Posted for fair use and discussion.
https://in.news.yahoo.com/netherlands-evacuate-two-doctors-had-contact-ebola-victims-101916632.html?
Netherlands to evacuate two doctors who had contact with Ebola victims
ReutersReuters – 2 hours 51 minutes ago
AMSTERDAM (Reuters) - Authorities in the Netherlands are preparing to evacuate two Dutch doctors who had unprotected contact in Sierra Leone with patients who later died of Ebola, a Dutch public health official said on Friday.
The two doctors have shown no symptoms of the virus but authorities believe there is cause for concern because they were not wearing full protective clothing when they came into contact with the patients, who had not yet been diagnosed with Ebola.
"The two doctors' personal protection should be considered inadequate. They could potentially have been exposed," said Jaap van Dissel, director of the Dutch Centre for Infectious Disease Control.
The two doctors will be evacuated on a special flight to minimise the risk of contagion to other passengers and monitored closely on arrival, according to media reports.
"It's only contagious if they have a fever," van Dissel said, and added that if symptoms developed, the two would be placed in quarantine in a university hospital.
Dutch public television said the case was discovered when the doctors came to the Netherlands' nearest embassy in Ghana after the patients they had been in contact with at the Lion Heart Medical Centre in Yele town died of Ebola.
The clinic, which normally deals with cases of malaria, which has symptoms similar to Ebola, has since been shut down by authorities in Sierra Leone.
More than 2,400 people have died so far from Ebola in West Africa since the outbreak started in March, taking a particularly heavy toll among medical workers, more than 120 of whom have died of the disease as of late August, according to the World Health Organisation.
(Reporting by Thomas Escritt; Editing by Sonya Hepinstall)
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Pixie: Comment
Note that the Dutch doctors crossed the border from Sierra Leone and headed into Ghana.
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Posted for fair use and discussion.
http://who.int/csr/don/2014_09_10_ebola/en/
Ebola virus disease – Democratic Republic of Congo
Disease outbreak news
10 September 2014
Epidemiological situation
Between 2 and 9 September 2014, there have been 31 more cases of Ebola virus disease (EVD) reported in the Democratic Republic of the Congo (DRC), increasing the cumulative number of cases to 62 (14 confirmed, 26 probable, and 22 suspect). In total, 35 deaths have been reported (9 confirmed and 26 probable). No deaths have been reported among suspected cases. Nine health-care workers have been diagnosed with EVD, including 7 deaths. All the cases have been localized in Jeera county. The affected villages are Watsi Kengo, Lokolia, Boende, and Boende Muke. Currently, 9 cases have been hospitalized: 4 in Lokolia; 2 in Watsikengo; 2 in Boende; and 1 in Boende Moke. A total of 386 contacts have been listed and 239 contacts have been followed-up. All cases and contacts are linked to the initial index case reported to the World Health Organization on 26 August 2014.
Response activities
During a regional meeting between the Ministry of Health of DRC and the Southern African Development Community on the management and prevention of EVD transmission, the following measures were recommended: standardization of the interventions for the prevention of EVD and enhancement of sanitary border control without impeding international traffic.
Under the leadership of the Government, the international community is providing strong logistical support and sending experts, equipment, food, and transportation means to the field.
A team of national and international specialists have been deployed to work with the local response teams. Patients are being treated in temporary isolation units in Watsi Kengo, Lokolia, Boende, and Boende Muke. A mobile laboratory from the National Institute of Biomedical Research (INRB) has been installed in Lokolia and is currently functional. Two laboratory epidemiologists from the US Centers for Disease Control and Prevention have arrived in DRC to support the INRB field team.
Contact tracing activities are being carried out by an assigned team with supervision from of a medical epidemiologist and a community worker, and when required, psychologists visit and dialogue with communities. Ongoing sensitization activities to mobilize community leaders are being implemented.
Data reported in the Disease Outbreak News are based on official information reported by the Ministry of Health. These numbers are subject to change due to ongoing reclassification, retrospective investigation, and availability of laboratory results.
WHO does not recommend any travel or trade restrictions be applied except in cases where individuals have been confirmed or are suspected of being infected with EVD or where individuals have had contact with cases of EVD. (Contacts do not include properly-protected health-care workers and laboratory staff.)
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Posted for fair use and discussion.
http://www.nytimes.com/2014/09/13/world/africa/ebola-who-africa.html?
Ebola Outpaces Global Response, W.H.O. Says
By NICK CUMMING-BRUCESEPT. 12, 2014
GENEVA — A month after declaring the Ebola outbreak in West Africa a global health emergency, the World Health Organization warned on Friday that the disease is still outpacing the international response to contain it.
“The Ebola outbreak that is ravaging parts of West Africa is the largest, most severe and most complex in the nearly four-decade history of this disease,” Margaret Chan, the health organization’s director general, said at a news conference. “The number of new cases is moving far faster than the capacity to treat them.”
So far, 4,784 Ebola cases have been reported and more than 2,400 people have died in the outbreak, which is concentrated in Guinea, Liberia and Sierra Leone, Ms. Chan said on Friday, citing the latest data available. But she made clear the figures were “an underestimate.”
A surge of 400 new cases in Liberia in the past week, double the number of new cases in the preceding week, was “a particular cause for concern,” the health organization said. Sierra Leone reported 200 new cases in the past week and a high rate of transmission in the capital, Freetown, the W.H.O. said. Nearly half the total number of infections in West Africa and just over half the deaths occurred in the last 21 days, it said.
Releasing a road map to guide the international response to the crisis two weeks ago, the health organization said some 20,000 people could ultimately be affected, but Ms. Chan said Friday that the estimate could change as the epidemic evolves.
The outbreak has already stricken more people than all other outbreaks of the disease combined, Sarah Crowe, a staff member for the United Nations children’s fund, Unicef, told reporters in a telephone briefing from Monrovia, the capital of Liberia.
Ms. Chan’s comments came at a joint news conference with Cuba’s public health minister, Roberto Morales Ojeda, to announce that Cuba would send 165 doctors and nurses to Sierra Leone, the biggest commitment of personnel to the health crisis so far by any country, Ms. Chan said.
The new team, now receiving specialist training in Cuba, will deploy in the first week of October and will stay six months, the health organization said in a statement.
“I’m quite positive more support will be forthcoming,” Ms. Chan said, noting assistance offered by Britain, Canada, the Democratic Republic of Congo, the European Union, France, Uganda and the United States.
The World Health Organization has said it will earmark $100 million to fight the outbreak. Other commitments include $200 million from the World Bank, $181 million from the European Union, $75 million from the United States and $50 million from the Gates Foundation.
Among other aid commitments, the United States said this week that it would send a 25-bed military field hospital to Monrovia to treat health care workers infected by the virus, and Britain has promised to provide a 62-bed unit for Sierra Leone.
But despite the efforts to scale up the response, World Health Organization data makes clear that the resources available to date are a small fraction of what is needed. In Liberia, which accounts for roughly half the number of cases and more than half the number of deaths reported so far, not a single hospital bed is available to receive people infected, Ms. Chan said.
Liberia has a total of 314 beds in centers for treating Ebola patients, but Monrovia alone needs another 760 beds, the W.H.O. said this week.
“The thing we need most of all is people, health care workers,” Ms. Chan said, citing the urgency of providing pay and hazard allowances to get national staff in the affected countries back to work.
Already fragile health services in countries that rank among the world’s poorest have been weakened by the effect of the Ebola epidemic on medical staff, who have lacked sufficient supplies of the materials and equipment needed to protect themselves.
In Sierra Leone, where health care workers have died in disproportionate numbers since the epidemic began, officials said on Friday that a fourth doctor, Olivette Buck, had become infected with the virus and that the three other doctors to contract the disease had died.
The authorities in Sierra Leone were urgently attempting on Friday to evacuate Dr. Buck for treatment abroad, saying the loss of another prominent doctor would be disastrous for the country’s already battered morale.
In Liberia, where 153 health workers have become infected and 79 have died, Unicef said it had delivered nearly 248 metric tons of personal protection equipment, hygiene kits and the chlorine needed for routine hand washing, but it reinforced the warning that the international efforts still fell far short of what was needed.
“We don’t have enough partners,” Ms. Crowe said in her telephone briefing. “Many Liberians say they feel abandoned.”
“Ebola has turned survivors into human booby traps, unexploded ordnance — touch and you die,” Ms. Crowe said in an article published by the BBC. “Ebola psychosis is paralyzing.”
“It’s quite surreal,” she added in her briefing. "Everywhere you go there’s a sense of this virus taking over.”
The outbreak is deeply disturbing for children who “are seeing family members and relatives taken away by people in astronaut suits,” Ms. Crowe said. They live in a “twilight zone” where normal play with their peers is a risk. “It’s almost as if they have to unwire their normal human ways,” she said.
Aid agencies are also concerned that the impact of the epidemic is collapsing the ability of health services to address other medical needs. Unicef said children were dying from measles because they had not been vaccinated, and pregnant women had few places where they could safely deliver children.
Emerging from years of brutal conflict, Liberia had achieved the fastest rate of decline in child mortality in Africa, Sheldon Yett, Unicef’s representative in Liberia, said in a statement. “Now Ebola is threatening to wipe out all those hard-earned gains for children and for Liberia,” he said.
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Posted for fair use and discussion.
http://www.digitaljournal.com/life/h...rticle/402920?
New study demonstrates how fast Ebola virus can spread
13 mins ago in Health
By Karen Graham
Earlier this week, Liberia's defense minister, Brownie Samukai told the U.N. Security Council that Ebola "is now spreading like wildfire, devouring everything in its path." A new study just released shows us how fast the deadly virus is spreading.
New research was published on Sept. 11, demonstrating the rates of transmission of the Ebola virus in West African nations. The work is a combined effort between Arizona State University and the University of Tokyo using case counts provided by the World Health Organization up to Aug.26, 2014.
The paper, "Early transmission dynamics of Ebola virus disease, West Africa, March to August 2014," was published yesterday in Eurosurveillance.
Associate professor Gerardo Chowell-Puente, ASU School of Human Evolution and Social Change, and Hiroshi Nishiura of the University of Tokyo, were able to demonstrate the transmission rate for every single Ebola case consistently showed at least one or more new cases being transmitted.
The researchers were able to show country-specific rates of transmission in Liberia and Sierra Leone that were in keeping with their analysis of every single new case adding one to two secondary transmissions.
"Our analysis of the reproduction numbers of Ebola cases shows continuous growth from June to August 2014 that signalled a major epidemic," Nishiura said. "Uncontrolled cross-border transmission could fuel a major epidemic to take off in new geographical areas as was seen in Liberia."
Statistical analysis showed the rate of transmission increased from June to July in Sierra Leone and Liberia fro 1.4 to 1.7 respectively for every individual case. "Our findings suggest that control of the Ebola epidemic that has taken so many lives could be attained by preventing more than half of the secondary transmissions for each primary case. This could be attained by isolating those with Ebola and tracing each case to its source," Chowell said.
In examining the case counts in the two affected countries using data from WHO, the information was divided into two groups: "confirmed and probable cases; and the total number of reported cases (confirmed, probable and suspected cases)." The researchers found the rates of transmission in this Ebola outbreak to be consistent with the rates of spread from earlier outbreaks in Central Africa.
Using statistical analysis, the researchers demonstrated the probability of increasing cases of Ebola at a rate of 1.0 to 2.0 for all three countries studied (Guinea, Sierra Leone and Liberia). They showed that in Sierra Leone and Liberia, where the importation of the disease was probable, the significant rise in cases in June and July demonstrated a major epidemic.
According to the researchers: "Uncontrolled cross-border transmission could fuel a major epidemic to take off in new geographical areas (e.g. as seen in Liberia). Unaffected countries at risk of transnational spread should be on high alert for potential EVD introductions and be ready to launch comprehensive and timely containment responses to avert outbreaks."
The Washington Post reported on Thursday that 4,293 Ebola virus cases have been confirmed by WHO, with 2,296 deaths as of Sept. 6.
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Osterholm's opinion piece gets picked up by the BBC:
Posted for fair use and discussion.
http://www.bbc.com/news/blogs-echochambers-29168905?
Ebola mutation 'presents nightmare scenario'
12 September 2014 Last updated at 16:21 ET
Virologists may not be publicly talking about the possibility that the Ebola virus could someday mutate into an airborne strain, writes Michael T Osterholm in the New York Times, but it's something they are "definitely considering in private".
The director of the Center for Infectious Disease Research and Policy at the University of Minnesota says that the virus - which currently can only be transmitted through contact with bodily fluids - has proven to be "notoriously sloppy in replicating", which increases the chances that it could turn into something more contagious.
"Why are public officials afraid to discuss this?" he asks. "They don't want to be accused of screaming 'fire!' in a crowded theatre - as I'm sure some will accuse me of doing. But the risk is real, and until we consider it, the world will not be prepared to do what is necessary to end the epidemic."
The second disturbing scenario he envisions is if the Ebola virus is brought to a more densely populated area of the world, where it would be more difficult to contain.
According to the World Health Organisation, the virus has already infected almost 4,800 people and killed around 2,400. It is now predicting that more than 20,000 may contract the virus before the current outbreak is over.
"What happens when an infected person yet to become ill travels by plane to Lagos, Nairobi, Kinshasa or Mogadishu - or even Karachi, Jakarta, Mexico City or Dhaka?" he asks. The more people who get infected, he says, the greater the opportunities for mutation.
"The current Ebola virus' hyper-evolution is unprecedented; there has been more human-to-human transmission in the past four months than most likely occurred in the last 500 to 1,000 years," he writes.
To prevent this, Osterholm says, the United Nations should be put in charge of overseeing containment of the outbreak by managing air supply chains, providing hospital beds and training medical staff.
Waiting for a vaccine isn't a realistic solution, he concludes. By the time one is developed, the disease could be in "our own backyards".
Although Osterholm paints a dark picture - and it's not the first time he's taken to a major daily newspaper to do so - other public health professionals are unconvinced. Scott Gottlieb, former deputy director of the US Food and Drug Administration, writes in Forbes that it is very unlikely that the Ebola virus would ever mutate into an airborne version.
"It would be unusual for a virus to transform in a way that changes its mode of infection," he writes. "Of the 23 known viruses that cause serious disease in man, none are known to have mutated in ways that changed how they infect humans."
Tara C Smith, writing for ScienceBlogs, says that diseases similar to Ebola have already appeared in the US and have been easily controlled. She adds that she is much more concerned with "ordinary" viruses like influenza and measles.
"Ebola is exotic and its symptoms can be terrifying, but also much easier to contain by people who know their stuff," she concludes. {right, easy…}
In 2005 Wendy Orent, writing in the New Republic, called Osterholm a "doomsayer" who has been on the "disease and terrorism circuit" for decades, warning of impending dangers like smallpox, mosquito-borne viruses and swine flu.
So is Osterholm's op-ed a "clarion call to action" or nothing but "fearmongering", as one molecular virologist called it on Twitter?
If it's the former, we've been warned. If it's the latter, then it's fearmongering on some prime real estate - the opinion pages of the New York Times.
