the disease was identified in 1976.

The Yale model calculates the spread of Ebola in the community, in hospitals and at funerals, including how many secondary cases are caused by the average case in each setting.

If transmission in the community or in hospitals could be eliminated through better isolation practices, Yale's Alison Galvani and her colleagues found, each Ebola case would still cause 1.4 or 1.5 additional infections.

But if transmission via burial practices were eliminated, the secondary infection rate would drop below one per Ebola case, the sole way epidemics peter out.

"Reducing transmission in hospitals and the community is insufficient to stop the exponentially growing epidemic," the scientists wrote. The most effective intervention is halting burial practices in which mourners handle bodies, which "are effectively serving as superspreader events."

Because making all Ebola burials sanitary might not be feasible, said Yale's Martial Ndeffo-Mbah, the Ebola response must also continue to isolate cases.

Other modelers predicted the study's emphasis on funerals would be "quite controversial," according to biostatistician Ira Longini of the University of Florida.

Longini and colleagues at Northeastern University created a mathematical model that shows that most Ebola transmission occurs in the community and within households, so isolating patients would have the most effect on the epidemic.

Still, "Liberia has concentrated hard on the funeral problems," Longini said, and is now seeing fewer new cases than in recent weeks.


http://news.yahoo.com/stop-ebolas-spread-west-africa-target-funerals-study-071826419.html

[Buster's Uncle]

African funeral rites are 'superspreaders' of Ebola: study
AFP  21 hours ago



A man walks in the Tweh farm cemetery on September 30, 2014 in Monrovia (AFP Photo/Pascal Guyot)



Washington (AFP) - Traditional funeral rites in West Africa that include kissing and touching a dead body are "superspreaders" of Ebola and must be halted, researchers said Thursday.

If not, Liberia can expect 224 new cases per day by the beginning of December, and 348 new Ebola infections per day by the end of December, according to the study in the journal Science.

"To stem Ebola transmission in Liberia, it is imperative to simultaneously restrict traditional burials, which are effectively serving as superspreader events," it said.

Funeral practices often include washing, touching and kissing bodies that are still capable of transmitting Ebola, and may have particularly high levels of the live virus in excretions.

The findings were based on mathematical modeling done by scientists at Yale University, Oregon State University and the Ministry of Health in Liberia, the country hardest hit by the current Ebola epidemic.

"It is imperative that funeral transmission be stopped," said Jan Medlock, an assistant professor in the OSU Department of Biomedical Sciences and an expert in mathematical epidemiology and the evolution of infectious disease.

"The cultural body preparation and funeral practices that are common in West Africa have driven the initial spread of this disease."

The virus has already infected more than 13,000 people in West Africa since the beginning of the year and killed more than 4,900 according to the World Health Organization.

Ebola is spread through close contact with the bodily fluids of an infected person or a person who has recently died of the virus.

While it is important to isolate patients, trace their contacts and provide better protection for health care workers, these measures alone are insufficient, the researchers said.

Every two Ebola cases currently result in the infections of three more people in Liberia, the study found.

A better way to safely bury the dead would be to disinfect "the cadaver before placing it in a plastic body bag and doing further disinfecting," said the study.

The authors also called for substantial international aid to help end the outbreak.


http://news.yahoo.com/african-funeral-rites-superspreaders-ebola-study-195237488.html

[Buster's Uncle]

Flu or Ebola? US hospitals prepare for a confusing season
AFP
By Kerry Sheridan  45 minutes ago



Washington (AFP) - After weeks of Ebola panic, false alarms and quibbles over quarantine in the United States, health authorities are bracing for a new battle: flu season.

The end of October marks the start of influenza season, bringing with it the predictable sniffles, sneezes, fever and aches that can extend well into the spring months.

But this year is different for two reasons. First is the Ebola epidemic in West Africa that spilled into the United States when a Liberian man traveled to Texas in September and infected two nurses who helped care for him.

The second is the late summer outbreak of enterovirus D68, a respiratory illness that has sickened more than 1,100 people in 46 states since August, the US Centers for Disease Control and Prevention said.

Most areas of the country are reporting a decline in EV-D68, but seven states including California say they are still seeing increases.

There is no vaccine against the EV-D68, which has been linked to paralysis and neurologic symptoms in a small number of child patients.

Nor is there any treatment on the market to cure or prevent Ebola, though experimental vaccines are being fast-tracked.

The prospect of facing all three illnesses in a single season has led the CDC to start a public education campaign to help people understand the risks, and to remind people to get their annual flu vaccine.

"There may be some public concern or confusion between seasonal influenza and Ebola this season," a CDC spokeswoman said in an email to AFP, citing past experience with fears over the Middle East respiratory syndrome (MERS) and Severe acute respiratory syndrome (SARS).

"Flu-like symptoms in US residents this flu season will most likely be caused by seasonal influenza, not Ebola."


- Similar symptoms -

Flu and Ebola share some common symptoms, such as fever, headache, fatigue and aches and pains.

But there are big differences, too. Influenza causes cough, sore throat and runny nose, while Ebola does not.

Ebola leads to vomiting and diarrhea within three to six days, severe weakness and stomach pain, as well as unexplained bleeding and bruising.

To illustrate these differences, the CDC has issued a flyer titled "Flu or Ebola?" that offers a side-by-side comparison, available at www.cdc.gov/vhf/ebola/pdf/is-it-flu-or-ebola.pdf.

The simple, bold print is accompanied by graphics, including one person sneezing on another to show how flu transmits by droplets spewed when sick people cough, sneeze or talk.

Ebola transmission is illustrated by a bright red blood drop and needle. "Ebola can only be spread by direct contact with blood or bodily fluids," the flyer says.

As part of increased screening measures, patients around the country are now asked to fill out a questionnaire asking if they have traveled to West Africa recently and if they have any Ebola symptoms.

"Everybody is screening now, in outpatient offices, in hospital emergency rooms, in ambulatory centers," said Debra Spicehandler, infectious disease expert at Northern Westchester Hospital in New York.

"The only problem is we are all spending a lot of time getting prepared for Ebola, so we may have lost our focus a bit on influenza and preparation for the influenza season," she told AFP.

The CDC recommends an annual flu shot for everyone over six months of age, preferably by the end of October.

Last year, 42 percent of adults and 59 percent of children received their flu shots. The CDC said it is too early to tell how many have received their vaccinations this year.


- By the numbers -

Every year, between five and 20 percent of Americans get the flu, as many as 200,000 are hospitalized and deaths have reached as high as 49,000 in recent decades, the CDC says.

Worldwide, the flu infects anywhere from three to five million people per year and kills up to 500,000, according to the World Health Organization.

The current outbreak of Ebola in West Africa is the world's largest in history, killing more than 4,900 people and infecting more than 13,000 since the beginning of the year.

Ebola is rare, but lethal about half the time. Of the nine patients treated for Ebola in US hospitals this year, however, just one has died.

The flu is common, but rarely lethal except among the young, the elderly and those with weakened immune systems.

Only a doctor can tell if a patient should be tested for Ebola, based on travel history and potential exposure to infected patients.

"The important thing is not to panic. The most important thing to be concerned about is the flu, not Ebola," said Robert Glatter, an emergency physician at Lenox Hill Hospital in New York.

"The most important thing people can do is get a flu shot."


http://news.yahoo.com/flu-ebola-us-hospitals-prepare-confusing-season-164009730.html

[Buster's Uncle]

Judge enforces Ebola isolation of defiant Maine nurse
Reuters
By Joel Page  17 minutes ago



Kaci Hickox (L) and boyfriend Ted Wilbur go for a bike ride in Fort Kent, Maine October 30, 2014. Hickox, who treated Ebola patients in Sierra Leone but has tested negative for the virus, ventured out of her home Thursday, defying a Maine quarantine order and setting up a legal collision with state authorities. (REUTERS/Ashley L. Conti/Bdn)



FORT KENT Maine (Reuters) - A judge on Friday ordered an American nurse who treated Ebola patients in Sierra Leone for the disease to obey a state-imposed quarantine after she defied Maine officials and went for a bike ride.

The temporary order from Charles LaVerdiere, chief judge of the Maine District Court, turned up the heat in the confrontation over the quarantine between the New England state's officials and nurse Kaci Hickox.

LaVerdiere instructed Hickox to submit to "direct active monitoring" and "not to be present in public places" like shopping centers, movie theaters or workplaces, except to receive necessary healthcare.

Hickox, 33, has tested negative for Ebola after returning from working for Doctors Without Borders in Sierra Leone, one of the three impoverished West African countries at the heart of the outbreak that has killed about 5,000 people there. Saying she is completely healthy, she has challenged quarantines imposed on her in both New Jersey, where she arrived, and her home state of Maine.

The confrontation between Hickox and Maine has become the focal point of a dispute pitting several U.S. states opting for stringent measures to guard against Ebola against the federal government, which has expressed concern that such measures could discourage potential medical volunteers from fighting the outbreak in West Africa.



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)


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.

The Maine order permits Hickox to engage in what the judge called "non-congregate public activities" like walking or jogging in a park, but instructs her to maintain a three-foot (1-metre) distance from other people.

Outside her two-story home on Friday, there were numerous journalists and television news trucks, as well as a state trooper parked across the street to keep an eye on the house. The local police chief entered the home but afterward declined to tell reporters what was discussed, saying it was a "good morning conversation." Hickox did not appear in public.

Judge LaVerdiere wrote that his order came in response to the state's request "regarding the public health threat allegedly posed" by the nurse.

The order, dated on Thursday but made public on Friday, said Hickox's attorney agreed that the nurse would not leave her home for the time being. LaVerdiere wrote that a full hearing on the matter must be held not less than three days and not more than 10 days from when the state sought to enforce its quarantine.

On Thursday, Hickox defied Maine officials and left her home in the small town of Fort Kent, along the Canadian border, taking a bicycle ride with her boyfriend. Hickox had given Maine a deadline of Thursday to lift an order that she remain at home until Nov. 10. The state did not lift the quarantine.

Maine Governor Paul LePage's office said on Thursday that 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."

The nurse previously blasted New Jersey Governor Chris Christie after she was taken from Newark's airport and put in isolation in an unheated tent before being taken to Maine to spend the rest of her 21-day quarantine at home. Twenty-one days is the maximum incubation period for Ebola.

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

In New York on Friday, U.S. Ambassador to the United Nations Samantha Power defended federal guidelines for monitoring healthcare workers returning from the three Ebola-stricken countries. Power spoke at a Reuters Newsmaker event hours after returning from a four-day trip to Liberia, Guinea and Sierra Leone.

She said she believed current federal guidelines for returning healthcare workers balanced "the need to respond to the fears that this has generated" in the United States with the known science on the disease.

(Additional reporting by Brendan O'Brien)


http://news.yahoo.com/nurse-defies-ebola-quarantine-bike-ride-negotiations-fail-013108894.html

[Buster's Uncle]

U.S. envoy to U.N. defends Ebola guidelines; praises airlines
Reuters
By Louis Charbonneau and Bill Berkrot  37 minutes ago



U.S. Ambassador to the United Nations Samantha Power speaks during a Reuters Newsmaker panel discussion, "The Ebola Crisis: How it Arose and What you Need to Know" in New York, October 31, 2014. REUTERS/Andrew Kelly



NEW YORK (Reuters) - U.S. Ambassador to the United Nations Samantha Power on Friday defended federal guidelines for monitoring health workers returning from three Ebola-stricken West African countries and praised the airlines still flying there.

Amid controversy in the United States over some states ordering 21-day quarantines for nurses and doctors returning home after treating Ebola patients, Power said current federal rules balanced "the need to respond to the fears that this has generated" with the known science on the disease.

"Let me commend Air Brussels, Air France and Moroccan Airways for keeping their flights going. Those flights are a lifeline," Power said at a Reuters Newsmaker event in New York hours after returning from a four-day trip to Ebola-hit Liberia, Guinea and Sierra Leone, with a quick stop to drop her son off at school.

Ebola, which has killed about 5,000 people in the three countries, is transmitted through the bodily fluids of an infected person and is not airborne. Some states, including New York and New Jersey, have gone beyond the U.S. guidelines with isolation periods for health workers equivalent to the maximum time it can take for Ebola to develop.

Power said she was considered at low risk for contracting the virus because she did not have direct contact with Ebola patients while in West Africa. She said she had her temperature taken three times before boarding a plane home from Liberia and was checked again upon arriving at New York's John F. Kennedy International Airport.



U.S. Ambassador to the United Nations, Samantha Power, (R) visits the Western Area Emergency Response Centre in Freetown, Sierra Leone, October 27, 2014. REUTERS/Michelle Nichols


Several U.S. politicians have called for a outright ban on flights from Liberia, Sierra Leone and Guinea, which government and aid organizations said would hurt efforts to control the outbreak at its source by deterring medical volunteers.

Power said health officials are capable of self monitoring with regular checks for symptoms, which can include fever, diarrhea and vomiting.

The envoy had high praise for countries that have people on the ground battling the epidemic, including Cuba, with which the United States has had strained relations and economic bans for decades, and China.

"Although I did not encounter them personally, I have to commend Cuba..." Power said. Havana has sent more than 260 medical professionals and plans on assigning 200 more.

"One hopeful sign I saw as I left Liberia ... was a big old Air China cargo plane, which was offloading a huge number of supplies, and it was American soldiers, Liberian soldiers and the Chinese workers on the plane who were doing it together," Power said.

"These kinds of infusions are very important and I think China's response is steadily increasing," the envoy said.

In the diplomatic way that only a professional diplomat could put it, Power responded to a direct question by suggesting that France could be doing more in Guinea.

"There's a command and control issue in Guinea," she said, adding that the United Nations command center and that of Guinea officials should be co-located for better coordination.

"I think the French, because of the French speaking aspect of this, could play an important role," Power said.

(This story has been refiled to correct to 'Power' instead of 'Powers' in third paragraph)

(Reporting by Louis Charbonneau and Bill Berkrot; Editing by Jonathan Oatis and Grant McCool)


http://news.yahoo.com/samantha-power-defends-ebola-guidelines-praises-airlines-150518445--finance.html

[Buster's Uncle]

Africans worst responders in Ebola crisis
Associated Press
By MICHELLE FAUL  1 hour ago



The World Health Organization said Wednesday, the rate of new Ebola infections in Liberia appears to be declining and could represent a genuine trend, but the epidemic is far from over. Dr. Bruce Aylward, an assistant director-general for WHO, warned, 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. Several times during the outbreak officials have thought the disease's spread was slowing, only to surge again later.



JOHANNESBURG (AP) — The head of Africa's continental body did not get to an Ebola-hit country until last week — months after alarm bells first rang and nearly 5,000 deaths later.

Pledges to deploy 2,000 African health workers have remained largely that — promises.

No African countries are on the United Nations list of contributors to fight the epidemic.

The E-word did not even figure on the agenda of a session on peace and security at the Pan-African Parliament in South Africa last week — more than a month after the U.N. Security Council declared the Ebola outbreak a "threat to international peace and security."

Angry legislators from Sierra Leone and Liberia got up to protest. "They said as far as they are concerned, nobody wants to talk about Ebola," said Jeggan Grey-Johnson, a governance expert who watched the session.

"They said countries like Liberia feel totally abandoned by the rest of Africa and shut off from the rest of the continent," he told The Associated Press.



In this Tuesday, Sept. 23, 2014 file photo, Nkosazana Dlamini Zuma, chairperson of the African Union Commission, speaks at United Nations headquarters in New York. The head of Africa’s continental body did not get to an Ebola-hit country until last week - months after alarm bells first rang and nearly 5,000 deaths later. (AP Photo/Seth Wenig, File)


With few exceptions, African governments and institutions are offering only marginal support as the continent faces its most deadly threat in years, once again depending on the international community to save them.

Ebola "caught us by surprise," the chairwoman of the 53-nation African Union, Nkosazana Dlamini-Zuma, said this week at a meeting with the U.N. secretary-general and the World Bank president in Ethiopia.

"With the wisdom of hindsight, our responses at all levels - continental, global and national - were slow, and often knee-jerk reactions that did not always help," she said.

She is a medical doctor from South Africa, where mining magnate Patrice Motsepe Tuesday announced he has donated $1 million to the fight against Ebola in Guinea, where the outbreak started.

Motsepe's gift, the largest donation by far from any African individual, came after the World Food Program lashed out at China's billionaires, saying their contributions lagged behind their companies' huge economic interests in the mineral-rich region. Motsepe's office said his company has no interests in any of the countries where Ebola is raging out of control — Guinea, Sierra Leone and Liberia. China's government has sent many health workers and given more than $8 million with a promise of $6 million more to the U.N. Ebola fund.



In this photo taken on Monday, Oct. 27, 2014, health workers prepare to place the body of a man who was suspected of dying from the Ebola virus into a grave on the outskirts of Monrovia, Liberia. The head of Africa’s continental body did not get to an Ebola-hit country until last week - months after alarm bells first rang and nearly 5,000 deaths later. (AP Photo/Abbas Dulleh)


"Ebola is first and foremost our problem," the president of the African Development Bank, Donald Kaberuka, told a business forum in Brussels this month. "Before relying on international aid, we must first encourage Africans to take action."

The African Development Bank is the second largest institutional contributor to the U.N. fund to fight Ebola, second only to the World Bank, having given $45.4 million and promised another $17.4 million. In addition it has given loans and grants individually to the most affected countries.

By contrast, the African Union has made an "uncommitted pledge" of just $700,000. Africa's equivalent of the Organization of America States, it is the body many believe should have taken the lead from the start.

No finger has been pointed at the Africans, even as rich countries have blamed each other for delays in responding to the crisis and the lack of financing. WHO chief Margaret Chan has said that governments have the first responsibility for taking care of their citizens, including in West Africa.

The WHO identified the first Ebola case in Guinea on March 21; on March 30 the virus crossed the border into Liberia; Sierra Leone reported its first two cases on May 30. On June 20, with some 330 recorded deaths, Doctors Without Borders warned that the outbreak was "totally out of control."



In this photo taken Wednesday, Oct. 29, 2014, a medical car that will be used for the fight against the Ebola virus is unloaded upon arrival by air from the United States at an airport in Conakry, Guinea. The head of Africa’s continental body did not get to an Ebola-hit country until last week - months after alarm bells first rang and nearly 5,000 deaths later. (AP Photo/Youssouf Bah)


Yet it was only on Sept. 20 that the first team of 30 military and civilian volunteers were deployed by a newly designated African Union Support to the Ebola Outbreak in West Africa. Most costs for that mission are being paid by the U.S. and other governments.

Jacob Enoh Eben, spokesman for the AU chairwoman, said more than 2,000 volunteers have been pledged to date: 1,000 from Congo, 600 from the East African Community, 500 from Ethiopia and 506 from Nigeria.

But he said they still need to know "when the first of these pledges will materialize."

Those promised volunteers are only a tiny fraction of the number needed to stem the outbreak. The European Union said this week it is looking to put 40,000 local and European workers into place in the affected countries.

Uganda and Congo, which both have experienced Ebola outbreaks in the past, already have medical teams deployed in Liberia, under contract to WHO and not funded by their governments.



In this photo taken Wednesday, Oct. 29, 2014, a medical car that will be used for the fight against the Ebola virus is unloaded upon arrival by air from the United States at an airport in Conakry, Guinea. The head of Africa’s continental body did not get to an Ebola-hit country until last week - months after alarm bells first rang and nearly 5,000 deaths later. (AP Photo/Youssouf Bah)


It is difficult to say how many Africans are deployed on the front lines of the Ebola battle.

In Uganda, Dr. Anthony Mbonye, the commissioner for community health services at Uganda's Health Ministry, said he believes up to 40 Ugandan health workers are on the ground but that most traveled privately. He said the Ministry of Health had officially approved the deployment of about 10 doctors to Sierra Leone, Liberia and Guinea.

South Africa has been the most responsive African country and has budgeted $3.2 million, according to the Department of Health. That includes funding for a mobile testing lab operating in Sierra Leone since August.

The continental body's lack of a robust response "showed the fragility of our African Union, so heavily dependent on the international community to rescue us from catastrophe," said Isata Kabia, a Sierra Leonean legislator at the Pan-African Parliament.

"We cannot blame the WHO for their lack of knowledge; we can't blame the EU for lack of interest," she told The Associated. "But I think the AU should not only have led the response but also the requests to the international community."

---

Associated Press writer Rodney Muhumuza contributed to this report from Kampala, Uganda, and AP medical writer Maria Cheng contributed from London.


http://news.yahoo.com/africans-worst-responders-ebola-crisis-093307593.html

[Buster's Uncle]

Mali Ebola victim had contact with 141 people, 57 still sought
Reuters
By Tom Miles  45 minutes ago


GENEVA (Reuters) - A 2-year-old girl who brought Ebola to Mali may have had contact with as many as 141 people, 57 of whom have yet to be traced, according to health experts concerned the disease could spread in Mali and beyond.

Two people known to have had contact with the girl were suspected of having the disease, according to a slide presentation by the World Health Organization and the U.S. Centers for Disease Control seen by Reuters on Friday.

One of the two had not been tested and the other had been tested but with no result yet known. Tests for three other suspected cases showed negative results, it said.

The seven-slide presentation breaks down the journey the girl took with her grandmother, uncle and five-year-old sister, and shows she may have had contact with 141 people, although it stresses there may be some double counting in the numbers.

Ebola is contagious when a patient has symptoms, meaning she may have been infectious throughout her long and broken journey from Guinea, where controls are supposed to be in place to screen people for Ebola symptoms before they cross the border.



A health worker checks the temperature of a baby entering Mali from Guinea at the border in Kouremale, October 2, 2014. REUTERS/Joe Penney


If other travelers caught the disease, their onward journeys risk spreading it in the capital Bamako or deeper into Mali, which borders Niger, Algeria, Senegal, Mauritania, Burkina Faso and Ivory Coast. None of them currently have Ebola cases.

The young girl's case made Mali the sixth country in West Africa hit by the worst Ebola outbreak on record, which has killed at least 4,920 people so far, according to the WHO.


CONTACT TRACING EFFORT

The first leg of the girl's journey took her from the border to Bamako by bus. Six of the 10 passengers remain unknown. She then went to and from the Bagadadji neighborhood in 5-seater taxis, with one person in each taxi ride still unknown. It was not clear from the presentation if those were the drivers.

She then sat by the window on a bus from Bamako to Kayes, and 34 contacts from that journey remain unaccounted for.

Nobody at WHO was immediately available to answer questions about the data contained in the presentation.

Contact tracing is seen as the key to stopping new outbreaks. Nigeria and Senegal have already beaten Ebola by meticulous contact-tracing and regular checks on all the contacts who were identified.

The risk of the disease spreading to new areas comes just as the first glimmer of hope appeared at the disease's epicenter, with some signs of a slowdown in its spread in Liberia, although the WHO has said Ebola remains "rampant" in Sierra Leone.

In Guinea, where the outbreak started, a U.N. study has shown the disease has slashed economic growth from 4.5 percent to 2.4 percent, with government expenditure up by $100 million and revenues down by $105 million.

That has prompted the government to revise its budget for the coming months, a U.N. daily update said.

(Reporting by Tom Miles, editing by Stephanie Nebehay and Tom Heneghan)


http://news.yahoo.com/says-two-suspected-ebola-cases-mali-57-contacts-120128398.html

[Buster's Uncle]

Liberia opens 1 of largest Ebola treatment centers
Associated Press
By JONATHAN PAYE-LAYLEH  30 minutes ago



In this photo taken Wednesday, Oct. 29, 2014, aid is offloaded to be used in the fight of the Ebola virus, as it arrives by air from America at the airport in Conakry, Guinea. No African countries are on the United Nations list of contributors to fight the Ebola epidemic, and angry legislators from Sierra Leone and Liberia got up to protest at a session on peace and security at the Pan-African Parliament in South Africa last "They said as far as they are concerned, nobody wants to talk about Ebola," said Jeggan Grey-Johnson, a governance expert. (AP Photo/ Youssouf Bah)



MONROVIA, Liberia (AP) — Liberia's president opened one of the country's largest Ebola treatment centers in Monrovia on Friday, remembering the days when "the dying, the sick, the dead who could not picked up on time" as officials hope the disease is on the decline in this West African country.

American and U.N. officials as well as Cuban doctors were among the crowd as President Ellen Johnson Sirleaf opened the treatment center, which can currently hold 200 patients and could eventually treat as many as 300. With the opening of the center, an Ebola treatment unit at JFK Medical Center has been closed. Many people with other diseases had been nervous about going to the nation's largest referral hospital, and officials hope they will now come back.

The official opening comes as fewer people are showing up for treatment at various centers. Officials are not sure how to interpret that. Some believe it's a sign that the Ebola outbreak is finally on the wane in Liberia, but others believe Sirleaf's order that the bodies of Ebola victims in the capital be cremated has led to people with symptoms hiding at home, because cremation violates traditions.

For example, Doctors Without Borders, known as MSF, said that as of Tuesday there were around 80 patients in its 250-bed facility. "MSF teams are looking into the reasons for this; a widespread aversion to the government's mandatory cremation policy, poor ambulance and referral systems, changes in behavior, and other factors may play a role," the aid group said.

Assistant Health Minister Tolbert Nyenswah, who heads the government's Ebola response, told The Associated Press the JFK Ebola medical team and a team of Cuban doctors will be in charge of the new center, located in Congo Town in eastern Monrovia.

The World Health Organization said this week that the rate of infection in Liberia appears to be falling but warned that the response effort must be kept up or the trend could be reversed.



In this photo taken Wednesday, Oct. 29, 2014, a medical car that will be used for the fight against the Ebola virus is unloaded upon arrival by air from the United States at an airport in Conakry, Guinea. The head of Africa’s continental body did not get to an Ebola-hit country until last week - months after alarm bells first rang and nearly 5,000 deaths later. (AP Photo/Youssouf Bah)


Foreign aid is now pouring into Liberia and other West African countries hard hit by Ebola. The United States has promised up to 4,000 American troops for Liberia and is building 17 treatment centers and helping to train thousands of health care workers.

More than 13,700 people have been sickened by the disease, and nearly 5,000 have died. The outbreak has hit Liberia, Sierra Leone and Guinea hardest and all three countries have resorted to extraordinary measures to combat it.

Sierra Leone has had a state of emergency in place for three months that bans public gatherings and, at one point, the entire country was locked down for three days to seek out hidden cases. There have been rumors that the emergency measures would be lifted, but Attorney General and Justice Minister Franklyn Bai Kargbo told AP on Friday that they are still in force. By law, they can last for 12 months and parliament put no time limit on them, he said.

While the disease is beginning to let up in some of Sierra Leone's eastern districts, infections are continuing in the capital and surrounding areas.

Despite some signs of hope in Liberia, many officials warn that the fight cannot be let up. Sirleaf said the memory of sick and dying people with no place to go is still too fresh.



Relatives react as the lifeless body of their family member is carried away by health workers, after he died suspecting he contracted the Ebola virus, on the outskirts of Monrovia, Liberia, Friday, Oct. 31, 2014. The World Health Organization said this week that the rate of infection in Liberia appears to be falling but warned that the response effort must be kept up or the trend could be reversed. (AP Photo/ Abbas Dulleh)


"We can all imagine those early days when journalists .. went into the streets and into the communities and took those pictures that were put on all the television screens all over the world of the dying, the sick, the dead who could not picked up on time and portrayed us as a nation in despair, a nation confused not knowing this enemy with which it had to confront," she said.

Despite those dark days, Liberia health workers fought on, she said

"To our health workers," she said, "we owe you a lot for the courage you continue to bring forth."

___

Clarence Roy-Macaulay in Freetown, Sierra Leone contributed to this report.


http://news.yahoo.com/liberia-opens-1-largest-ebola-treatment-centers-114728548.html

[Buster's Uncle]

Genetics could influence whether Ebola will kill: study
AFP  21 hours ago



The Ebola virus is often deadly, but not always, and a study on mice suggests that genetics may play a role in the severity of the illness (AFP Photo/Doug Hansen)



Washington (AFP) - The Ebola virus is often deadly, but not always, and a study on mice Thursday suggested that genetics may play a role in the severity of the illness.

At a high-security, state-of-the-art biocontainment laboratory in Hamilton, Montana, scientists infected mice with a mouse form of the same species of the Ebola virus that is sweeping West Africa.

Seventy percent of the mice got sick, and more than half of this group died, some due to liver inflammation and others due to internal hemorrhage, according to the study in the US journal Science.

About 19 percent of the mice lost weight initially but then regained it in two weeks and made a full recovery.

The remaining 11 percent showed a partial response to the virus and less than half in this group died.

Scientists said the variability in outcomes resembled what has been seen in the human epidemic sweeping West Africa this year, killing more than 4,900 people and infecting more than 13,000.

They were also able to find associations in disease outcomes and mortality rates according to specific genetic lines of mice.

"Our data suggest that genetic factors play a significant role in disease outcome," said Michael Katze from the University of Washington Department of Microbiology.

Those that died showed more activity in genes that promoted blood vessel inflammation and cell death, leading to more serious illness.

Those that survived tended to show more activity in genes responsible for blood vessel repair and making infection–fighting white blood cells.

Specialized types of liver cells might have also helped stop the virus from reproducing, the study said.

"We hope that medical researchers will be able to rapidly apply these findings to candidate therapeutics and vaccines," Katze said.

Similar observations about the link between genes and outcomes have been made in many different viruses, so the finding should not come as a surprise in Ebola, said Andrew Easton, professor of virology at the University of Warwick.

"While this is valuable information, the data in the paper cannot be directly extrapolated to the human situation and used as a basis for potential therapy at the moment," said Easton, who was not involved in the study.

"Unlike the mice used in the study, humans are extensively outbred and have a large variety of genetic combinations, making assessment of the impact of the genes in humans difficult."

The study also did not account for environmental factors that experts say can affect whether a person lives or dies from Ebola, including the quality of care, their age and how healthy they are when they first become infected.


http://news.yahoo.com/genetics-could-influence-whether-ebola-kill-study-204302244.html

[Buster's Uncle]

Liberia Ebola deaths down, Sierra Leone up after revision: WHO
Reuters
By Tom Miles  October 29, 2014 7:01 PM



GENEVA (Reuters) - Almost 300 fewer people are known to have died from Ebola in Liberia than previously thought, while more than 200 have been added to Sierra Leone's death toll, the World Health Organization said in a regular Ebola update on Wednesday.

The WHO said it had tried to clean up data after laboratory tests weeded out many false positives -- "probable" and "suspected" deaths that turned out not to be Ebola -- with the end result that the total death toll stood at about 4,922, unchanged from the previous count last Friday.

Experts say that monitoring the spread of Ebola is key to defeating it and more accurate data will help to gauge the success of efforts to contain the virus.

The WHO has always given strong warnings that although the Ebola figures it presents are the best available, numbers are subject to revisions.

"Many people who were 'probable' turned out not to be Ebola after all," said WHO spokesman Tarik Jasarevic. "The numbers are changing all the time. It's not that from now on it's always going to be the definitive number."

Even the latest, revised death toll contains unconfirmed Ebola cases that could later be removed, and the data will be revised again in future, he said.

Apart from the sheer number of Ebola cases, experts say that there are many other feverish illnesses that can be mistaken for Ebola. Jasarevic cited the case of a village where many people had died and the deaths were ascribed to Ebola. But on checking, "it turned out many of them were not Ebola cases".

The WHO document gave figures totaling 4,920 deaths and 13,703 cases in the eight countries affected by the outbreak, as of the end of Oct. 27. That would imply two fewer deaths than in the previous update.

WHO Assistant Director General Bruce Aylward had already disclosed the number of cases earlier on Wednesday, and said it had surged by more than 3,000 since last week largely because a backlog of old cases had been added to the database.

(Reporting by Tom Miles; editing by Andrew Roche)


http://news.yahoo.com/liberia-ebola-deaths-down-sierra-leone-revision-210243440.html