HEALTH MAIN EBOLA DISCUSSION THREAD - WEEK OF 8/1/14 - 8/15/14
- Thread starter Dennis Olson
- Start date
- Status
Lilbitsnana
On TB every waking moment
More on the original qoted post below. We better hope it comes back negative, since his exposure would have been in Uganda or an airplane and not one of the four countries.
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http://www.hurriyetdailynews.com/ne...urkey.aspx?pageID=238&nID=70487&NewsCatID=341
New case rekindles Ebola fears in Turkey
OSMANİYE
A 34-year-old citizen has been quarantined in a southeastern Turkish town, rekindling fears of a possible case of the Ebola virus.
The patient, who works in Uganda and was visiting his hometown, was taken to an isolated room at the infection service of Çukurova University Balcalı Hospital in the Osmaniye province, Anadolu Agency reported Aug. 15.
Dr. Yeşim Taşova, the chief physician of the hospital, said the patient, identified as İ.K., was hospitalized on the night of Aug. 14, after having fever and severe diarrhea caused by an upper respiratory tract infection.
“The patient has been examined. He’s fine now and has no fever,” Taşova said, stressing all related authorities have been informed and the results of a blood analysis is expected to soon confirm or deny the suspicion of Ebola.
A Nigerian passenger, who arrived in Turkey early Aug. 12, had created panic when she became ill onboard while flying from Lagos to Istanbul. She was diagnosed with Malaria, not Ebola and was hence able to leave Turkey.
Turkish authorities are on high alert as the virus keeps spreading in Africa. A boy who was travelling with his parents from Nairobi to Istanbul was taken to a doctor due to fever and vomiting after their plane landed in Istanbul. He was allowed to fly in transit to another country after officials of the Directorate General of Health for Border and Coastal Areas approved of the decision.
August/15/2014
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http://www.hurriyetdailynews.com/ne...urkey.aspx?pageID=238&nID=70487&NewsCatID=341
New case rekindles Ebola fears in Turkey
OSMANİYE
A 34-year-old citizen has been quarantined in a southeastern Turkish town, rekindling fears of a possible case of the Ebola virus.
The patient, who works in Uganda and was visiting his hometown, was taken to an isolated room at the infection service of Çukurova University Balcalı Hospital in the Osmaniye province, Anadolu Agency reported Aug. 15.
Dr. Yeşim Taşova, the chief physician of the hospital, said the patient, identified as İ.K., was hospitalized on the night of Aug. 14, after having fever and severe diarrhea caused by an upper respiratory tract infection.
“The patient has been examined. He’s fine now and has no fever,” Taşova said, stressing all related authorities have been informed and the results of a blood analysis is expected to soon confirm or deny the suspicion of Ebola.
A Nigerian passenger, who arrived in Turkey early Aug. 12, had created panic when she became ill onboard while flying from Lagos to Istanbul. She was diagnosed with Malaria, not Ebola and was hence able to leave Turkey.
Turkish authorities are on high alert as the virus keeps spreading in Africa. A boy who was travelling with his parents from Nairobi to Istanbul was taken to a doctor due to fever and vomiting after their plane landed in Istanbul. He was allowed to fly in transit to another country after officials of the Directorate General of Health for Border and Coastal Areas approved of the decision.
August/15/2014
almost ready
Inactive
Laurie Garrett on the same page as Doomer Doug et moi and several others.....
http://www.foreignpolicy.com/articl...red_enough_ebola_vaccine_west_africa_outbreak
The magazine let me read it once and now is blocking me unless I register. Maybe you'll have the same experience.
The jist of it is that this is serious - deadly serious - and airport screening won't do anything to stop it. The tone of the article is just below shouting and stomping. She is saying that "YOU JUST DON'T GET IT". Sadly, many do get it and don't care or actually think this is a good thing....especially her intended readers at the CFR.
It's very, very hard to look at the photos of the slum in Monrovia which houses 75,000 people, who now have ebola deaths in their midst and think that this was an accident waiting to happen, with fuel and dry tinder just waiting for a gentle zepher to set it off.
No plumbing, no sewage system. Use the surrounds both as the toilet and washing (perhaps drinking) supply.
http://fluboard.rhizalabs.com/forum/viewtopic.php?f=5&t=12031
Article recommended highly. Scroll down until you see the pictures. Warning: For mature audiences only. It's severe. Stuff that makes you want to vomit.
http://www.foreignpolicy.com/articl...red_enough_ebola_vaccine_west_africa_outbreak
The magazine let me read it once and now is blocking me unless I register. Maybe you'll have the same experience.
The jist of it is that this is serious - deadly serious - and airport screening won't do anything to stop it. The tone of the article is just below shouting and stomping. She is saying that "YOU JUST DON'T GET IT". Sadly, many do get it and don't care or actually think this is a good thing....especially her intended readers at the CFR.
It's very, very hard to look at the photos of the slum in Monrovia which houses 75,000 people, who now have ebola deaths in their midst and think that this was an accident waiting to happen, with fuel and dry tinder just waiting for a gentle zepher to set it off.
No plumbing, no sewage system. Use the surrounds both as the toilet and washing (perhaps drinking) supply.
http://fluboard.rhizalabs.com/forum/viewtopic.php?f=5&t=12031
Article recommended highly. Scroll down until you see the pictures. Warning: For mature audiences only. It's severe. Stuff that makes you want to vomit.
Tygerkittn
Veteran Member
Thank you!
almost ready
Inactive
Why in the hell are they flooding Scotland with immigrants? WHo are the people responsible for this madness? Names, faces, addresses....
Enough of the silent rule from the shadows.
Possible Impact
TB Fanatic
Excerpt from FDA booklet:
1. INTENDED USE STATEMENT
The Ebola Zaire Target 1 (EZ1) real-time reverse transcription (rRT) polymerase chain
reaction (PCR) (TaqMan®) assay (EZ1 assay) is for the presumptive detection of Ebola
Zaire virus (detected in the West Africa outbreak in 2014) on specified instruments in
individuals in affected areas with signs and symptoms of Ebola virus infection or who
are at risk for exposure or may have been exposed to the Ebola Zaire virus (detected
in the West Africa outbreak in 2014) in conjunction with epidemiological risk factors.
The EZ1 assay is intended for use only on authorized platforms by laboratories
designated by DoD.
Testing with the EZ1 assay should not be performed unless the individual has been
exposed to or is at risk for exposure to Ebola Zaire virus or has signs and symptoms
of infection with Ebola Zaire virus (detected in the West Africa outbreak in 2014)
that meet clinical and epidemiologic criteria for testing suspect specimens.
The level of Ebola Zaire virus (detected in the West Africa outbreak in 2014) present
in blood from individuals with early systemic infection is unknown. Negative results
do not preclude Ebola Zaire virus (detected in the West Africa outbreak in 2014)
infection and should not be used as the sole basis for patient management decisions.
Results are for the presumptive identification of the Ebola Zaire virus (detected in the
West Africa outbreak in 2014). The definitive identification of the Ebola Zaire virus
(detected in the West Africa outbreak in 2014) requires additional testing and
confirmation procedures in consultation with public health or other authorities for
whom reporting is required. The diagnosis of Ebola Zaire virus (detected in the West
Africa outbreak in 2014) infection must be made based on history, signs, symptoms,
exposure likelihood, and other laboratory evidence in addition to the identification of
the Ebola Zaire virus (detected in the West Africa outbreak in 2014) by this test.
The EZ1 assay is for use only under Emergency Use Authorization (EUA) by specified
laboratories and clinical laboratory personnel who have been trained on authorized
instruments.
2. INTRODUCTION
The EZ1 assay has been authorized for use on the Applied Biosystems® 7500 Fast Dx
Real-Time PCR Instrument (ABI 7500 Fast Dx), Roche LightCycler® (LightCycler), and
Biofire Defense Joint Biological Agent Identification and Diagnostic System (JBAIDS) to
provide Ebola Zaire virus testing capability to sites that currently perform PCR testing
on these instruments.
All users, analysts, and any person reporting diagnostic results from the use of these
devices should be trained in rRT-PCR on the specified instrument. Use of this assay is
limited to laboratories designated by DoD.
1. INTENDED USE STATEMENT
The Ebola Zaire Target 1 (EZ1) real-time reverse transcription (rRT) polymerase chain
reaction (PCR) (TaqMan®) assay (EZ1 assay) is for the presumptive detection of Ebola
Zaire virus (detected in the West Africa outbreak in 2014) on specified instruments in
individuals in affected areas with signs and symptoms of Ebola virus infection or who
are at risk for exposure or may have been exposed to the Ebola Zaire virus (detected
in the West Africa outbreak in 2014) in conjunction with epidemiological risk factors.
The EZ1 assay is intended for use only on authorized platforms by laboratories
designated by DoD.
Testing with the EZ1 assay should not be performed unless the individual has been
exposed to or is at risk for exposure to Ebola Zaire virus or has signs and symptoms
of infection with Ebola Zaire virus (detected in the West Africa outbreak in 2014)
that meet clinical and epidemiologic criteria for testing suspect specimens.
The level of Ebola Zaire virus (detected in the West Africa outbreak in 2014) present
in blood from individuals with early systemic infection is unknown. Negative results
do not preclude Ebola Zaire virus (detected in the West Africa outbreak in 2014)
infection and should not be used as the sole basis for patient management decisions.
Results are for the presumptive identification of the Ebola Zaire virus (detected in the
West Africa outbreak in 2014). The definitive identification of the Ebola Zaire virus
(detected in the West Africa outbreak in 2014) requires additional testing and
confirmation procedures in consultation with public health or other authorities for
whom reporting is required. The diagnosis of Ebola Zaire virus (detected in the West
Africa outbreak in 2014) infection must be made based on history, signs, symptoms,
exposure likelihood, and other laboratory evidence in addition to the identification of
the Ebola Zaire virus (detected in the West Africa outbreak in 2014) by this test.
The EZ1 assay is for use only under Emergency Use Authorization (EUA) by specified
laboratories and clinical laboratory personnel who have been trained on authorized
instruments.
2. INTRODUCTION
The EZ1 assay has been authorized for use on the Applied Biosystems® 7500 Fast Dx
Real-Time PCR Instrument (ABI 7500 Fast Dx), Roche LightCycler® (LightCycler), and
Biofire Defense Joint Biological Agent Identification and Diagnostic System (JBAIDS) to
provide Ebola Zaire virus testing capability to sites that currently perform PCR testing
on these instruments.
All users, analysts, and any person reporting diagnostic results from the use of these
devices should be trained in rRT-PCR on the specified instrument. Use of this assay is
limited to laboratories designated by DoD.
Lilbitsnana
On TB every waking moment
BBC Breaking News @BBCBreaking 8h
It'll take "at least 6 months" to bring #Ebola under control, @MSF says http://bbc.in/1pfS62I
BBC News (World) @BBCWorld 8h
#Ebola "is like a frontline" - it's advancing but "we have no clue" where it'll go, @MSF says http://bbc.in/1pfQ6Yo
It'll take "at least 6 months" to bring #Ebola under control, @MSF says http://bbc.in/1pfS62I
BBC News (World) @BBCWorld 8h
#Ebola "is like a frontline" - it's advancing but "we have no clue" where it'll go, @MSF says http://bbc.in/1pfQ6Yo
Tristan
Has No Life - Lives on TB
It's a document that explains how to take a blood sample and test it for Ebola based on a particular brand of test. Here's the not so good part:
Assay Limitations
1. All results should be interpreted by a trained professional in conjunction with the patient’s history and clinical signs and symptoms.
2. Interpretation of results from the EZ1 assay must account for the possibility of false-negative and false-positive results.
3. Negative results do not preclude infection with Ebola virus and should not be the sole basis of a patient treatment/management decision.
4. False positive results may occur from cross-contamination by target organisms, their nucleic acids or amplified product.
5. Failure to follow the assay procedures may lead to false negative results.
6. Improper collection, storage, or transport of specimens may lead to false negative results.
7. Inhibitors present in the samples may lead to false negative results.
So basically, if it comes back positive then you probably have ebola. If it comes back negative then maybe you do or maybe you don't. A negative means they have to make an educated guess based on your travel history and who you've been in contact with.
Hopefully now that they have pinned down the strain that they're working with they'll be able to refine the test and make it more accurate (unless the accuracy is purely dependent on viral load, in which case never mind.)
Marthanoir
TB Fanatic
It's a detention centre for illegal immigrants, http://en.wikipedia.org/w/index.php?title=Dungavel
there's a few of them around the UK, it can take years to deport somebody from the UK and that's if the EHRC (European Court of Human Rights) don't block it,
Do you remember the hassle the Brits had trying to deport convicted terrorist Abu Hamza to the US and then to Jordan, ECHR were blocking it all the way
http://en.wikipedia.org/w/index.php?title=Abu_Hamza_al-Masri
Countrymouse
Country exile in the city
But--unfortunately--most countries are blithely ASSUMING that a "negative" is a definitive NEGATIVE--and letting airline passengers, for instance, go on to their destination...
Baloo
Veteran Member
I have read somewhere that the average grocery store only has two days worth of food (two normal sales days).
I also have talked with my neighbors (who goto the grocery every couple of days) about maybe keeping some food around in case power goes out or something happens--they laughed.
I also have talked with my neighbors (who goto the grocery every couple of days) about maybe keeping some food around in case power goes out or something happens--they laughed.
Sacajawea
Has No Life - Lives on TB
SIGH. Yes. I know. And sadly, a lot of the time it's medical pros putting their total trust in a test -- often in countries that where the directions aren't rigorously followed. "Well, we have a test. It came back negative. What are y'all worried about?"
I just wanna
Medical Maven
Deceased
Before you spoke you should have thought of this old saying: "Remember that no good deed goes unpunished". They will remember what you said when their hunger becomes unbearable.
LightEcho
Has No Life - Lives on TB
Sanitizing a piece of metal or plastic is fairly easy. Heat it to a kill temperature long enough or douse it with a cold chemical sterilant strong enough and long enough, and you kill the infection/virus/bacteria.
But with people it is entirely different. Viruses are particularly scary because they can reside in places in the body away from infection-fighting white blood cells. Once the immune response subsides, they can regenerate, or be excreted.
The report of "cured" Ebola patients still having deadly semen samples for 2 weeks is an interesting observation. And what about fecal matter. Will they sterilize all excretions? How long? I don't believe the human "cure" will make them entirely safe. Can this virus hibernate in the victim's finger nails, bones, spinal column, brain, connective tissue, cartilage?
But with people it is entirely different. Viruses are particularly scary because they can reside in places in the body away from infection-fighting white blood cells. Once the immune response subsides, they can regenerate, or be excreted.
The report of "cured" Ebola patients still having deadly semen samples for 2 weeks is an interesting observation. And what about fecal matter. Will they sterilize all excretions? How long? I don't believe the human "cure" will make them entirely safe. Can this virus hibernate in the victim's finger nails, bones, spinal column, brain, connective tissue, cartilage?
Medical Maven
Deceased
And how long will those current Hot Zones in West Africa be prone to flare-ups of new infections of New Ebola? There is a lot of New Ebola virus finding a lot of diverse environments for maybe a long term stay. I would rather camp near Chernobyl than camp near Monrovia ten years from now, (if there is a ten years from now).
Lilbitsnana
On TB every waking moment
It's seven + weeks, not two. (actually I believe it was 62 days and still virulent, so even longer than seven weeks)
Countrymouse
Country exile in the city
Oh. Joy.
From the PFI Forum:
Pixie: Not "at" big airports, but in passengers passing through them who may become symptomatic several days later while at Chuck E. Cheese.
THREAT OF EBOLA OUTBREAK HIGHEST AT BIG US AIRPORTS, HEALTH ALLIANCE SAYS
NEWS LAST MODIFIED ON AUGUST 15, 2014
http://www.airport-world.com/news/g...at-big-us-airports-health-alliance-says.html?
A non-profit organization has developed global maps using airline flight route data to calculate and predict the potential arrival of Ebola hemorrhagic fever virus from infected travellers in West Africa.
The EcoHealth Alliance has collected data from flight schedules from infected countries Liberia, Guinea, Sierra Leone, and Nigerian, along with data from Morocco, and Ghana, and found the highest risk countries for the Ebola outbreak in West Africa, are the US and much of Europe.
EcoHealth Alliance's modeling team says New York's JFK International Airport, Washington Dulles International Airport, Hartsfield-Jackson Atlanta International Airport, Houston's George Bush Intercontinental Airport and Boston Logan International Airport are at highest risk - as they are the top US airports with direct flight arrivals from the region.
Dr William Karesh, executive vice president of health and policy at EcoHealth Alliance, comments: “It's easy to point the finger at wildlife as the reservoirs of disease, but the real culprit in this scenario is human interaction with wildlife from bushmeat hunting, illegal wildlife trade, habitat destruction and deforestation.”
The global maps prepared by EcoHealth Alliance scientists explain how Ebola may spread via international flight routes, and the alliance says other countries most at risk include the UK, Netherlands, Germany, France, Switzerland, Denmark, Portugal, Austria, Ireland, Italy, Spain, Senegal, Ghana, Gambia, Israel, UAE, Qatar, and Japan.
The EcoHealth Alliance says the capacity of diseases to spread via traveling passengers varies significantly and scientists cannot predict the actual date or times of the plausible arrival of the Ebola virus via an infected traveller.
Scientists can estimate the relative risk of the virus spreading from country to country by identifying the most direct entry points.
Many gateways across the globe have already taken out measures to prevent the disease, by refusing flights from East African countries, and carrying out health screening checks on passengers arriving.
Last week, the World Health Organization (WHO) declared the Ebola outbreak in West Africa to be an international public health emergency.
The WHO has also now classified Kenya as a "high-risk" country for the spread of the deadly virus, andit is a major transport hub, with many flights from West Africa.
http://www.singtomeohmuse.com/viewt...art=1185&sid=334d90957cda0b9e443594f4c1589324
From the PFI Forum:
Pixie: Not "at" big airports, but in passengers passing through them who may become symptomatic several days later while at Chuck E. Cheese.
THREAT OF EBOLA OUTBREAK HIGHEST AT BIG US AIRPORTS, HEALTH ALLIANCE SAYS
NEWS LAST MODIFIED ON AUGUST 15, 2014
http://www.airport-world.com/news/g...at-big-us-airports-health-alliance-says.html?
A non-profit organization has developed global maps using airline flight route data to calculate and predict the potential arrival of Ebola hemorrhagic fever virus from infected travellers in West Africa.
The EcoHealth Alliance has collected data from flight schedules from infected countries Liberia, Guinea, Sierra Leone, and Nigerian, along with data from Morocco, and Ghana, and found the highest risk countries for the Ebola outbreak in West Africa, are the US and much of Europe.
EcoHealth Alliance's modeling team says New York's JFK International Airport, Washington Dulles International Airport, Hartsfield-Jackson Atlanta International Airport, Houston's George Bush Intercontinental Airport and Boston Logan International Airport are at highest risk - as they are the top US airports with direct flight arrivals from the region.
Dr William Karesh, executive vice president of health and policy at EcoHealth Alliance, comments: “It's easy to point the finger at wildlife as the reservoirs of disease, but the real culprit in this scenario is human interaction with wildlife from bushmeat hunting, illegal wildlife trade, habitat destruction and deforestation.”
The global maps prepared by EcoHealth Alliance scientists explain how Ebola may spread via international flight routes, and the alliance says other countries most at risk include the UK, Netherlands, Germany, France, Switzerland, Denmark, Portugal, Austria, Ireland, Italy, Spain, Senegal, Ghana, Gambia, Israel, UAE, Qatar, and Japan.
The EcoHealth Alliance says the capacity of diseases to spread via traveling passengers varies significantly and scientists cannot predict the actual date or times of the plausible arrival of the Ebola virus via an infected traveller.
Scientists can estimate the relative risk of the virus spreading from country to country by identifying the most direct entry points.
Many gateways across the globe have already taken out measures to prevent the disease, by refusing flights from East African countries, and carrying out health screening checks on passengers arriving.
Last week, the World Health Organization (WHO) declared the Ebola outbreak in West Africa to be an international public health emergency.
The WHO has also now classified Kenya as a "high-risk" country for the spread of the deadly virus, andit is a major transport hub, with many flights from West Africa.
http://www.singtomeohmuse.com/viewt...art=1185&sid=334d90957cda0b9e443594f4c1589324
LightEcho
Has No Life - Lives on TB
Thanks. That just thrills me all the more.
They buried many bodies. Those burial pits are virus factories. Africa is toast. Each day there is a greater chance that this thing mutates into a more "virulent" virus. We are approaching the precipice of a great abyss. A couple months ago I held judgment to see if the infection/death toll would double in a month. We have exceeded what I set for my personal alarm clock. The numbers of potential streams for this thing is going exponential.
That's an awesome question. Why does the virus remain in the semen so long? I think it's specific to the semen because the testes don't permit the same kind of immunological response as the rest of the body, and so it takes a little longer to destroy the virus there. See here for more details.
+++++++++++++++++++++++++++++++++++++==http://www.foreignpolicy.com/articl...red_enough_ebola_vaccine_west_africa_outbreak
The magazine let me read it once and now is blocking me unless I register. Maybe you'll have the same experience.
The jist of it is that this is serious - deadly serious - and airport screening won't do anything to stop it. The tone of the article is just below shouting and stomping. She is saying that "YOU JUST DON'T GET IT". Sadly, many do get it and don't care or actually think this is a good thing....especially her intended readers at the CFR.
It's very, very hard to look at the photos of the slum in Monrovia which houses 75,000 people, who now have ebola deaths in their midst and think that this was an accident waiting to happen, with fuel and dry tinder just waiting for a gentle zepher to set it off.
No plumbing, no sewage system. Use the surrounds both as the toilet and washing (perhaps drinking) supply.
http://fluboard.rhizalabs.com/forum/viewtopic.php?f=5&t=12031
Article recommended highly. Scroll down until you see the pictures. Warning: For mature audiences only. It's severe. Stuff that makes you want to vomit.
Here is the entire article, almost ready, thanks for the heads-up. Take care. BREWER
Posted for fair use and discussion.
http://www.foreignpolicy.com/articl...red_enough_ebola_vaccine_west_africa_outbreak
You Are Not Nearly Scared Enough About Ebola
Experimental drugs and airport screenings will do nothing to stop this plague. If Ebola hits Lagos, we're in real trouble.
AUGUST 14, 2014
BY Laurie Garrett
[Laurie Garrett is senior fellow for global health at the Council on Foreign Relations and a Pulitzer Prize winning science writer.]
Attention, World: You just don't get it.
You think there are magic bullets in some rich country's freezers that will instantly stop the relentless spread of the Ebola virus in West Africa? You think airport security guards in Los Angeles can look a traveler in the eyes and see infection, blocking that jet passenger's entry into La-la-land? You believe novelist Dan Brown's utterly absurd description of a World Health Organization that has a private C5-A military transport jet and disease SWAT team that can swoop into outbreaks, saving the world from contagion?
Wake up, fools. What's going on in West Africa now isn't Brown's silly Inferno scenario -- it's Steven Soderbergh's movie Contagion, though without a modicum of its high-tech capacity.
Last week, my brilliant Council on Foreign Relations colleague John Campbell, former U.S. ambassador to Nigeria, warned that spread of the virus inside Lagos -- which has a population of 22 million -- would instantly transform this situation into a worldwide crisis, thanks to the chaos, size, density, and mobility of not only that city but dozens of others in the enormous, oil-rich nation. Add to the Nigerian scenario civil war, national elections, Boko Haram terrorists, and a countrywide doctors' strike -- all of which are real and current -- and you have a scenario so overwrought and frightening that I could not have concocted it even when I advised screenwriter Scott Burns on his Contagion script.
Inside the United States, politicians, gadflies, and much of the media are focused on wildly experimental drugs and vaccines, and equally wild notions of "keeping the virus out" by barring travelers and "screening at airports."
Let's be clear: Absolutely no drug or vaccine has been proven effective against the Ebola virus in human beings.
Let's be clear: Absolutely no drug or vaccine has been proven effective against the Ebola virus in human beings. To date, only one person -- Dr. Kent Brantly -- has apparently recovered after receiving one of the three prominent putative drugs, and there is no proof that the drug was key to his improvement. None of the potential vaccines has even undergone Phase One safety trials in humans, though at least two are scheduled to enter that stage before December of this year. And Phase One is the swiftest, easiest part of new vaccine trials -- the two stages of clinical trials aimed at proving that vaccines actually work will be difficult, if not impossible, to ethically and safely execute. If one of the vaccines is ready to be used in Africa sometime in 2015, the measure will be executed without prior evidence that it can work, which in turn will require massive public education to ensure that people who receive the vaccination do not change their behaviors in ways that might put them in contract with Ebola -- because they mistakenly believe they are immune to the virus.
We are in for a very long haul with this extremely deadly disease -- it has killed more than 50 percent of those laboratory-confirmed infections, and possibly more than 70 percent of the infected populations of Liberia, Sierra Leone, and Guinea. Nigeria is struggling to ensure that no secondary spread of Ebola comes from one of the people already infected by Liberian traveler Patrick Sawyer -- two of whom have died so far. That effort was expanded on Wednesday, when Nigerian health authorities announced that a nurse who had treated Sawyer escaped her quarantine confinement in Lagos and traveled to Enugu, a state that, as of 2006, has a population of about 3 million. Though the nurse has not shown symptoms of the disease, the incubation time for infection, which is up to 21 days, hasn't elapsed.
Since the Ebola outbreak began in March there have been many reports of isolated cases of the disease in travelers to other countries. None have resulted, so far, in secondary spread, establishing new epidemic focuses of the disease. As I write this, one such case is thought to have occurred in Johannesburg, South Africa's largest city, and another suspected case reportedly died in isolation in Jeddah, Saudi Arabia, prompting the kingdom to issue special Ebola warnings for the upcoming hajj. It's only a matter of time before one of these isolated cases spreads, possibly in a chaotic urban center far larger than the ones in which it is now claiming lives: Conakry, Guinea; Monrovia, Liberia; and Freetown, Sierra Leone.
So what does "getting it" mean for understanding what we, as a global community, must now do?
First of all, we must appreciate the scale of need on the ground in the three Ebola-plagued nations. While the people may pray for magic bullets, their health providers are not working in Hollywood, but rather in some of the most impoverished places on Earth. Before Ebola, these countries spent less than $100 per year per capita on health care. Most Americans spend more than that annually on aspirin and ibuprofen.
We must collectively listen to the pleading and anguish coming from those courageous health providers who have seen Ebola claim more than 80 of their colleagues since the crisis began. What do they want?
On Aug. 8, the World Health Organization (WHO) declared the Ebola epidemic a "public health emergency of international concern." In its pronouncement, the agency noted the urgent need for local government actions, such as the recently erected cordons sanitaires, and for global mobilization of medical resources. The WHO has repeatedly warned that this epidemic could persist for a minimum of six months, perhaps a year. The director of the U.S. Centers for Disease Control and Prevention, Dr. Tom Frieden, has concurred with that grim forecast.
"It's like fighting a forest fire: leave behind one burning ember, one case undetected, and the epidemic could re-ignite," Frieden recently told Congress. "Ending this outbreak will take time, at least three to six months in a best case scenario, but this is very far from a best case scenario."
At the same congressional hearing Dr. Frank Glover, a medical missionary who partners with SIM, a Christian missions organization, and president of SHIELD, a U.S.-based NGO in Africa, warned that Liberia had less than 200 doctors struggling to meet the health needs of 4 million people before the epidemic. "After the outbreak that number went down to about 50 doctors involved in clinical care," said Glover.
I myself have received emails from physicians in these countries, describing the complete collapse of all non-Ebola care, from unassisted deliveries to untended auto accident injuries. People aren't just dying of the virus, but from every imaginable medical issue a system of care usually faces.
Ken Isaacs, vice president of International Programs and Government Relations at Samaritan's Purse, the aid organization that has two of its members fighting for their lives in Ebola quarantine in Atlanta, told Congress, "It took two Americans getting the disease in order for the international community and United States to take serious notice of the largest outbreak of the disease in history. 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."
Despite current response mechanisms, this Ebola outbreak, Isaacs said as he closed his remarks, "is uncontained and out of control in West Africa."
Even if the world dodges a viral bullet and Ebola fails to take hold in a metropolis in a different country (such as Lagos, Johannesburg, Delhi, or Sao Paulo), controlling the disease and saving lives in Liberia, Sierra Leone, and Guinea will require resources on a scale nobody has delineated. The emotionally distraught doctors and nurses on the front lines are screaming for help.
Let's start with simple, on-the-ground manpower. All three countries desperately need doctors, nurses, medical technicians, ambulance drivers, Red Cross volunteers, epidemiologists, and health logistics experts. They do not need novice do-gooders from the wealthy world, but people experienced in working under the stifling conditions of tropical heat, the desperation of supplies deficits, and the fearfulness of epidemics. The lion's share of care to date has been provided by one group -- Médecins Sans Frontières -- which is pleading for others to relieve their exhausted ranks -- 600 people who have been fighting for months on the front lines in this war.
Nothing could be clearer than this MSF press release, dated Aug. 8:
Dr. Bart Janssens, MSF Director of Operations
"Declaring Ebola an international public health emergency shows how seriously WHO is taking the current outbreak; but statements won't save lives. Now we need this statement to translate into immediate action on the ground. For weeks, MSF has been repeating that a massive medical, epidemiological and public health response is desperately needed to saves lives and reverse the course of the epidemic. Lives are being lost because the response is too slow.
Countries possessing necessary capacities must immediately dispatch available infectious disease experts and disaster relief assets to the region. It is clear the epidemic will not be contained without a massive deployment on the ground from these states.
In concrete terms, all of the following need to be radically scaled up: medical care, training of health staff, infection control, contact tracing, epidemiological surveillance, alert and referral systems, community mobilisation and education.
MSF currently has 66 international and 610 national staff responding to the crisis in the three affected countries. All our Ebola experts are mobilized, we simply cannot do more."
Here is the list of supplies Emmet A. Dennis, president of the University of Liberia, e-mailed that he needs for his medical school personnel now fighting cases in Monrovia:
Gowns -- Isolation
Underpads -- Disposable
Gloves, Examination -- All Sizes
Body Bags - Adult & Children
Infectious Waste Bag -- Red
Face Mask -- Duckbilled
Face Shield Disposable
Eye Shields -- Disposable
Shoe Covers
Aprons - Disposable
Sanitizer Wipes
Plastic Boots
Surgical Caps -- Disposable
Disinfectant
Scrubs (L & XL)
Thermometer: Infrared -- Thermofocus
Disinfectant Soap
Chlorinated Disinfectant
Rehydration Fluids
R/L Solution
N/S Solution
It simply does not get more basic. As there are no miracle drugs for Ebola, the needs include few medicines, though other local responders tell me that they wish they had sterile syringes, saline drips, and fever modulators such as aspirin.
"Getting it," in this epidemic, means realizing that over the next six to 12 months, these countries will needs millions of dollars' worth of basic supplies, hundreds of highly skilled healthcare workers, including logistics supplies officers, and self-sufficiency for all foreigners (food, water, personal supplies). As the border blockades ending trade to these nations persist, food supplies for the population will also become acutely short, probably necessitating World Food Program assistance. Exhausted, frightened young soldiers and police will need their ranks replaced slowly with United Nations Peacekeepers or soldiers from the African Union.
And of course this list assumes Ebola remains confined in terms of secondary spread to Liberia, Sierra Leone, and Guinea. If the virus takes hold in another, more populous nation, the needs will grow exponentially, and swiftly.
Posted for fair use and discussion. H/t Pixie
http://www.usatoday.com/story/news/nation/2014/08/15/ebola-detection-mount-sinai/13969031/
Ebola control suffers from lack of fast detection tool
Karen Weintraub, Special for USA TODAY 8 a.m. EDT August 15, 2014
Early in August, when doctors worried that a patient at Mount Sinai Hospital in New York had Ebola, it took nearly three days to confirm that he didn't. And that was in one of the richest, most medically advanced cities in the world.
In Sierra Leone and neighboring Liberia, local hospitals have closed because no one can tell the difference between early Ebola and other common ailments. This means no one is getting care for other illnesses like malaria and the even deadlier Lassa fever, multiplying the misery there.
Detection will become particularly crucial when drugs are available to treat the virus, which has killed more than 1,000 people in four West African nations since late last year. No one will want to waste scarce medications on someone unless they are convinced the person has Ebola, said John Connor, a microbiologist at Boston University. and the drugs are more effective the earlier they are given.
"The faster you can diagnose, the better chance you have of giving therapy effectively," Connor said.
But diagnosing diseases in sub-Saharan Africa remains a challenge, despite years of research.
Current systems of detection involve large, expensive machines that depend on water and electricity, and require skilled technicians to operate and maintain. It took so long to diagnose the man at Mount Sinai, because his blood sample had to be shipped to the Centers for Disease Control and Prevention in Atlanta, which has one of the few labs in America that can diagnose Ebola.
Such a process is totally impractical in low-income countries like Sierra Leone and Liberia, which lack basic infrastructure. Liberia, a nation of 3.5 million, reportedly has just 50 doctors.
What's needed is something as easy to use as a pregnancy test, said Bill Rodriguez, CEO of Daktari Diagnostics, which has been developing a diagnostic device for HIV/AIDS.
But getting to that point from where we are now "would be like (leaping) from the early days of stereo systems 100 years ago to the world's smallest iPod overnight," said Rodriguez, an infectious disease doctor who left Harvard to start the company. "No one's done it yet for anything, let alone Ebola."
Ebola is particularly challenging, he said, because it is so dangerous to study.
A number of American academics and small companies have been working on detection methods for Ebola, and others like Daktari are now thinking about how to adapt their technologies to help fight an outbreak that has already killed more than 1,000 people in West Africa. None of the approaches has yet received regulatory approval to be used on patients, though several are in or getting close to human testing.
Daktari, based in Cambridge, Mass., uses a device that looks like an old tape recorder: Slide in a cassette with a sample of blood and the device determines within three or four minutes whether the sample contains HIV. Rodriguez said he has been discussing the possibility of retooling the device to screen for Ebola.
Connor at Boston University is using LED lights to illuminate and identify viruses in what will be a portable device. Developed to detect Ebola, he and his colleagues have tested the device on similar diseases and are now getting ready to test it with the deadly pathogen, said Connor, an investigator at a Boston University lab, which is awaiting federal approval to begin working with Ebola.
A third approach pioneered by a company called Nanobiosym, also in Cambridge, reads the genetic fingerprint of a virus. Company CEO and founder Anita Goel said her Gene-RADAR device can accurately detect a wide range of pathogens within an hour for a few dollars a test. Goel said her company is in discussions with potential clients now about the possibility of adapting the device to detect Ebola.
Any rapid detection method will also benefit patients and health-care providers in the United States, according to Belinda Ostrowsky, an infectious disease specialist at Albert Einstein College of Medicine and Montefiore Medical Center in New York City.
Otherwise, someone has to take a sample from a sick patient, transport the sample to a lab, and examine the sample — putting themselves at risk for accidental exposure. Quickly ruling out Ebola or other diseases will allow those lab workers and the patient to breathe easier.
"We want to protect our workers and really take care of that patient," Ostrowsky said.
Getting funding to develop such devices remains a major challenge, Rodriguez said. "People are much more aware of the need for drugs than diagnostics," he said. "There's no economic incentive for a company to develop an Ebola diagnostic test."
Until they do, Rodriguez said, the most common method of Ebola detection is simply waiting out the disease.
"It's pretty easy to diagnose Ebola four weeks later," he said, based on their symptoms and survival. But that doesn't help the patient or contain the outbreak.
http://www.usatoday.com/story/news/nation/2014/08/15/ebola-detection-mount-sinai/13969031/
Ebola control suffers from lack of fast detection tool
Karen Weintraub, Special for USA TODAY 8 a.m. EDT August 15, 2014
Early in August, when doctors worried that a patient at Mount Sinai Hospital in New York had Ebola, it took nearly three days to confirm that he didn't. And that was in one of the richest, most medically advanced cities in the world.
In Sierra Leone and neighboring Liberia, local hospitals have closed because no one can tell the difference between early Ebola and other common ailments. This means no one is getting care for other illnesses like malaria and the even deadlier Lassa fever, multiplying the misery there.
Detection will become particularly crucial when drugs are available to treat the virus, which has killed more than 1,000 people in four West African nations since late last year. No one will want to waste scarce medications on someone unless they are convinced the person has Ebola, said John Connor, a microbiologist at Boston University. and the drugs are more effective the earlier they are given.
"The faster you can diagnose, the better chance you have of giving therapy effectively," Connor said.
But diagnosing diseases in sub-Saharan Africa remains a challenge, despite years of research.
Current systems of detection involve large, expensive machines that depend on water and electricity, and require skilled technicians to operate and maintain. It took so long to diagnose the man at Mount Sinai, because his blood sample had to be shipped to the Centers for Disease Control and Prevention in Atlanta, which has one of the few labs in America that can diagnose Ebola.
Such a process is totally impractical in low-income countries like Sierra Leone and Liberia, which lack basic infrastructure. Liberia, a nation of 3.5 million, reportedly has just 50 doctors.
What's needed is something as easy to use as a pregnancy test, said Bill Rodriguez, CEO of Daktari Diagnostics, which has been developing a diagnostic device for HIV/AIDS.
But getting to that point from where we are now "would be like (leaping) from the early days of stereo systems 100 years ago to the world's smallest iPod overnight," said Rodriguez, an infectious disease doctor who left Harvard to start the company. "No one's done it yet for anything, let alone Ebola."
Ebola is particularly challenging, he said, because it is so dangerous to study.
A number of American academics and small companies have been working on detection methods for Ebola, and others like Daktari are now thinking about how to adapt their technologies to help fight an outbreak that has already killed more than 1,000 people in West Africa. None of the approaches has yet received regulatory approval to be used on patients, though several are in or getting close to human testing.
Daktari, based in Cambridge, Mass., uses a device that looks like an old tape recorder: Slide in a cassette with a sample of blood and the device determines within three or four minutes whether the sample contains HIV. Rodriguez said he has been discussing the possibility of retooling the device to screen for Ebola.
Connor at Boston University is using LED lights to illuminate and identify viruses in what will be a portable device. Developed to detect Ebola, he and his colleagues have tested the device on similar diseases and are now getting ready to test it with the deadly pathogen, said Connor, an investigator at a Boston University lab, which is awaiting federal approval to begin working with Ebola.
A third approach pioneered by a company called Nanobiosym, also in Cambridge, reads the genetic fingerprint of a virus. Company CEO and founder Anita Goel said her Gene-RADAR device can accurately detect a wide range of pathogens within an hour for a few dollars a test. Goel said her company is in discussions with potential clients now about the possibility of adapting the device to detect Ebola.
Any rapid detection method will also benefit patients and health-care providers in the United States, according to Belinda Ostrowsky, an infectious disease specialist at Albert Einstein College of Medicine and Montefiore Medical Center in New York City.
Otherwise, someone has to take a sample from a sick patient, transport the sample to a lab, and examine the sample — putting themselves at risk for accidental exposure. Quickly ruling out Ebola or other diseases will allow those lab workers and the patient to breathe easier.
"We want to protect our workers and really take care of that patient," Ostrowsky said.
Getting funding to develop such devices remains a major challenge, Rodriguez said. "People are much more aware of the need for drugs than diagnostics," he said. "There's no economic incentive for a company to develop an Ebola diagnostic test."
Until they do, Rodriguez said, the most common method of Ebola detection is simply waiting out the disease.
"It's pretty easy to diagnose Ebola four weeks later," he said, based on their symptoms and survival. But that doesn't help the patient or contain the outbreak.
Is there a source for this? The number of people who have recovered from Ebola prior to this epidemic is small, probably less than a thousand, and they're all in a different part of Africa. So I think it would be very unlikely that anyone who has recovered from a previous strain has been infected by this one.
Posted for fair use and discussion. H/t Pixie
http://www.liberianobserver.com/news/nurses-use-3-thermometers-thousands
Liberia:Nurses Use 3 Thermometers On Thousands
Thu, 08/14/2014 - 07:48
By: Gloria T.Tamba
The Government of Liberia has begun testing citizens in eight counties for the deadly Ebola disease.
This testing of individuals is meant to control the spread from counties believed to be highly infected with the killer disease.
Several counties, including Bomi, Lofa, Grand Cape Mount, Grand Bassa, Margibi Montserrado and Grand Gedeh, have been controlled to regulate the movement of people going in and out of those areas.
The Daily Observer recently discovered that the control process as announced by the Liberian government took a different dimension as the temperatures of those leaving from one area to another were tested by nurses assigned at various checkpoints using only three thermometers.
The testing process has been questioned by some segments of the Liberian society, including foreign nationals who visited Bomi over the weekend.
Bomi County is among eight counties quarantined by the Liberian government.
In an interview with the Daily Observer over the weekend, Mr. Shang Guan, a Chinese national, said the intention of the government is good but is also dangerous to the health of citizens and foreigners alike.
Mr. Guan refused to be tested with any of the three thermometers used by the county health team at the Bomi checkpoint.
He said the use of manual thermometers to check the temperature of travelers as a means of containing the spread of the deadly virus was not the right thing to do. Experts have said that one way the deadly Ebola virus is spread is through contact with bodily fluids. Thermometers are either inserted in the mouth or under the arm, both of which involve the transfer of saliva and sweat respectively.
According to him, since the virus quickly spreads and kills 90% of its victims, it would be prudent for authorities at the Health Ministry to use advanced rather than standard thermometers that do not involve physical contact with individuals.
“I was worried about taking the test because even if you have malaria your temperature will be high and even if that person has Ebola, it might spread to the others just by the use of the so few thermometers”, Mr. Guan said.
He disclosed that what was even more scary to him was that all those who were being tested used the same three thermometers, with nurses having physical contact with travelers. Such a situation is highly risky for the people of Liberia.
The Chinese national hailed Liberians as well as foreigners alike who have cooperated with the testing, but suggested that the limited thermometers being used must be well sanitized to avoid endangering the lives of others.
Another Liberian, Oscar Dolo, who was seen at the checkpoint said, the process was poorly coordinated by the county health authorities.
He added that the process was hampering their free movement from one area to another.
“I came since this morning and spent over two hours at this checkpoint. Those health workers who were to come early were the last to arrive, keeping us here for hours.”
According to Dolo, the process is good but he advised that the Ministry of Health and Social Welfare should handle the process properly to have it well done. He added, “What is not done well is not done at all.”
Speaking to a team of Liberian journalists under the supervision of the IREX and the Liberia Media Center training program, the Registered Nurse (RN) and focus person at the youth friendly center, Gabriel E. Moore, said the process is intended to run a fever test and not to carry out a complete physical test.
Additionally, Mr. Moore said they were given a direct mandate to only carry out a fever test for people crossing over from one county to the other.
“One of the signs of the Ebola virus is fever and so what we are basically doing is to just search for fever and if one has fever we send that person back to his or her community.”
When asked by the team of reporters as to what was the next step if a person is diagnosed with fever, Mr. Moore said, the individual will be sent to his community and if there should be any other measure it would be communicated to the health team.
Responding to the complaints made by passengers and drivers who expressed frustration with spending a night and several hours at the check point, Moore admitted that they arrived at the area late on grounds that their mandate came late.
_________________
http://www.liberianobserver.com/news/nurses-use-3-thermometers-thousands
Liberia:Nurses Use 3 Thermometers On Thousands
Thu, 08/14/2014 - 07:48
By: Gloria T.Tamba
The Government of Liberia has begun testing citizens in eight counties for the deadly Ebola disease.
This testing of individuals is meant to control the spread from counties believed to be highly infected with the killer disease.
Several counties, including Bomi, Lofa, Grand Cape Mount, Grand Bassa, Margibi Montserrado and Grand Gedeh, have been controlled to regulate the movement of people going in and out of those areas.
The Daily Observer recently discovered that the control process as announced by the Liberian government took a different dimension as the temperatures of those leaving from one area to another were tested by nurses assigned at various checkpoints using only three thermometers.
The testing process has been questioned by some segments of the Liberian society, including foreign nationals who visited Bomi over the weekend.
Bomi County is among eight counties quarantined by the Liberian government.
In an interview with the Daily Observer over the weekend, Mr. Shang Guan, a Chinese national, said the intention of the government is good but is also dangerous to the health of citizens and foreigners alike.
Mr. Guan refused to be tested with any of the three thermometers used by the county health team at the Bomi checkpoint.
He said the use of manual thermometers to check the temperature of travelers as a means of containing the spread of the deadly virus was not the right thing to do. Experts have said that one way the deadly Ebola virus is spread is through contact with bodily fluids. Thermometers are either inserted in the mouth or under the arm, both of which involve the transfer of saliva and sweat respectively.
According to him, since the virus quickly spreads and kills 90% of its victims, it would be prudent for authorities at the Health Ministry to use advanced rather than standard thermometers that do not involve physical contact with individuals.
“I was worried about taking the test because even if you have malaria your temperature will be high and even if that person has Ebola, it might spread to the others just by the use of the so few thermometers”, Mr. Guan said.
He disclosed that what was even more scary to him was that all those who were being tested used the same three thermometers, with nurses having physical contact with travelers. Such a situation is highly risky for the people of Liberia.
The Chinese national hailed Liberians as well as foreigners alike who have cooperated with the testing, but suggested that the limited thermometers being used must be well sanitized to avoid endangering the lives of others.
Another Liberian, Oscar Dolo, who was seen at the checkpoint said, the process was poorly coordinated by the county health authorities.
He added that the process was hampering their free movement from one area to another.
“I came since this morning and spent over two hours at this checkpoint. Those health workers who were to come early were the last to arrive, keeping us here for hours.”
According to Dolo, the process is good but he advised that the Ministry of Health and Social Welfare should handle the process properly to have it well done. He added, “What is not done well is not done at all.”
Speaking to a team of Liberian journalists under the supervision of the IREX and the Liberia Media Center training program, the Registered Nurse (RN) and focus person at the youth friendly center, Gabriel E. Moore, said the process is intended to run a fever test and not to carry out a complete physical test.
Additionally, Mr. Moore said they were given a direct mandate to only carry out a fever test for people crossing over from one county to the other.
“One of the signs of the Ebola virus is fever and so what we are basically doing is to just search for fever and if one has fever we send that person back to his or her community.”
When asked by the team of reporters as to what was the next step if a person is diagnosed with fever, Mr. Moore said, the individual will be sent to his community and if there should be any other measure it would be communicated to the health team.
Responding to the complaints made by passengers and drivers who expressed frustration with spending a night and several hours at the check point, Moore admitted that they arrived at the area late on grounds that their mandate came late.
_________________
Posted for fair use and discussion.
http://www.liberianobserver.com/news/38-deaths-3-days-ebola-wreaks-havoc-lofa
Liberia: 38 Deaths In 3 Days: Ebola Wreaks Havoc In Lofa
Entire Family on the Verge of Extinction
Thu, 08/14/2014 - 09:01
By: William Q. Harmon
The Ebola virus is taking a deadly toll on the northern county of Lofa where the deadly disease initially crossed over from neighboring Guinea. More and more people in that county continue to be victimized by the virus.
In a statistical report provided by the Lofa Health Team on the status of the situation in the county, made available to the Daily Observer Wednesday, August 13, there were 38 deaths recorded in three days. These include confirmed Ebola cases, probable and suspected. This report covers the three-day period August 8 to 11, 2014. The number of new contact cases within this period (August 8-11) stands at 81.
The total deaths in the county since May 29, 2014 to date stands at 221. Lofa is so far one of the most highly affected counties.
The update also disclosed that the number of patients presently at the Foya Care Center (August 8-11), one of the two Ebola centers in the country, stands at 81.
New reported death amongst health workers (August 8-11) is one, totaling 12 deaths since the outbreak in May.
During this period, 45 specimens were taken and tested: 15 were positive, 8 negative and the rest are still pending.
President Ellen Johnson Sirleaf recently said she is saddened by the fast pace at which the virus is spreading in the country, especially to other communities that were not previously affected. “And what this means is that our people are still not listening to the pieces of advice and instructions that are being given.” Such instructions include constant hand washing; avoiding handshakes and touching in general; immediate reporting of cases of high fever, vomiting and bleeding; and avoiding touching anyone suspected to have the virus.
Meanwhile it is being reported that nine members of a single family of 15 were being removed from the Macenta road community, in the capital Voinjama, to the Foya Care Center. This is, however, another worrying concern for the people of Voinjama City, as it wrestles in the grip of the virus.
Macenta road community is located just after the Mandingo quarter where eight persons died few days ago, and is also a predominantly Mandingo community.
According to sources, six members of this family of 15 had already died from the virus. The nine remaining family members were being taken to the Foya Care Center.
President Sirleaf, while declaring a State of Emergency last week, said the Ebola threat continues to grow as a result of ignorance, poverty as well as entrenched religious and cultural practices. She indicated that these continue to exacerbate the spread of the disease, especially in the counties.
The Liberian President added that actions allowed by statute under the public health law are no longer adequate to deal with the Ebola epidemic, as comprehensively and holistically, as the outbreak requires.
The President noted that the scope and skills of the epidemic now exceed the capacity and statutory mandates of any one government agency or ministry.
The Ebola virus disease, and the ramifications and the consequences thereof, now constitute an outright national calamity.
Health authorities in Lofa County said due to the influx of suspected cases, patients are now being transported in pickup trucks, which have no sirens, rather than the ambulances, whose sirens are causing a lot of trauma for residents.
Meanwhile, the Ministry of Health and Social Welfare Ebola Situation Report (SitRep) has recorded that since the outbreak of the virus in March to August 11, at least 149 confirmed deaths from 166 confirmed positive victims.
Among the 149 have been 37 health workers out of 86, who now fallen prey to the virus.
However, the SitRep lists total deaths in confirmed, probable and suspected cases as 355, for the record.
_________________
http://www.liberianobserver.com/news/38-deaths-3-days-ebola-wreaks-havoc-lofa
Liberia: 38 Deaths In 3 Days: Ebola Wreaks Havoc In Lofa
Entire Family on the Verge of Extinction
Thu, 08/14/2014 - 09:01
By: William Q. Harmon
The Ebola virus is taking a deadly toll on the northern county of Lofa where the deadly disease initially crossed over from neighboring Guinea. More and more people in that county continue to be victimized by the virus.
In a statistical report provided by the Lofa Health Team on the status of the situation in the county, made available to the Daily Observer Wednesday, August 13, there were 38 deaths recorded in three days. These include confirmed Ebola cases, probable and suspected. This report covers the three-day period August 8 to 11, 2014. The number of new contact cases within this period (August 8-11) stands at 81.
The total deaths in the county since May 29, 2014 to date stands at 221. Lofa is so far one of the most highly affected counties.
The update also disclosed that the number of patients presently at the Foya Care Center (August 8-11), one of the two Ebola centers in the country, stands at 81.
New reported death amongst health workers (August 8-11) is one, totaling 12 deaths since the outbreak in May.
During this period, 45 specimens were taken and tested: 15 were positive, 8 negative and the rest are still pending.
President Ellen Johnson Sirleaf recently said she is saddened by the fast pace at which the virus is spreading in the country, especially to other communities that were not previously affected. “And what this means is that our people are still not listening to the pieces of advice and instructions that are being given.” Such instructions include constant hand washing; avoiding handshakes and touching in general; immediate reporting of cases of high fever, vomiting and bleeding; and avoiding touching anyone suspected to have the virus.
Meanwhile it is being reported that nine members of a single family of 15 were being removed from the Macenta road community, in the capital Voinjama, to the Foya Care Center. This is, however, another worrying concern for the people of Voinjama City, as it wrestles in the grip of the virus.
Macenta road community is located just after the Mandingo quarter where eight persons died few days ago, and is also a predominantly Mandingo community.
According to sources, six members of this family of 15 had already died from the virus. The nine remaining family members were being taken to the Foya Care Center.
President Sirleaf, while declaring a State of Emergency last week, said the Ebola threat continues to grow as a result of ignorance, poverty as well as entrenched religious and cultural practices. She indicated that these continue to exacerbate the spread of the disease, especially in the counties.
The Liberian President added that actions allowed by statute under the public health law are no longer adequate to deal with the Ebola epidemic, as comprehensively and holistically, as the outbreak requires.
The President noted that the scope and skills of the epidemic now exceed the capacity and statutory mandates of any one government agency or ministry.
The Ebola virus disease, and the ramifications and the consequences thereof, now constitute an outright national calamity.
Health authorities in Lofa County said due to the influx of suspected cases, patients are now being transported in pickup trucks, which have no sirens, rather than the ambulances, whose sirens are causing a lot of trauma for residents.
Meanwhile, the Ministry of Health and Social Welfare Ebola Situation Report (SitRep) has recorded that since the outbreak of the virus in March to August 11, at least 149 confirmed deaths from 166 confirmed positive victims.
Among the 149 have been 37 health workers out of 86, who now fallen prey to the virus.
However, the SitRep lists total deaths in confirmed, probable and suspected cases as 355, for the record.
_________________
When you read the doc and see the limits of detection it gets even worse.
this system can apparently 'see' 0.00001 pfu (what ever that is(sorry I could not decipher that part) with no detection at lower concentration. So I am guessing part of the negatives are not enough ebola in the sample to 'see' err edit to add PFU is amount of ebola per sample earlier in doc is called out for
Titer (PFU/mL)
graph below
PFU Call
Strain tested
Ebola Zaire
Equivalents/Rxn rate Run 1 Cp Run 2 Cp Run 3 Cp
1.0 3/3 23.10 22.86 22.79
0.1 3/3 26.84 26.71 26.86
0.01 3/3 30.52 30.48 30.46
0.001 3/3 33.57 33.98 33.79
0.0001 3/3 35.90 35.95 35.5
0.00001 1/3 36.64 N/D N/D
0.000001 0/3 N/D N/D N/D
0.0000001 0/3 N/D N/D N/D
0.00000001 0/3 N/D N/D N/D
Possible Impact
TB Fanatic
Gregor Peter @L0gg0l · 2h
Train system at Atlanta airport breaks down causing huge logjam
pic.twitter.com/vALoUGa0sk
Rob Coloney @robcoloney · 2h
The Atlanta Airport is like nothing I've ever seen before.
Hundreds of people just trying to get out of the building
are unable to. Trapped.
Eric Callahan @EriCallahan · 2h
Atlanta airport is getting worse. Completely jammed.
No way to get out of the terminal.
pic.twitter.com/dXdYKWagyS
Natalie Schubert @nschubert2008 · 2h Never seen anything like Atlanta airport mess!
This is not due to the trains down no way!
No communication
pic.twitter.com/Xds74zJ3qg
Rob Coloney @robcoloney · 2h
Was just asked to form 2 lines at Term. C in #Atlanta Airport.
People gridlocked in underground tunnels. No exits.
pic.twitter.com/KZqZAbkpdz
Lilbitsnana
On TB every waking moment
IRELAND
Ebola virus ruled out for patient in Dublin hospital
A Dublin hospital had restricted access to the patient as they investigated Ebola as a possibility – they have now cleared him.
15 hours ago 166,762 Views 398 Comments
Email228
Image: Global Panorama via Flickr
Update, 10.29am: Medics rule out suspected Ebola in Dublin patient>
THE HSE HAS said today that it has not been notified of any official suspected case of Ebola in a Dublin hospital – but that it could not rule out that the virus was being looked at earlier this morning as one of several possibilities for a patient being treated there.
TheJournal.ie has confirmed with hospital sources this morning that a patient who had recently travelled abroad was being investigated as having a suspected virus. He is suffering from flu-like symptoms and consultants had been looking at Ebola as one of the possibilities.
A HSE spokesperson told TheJournal.ie that there is no confirmed case this morning. They also say that there is no ‘official’ suspected case of Ebola. The HSE has confirmed that the WHO guidelines are in place in Ireland and in line with this, there are specific steps that need to be followed by a hospital should they have a suspected case. This includes notifying HPSC and referring samples for lab tests.
These steps were not been taken in this case but the HSE could not rule out that Ebola is was not being “considered” among a range of possibilities to explain the man’s symptoms. The patient was being treated using barrier nursing methods.
A source in the Mater Hospital also confirmed early this morning that a room was being prepared in the National Isolation Unit for a potential arrival. However, the decision was made not to transfer him as consultants continued their investigations in a restricted area in the initial hospital where the man was admitted. The Mater has said that it is not expecting any patient transfer.
Ebola is a highly infectious virus and this is the first suspected case in the country. So far over 1,000 people have died across West Africa from the disease. Yesterday the WHO warned that the outbreak was worse than previously thought.
Unlike other infections like influenza, Ebola is not airborne. It can only be transmitted by direct contact with the body fluids of a person who has the disease.
- Additional reporting by Aoife Barry.
http://www.thejournal.ie/ebola-1621206-Aug2014/?utm_source=shortlink
Ebola virus ruled out for patient in Dublin hospital
A Dublin hospital had restricted access to the patient as they investigated Ebola as a possibility – they have now cleared him.
15 hours ago 166,762 Views 398 Comments
Email228
Image: Global Panorama via Flickr
Update, 10.29am: Medics rule out suspected Ebola in Dublin patient>
THE HSE HAS said today that it has not been notified of any official suspected case of Ebola in a Dublin hospital – but that it could not rule out that the virus was being looked at earlier this morning as one of several possibilities for a patient being treated there.
TheJournal.ie has confirmed with hospital sources this morning that a patient who had recently travelled abroad was being investigated as having a suspected virus. He is suffering from flu-like symptoms and consultants had been looking at Ebola as one of the possibilities.
A HSE spokesperson told TheJournal.ie that there is no confirmed case this morning. They also say that there is no ‘official’ suspected case of Ebola. The HSE has confirmed that the WHO guidelines are in place in Ireland and in line with this, there are specific steps that need to be followed by a hospital should they have a suspected case. This includes notifying HPSC and referring samples for lab tests.
These steps were not been taken in this case but the HSE could not rule out that Ebola is was not being “considered” among a range of possibilities to explain the man’s symptoms. The patient was being treated using barrier nursing methods.
A source in the Mater Hospital also confirmed early this morning that a room was being prepared in the National Isolation Unit for a potential arrival. However, the decision was made not to transfer him as consultants continued their investigations in a restricted area in the initial hospital where the man was admitted. The Mater has said that it is not expecting any patient transfer.
Ebola is a highly infectious virus and this is the first suspected case in the country. So far over 1,000 people have died across West Africa from the disease. Yesterday the WHO warned that the outbreak was worse than previously thought.
Unlike other infections like influenza, Ebola is not airborne. It can only be transmitted by direct contact with the body fluids of a person who has the disease.
- Additional reporting by Aoife Barry.
http://www.thejournal.ie/ebola-1621206-Aug2014/?utm_source=shortlink
Possible Impact
TB Fanatic
Yes. But you need to be wearing a level 4 suit to handle them before washing!
A Comprehensive infection control protocol is needed
when entering and exiting potentially contaminated zones.
Be Well
may all be well
From Niman's site, via PFI, and I can't remember Niman saying anything like that either, and I"ve read his comments for several years. Not all of them of course, but when things get "hot" in the flu/disease world, I read them.
Pixie's comment:
Recombinomics Commentary 18:15
August 15, 2014
http://www.recombinomics.com/News/08151401/Ebola_Liberia_Death_Spiral.html
The latest Ebola WHO update (reporting case between August 12-13) shows a dramatic jump in new cases in deaths (116 and 58, respectively). These numbers dwarf those from Liberia in the same period (27 and 14, respectively) and suggest that yesterday’s WHO announcement that “Staff at the outbreak sites see evidence that the numbers of reported cases and deaths vastly underestimate the magnitude of the outbreak” may have a significant relationship to the deteriorating situation in Liberia in general and Monrovia in particular.
Recent reports indicate that efforts to limit movement from heavily impacted rural regions in Liberia have not prevented flow of cases into Monrovia. Moreover, recent reports have cited bodies in the streets of two of Monrovia’s slums, West Point and Clara Town, which may represent a fraction of infected and/or fatal cases in these densely populated regions.
WHO has noted barriers to control, which included infections and deaths of a large number of health care workers and closing of hospitals, resulting in bed shortages and treatment limitations.
These recent developments raise concerns of a literal “death spiral”.
Pixie's comment:
Recombinomics Commentary 18:15
August 15, 2014
http://www.recombinomics.com/News/08151401/Ebola_Liberia_Death_Spiral.html
The latest Ebola WHO update (reporting case between August 12-13) shows a dramatic jump in new cases in deaths (116 and 58, respectively). These numbers dwarf those from Liberia in the same period (27 and 14, respectively) and suggest that yesterday’s WHO announcement that “Staff at the outbreak sites see evidence that the numbers of reported cases and deaths vastly underestimate the magnitude of the outbreak” may have a significant relationship to the deteriorating situation in Liberia in general and Monrovia in particular.
Recent reports indicate that efforts to limit movement from heavily impacted rural regions in Liberia have not prevented flow of cases into Monrovia. Moreover, recent reports have cited bodies in the streets of two of Monrovia’s slums, West Point and Clara Town, which may represent a fraction of infected and/or fatal cases in these densely populated regions.
WHO has noted barriers to control, which included infections and deaths of a large number of health care workers and closing of hospitals, resulting in bed shortages and treatment limitations.
These recent developments raise concerns of a literal “death spiral”.
Be Well
may all be well
Via PFI, bloding and snips are Pixie's:
Aid group: W. Africa Ebola outbreak like 'wartime'
BY JONATHAN PAYE-LAYLEH AND SARAH DILORENZO
The Associated Press
August 15, 2014 Updated 37 minutes ago
http://www.centredaily.com/2014/08/15/4306474/ebola-centers-fill-faster-than.html?sp=/99/188/220/
MONROVIA, LIBERIA — The Ebola outbreak that has killed more than 1,100 people in West Africa could last another six months, the Doctors Without Borders charity group said Friday. One aid worker acknowledged that the true death toll is still unknown.
[snip]
Tarnue Karbbar, who works for the aid group Plan International in northern Liberia, said response teams simply aren't able to document all the erupting Ebola cases. Many of the sick are still being hidden at home by their relatives, who are too fearful of going to an Ebola treatment center.
Others are being buried before the teams can get to remote areas, he said. In the last several days, about 75 cases have emerged in Voinjama, a single Liberian district.
"Our challenge now is to quarantine the area (in Voinjama) to successfully break the transmission," he said.
[snip]
Liberia's assistant health minister, Tolbert Nyenswah, said three people in Liberia were receiving the ZMapp on Friday. Previously, only two Americans and a Spaniard had gotten it. The Americans are improving, but it is not known what role ZMapp played. The Spaniard died.
The American doctor infected with Ebola while working in Liberia said Friday he is "recovering in every way" and holding onto the hope of a reunion with his family.
[snip]
The U.N. health agency has said the focus on containing the outbreak should be on practicing good hygiene and quickly identifying the sick and isolating them. That task is made harder, however, by the shortage of treatment facilities.
Beds in such centers are filling up faster than they can be provided, evidence that the outbreak in West Africa is far more severe than the numbers show, said Gregory Hartl, a spokesman for World Health Organization in Geneva.
There are 40 beds at one treatment center that Doctors Without Borders recently took over in one quarantined county in Liberia. But 137 people have flocked there, packing the hallways until they can be sorted into those who are infected and those are not, said Joanne Liu, the group's international president.
Nyenswah described a similar situation in a treatment center in Liberia's capital of Monrovia: In one ward meant to accommodate up to 25 people, 80 are now crowded in. Another treatment center with 120 beds is expected to open Saturday outside Monrovia.
"It's absolutely dangerous," said Liu, who recently returned from Guinea, Liberia and Sierra Leone. "With the massive influx of patients that we had over the last few days, we're not able to keep zones of patients anymore. Everybody is mixed."
Liu likened the situation to a state of war because the "frontline" was always moving and unpredictable. She said the outbreak could last six more months.
[snip]
Sierra Leone's president, Ernest Bai Koroma, told journalists Friday that the country has lost two doctors and 32 nurses to Ebola.
"We need specialized clinicians and expertise and that is why we are appealing to the international community for an enhanced response to our fight" against Ebola, he said.
The Ebola crisis is also disrupting food supplies and transportation. Some 1 million people in isolated areas could need food assistance in the coming months, according to the U.N. World Food Program, which is preparing a regional emergency operation.
Amid a growing number of airline cancellations, the U.N. will start flights for humanitarian workers on Saturday to ensure that aid operations aren't interrupted. In the coming weeks, they will also ferry staff to remote areas by helicopter. {thank you Dr. Nabarro}
Aid group: W. Africa Ebola outbreak like 'wartime'
BY JONATHAN PAYE-LAYLEH AND SARAH DILORENZO
The Associated Press
August 15, 2014 Updated 37 minutes ago
http://www.centredaily.com/2014/08/15/4306474/ebola-centers-fill-faster-than.html?sp=/99/188/220/
MONROVIA, LIBERIA — The Ebola outbreak that has killed more than 1,100 people in West Africa could last another six months, the Doctors Without Borders charity group said Friday. One aid worker acknowledged that the true death toll is still unknown.
[snip]
Tarnue Karbbar, who works for the aid group Plan International in northern Liberia, said response teams simply aren't able to document all the erupting Ebola cases. Many of the sick are still being hidden at home by their relatives, who are too fearful of going to an Ebola treatment center.
Others are being buried before the teams can get to remote areas, he said. In the last several days, about 75 cases have emerged in Voinjama, a single Liberian district.
"Our challenge now is to quarantine the area (in Voinjama) to successfully break the transmission," he said.
[snip]
Liberia's assistant health minister, Tolbert Nyenswah, said three people in Liberia were receiving the ZMapp on Friday. Previously, only two Americans and a Spaniard had gotten it. The Americans are improving, but it is not known what role ZMapp played. The Spaniard died.
The American doctor infected with Ebola while working in Liberia said Friday he is "recovering in every way" and holding onto the hope of a reunion with his family.
[snip]
The U.N. health agency has said the focus on containing the outbreak should be on practicing good hygiene and quickly identifying the sick and isolating them. That task is made harder, however, by the shortage of treatment facilities.
Beds in such centers are filling up faster than they can be provided, evidence that the outbreak in West Africa is far more severe than the numbers show, said Gregory Hartl, a spokesman for World Health Organization in Geneva.
There are 40 beds at one treatment center that Doctors Without Borders recently took over in one quarantined county in Liberia. But 137 people have flocked there, packing the hallways until they can be sorted into those who are infected and those are not, said Joanne Liu, the group's international president.
Nyenswah described a similar situation in a treatment center in Liberia's capital of Monrovia: In one ward meant to accommodate up to 25 people, 80 are now crowded in. Another treatment center with 120 beds is expected to open Saturday outside Monrovia.
"It's absolutely dangerous," said Liu, who recently returned from Guinea, Liberia and Sierra Leone. "With the massive influx of patients that we had over the last few days, we're not able to keep zones of patients anymore. Everybody is mixed."
Liu likened the situation to a state of war because the "frontline" was always moving and unpredictable. She said the outbreak could last six more months.
[snip]
Sierra Leone's president, Ernest Bai Koroma, told journalists Friday that the country has lost two doctors and 32 nurses to Ebola.
"We need specialized clinicians and expertise and that is why we are appealing to the international community for an enhanced response to our fight" against Ebola, he said.
The Ebola crisis is also disrupting food supplies and transportation. Some 1 million people in isolated areas could need food assistance in the coming months, according to the U.N. World Food Program, which is preparing a regional emergency operation.
Amid a growing number of airline cancellations, the U.N. will start flights for humanitarian workers on Saturday to ensure that aid operations aren't interrupted. In the coming weeks, they will also ferry staff to remote areas by helicopter. {thank you Dr. Nabarro}
Yes. But you need to be wearing a level 4 suit to handle them before washing!
A Comprehensive infection control protocol is needed
when entering and exiting potentially contaminated zones.
Thanks, PI! I appreciate the candor!
I guess this is one of those things that requires a '10 foot pole!'
Be Well
may all be well
One more via PFI, I should post the link to the thread there from now on, too. The situation there (and soon to be elsewhere) is like the worst nightmare or horror movie.
For Want of Gloves, Ebola Doctors Die
On the front lines of the Ebola outbreak in Liberia, health-care workers believe its toll on their own staffs could be mitigated if only they had enough basic hospital supplies such as gloves
By DREW HINSHAW
Updated Aug. 15, 2014 7:17 p.m. ET
http://online.wsj.com/articles/ebola-doctors-with-no-rubber-gloves-1408142137
SERGEANT KOLLIE TOWN, Liberia—Rubber gloves were nearly as scarce as doctors in this part of rural Liberia, so Melvin Korkor would swaddle his hands in plastic grocery bags to deliver babies.
His staff didn't bother even with those when a woman in her 30s stopped by complaining of a headache. Five nurses, a lab technician—then a local woman who was helping out—cared for her with their bare hands.
Within weeks, all of them died. The woman with a headache, they learned too late, had Ebola. {R0=7 here?}
Somewhere in the workplace exchange of handshakes and sweat, Dr. Korkor caught the virus, too. For five days, he read the Bible on a cot in an Ebola ward, watching his colleagues bleed to death from a disease they weren't equipped or trained to treat. Across the room, a nurse pregnant with what would have been her third child slipped away. "She told me 'Doc, I'm dying,' " he recalled Kou Gbanjah saying.
In the Liberian capital of Monrovia, the city's main hospital has very little staff and few patients — an exodus triggered by several Ebola-related deaths at the facility.
Though Dr. Korkor survived, his hospital has closed, as have dozens of other health centers in Liberia, Sierra Leone and Guinea. It is a devastating setback for countries facing a range of deadly diseases in addition to Ebola. The World Health Organization estimates the region's Ebola outbreak has killed 1,145 people, roughly half the 2,127 believed to have been infected. West African countries that had only begun to climb out from civil war and poverty have slipped into economic disarray.
Much of this toll could have been avoided or at least mitigated, hospital workers on the front lines say, if they had been provided with medical basics, starting with one of the simplest: disposable rubber gloves.
Instead, health workers have been treating many patients with unprotected hands, greatly increasing the risk the Ebola virus will kill the very professionals trying to fight it.
As of Tuesday, at least 36 health workers in Liberia had died from the disease, according to health ministry records. Many who have caught but survived the virus are traumatized, as are colleagues, and may prove difficult to coax back to work.
Their absence is deeply felt. Even before Ebola, Liberia—with just 51 doctors for four million people—had the second-fewest physicians per person on Earth, after Tanzania, according to the WHO.
Hospital staff members throughout Liberia, including at Dr. Korkor's Phebe Hospital, have gone on strike until the government meets their demands. They want rubber gloves, safety goggles, protective suits, life insurance and a fivefold pay increase for the hazardous work. The government has said it plans to meet those requests.
In the meantime, because doctors aren't at work, other diseases besides Ebola are going untreated. As a result, those ailments—chiefly typhoid and dysentery—may be killing more West Africans than Ebola, according to the United Nations Children's Fund.
Hospitals across the region have closed at the peak of malaria season. Meningitis, measles and polio vaccinations are on hold, said Liberia's information minister, Lewis Brown.
In countries with some of the world's highest rates of death during childbirth, women are having babies at home. They aren't bringing in children for check-ups in Liberia, a nation where nearly half of children are malnourished, according to Unicef.
It is an unprecedented toll for a viral illness first identified in 1976, which cropped up eight months ago in Guinea and quickly spread to Liberia and Sierra Leone. The virus is spread chiefly through contact with bodily fluids. It begins with vague feverish symptoms that could be due to any number of ailments, until patients worsen and often begin bleeding from their eyes, nose and mouth.
There is no approved vaccine or treatment, although two American health-care workers infected in Liberia have been treated with an experimental drug. The Liberian government ordered three courses of the drug to give to some ill doctors.
A Liberian clinic called Dolo Town Health Center shut down last month when it ran out of gloves and left staff members to choose between treating Ebola patients bare-handed or leaving, said MacFarland Keraulah, a physician's assistant. The clinic had received only one glove delivery since April, and it was a single box of 50 pairs.
Since the staff walked off, 37 people have died of Ebola in that area, two hours outside the Liberian capital of Monrovia. Seven were health workers at another now-closed health center, according to workers.
Both clinics are in a 200-square-mile forest of rubber trees. "We are sitting inside one of the world's largest rubber plantations, and people are dying because we don't have gloves," Mr. Keraulah said.
Liberia's government said it didn't provide enough materials early on because it is still recovering from a 14-year civil war that ended in 2003 with both the federal coffers and hospital shelves left bare.
More recently, health funding faced opposition from lawmakers who believed Ebola was a scam perpetuated to draw aid money. In a heated congressional debate in May, one legislator called the virus "that thing you did to get donor funding," according to Liberia's FrontPage Africa newspaper.
Such sentiments were common within the government, said Tolbert Nyenswah, assistant health minister. "Even senior government officials were in denial, so it did not receive the political will," he said.
Some officials blame the shortage on another epidemic: corruption in the civil service, something that Liberian President Ellen Johnson Sirleaf has complained about during her eight years in office. Many workers on the government payroll earn as little as $5 a day. A government devastated by years of civil strife doesn't have the record-keeping skills to make sure its own members don't steal supplies, said Mr. Brown, the information minister.
"I don't think the government of Liberia has reached a point where it cannot afford gloves," said Marcus Speare, district superintendent of Liberia's Margibi County. "We have to look at where these things go after the government has made its appropriation.... We will launch an investigation to find out."
Now, the government faces the task of getting health-care workers back on the job. It has sent priests and politicians to speak with them.
This week, China donated 10,000 protective suits. But training workers at far-flung clinics in how to don them and take them off could take several weeks, according to Liberia's health ministry.
Other basic supplies remain stretched, ranging from plastic sheeting to painkillers to ambulances, said Mr. Nyenswah, the assistant health minister.
In the capital, the government is trying to turn some empty school classrooms into holding centers for people with symptoms suggesting Ebola. But workers don't have enough bedding, Mr. Nyenswah said.
Sitting at a desk stacked with papers waiting to be signed, Mr. Nyenswah shouted into a phone call with an aid agency: "I need 20 mattresses like yesterday!"
Shortages are something Dr. Korkor learned to work around.
In the four years he ran Phebe Hospital in rural Liberia, Dr. Korkor got used to treating patients without painkillers, anti-parasite drugs, test tubes or even scrubs. "We had to improvise," said a nurse, Martha Morris.
The staff members reused the few rubber gloves they had, and put them on only to treat the sickest patients.
On July 3, the staff realized that the woman they had been handling with bare hands wasn't a local villager with a headache. She was an Ebola patient who had broken out of a hospital about 100 miles away under circumstances that are still unclear. By July 15, the woman had died.
So had three nurses.
Days later, Dr. Korkor felt a chill rush through his body. He locked himself in a bedroom away from his family until a blood test returned—positive for Ebola. A car took him to an Ebola ward in the capital.
The room smelled of bleach, blood and vomit, he said. Most of the roughly 15 patients inside appeared to be health workers, including the man dying next to him in their two-cot cubicle.
One morning, Dr. Korkor realized he was lying across from the chief doctor at the country's top hospital, Samuel Brisbane, under whom he had done his residency. "He said, 'My son, you're here?' " Dr. Korkor recalled. "I said, 'Yes, Doc.' "
Dr. Brisbane died the next day, his obituary displayed prominently on front pages of the country's newspapers. He probably contracted Ebola giving a patient cardiopulmonary resuscitation without a pair of gloves, said Wvanne McDonald, chief executive officer of the John F. Kennedy Memorial Medical Center, where Dr. Brisbane worked.
For the next three days, Dr. Korkor forced down balls of rice and, by his count, drank 24 bottles of water—one every hour. Finally, he felt his chills disappear and his hunger rebound with ferocity. After a blood test and four showers in bleach-spiked water, the staff let him leave.
On a recent Tuesday morning, chickens were clucking in the yard at his home as he sat in a chair under a tree. "Ebola-free!" he laughed over the phone to a friend.
The ordeal, though, has left him torn. He can stay in Liberia and risk his life to fight the outbreak—on a $1,000-a-month paycheck—or try to move his family to America, to work his way up a hospital system that hasn't collapsed.
He glanced at the porch, where his wife, daughter, two sons, mother-in-law, niece and niece's daughter was hanging about. "If I'm going to die, God forbid, who's going to take care of them?" he asked.
If he stays in Liberia, Dr. Korkor said, he is going to need a great deal more supplies. He isn't going back to work until he gets them. "This time around, we're not going to improvise," he said.
For Want of Gloves, Ebola Doctors Die
On the front lines of the Ebola outbreak in Liberia, health-care workers believe its toll on their own staffs could be mitigated if only they had enough basic hospital supplies such as gloves
By DREW HINSHAW
Updated Aug. 15, 2014 7:17 p.m. ET
http://online.wsj.com/articles/ebola-doctors-with-no-rubber-gloves-1408142137
SERGEANT KOLLIE TOWN, Liberia—Rubber gloves were nearly as scarce as doctors in this part of rural Liberia, so Melvin Korkor would swaddle his hands in plastic grocery bags to deliver babies.
His staff didn't bother even with those when a woman in her 30s stopped by complaining of a headache. Five nurses, a lab technician—then a local woman who was helping out—cared for her with their bare hands.
Within weeks, all of them died. The woman with a headache, they learned too late, had Ebola. {R0=7 here?}
Somewhere in the workplace exchange of handshakes and sweat, Dr. Korkor caught the virus, too. For five days, he read the Bible on a cot in an Ebola ward, watching his colleagues bleed to death from a disease they weren't equipped or trained to treat. Across the room, a nurse pregnant with what would have been her third child slipped away. "She told me 'Doc, I'm dying,' " he recalled Kou Gbanjah saying.
In the Liberian capital of Monrovia, the city's main hospital has very little staff and few patients — an exodus triggered by several Ebola-related deaths at the facility.
Though Dr. Korkor survived, his hospital has closed, as have dozens of other health centers in Liberia, Sierra Leone and Guinea. It is a devastating setback for countries facing a range of deadly diseases in addition to Ebola. The World Health Organization estimates the region's Ebola outbreak has killed 1,145 people, roughly half the 2,127 believed to have been infected. West African countries that had only begun to climb out from civil war and poverty have slipped into economic disarray.
Much of this toll could have been avoided or at least mitigated, hospital workers on the front lines say, if they had been provided with medical basics, starting with one of the simplest: disposable rubber gloves.
Instead, health workers have been treating many patients with unprotected hands, greatly increasing the risk the Ebola virus will kill the very professionals trying to fight it.
As of Tuesday, at least 36 health workers in Liberia had died from the disease, according to health ministry records. Many who have caught but survived the virus are traumatized, as are colleagues, and may prove difficult to coax back to work.
Their absence is deeply felt. Even before Ebola, Liberia—with just 51 doctors for four million people—had the second-fewest physicians per person on Earth, after Tanzania, according to the WHO.
Hospital staff members throughout Liberia, including at Dr. Korkor's Phebe Hospital, have gone on strike until the government meets their demands. They want rubber gloves, safety goggles, protective suits, life insurance and a fivefold pay increase for the hazardous work. The government has said it plans to meet those requests.
In the meantime, because doctors aren't at work, other diseases besides Ebola are going untreated. As a result, those ailments—chiefly typhoid and dysentery—may be killing more West Africans than Ebola, according to the United Nations Children's Fund.
Hospitals across the region have closed at the peak of malaria season. Meningitis, measles and polio vaccinations are on hold, said Liberia's information minister, Lewis Brown.
In countries with some of the world's highest rates of death during childbirth, women are having babies at home. They aren't bringing in children for check-ups in Liberia, a nation where nearly half of children are malnourished, according to Unicef.
It is an unprecedented toll for a viral illness first identified in 1976, which cropped up eight months ago in Guinea and quickly spread to Liberia and Sierra Leone. The virus is spread chiefly through contact with bodily fluids. It begins with vague feverish symptoms that could be due to any number of ailments, until patients worsen and often begin bleeding from their eyes, nose and mouth.
There is no approved vaccine or treatment, although two American health-care workers infected in Liberia have been treated with an experimental drug. The Liberian government ordered three courses of the drug to give to some ill doctors.
A Liberian clinic called Dolo Town Health Center shut down last month when it ran out of gloves and left staff members to choose between treating Ebola patients bare-handed or leaving, said MacFarland Keraulah, a physician's assistant. The clinic had received only one glove delivery since April, and it was a single box of 50 pairs.
Since the staff walked off, 37 people have died of Ebola in that area, two hours outside the Liberian capital of Monrovia. Seven were health workers at another now-closed health center, according to workers.
Both clinics are in a 200-square-mile forest of rubber trees. "We are sitting inside one of the world's largest rubber plantations, and people are dying because we don't have gloves," Mr. Keraulah said.
Liberia's government said it didn't provide enough materials early on because it is still recovering from a 14-year civil war that ended in 2003 with both the federal coffers and hospital shelves left bare.
More recently, health funding faced opposition from lawmakers who believed Ebola was a scam perpetuated to draw aid money. In a heated congressional debate in May, one legislator called the virus "that thing you did to get donor funding," according to Liberia's FrontPage Africa newspaper.
Such sentiments were common within the government, said Tolbert Nyenswah, assistant health minister. "Even senior government officials were in denial, so it did not receive the political will," he said.
Some officials blame the shortage on another epidemic: corruption in the civil service, something that Liberian President Ellen Johnson Sirleaf has complained about during her eight years in office. Many workers on the government payroll earn as little as $5 a day. A government devastated by years of civil strife doesn't have the record-keeping skills to make sure its own members don't steal supplies, said Mr. Brown, the information minister.
"I don't think the government of Liberia has reached a point where it cannot afford gloves," said Marcus Speare, district superintendent of Liberia's Margibi County. "We have to look at where these things go after the government has made its appropriation.... We will launch an investigation to find out."
Now, the government faces the task of getting health-care workers back on the job. It has sent priests and politicians to speak with them.
This week, China donated 10,000 protective suits. But training workers at far-flung clinics in how to don them and take them off could take several weeks, according to Liberia's health ministry.
Other basic supplies remain stretched, ranging from plastic sheeting to painkillers to ambulances, said Mr. Nyenswah, the assistant health minister.
In the capital, the government is trying to turn some empty school classrooms into holding centers for people with symptoms suggesting Ebola. But workers don't have enough bedding, Mr. Nyenswah said.
Sitting at a desk stacked with papers waiting to be signed, Mr. Nyenswah shouted into a phone call with an aid agency: "I need 20 mattresses like yesterday!"
Shortages are something Dr. Korkor learned to work around.
In the four years he ran Phebe Hospital in rural Liberia, Dr. Korkor got used to treating patients without painkillers, anti-parasite drugs, test tubes or even scrubs. "We had to improvise," said a nurse, Martha Morris.
The staff members reused the few rubber gloves they had, and put them on only to treat the sickest patients.
On July 3, the staff realized that the woman they had been handling with bare hands wasn't a local villager with a headache. She was an Ebola patient who had broken out of a hospital about 100 miles away under circumstances that are still unclear. By July 15, the woman had died.
So had three nurses.
Days later, Dr. Korkor felt a chill rush through his body. He locked himself in a bedroom away from his family until a blood test returned—positive for Ebola. A car took him to an Ebola ward in the capital.
The room smelled of bleach, blood and vomit, he said. Most of the roughly 15 patients inside appeared to be health workers, including the man dying next to him in their two-cot cubicle.
One morning, Dr. Korkor realized he was lying across from the chief doctor at the country's top hospital, Samuel Brisbane, under whom he had done his residency. "He said, 'My son, you're here?' " Dr. Korkor recalled. "I said, 'Yes, Doc.' "
Dr. Brisbane died the next day, his obituary displayed prominently on front pages of the country's newspapers. He probably contracted Ebola giving a patient cardiopulmonary resuscitation without a pair of gloves, said Wvanne McDonald, chief executive officer of the John F. Kennedy Memorial Medical Center, where Dr. Brisbane worked.
For the next three days, Dr. Korkor forced down balls of rice and, by his count, drank 24 bottles of water—one every hour. Finally, he felt his chills disappear and his hunger rebound with ferocity. After a blood test and four showers in bleach-spiked water, the staff let him leave.
On a recent Tuesday morning, chickens were clucking in the yard at his home as he sat in a chair under a tree. "Ebola-free!" he laughed over the phone to a friend.
The ordeal, though, has left him torn. He can stay in Liberia and risk his life to fight the outbreak—on a $1,000-a-month paycheck—or try to move his family to America, to work his way up a hospital system that hasn't collapsed.
He glanced at the porch, where his wife, daughter, two sons, mother-in-law, niece and niece's daughter was hanging about. "If I'm going to die, God forbid, who's going to take care of them?" he asked.
If he stays in Liberia, Dr. Korkor said, he is going to need a great deal more supplies. He isn't going back to work until he gets them. "This time around, we're not going to improvise," he said.
jed turtle
a brother in the Lord
thanks for the replies Summerthyme, Mala, and others.
it seems regardless of the nature of the inevitable black swan event, the same response is required:
stocking one's "life-raft" for at least a year's isolation, preferably far from towns and cities,
with the ability to place late-comers (typically friends and family) in adjacent quarantine shelters until their 21 day incubation period is up.
other replies regarding the tests indicate that testing at this point is not reliable enough nor widely enough available to even consider using or accepting the results. leaving isolation as they only option.
i have considered, because of the universal exchange of dollar bills in public, that we are all potential "carriers" even right now, although our statistical odds are yet very low - but not zero - we are all traveling on a graph that eventually goes exponential the longer we remain exposed to the public world via travel, commerce, and social intercourse.
one's statistical odds of survival increase only in relation to the sooner one pulls away from the public world.
and now is not too soon, although it seems most of us are waiting until Labor Day at least to pull the plug. i would suggest that allowing your children to go back to school - considering the influx of illegal alien refugees with high rates of infectious disease (drug-resistant TB for starters) - might be the very worst decision one could acquiesce to .
Be Well
may all be well
Hub is a first responder/firefighter and we are considering very carefully what to do.
We are trying to inform the department about ebola in a way they can accept - authoritative things, not a deluge of articles - so they get the picture. He's going to email Isaacs' Congressional testimony and I will try to come up with relevant bits from authoritative sources.
We are trying to inform the department about ebola in a way they can accept - authoritative things, not a deluge of articles - so they get the picture. He's going to email Isaacs' Congressional testimony and I will try to come up with relevant bits from authoritative sources.
rummer
Veteran Member
http://www.breitbart.com/Big-Peace/2014/08/14/Five-Suspected-Ebola-Victims-Found-in-Albania
FIVE SUSPECTED EBOLA VICTIMS FOUND IN ALBANIA
Newsweek is reporting that five immigrants out of 40 who were arrested in Albania on Thursday have shown signs of symptoms of Ebola, according to the Macedonian newspaper Vecer.
Albanian police believe the five immigrants arrived from Eritrea by illegally emigrating to Europe through Greece. The immigrants are being tested in a hospital in Vlore, roughly 85 miles from Italy’s closest port. Earlier on Thursday, one person in Montenegro was quarantined and was suspected of carrying the Ebola virus. That person apparently got to Montenegro from a West African country.
Meanwhile, Serbian authorities have 14 people from Liberia, Sierra Leone, Guinea or Nigeria under 21-day medical surveillance for fear they, too, may carry the Ebola virus, according to the Bulgarian newspaper Standart. If they do have the virus, they would be the first uncontrolled instances of the virus in Europe. A Spanish priest was the first European victim of the virus; he was flown to Madrid after contracting Ebola in Liberia.
In 2014, Albanian police have arrested more than 500 illegal immigrants, chiefly from Somalia and Eritrea. Guinea declared a public health emergency on Thursday; Ebola has killed over 1,000 people there. Liberia started giving victims of the virus the experimental Ebola drug ZMapp on Thursday.
FIVE SUSPECTED EBOLA VICTIMS FOUND IN ALBANIA
Newsweek is reporting that five immigrants out of 40 who were arrested in Albania on Thursday have shown signs of symptoms of Ebola, according to the Macedonian newspaper Vecer.
Albanian police believe the five immigrants arrived from Eritrea by illegally emigrating to Europe through Greece. The immigrants are being tested in a hospital in Vlore, roughly 85 miles from Italy’s closest port. Earlier on Thursday, one person in Montenegro was quarantined and was suspected of carrying the Ebola virus. That person apparently got to Montenegro from a West African country.
Meanwhile, Serbian authorities have 14 people from Liberia, Sierra Leone, Guinea or Nigeria under 21-day medical surveillance for fear they, too, may carry the Ebola virus, according to the Bulgarian newspaper Standart. If they do have the virus, they would be the first uncontrolled instances of the virus in Europe. A Spanish priest was the first European victim of the virus; he was flown to Madrid after contracting Ebola in Liberia.
In 2014, Albanian police have arrested more than 500 illegal immigrants, chiefly from Somalia and Eritrea. Guinea declared a public health emergency on Thursday; Ebola has killed over 1,000 people there. Liberia started giving victims of the virus the experimental Ebola drug ZMapp on Thursday.
rummer
Veteran Member
http://www.telegraph.co.uk/news/worldnews/ebola/11037842/Woman-tested-for-Ebola-in-Scotland.html
Woman tested for Ebola in Scotland
NHS investigating 'possible' case of Ebola after woman from Sierra Leone falls ill at immigration removal centre
A woman has been tested for the Ebola virus in Scotland after falling ill at an immigration removal centre.
Health authorities confirmed they had been investigating a "possible" case of the deadly virus, adding later that the test had turned out to be negative.
The woman is believed to have arrived from Sierra Leone, one of the countries most affected by the epidemic that has claimed more than 1,000 lives across West Africa.
She was being held at the Dungavel Detention Centre in South Lanarkshire and was taken to hospital for tests.
A spokesman for NHS Lanarkshire said before the negative test results were known: "We are currently investigating a possible case of Viral Haemorrhagic Fever (Ebola).
"This is a precautionary measure and it would appear at this stage to be highly unlikely the patient will test positive for Ebola."
A spokesman for the Home Office declined to give any further details, saying it did not comment on operational matters.
A man was previously tested for the Ebola virus in Birmingham but he, and another man who took himself to hospital fearing he had the virus, were both given the all clear.
Ebola causes severe fever and, in the worst cases, unstoppable bleeding. It is transmitted through contact with bodily fluids, and people who live with or care for patients are most at risk.
Woman tested for Ebola in Scotland
NHS investigating 'possible' case of Ebola after woman from Sierra Leone falls ill at immigration removal centre
A woman has been tested for the Ebola virus in Scotland after falling ill at an immigration removal centre.
Health authorities confirmed they had been investigating a "possible" case of the deadly virus, adding later that the test had turned out to be negative.
The woman is believed to have arrived from Sierra Leone, one of the countries most affected by the epidemic that has claimed more than 1,000 lives across West Africa.
She was being held at the Dungavel Detention Centre in South Lanarkshire and was taken to hospital for tests.
A spokesman for NHS Lanarkshire said before the negative test results were known: "We are currently investigating a possible case of Viral Haemorrhagic Fever (Ebola).
"This is a precautionary measure and it would appear at this stage to be highly unlikely the patient will test positive for Ebola."
A spokesman for the Home Office declined to give any further details, saying it did not comment on operational matters.
A man was previously tested for the Ebola virus in Birmingham but he, and another man who took himself to hospital fearing he had the virus, were both given the all clear.
Ebola causes severe fever and, in the worst cases, unstoppable bleeding. It is transmitted through contact with bodily fluids, and people who live with or care for patients are most at risk.
- Status