Fears hundreds exposed to Ebola after girl in Mali dies
October 26, 2014 - 9:29AM
BAMAKO: Mali authorities are scrambling to calm fears after Ebola claimed its first victim in the African country, a contagious toddler who took a 1000-kilometre bus journey before being treated.
The World Health Organisation warned the situation in Mali was an "emergency", and said in its latest Ebola situation report that the biggest outbreak on record has now killed 4922 people, the vast majority of them in Guinea, Liberia and Sierra Leone, with 10,141 cases reported.
The US states of New York and New Jersey ordered mandatory quarantine for medics who had treated victims of the disease in West Africa, after a doctor who had returned from the region became the first Ebola case in New York City.
President Barack Obama told Americans on Saturday that they must be "guided by the facts, not fear".
He sought to calm a jittery public by hugging one of the two nurses who became the first to contract Ebola on American soil after treating a patient, but has now been declared free of the disease.
Mali President Ibrahim Boubacar Keita aimed to ease fears after the death of a two-year-old girl, the first Ebola case in the landlocked country, who travelled from neighbouring Guinea.
"We are doing everything to prevent panic and psychosis," he said in an interview with French radio.
"Since the start of this epidemic, we in Mali took all measures to be safe, but we can never hermetically seal ourselves from this," he said.
"Guinea is a neighbouring country, we have a common border that we have not closed and that we will not close."
Mauritania meanwhile reinforced controls on its border with Mali, which led to a de facto closing of the border, according to local sources.
The WHO said it was treating the situation in Mali as an "emergency" because the toddler had travelled for hundreds of kilometres on public transport with her grandmother while showing symptoms of the disease - meaning that she was contagious.
The girl and her grandmother travelled by public transport from Keweni in Guinea through the towns of Kankan, Sigouri and Kouremale to the Malian capital, Bamako.
The route made for a journey of around 1000 kilometres.
Mali's health ministry however denied that the girl had been showing symptoms before she reached Kayes.
One metric ton of medical supplies was dispatched from WHO stocks in Liberia to Bamako late on Friday.
New York City's first Ebola case, 33-year-old doctor Craig Spencer who fell ill one week after returning from treating patients in Guinea, was said to be in a stable condition in isolation at the city's Bellevue Hospital Center.
His fiancee and two of his friends are in quarantine but appear healthy, officials said.
In the wake of his diagnosis in the country's largest city, the US states of New York and New Jersey ordered mandatory quarantines of 21 days - the maximum gestation period for Ebola - for any individuals who have had direct contact with an Ebola patient while in the worst affected countries.
Dallas-based nurse Nina Pham, who became the first person to contract Ebola in the US after treating an Ebola patient who eventually died at a Dallas hospital, was declared free of the disease.
Her nursing colleague Amber Vinson, who had also caught the disease, has also been given the all-clear.
Canada imposes visa ban on three Ebola-hit countries
November 1, 2014
Ottawa: In a move that echoes a recent Australian decision, Canada will stop issuing visas to people from the three West African nations where Ebola is widespread, the government said on Friday.
The federal citizenship ministry, explaining the decision, said in an official document that "the introduction or spread of the disease would pose an imminent and severe risk to public health".
About 5000 people have died in Guinea, Liberia and Sierra Leone this year in the worst Ebola outbreak on record. Fears rose that the disease could spread beyond the region after a few cases were diagnosed in Spain and the United States.
Canada, which has not reported any cases of Ebola, is following in the footsteps of Australia, which on Tuesday became the first rich nation to issue such a ban. Canada's official in charge of the response to Ebola said the move was medically unjustified.
Under the new regulations, which come into force immediately, Canada will not process visa applications from foreign nationals who have been in an Ebola-affected country within the previous three months.
US President Barack Obama is so far resisting pressure to impose similar travel restrictions.
Canada's Conservative government's decision drew fire from Canada's official opposition New Democratic Party.
"The experts we're relying on to fight Ebola are saying this is not the right approach," the party's health critic Libby Davies said.
Codie Taylor, the chief spokeswoman for Immigration Minister Chris Alexander, did not immediately respond to a request for comment.
The bar on visas from Canada came as judge in the US state of Maine ruled that a nurse who treated victims of Ebola in West Africa does not need to be confined to her home, declaring Ebola fears in the United States "not entirely rational".
Nurse Kaci Hickox's challenge of Maine's 21-day isolation regime became a key battle in the dispute between some US states and the federal government. A handful of states have imposed mandatory quarantines on health workers returning from three Ebola-ravaged West African countries while the federal government is wary of discouraging potential medical volunteers.
While she may travel freely in public, the judge decided that Ms Hickox must continue direct monitoring of her health, co-ordinate travel plans with health officials and report any symptoms.
"I'm happy with the decision the judge made today," Hickox told reporters via a live video feed from her house in Maine to her lawyer's New York City office. "I think we are on the right track. I think now we're discussing as a nation and individual communities about this disease."
Some US politicians have called for a travel ban similar to Canada's, making Ebola as much of a political issue as a public health question.
Only one person in the United States is currently being treated for Ebola, a New York doctor, Craig Spencer, who cared for patients in West Africa.
Genetic factors behind surviving or dying from Ebola shown in mouse study
October 30, 2014
A newly developed mouse model suggests that genetic factors are behind the mild-to-deadly range of reactions to the Ebola virus.
People exposed to Ebola vary in how the virus affects them. Some completely resist the disease, others suffer moderate to severe illness and recover, while those who are most susceptible succumb to bleeding, organ failure and shock.
In earlier studies of populations of people who have contracted Ebola, these differences are not related to any specific changes in the Ebola virus itself that made it more or less dangerous; instead, the body's attempts to fight infection seems to determine disease severity.
In the Oct. 30 edition of Science, scientists describe strains of laboratory mice bred to test the role of an individual's genetic makeup in the course of Ebola disease. Systems biologists and virologists Angela Rasmussen and Michael Katze from the Katze Laboratory at the University of Washington Department of Microbiology led the study in collaboration with the National Institutes of Health's Rocky Mountain Laboratories in Montana and University of North Carolina at Chapel Hill.
Research on Ebola prevention and treatment has been hindered by the lack of a mouse model that replicates the main characteristics of human Ebola hemorrhagic fever. The researchers had originally obtained this genetically diverse group of inbred laboratory mice to study locations on mouse genomes associated with influenza severity.
The research was conducted in a highly secure, state-of-the-art biocontainment safety level 4 laboratory in Hamilton, Mont. The scientists examined mice that they infected with a mouse form of the same species of Ebola virus causing the 2014 West Africa outbreak. The study was done in full compliance with federal, state, and local safety and biosecurity regulations. This type of virus has been used several times before in research studies. Nothing was done to change the virus.
Interestingly, conventional laboratory mice previously infected with this virus died, but did not develop symptoms of Ebola hemorrhagic fever.
In the present study, all the mice lost weight in the first few days after infection. Nineteen percent of the mice were unfazed. They not only survived, but also fully regained their lost weight within two weeks. They had no gross pathological evidence of disease. Their livers looked normal.
Eleven percent were partially resistant and less than half of these died. Seventy percent of the mice had a greater than 50 percent mortality. Nineteen percent of this last group had liver inflammation without classic symptoms of Ebola, and thirty-four percent had blood that took too long to clot, a hallmark of fatal Ebola hemorrhagic fever in humans. Those mice also had internal bleeding, swollen spleens and changes in liver color and texture.
The scientists correlated disease outcomes and variations in mortality rates to specific genetic lines of mice.
"The frequency of different manifestations of the disease across the lines of these mice screened so far are similar in variety and proportion to the spectrum of clinical disease observed in the 2014 West African outbreak," Rasmussen said.
While acknowledging that recent Ebola survivors may have had immunity to this or a related virus that saved them during this epidemic, Katze said, "Our data suggest that genetic factors play a significant role in disease outcome."
In general, when virus infection frenzied the genes involved in promoting blood vessel inflammation and cell death, serious or fatal disease followed. On the other hand, survivors experienced more activity in genes that order blood vessel repair and the production of infection-fighting white blood cells.
The scientists note that certain specialized types of cells in the liver could also have limited virus reproduction and put a damper on systemic inflammation and blood clotting problems in resistant mice. Susceptible mice had widespread liver infection, which may explain why they had more virus in their bodies and poorly regulated blood coagulation. The researchers also noticed that spleens in the resistant and susceptible mice took alternate routes to try to ward off infection.
"We hope that medical researchers will be able to rapidly apply these findings to candidate therapeutics and vaccines," Katze said. They believe this mouse model can be promptly implemented to find genetic markers, conduct meticulous studies on how symptoms originate and take hold, and evaluate drugs and that have broad spectrum anti-viral activities against all Zaire ebolaviruses, including the one responsible for the current West African epidemic.
The above story is based on materials provided by University of Washington Health Sciences/UW Medicine. Note: Materials may be edited for content and length.
Angela L. Rasmussen, Atsushi Okumura, Martin T. Ferris, Richard Green, Friederike Feldmann, Sara M. Kelly, Dana P. Scott, David Safronetz, Elaine Haddock, Rachel LaCasse, Matthew J. Thomas, Pavel Sova, Victoria S. Carter, Jeffrey M. Weiss, Darla R. Miller, Ginger D. Shaw, Marcus J. Korth, Mark T. Heise, Ralph S. Baric, Fernando Pardo Manuel de Villena, Heinz Feldmann, and Michael G. Katze. Host genetic diversity enables Ebola hemorrhagic fever pathogenesis and resistance. Science, 30 October 2014 DOI: 10.1126/science.1259595
WHO boss blames drug industry's profit drive for Ebola cure delay
November 4, 2014 - 3:49PM
New York: The leader of the World Health Organisation has criticised the drug industry, saying that the drive for profit was one reason no cure had yet been found for Ebola.
In a speech at a conference in Cotonou, Benin, WHO director-general Margaret Chan also decried the glaring absence of effective public health systems in the worst-affected countries.
At least 13,567 people are known to have contracted the Ebola virus in the latest outbreak, and 4951 have died, the latest WHO data shows. All but a few of the cases have been in Guinea, Liberia and Sierra Leone.
Dr Chan said her organisation had long warned of the consequences of greed in drug development and of neglect in public health.
In the midst of the Ebola crisis, she said, these "two WHO arguments that have fallen on deaf ears for decades are now out there with consequences that all the world can see, every day, on prime-time TV news".
The Ebola virus was discovered in the Democratic Republic of Congo, then known as Zaire, in 1976.
But because it was confined to impoverished African countries, Dr Chan said, there was no incentive to develop a vaccine until this year, when Ebola became a broader threat.
"A profit-driven industry does not invest in products for markets that cannot pay," she said. "WHO has been trying to make this issue visible for ages. Now people can see for themselves."
Dr Chan reiterated her contention that the Ebola crisis "is the most severe acute public health emergency seen in modern times".
Efforts to find a cure have been stepped up in recent months as the disease has spread, with a small outbreak in Nigeria and isolated cases in Mali, Senegal, Spain and the United States.
At an emergency meeting in September, the UN Security Council declared the Ebola crisis a threat to international security.
Officials at WHO and other public health authorities reported on October 24 that they hoped to begin vaccine trials as early as December and that it should be known by April whether they are effective.
Researchers have been testing two experimental vaccines in healthy volunteers in the US and in other countries outside the main outbreak region in West Africa. One has been developed by the National Institutes of Health and GlaxoSmithKline, and the other by the Canadian government and NewLink Genetics.
Testing on humans of at least five other vaccines could begin in early 2015, WHO officials have said.
Doctors, nurses and other health workers have been especially susceptible to infection because of the way the disease spreads through contact with fluids.
In Sierra Leone on Monday, the authorities reported that a fifth local doctor had died of the disease, news agencies reported.
UN secretary-general Ban Ki-moon on Monday warned against what he called overly strict international restraints on the movement of health workers who are fighting Ebola.
Some countries and some states in the US have quarantined health professionals returning from Guinea, Liberia or Sierra Leone. Other countries, including Canada and Australia, have gone further, temporarily halting the issuance of visas to citizens of the worst-affected countries.
The best way to stop this virus was to stop this virus at its source, rather than limiting for work, or restricting the movement of people or trade, Mr Ban said.
He called Ebola health workers "extraordinary people who are giving of themselves; they are risking their own lives".
Ebola death toll passes 5000, says World Health Organisation
November 13, 2014 - 7:07AM
Geneva: The World Health Organisation says 5160 people have so far died of Ebola across eight countries, from a total 14,098 cases of infection.
WHO has acknowledged though that the number of deaths is likely far higher, given that the fatality rate in the current outbreak is known to be about 70 per cent.
The fresh toll released on Wednesday, which was for up until November 9, comes as Mali reported a second death from Ebola, four days after Medecins Sans Frontieres said it appeared the country may have prevented the spread of the disease.
A nurse died on Tuesday after treating a man from Guinea, WHO spokeswoman Sona Bari said. The man, who died on October 26, was treated for kidney failure and wasn't suspected of having Ebola at the time, she said. Tests are pending.
Mali became the sixth country in West Africa to confirm a case of Ebola last month when a woman brought her infected two-year-old granddaughter from Guinea into the country. The girl died on October 24.
Mali is now monitoring 28 people for possible exposure to the virus, said WHO's representative in Mali, Ibrahima-Soce Fall. The clinic where the nurse worked has been quarantined, the BBC reported.
The worst-hit countries in the Ebola outbreak are Guinea, Liberia and Sierra Leone.
In its latest toll, the WHO said 2836 deaths were recorded in Liberia, out of a total of 6822 cases. In Sierra Leone, 1169 people had died from the virus out of 5368 cases. In Guinea, there were 1142 deaths from 1878 cases.
Data from Nigeria and Senegal remained unchanged, and both countries have been declared Ebola free. Nigeria had eight deaths and 20 cases, while Senegal had one case and no deaths.
In Mali, WHO reported three additional Ebola deaths, but said they were not linked to the only other case and death recorded in the country - that of a two-year-old girl from Guinea.
There has been one case of infection in Spain, where an infected nurse has recovered. In the United States, four Ebola cases have been recorded and one person - a Liberian - had died from the virus.
Ebola is spread only through direct contact with the bodily fluids of an infected person showing symptoms such as fever or vomiting.
People caring for the sick or handling the bodies of people infected Ebola are especially exposed.
WHO said on Wednesday that a total of 564 healthcare workers were known to have contracted the virus, and 320 of them had died.
Ebola in Mali: Nurse dies after sick imam from Guinea was never tested for virus
November 13, 2014 - 2:52AM
The clinic where a nurse died from the Ebola in Mali capital Bamako. Photo: AP
Bamako: Authorities in Mali have quarantined dozens of people at the home of a 25-year-old nurse who died from Ebola in the capital, Bamako, and at the clinic where he treated an imam from Guinea who died with Ebola-like symptoms.
The imam from the border town of Kouremale was never tested for the disease and his body was washed in Mali and returned to Guinea for burial without precautions against the virus.
Two aid workers said that another person who lived in the house where the imam stayed in Bamako had died this week and was buried without being tested.
A doctor at the Pasteur Clinic where the nurse worked - one of Bamako's top medical centres - is also suspected to have contracted Ebola.
Mali, the sixth West African nation to record Ebola, must now trace a new batch of contacts just as people linked to its first and only other case - a two-year-old girl who died last month - completed their 21-day quarantine on Tuesday.
Concern is growing at the time it took between the imam dying and the steps needed to contain the deadly disease being put in place. Dr Samba Sow, head of Mali's Ebola response, said the imam died on October 27, two days after going to the clinic.
"This case shows the lack of training of doctors in Bamako. This training should have been done six months ago," one aid worker said, asking not to be named.
The government said in a statement on Wednesday that the nurse was confirmed to have Ebola on Tuesday and died later that evening. All necessary steps to identify people who had come into contact with the nurse had been taken, it said.
Ousmane Doumbia, secretary-general of the health ministry, said 70 people had been quarantined. The Pasteur Clinic was locked down by police on Tuesday night.
Mali shares an 800 kilometre border with Guinea, which alongside Liberia and Sierra Leone, has been worst affected by an outbreak that has killed nearly 5,000 people this year. The two-year-old girl had also brought Ebola to Mali from Guinea.
New York doctor Craig Spencer declared Ebola-free, released from hospital
November 12, 2014 - 1:41PM
New York: A visibly giddy Craig Spencer, the doctor diagnosed with Ebola in New York City, has been released from hospital, ending a saga that began nearly three weeks ago when he was rushed there and tested for the virus.
Dr Spencer walked outside to cheers from the medical personnel who had treated him and from the crowd gathered nearby. He was greeted with what New York Mayor Bill de Blasio called "the official mayoral hug," along with hugs from Chirlane McCray, the city's first lady, and nurses.
Dr Spencer was declared free of the virus on Monday night, 19 days after he was taken to Bellevue Hospital Centre and diagnosed with Ebola. His clean bill of health means the United States now has no known cases of Ebola.
"It's a very, very good day ... Dr Spencer is Ebola-free, and New York City is Ebola-free," Mr de Blasio said outside the hospital.
Mr de Blasio praised Dr Spencer for his work caring for patients in West Africa and for keeping his sense of humour during his treatment in Manhattan.
"It is a good feeling to hug a hero," Mr de Blasio said. "And we have a hero here in our midst, someone who served others no matter how much danger. And he has been an inspiration throughout the challenges he has faced."
Dr Spencer urged the public and the media to focus attention on the crisis in West Africa, where the disease has killed almost 5000 people in Liberia, Guinea and Sierra Leone. He also said medical workers and others who travel to West Africa to fight the disease should not be stigmatised on their return.
Dr Spencer's diagnosis prompted concerns in New York, where he had taken the subway and visited restaurants and bars before testing positive for the virus, and it sparked a larger debate over how to deal with medical personnel returning from countries facing the Ebola epidemic. Government officials in New Jersey, New York and other states vowed to quarantine returning medical workers, moves that were criticised by aid groups and public-health experts.
The New York City health department has said it is monitoring hundreds of people for possible exposure to Ebola, including individuals who treated Dr Spencer at Bellevue and others who had travelled from West Africa but did not have a connection to him. These people are being watched for 21 days, which is the time it takes a person to develop Ebola symptoms.
Doctor dies in Nebraska after Ebola infection in Sierra Leone
November 18, 2014 - 12:51AM
A physician infected with the Ebola virus died on Monday at the Nebraska Medical Centre after being evacuated from Sierra Leone.
Martin Salia was on dialysis, a ventilator and multiple medications after suffering from kidney and respiratory failure, the hospital said in a statement. He also got a dose of plasma from an Ebola survivor and Mapp Biopharmaceutical's ZMapp drug.
"We used every possible treatment available to give Dr Salia every possible opportunity for survival," Phil Smith, medical director of the hospital's biocontainment unit, said in the statement.
"As we have learned, early treatment with these patients is essential. In Dr Salia's case, his disease was already extremely advanced by the time he came here for treatment."
Salia was chief medical officer and surgeon at Kissy United Methodist Hospital in Freetown, the capital of Sierra Leone. That facility was closed on November 11 after Salia tested positive for Ebola, the United Methodist Church said.
The hospital had said Salia arrived in an "extremely critical" condition. He is the sixth doctor in Sierra Leone to be infected with the deadly virus; the other five also died.
The patient, a permanent US resident from Sierra Leone, was evacuated at the request of his wife, who lives in Maryland, the State Department has said.
"We are so appreciative of the opportunity for my husband to be treated here and believe he was in the best place possible," his wife, Isatu Salia, said in the hospital's statement.
Salia was the third person treated for the deadly virus at Nebraska Medical Centre, following a missionary worker, Rick Sacra, and a freelance journalist, Ashoka Mukpo. Both were evacuated from West Africa after becoming infected, and recovered. Neither arrived at the hospital in as grave condition as Salia.
Eight people treated in US hospitals have been cured. The only other person to die of Ebola in the US, Thomas Eric Duncan, was initially released from a Dallas hospital in September before returning with worsening symptoms. Two nurses were infected after contact with Duncan; both recovered.
The virus has ravaged West Africa, killing more than 5,170, mostly in Liberia, Guinea and Sierra Leone.
Is the US pursuing the right strategy against Ebola?
November 19, 2014 - 7:41AM
While large Ebola treatment units are under construction in Liberia, the number of new cases has slowed to a trickle.
Washington: Just two months ago, patients were being turned away from Ebola treatment units in Liberia because there weren't enough beds to cope with the spiralling caseload.
US President Barack Obama dispatched hundreds of troops to build and supply 17 new units, along with a 25-bed field hospital dedicated to treating infected healthcare workers. But before the first of the 100-bed units opened this month in Tubmanburg, there were signs that the epidemic was slowing down.
The number of new cases reported in Lofa County, where Liberia's outbreak began, decreased from a peak of 153 in the week ending August 16 to four new cases in the week ending November 1, according to a report issued by the US Centres for Disease Control and Prevention.
Death in United States: Dr Phil Smith, medical director of the Biocontainment Unit at a press conference on Monday after the death of Dr Martin Salia as a result of the advanced symptoms of Ebola at the University of Nebraska Medical Centre.
In Montserrado, Liberia's most populous county, which accounts for half of the nation's Ebola cases, there has been a 73 per cent decline in admissions to isolation wards, a 58 per cent drop in blood samples testing positive for the virus and a 53 per cent decline in the number of bodies collected for burial since mid-September, according to another report that appeared in an early version of the CDC's Morbidity and Mortality Weekly Report on Friday.
Researchers caution, however, that new outbreaks continue to emerge in more remote parts of Liberia that could drive the numbers back up if they aren't swiftly contained.
The country accounts for more than 6800 of the 14,400 confirmed and suspected Ebola cases and more than 2800 of the 5100 deaths reported to the World Health Organisation since March.
The latest twists are forcing the United States and its partners to re-evaluate their response in West Africa, which has continued to lag behind the epidemic.
Rather than focus on building large treatment units, international aid groups such as Doctors Without Borders are urging donors to finance mobile teams that can quickly respond to new hot spots to isolate the sick, trace those who came into contact with them, disinfect contaminated areas and conduct safe burials.
Mr Obama has asked Congress for $6 billion to expand the fight against Ebola in West Africa and at home.
The Los Angeles Times spoke with Rajiv Shah, the administrator of the US Agency for International Development, to find out what the government is doing to get ahead of the virus. Here is an edited transcript of the conversation.
It's been two months since the president announced that he was sending troops to West Africa as part of stepped-up efforts to fight Ebola. Have they had any effect?
If I could step back and just say, I fundamentally believe that we will not resolve the risk of Ebola in the United States until we tackle Ebola at its source in West Africa. To that end, the president has led an international effort that includes a number of other partners that have stepped up efforts in the last three months, two months in particular, and I think we've started to see that those efforts have made a very significant impact in beginning to stem the tide of this really disastrous disease.
In Liberia, for example, the USAID-co-ordinated effort has helped to already build and staff a number of new Ebola treatment units. We have helped to set up more than 50 burial teams that go out and get the bodies of the deceased, and safely and in a dignified way dispose of those bodies. And we have really worked throughout the country to communicate that Ebola is real, that people need to wash their hands, not touch each other and change their basic behavioural norms in order to protect themselves.
The result of that effort is that we've seen a reduction in the number of new cases per day from around 70 to around 20. And while there's a lot of work to be done in the year ahead to really fundamentally tackle Ebola, there has without a question in Liberia been a significant reduction in transmission as a result of US investments that are evidence-based and results-oriented.
There has been some concern that the decline in cases may also be a sign that the virus is moving into new places, and people are not bringing patients to treatment centres or contacting burials teams. Are you confident that this really is a decline in the spread of the virus?
There's no question there's been a real and significant decline in the transmission of the virus. It's more pronounced in some districts and counties than others. You're also right that there continue to be cases that are not identified, people that are not coming out and seeking care and isolation, and communities that are suffering from micro-epidemics that are faster moving, more rural and more difficult to reach.
We know that going forward we have to have a nimble, flexible, rapid response in communities that often are less aware of the virus, less eager to seek support, and where you can otherwise have clusters of new cases.
Which raises the question whether the US is pursuing the right strategy at this point by focusing on building large treatment centres, particularly in Liberia where there are empty beds.
Empty beds are OK. You want to have capacity for when cases arise.
We will continually adapt the strategy based on evidence. And right now the focus is building these rapid-response capabilities that allow us to set up a 10 or 15-bed mini ETU (Ebola treatment unit) in a rural community that needs it right away, as opposed to fully staffing out very large treatment units that don't necessarily need extra beds. The reality of the strategy that we have allows for flexibility, so that if an ETU should be at 30 beds and doesn't need to be at 100 beds, we can run it at 30.
Are you talking about something that would be mobile?
Well, people are discussing what that means. To me they are largely static but established quickly. Remember, an ETU is not a physical hospital structure. It is a series of tents organised in a way that keeps people who are at risk of being positive separated from people who are not, with a very, very clear layout for infection control and management.
Part of their job would be treatment, but there would also be people who could be involved in safe burials, in community mobilisation, contact tracing and all of the other things that need to happen in order to bring a flare-up under control.
The International Medical Corps, which is based in Los Angeles, has been an important partner for building and staffing Ebola treatment units, and we're working hand in glove with them to create this more mobile, rapid-response approach to case isolation in rural communities.
Do you have any of these mini ETUs up and running yet?
There are some that are up and running. Until recently, we've been calling them community care centres. Samaritan's Purse is already helping to do this. UNICEF is already doing it, and IMC I think will start doing this. And I hope MSF (the French acronym for Doctors Without Borders) will also, since they are part of designing this approach.
Remember, this is an epidemic that we haven't seen before, this scale, and the epidemiology will shift as we achieve success with our efforts. As the epidemiology shifts, we need to adapt our approach based on what's working and what the data tells us.
Another big challenge has been personnel. What we're hearing from aid groups is that they still feel there aren't enough people responding in West Africa, particularly medical personnel. Why is that?
We are already supporting 1000 medical personnel throughout the region. We recognise that that is going to have to continue and accelerate. We did see a decline in volunteers to our system, almost a 20 per cent decline, after the New Jersey quarantine episode. It's important to make sure that we're treating these health workers like the heroes that they are and managing their return in a way that is driven by the science and the evidence as to what's best.
We continue to work with our international partners and are trying to get doctors from Norway and epidemiologists from the African Union and scientists from India and medical personnel and construction engineers from China all involved in what needs to be an international response.
At the same time that we've seen a decline in new cases in Liberia, the number of cases has been picking up in Sierra Leone. There have also been flare-ups in parts of Guinea, and now a new chain of transmission has been identified in Mali. Is there enough aid going to those countries?
I think that's exactly why the president has put forward a funding request to the Congress, so that we can continue to accelerate and intensify this response over the course of the next year.
It is going to take time to deal with a complex epidemic that, as we've seen before, can look like it's dying down and then quickly explode again. So we're not declaring success. We're not at all suggesting the fight is over. In fact, what we're doing is learning and adapting from data and evidence about what works and setting ourselves up so that we have the resources, partners and capabilities to lead the effort to tackle Ebola at its source through the coming year.
Cuban doctor in Sierra Leone tests positive for Ebola
November 19, 2014 - 8:21PM
Havana: A Cuban doctor treating Ebola patients in Sierra Leone has tested positive for the disease and was being sent to Geneva for treatment, officials said, the first Cuban known to have contracted the potentially deadly haemorrhagic fever.
The doctor, identified by Cuba's official website Cubadebate on Tuesday as Felix Baez Sarria, is one of 165 Cuban doctors and nurses treating Ebola patients in Sierra Leone. They have been there since early October.
They are part of a Cuban team of 256 medical professionals sent to West Africa to treat patients in the worst Ebola outbreak on record that has killed more than 5000 people.
Dr Baez, a specialist in internal medicine, had a fever of 38 degrees on Sunday and tested positive on Monday after being taken to the capital Freetown, Cubadebate reported, citing a Health Ministry statement. He has not shown complications and is "hemodynamically stable", the statement said.
"Our collaborator is being tended to by a team of British professionals with experience in treating patients who have displayed the disease and they have maintained constant communication with our brigade," the statement said.
Cuban officials did not say how he caught the disease or immediately release any other information about the case, the first reported among the health workers the island sent to Africa.
At the urging of the World Health Organisation it was decided to send him to a university hospital in Geneva, where he would be treated by experts in infectious diseases, the ministry statement said. His whereabouts in Sierra Leone early on Wednesday were unclear.
The Cuban commitment to treating Ebola patients in West Africa has won international praise as more substantial than contributions from many wealthy countries. Among those recognising Cuba has been the United States, its political adversary for the past 55 years.
Some 165 Cuban doctors and nurses have gone to Sierra Leone for a six-month mission, with another 53 in Liberia and 38 in Guinea.
Another 205 have undergone three weeks of training, with extensive practice in using protective full-body suits, and are ready to receive an Ebola assignment.
The Communist-run island has practised medical diplomacy since Fidel Castro came to power in a 1959 revolution.
While Cuba provides disaster relief around the world free of charge, it also exchanges doctors for cash or goods on more routine missions. The island receives an estimated 100,000 barrels of oil a day from Venezuela, where some 30,000 Cuban medical professionals are posted.
In all, there are more than 50,000 health workers in 67 countries.
The latest WHO tally on November 14 reported 5177 Ebola deaths out of 14,133 cases, mostly in Liberia, Sierra Leone and Guinea.
US pharmaceutical giant Merck buys rights to experimental Ebola vaccine
Tue 25 Nov 2014, 6:54am
US pharmaceutical giant Merck will compete with rival GlaxoSmithKline to produce a commercial vaccine for the Ebola virus. (Reuters: Steve Parsons/pool)
The United States' second biggest pharmaceuticals company has announced it will buy worldwide commercial rights to an experimental vaccine against the Ebola virus.
NewLink Genetics Corp, whose subsidiary licensed commercial rights to the rVSV-EBOV vaccine in 2010, said it would receive $50 million plus royalties from Merck & Co Inc.
Large late-stage trials of the product could begin early next year, said Merck, one of the world's biggest makers of vaccines.
Merck, which would be able to speed up and significantly boost production, would take over development of the vaccine and any follow-on products.
The Public Health Agency of Canada, which originally developed the vaccine, would retain non-commercial rights to it.
The deal between Merck and NewLink, a tiny biotechnology company based in Ames, Iowa, came as other drugmakers were also racing to test and scale-up production of treatments and preventive vaccines for Ebola, which has killed more than 5,400 people this year.
It is the worst Ebola outbreak on record. Guinea, Sierra Leone and Liberia account for all but 15 of the deaths.
The Walter Reed Army Institute of Research and the US National Institute of Allergy and Infectious Diseases were conducting early-stage trials of the NewLink vaccine.
The trials involved healthy volunteers and were testing whether the vaccine was safe and provoked a protective immune response.
If Phase I studies proved favourable, large late-stage trials would be set to begin early next year.
The World Health Organisation was also coordinating early-stage trials in Switzerland, Germany, Kenya and Gabon.
In a regulatory filing on Monday, NewLink said Merck would pay it $30 million upfront and $20 million once larger formal trials begin.
The company would also be eligible to receive royalties on sales in certain markets.
Rival pharmaceutical producer GlaxoSmithKline Plc was developing its own Ebola vaccine and planned to build a stockpile of thousands of doses for emergency deployment if results were good.
Sierra Leone Ebola burial workers dump bodies in pay protest
November 26, 2014 - 12:49PM
The Ebola epidemic has killed nearly 5500 people since March. Photo: AFP
Freetown: Burial workers in Sierra Leone have dumped bodies in the street outside a hospital in protest at authorities' failure to pay bonuses for handling Ebola victims.
Residents said up to 15 corpses had been abandoned in the eastern town of Kenema, three of them at a hospital entrance to stop people entering. The head of the district Ebola Response Team, Abdul Wahab Wan, said the bodies included those of two babies.
A spokesman for the striking workers said they had not been paid their weekly hazard allowance for seven weeks.
Authorities acknowledged the money had not been paid but said that all the striking members of the Ebola Burial Team would be dismissed.
"Displaying corpses in a very, very inhumane manner is completely unacceptable," said National Ebola Response Centre spokesman Sidi Yahya Tunis.
He added that the central government had paid the money to the district health management team. "Somebody somewhere needs to be investigated [to find out] where these monies have been going," he said.
Healthcare workers have repeatedly gone on strike in Liberia and Sierra Leone over pay and dangerous working conditions. Two weeks ago, workers walked off the job at a clinic in Bo in Sierra Leone.
Sierra Leone has become the biggest hotspot in the West African Ebola epidemic, which has killed nearly 5500 people since March.
Underscoring the gravity, a medical source said on Tuesday that another Sierra Leonean doctor, Aiah Solomon Konoyeima, had tested positive for the disease. All seven Sierra Leonean doctors who have caught Ebola have died.
The outbreak appears to be coming under control in neighbouring Liberia and Guinea, but infection rates have accelerated in Sierra Leone. The head of a special UN mission on Ebola acknowledged on Monday it would not meet the target of containing the outbreak by early December.
Despite pledges of hundreds of millions of dollars in aid, and the deployment of US and British troops, the weakness of healthcare systems and infrastructure in the affected countries has hampered the fight against the worst outbreak of the Ebola virus on record.
Ebola crisis: Vaccine one step closer, as infection rates accelerate in Sierra Leone
November 27, 2014
Washington: Researchers say they are one step closer to developing an Ebola vaccine, with a trial showing promising results.
However, it will be months before any vaccine can be used in the field. Pharmaceutical companies and health agencies are scrambling to fast-track experimental drugs and vaccines that could help.
In the first phase of testing, all 20 healthy adults injected with a higher or lower dose of the vaccine developed antibodies needed to fight Ebola, said the National Institutes of Health, which conducted the study. Results were published on Wednesday in the New England Journal of Medicine.
"The unprecedented scale of the current Ebola outbreak in West Africa has intensified efforts to develop safe and effective vaccines," said Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, which is developing the vaccine alongside GlaxoSmithKline.
The vaccines under development "may play a role in bringing this epidemic to an end and undoubtedly will be critically important in preventing future large outbreaks", he noted.
The institute is "in active discussions with Liberian officials and other partners about next-stage vaccine testing in West Africa" for efficacy and safety, it said, but no announcement on larger-scale trials was expected before early next year.
The volunteers were injected starting in September, and each showed a positive result for Ebola antibodies in blood tests within four weeks.
The 10 volunteers in the higher-dose group developed higher antibody levels, the NIH said.
In Sierra Leone, the government has appealed to the United States to send military aid to help it battle Ebola as it falls behind its West African neighbours Guinea and Liberia in the fight against the virus.
The worst recorded Ebola outbreak has killed at least 5689 people out of out of 15,935 cases, the World Health Organisation said on Wednesday, as the virus has overwhelmed African countries with weak infrastructure and healthcare systems.
While the outbreak appears to be coming under control in Liberia, thanks partly to a health operation run by US troops, infection rates have accelerated in Sierra Leone.
The rate of transmission is also beginning to slow in neighbouring Guinea, the first country to report an Ebola case, although case numbers are rising in Mali.
"I believe now that the cases are reducing in Liberia, he [US President Barack Obama] will ask the Department of Defence and the State Department also to turn attention to helping the efforts in Sierra Leone," said Alpha Kanu, Sierra Leone's minister of information and communication.
He also appealed to the United States to help Guinea, and urged Britain to provide more assistance to Sierra Leone.
Sierra Leone's President Ernest Bai Koroma has introduced emergency Ebola measures. He said it might be necessary to call another three-day lockdown to remove the sick from communities and transfer them to newly built treatment centres.
"Liberia and Sierra Leone report that fewer than 70 per cent of patients are isolated, though there is wide variation among districts," the World Health Organisation said, referring to an international target set for December 1. However, some data is out of date, it said.
Isolation is required to halt further spread of the viral hemorrhagic disease, and the aim is to isolate 100 per cent of patients by January 1, it added.
Meanwhile, the European Commission called on Wednesday for 5000 doctors to be sent from European Union states to combat west Africa's Ebola epidemic, a European source said on Wednesday.
"The situation is too serious and it needs an immediate response," the source said, adding that senior EU officials were in contact with national governments to mobilise the response. "Thousands of other medical caregivers were also being called for," the source said.
Eurpean Union calls for 5000 doctors to fight Ebola: source
November 27, 2014
The European Commission called on Wednesday for 5000 doctors to be sent from European Union states to combat west Africa's Ebola epidemic, a European source with knowledge of the matter said on Wednesday.
"The situation is too serious and it needs an immediate response," the source, who spoke on condition of anonymity, said, adding that senior EU officials were in contact with national governments to mobilise the response.
"Thousands of other medical caregivers were also being called for," the source said.
In a tweet, EU Health Commissioner Vytenis Andriukaitis said he had so far reached 14 EU ministers, urging them to send more medical staff to Ebola-hit countries.
"Positive responses," he added, without providing more details.
The source said the EU's Ebola coordinator, Christos Stylianides, was also reaching out to ministers, with more funds and logistic materials on the list of demands.
European officials were casting a wide net, asking for both medical staff directly from national authorities as well as volunteers operating through charities.
Earlier this month, Andriukaitis and Stylianides took part in a joint trip to the three worst hit West African countries: Sierra Leone, Liberia and Guinea.
Upon their return, the officials made an immediate call for epidemiologists to do more to diagnose and track the disease's progression.
The EU as a whole has so far mobilised more than one billion euros ($1.47 billion) for the fight against Ebola, including 373 million euros ($547.5 million) from the Commission, the EU's executive arm in Brussels.
Ebola has killed nearly 5500 people and infected 15,351, mainly in west Africa, according to the latest figures from the World Health Organisation.