Ebola News 12/21

[Buster's Uncle]

Ebola response in rural Sierra Leone not yet rapid enough
Reuters
By Emma Farge  2 hours ago



Health workers rest outside a quarantine zone at a Red Cross facility in the town of Koidu, Kono district in Eastern Sierra Leone December 19, 2014. . REUTERS/Baz Ratner



KOIDU, Sierra Leone (Reuters) - The rapid response team has arrived and the chaos is easing, but medics in a remote Sierra Leonean district are struggling to control a local Ebola outbreak when it's too late to nip it in the bud.

A deployment of medical workers and equipment to Kono District has been the fastest so far in Sierra Leone, a country with nearly half the total Ebola cases,- under a strategy of tackling epidemic hotspots before they get too big.

But officials say responses need to be yet faster to fight the fever that has killed more than 7,000 people across West Africa.

In Koidu, the capital of Kono district, people continue to die of what is thought to be Ebola while others seem unaware of the risks. A Reuters reporter saw a young man lying on a city street, vomiting. He died there before an ambulance could come.

An almost hysterical soldier ordered bystanders next to the highly contagious corpse, who were wearing open-toed rubber flip-flops, to stand back. "This is the reason we have Ebola. Your bad habits. Look at you, in slippers, in slippers!" he yelled.

Less than a month ago, conditions were far worse. A small team of local nurses left at the makeshift Ebola center were so afraid of patients they resorted to throwing packets of medicine inside, according to two U.S. doctors on the scene.

Suspected and confirmed Ebola patients were mixed together, sometimes next to corpses. A single trolley was used to move the dead and mattresses were soiled with diarrhea.

While fellow Americans celebrated the Thanksgiving holiday in late November, the two doctors witnessed a descent into chaos in Kono, about 450 km (280 miles) east of the capital Freetown.

"By Thanksgiving things had exploded. The hospital was getting overrun by Ebola patients," said Dan Kelly, one of the doctors and founder of the non-profit organization Wellbody Alliance. Ten staff at the center caught Ebola and five have died so far.

Shortly afterwards, help began to arrive in Kono, which lies in the diamond mining eastern province, and the Red Cross is building a 30-bed treatment center.

The buzzwords in the international strategy for stamping out the nine month-old epidemic - which has hit Liberia and Guinea as well as Sierra Leone - are "rapid response": quickly mobilizing flexible teams to prevent new hotspots from emerging.

"Speed really matters. Our experience in communities in all three countries, is that if we can get rapid response teams very quickly we can stop a cluster," Dr Thomas Frieden, Director of the U.S. Centers for Disease Control and Prevention (CDC), told reporters this week.

CDC says this has been done this successfully in one Sierra Leone district and now the same tactics are being used in Kono.

But help needs to arrive when case numbers are still low. "Right now we are seeing an intensive influx of resources and it's a good example of a rapid response," said Kelly, 33 from San Francisco. "But we need to be proactive, not reactive next time."

In Liberia, the Medecins Sans Frontieres group sent a team within two days after a case was confirmed in one isolated village. A 12 bed treatment center was built within eight days. "It's about nipping it in the bud when it's still small," said an MSF spokeswoman in Liberia.

Fernando Fernandez, a member of the European Commission's Ebola response team in Freetown, said this was not yet being matched in Sierra Leone. "Kono is the fastest response so far in the country. But we have to be much faster than that. We should be aiming at what they are doing in Liberia."


THIN RESOURCES

In Koidu, rumors of the previously abominable conditions at the Ebola center spread fear among local people, causing families to hide the sick and bury the dead in secret.

Recently a two-year-old arrived dead at the facility; her mother had kept her at home for three days with a fever because she was worried about conditions.

Even now, the district has just two ambulances and officials complain one of them spends half the time in the garage. Two of the drivers have died from Ebola. Patients are sent to the town of Kenema on a three hour journey via a bumpy dirt road crossing the mountains.

There is no laboratory for testing cases and swabs have to be sent to a town more than 100 km (60 miles) away. On many days, burial teams cannot cope with all the corpses.

At a military command center, housed in an office for diamond workers, only about half a dozen soldiers are present. The surveillance desk is empty, although its staff are due to be built up. A military briefing note seen by Reuters said the center needed a regular power supply.

A lack of resources meant aid workers could not evaluate the number of cases in Kono. "The case count did not look that bad from Freetown. But the problem is you can't know the scale until you have enough people on the ground," said Colin Basler, a CDC epidemiologist in Kono.

Authorities are trying to manage over 400 people who came into contact with Ebola sufferers under quarantine.

Paul Saquee, chairman of the Kono council of chiefs, had mixed feelings about the help. "Was the response rapid enough? No. But is it too late? No," he said.

(editing by David Stamp)


http://news.yahoo.com/ebola-response-rural-sierra-leone-not-yet-rapid-151310055.html

[Buster's Uncle]

American nurse exposed to Ebola released from hospital
Reuters  December 19, 2014 10:52 PM



The patient's entrance at the National Institutes of Health is shown in Bethesda, Maryland October 16, 2014. REUTERS/Gary Cameron



(Reuters) - An American nurse who was exposed to Ebola while volunteering in Sierra Leone was released from the National Institutes of Health's Clinical Center in Maryland on Friday without showing signs of the disease, NIH said.

"The patient has shown no clinical or laboratory evidence of Ebola infection and will complete 21 days of monitoring at a private residence in Virginia under the direction of the Virginia Department of Health," NIH said in a statement.

NIH did not release any further information on the nurse, including when he or she might have been exposed to the virus, affiliation or name.

The NIH clinical center is one of the facilities across the United States designated as an Ebola treatment center by the U.S. Centers for Disease Control and Prevention.

A child who arrived in Chicago with a fever was under observation on Friday at a city hospital to rule out the Ebola virus, hospital officials said.

Ebola has killed nearly 7,000 people out of more than 18,600 infected, nearly all of them in the impoverished West African countries of Liberia, Sierra Leone and Guinea.

(Reporting by Curtis Skinner in San Francisco; Editing by Jeremy Laurence)


http://news.yahoo.com/american-nurse-exposed-ebola-released-hospital-035225712.html

[Buster's Uncle]

U.N.'s Ebola mission should be closed once battle won: Ban
Reuters
By Matthew Mpoke Bigg  15 hours ago



United Nations Secretary General Ban Ki-moon (L) speaks during a meeting with Liberia's President Ellen Johnson Sirleaf at the Ministry of Foreign Affairs in Monrovia December 19, 2014. REUTERS/UN/Evan Schneider/Handout via Reuters



BAMAKO (Reuters) - The United Nations mission to fight Ebola should be wound down quickly once the battle is won, U.N. Secretary General Ban Ki-moon said on Saturday during his first tour of countries stricken with the virus.

The U.N. emergency Ebola response mission, or UNMEER, was set up in September to coordinate policy and logistics for a campaign that includes governments, charities and healthcare workers from affected countries.

Ban said UNMEER differed from peacekeeping missions and should not outlive its immediate purpose.

"There's a tendency that missions go on because of continuing political instability and conflict. Ebola is a very urgent and unprecedented epidemic, therefore we cannot take too long in eliminating it," he told Reuters.

"That is why I am sending a political message. It is not because we have made any decision on when UNMEER should end, but it should be a short-term mission," he said.

More than 7,300 people have died of Ebola in the three worst-affected countries, Liberia, Sierra Leone and Guinea. Ban declined to name a target date for ending the outbreak, but said he was encouraged that the rate of new cases is declining.

He visited treatment centres in the countries at the heart of the epidemic during a 36-hour tour to raise the profile of the struggle against the virus and encourage healthcare workers.

On Saturday, he also met Ibrahim Boubacar Keita, the president of Mali, a country that recently saw the last of eight Ebola cases released from hospital.

At every stop, health authorities took his temperature and ensured he washed his hands with chlorinated water in a sign that nobody is exempt from protection measures.In Guinea on Saturday, Ban urged countries to avoid discriminating against healthcare workers fighting the virus.

His comments followed a meeting at a treatment centre in Sierra Leone on Friday in which Rebecca Johnson, a nurse treating virus patients, recounted how she fell ill, recovered and is now back treating Ebola patients.

Ban publicly embraced Johnson and repeatedly cited her as an example of heroism, not least because she said she still faced stigma as a survivor.

"There should be no discrimination for those who have been working or helping with Ebola. Those people are giving all of themselves," Ban said.


http://news.yahoo.com/u-n-ebola-mission-closed-once-battle-won-075325765.html

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Child tests negative for Ebola at Chicago hospital
Reuters  December 20, 2014 3:33 PM



(Reuters) - A child being monitored for Ebola in a Chicago hospital has been discharged after testing negative for the virus, the state health agency said on Saturday.

Federal officials screening for Ebola at O'Hare International Airport in Chicago detected a fever in the child, who had been held in isolation at the University of Chicago Medical Center for monitoring since Friday.

"Tests by the Illinois Department of Public Health confirmed a negative result for Ebola," the Illinois Department of Public Health said in a statement.

Hospital officials have given no details on the child, including age or sex, citing patient privacy laws.

The University of Chicago Medical Center is one of the U.S. hospitals designated as an Ebola treatment center by the U.S. Centers for Disease Control and Prevention.

Ebola has killed nearly 7,000 people out of more than 18,600 infected, nearly all of them in the impoverished West African countries of Liberia, Sierra Leone and Guinea.

Four people since September have tested positive for Ebola in the United States, according to the Centers for Disease Control and Prevention. There are currently no cases of Ebola in the country.

There have been no confirmed cases of Ebola in Chicago.

(Reporting by Laila Kearney; editing by Andrew Hay)


http://news.yahoo.com/child-tests-negative-ebola-chicago-hospital-201713983.html

[Buster's Uncle]

IMF policies criticised over Ebola outbreak
AFP  1 hour ago



A health worker wearing protective equipment assists an Ebola patient at the Kenama treatment centre run by the Red Cross Society on November 15, 2014 in Sierra Leone (AFP Photo/Francisco Leong)



London (AFP) - International Monetary Fund (IMF) policies left healthcare systems in the African countries worst affected by Ebola underfunded and lacking doctors, and hampered a coordinated response to the outbreak, researchers said Monday.

Links between the IMF and the rapid spread of the disease were examined by researchers from Cambridge University's sociology department, with colleagues from Oxford University and the London School of Hygiene and Tropical Medicine.

They found IMF programmes held back the development of effective health systems in Guinea, Liberia and Sierra Leone, the three countries at the epicentre of the outbreak that has killed over 7,370 people.

Reforms advocated by the IMF hampered the ability of the health systems to cope with infectious disease outbreaks and other emergencies, the researchers found.

"A major reason why the Ebola outbreak spread so rapidly was the weakness of healthcare systems in the region, and it would be unfortunate if underlying causes were overlooked," said Cambridge sociologist and lead study author Alexander Kentikelenis.

"Policies advocated by the IMF have contributed to under-funded, insufficiently staffed, and poorly prepared health systems in the countries with Ebola outbreaks."



Guinean Red Cross workers wearing protective suits carry the corpse of a victim of Ebola in Macenta on November 21, 2014 (AFP Photo/Kenzo Tribouillard)


The researchers examined policies enforced by the IMF before the outbreak, using information from IMF lending programmes from 1990 to 2014, and analysed their effects on Guinea, Liberia and Sierra Leone.

They found the healthcare systems were weakened by the IMF's requirement of economic reforms that cut government spending, a requirement of caps on the public sector wage bill, and a policy of decentralised healthcare systems.

On the requirement to reduce government spending, researchers found that "such policies have been extremely strict, absorbing funds that could be directed to meeting pressing health challenges."

"In 2013, just before the Ebola outbreak, the three countries met the IMF's economic directives, yet all failed to raise their social spending despite pressing health needs," said Cambridge sociologist and study co-author Lawrence King.

The public wage cap meant the countries were unable to hire nurses and doctors and pay them adequately, while decentralised healthcare systems made it hard to mobilise coordinated responses to outbreaks of infectious diseases such as Ebola.

A spokesman for the IMF said that the organisation's mandate did not specifically include public health and that it was "completely untrue" that the spread of Ebola was a consequence of IMF policies.

"Such claims are based on a misunderstanding, and, in some cases, a misrepresentation, of IMF policies," the spokesman said.

"Since 2009, loans from the IMF to low-income countries have been at zero interest rate, which has freed up resources for countries to spend more on health and education."

The spokesman added that the IMF had provided a $130 million financial package in September towards Ebola, and that they were working towards offering a package worth a similar amount to Guinea, Liberia and Sierra Leone next year.


http://news.yahoo.com/imf-policies-criticised-over-ebola-outbreak-002918967.html

[Buster's Uncle]

Child being observed at Chicago hospital to rule out Ebola
Reuters
By Mary Wisniewski  December 20, 2014 9:52 AM



Customs Border Protection (CBP) Supervisor Sam Ko conducts an interview with a passenger arriving from Sierra Leone at O?Hare International Airport's Terminal 5 in Chicago, in this handout picture taken October 16, 2014. Picture taken October 16, 2014. REUTERS/U.S. Customs Border Protection/Melissa Maraj/Handout via Reuters



CHICAGO (Reuters) - A child who arrived in Chicago with a fever was under observation on Friday at a city hospital to rule out the Ebola virus, hospital officials said.

Federal officials screening arriving passengers at O'Hare International Airport detected the fever, but no other symptoms of the disease, the University of Chicago Medical Center said in a statement.

The patient was isolated under strict quarantine protocols until the child’s condition improves and a diagnosis is established, the hospital said. The child was in stable condition.

The hospital gave no details on the child, including age, gender or where the patient flew from, citing patient privacy laws.

The medical center said later in the day that the child remained in stable condition, without giving any information on whether the patient had been infected.

"There is no threat to the public, our staff and our patients," it said.

The University of Chicago Medical Center is one of the facilities across the United States designated as an Ebola treatment center by the U.S. Centers for Disease Control and Prevention.

There have been no confirmed cases of Ebola in Chicago

Ebola has killed nearly 7,000 people out of more than 18,600 infected, nearly all of them in the impoverished West African countries of Liberia, Sierra Leone and Guinea.


http://news.yahoo.com/child-under-observation-chicago-hospital-rule-ebola-103600185.html

[Buster's Uncle]

Sierra Leone urges safe burials to stem Ebola
Associated Press
By SARAH DiLORENZO  7 hours ago



In this Saturday Nov. 8, 2014 file photo, Ebola health care workers bury the body of a person suspected of dying of Ebola virus on the outskirts of Monrovia Liberia. Ebola has killed more than 2,000 people in Sierra Leone and unsafe burials may be responsible for up to 70 percent of new infections, say experts. Officials are resorting to increasingly desperate measures to clamp down on traditional burials in Sierra Leone, where Ebola is now spreading fastest. The head of the Ebola response has even threatened to jail people who prepare the corpses of their loved ones. (AP Photo/Abbas Dulleh, File)



DAKAR, Senegal (AP) — The radio announcement is chilling and blunt: "If I die, I want the deaths to stop with me."

Dr. Desmond Williams continues: "I want to give my family the permission to request a safe and dignified, medical burial for me."

The announcement is part of a campaign to urge Sierra Leoneans to abandon traditional burial practices, such as relatives touching or washing the dead bodies, that are fueling the spread of Ebola in the West African country.

Ebola has killed more than 2,000 people in Sierra Leone and unsafe burials may be responsible for up to 70 percent of new infections, say experts.

Officials are resorting to increasingly desperate measures to clamp down on traditional burials in Sierra Leone, where Ebola is now spreading fastest. The head of the Ebola response has even threatened to jail people who prepare the corpses of their loved ones.

Williams, a Sierra Leonean-American doctor who works for the U.S. Centers for Disease Control and Prevention, took to the airwaves last month as part of efforts to encourage people to avoid dangerous burial practices. Now similar pledges have been made by prominent Sierra Leoneans, including the communications director for the Health Ministry, pop stars and radio DJ's.



In this Wednesday, Sept. 24, 2014 file photo, healthcare workers load a man suspected of suffering from the Ebola virus onto an ambulance in Kenema, Sierra Leone. A radio announcement has begun as part of a campaign to urge Sierra Leoneans to abandon traditional burial practices that are fueling the spread of Ebola in the West African country. Ebola has killed more than 2,000 people in Sierra Leone and unsafe burials may be responsible for up to 70 percent of new infections, say experts. Officials are resorting to increasingly desperate measures to clamp down on traditional burials in Sierra Leone, where Ebola is now spreading fastest. (AP Photo/Tanya Bindra, File)


But old ways are hard to break. Many believe a traditional burial is necessary to make sure the dead don't return to haunt the living. Funerals are important social occasions in the three most-affected countries, Sierra Leone, Liberia and Guinea. People often travel great distances to attend and bodies are typically washed and dressed by relatives or friends.

Unfortunately, these practices are the perfect breeding ground for Ebola: The bodies of Ebola victims can be up to 10 times more infectious than those of people living with the disease, according to the International Federation of the Red Cross.

A well-attended funeral where many people touch the body provides the opportunity for the disease to disperse into a crowd and then be carried long distances back to their homes, where it can seed new clusters, according to Rebecca Bunnell, a behavioral epidemiologist with the CDC.

People have been washing their hands more and avoiding crowded places, but changing burial traditions has proven particularly hard.

Burial teams arriving at homes sometimes find the Ebola victims already washed or dressed. Now officials are warning that those who persist in traditional burial practices will be jailed once it's clear they have not caught the disease.



In this Sunday, Aug. 10, 2014 file photo, an ambulance leaves the Ebola isolation unit carrying the bodies of Ebola victims that are highly contagious to a burial site, at the Kenema Government Hospital situated in the Eastern Province around 300 km, (186 miles), from the capital city of Freetown in Kenema, Sierra Leone . A radio announcement has begun as part of a campaign to urge Sierra Leoneans to abandon traditional burial practices that are fueling the spread of Ebola in the West African country. Ebola has killed more than 2,000 people in Sierra Leone and unsafe burials may be responsible for up to 70 percent of new infections, say experts. Officials are resorting to increasingly desperate measures to clamp down on traditional burials in Sierra Leone, where Ebola is now spreading fastest. (AP Photo/Michael Duff, File)


"Burials and funerals are deeply, deeply ingrained in Sierra Leone," said Austin Demby, a Sierra Leonean-American epidemiologist who has also taken the burial pledge. He is the director of a U.S. government AIDS program but has been helping with Ebola containment. "People put a lot of premium on this."

It's hard to pin down just how many dangerous burials are taking place because they are secret, but even the most conservative estimates suggest that burials are responsible for at least one quarter of all infections in the region.

In the early days of the Ebola epidemic, some families held their own burials because teams were slow to arrive or carried off bodies without telling relatives where they would be buried, said Bunnell of the CDC. But as more teams have been put in the field and relatives have increasingly been able to watch funerals, compliance appears to be increasing.

The burial pledge is one more way to release families from the obligation of carrying out a traditional funeral. Some experts have also urged families to apologize to the corpse before handing it over for a safe burial, said Dr. Nuhu Maksha, a health specialist with the U.N. Children's Fund in Sierra Leone.

But the biggest motivator for change is the devastating toll on those who have prepared the dead, said Maksha: "People have to die before the others believe."

___

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


http://news.yahoo.com/sierra-leone-urges-safe-burials-stem-ebola-143026184.html

[Buster's Uncle]

Ebola death toll in three African countries hits 7,373: WHO
Reuters  December 20, 2014 8:57 AM



Health workers push a gurney with a dead body at a Red Cross facility in the town of Koidu, Kono district in Eastern Sierra Leone December 19, 2014. REUTERS/Baz Ratner



GENEVA (Reuters) - The death toll from Ebola in the three worst-affected countries in West Africa has risen to 7,373 among 19,031 cases known to date there, the World Health Organization said on Saturday.

The latest data, posted overnight on the WHO website, reflected nearly 500 new deaths from the worst ever outbreak of the hemorrhagic fever in Guinea, Liberia and Sierra Leone since previous WHO figures were issued on Dec. 17.

Sierra Leone accounts for the most cases, 8,759, against 7,819 for Liberia. But Sierra Leone's death toll of 2,477 is far less than 3,346 recorded in Liberia, leading some experts to question the credibility of the figures reported by Freetown.

Sierra Leone's government this week launched a major operation to contain the epidemic in West Africa's worst-hit country.

President Ernest Bai Koroma said on national television that travel between all parts of the country had been restricted as part of "Operation Western Area Surge", and public gatherings would be strictly controlled in the run-up to Christmas.

Sierra Leone's leading doctor, Victor Willoughby, died of Ebola on Thursday, hours after the arrival in the country of an experimental drug that could have been used to treat him, the government's chief medical officer said.

U.N. Secretary-General Ban Ki-moon on Friday praised health care workers fighting the Ebola virus as he paid his first visit to Liberia and Sierra Leone following the outbreak.

(Reporting by Stephanie Nebehay; Editing by Mark Heinrich and Stephen Powell)


http://news.yahoo.com/ebola-death-toll-three-african-countries-hits-7-132256151.html