Liberia closes its borders to stop Ebola .. with videos ..
"Deadly Ebola virus reaches Guinea capital Conakry - UN 23 March 2014 Last updated at 14:09 ET"
By Jen Christensen, CNN July 28, 2014 -- Updated 2102 GMT (0502 HKT)
Watch this video Officials: Deadliest Ebola outbreak ever
STORY HIGHLIGHTS
* Aid organization trying to evacuate doctor infected with Ebola * Liberia closes its borders to stop Ebola from spreading * This is the deadliest outbreak in the history of the disease
(CNN) -- The deadliest Ebola outbreak in history continues to plague West Africa as leaders scramble to stop the virus from spreading.
Over the weekend, Liberian President Ellen Johnson Sirleaf closed most of the country's borders. The few points of entry that are still open will have Ebola testing centers and will implement preventive measures, she said. The president also placed restrictions on public gatherings and ordered hotels, restaurants and other entertainment venues to play a five-minute video on Ebola safety.
"No doubt the Ebola virus is a national health problem," Sirleaf said. "It attacks our way of life, with serious economic and social consequences. As such we are compelled to bring the totality of our national resolve to fight this scourge."
Photos: Ebola outbreak in West Africa
As of July 20 .. http://www.who.int/csr/don/2014_07_24_ebola/en/ , the World Health Organization had confirmed 224 cases of Ebola in Liberia, including 127 deaths. Overall, Ebola has killed at least 660 people in West Africa. There were 45 new cases reported in the region between July 18 and July 20.
Health officials are worried about the virus spreading to other countries in the region. This is the first such outbreak to hit West Africa. On Friday, a Liberian man with Ebola died in Lagos, Nigeria, Nigerian Health Minister Onyebuchi Chukwu said.
Patrick Sawyer arrived at Lagos' airport on July 20 and was isolated at a local hospital after exhibiting common Ebola symptoms. He told officials he had no direct contact with anyone who had the virus.
Lagos State Health Commissioner Dr. Jide Idris said authorities are working to identify people who may have come in contact with the man on his flights. The process has been delayed, he said, because the airline has not provided the passenger lists for all three of the flights Sawyer took. Sawyer flew first to Ghana before he went to Togo and then switched planes to fly to Nigeria, according to the health commissioner.
"In collaboration with the Federal Ministry of Aviation, I've also put into motion mechanisms to track down all contacts at high risk," Idris said.
The state department has identified 59 people so far who came into contact with the man. Twenty have been tested for Ebola.
It is unlikely the virus would spread on a plane unless a passenger were to come into contact with a sick person's bodily fluids, according to the Centers for Disease Control and Prevention.
Meanwhile, American health care workers helping to fight this deadly disease abroad have put themselves at risk.
Dr. Kent Brantly, a 33-year-old Indianapolis resident, had been treating Ebola patients in Monrovia when he started to feel sick.
Brantly works with Samaritan's Purse .. http://www.samaritanspurse.org/our-ministry/about-us/ , a Christian international relief agency founded by evangelists Franklin Graham and Robert Pierce. He has been the medical director for the Ebola Consolidated Case Management Center in Monrovia and has been working to help Ebola patients since October.
[VIDEOS] Worst Ebola outbreak in history Fighting Ebola through education Rare glimpse inside deadly Ebola clinic Ebola epidemic 'out of control'
"When the Ebola outbreak hit, he took on responsibilities with our Ebola direct clinical treatment response, but he was serving in a missionary hospital in Liberia prior to his work with Ebola patients," said Melissa Strickland, a spokeswoman for the organization.
After testing positive for Ebola, he went into treatment at a Samaritan's Purse isolation center at ELWA Hospital .. http://www.elwaministries.org/AreasofMinistry/Hospital/tabid/59/Default.aspx .. in Paynesville City, Monrovia. His condition is rapidly deteriorating and Samaritan's Purse has been working to evacuate him for better care, but Liberia is not allowing the evacuation, according to Samaritan's Purse vice president of international relief, Ken Isaacs. The reason for the delay is unclear.
The CDC said the doctor's family had been with him, but left for the United States before he became symptomatic; as such it is highly unlikely that they caught the virus from him. Out of an abundance of caution they are on a 21-day fever watch, the CDC said.
Another American working with Samaritan's Purse has also been infected. Nancy Writebol .. http://www.sim.org/index.php/worker/5144941 .. from Charlotte, North Carolina, works with Serving in Mission, or SIM .. http://www.sim.org/index.php/webregion/africa-europe . She and her husband used to work with orphans and other children who struggle with poverty-related issues but expanded their efforts to take on the complex medical problems in Monrovia.
She had teamed up with the staff from Samaritan's Purse to help fight the Ebola outbreak in Monrovia when she got sick. She, too, is undergoing treatment.
A spokesperson for Samaritan's Purse said there have been riots outside the clinic.
Another doctor who has played a key role in fighting the outbreak in Sierra Leone, Dr. Sheik Humarr Kahn .. http://vhfc.org/consortium/people/humarr-khan , is sick. He is being treated by the French aid group Medecins Sans Frontieres --also known as Doctors Without Borders -- in Kailahun, Sierra Leone, according to a representative of that agency.
Kahn had been overseeing treatment of Ebola patients in isolation units at Kenema Government Hospital, which is about 185 miles (298 kilometers) east of the capital, Freetown.
Sierra Leone's minister of health and sanitation called the doctor a national hero for the sacrifices he has made in trying to stop the outbreak.
Doctors and medical staff are particularly vulnerable to the virus because it spreads through exposure to bodily fluids from the infected. It can also spread through contact with an object contaminated by an infected person's bodily fluids.
The disease is not contagious until symptoms appear. Symptoms of Ebola .. http://www.cnn.com/2014/04/11/health/ebola-fast-facts/index.html .. include fever, fatigue and headaches. They can appear two to 21 days after infection, meaning many who are sick don't know it.
The early symptoms then can progress to vomiting, diarrhea, impaired kidney and liver function, and sometimes internal and external bleeding.
Leaders in the international health community characterize the Ebola epidemic as the "deadliest ever."
While the World Health Organization has mobilized to fight the epidemic, it can be a difficult one to stop. It is so highly infectious that it typically kills 90% of those who catch it. The death rate in this particular outbreak had dropped to roughly 60% since it has been treated early in many cases. There is, however, no Ebola vaccination.
With the announcement that Liberia is closing its borders, the country also instituted a new travel policy to inspect and test all outgoing and incoming passengers. The hope is that such measures will stop the spread of the virus.
There has never been a confirmed case of Ebola spreading to a developed country, said Kamiliny Kalahne .. http://www.msf-seasia.org/news/15485 , an epidemiologist with Doctors Without Borders.
"This is because people generally transmit the infection when they are very sick, have a high fever and a lot of symptoms -- and in these situations, they don't travel.
"And even if they do get sick once they travel to a developed country, they will be in a good hospital with good infection control, so they are very unlikely to infect others," she said.
"This is not the great plague," CNN's Dr. Sanjay Gupta said after his trip to the region in the spring. "But it is a pretty formidable killer."
"The grim reality is it often kills so quickly, people don't have time to spread it."
The CDC held a media briefing Monday to emphasize the fact that there is "no significant risk in the U.S." for an Ebola outbreak. CDC officials said with the spread of Ebola to U.S. health care workers, there is a real need for "vigilance" to make sure workers are careful, get tested if there is any suspicion of illness, and that all sick travelers should remain isolated when returning from areas affected directly by the epidemic.
Stephan Monroe, CDC's deputy director of the National Center for Emerging & Zoonotic Infectious Diseases, said the CDC is working with American health care providers to educate them about Ebola. The agency sent a notice Monday to remind doctors to take important steps to avoid the spread of the illness, including asking their patients about their travel history, particularly if they have traveled to West Africa in the last three weeks.
First of two American aid workers stricken with Ebola to arrive in U.S.
By David Beasley
ATLANTA Sat Aug 2, 2014 5:29am EDT 2 Comments
1 of 4. Dr. Kent Brantly (R) speaks with colleagues at the case management center on the campus of ELWA Hospital in Monrovia, Liberia in this undated handout photograph courtesy of Samaritan's Purse.
Credit: Reuters/Samaritan's Purse/Handout via Reuters
(Reuters) - The first of two American aid workers infected with the deadly Ebola virus while in Liberia is set to arrive in the United States on Saturday to begin treatment in isolation at an Atlanta hospital, officials said.
A plane equipped to transport Dr. Kent Brantly and missionary Nancy Writebol back to the country can carry only one patient back at a time and it was unclear early on Saturday which of the two would be arriving first.
"We have learned that we will be receiving a patient with Ebola at Emory University Hospital on Saturday," Holly Korschun, spokeswoman for the facility where they will be treated, said late on Friday. "The second patient was going to follow in the next few days," she added.
Despite alarm by some in the United States over the transport, health officials have said bringing the sickened aid workers into the country would not put the American public at risk.
The patients were helping respond to the worst West African Ebola outbreak on record with the North Carolina-based Christian organization Samaritan's Purse and missionary group SIM USA when they contracted the disease. Since February, more than 700 people in the region have died from the infection.
The facility at Emory, set up with the U.S. Centers for Disease Control and Prevention, is one of only four in the country and is physically separate from other patient areas, providing a high level of clinical isolation.
"We have a specially designed unit, which is highly contained. We have highly trained personnel who know how to safely enter the room of a patient who requires this form of isolation," Bruce Ribner, an infectious disease specialist at Emory, told a news conference on Friday.
Ribner said he hoped the medical support available at Emory could improve the chances of survival from that seen on the ground in West Africa.
The hemorrhagic virus can kill up to 90 percent of those who become infected, and the fatality rate in the current epidemic is about 60 percent.
Brantly, a 33-year-old father of two young children, and Writebol, a 59-year-old mother of two, will each arrive at Dobbins Air Reserve Base outside Atlanta before being transported to Emory, officials at the Pentagon and the hospital said.
The two will be treated primarily by a team of four infectious disease physicians. The workers will be able to see loved ones through a plate glass window and speak to those outside their rooms by phone or intercom.
Samaritan's Purse and SIM said they were sending 60 healthy U.S. staff and family members home from Liberia by this weekend as well.
(Additional reporting by Colleen Jenkins in Winston-Salem, N.C., Missy Ryan and Mark Felsenthal in Washington, Barbara Goldberg, Edith Honan, and Scott Malone in Boston; Writing by Curtis Skinner Editing by Matt Driskill)
Ebola Drug Made From Tobacco Plant Saves U.S. Aid Workers .. with links ..
.. imo, a sensationalist heading as the two might well have survived without the trial drug .. no one will ever know, i guess, but they couldn't, under the circumstances, run one of the two as a control .. anyway, the heading is a bad one, the rest though is interesting in parts .. sure beats smoking it .. lol ..
By Robert Langreth, Caroline Chen and John Lauerman Aug 5, 2014 12:52 PM ET 6 Comments
An ambulance arrives with Ebola victim Dr. Kent Brantly, right, to Emory University... Read More
A tiny San Diego-based company provided an experimental Ebola treatment for two Americans infected with the deadly virus in Liberia. The biotechnology drug, produced with tobacco plants, appears to be working.
In an unusual twist of expedited drug access, Mapp Biopharmaceutical Inc., which has nine employees, released its experimental ZMapp drug, until now only tested on infected animals, for the two health workers. Kentucky BioProcessing LLC, a subsidiary of tobacco giant Reynolds American Inc. (RAI), manufactures the treatment for Mapp from tobacco plants.
The first patient, Kent Brantly, a doctor, was flown from Liberia to Atlanta on Aug. 2, and is receiving treatment at Emory University Hospital. Nancy Writebol, an aid worker, is scheduled to arrive in Atlanta today and will be treated at the same hospital, according to the charity group she works with. Both are improving, according to relatives and supporters.
Each patient received at least one dose of ZMapp in Liberia before coming to the U.S., according to Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.
“There’s a very scarce number of doses,” and it’s not clear how many each patient needs for treatment, Fauci said. “I’m not sure how many doses they’ll get.”
Citing unnamed sources, CNN yesterday reported that the drug used for the treatment is Mapp’s.
Ebola Outbreak
Ebola, spread through direct contact with body fluids such as blood and urine, has sickened 1,603 people in West Africa, killing 887, according to the World Health Organization. The disease, first reported in what is now the Democratic Republic of Congo in 1976, can cause bleeding from the eyes, ears and nose.
The virus has historically killed as many as 90 percent of those who contract it. The current outbreak has a fatality rate of about 60 percent, probably because of early treatment efforts, officials have said.
There is no cure for Ebola, although several companies -- including Mapp -- are working on drug candidates that are undergoing animal testing. Normally, patients are given fluids, blood transfusions and antibiotics with the hope their immune systems can fight off Ebola’s onslaught.
The two scientists behind Mapp, President Larry Zeitlin and Chief Executive Officer Kevin Whaley, “are both brilliant,” said Charles Arntzen, a plant biotechnology expert at Arizona State University who collaborated with the two researchers years ago. “They are very, very bright guys and free spirits.”
The antibody work came out of research projects funded more than a decade ago by the U.S. Army to develop treatments and vaccines against potential bio-warfare agents, such as the Ebola virus, Arntzen said in a telephone interview.
Tobacco Plant
The tobacco plant production system was developed because it was a method that could produce antibodies rapidly in the event of an emergency, he said.
To produce therapeutic proteins inside a tobacco plant, genes for the desired antibodies are fused to genes for a natural tobacco virus, said Arntzen. The tobacco plants are then infected with this new artificial virus, he said.
“The infection results in the production of antibodies inside the plant,” Arntzen said. The plant is eventually ground up and the antibody is extracted, he said. The whole process takes a matter of weeks.
When confronted by reporters about the Ebola infections in Liberia and subsequent treatments, Whaley said he needed to get up to speed on the developing events.
“This is all new to me,” said Whaley, who was dressed in shorts, a well-worn T-shirt and flip-flops while addressing reporters’ questions outside the company’s offices in a San Diego business park. “I just don’t want to give out any inaccurate information, that’s all.”
Antibody Cocktail
Mapp’s drug is being developed with Toronto-based Defyrus Inc., which has six employees, according to Defyrus CEO Jeff Turner. ZMapp is a “cocktail” of monoclonal antibodies that help the immune system attack the virus.
Monoclonal antibodies designed to fight and block specific proteins can stop the virus from latching onto and entering cells, said Heinz Feldmann, chief of the National Institute of Allergy and Infectious Diseases’ Laboratory of Virology in Hamilton, Montana.
The key is to find antibodies that can prevent viral infection, and to attack several points on the virus so that mutants won’t “escape” treatment, he said.
“What you want is a cocktail of antibodies that target different domains on the virus so escape is less likely in treatment,” he said in a telephone interview. Feldmann said he hasn’t been involved in developing treatments.
ZMapp’s predecessor, MB-003, protected three of seven rhesus macaques in a study run in 2013 by Mapp and the U.S. Army Medical Research Institute of Infectious Diseases.
Ethical Questions
Ebola and virology experts believe the use of the Mapp drug for Brantly and Writebol is unusual in the annals of emergency drug treatments. While potentially saving lives, the cases raise questions about who should have the right to receive experimental drugs years before they gain FDA approval.
“There are a lot of Africans that are also dying,” Robert Garry, a virologist at Tulane University, said in a telephone interview. “If we are going to do it for the Americans then we should certainly step up our game for the Africans.”
Although no drugs to treat Ebola are approved by U.S. regulators, the Food and Drug Administration can approve an emergency application to provide access to unapproved drugs, Stephanie Yao, an FDA spokeswoman, said in an e-mail.
Emergency Approval
Approval for emergency drug use outside of a clinical trial can be made within 24 hours, Yao wrote. Shipment and treatment with the drug could begin even before completed written forms are submitted to the FDA, which can approve the use of an experimental treatment by telephone in an emergency.
“The FDA stands ready to work with companies and investigators treating these patients who are in dire need of treatment,” Yao said. She declined to say whether the FDA had allowed any drug to be used in the Ebola outbreak.
Erica Ollmann Saphire, a molecular biologist at the Scripps Research Institute in San Diego, worked with Mapp and the other biotechnology companies to develop models of the Ebola virus and potential antibodies.
She directs a global consortium given the job of modeling the virus and the mixture of antibodies needed to defeat it. She said the drug was approved for the two American medical workers in Liberia under a compassionate-use doctrine, because it’s not even scheduled for clinical trials until next year.
Informed Consent
“I’d take it myself,” she said in an interview in her laboratory, near La Jolla. “Absolutely. I wouldn’t think twice.”
She said the American medical aid workers were in a better position to give consent to the treatment than African disease victims.
“Do you put an untested therapy in a human or do you just watch them die?” Saphire asked. “Certainly these two Americans are medically trained individuals who knew what they were getting into. They are able to give informed consent.”
Medical care of the two U.S. citizens may take two to three weeks if all goes well, Bruce Ribner, an infectious disease specialist at Emory, said in an Aug. 1 news conference.
The Atlanta-based Centers for Disease Control and Prevention, which confirmed that Brantly and Writebol are the first Ebola patients on U.S. soil, is working with the hospital and transport company to make sure evacuation of the two patients goes safely, said Barbara Reynolds, an agency spokeswoman.
“We’re here to make sure the transportation process and the care here in the U.S. ensures there’s no spread,” Reynolds said. “It’s important to remember this is not an airborne virus, it requires close contact with body fluids. It’s minimal risk as long as the people caring for the patient use meticulous procedures.”
To contact the reporters on this story: Robert Langreth in New York at rlangreth@bloomberg.net; Caroline Chen in New York at cchen509@bloomberg.net; John Lauerman in Boston at jlauerman@bloomberg.net
To contact the editors responsible for this story: Rick Schine at eschine@bloomberg.net Andrew Pollack
Something I don't understand, yet. If Ebola is not airborne how could it be transmitted by "indirect contact with environments contaminated with such fluids."?
Ebola virus disease
Fact sheet N°103 Updated April 2014
Key facts
* Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, is a severe, often fatal illness in humans. * EVD outbreaks have a case fatality rate of up to 90%. * EVD outbreaks occur primarily in remote villages in Central and West Africa, near tropical rainforests. * The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission. * Fruit bats of the Pteropodidae family are considered to be the natural host of the Ebola virus. * Severely ill patients require intensive supportive care. No licensed specific treatment or vaccine is available for use in people or animals.
Ebola first appeared in 1976 in 2 simultaneous outbreaks, in Nzara, Sudan, and in Yambuku, Democratic Republic of Congo. The latter was in a village situated near the Ebola River, from which the disease takes its name.
Genus Ebolavirus is 1 of 3 members of the Filoviridae family (filovirus), along with genus Marburgvirus and genus Cuevavirus. Genus Ebolavirus comprises 5 distinct species:
BDBV, EBOV, and SUDV have been associated with large EVD outbreaks in Africa, whereas RESTV and TAFV have not. The RESTV species, found in Philippines and the People’s Republic of China, can infect humans, but no illness or death in humans from this species has been reported to date.
Transmission
Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals. In Africa, infection has been documented through the handling of infected chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest.
Ebola then spreads in the community through human-to-human transmission, with infection resulting from direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and indirect contact with environments contaminated with such fluids. .. more .. http://www.who.int/mediacentre/factsheets/fs103/en/
I mean even touching a wall someone had sneezed upon, or worse, would be 'direct contact'. How does transmission from contaminated environments arise from "indirect contact" with such environments if the virus is not airborne?
Doctors Without Borders workers at an Ebola treatment center in Guinea in April, shortly after the virus was recognized. Credit Kjell Gunnar Beraas/Doctors Without Borders
A week later, it killed the boy’s mother, then his 3-year-old sister, then his grandmother. All had fever, vomiting and diarrhea, but no one knew what had sickened them.
Two mourners at the grandmother’s funeral took the virus home to their village. A health worker carried it to still another, where he died, as did his doctor. They both infected relatives from other towns. By the time Ebola was recognized, in March, dozens of people had died in eight Guinean communities, and suspected cases were popping up in Liberia and Sierra Leone — three of the world’s poorest countries, recovering from years of political dysfunction and civil war.
A nurse sweeping outside St. Joseph’s Catholic Hospital, now closed because of the Ebola outbreak, in Monrovia, Liberia, on Saturday. Credit Ahmed Jallanzo/European Pressphoto Agency
In Guéckédou, where it all began, “the feeling was fright,” said Dr. Kalissa N’fansoumane, the hospital director. He had to persuade his employees to come to work.
Some experts warn that the outbreak could destabilize governments in the region. It is already causing widespread panic and disruption. On Saturday, Guinea announced that it had closed its borders with Sierra Leone and Liberia in a bid to halt the virus’s spread. Doctors worry that deaths from malaria, dysentery and other diseases could shoot up as Ebola drains resources from weak health systems. Health care workers, already in short supply, have been hit hard by the outbreak: 145 have been infected, and 80 of them have died.
Past Ebola outbreaks have been snuffed out, often within a few months. How, then, did this one spin so far out of control? It is partly a consequence of modernization in Africa, and perhaps a warning that future outbreaks, which are inevitable, will pose tougher challenges. Unlike most previous outbreaks, which occurred in remote, localized spots, this one began in a border region where roads have been improved and people travel a lot. In this case, the disease was on the move before health officials even knew it had struck.
Also, this part of Africa had never seen Ebola before. Health workers did not recognize it and had neither the training nor the equipment to avoid infecting themselves or other patients. Hospitals in the region often lack running water and gloves, and can be fertile ground for epidemics. Continue reading the main story
Public health experts acknowledge that the initial response, both locally and internationally, was inadequate.
He added, “A couple of months ago, there was a false sense of confidence that it was controlled, a stepping back, and then it flared up worse than before.”
Health experts have grown increasingly confident in recent years that they can control Ebola, Dr. Frieden said, based on success in places like Uganda.
But those successes hinged on huge education campaigns to teach people about the disease and persuade them to go to treatment centers. Much work also went into getting people to change funeral practices that involve touching corpses, which are highly infectious.
“Early on in the outbreak, we had at least 26 villages or little towns that would not cooperate with responders in terms of letting people into the village, even,” said Gregory Hartl, a spokesman for the World Health Organization.
The outbreak has occurred in three waves: The first two were relatively small, and the third, starting about a month ago, was much larger, Mr. Hartl said. “That third wave was a clarion call,” he said.
At a House subcommittee hearing on Thursday, Ken Isaacs, a vice president of Samaritan’s Purse, said his aid group and Doctors Without Borders were doing much of the work on the outbreak.
“That the world would allow two relief agencies to shoulder this burden along with the overwhelmed Ministries of Health in these countries testifies to the lack of serious attention the epidemic was given,” he said.
Guinea’s Monumental Task
In mid-March, Guinea’s Ministry of Health asked Doctors Without Borders for help in Guéckédou.
At first, the group’s experts suspected Lassa fever, a viral disease endemic in West Africa. But this illness was worse. Isolation units were set up, and tests confirmed Ebola.
Like many African cities and towns, this region hums with motorcycle taxis and minivans crammed with passengers.
The mobility, and now the sheer numbers, make the basic work of containing the disease a monumental task. The only way to stop an outbreak is to isolate infected patients, trace all their contacts, isolate the ones who get sick and repeat the process until, finally, there are no more cases.
But how do you do that when there can easily be 500 names on the list of contacts who are supposed to be tracked down and checked for fever every day for 21 days?
“They go to the field to work their crops,” said Monia Sayah, a nurse sent in by Doctors Without Borders. “Some have phones, but the networks don’t always work. Some will say, ‘I’m fine; you don’t have to come,’ but we really have to see them and take their temperature. But if someone wants to lie and take Tylenol, they won’t have a temperature.”
Graphic What You Need to Know About the Ebola Outbreak
At Donka Hospital in Guinea’s capital,Dr. Simon Mardel, a British emergency physician who has worked in seven previous hemorrhagic fever outbreaks and was sent to Guinea by the World Health Organization, realized this outbreak was the worst he had seen. A man had arrived late one night, panting and with abdominal pain. During the previous few days, he had been treated at two private clinics, given intravenous fluids and sent home. The staff did not suspect Ebola because he had no fever. But fever can diminish at the end stage of the disease.
The treatment room at Donka was poorly lit and had no sink. There were few buckets of chlorine solution, and the staff found it impossible to clean their hands between patients.
The man died two hours after arriving. Tests later showed he had been positive for Ebola. Untold numbers of health care workers and their subsequent patients had been exposed to the disease.
Gloves, in short supply at the hospitals, were selling for 50 cents a pair on the open market, a huge sum for people who often live on less than a dollar a day. At homes where families cared for patients, even plastic buckets to hold water and bleach for washing hands and disinfecting linens were lacking.
Workers were failing to trace all patients’ contacts. The resulting unsuspected cases, appearing at hospitals without standard infection control measures, worsened the spread in a “vicious circle,” Dr. Mardel said.
Tracing an Epidemic’s Origins
As is often the case in Ebola outbreaks, no one knows how the first person got the disease or how the virus found its way to the region. The virus infects monkeys and apes, and some previous epidemics are thought to have begun when someone was exposed to blood while killing or butchering an infected animal. Cooking will destroy the virus, so the risk is not in eating the meat, but in handling it raw. Ebola is also thought to infect fruit bats without harming them, so the same risks apply to butchering bats. Some researchers also think that people might become infected by eating fruit or other uncooked foods contaminated by droppings from infected bats.
Once people become ill, their bodily fluids can infect others, and they become more infectious as the illness progresses. The disease does not spread through the air like the flu; contact with fluids is necessary, usually through the eyes, nose, mouth or cuts in the skin. One drop of blood can harbor millions of viruses, and corpses become like virus bombs.
A research team that studied the Guinea outbreak traced the disease back to the 2-year-old who died in Guéckédou and published a report in The New England Journal of Medicine .. http://www.nejm.org/doi/full/10.1056/NEJMoa1404505 . He and his relatives were never tested to confirm Ebola, but their symptoms matched it and they fit into a pattern of transmission that included other cases confirmed by blood tests.
But no one can explain how such a small child could have become the first person infected. Contaminated fruit is one possibility. An injection with a contaminated needle is another. Continue reading the main story Continue reading the main story
Sylvain Baize, part of the team that studied the Guinea outbreak and head of the national reference center for viral hemorrhagic fevers at the Pasteur Institute in Lyon, France, said there might have been an earlier case that went undiscovered, before the 2-year-old.
“We suppose that the first case was infected following contact with bats,” he said. “Maybe, but we are not sure.”
Health workers in protective clothing screened people for Ebola on Saturday at the government hospital in Kenema, Sierra Leone. Credit Michael Duff/Associated Press
Roaring Back in Liberia
Dr. Fazlul Haque, deputy representative of Unicef in Liberia, said that after a few cases there in March and April, health workers thought the disease had gone away. But it came roaring back about a month later.
“It reappeared, and this time, it came in a very big way,” he said. “The rate of increase is very high now.”
From July 30 to Aug. 6, Liberia’s government reported more than 170 new cases and over 90 deaths.
“Currently, our efforts are not enough to stop the virus,” Dr. Haque said.
He added that most health agencies believed the true case numbers to be far higher, in part because locals were not coming forward when relatives fell ill, and because detection by the health authorities has been weak. Rukshan Ratnam, a spokesman for Unicef in Liberia, said some families had hidden their sick to avoid sending them to isolation wards, or out of shame stemming from traditional beliefs that illness is a punishment for doing something wrong.
Dr. Haque said that the tracing of cases, crucial for the containment of the disease, was moving too slowly to keep up with new infections. Seven counties have confirmed cases, and the government has deployed security forces in Lofa County, where Liberia’s first case was detected, he said. But the government has given leave to nonessential employees in those areas, so it is not clear how they will have the staffing to isolate the sick. Some hospitals have closed because so many health workers have fallen ill.
Liberia has closed markets and many border crossings. It has said testing and screening will be done at immigration checkpoints.
But on Thursday, at a checkpoint staffed by at least 30 soldiers in Klay, Bomi County, there was no screening — just a blockade and a line of trucks loaded with bags of charcoal, plantains and potato greens.
Hilary Wesseh, a truck driver who was sucking the last drops of juice out of a small lime, said he had been stuck there for two days.
“They are holding us hostage,” he said.
A Desperate Call for Help
By June and July, Sierra Leone was becoming the center of the outbreak.At the government hospital in Kenema, Dr. Sheik Umar Khan was leading the efforts to treat patients and control the epidemic.
But he was desperate for supplies: chlorine for disinfection, gloves, goggles, protective suits, rudimentary sugar and salt solutions to fight dehydration and give patients a chance to survive. Early in July, he emailed friends and former medical school classmates in the United States, asking for their help and sending a spreadsheet listing what he needed, and what he had. Many of the lines in the “available” column were empty. One of his requests was for body bags: 3,000 adult, 2,000 child.
Before his friends could send the supplies, Dr. Khan contracted Ebola himself. He died on July 29.
Reporting was contributed by Sabrina Tavernise and Catherine Saint Louis from New York; Clair MacDougall from Monrovia, Liberia; and Elena Schneider from Washington.
A version of this article appears in print on August 10, 2014, on page A1 of the New York edition with the headline: Tracing Ebola’s Breakout to a 2-Year-Old in Guinea.
How the new coronavirus differs from SARS, measles and Ebola
"Deadly Ebola virus reaches Guinea capital Conakry - UN 23 March 2014 Last updated at 14:09 ET"
VIDEO - How the new coronavirus compares to Ebola, Zika and SARS Scientists have identified certain parts of the world as hot spots for emerging diseases. (Blair Guild, Luis Velarde/The Washington Post)
By Yasmeen Abutaleb Jan. 24, 2020 at 11:46 a.m. GMT+11
Similar to SARS, or severe acute respiratory syndrome, which infected more than 8,000 people and killed nearly 800 before it was mostly contained in 2003, the new virus spreads through close person-to-person contact. Each infected person seems to spread the virus to about two others, through coughing or sneezing or by leaving germs on a surface that is touched by non-infected people who touch their faces, said Colleen Kraft, who is associate chief medical officer for Emory University Hospital and helped treat the first U.S. Ebola cases in 2014.
The latest report from Chinese health authorities put the death toll from the new coronavirus at 25, with 830 confirmed cases nationwide.
Still, it is not nearly as infectious as the measles virus, which can live for up to two hours in the air after an infected person coughs or sneezes. Nor does it appear to be anywhere near as deadly as Ebola, which is also much harder to transmit. Ebola is passed largely through direct contact with an infected person’s blood or bodily fluids.
Yet Kraft and global health officials from the World Health Organization cautioned that understanding of the novel virus is still evolving and that the way it spreads and infects people could also change over time.
“The transmission is going to be the same as other respiratory viruses,” Kraft said. “Whether it’s more severe in a person or lasts longer on the surface, those are things that can change. As we learn those things, we can gauge what our panic mode needs to be.”
The WHO on Thursday said it was still too early to declare the outbreak an international public health emergency — a step the international body ultimately took for Ebola in 2014 and Zika in 2016.
Coronaviruses range from the common cold to more-severe diseases such as SARS and Middle East respiratory syndrome, or MERS. Some coronaviruses, including this new one, can cause severe symptoms and illnesses, including pneumonia.
Yet because there are still so many unknowns, there are many scenarios of how this virus could spread, said Tom Frieden, former director of the Centers for Disease Control and Prevention.
An unlikely possibility is that it can be transmitted as readily as the common cold and cause severe pneumonia in a small fraction of people, Frieden said. “That seems quite unlikely, but it would be alarming because it could become like a circulating strain of flu all over the world,” Frieden said.
Another possibility: The virus spreads like SARS — in other words not as readily as the flu — but causes less severe illness than that sister virus. “That would be concerning but not as alarming, and potentially more controllable,” he said.
There is no vaccine or treatment for this coronavirus, but the National Institutes of Health said human trials for a coronavirus vaccine could begin within three months .. https://tinyurl.com/r7lasrm . It is spreading in health-care settings, which officials say is also cause for concern.
“Many things are giving us an advantage, but our disadvantage is the unknown — not fully understanding the disease, its severity and its transmission,” Michael Ryan, executive director of the WHO’s health emergencies program, said at a news conference Thursday.
Guinea enters 'epidemic situation' as seven Ebola cases confirmed
Mar. 2014 - "Deadly Ebola virus reaches Guinea capital Conakry - UN"
Health minister says officials ‘really concerned’ after three deaths from the infectious disease
The previous Ebola epidemic from 2013-16 began in Guinea and left 11,300 dead across the region. Photograph: Carl de Souza/AFP/Getty Images
Agence France-Presse Mon 15 Feb 2021 02.38 AEDT First published on Sun 14 Feb 2021 09.32 AEDT
Guinea has entered an Ebola “epidemic situation” with seven cases confirmed, including three deaths, a leading health official in the west African nation has said.
“Very early this morning, the Conakry laboratory confirmed the presence of the Ebola .. https://www.theguardian.com/world/ebola .. virus,” Sakoba Keita said after an emergency meeting in the capital.
The health minister, Remy Lamah, had earlier spoken of four deaths. It was not immediately clear why the new toll was lower.
The cases marked the first known resurgence of Ebola in west Africa since the 2013-16 epidemic that began in Guinea .. https://www.theguardian.com/world/guinea .. and killed more than 11,300 people across the region. The virus was first identified in 1976 in Zaire, now the Democratic Republic of the Congo (DRC).
Keita, the head of the National Agency for Health Security, said one person had died in late January in Gouécké, south-east Guinea, near the Liberian border. The victim was buried on 1 February “and some people who took part in this funeral began to have symptoms of diarrhoea, vomiting, bleeding and fever a few days later”, he said.
Samples tested by a laboratory set up by the EU in Guéckédou, located in the same region, revealed the presence of Ebola in some of them on Friday, said Keita. He added that with a total of seven cases and three deaths, Guinea was in an “Ebola epidemic situation”.
The WHO representative Alfred George Ki-Zerbo told a press briefing: “We are going to rapidly deploy crucial assets to help Guinea, which already has considerable experience [treating the disease]. The arsenal is stronger now and we will take advantage of that to contain this situation as fast as possible.
“The WHO is on full alert and is in contact with the manufacturer [of a vaccine] to ensure the necessary doses are made available as quickly as possible to help fight back.”
The WHO has regarded each new Ebola outbreak since 2016 with great concern, treating the most recent one, in DRC, as an international health emergency.
In Guinea’s neighbour Liberia, the president, George Weah, put the country’s health authorities on heightened alert on Sunday. Weah “has mandated the Liberian health authorities and related stakeholders in the sector to heighten the country’s surveillance and preventative activities”, his office said in a statement.
No cases of Ebola had been detected in Liberia so far, it added. “The president’s instruction is intended to ensure Liberia acts proactively to avoid any epidemic situation, the kind Liberia witnessed in 2014.”
Weah also told health authorities “to immediately engage communities in towns and villages bordering Guinea and increase anti-Ebola measures”, the statement said.
The widespread use of vaccinations, which were administered to more than 40,000 people, helped curb the disease there.
The 2013-16 outbreak sped up the development of a vaccine against Ebola, with a global emergency stockpile of 500,000 doses planned to respond quickly to future outbreaks, the vaccine alliance Gavi said in January.
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