A Saudi man who was being treated for Ebola-like symptoms has died at a hospital in Jeddah, Saudi Arabia's health ministry says.
If confirmed, this would be the first Ebola-related death outside Africa in an outbreak that has killed more than 900 people this year.
The man recently visited Sierra Leone, one of four countries in the outbreak.
World Health Organization (WHO) experts are meeting in Geneva, Switzerland, to discuss a response to the outbreak.
The two-day meeting will decide whether to declare a global health emergency.
Ebola, a viral haemorrhagic fever, is one of the deadliest diseases known to humans, with a fatality rate of between 55% and 90%.
A WHO statement on Wednesday said 932 patients had died of the disease in West Africa so far, with most of the latest fatalities reported in Liberia.
A man who attended Mt Sinai hospital in New York on Monday, after returning from West Africa and suffering from a fever, has tested negative for ebola, the Centers for Disease Control and Prevention said.
Visa block
Concern has also been growing over a number of new cases in Nigeria, the region's most populous nation. On Wednesday, a nurse who treated an Ebola patient became the second person to die of the disease there.
Nigeria's Health Minister Onyebuchi Chukwu described the outbreak as a national emergency, adding that "everyone in the world is at risk" because of air travel.
The Saudi man who was suspected of contracting the disease died of cardiac arrest, according to the website of the country's health ministry.
The 40-year-old is said to have returned from a recent business trip to Sierra Leone.
The ministry's website said he was being tested for Ebola, but did not say if the tests had concluded that he had the disease.
The website said the man had been treated in an isolation ward and would be buried according to Islamic tradition, while following precautions set out by world health authorities.
Earlier this year, Saudi Arabia stopped issuing visas to Muslims from several West African countries, amid concerns that visiting pilgrims could spread the disease.
Meanwhile, two US aid workers who contracted Ebola in Liberia appear to be improving after receiving an unapproved medicine ahead of their evacuation back to the US.
But it is not clear if the ZMapp drug, which has only been tested on monkeys, can be credited with their improvement.
WHO response
In a surprise move, the WHO said on Wednesday it would convene a meeting of medical ethics specialists next week to decide whether to approve experimental treatment for Ebola.
"We need to ask the medical ethicists to give us guidance on what the responsible thing to do is," WHO Assistant Director General Marie-Paule Kieny said in a statement.
Some leading infectious disease experts have been calling for experimental treatments to be offered more widely to treat the disease.
The aim of the WHO's emergency committee meeting is to focus solely on how to respond to the Ebola outbreak.
If a public health emergency is declared, it could involve detailed plans to identify, isolate and treat cases, as well as impose travel restrictions on affected areas.
A WHO spokesman said: "We can't speculate in advance what the committee members are going to decide in advance."
The World Bank is allocating $200m (£120m) in emergency assistance for countries battling to contain Ebola.
The virus spreads by contact with infected blood and bodily fluids. The current outbreak is killing between 50% and 60% of people infected.
There is no cure or vaccine for Ebola - but patients have a better chance of survival if they receive early treatment.
Ebola has initial flu-like symptoms that can lead to external haemorrhaging from areas like eyes and gums, and internal bleeding which can lead to organ failure.
Monday, September 8, 2014
Saturday, September 6, 2014
05 August 2014 (Primary Source) Concerned about Ebola? You’re worrying about the wrong disease
A deadly disease is set to hit the shores of the US, UK and much of the rest of the northern hemisphere in the coming months. It will swamp our hospitals, lay millions low and by this time next year between 250,000 and 500,000 worldwide will be dead, thousands of them in the US and Britain.
Despite the best efforts of the medical profession, there’s no reliable cure, and no available vaccine offers effective protection for longer than a few months at a time.
If you’ve been paying attention to recent, terrifying headlines, you may assume the illness is the Ebola virus. Instead, the above description refers to seasonal flu – not swine or bird flu, but regular garden variety influenza.
Our fears about illness often bear little relation to our chances of falling victim to it, a phenomenon not helped by media coverage, which tends towards the novel and lurid rather than the particularly dangerous.
Ebola has become the stuff of hypochondriacs’ nightmares across the world. In the UK, the Daily Mirror had “Ebola terror as passenger dies at Gatwick” (the patient didn’t have Ebola), while New York’s news outlets (and prominent tweeters) experienced their own Ebola scare.
Even intellectual powerhouses such as Donald Trump have fallen into panic, with the mogul calling for the US to shut off all travel to west Africa and revoke citizens’ right to return to the country – who cares about fundamental rights during an outbreak? Not to be outdone, the endlessly asinine “explanatory journalism” site Vox informed us that “If the supercontinent Pangaea spontaneously reunited, the US would border the Ebola epidemic”.
Ebola is a horrific disease that kills more than half of people infected by it, though with specialist western treatment that death rate would likely fall a little. It’s unsurprising that the prospect of catching it is a scary one. The relief is that it’s not all that infectious: direct contact with bodily fluids of a visibly infected person is required, meaning that, compared with many illnesses, it’s easily contained.
Even in the midst of the current outbreak – the worst ever – the spread of the disease has not been rapid in west Africa: around 400 new cases were reported in June, and a further 500 or so in July. This is a linear spread, meaning each person at present is infecting on average around (actually just over) one additional person.
Far more worrying are diseases that spread exponentially: if one infected person spreads the disease to two or more on average, the illness spreads far quicker and is a much more worrying prospect, even if mortality is considerably lower.
The 800-plus deaths from Ebola in Africa so far this year are indisputably tragic, but it is important to keep a sense of proportion – other infectious diseases are far, far deadlier.
Since the Ebola outbreak began in February, around 300,000 people have died from malaria, while tuberculosis has likely claimed over 600,000 lives. Ebola might have our attention, but it’s not even close to being the biggest problem in Africa right now. Even Lassa fever, which shares many of the terrifying symptoms of Ebola (including bleeding from the eyelids), kills many more than Ebola – and frequently finds its way to the US.
The most real effect for millions of people reading about Ebola will be fear and stigma. During the Sars outbreak of 2003, Asian-Americans became the targets of just that, with public health hotlines inundated with calls from Americans worried about “buying Asian merchandise”, “living near Asians”, “going to school with Asians”, and more.
Similarly, during the H1N1 “swine flu” outbreak, which had almost identical spread and mortality to seasonal flu, patients reported extreme fear, prompted largely by the hysterical coverage.
In the coming months, almost none of us will catch the Ebola virus. Many of us, though, will get fevers, headaches, shivers and more.
As planes get grounded, communities are stigmatised, and mildly sick people fear for their lives, it’s worth reflecting what the biggest threat to our collective wellbeing is: rare tropical diseases, or our terrible coverage of them.
Despite the best efforts of the medical profession, there’s no reliable cure, and no available vaccine offers effective protection for longer than a few months at a time.
If you’ve been paying attention to recent, terrifying headlines, you may assume the illness is the Ebola virus. Instead, the above description refers to seasonal flu – not swine or bird flu, but regular garden variety influenza.
Our fears about illness often bear little relation to our chances of falling victim to it, a phenomenon not helped by media coverage, which tends towards the novel and lurid rather than the particularly dangerous.
Ebola has become the stuff of hypochondriacs’ nightmares across the world. In the UK, the Daily Mirror had “Ebola terror as passenger dies at Gatwick” (the patient didn’t have Ebola), while New York’s news outlets (and prominent tweeters) experienced their own Ebola scare.
Even intellectual powerhouses such as Donald Trump have fallen into panic, with the mogul calling for the US to shut off all travel to west Africa and revoke citizens’ right to return to the country – who cares about fundamental rights during an outbreak? Not to be outdone, the endlessly asinine “explanatory journalism” site Vox informed us that “If the supercontinent Pangaea spontaneously reunited, the US would border the Ebola epidemic”.
Ebola is a horrific disease that kills more than half of people infected by it, though with specialist western treatment that death rate would likely fall a little. It’s unsurprising that the prospect of catching it is a scary one. The relief is that it’s not all that infectious: direct contact with bodily fluids of a visibly infected person is required, meaning that, compared with many illnesses, it’s easily contained.
Even in the midst of the current outbreak – the worst ever – the spread of the disease has not been rapid in west Africa: around 400 new cases were reported in June, and a further 500 or so in July. This is a linear spread, meaning each person at present is infecting on average around (actually just over) one additional person.
Far more worrying are diseases that spread exponentially: if one infected person spreads the disease to two or more on average, the illness spreads far quicker and is a much more worrying prospect, even if mortality is considerably lower.
The 800-plus deaths from Ebola in Africa so far this year are indisputably tragic, but it is important to keep a sense of proportion – other infectious diseases are far, far deadlier.
Since the Ebola outbreak began in February, around 300,000 people have died from malaria, while tuberculosis has likely claimed over 600,000 lives. Ebola might have our attention, but it’s not even close to being the biggest problem in Africa right now. Even Lassa fever, which shares many of the terrifying symptoms of Ebola (including bleeding from the eyelids), kills many more than Ebola – and frequently finds its way to the US.
The most real effect for millions of people reading about Ebola will be fear and stigma. During the Sars outbreak of 2003, Asian-Americans became the targets of just that, with public health hotlines inundated with calls from Americans worried about “buying Asian merchandise”, “living near Asians”, “going to school with Asians”, and more.
Similarly, during the H1N1 “swine flu” outbreak, which had almost identical spread and mortality to seasonal flu, patients reported extreme fear, prompted largely by the hysterical coverage.
In the coming months, almost none of us will catch the Ebola virus. Many of us, though, will get fevers, headaches, shivers and more.
As planes get grounded, communities are stigmatised, and mildly sick people fear for their lives, it’s worth reflecting what the biggest threat to our collective wellbeing is: rare tropical diseases, or our terrible coverage of them.
06 August 2014 (Primary Source) WHO to convene emergency meeting on Ebola
UNITED NATIONS, Aug. 5 (Xinhua) -- The United Nations health agency will convene a two-day meeting of its emergency committee starting Wednesday to discuss the current Ebola outbreak in West Africa, a UN spokeswoman said here on Tuesday.
"According to the World Health Organization (WHO), as of 1 August, the number of Ebola cases stands at 1,603, including 887 deaths, in four countries: Guinea, Liberia, Nigeria and Sierra Leone," UN Associate Spokesperson Vannina Maestracci said at a daily briefing.
Maestracci noted that between July 31 and Aug. 1, there were a total of 163 new cases and 61 deaths in two days.
"Human and financial resource mobilization continues to be sought from WHO's partners, UN agencies, and other stakeholders," she said.
"WHO has also announced it was convening a meeting of its emergency committee over the next two days," said the spokeswoman.
The aim of the emergency meeting is to determine whether the current Ebola viral disease outbreak in West Africa constitutes a public health emergency of international concern.
If so, the committee would recommend to the WHO Director- General to declare it a public health emergency of international concern and recommend appropriate temporary measures to reduce international spread of the virus.
The UN health agency is scheduled to hold a press conference with Dr. Keiji Fukuda, WHO Assistant Director-General for Health Security, at 9 a.m. Geneva time on Friday on the outcome of the meeting of the emergency committee, which might finish its work quite late at night on Thursday.
Ebola, which spreads through mucous and other body fluid or secretions such as stool, urine, saliva and semen of infected people, is believed to be very difficult to control.
"According to the World Health Organization (WHO), as of 1 August, the number of Ebola cases stands at 1,603, including 887 deaths, in four countries: Guinea, Liberia, Nigeria and Sierra Leone," UN Associate Spokesperson Vannina Maestracci said at a daily briefing.
Maestracci noted that between July 31 and Aug. 1, there were a total of 163 new cases and 61 deaths in two days.
"Human and financial resource mobilization continues to be sought from WHO's partners, UN agencies, and other stakeholders," she said.
"WHO has also announced it was convening a meeting of its emergency committee over the next two days," said the spokeswoman.
The aim of the emergency meeting is to determine whether the current Ebola viral disease outbreak in West Africa constitutes a public health emergency of international concern.
If so, the committee would recommend to the WHO Director- General to declare it a public health emergency of international concern and recommend appropriate temporary measures to reduce international spread of the virus.
The UN health agency is scheduled to hold a press conference with Dr. Keiji Fukuda, WHO Assistant Director-General for Health Security, at 9 a.m. Geneva time on Friday on the outcome of the meeting of the emergency committee, which might finish its work quite late at night on Thursday.
Ebola, which spreads through mucous and other body fluid or secretions such as stool, urine, saliva and semen of infected people, is believed to be very difficult to control.
05 August 2014 (Primary Soucre) World Bank pledges $200m to contain Ebola
The World Bank has pledged $200m to help contain the deadly Ebola virus, with the growing crisis forcing healthcare system in Liberia to shut down out of fear of staff contracting the virus.
The World Bank said on Monday that it would provide up to $200m in emergency assistance to Guinea, Liberia, and Sierra Leone to help the West African nations contain the deadly outbreak which has killed 887 since the outbreak began in March this year.
Jim Yong Kim, World Bank president, himself an expert on infectious diseases, said he has been monitoring the spread of the virus and was "deeply saddened" at how it was contributing to the breakdown of "already weak health systems in the three countries".
The funding will help provide medical supplies, pay healthcare staff, and take care of other priorities to contain the epidemic and try to prevent future outbreaks, the World Bank said.
The announcement came as health centres in Liberia's capital city of Monrovia shut down because medical personnel became too afraid to turn up to work, the Associated Press news agency reported.
Both Liberia's and Sierra Leone's top Ebola doctors lost their lives to the disease after caring for numerous people.
Healthcare personnel in Liberia say they have not received sufficient support from the government to be able to deal with possible Ebola patients walking through their doors.
"The health workers think that they are not protected, they don't have the requisite material to use as to protect themselves against the Ebola disease, so many of the health workers including physician's assistants, nurses, are staying home," said Amos Richards, a physician's assistant from Monrovia.
Crisis meeting
Liberian President Ellen Johnson-Sirleaf and ministers held a crisis meeting on Sunday to discuss a series of anti-Ebola measures as police contained infected communities in the northern Lofa county.
Tolbert Nyensuah, deputy health minister, said the government was doing its best to collect bodies as quickly as possible. He said that 30 bodies were buried over the weekend in a mass grave outside the city.
The government purchased land from a private citizen and that land will be used to bury the bodies, he said.
Nigeria's health ministry announced on Monday that a doctor in Lagos who treated a Liberian victim had contracted the virus - the second confirmed case in the city, and the fourth case involving a doctor.
The US doctor infected with the virus, "seems to be improving", the director of the Atlanta-based Centers for Disease Control, where he is being treated in an isolation unit, said on Sunday.
A second American infected with the virus while working in Liberia was flying back to the US on Tuesday.
The government purchased land from a private citizen and that land will be used to bury the bodies, he said.
Nigeria's health ministry announced on Monday that a doctor in Lagos who treated a Liberian victim had contracted the virus - the second confirmed case in the city, and the fourth case involving a doctor.
The US doctor infected with the virus, "seems to be improving", the director of the Atlanta-based Centers for Disease Control, where he is being treated in an isolation unit, said on Sunday.
A second American infected with the virus while working in Liberia was flying back to the US on Tuesday.
05 August 2014 (Primary Source) The Ebola Outbreak: 'A Dress Rehearsal For The Next Big One'
Until this year, the world had recorded 1,640 deaths from Ebola since the virus was discovered in 1976.
Then Ebola appeared in West Africa.
So far this year, 887 people have died of Ebola in West Africa, the World Health Organization said Monday.
To put that into perspective, more than a third of all people known to have died from the Ebola virus have died in the current outbreak.
And the outbreak is still spreading at a frightening rate. Last week, there were more than 200 new cases reported across four countries.
To find out more about the origins of Ebola — and what may lie ahead — we talked to author David Quammen. He wrote the book Spillover, which traces the evolution of Ebola, HIV and other diseases that move from animals to people.
Here's an excerpt from our conversation, which has been edited for clarity.
The title of your book is Spillover. What does this term mean?
Spillover is the event when a disease, or the agent that causes it, moves from one species to another.
In particular, there's a group of diseases, called zoonotic diseases, which pass from nonhuman animals into humans. And spillover is the moment when a new virus has the opportunity to leap from a bat, monkey or rodent into its first human victim.
We're pretty sure that's what happened with the Ebola outbreak in West Africa.
How widespread is the Ebola virus in Africa? Are there pockets of wild animals, such as fruit bats, carrying Ebola in certain regions? Or is the virus really widespread in animals?
The Ebola virus seems to be confined to the moist forests of Central and West Africa.
We don't know where Ebola lives permanently — its so-called reservoir host. A reservoir is the animal in which a pathogen or virus lives inconspicuously, without causing symptoms. That's its refuge, its home. The virus replicates in the reservoir host at a relatively low rate and doesn't cause trouble.
For Ebola, bats are a key suspect. Three species have been found to carry antibodies to Ebola. But nobody has actually found live Ebola viruses in those bats.
Scientists don't know how the Ebola outbreak in West Africa started. But how have other Ebola outbreaks begun?
Each of these new, emerging diseases is sort of a mystery story. The first mystery to be solved is what's the reservoir host and what caused it to spill over into humans.
There was one Ebola outbreak in the Democratic Republic of Congo, where it was suspected that the first case involved contact with a big fruit bat.
There were some large, migratory fruit bats roosting along the river in this area. One man in particular bought a bat at a market and carried it home. Then, I believe, the infection passed from him to his daughter. There was a strong, but not definite, implication that the killing of fruit bats, and the selling and buying of them in the market, is what triggered an outbreak.
How did we go from a virus that's found largely in animals to a virus that can be deadly for humans — and spread across four countries?
Human behavior is causing this problem. More and more, we're going into wild, diverse ecosystems around the world, especially tropical forests.
Some scientists believe that each individual species of animal, plant, bacterium and fungus in these places carries at least one unique virus, maybe even 10 of them.
We, humans, go into those wild ecosystems. We cut down trees. We build mines, roads and villages. We kill the animals and eat them. Or we capture them and transport them around the world.
In doing that, we expose ourselves to all these viruses living around the world. That gives the viruses the opportunity to spill over into humans. Then in some cases, once the virus makes that first spillover, it discovers that it might be highly transmissible in humans. Then you might have an epidemic or a pandemic.
Is the Ebola virus in West Africa changing over time and becoming more contagious in people?
Potentially. That's a real concern.
Viruses evolve by way of Darwinian natural selection. The more cases of Ebola we have, the more chances the virus gets to replicate. And the more chances there [are] for it to mutate in a particular way that it adapts well to living in humans — and perhaps transmitting more easily from human to human.
The longer this outbreak in West Africa goes on, the more chances there are for the Ebola virus to mutate and adapt. That's no small concern.
Do you think this Ebola outbreak is the next "big one"?
I would hope that this outbreak could — however bad it may become — could be controlled short of the scope of the big epidemics and pandemics. It seems more than likely that it can.
So I don't think this Ebola outbreak is the next big one. But I think it's a dress rehearsal for the next big one.
The experts I talk to say the next big one will almost certainly be caused by a zoonotic virus, coming out of animals. And it's likely to be one that is transmissible through the respiratory route — that is, through a sneeze or cough.
Ebola is not an easily transmissible virus. It requires direct contact with bodily fluids. It doesn't travel on the respiratory route.
Viruses such as the Middle East respiratory syndrome and SARS are much more of a concern to scientists that study these things than Ebola because they are already transmissible through the respiratory route. They are also highly adaptable, and they mutate quickly.
In terms of the next big one, SARS and MERS stand higher on the watch list than Ebola.
05 August 2014 (Primary Source) Nigerian Official Says 7 More Show Ebola Symptoms
LAGOS, Nigeria (AP) — A total of eight people in Nigeria who were in direct contact with a man who flew to Lagos and died of Ebola now have symptoms of the dreaded and deadly disease and have been placed into quarantine, a Nigerian health official said Tuesday.
Of the eight, only a doctor who treated the traveler has so far tested positive for Ebola. The others are being tested, with results pending, said Lagos state health health commissioner Jide Idris.
The official death toll for the worst-ever outbreak for the disease stood on Monday at 887, according to the World Health Organization. Guinea, Sierra Leone and Liberia have been affected much more severely than Nigeria, which has experienced only one death. Though as Africa's most populous nation, Nigeria poses a grave risk of the disease catching on like wildfire.
Most of the people in quarantine had made contact in a hospital in Lagos with Liberian-American Patrick Sawyer, Idris told reporters. Sawyer died on July 25, five days after arriving in Nigeria.
Others may have been infected in Lagos, a city with a population of about 21 million, before doctors suspected that Sawyer had Ebola. They put him in isolation about 24 hours after he arrived at the hospital.
"At that point in time, especially the first day, the nature of the disease was not known," said Idris.
During that window of time, it's possible more people got infected, he said as he defended the actions of health authorities.
"If they knew his history they probably would have taken better precautions," he said.
The eight quarantined people, who include the doctor, are among 14 who had "serious direct contact" with Sawyer, most of them at the hospital, Idris said. Authorities are following the conditions of a total of 70 people who had primary contact with Sawyer, and now they are tracking the secondary contacts of the eight people in quarantine, Idris said.
He said volunteers are needed to track down all the people who potential carriers of the disease had been in contact with.
The West African outbreak of Ebola started in March.
Friday, September 5, 2014
01 August 2014 (Primary Source) Obama says Ebola outbreak must be taken seriously, US taking precautions for US-Africa summit
WASHINGTON - President Barack Obama says he is taking the
Ebola outbreak in Africa seriously. He says the United States is taking
precautions for next week's U.S.-African summit in the nation's capital.
He says the federal Centers for Disease Control is working
with international health organizations to provide assistance to the affected
countries. He says this outbreak is more aggressive than in the past.
Administration officials said the leaders of Liberia and
Sierra Leone had cancelled their trip to Washington for the gathering of
African leaders.
U.S. health officials on Thursday warned Americans not to
travel to Guinea, Liberia and Sierra Leone, where the Ebola virus has killed
more than 700 people this year. The current outbreak is the largest since the
disease first emerged in Africa nearly 40 years ago.
Thursday, September 4, 2014
05 August 2014 (Primary Source) US government had role in experimental Ebola treatment given to 2 American aid workers
Two American aid workers infected with Ebola are getting an experimental drug so novel it has never been tested for safety in humans and was only identified as a potential treatment earlier this year, thanks to a longstanding research program by the U.S. government and the military.
The workers, Nancy Writebol and Dr. Kent Brantly, are improving, although it's impossible to know whether the treatment is the reason or they are recovering on their own, as others who have survived Ebola have done. Brantly is being treated at a special isolation unit at Atlanta's Emory University Hospital, and Writebol was expected to be flown there Tuesday in the same specially equipped plane that brought Brantly.
The workers, Nancy Writebol and Dr. Kent Brantly, are improving, although it's impossible to know whether the treatment is the reason or they are recovering on their own, as others who have survived Ebola have done. Brantly is being treated at a special isolation unit at Atlanta's Emory University Hospital, and Writebol was expected to be flown there Tuesday in the same specially equipped plane that brought Brantly.
They were infected while working in Liberia, one of four West African nations dealing with the world's largest Ebola outbreak. On Monday, the World Health Organization said the death toll had increased from 729 to 887 deaths in Guinea, Sierra Leone, Liberia and Nigeria, and that more than 1,600 people have been infected.
In a worrisome development, the Nigerian Health Minister said a doctor who had helped treat Patrick Sawyer, the Liberian-American man who died July 25 days after arriving in Nigeria, has been confirmed to have the deadly disease. Tests are pending for three other people who also treated Sawyer and are showing symptoms.
There is no vaccine or specific treatment for Ebola, but several are under development.
The experimental treatment the U.S. aid workers are getting is called ZMapp and is made by Mapp Biopharmaceutical Inc. of San Diego. It is aimed at boosting the immune system's efforts to fight off Ebola and is made from antibodies produced by lab animals exposed to parts of the virus.
In a statement, the company said it was working with LeafBio of San Diego, Defyrus Inc. of Toronto, the U.S. government and the Public Health Agency of Canada on development of the drug, which was identified as a possible treatment in January.
The drug is made in tobacco plants at Kentucky BioProcessing, a subsidiary of Reynolds American Inc., in Owensboro, Kentucky, said spokesman David Howard. The plant "serves like a photocopier," and the drug is extracted from the plant, he said.
Kentucky BioProcessing complied with a request from Emory and the international relief group Samaritan's Purse to provide a limited amount of ZMapp to Emory, he said. Brantly works for the aid group.
The Kentucky company is working "to increase production of ZMapp but that process is going to take several months," Howard said. The drug has been tested in animals and testing in humans is expected to begin later this year.
The U.S. Food and Drug Administration must grant permission to use experimental treatments in the United States, but the FDA does not have authority over the use of such a drug in other countries, and the aid workers were first treated in Liberia. An FDA spokeswoman said she could not confirm or deny FDA granting access to any experimental therapy for the aid workers while in the U.S.
Writebol, 59, has been in isolation at her home in Liberia since she was diagnosed last month. She's now walking with assistance and has regained her appetite, said Bruce Johnson, president of SIM USA, the Charlotte, North Carolina-based group that she works for in Africa.
Writebol has received two doses of the experimental drug so far, but Johnson was hesitant to credit the treatment for her improvement.
"Ebola is a tricky virus and one day you can be up and the next day down. One day is not indicative of the outcome," he said. But "we're grateful this medicine was available."
Brantly, 33, also was said to be improving. Besides the experimental dose he got in Liberia, he also received a unit of blood from a 14-year-old boy, an Ebola survivor, who had been under his care. That seems to be aimed at giving Brantly antibodies the boy may have made to the virus.
Samaritan's Purse initiated the events that led to the two workers getting ZMapp, according to a statement Monday by the National Institute of Allergy and Infectious Diseases, part of the U.S. National Institutes of Health. The Boone, North Carolina-based group contacted U.S. Centers for Disease Control and Prevention officials in Liberia to discuss various experimental treatments and were referred to an NIH scientist in Liberia familiar with those treatments.
The scientist answered some questions and referred them to the companies but was not officially representing the NIH and had no "official role in procuring, transporting, approving, or administering the experimental products," the statement says.
In the meantime, dozens of African heads of state were in Washington for the U.S.-Africa Leaders Summit, a three-day gathering hosted by President Barack Obama. U.S. health officials on Monday spoke with Guinean President Alpha Conde and senior officials from Liberia and Sierra Leone about the Ebola outbreak.
The Defense Department has long had a hand in researching infectious diseases, including Ebola. During much of the Cold War period this served two purposes: to keep abreast of diseases that could limit the effectiveness of troops deployed abroad and to be prepared if biological agents were used as weapons.
The U.S. military has no biological weapons program but continues to do research related to infectious diseases as a means of staying current on potential threats to the health of troops. It may also contribute medical expertise as part of interagency efforts in places like Africa where new infectious disease threats arise.
The hospital in Atlanta treating the aid workers has one of the nation's most sophisticated infectious disease units. Patients are sealed off from anyone not in protective gear. Ebola is only spread through direct contact with an infected person's blood or other bodily fluids, not through the air.
The CDC last week told U.S. doctors to ask about foreign travel by patients who come down with Ebola-like symptoms, including fever, headache, vomiting and diarrhea. A spokesman said three people have been tested so far in the U.S. — and all tested negative. Additionally, a New York City hospital on Monday said a man was being tested for Ebola but he likely didn't have it.
Writebol and her husband, David, had been in Liberia since last August, sent there by SIM USA and sponsored by their home congregation at Calvary Church in Charlotte. At the clinic, Nancy Writebol's duties included disinfecting staff entering or leaving the Ebola treatment area.
"Her husband, David, told me Sunday her appetite has improved and she requested one of her favorite dishes - Liberian potato soup — and coffee," SIM's Johnson said.
05 August 2014 (Primary Source) Ebola: BA suspends flights to Liberia and Sierra Leone
British Airways has suspended flights to and from Liberia and Sierra Leone until the end of August amid concerns over the Ebola outbreak.
The airline normally has four flights a week from London Heathrow to Freetown in Sierra Leone, with a connection to Monrovia in Liberia.
BA said the move was due to the "deteriorating public health situation" in the two west African countries.
Customers can get a refund or rearrange their flight for a later date.
'Constant review'
The Liberian government said it regretted BA's decision, but added: "We fully understand that international airlines must keep the safety of customers and crew as their highest priority."
BA said in a statement: "We have temporarily suspended our flights to and from Liberia and Sierra Leone until 31 August 2014 due to the deteriorating public health situation in both countries.
"The safety of our customers, crew and ground teams is always our top priority and we will keep the routes under constant review in the coming weeks.
"Customers with tickets on those routes are being offered a range of options including a full refund and the ability to rebook their flights to a later date."
BA's move follows a similar suspension by two regional carriers last week.
Health checks
Since February, nearly 900 people have died from the disease affecting four west African countries - Guinea, Liberia, Sierra Leone and Nigeria.
The virus spreads by contact with infected blood and bodily fluids. The current outbreak is killing between 50% and 60% of people infected.
There is no cure or vaccine for Ebola but patients have a better chance of survival if they receive early treatment.
The Liberian government statement said all outgoing passengers were receiving mandatory health checks, and that it would "work around the clock" to ensure international entry points were secure from Ebola.
It added: "We will continue to engage openly and positively with regional and international carriers so that any suspended flights can be resumed as soon as possible."
The airline normally has four flights a week from London Heathrow to Freetown in Sierra Leone, with a connection to Monrovia in Liberia.
BA said the move was due to the "deteriorating public health situation" in the two west African countries.
Customers can get a refund or rearrange their flight for a later date.
'Constant review'
The Liberian government said it regretted BA's decision, but added: "We fully understand that international airlines must keep the safety of customers and crew as their highest priority."
BA said in a statement: "We have temporarily suspended our flights to and from Liberia and Sierra Leone until 31 August 2014 due to the deteriorating public health situation in both countries.
"The safety of our customers, crew and ground teams is always our top priority and we will keep the routes under constant review in the coming weeks.
"Customers with tickets on those routes are being offered a range of options including a full refund and the ability to rebook their flights to a later date."
BA's move follows a similar suspension by two regional carriers last week.
Health checks
Since February, nearly 900 people have died from the disease affecting four west African countries - Guinea, Liberia, Sierra Leone and Nigeria.
The virus spreads by contact with infected blood and bodily fluids. The current outbreak is killing between 50% and 60% of people infected.
There is no cure or vaccine for Ebola but patients have a better chance of survival if they receive early treatment.
The Liberian government statement said all outgoing passengers were receiving mandatory health checks, and that it would "work around the clock" to ensure international entry points were secure from Ebola.
It added: "We will continue to engage openly and positively with regional and international carriers so that any suspended flights can be resumed as soon as possible."
04 August 2014 (Primary Source) Ebola Drug Made From Tobacco Plant Saves U.S. Aid Workers
A tiny San Diego-based company provided an experimental Ebola treatment for two Americans infected with the deadly virus in Liberia. The biotechnology drug, produced with tobacco plants, appears to be working.
In an unusual twist of expedited drug access, Mapp Biopharmaceutical Inc., which has nine employees, released its experimental ZMapp drug, until now only tested on infected animals, for the two health workers. Kentucky BioProcessing LLC, a subsidiary of tobacco giant Reynolds American Inc. (RAI), manufactures the treatment for Mapp from tobacco plants.
The first patient, Kent Brantly, a doctor, was flown from Liberia to Atlanta on Aug. 2, and is receiving treatment at Emory University Hospital. Nancy Writebol, an aid worker, is scheduled to arrive in Atlanta today and will be treated at the same hospital, according to the charity group she works with. Both are improving, according to relatives and supporters.
Each patient received at least one dose of ZMapp in Liberia before coming to the U.S., according to Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.
“There’s a very scarce number of doses,” and it’s not clear how many each patient needs for treatment, Fauci said. “I’m not sure how many doses they’ll get.”
Citing unnamed sources, CNN yesterday reported that the drug used for the treatment is Mapp’s.
Ebola Outbreak
Ebola, spread through direct contact with body fluids such as blood and urine, has sickened 1,603 people in West Africa, killing 887, according to the World Health Organization. The disease, first reported in what is now the Democratic Republic of Congo in 1976, can cause bleeding from the eyes, ears and nose.
The Deadliest Disease on Earth
The virus has historically killed as many as 90 percent of those who contract it. The current outbreak has a fatality rate of about 60 percent, probably because of early treatment efforts, officials have said.
There is no cure for Ebola, although several companies -- including Mapp -- are working on drug candidates that are undergoing animal testing. Normally, patients are given fluids, blood transfusions and antibiotics with the hope their immune systems can fight off Ebola’s onslaught.
The two scientists behind Mapp, President Larry Zeitlin and Chief Executive Officer Kevin Whaley, “are both brilliant,” said Charles Arntzen, a plant biotechnology expert at Arizona State University who collaborated with the two researchers years ago. “They are very, very bright guys and free spirits.”
The antibody work came out of research projects funded more than a decade ago by the U.S. Army to develop treatments and vaccines against potential bio-warfare agents, such as the Ebola virus, Arntzen said in a telephone interview.
Tobacco Plant
The tobacco plant production system was developed because it was a method that could produce antibodies rapidly in the event of an emergency, he said.
To produce therapeutic proteins inside a tobacco plant, genes for the desired antibodies are fused to genes for a natural tobacco virus, said Arntzen. The tobacco plants are then infected with this new artificial virus, he said.
“The infection results in the production of antibodies inside the plant,” Arntzen said. The plant is eventually ground up and the antibody is extracted, he said. The whole process takes a matter of weeks.
When confronted by reporters about the Ebola infections in Liberia and subsequent treatments, Whaley said he needed to get up to speed on the developing events.
“This is all new to me,” said Whaley, who was dressed in shorts, a well-worn T-shirt and flip-flops while addressing reporters’ questions outside the company’s offices in a San Diego business park. “I just don’t want to give out any inaccurate information, that’s all.”
Antibody Cocktail
Mapp’s drug is being developed with Toronto-based Defyrus Inc., which has six employees, according to Defyrus CEO Jeff Turner. ZMapp is a “cocktail” of monoclonal antibodies that help the immune system attack the virus.
Monoclonal antibodies designed to fight and block specific proteins can stop the virus from latching onto and entering cells, said Heinz Feldmann, chief of the National Institute of Allergy and Infectious Diseases’ Laboratory of Virology in Hamilton, Montana.
The key is to find antibodies that can prevent viral infection, and to attack several points on the virus so that mutants won’t “escape” treatment, he said.
“What you want is a cocktail of antibodies that target different domains on the virus so escape is less likely in treatment,” he said in a telephone interview. Feldmann said he hasn’t been involved in developing treatments.
ZMapp’s predecessor, MB-003, protected three of seven rhesus macaques in a study run in 2013 by Mapp and the U.S. Army Medical Research Institute of Infectious Diseases.
Ethical Questions
Ebola and virology experts believe the use of the Mapp drug for Brantly and Writebol is unusual in the annals of emergency drug treatments. While potentially saving lives, the cases raise questions about who should have the right to receive experimental drugs years before they gain FDA approval.
“There are a lot of Africans that are also dying,” Robert Garry, a virologist at Tulane University, said in a telephone interview. “If we are going to do it for the Americans then we should certainly step up our game for the Africans.”
Although no drugs to treat Ebola are approved by U.S. regulators, the Food and Drug Administration can approve an emergency application to provide access to unapproved drugs, Stephanie Yao, an FDA spokeswoman, said in an e-mail.
Emergency Approval
Approval for emergency drug use outside of a clinical trial can be made within 24 hours, Yao wrote. Shipment and treatment with the drug could begin even before completed written forms are submitted to the FDA, which can approve the use of an experimental treatment by telephone in an emergency.
“The FDA stands ready to work with companies and investigators treating these patients who are in dire need of treatment,” Yao said. She declined to say whether the FDA had allowed any drug to be used in the Ebola outbreak.
Erica Ollmann Saphire, a molecular biologist at the Scripps Research Institute in San Diego, worked with Mapp and the other biotechnology companies to develop models of the Ebola virus and potential antibodies.
She directs a global consortium given the job of modeling the virus and the mixture of antibodies needed to defeat it. She said the drug was approved for the two American medical workers in Liberia under a compassionate-use doctrine, because it’s not even scheduled for clinical trials until next year.
Informed Consent
“I’d take it myself,” she said in an interview in her laboratory, near La Jolla. “Absolutely. I wouldn’t think twice.”
She said the American medical aid workers were in a better position to give consent to the treatment than African disease victims.
“Do you put an untested therapy in a human or do you just watch them die?” Saphire asked. “Certainly these two Americans are medically trained individuals who knew what they were getting into. They are able to give informed consent.”
Medical care of the two U.S. citizens may take two to three weeks if all goes well, Bruce Ribner, an infectious disease specialist at Emory, said in an Aug. 1 news conference.
The Atlanta-based Centers for Disease Control and Prevention, which confirmed that Brantly and Writebol are the first Ebola patients on U.S. soil, is working with the hospital and transport company to make sure evacuation of the two patients goes safely, said Barbara Reynolds, an agency spokeswoman.
“We’re here to make sure the transportation process and the care here in the U.S. ensures there’s no spread,” Reynolds said. “It’s important to remember this is not an airborne virus, it requires close contact with body fluids. It’s minimal risk as long as the people caring for the patient use meticulous procedures.”
In an unusual twist of expedited drug access, Mapp Biopharmaceutical Inc., which has nine employees, released its experimental ZMapp drug, until now only tested on infected animals, for the two health workers. Kentucky BioProcessing LLC, a subsidiary of tobacco giant Reynolds American Inc. (RAI), manufactures the treatment for Mapp from tobacco plants.
The first patient, Kent Brantly, a doctor, was flown from Liberia to Atlanta on Aug. 2, and is receiving treatment at Emory University Hospital. Nancy Writebol, an aid worker, is scheduled to arrive in Atlanta today and will be treated at the same hospital, according to the charity group she works with. Both are improving, according to relatives and supporters.
Each patient received at least one dose of ZMapp in Liberia before coming to the U.S., according to Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.
“There’s a very scarce number of doses,” and it’s not clear how many each patient needs for treatment, Fauci said. “I’m not sure how many doses they’ll get.”
Citing unnamed sources, CNN yesterday reported that the drug used for the treatment is Mapp’s.
Ebola Outbreak
Ebola, spread through direct contact with body fluids such as blood and urine, has sickened 1,603 people in West Africa, killing 887, according to the World Health Organization. The disease, first reported in what is now the Democratic Republic of Congo in 1976, can cause bleeding from the eyes, ears and nose.
The Deadliest Disease on Earth
The virus has historically killed as many as 90 percent of those who contract it. The current outbreak has a fatality rate of about 60 percent, probably because of early treatment efforts, officials have said.
There is no cure for Ebola, although several companies -- including Mapp -- are working on drug candidates that are undergoing animal testing. Normally, patients are given fluids, blood transfusions and antibiotics with the hope their immune systems can fight off Ebola’s onslaught.
The two scientists behind Mapp, President Larry Zeitlin and Chief Executive Officer Kevin Whaley, “are both brilliant,” said Charles Arntzen, a plant biotechnology expert at Arizona State University who collaborated with the two researchers years ago. “They are very, very bright guys and free spirits.”
The antibody work came out of research projects funded more than a decade ago by the U.S. Army to develop treatments and vaccines against potential bio-warfare agents, such as the Ebola virus, Arntzen said in a telephone interview.
Tobacco Plant
The tobacco plant production system was developed because it was a method that could produce antibodies rapidly in the event of an emergency, he said.
To produce therapeutic proteins inside a tobacco plant, genes for the desired antibodies are fused to genes for a natural tobacco virus, said Arntzen. The tobacco plants are then infected with this new artificial virus, he said.
“The infection results in the production of antibodies inside the plant,” Arntzen said. The plant is eventually ground up and the antibody is extracted, he said. The whole process takes a matter of weeks.
When confronted by reporters about the Ebola infections in Liberia and subsequent treatments, Whaley said he needed to get up to speed on the developing events.
“This is all new to me,” said Whaley, who was dressed in shorts, a well-worn T-shirt and flip-flops while addressing reporters’ questions outside the company’s offices in a San Diego business park. “I just don’t want to give out any inaccurate information, that’s all.”
Antibody Cocktail
Mapp’s drug is being developed with Toronto-based Defyrus Inc., which has six employees, according to Defyrus CEO Jeff Turner. ZMapp is a “cocktail” of monoclonal antibodies that help the immune system attack the virus.
Monoclonal antibodies designed to fight and block specific proteins can stop the virus from latching onto and entering cells, said Heinz Feldmann, chief of the National Institute of Allergy and Infectious Diseases’ Laboratory of Virology in Hamilton, Montana.
The key is to find antibodies that can prevent viral infection, and to attack several points on the virus so that mutants won’t “escape” treatment, he said.
“What you want is a cocktail of antibodies that target different domains on the virus so escape is less likely in treatment,” he said in a telephone interview. Feldmann said he hasn’t been involved in developing treatments.
ZMapp’s predecessor, MB-003, protected three of seven rhesus macaques in a study run in 2013 by Mapp and the U.S. Army Medical Research Institute of Infectious Diseases.
Ethical Questions
Ebola and virology experts believe the use of the Mapp drug for Brantly and Writebol is unusual in the annals of emergency drug treatments. While potentially saving lives, the cases raise questions about who should have the right to receive experimental drugs years before they gain FDA approval.
“There are a lot of Africans that are also dying,” Robert Garry, a virologist at Tulane University, said in a telephone interview. “If we are going to do it for the Americans then we should certainly step up our game for the Africans.”
Although no drugs to treat Ebola are approved by U.S. regulators, the Food and Drug Administration can approve an emergency application to provide access to unapproved drugs, Stephanie Yao, an FDA spokeswoman, said in an e-mail.
Emergency Approval
Approval for emergency drug use outside of a clinical trial can be made within 24 hours, Yao wrote. Shipment and treatment with the drug could begin even before completed written forms are submitted to the FDA, which can approve the use of an experimental treatment by telephone in an emergency.
“The FDA stands ready to work with companies and investigators treating these patients who are in dire need of treatment,” Yao said. She declined to say whether the FDA had allowed any drug to be used in the Ebola outbreak.
Erica Ollmann Saphire, a molecular biologist at the Scripps Research Institute in San Diego, worked with Mapp and the other biotechnology companies to develop models of the Ebola virus and potential antibodies.
She directs a global consortium given the job of modeling the virus and the mixture of antibodies needed to defeat it. She said the drug was approved for the two American medical workers in Liberia under a compassionate-use doctrine, because it’s not even scheduled for clinical trials until next year.
Informed Consent
“I’d take it myself,” she said in an interview in her laboratory, near La Jolla. “Absolutely. I wouldn’t think twice.”
She said the American medical aid workers were in a better position to give consent to the treatment than African disease victims.
“Do you put an untested therapy in a human or do you just watch them die?” Saphire asked. “Certainly these two Americans are medically trained individuals who knew what they were getting into. They are able to give informed consent.”
Medical care of the two U.S. citizens may take two to three weeks if all goes well, Bruce Ribner, an infectious disease specialist at Emory, said in an Aug. 1 news conference.
The Atlanta-based Centers for Disease Control and Prevention, which confirmed that Brantly and Writebol are the first Ebola patients on U.S. soil, is working with the hospital and transport company to make sure evacuation of the two patients goes safely, said Barbara Reynolds, an agency spokeswoman.
“We’re here to make sure the transportation process and the care here in the U.S. ensures there’s no spread,” Reynolds said. “It’s important to remember this is not an airborne virus, it requires close contact with body fluids. It’s minimal risk as long as the people caring for the patient use meticulous procedures.”
05 August 2014 (Primary Source) US government had role in experimental Ebola treatment given to 2 American aid workers
Two American aid workers infected with Ebola are getting an experimental drug so novel it has never been tested for safety in humans and was only identified as a potential treatment earlier this year, thanks to a longstanding research program by the U.S. government and the military.
The workers, Nancy Writebol and Dr. Kent Brantly, are improving, although it's impossible to know whether the treatment is the reason or they are recovering on their own, as others who have survived Ebola have done. Brantly is being treated at a special isolation unit at Atlanta's Emory University Hospital, and Writebol was expected to be flown there Tuesday in the same specially equipped plane that brought Brantly.
They were infected while working in Liberia, one of four West African nations dealing with the world's largest Ebola outbreak. On Monday, the World Health Organization said the death toll had increased from 729 to 887 deaths in Guinea, Sierra Leone, Liberia and Nigeria, and that more than 1,600 people have been infected.
In a worrisome development, the Nigerian Health Minister said a doctor who had helped treat Patrick Sawyer, the Liberian-American man who died July 25 days after arriving in Nigeria, has been confirmed to have the deadly disease. Tests are pending for three other people who also treated Sawyer and are showing symptoms.
There is no vaccine or specific treatment for Ebola, but several are under development.
The experimental treatment the U.S. aid workers are getting is called ZMapp and is made by Mapp Biopharmaceutical Inc. of San Diego. It is aimed at boosting the immune system's efforts to fight off Ebola and is made from antibodies produced by lab animals exposed to parts of the virus.
In a statement, the company said it was working with LeafBio of San Diego, Defyrus Inc. of Toronto, the U.S. government and the Public Health Agency of Canada on development of the drug, which was identified as a possible treatment in January.
The drug is made in tobacco plants at Kentucky BioProcessing, a subsidiary of Reynolds American Inc., in Owensboro, Kentucky, said spokesman David Howard. The plant "serves like a photocopier," and the drug is extracted from the plant, he said.
Kentucky BioProcessing complied with a request from Emory and the international relief group Samaritan's Purse to provide a limited amount of ZMapp to Emory, he said. Brantly works for the aid group.
The Kentucky company is working "to increase production of ZMapp but that process is going to take several months," Howard said. The drug has been tested in animals and testing in humans is expected to begin later this year.
The U.S. Food and Drug Administration must grant permission to use experimental treatments in the United States, but the FDA does not have authority over the use of such a drug in other countries, and the aid workers were first treated in Liberia. An FDA spokeswoman said she could not confirm or deny FDA granting access to any experimental therapy for the aid workers while in the U.S.
Writebol, 59, has been in isolation at her home in Liberia since she was diagnosed last month. She's now walking with assistance and has regained her appetite, said Bruce Johnson, president of SIM USA, the Charlotte, North Carolina-based group that she works for in Africa.
Writebol has received two doses of the experimental drug so far, but Johnson was hesitant to credit the treatment for her improvement.
"Ebola is a tricky virus and one day you can be up and the next day down. One day is not indicative of the outcome," he said. But "we're grateful this medicine was available."
Brantly, 33, also was said to be improving. Besides the experimental dose he got in Liberia, he also received a unit of blood from a 14-year-old boy, an Ebola survivor, who had been under his care. That seems to be aimed at giving Brantly antibodies the boy may have made to the virus.
Samaritan's Purse initiated the events that led to the two workers getting ZMapp, according to a statement Monday by the National Institute of Allergy and Infectious Diseases, part of the U.S. National Institutes of Health. The Boone, North Carolina-based group contacted U.S. Centers for Disease Control and Prevention officials in Liberia to discuss various experimental treatments and were referred to an NIH scientist in Liberia familiar with those treatments.
The scientist answered some questions and referred them to the companies but was not officially representing the NIH and had no "official role in procuring, transporting, approving, or administering the experimental products," the statement says.
In the meantime, dozens of African heads of state were in Washington for the U.S.-Africa Leaders Summit, a three-day gathering hosted by President Barack Obama. U.S. health officials on Monday spoke with Guinean President Alpha Conde and senior officials from Liberia and Sierra Leone about the Ebola outbreak.
The Defense Department has long had a hand in researching infectious diseases, including Ebola. During much of the Cold War period this served two purposes: to keep abreast of diseases that could limit the effectiveness of troops deployed abroad and to be prepared if biological agents were used as weapons.
The U.S. military has no biological weapons program but continues to do research related to infectious diseases as a means of staying current on potential threats to the health of troops. It may also contribute medical expertise as part of interagency efforts in places like Africa where new infectious disease threats arise.
The hospital in Atlanta treating the aid workers has one of the nation's most sophisticated infectious disease units. Patients are sealed off from anyone not in protective gear. Ebola is only spread through direct contact with an infected person's blood or other bodily fluids, not through the air.
The CDC last week told U.S. doctors to ask about foreign travel by patients who come down with Ebola-like symptoms, including fever, headache, vomiting and diarrhea. A spokesman said three people have been tested so far in the U.S. — and all tested negative. Additionally, a New York City hospital on Monday said a man was being tested for Ebola but he likely didn't have it.
Writebol and her husband, David, had been in Liberia since last August, sent there by SIM USA and sponsored by their home congregation at Calvary Church in Charlotte. At the clinic, Nancy Writebol's duties included disinfecting staff entering or leaving the Ebola treatment area.
"Her husband, David, told me Sunday her appetite has improved and she requested one of her favorite dishes - Liberian potato soup — and coffee," SIM's Johnson said.
The workers, Nancy Writebol and Dr. Kent Brantly, are improving, although it's impossible to know whether the treatment is the reason or they are recovering on their own, as others who have survived Ebola have done. Brantly is being treated at a special isolation unit at Atlanta's Emory University Hospital, and Writebol was expected to be flown there Tuesday in the same specially equipped plane that brought Brantly.
They were infected while working in Liberia, one of four West African nations dealing with the world's largest Ebola outbreak. On Monday, the World Health Organization said the death toll had increased from 729 to 887 deaths in Guinea, Sierra Leone, Liberia and Nigeria, and that more than 1,600 people have been infected.
In a worrisome development, the Nigerian Health Minister said a doctor who had helped treat Patrick Sawyer, the Liberian-American man who died July 25 days after arriving in Nigeria, has been confirmed to have the deadly disease. Tests are pending for three other people who also treated Sawyer and are showing symptoms.
There is no vaccine or specific treatment for Ebola, but several are under development.
The experimental treatment the U.S. aid workers are getting is called ZMapp and is made by Mapp Biopharmaceutical Inc. of San Diego. It is aimed at boosting the immune system's efforts to fight off Ebola and is made from antibodies produced by lab animals exposed to parts of the virus.
In a statement, the company said it was working with LeafBio of San Diego, Defyrus Inc. of Toronto, the U.S. government and the Public Health Agency of Canada on development of the drug, which was identified as a possible treatment in January.
The drug is made in tobacco plants at Kentucky BioProcessing, a subsidiary of Reynolds American Inc., in Owensboro, Kentucky, said spokesman David Howard. The plant "serves like a photocopier," and the drug is extracted from the plant, he said.
Kentucky BioProcessing complied with a request from Emory and the international relief group Samaritan's Purse to provide a limited amount of ZMapp to Emory, he said. Brantly works for the aid group.
The Kentucky company is working "to increase production of ZMapp but that process is going to take several months," Howard said. The drug has been tested in animals and testing in humans is expected to begin later this year.
The U.S. Food and Drug Administration must grant permission to use experimental treatments in the United States, but the FDA does not have authority over the use of such a drug in other countries, and the aid workers were first treated in Liberia. An FDA spokeswoman said she could not confirm or deny FDA granting access to any experimental therapy for the aid workers while in the U.S.
Writebol, 59, has been in isolation at her home in Liberia since she was diagnosed last month. She's now walking with assistance and has regained her appetite, said Bruce Johnson, president of SIM USA, the Charlotte, North Carolina-based group that she works for in Africa.
Writebol has received two doses of the experimental drug so far, but Johnson was hesitant to credit the treatment for her improvement.
"Ebola is a tricky virus and one day you can be up and the next day down. One day is not indicative of the outcome," he said. But "we're grateful this medicine was available."
Brantly, 33, also was said to be improving. Besides the experimental dose he got in Liberia, he also received a unit of blood from a 14-year-old boy, an Ebola survivor, who had been under his care. That seems to be aimed at giving Brantly antibodies the boy may have made to the virus.
Samaritan's Purse initiated the events that led to the two workers getting ZMapp, according to a statement Monday by the National Institute of Allergy and Infectious Diseases, part of the U.S. National Institutes of Health. The Boone, North Carolina-based group contacted U.S. Centers for Disease Control and Prevention officials in Liberia to discuss various experimental treatments and were referred to an NIH scientist in Liberia familiar with those treatments.
The scientist answered some questions and referred them to the companies but was not officially representing the NIH and had no "official role in procuring, transporting, approving, or administering the experimental products," the statement says.
In the meantime, dozens of African heads of state were in Washington for the U.S.-Africa Leaders Summit, a three-day gathering hosted by President Barack Obama. U.S. health officials on Monday spoke with Guinean President Alpha Conde and senior officials from Liberia and Sierra Leone about the Ebola outbreak.
The Defense Department has long had a hand in researching infectious diseases, including Ebola. During much of the Cold War period this served two purposes: to keep abreast of diseases that could limit the effectiveness of troops deployed abroad and to be prepared if biological agents were used as weapons.
The U.S. military has no biological weapons program but continues to do research related to infectious diseases as a means of staying current on potential threats to the health of troops. It may also contribute medical expertise as part of interagency efforts in places like Africa where new infectious disease threats arise.
The hospital in Atlanta treating the aid workers has one of the nation's most sophisticated infectious disease units. Patients are sealed off from anyone not in protective gear. Ebola is only spread through direct contact with an infected person's blood or other bodily fluids, not through the air.
The CDC last week told U.S. doctors to ask about foreign travel by patients who come down with Ebola-like symptoms, including fever, headache, vomiting and diarrhea. A spokesman said three people have been tested so far in the U.S. — and all tested negative. Additionally, a New York City hospital on Monday said a man was being tested for Ebola but he likely didn't have it.
Writebol and her husband, David, had been in Liberia since last August, sent there by SIM USA and sponsored by their home congregation at Calvary Church in Charlotte. At the clinic, Nancy Writebol's duties included disinfecting staff entering or leaving the Ebola treatment area.
"Her husband, David, told me Sunday her appetite has improved and she requested one of her favorite dishes - Liberian potato soup — and coffee," SIM's Johnson said.
04 August 2014 (Primary Source) Patients’ Symptoms Raise Concern About Ebola in New York
Heightened concern about the Ebola virus has led to alarms being raised at three hospitals in New York City. But so far, no Ebola cases have turned up.
The latest episode involved a man who had recently been to West Africa, and who went to the emergency room at Mount Sinai Hospital in Manhattan late Sunday with a high fever and gastrointestinal problems, the hospital reported on Monday. He is being kept in isolation at the hospital while tests are being done for Ebola, a deadly disease, but also for other illnesses that could have caused his symptoms.
But the city’s health department issued a statement on Monday saying that after consulting with Mount Sinai and the Centers for Disease Control and Prevention in Atlanta, “the health department has concluded that the patient is unlikely to have Ebola. Specimens are being tested for common causes of illness and to definitively exclude Ebola. Testing results will be made available by C.D.C. as soon as they are available.”
At NYU Langone Medical Center last week, a patient who went to the emergency room with a fever and who mentioned a recent visit to West Africa was given a mask and moved to a secluded area, said Dr. Michael Phillips, the hospital’s director of Infection Prevention and Control. But further questioning revealed that the patient had not visited any of the affected countries, “so we stopped right there,” Dr. Phillips said.
At Bellevue Hospital Center last week, a patient was placed in isolation, but it quickly became clear that he did not have Ebola.
An Ebola outbreak centered mainly in three West African countries — Sierra Leone, Guinea and Liberia — has infected more than 1,300 people and killed more than 700 of them. American health officials have advised against nonessential travel to the three countries, and have urged doctors to be on high alert for people who return from the region with symptoms like fever, diarrhea and vomiting.
A Mount Sinai spokeswoman, Dorie Klissas, said that to protect the patient’s privacy, the hospital was not making public his occupation, which country he had been in, whether he had been exposed to a patient with Ebola there, or whether he had close contacts like family members, friends or co-workers who were also at risk. Officials said they expected the results of the tests for Ebola in 24 to 48 hours.
In a statement to employees, hospital officials said that Ebola was spread only by direct contact with bodily fluids, and that infection control measures were being employed to protect patients and staff members.
In the Bellevue Hospital Center case, Dr. Ross Wilson, the chief medical officer at the New York City Health and Hospitals Corporation, said that the man had symptoms also found in Ebola patients. He had arrived at Kennedy International Airport from West Africa and was being detained by security personnel at the airport for an unrelated matter when he fell ill.
“He developed a headache and fever,” Dr. Wilson said. He was transported to Bellevue, but the people who brought him there did not suspect Ebola.
“We immediately put the dots together,” Dr. Wilson said.
Following the guidance of the Centers for Disease Control and Prevention, every patient entering one of the city’s hospitals who has fever, headache and other symptoms associated with Ebola (as well as countless other ailments), is asked two new questions.
“Have you traveled to or from West African countries in the last 10 days? Have you been in contact with an Ebola patient or with anyone who has been in contact with an Ebola patient?”
04 August 2014 (Primary Source) "Patient at Mount Sinai Has Ebola-Like Symptoms, Hospital Says"
Heightened concern about the Ebola virus has led to alarms being raised at three hospitals in New York City. But so far, no Ebola cases have turned up.
The latest episode involved a man who had recently been to West Africa, and who went to the emergency room at Mount Sinai Hospital in Manhattan late Sunday with a high fever and gastrointestinal problems, the hospital reported on Monday. He is being kept in isolation at the hospital while tests are being done for Ebola, a deadly disease, but also for other illnesses that could have caused his symptoms.
But the city’s health department issued a statement on Monday saying that after consulting with Mount Sinai and the Centers for Disease Control and Prevention in Atlanta, “the health department has concluded that the patient is unlikely to have Ebola. Specimens are being tested for common causes of illness and to definitively exclude Ebola. Testing results will be made available by C.D.C. as soon as they are available.”
At NYU Langone Medical Center last week, a patient who went to the emergency room with a fever and who mentioned a recent visit to West Africa was given a mask and moved to a secluded area, said Dr. Michael Phillips, the hospital’s director of Infection Prevention and Control. But further questioning revealed that the patient had not visited any of the affected countries, “so we stopped right there,” Dr. Phillips said.
At Bellevue Hospital Center last week, a patient was placed in isolation, but it quickly became clear that he did not have Ebola.
An Ebola outbreak centered mainly in three West African countries — Sierra Leone, Guinea and Liberia — has infected more than 1,300 people and killed more than 700 of them. American health officials have advised against nonessential travel to the three countries, and have urged doctors to be on high alert for people who return from the region with symptoms like fever, diarrhea and vomiting.
A Mount Sinai spokeswoman, Dorie Klissas, said that to protect the patient’s privacy, the hospital was not making public his occupation, which country he had been in, whether he had been exposed to a patient with Ebola there, or whether he had close contacts like family members, friends or co-workers who were also at risk. Officials said they expected the results of the tests for Ebola in 24 to 48 hours.
In a statement to employees, hospital officials said that Ebola was spread only by direct contact with bodily fluids, and that infection control measures were being employed to protect patients and staff members.
In the Bellevue Hospital Center case, Dr. Ross Wilson, the chief medical officer at the New York City Health and Hospitals Corporation, said that the man had symptoms also found in Ebola patients. He had arrived at Kennedy International Airport from West Africa and was being detained by security personnel at the airport for an unrelated matter when he fell ill.
“He developed a headache and fever,” Dr. Wilson said. He was transported to Bellevue, but the people who brought him there did not suspect Ebola.
“We immediately put the dots together,” Dr. Wilson said.
Following the guidance of the Centers for Disease Control and Prevention, every patient entering one of the city’s hospitals who has fever, headache and other symptoms associated with Ebola (as well as countless other ailments), is asked two new questions.
“Have you traveled to or from West African countries in the last 10 days? Have you been in contact with an Ebola patient or with anyone who has been in contact with an Ebola patient?”
The latest episode involved a man who had recently been to West Africa, and who went to the emergency room at Mount Sinai Hospital in Manhattan late Sunday with a high fever and gastrointestinal problems, the hospital reported on Monday. He is being kept in isolation at the hospital while tests are being done for Ebola, a deadly disease, but also for other illnesses that could have caused his symptoms.
But the city’s health department issued a statement on Monday saying that after consulting with Mount Sinai and the Centers for Disease Control and Prevention in Atlanta, “the health department has concluded that the patient is unlikely to have Ebola. Specimens are being tested for common causes of illness and to definitively exclude Ebola. Testing results will be made available by C.D.C. as soon as they are available.”
At NYU Langone Medical Center last week, a patient who went to the emergency room with a fever and who mentioned a recent visit to West Africa was given a mask and moved to a secluded area, said Dr. Michael Phillips, the hospital’s director of Infection Prevention and Control. But further questioning revealed that the patient had not visited any of the affected countries, “so we stopped right there,” Dr. Phillips said.
At Bellevue Hospital Center last week, a patient was placed in isolation, but it quickly became clear that he did not have Ebola.
An Ebola outbreak centered mainly in three West African countries — Sierra Leone, Guinea and Liberia — has infected more than 1,300 people and killed more than 700 of them. American health officials have advised against nonessential travel to the three countries, and have urged doctors to be on high alert for people who return from the region with symptoms like fever, diarrhea and vomiting.
A Mount Sinai spokeswoman, Dorie Klissas, said that to protect the patient’s privacy, the hospital was not making public his occupation, which country he had been in, whether he had been exposed to a patient with Ebola there, or whether he had close contacts like family members, friends or co-workers who were also at risk. Officials said they expected the results of the tests for Ebola in 24 to 48 hours.
In a statement to employees, hospital officials said that Ebola was spread only by direct contact with bodily fluids, and that infection control measures were being employed to protect patients and staff members.
In the Bellevue Hospital Center case, Dr. Ross Wilson, the chief medical officer at the New York City Health and Hospitals Corporation, said that the man had symptoms also found in Ebola patients. He had arrived at Kennedy International Airport from West Africa and was being detained by security personnel at the airport for an unrelated matter when he fell ill.
“He developed a headache and fever,” Dr. Wilson said. He was transported to Bellevue, but the people who brought him there did not suspect Ebola.
“We immediately put the dots together,” Dr. Wilson said.
Following the guidance of the Centers for Disease Control and Prevention, every patient entering one of the city’s hospitals who has fever, headache and other symptoms associated with Ebola (as well as countless other ailments), is asked two new questions.
“Have you traveled to or from West African countries in the last 10 days? Have you been in contact with an Ebola patient or with anyone who has been in contact with an Ebola patient?”
04 August 2014 (Primary Source) The economics of Ebola, or why there's no cure
Of all the horrific features of Ebola disease--its deadliness, its virulence--perhaps the scariest is that there's no cure.
This is not the same thing as saying it's incurable or untreatable. In fact, scientists are fairly confident they can develop effective treatments and a vaccine, given a bit of time and somewhat more money. So the question is why that hasn't happened.
The simple answer, as Beth Skwarecki of PLoS.org explains, can be found in economics. The Ebola virus doesn't rank as a major disease. As the accompanying chart shows, measles strikes about 20 million people a year and kills more than 120,000; cancer adds 14.1 million cases a year and kills 8.2 million; HIV infects 2.5 million people a year and kills 1.7 million. (The cancer statistics are from 2012 and the HIV numbers from 2011.) The current outbreak of Ebola numbered 1,323 cases and 729 deaths.
An outbreak on that scale--leaving aside that it occurs in the poorest region of the world--isn't threatening enough to grab the attention of pharmaceutical R&D departments. That doesn't necessarily make Big Pharma the villain of the piece, since it's hard to argue that a rare disease that erupts sporadically should be a higher priority than, say, malaria, which strikes 220 million people a year and kills 660,000.
Researchers says the current Ebola outbreak, which has proven especially hard to control, has focused new attention on the need for a treatment.
Three possible treatments are under study by researchers funded by the National Institutes of Health, with good prospects for a human clinical trial this year.
Some biotech companies are trying to tweak the economics of the disease by addressing fears that it could be a bioterror threat, which would turn the federal government into a well-heeled customer for their remedies. The Centers for Disease Control and Prevention lists Ebola as a "Category A," or "high-priority" threat, along with smallpox and plague, because it can be disseminated easily and has a high mortality rate.
Among the problems faced by Ebola fighters are economic and cultural factors that interfere with its treatment and containment. As Skwarecki reports, the chief weapons in limiting Ebola's spread are isolating the disease's carriers from others and quarantining and observing those thought to be exposed. Remedial actions like hydration could also reduce the death toll, and education of rural populations to keep them from eating bats (thought to be among the main carriers of the virus) or handling the bodies of deceased Ebola victims is also important.
But all those steps are difficult in West Africa. "This is not just a medical or public health problem," Margaret Chan, director-general of the World Health Organization, observed last week. "It is a social problem. Deep-seated beliefs and cultural practices are a significant cause of further spread and a significant barrier to rapid and effective containment." Fears of the disease and of community reactions have forced some chains of transmission "underground," she reported.
"Because of the high fatality rate, many people in affected areas associate isolation wards with a sure death sentence, and prefer to care for loved ones in homes or seek assistance from traditional healers. Such hiding of cases defeats strategies for rapid containment."
This is not the same thing as saying it's incurable or untreatable. In fact, scientists are fairly confident they can develop effective treatments and a vaccine, given a bit of time and somewhat more money. So the question is why that hasn't happened.
The simple answer, as Beth Skwarecki of PLoS.org explains, can be found in economics. The Ebola virus doesn't rank as a major disease. As the accompanying chart shows, measles strikes about 20 million people a year and kills more than 120,000; cancer adds 14.1 million cases a year and kills 8.2 million; HIV infects 2.5 million people a year and kills 1.7 million. (The cancer statistics are from 2012 and the HIV numbers from 2011.) The current outbreak of Ebola numbered 1,323 cases and 729 deaths.
An outbreak on that scale--leaving aside that it occurs in the poorest region of the world--isn't threatening enough to grab the attention of pharmaceutical R&D departments. That doesn't necessarily make Big Pharma the villain of the piece, since it's hard to argue that a rare disease that erupts sporadically should be a higher priority than, say, malaria, which strikes 220 million people a year and kills 660,000.
Researchers says the current Ebola outbreak, which has proven especially hard to control, has focused new attention on the need for a treatment.
Three possible treatments are under study by researchers funded by the National Institutes of Health, with good prospects for a human clinical trial this year.
Some biotech companies are trying to tweak the economics of the disease by addressing fears that it could be a bioterror threat, which would turn the federal government into a well-heeled customer for their remedies. The Centers for Disease Control and Prevention lists Ebola as a "Category A," or "high-priority" threat, along with smallpox and plague, because it can be disseminated easily and has a high mortality rate.
Among the problems faced by Ebola fighters are economic and cultural factors that interfere with its treatment and containment. As Skwarecki reports, the chief weapons in limiting Ebola's spread are isolating the disease's carriers from others and quarantining and observing those thought to be exposed. Remedial actions like hydration could also reduce the death toll, and education of rural populations to keep them from eating bats (thought to be among the main carriers of the virus) or handling the bodies of deceased Ebola victims is also important.
But all those steps are difficult in West Africa. "This is not just a medical or public health problem," Margaret Chan, director-general of the World Health Organization, observed last week. "It is a social problem. Deep-seated beliefs and cultural practices are a significant cause of further spread and a significant barrier to rapid and effective containment." Fears of the disease and of community reactions have forced some chains of transmission "underground," she reported.
"Because of the high fatality rate, many people in affected areas associate isolation wards with a sure death sentence, and prefer to care for loved ones in homes or seek assistance from traditional healers. Such hiding of cases defeats strategies for rapid containment."
04 August 2014 (Primary Source) Nigeria Confirms Doctor as 2nd Ebola Case
ABUJA, Nigeria (AP) — Nigerian authorities on Monday confirmed a second case of Ebola in Africa’s most populous country, an alarming setback as officials across the region battle to stop the spread of a disease that has killed more than 700 people.
Nigerian Health Minister Onyebuchi Chukwu also said test samples were pending for three other people who had shown symptoms of Ebola.
The confirmed second case is a doctor who had helped treat Patrick Sawyer, the Liberian-American man who died July 25 days after arriving in Nigeria amid the unprecedented outbreak in West Africa.
“Three others who participated in that treatment who are currently symptomatic have had their samples taken and hopefully by the end of today we should have the results of their own test,” Chukwu said.
The emergence of a second case raises serious concerns about the infection control practices that were used while Sawyer was in Nigeria, and also raise the specter that more cases could emerge. It can take up to 21 days after exposure to the virus for symptoms to appear. They include fever, sore throat, muscle pains and headaches. Often nausea, vomiting and diarrhea follow, along with bleeding.
Sawyer, who was traveling to Nigeria on business, became ill while aboard a flight and Nigerian authorities immediately took him into isolation. They did not quarantine his fellow passengers, and have insisted that the risk of additional cases was minimal.
Nigeria is the fourth country to report Ebola cases and at least 728 other people have died in Guinea, Sierra Leone and Liberia.
Nigerian authorities said a total of 70 people are under surveillance and that they hoped to have eight people in quarantine by the end of Monday in an isolation ward in Lagos.
04 August 2014 (Primary Source) Contagion Screenwriter: Ebola Isn’t the Pandemic. Fear Is
What we should really be afraid of: our inability to assess risk
There is an animal somewhere in Africa — most likely a bat — that has worked out an arrangement with a microscopic agent. The deal is this: the agent won’t kill the bat if the bat will transport it to other warm-blooded animals and give it a chance do its gruesome work. All the bat had to do to enter this arrangement was build up a resistance to the agent over generations and become a good hiding place — and then continue about its business of being a bat.
We identified such an agent in 1976 and named it Ebola for a nearby river. Unfortunately, we didn’t find it in a bat but as a virus in the blood of a dead man.
A virus that kills quickly does not take full advantage of the social behavior of humans and tends to burn itself out. That behavior includes the profound compassion of health care workers who are always among the secondary infections; funereal practices that bring the healthy in contact with the infected dead; and illiteracy, which keeps the local population from understanding what is afoot. The very lethality of Ebola — killing up to 90% of its victims — becomes a self-limiting proposition. It will never become a pandemic, according to public-health experts, unless we help it along.
And how would we do that?
Public health is a kind of math class we seem to fail year after year. Its most basic equation addresses the following question: for every infected person today, how many more infected people can we anticipate? The numerical answer to this question is called the R-nought of the disease. Smallpox has an R-nought of between 3 and 7, depending on population density. The Spanish flu of 1918 had an R-nought between 3 and 4 and killed an estimated 100 million people. Ebola has an R-nought of 1.5.
The people who are infected with Ebola develop a screenwriter’s list of symptoms: bleeding from the mouth, nail beds and eyes as their capillaries disintegrate inside them. Their brains, awash in the blood of hemorrhagic fever, become deranged. There is no vaccine and there is no cure approved for use.
It is a terrifying prospect.
And there is no more effective contagion than fear. Rest assured, it has an R-nought far greater than Ebola. To contract it you do not need to have contact with bodily fluids, only limited exposure to sensationalizing media or a water-cooler conversation embellished with misinformation. And fear has a tendency to shut down the parts of our brain we need most in these moments and leave us at the mercy of our most primitive urges.
There is an equation used in the security world that would help inoculate us against the paralysis and bad judgment symptomatic of fear. It goes like this: risk = threat x vulnerability x consequences. In the case of Ebola, the threat is isolated to West Africa. If you have not traveled to any of the countries involved, your level of threat is zero. Even if you have visited these countries, you would still need direct contact with a sick person or animal — or the American doctor or missionary being treated in isolation at Emory University Hospital in Atlanta. But they are isolated and being treated by people who understand the equation above. Furthermore, your vulnerability is next to nil given our relatively robust public-health system that protects us from such an outbreak and, given the advanced medicine that exists in the U.S., even the consequences of such an infection are much lower.
Contrast this with places like Sierra Leone, Liberia and Guinea. The threat is clear and present, and there couldn’t be a more vulnerable population. These are countries struggling to emerge from years of civil war and violence, poor places with little to spend on public health. Pulitzer Prize–winning journalist Laurie Garrett has pointed out that Liberia spends $18 per capita on public health, Sierra Leone spends $13 per capita and Guinea a mere $7 per capita on the health of their people. (By contrast Hawaii spends $155 per capita on public health.) In addition, their cultural practices and distrust of outside aid make the consequences that much more dire. The death toll from the current Ebola outbreak tops 800. Yet 1.5 million people will die of malaria this year without the proportional coverage to the threat it poses, many of them dying in the same cash-strapped hospitals treating the current victims of Ebola.
So what should we be afraid of?
On the heels of 9/11, five deadly cases of anthrax shut down the government. And yet when 200,000 died from last year’s influenza, less than 37% of the population opted for a flu shot. It is our inability to assess risk that should scare us into action. The threat of influenza is high: we are all vulnerable regardless of geography, and the consequences can be extreme. The notion that vaccines can cause autism has long been discredited, but many of us still suffer from this fear that prevents us from protecting ourselves, our children and our neighbors.
The monster we can see — the nuclear bomb, the fanatic with the suicide vest, the swirl of hurricane in the satellite photo — leads us to build shelters, change security policy or head for high ground. But the monster in the microscope seems to sneak up on us every time. There is, without a doubt, another bat in another tree harboring another agent. But maybe this bat is in Southeast Asia or South America or in another war-torn country that can’t provide medical care for its people. And there are migratory birds crisscrossing our borders and differing standards of health care that are consorting with livestock and bringing with them novel viruses that will play genetic roulette with our collective futures. These are the real risks. This is the math exam the future holds for us.
The author would like to thank Dr. Larry Brilliant, president of the Skoll Global Threats Fund, and Dr. Alex Garza, former assistant secretary and chief medical officer of the U.S. Department of Homeland Security, for their guidance on this piece.
Burns is a screenwriter, director, producer and playwright. He wrote the screenplay for Contagion, directed by Steven Soderbergh, and produced the Academy Award–winning documentary An Inconvenient Truth.
There is an animal somewhere in Africa — most likely a bat — that has worked out an arrangement with a microscopic agent. The deal is this: the agent won’t kill the bat if the bat will transport it to other warm-blooded animals and give it a chance do its gruesome work. All the bat had to do to enter this arrangement was build up a resistance to the agent over generations and become a good hiding place — and then continue about its business of being a bat.
We identified such an agent in 1976 and named it Ebola for a nearby river. Unfortunately, we didn’t find it in a bat but as a virus in the blood of a dead man.
A virus that kills quickly does not take full advantage of the social behavior of humans and tends to burn itself out. That behavior includes the profound compassion of health care workers who are always among the secondary infections; funereal practices that bring the healthy in contact with the infected dead; and illiteracy, which keeps the local population from understanding what is afoot. The very lethality of Ebola — killing up to 90% of its victims — becomes a self-limiting proposition. It will never become a pandemic, according to public-health experts, unless we help it along.
And how would we do that?
Public health is a kind of math class we seem to fail year after year. Its most basic equation addresses the following question: for every infected person today, how many more infected people can we anticipate? The numerical answer to this question is called the R-nought of the disease. Smallpox has an R-nought of between 3 and 7, depending on population density. The Spanish flu of 1918 had an R-nought between 3 and 4 and killed an estimated 100 million people. Ebola has an R-nought of 1.5.
The people who are infected with Ebola develop a screenwriter’s list of symptoms: bleeding from the mouth, nail beds and eyes as their capillaries disintegrate inside them. Their brains, awash in the blood of hemorrhagic fever, become deranged. There is no vaccine and there is no cure approved for use.
It is a terrifying prospect.
And there is no more effective contagion than fear. Rest assured, it has an R-nought far greater than Ebola. To contract it you do not need to have contact with bodily fluids, only limited exposure to sensationalizing media or a water-cooler conversation embellished with misinformation. And fear has a tendency to shut down the parts of our brain we need most in these moments and leave us at the mercy of our most primitive urges.
There is an equation used in the security world that would help inoculate us against the paralysis and bad judgment symptomatic of fear. It goes like this: risk = threat x vulnerability x consequences. In the case of Ebola, the threat is isolated to West Africa. If you have not traveled to any of the countries involved, your level of threat is zero. Even if you have visited these countries, you would still need direct contact with a sick person or animal — or the American doctor or missionary being treated in isolation at Emory University Hospital in Atlanta. But they are isolated and being treated by people who understand the equation above. Furthermore, your vulnerability is next to nil given our relatively robust public-health system that protects us from such an outbreak and, given the advanced medicine that exists in the U.S., even the consequences of such an infection are much lower.
Contrast this with places like Sierra Leone, Liberia and Guinea. The threat is clear and present, and there couldn’t be a more vulnerable population. These are countries struggling to emerge from years of civil war and violence, poor places with little to spend on public health. Pulitzer Prize–winning journalist Laurie Garrett has pointed out that Liberia spends $18 per capita on public health, Sierra Leone spends $13 per capita and Guinea a mere $7 per capita on the health of their people. (By contrast Hawaii spends $155 per capita on public health.) In addition, their cultural practices and distrust of outside aid make the consequences that much more dire. The death toll from the current Ebola outbreak tops 800. Yet 1.5 million people will die of malaria this year without the proportional coverage to the threat it poses, many of them dying in the same cash-strapped hospitals treating the current victims of Ebola.
So what should we be afraid of?
On the heels of 9/11, five deadly cases of anthrax shut down the government. And yet when 200,000 died from last year’s influenza, less than 37% of the population opted for a flu shot. It is our inability to assess risk that should scare us into action. The threat of influenza is high: we are all vulnerable regardless of geography, and the consequences can be extreme. The notion that vaccines can cause autism has long been discredited, but many of us still suffer from this fear that prevents us from protecting ourselves, our children and our neighbors.
The monster we can see — the nuclear bomb, the fanatic with the suicide vest, the swirl of hurricane in the satellite photo — leads us to build shelters, change security policy or head for high ground. But the monster in the microscope seems to sneak up on us every time. There is, without a doubt, another bat in another tree harboring another agent. But maybe this bat is in Southeast Asia or South America or in another war-torn country that can’t provide medical care for its people. And there are migratory birds crisscrossing our borders and differing standards of health care that are consorting with livestock and bringing with them novel viruses that will play genetic roulette with our collective futures. These are the real risks. This is the math exam the future holds for us.
The author would like to thank Dr. Larry Brilliant, president of the Skoll Global Threats Fund, and Dr. Alex Garza, former assistant secretary and chief medical officer of the U.S. Department of Homeland Security, for their guidance on this piece.
Burns is a screenwriter, director, producer and playwright. He wrote the screenplay for Contagion, directed by Steven Soderbergh, and produced the Academy Award–winning documentary An Inconvenient Truth.
03 August 2014 (Primary Source) Terrorists could use Ebola to create dirty bomb to kill large numbers in the UK, says Cambridge University disease expert
The deadly Ebola virus could be used by terrorists to create a dirty bomb capable of killing large numbers of people in the UK, a Cambridge University disease expert has warned.
As fears grow over the spread of the disease across parts of West Africa, biological anthropologist Dr Peter Walsh said that although the risk of it reaching the UK was small, a group such as Al Qaeda could use the virus to create a weapon.
There is currently no vaccine and no cure for Ebola, which kills up to 90 per cent of its victims.
Although there have been calls for the introduction of fever-screening cameras at UK airports in the wake of the current outbreak, Dr Walsh told a newspaper that should an infected air passenger unwittingly bring Ebola to Britain, medical experts would be able to stop the virus spreading further.
'A bigger and more serious risk is that a group manages to harness the virus as a power, then explodes it as a bomb in a highly populated public area,' Dr Walsh told The Sun on Sunday.
Is that it? UK's two-bed ebola unit: MP calls for fever scans at UK airports... but we have just one isolation facility
'It could cause a large number of horrific deaths.
'Only a handful of labs worldwide have the Ebola virus and they are extremely well-protected. So the risk is that a terrorist group seeks to obtain the virus out in West Africa.'
The current outbreak of Ebola has already claimed 729 deaths from 1329 confirmed cases in the
West African countries of Guinea, Sierra Leone, Nigeria and Liberia. The fatality rate in the current epidemic is about 60 per cent.
The outbreak is unusual for West Africa as the disease is typically found in the center and east of the continent.
Early symptoms of an Ebola infection include fever, headache, muscle aches and sore throat, while in the later stages of the disease victims begin bleeding both internally and externally, often through the nose and ears, and suffer organ failure.
Among those infected are American doctor Dr Kent Brantly, 33, who contracted the virus while in Liberia. He has been brought back to the U.S. for treatment in a special isolation ward, and was today said to be improving.
However, the top U.S. health official Dr Tom Frieden, director of the U.S. Centers for Disease Control in Atlanta, has said it was still too soon to predict whether he would survive.
A second U.S. aid worker who contracted Ebola while working in the same facility as Brantly, 59-year-old missionary Nancy Writebol, will be brought to the United States on a later flight as the medical aircraft is equipped to carry only one patient at a time.
The virus is not airborne and is transmitted through direct contact with the bodily fluids of an infected person.
However, WHO director-general Margaret Chan has warned the virus is currently moving faster than efforts to control it.
She said: ‘This outbreak is moving faster than our efforts to control it. If the situation continues to deteriorate, the consequences can be catastrophic in terms of lost lives, severe socioeconomic disruption and a high risk of spread to other countries.’
Speaking at a meeting in Guinea’s capital Conakry, she told the presidents of Guinea, Liberia, Sierra Leone and Ivory Coast that the virus could be stopped, but warned that some cultural practices such as traditional burials were helping it to spread.
Emirates, the Middle East's largest airline, said today it had halted flights to Guinea because of concerns about the spread of the Ebola virus.
The Dubai-based carrier said flights to the Guinean capital of Conakry were suspended beginning Saturday until further notice.
The airline will continue flying to the West African nation of Senegal, which borders Guinea, saying it 'will be guided by the updates from international health authorities'.
The Foreign Office refused to confirm if British citizens who contract the virus abroad would be flown back for treatment, saying only: ‘Procedures are in place but we are not going to speculate on what we would do in any individual case.’
Labour MP and chairman of the Home Affairs Select Committee has urged ministers to consider introducing fever-screening cameras at UK airports as up to 10,000 passengers arrive in the UK every week on 30 direct flights from West Africa.
South Africa, which has fewer direct flights from the region than the UK, introduced infra-red thermal imaging cameras at two major airports in April, in an early response to the ebola threat, while Sierra Leone, Guinea, Ghana, and Nigeria have pledged to introduce temperature screening at airports.
However critics say the cameras can give ‘false positives’ – including people with minor illnesses and those who are hot after a dash through the airport.
Mr Vaz said: ‘As far as I’m concerned any measures – including additional screening – which are felt necessary to reassure the public should be taken.
‘Prevention is always better than cure: We don’t want to have our first taste of ebola before taking action.’
As fears grow over the spread of the disease across parts of West Africa, biological anthropologist Dr Peter Walsh said that although the risk of it reaching the UK was small, a group such as Al Qaeda could use the virus to create a weapon.
There is currently no vaccine and no cure for Ebola, which kills up to 90 per cent of its victims.
Although there have been calls for the introduction of fever-screening cameras at UK airports in the wake of the current outbreak, Dr Walsh told a newspaper that should an infected air passenger unwittingly bring Ebola to Britain, medical experts would be able to stop the virus spreading further.
'A bigger and more serious risk is that a group manages to harness the virus as a power, then explodes it as a bomb in a highly populated public area,' Dr Walsh told The Sun on Sunday.
Is that it? UK's two-bed ebola unit: MP calls for fever scans at UK airports... but we have just one isolation facility
'It could cause a large number of horrific deaths.
'Only a handful of labs worldwide have the Ebola virus and they are extremely well-protected. So the risk is that a terrorist group seeks to obtain the virus out in West Africa.'
The current outbreak of Ebola has already claimed 729 deaths from 1329 confirmed cases in the
West African countries of Guinea, Sierra Leone, Nigeria and Liberia. The fatality rate in the current epidemic is about 60 per cent.
The outbreak is unusual for West Africa as the disease is typically found in the center and east of the continent.
Early symptoms of an Ebola infection include fever, headache, muscle aches and sore throat, while in the later stages of the disease victims begin bleeding both internally and externally, often through the nose and ears, and suffer organ failure.
Among those infected are American doctor Dr Kent Brantly, 33, who contracted the virus while in Liberia. He has been brought back to the U.S. for treatment in a special isolation ward, and was today said to be improving.
However, the top U.S. health official Dr Tom Frieden, director of the U.S. Centers for Disease Control in Atlanta, has said it was still too soon to predict whether he would survive.
A second U.S. aid worker who contracted Ebola while working in the same facility as Brantly, 59-year-old missionary Nancy Writebol, will be brought to the United States on a later flight as the medical aircraft is equipped to carry only one patient at a time.
The virus is not airborne and is transmitted through direct contact with the bodily fluids of an infected person.
However, WHO director-general Margaret Chan has warned the virus is currently moving faster than efforts to control it.
She said: ‘This outbreak is moving faster than our efforts to control it. If the situation continues to deteriorate, the consequences can be catastrophic in terms of lost lives, severe socioeconomic disruption and a high risk of spread to other countries.’
Speaking at a meeting in Guinea’s capital Conakry, she told the presidents of Guinea, Liberia, Sierra Leone and Ivory Coast that the virus could be stopped, but warned that some cultural practices such as traditional burials were helping it to spread.
Emirates, the Middle East's largest airline, said today it had halted flights to Guinea because of concerns about the spread of the Ebola virus.
The Dubai-based carrier said flights to the Guinean capital of Conakry were suspended beginning Saturday until further notice.
The airline will continue flying to the West African nation of Senegal, which borders Guinea, saying it 'will be guided by the updates from international health authorities'.
The Foreign Office refused to confirm if British citizens who contract the virus abroad would be flown back for treatment, saying only: ‘Procedures are in place but we are not going to speculate on what we would do in any individual case.’
Labour MP and chairman of the Home Affairs Select Committee has urged ministers to consider introducing fever-screening cameras at UK airports as up to 10,000 passengers arrive in the UK every week on 30 direct flights from West Africa.
South Africa, which has fewer direct flights from the region than the UK, introduced infra-red thermal imaging cameras at two major airports in April, in an early response to the ebola threat, while Sierra Leone, Guinea, Ghana, and Nigeria have pledged to introduce temperature screening at airports.
However critics say the cameras can give ‘false positives’ – including people with minor illnesses and those who are hot after a dash through the airport.
Mr Vaz said: ‘As far as I’m concerned any measures – including additional screening – which are felt necessary to reassure the public should be taken.
‘Prevention is always better than cure: We don’t want to have our first taste of ebola before taking action.’
3 August 2014 (Primary Source) Sunday Show Round Up: CDC downplays threat of Ebola outbreak on U.S. soil as American patient arrives in Atlanta
The Director of the Centers for Disease Control (CDC), Dr. Tom Frieden, appeared on four Sunday programs to quell fears that the United States may be at risk for an Ebola outbreak.
“We know that there are travelers from places where there’s Ebola. We know it’s possible that someone will come in. If they go to a hospital and that hospital doesn’t recognize it’s Ebola there could be additional cases or their family members could have cases. That’s all possible, but I don’t think it’s in the cards that we would have an outbreak in this country,” Frieden said on CBS’ “Face the Nation.”
“The way it spreads in Africa is really two things. First, in hospitals where there isn’t really infection control and second in burial practices where people are touching the bodies of people who have died from Ebola. So it’s not going to spread widely in the U.S. Could we have another people here, could we have a case or two, not impossible … but we know how to stop it here.”
The outbreak began in Guinea, before spreading to Liberia and Sierra Leone. As of July 30, 826 people have been killed by the illness that has a fatality rate of up to 90 percent.
Two American aid workers, Dr. Kent Brantly and Nancy Writebol, have contracted the disease.
Concern in the United States escalated after it was announced that both patients would be brought back to America. Brantly arrived in Atlanta, Ga., on Saturday and Writebol is expected to follow shortly.
Medical experts echoed Frieden’s position and downplayed the threat of an outbreak in the United States.
“This disease is spread by direct contact or body fluid contact, and inside these containment areas there’s negative pressure so any air going, would go into rather than come out of that facility. The workers are protected by complete covering of their face and all of their body, and they are isolated,” said Dr. Toby Cosgrove, President and CEO, of the Cleveland Clinic.
“Interestingly, this is not as highly contagious as many other diseases,” Cosgrove told NBC. “You have to understand that we’ve gone to a globalized world now, and disease are globalized as well. … With transportation, this is something we must learn to deal with.”
“There’s a humanitarian reason for stopping this in West Africa,” noted Dr. Richard Besser, “but the conversation we’ve been having also shows we have a self interest in doing that. The conversation really has to look at what will it take to beef up the health system to control this where it is.”
While officials understood the public’s concerns, they insisted there was no reason to worry.
“I can understand why people are scared of Ebola,” Frieden said on Fox News Sunday. “It’s deadly, it’s a gruesome death … but I hope and I’m confident that our fears are not going to overwhelm our compassion. We care for our own. We bring people home if they need to come home.”
The decision to bring Brantly back to America was made by the organization that sent him to Africa, Frieden said, and the role of CDC is to ensure the process of it is safe, by “isolat[ing] the patient so that it doesn’t spread during transit or when he’s in the hospital.”
Less than a month ago, Frieden appeared before a congressional committee to explain why researchers at the CDC “mishandled live anthrax and other deadly pathogens” on four different occasions. That history, which officials characterize as “lapses,” has resulted in skepticism over the safety of the transportation process.
There is currently no cure for the disease, but a vaccine is being developed and should be ready for human testing in early September.
“We would love an Ebola vaccine,” Frieden said, “but even in the best case, it’s a long way away and it’s uncertain.”
“Really, the tried and true public health mechanisms work. You find the patients. You isolate them. You find out who their contacts were. You trace the contacts. You track them everyday for 21 days. If they get fever you start that process again. You make sure there’s good infection control and you educate the community in Africa about safe burial practices. When you do those simple things, Ebola stops.”
Previous Ebola outbreaks were stopped through the process, Frieden noted, but the current outbreak is “out of control in West Africa and it may well spread further in that region.”
In the meantime, CDC is “surging their response,” sending more researchers to Africa in an effort to control it and “put out the embers.”
The U.S.-Africa Leaders Summit will be held in Washington, D.C., this week and the outbreak, while not the summit’s focus, will likely be addressed.
“We know that there are travelers from places where there’s Ebola. We know it’s possible that someone will come in. If they go to a hospital and that hospital doesn’t recognize it’s Ebola there could be additional cases or their family members could have cases. That’s all possible, but I don’t think it’s in the cards that we would have an outbreak in this country,” Frieden said on CBS’ “Face the Nation.”
“The way it spreads in Africa is really two things. First, in hospitals where there isn’t really infection control and second in burial practices where people are touching the bodies of people who have died from Ebola. So it’s not going to spread widely in the U.S. Could we have another people here, could we have a case or two, not impossible … but we know how to stop it here.”
The outbreak began in Guinea, before spreading to Liberia and Sierra Leone. As of July 30, 826 people have been killed by the illness that has a fatality rate of up to 90 percent.
Two American aid workers, Dr. Kent Brantly and Nancy Writebol, have contracted the disease.
Concern in the United States escalated after it was announced that both patients would be brought back to America. Brantly arrived in Atlanta, Ga., on Saturday and Writebol is expected to follow shortly.
Medical experts echoed Frieden’s position and downplayed the threat of an outbreak in the United States.
“This disease is spread by direct contact or body fluid contact, and inside these containment areas there’s negative pressure so any air going, would go into rather than come out of that facility. The workers are protected by complete covering of their face and all of their body, and they are isolated,” said Dr. Toby Cosgrove, President and CEO, of the Cleveland Clinic.
“Interestingly, this is not as highly contagious as many other diseases,” Cosgrove told NBC. “You have to understand that we’ve gone to a globalized world now, and disease are globalized as well. … With transportation, this is something we must learn to deal with.”
“There’s a humanitarian reason for stopping this in West Africa,” noted Dr. Richard Besser, “but the conversation we’ve been having also shows we have a self interest in doing that. The conversation really has to look at what will it take to beef up the health system to control this where it is.”
While officials understood the public’s concerns, they insisted there was no reason to worry.
“I can understand why people are scared of Ebola,” Frieden said on Fox News Sunday. “It’s deadly, it’s a gruesome death … but I hope and I’m confident that our fears are not going to overwhelm our compassion. We care for our own. We bring people home if they need to come home.”
The decision to bring Brantly back to America was made by the organization that sent him to Africa, Frieden said, and the role of CDC is to ensure the process of it is safe, by “isolat[ing] the patient so that it doesn’t spread during transit or when he’s in the hospital.”
Less than a month ago, Frieden appeared before a congressional committee to explain why researchers at the CDC “mishandled live anthrax and other deadly pathogens” on four different occasions. That history, which officials characterize as “lapses,” has resulted in skepticism over the safety of the transportation process.
There is currently no cure for the disease, but a vaccine is being developed and should be ready for human testing in early September.
“We would love an Ebola vaccine,” Frieden said, “but even in the best case, it’s a long way away and it’s uncertain.”
“Really, the tried and true public health mechanisms work. You find the patients. You isolate them. You find out who their contacts were. You trace the contacts. You track them everyday for 21 days. If they get fever you start that process again. You make sure there’s good infection control and you educate the community in Africa about safe burial practices. When you do those simple things, Ebola stops.”
Previous Ebola outbreaks were stopped through the process, Frieden noted, but the current outbreak is “out of control in West Africa and it may well spread further in that region.”
In the meantime, CDC is “surging their response,” sending more researchers to Africa in an effort to control it and “put out the embers.”
The U.S.-Africa Leaders Summit will be held in Washington, D.C., this week and the outbreak, while not the summit’s focus, will likely be addressed.
03 August 2014 (Primary Source) U.S. doctor quarantines himself at home after treating Ebola patients in Liberia
Patients are only contagious when they show symptoms, not during the incubation period, according to the World Health Organization.
“I was not concerned that I was contagious when I left Africa, and not concerned at this time because I have no symptoms of the disease,” Jamison said.
The retired pediatrician said he was volunteering with Medical Teams International.
“It was very stressful and emotional to see these things in Liberia,” Jamison said.
Liberia is one of three nations battling an outbreak of Ebola. The World Health Organization says Ebola has been confirmed or suspected to have infected more than 1,300 people, with more than 700 deaths in West Africa this year.
So far, the disease has been confined to Liberia, Sierra Leone and Guinea. One man died in quarantine in Nigeria after leaving Liberia.
Two American medical workers infected in West Africa will receive treatment in Atlanta.
Dr. Kent Brantly arrived in Georgia on Saturday aboard a specially equipped plane and was taken to Emory University Hospital.
The plane is headed to Liberia to retrieve the other American, fellow missionary Nancy Writebol.
The treatment of the patients will be conducted under strict safety protocols, U.S. officials said.
There’s no cure for Ebola. The most common approach is to support organ functions and keep up bodily fluids such as blood and water long enough for the body to fight off the infection.
Despite the risks, Jamison said he’d return to West Africa to help combat Ebola.
01 August 2014 (Primary Source) Liberian Dies in Morocco of Ebola - Internal Affairs Minister Discloses
The Minister of Internal Affairs, Mr. Morris Dukuly, has disclosed that a Liberian has died of the deadly Ebola virus in Morocco.
The Ebola virus, which has no cure, has killed at least 129 people here, and claimed more than 670 lives across the region. A top Liberian doctor working at Liberia's largest hospital died recently, and two American aid workers have fallen ill, underscoring the dangers facing those charged with bringing the outbreak under control.
Also recently, an official of the Ministry of Finance identified as Patrick Sawyer died of the disease at a Lagos hospital.
As a means of containing further spread of the disease, President Johnson-Sirleaf set up a taskforce to help in the fight of the disease and ordered the closure of the country's three land borders.
The Liberian leader also ordered that public gatherings be restricted and communities heavily affected by the Ebola outbreak be quarantined.
Making the disclosure at a news conference held at the Ministry on Wednesday, July 30, 2014, Minister Dukuly, who is also the Vice Chairman on the National Ebola Taskforce, further disclosed that the deceased left the country two days before his death.
Although Minister Dukuly did not disclose the name of the Liberian, who he said died of Ebola in Morocco, he averred that this means that there are many more people who are carrying the disease unknowingly.
Against this backdrop, the Internal Affairs Ministry boss called on traditional chiefs to help inform their local people on the threat of the deadly disease.
"You, traditional chiefs, are the owners of the land, and the land is under threat that I have not seen in my life before," said Minister Dukuly.
"Tell your people to stop running behind health workers. This may cause them to leave. For instance, Samaritan Purse, one of the partners, wanted to leave Lofa County due to threats they received from local people," he warned.
While urging the chiefs to adequately inform their people, he reminded them that Ebola is real and does not have to claim more lives before people get to believe it.
"We have a common challenge, which seems to be growing. This challenge is Ebola, and we need to fight it. Since the disease was discovered in March of this year," he noted.
He then lauded the Country Director of the World Health Organization (WHO) Dr. Nestor Ndayimirije for his care shown since the outbreak of the disease in March.
According to him, WHO through Dr. Ndayimirije has provided technical and other supports towards the fight of the disease in the country.
Speaking briefly, WHO Country boss, Dr. Ndayimirije said the disease can be prevented if people observe the necessary precautionary measures.
He disclosed that Ebola has killed 166 people since its outbreak.
Of this number, he said, over 20 health workers have died, while over 45 more are being affected by the disease.
Dr. Ndayimirije also disclosed that a total of 329 cases have been reported since the outbreak of the disease.
"You are the local leaders, tell your people to please support health workers and not to chase them. Samaritan Purse on yesterday said it will not continue because its workers were attacked and chased in Lofa with one of their staff wounded in the process in Foya. Please tell them to stop playing with dead bodies," he warned.
For his part, the Chairman of the National Traditional Council of Liberia (NTCL), Chief Zanzar Karwor, accepted the request from government and its partners to help in the campaign.
However, he urged that the government shows videos of patients and people who have died from the virus.
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