Sierra Leone orders three-day lockdown against Ebola

FREETOWN, Sierra Leone - Sierra Leone's President Ernest Koroma ordered the country's entire population Saturday to stay in their homes for three days in a bid to stem the spread of the deadly Ebola epidemic.

"All Sierra Leoneans must stay at home for three days," he announced, expanding a previous order for a lockdown in the capital Freetown and northern areas of the country nationwide.

"I have made my personal commitment to do whatever it takes to get to zero Ebola infections and I call on every Sierra Leonean in every community to pull together," he added.

People will be ordered to stay home from 0600 GMT March 27 to 1800 GMT March 29, with "no trading activities across the country".

Authorities in the Muslim-majority state will lift the lockdown for part of the day to allow church services on Palm Sunday.

Guinea, Liberia and Sierra Leone -- which have been the centres of the outbreak which has killed more than 10,000 people -- have set a goal of cutting off the  disease's spread by April 16.

"The economic development of our country and the lives of our people continue to be threatened by the ongoing presence of Ebola in Sierra Leone. The future of our country and the aspirations of our children are at stake," the president said.

One of the deadliest viruses known to man, Ebola is spread only through direct contact with the bodily fluids of the recently deceased or an infected person showing symptoms, such as fever or vomiting.

The worst-ever outbreak of the virus has claimed almost 3,700 lives in Sierra Leone, one of three impoverished west African nations that have seen their economies and healthcare systems wrecked  by the crisis.

source: interaksyon.com

Some US hospitals weigh withholding care to Ebola patients

CHICAGO/NEW YORK - The Ebola crisis is forcing the American healthcare system to consider the previously unthinkable: withholding some medical interventions because they are too dangerous to doctors and nurses and unlikely to help a patient.

US hospitals have over the years come under criticism for undertaking measures that prolong dying rather than improve patients' quality of life.

But the care of the first Ebola patient diagnosed in the United States, who received dialysis and intubation and infected two nurses caring for him, is spurring hospitals and medical associations to develop the first guidelines for what can reasonably be done and what should be withheld.

Officials from at least three hospital systems interviewed by Reuters said they were considering whether to withhold individual procedures or leave it up to individual doctors to determine whether an intervention would be performed.

Ethics experts say they are also fielding more calls from doctors asking what their professional obligations are to patients if healthcare workers could be at risk.

US health officials meanwhile are trying to establish a network of about 20 hospitals nationwide that would be fully equipped to handle all aspects of Ebola care.

Their concern is that poorly trained or poorly equipped hospitals that perform invasive procedures will expose staff to bodily fluids of a patient when they are most infectious. The US Centers for Disease Control and Prevention is working with kidney specialists on clinical guidelines for delivering dialysis to Ebola patients. The recommendations could come as early as this week.  

The possibility of withholding care represents a departure from the "do everything" philosophy in most American hospitals and a return to a view that held sway a century ago, when doctors were at greater risk of becoming infected by treating dying patients.

"This is another example of how this 21st century viral threat has pulled us back into the 19th century," said medical historian Dr. Howard Markel of the University of Michigan.  

Some ethicists and physicians take issue with the shift.

Because the world has almost no experience treating Ebola patients in state-of-the-art facilities rather than the rudimentary ones in Africa, there are no reliable data on when someone truly is beyond help, whether dialysis can make the difference between life and death, or even whether cardiopulmonary resuscitation (CPR) can be done safely with proper protective equipment and protocols.

Such procedures "may have diminishing effectiveness as the severity of the disease increases, but we simply have no data on that," said Dr. G. Kevin Donovan, director of the bioethics center at Georgetown University.

Donovan said he had received inquiries from fellow physicians about whether hospitals should draw up lists of procedures that would not be performed on an Ebola patient. "To have a blanket refusal to offer these procedures is not ethically acceptable,” he said he told the doctors.

New guidelines

Nevertheless, discussions about adopting policies to withhold care in Ebola cases are under way at places like Geisinger Health System, which operates hospitals in Pennsylvania, and Intermountain Healthcare, which runs facilities in Utah, according to their spokesmen.

Dr Nancy Kass, a bioethicist at Johns Hopkins Bloomberg School of Public Health, said healthcare workers should not hesitate to perform a medically necessary procedure so long as they have robust personal protective gear.

So far, only two US hospitals have used kidney dialysis: Texas Health Presbyterian Dallas, which treated Liberian patient Thomas Duncan and where two nurses became infected, and Emory University Hospital in Atlanta, which has treated four Ebola patients at its biocontainment unit without any healthcare workers becoming infected.

Although it is not yet clear how the Dallas nurses became infected, health officials have questioned both the lack of adequate training in the use of protective gear and the decision to perform invasive procedures.

The American Society of Nephrology and CDC are now working on new dialysis guidelines for Ebola patients, whose kidneys often fail. In some cases, dialysis can help a patient get through the worst of the illness until their own immune system can fend off the virus.

Nephrologist Dr. Harold Franch said the new guidelines will consider both whether the procedure is medically necessary and whether the hospital can do it safely.

"Most academic medical centers and many good private tertiary care hospitals will be able to do this," he said. Yet he thinks many hospitals may not offer the service, since “it takes a lot of money and time to train people.”

Treat, or flee? 


Throughout the history of medicine some doctors have declined to treat infectious patients or fled epidemics, said Michigan's Markel. Greek physician and philosopher Galen fled Rome during the bubonic plague 1,800 years ago, doctors deserted European cities stricken by the Black Death of the Middle Ages, and some health workers refused to treat HIV/AIDS patients in the 1980s.

"The idea that a doctor would stick to his post to the last during an epidemic, that's not part of the Hippocratic Oath," Markel said. "If you feel your life is at risk you don't have to stay and provide care."

At University of Chicago Medicine, questions of taking last-ditch measures were discussed early in the hospital's Ebola planning, said Dr. Emily Landon, a bioethicist and epidemiologist.

Decisions about offering services such as dialysis or inserting a breathing tube are made in advance by the hospital's care team in consultation with patients. But if a doctor on the team feels in the moment that she cannot provide the service, another may step in and do the procedure.

Landon views dialysis as a "no brainer" for Ebola patients, and believes the risks are fairly low to the well-trained nursing staff who have volunteered for the hospital's isolation ward.

But putting in a breathing tube and putting them on a ventilator is more controversial.

"We have very little experience with that except for Mr Duncan, who didn't do well," she said. The hospital plans to consult with patients before the need arises and plans to insert a breathing tube at the earliest sign that it might be needed.

CPR, which is performed when a patient's breathing or heart stops, also poses risks. It can involve chest compressions, inserting breathing tubes and other invasive procedures.

If a patient goes into cardiac or respiratory arrest, a team would have to don protective gear. Rushing could leave them without proper protection, but a delay could make the procedure ineffective.

That represents too great a risk for caregivers for what could be "a futile act," said Dr. Joseph Fins, chief of medical ethics at Weill Cornell Medical College in New York City.

source: interaksyon.com

EU summit tackles climate change, Ebola

BRUSSELS - European Union leaders meet at a summit in Brussels Thursday aimed at clinching a high-stakes deal on combating climate change and boosting efforts to fight the deadly Ebola virus.

The heads of state and government from the 28-member EU will also search during the two-day meeting for ways to foster economic growth and jobs amid fears of a triple-dip recession.

The main focus on Thursday will be on an ambitious package of climate change targets for 2030, but the leaders face 11th-hour differences over how member states share the burden.

Draft conclusions for the summit seen by AFP call for cutting greenhouse gases by 40 percent over 1990 levels, making renewables account for 27 percent of energy use and setting an energy savings target of 30 percent.

But there are objections all round the table, especially from coal-reliant Poland, which says the cost of updating its power plants is too high, and from Portugal, which wants closer cross-border energy infrastructure.

"There are still difficult issues which need to be resolved. We will see if we manage to do that," a German government source told reporters on condition of anonymity.

But other European sources were more upbeat.

"There is no agreement yet but I think the differences of opinion have been narrowed down to a couple of outstanding issues which will be settled by the leaders on Thursday night," said one source.

Ebola fight

Agreement is likely to be simpler on action to tackle the Ebola outbreak in west Africa, which has claimed nearly 4,900 lives, and prevent it from becoming a global threat, although money will again be an issue.

EU foreign and health ministers met on the subject over the past week.

"Our leaders will discuss the question on what more can be done to scale up our financial support and our medical care and equipment on the ground," an EU source told reporters.

EU member states and the European Commission have already pledged nearly 600 million euros ($750 million) to fight Ebola.

British Prime Minister David Cameron is expected to call on fellow EU leaders to boost that amount to one billion euros, British government sources said.

A Spanish nurse who was the first person to catch Ebola outside Africa has been cured of the deadly virus, doctors confirmed Tuesday, easing fears of it spreading in Europe.

The leaders will also discuss Ukraine although any progress is unlikely as an EU review on the ceasefire between Kiev and pro-Moscow rebels is not due until next Tuesday.

They may also discuss the threat from the Islamic State in Iraq and Syria, particularly the threat of foreign fighters returning to carry out attacks at home.

The EU economic talks on Friday will be joined by European Central Bank chief Mario Draghi. A eurozone summit will also be held Friday.

The climate debate is likely to be the toughest, coming against a backdrop of energy security worries in the EU, which is at odds with its biggest gas supplier Russia over the crisis in Ukraine.

EU sources said poorer fossil-fuel dependent states like Poland and others in eastern Europe are at loggerheads with richer northern nations over "who pays and how much" for modernizing power plants and cutting emissions.

Meanwhile, countries like Spain and Portugal are at odds with France over their desire to build more cross-border cables to export surplus electricity produced by wind power.

The EU wants to have an agreement on the climate change targets, among the world's toughest, in place ahead of a summit in Paris in 2015 at which a new UN-backed global treaty on climate change is to be agreed.

Climate negotiators have been meeting this week in Luxembourg and are likely to stay down to the wire, a Polish diplomat said.

"The balloon of expectation is pumped up so high that if we don't have a deal (at the summit) it will be perceived in a bad way," the diplomat said.

source: interaksyon.com

US to be 'more aggressive' in monitoring Ebola response: Obama

WASHINGTON - US President Barack Obama on Wednesday pledged a "much more aggressive" response at home to the Ebola threat, and insisted that the risk of a serious outbreak on US soil was low.

After a crisis meeting with top aides at the White House, Obama underlined the importance of helping African countries stem the spread of the virus, calling such aid "an investment in our own public health."

"If we are not responding internationally in an effective way... then we could have problems," Obama said in comments aired on US television.

The meeting -- attended by Vice President Joe Biden, Defense Secretary Chuck Hagel, Health and Human Services Secretary Sylvia Burwell and Homeland Security Secretary Jeh Johnson, among others -- came after a second US Ebola infection was diagnosed at a Texas hospital where a Liberian man died a week ago.

Obama said meeting participants discussed "monitoring, supervising, overseeing in a much more aggressive way exactly what's taking place in Dallas" to ensure those lessons are "transmitted to hospitals and clinics all across the country."

"This is not a situation in which, like a flu, the risks of a rapid spread of the disease are imminent," Obama said, adding he "shook hands with, hugged and kissed" nurses who had treated an Ebola patient at Emory University hospital in Atlanta.

"They followed the protocols. They knew what they were doing and I felt perfectly safe doing so," he said.

"I am absolutely confident that we can prevent a serious outbreak of the disease here in the United States... The key thing to understand about this disease is that these protocols work."

The White House said Obama had canceled plans to visit Rhode Island and New York on Thursday so he could follow up on the Ebola meeting.

So far, Ebola has killed nearly 4,500 people, the vast majority of them in West Africa, where the outbreak began early this year.

Since the announcement last month that the United States would send at least 3,000 troops to West Africa to help fight the outbreak, Obama has repeatedly criticized the international response to the health crisis as insufficient.

source: interaksyon.com

Obama sends 3,000 troops to W. Africa to 'turn tide' on Ebola

WASHINGTON - US President Barack Obama will try to "turn the tide" on the Ebola epidemic Tuesday by ordering 3,000 US military personnel to west Africa to curtail its spread as China also dispatched more experts to the region.

The White House said Obama will travel to the Centers for Disease Control and Prevention in Atlanta -- where US Ebola victims were treated -- to make the announcement, meant to spur a global effort to tackle the outbreak that has already killed 2,400 people.

It comes as alarm grows that the worst-ever Ebola epidemic which spread through Liberia, Sierra Leone and Guinea before reaching Nigeria, is out of control. A separate strain of the disease has appeared in the Democratic Republic of Congo.

Most of the US effort, which will draw heavily on its military medical corps, will be concentrated in impoverished Liberia -- the worst hit nation -- with plans to build 17 Ebola treatment centres with 100 beds in each.

China is also sending more medics to neighbouring Sierra Leone to help boost laboratory testing for the virus, raising the total number of Chinese medical experts there to 174, the UN said Tuesday.

The World Health Organization (WHO) said Tuesday it was reconvening its emergency committee in Geneva which declared the outbreak an international health emergency in August, to consider further measures to limit its spread.

Obama will announce that US Africa Command will set up a headquarters in the Sierra Leone capital Monrovia to act as a command and control centre for US military and international relief programmes.

But the main element of the push is a six-month training and hygiene drive to tackle the disease head-on.

US advisors will train up to 500 Liberian health care providers per week in how to safely handle and treat victims and their families in a bid to shore up the country's overwhelmed health infrastructure.

The intervention will involve an estimated 3,000 US military personnel, senior officials said, many working at a staging base for transit of equipment and personnel.

Washington will also send 65 experts from the public health service corps to Liberia to manage and staff a previously announced US military hospital to care for health workers who become sick with Ebola.

Ebola prevention kits, including disinfectant and advice, will also be supplied to 400,000 of the most vulnerable families in Liberia.

"What is clear is in order to combat and contain the outbreak at its source, we need to partner and lead an international response," said one senior US official, on condition of anonymity.

China said it is sending a mobile laboratory team to Sierra Leone, where more than 500 people have died so far from Ebola. The 59-person team from the Chinese Centre for Disease Control will include epidemiologists, clinicians and nurses, the WHO said.

"The newly announced team will join 115 Chinese medical staff on the ground in Sierra Leone virtually since the beginning," the agency's chief Margaret Chan said, hailing the new commitment as "a huge boost, morally and operationally".

Liberian Red Cross health workers wearing protective suits carry the body of a victim of the Ebola virus on September 12, 2014 in a district of Monrovia. AFP

source: interaksyon.com

Guinea detects Ebola in new region as US warns outbreak out of control

CONAKRY/DAKAR - Guinea's government said on Wednesday that Ebola had spread to a previously unaffected region of the country, as US experts warned that the worst ever outbreak of the deadly virus was spiraling out of control in West Africa.

Guinea, the first country to detect the hemorrhagic fever in March, had said it was containing the outbreak but authorities announced that nine new cases had been found in the southeastern prefecture of Kerouane.

The area, some 750 km (470 miles) southeast of the capital Conakry, lies close to where the virus was first detected deep in Guinea's forest region. The epidemic has since spread to four other West African countries and killed more than 1,500 people.

"There has been a new outbreak in Kerouane but we have sent in a team to contain it," said Aboubacar Sikidi Diakité, head of Guinea's Ebola task force. He insisted the outbreak was being contained.

The nine confirmed cases were in the town of Damaro in the Kerouane region, with a total of 18 people under observation, the health ministry said in a statement.

The latest outbreak started after the arrival of an infected person from neighboring Liberia, the ministry said. Guinea has recorded a total of 489 deaths and 749 Ebola cases as of Sept. 1.

President Alpha Conde urged health personnel to step up their efforts to avoid new infections.

"Even for a simple malaria, you have to protect yourselves before consulting any sick person until the end of this epidemic," Conde said in a televised broadcast. "We had started to succeed but you dropped the ball and here we go again."

Cases of Ebola have been reported in Liberia, Sierra Leone, Guinea, Nigeria, Senegal and Democratic Republic of Congo. The cases in Congo, which include 31 deaths, are a separate outbreak unrelated to the West African cases, however, the World Health Organization has said.

Outbreak not under control

In a stark analysis last week, the WHO warned that the Ebola epidemic in West Africa could infect more than 20,000 people and spread to 10 countries. It outlined a $490 million roadmap for tackling the epidemic.

Doctor Tom Kenyon, director of the US Centers for Disease Control's (CDC) Centre for Global Health, said on Wednesday the outbreak was "spiraling out of control" and he warned that the window of opportunity for controlling it was closing.

"Guinea did show that with action, they brought it partially under control. But unfortunately it is back on the increase now," he told a conference call. "It's not under control anywhere."

He warned that the longer the outbreak went uncontained, the greater the possibility the virus could mutate, making it more difficult to contain. Ebola is only transmitted in humans by contact with the blood or bodily fluids of sick people, though suspected cases of airborne infection have been reported in monkeys in laboratories.

A senior US official rebutted a call from medical charity Medecins Sans Frontieres (MSF) for wealthy nations to deploy specialized biological disaster response teams to the region. MSF on Tuesday had warned that 800 more beds for Ebola patients were urgently needed in the Liberian capital Monrovia alone.

"I don't think at this point deploying biological incident response teams is exactly what's needed," said Gayle Smith, Special Assistant to the President and Senior Director for Development and Democracy on the National Security Council.

She said the US government was focusing efforts on rapidly increasing the number of Ebola treatment centers in affected countries, providing protective equipment and ensuring local staff received training.

"We will see a considerable ramp-up in the coming days and weeks. If we find it is still moving out of control we will look at other options," Smith told a conference call.

The US Department of Health and Human Services said on Tuesday a federal contract worth up to $42.3 million would help accelerate testing of an experimental Ebola virus treatment being developed by privately held Mapp Biopharmaceutical Inc.

Human safety trials are due to begin this week on a vaccine from GlaxoSmithKline Plc and later this year on one from NewLink Genetics Corp.

source: interaksyon.com

GSK Ebola vaccine fast-tracked into U.S., UK and African trials

An experimental Ebola vaccine from GlaxoSmithKlineis being fast-tracked into human studies and the company plans to build up a stockpile of up to 10,000 doses for emergency deployment, if results are good.

Britain's biggest drugmaker said on Thursday the research was being accelerated with funding from an international consortium, reflecting mounting concern over the worst-ever outbreak of the disease in West Africa that has killed more than 1,500 people.

The candidate vaccine, which is being co-developed with the U.S. National Institutes of Health (NIH), is expected to be given to healthy volunteers in Britain and the United States from around mid-September, with the program then being extended to volunteers in Gambia and Mali.

source: interaksyon.com

West Africa Ebola death toll rises above 1,200; Liberia fights to halt spread of virus

MONROVIA/GENEVA - Liberia battled on Tuesday to halt the spread of the Ebola disease in its crowded, run-down oceanside capital Monrovia, recording the most new deaths as fatalities from the world's worst outbreak of the deadly virus rose above 1,200.

The epidemic of the hemorrhagic disease, which can kill up to 90 percent of those it infects, is ravaging the three small West African states of Liberia, Sierra Leone and Guinea, and also has a toehold in Nigeria, Africa's biggest economy.

As the Geneva-based World Health Organization rushed to ramp up the global response to the outbreak, including emergency food deliveries to quarantined zones, it announced that deaths from it had risen to 1,299 as of Aug. 16, out of 2,240 cases.

Between Aug. 14-16, Liberia recorded the most new deaths, 53, followed by Sierra Leone with 17, and Guinea with 14.

On a more hopeful note, the WHO expressed "cautious optimism" that the spread of the Ebola outbreak in Nigeria, Africa's most populous nation where four deaths out of 12 confirmed cases have been recorded since July, could be stopped.

It also described the situation in Guinea, where the virus made its first appearance in West Africa in December, as currently "less alarming" than in Liberia and Sierra Leone.

The WHO said it was working with the U.N.'s World Food Programme (WFP) to ensure food delivery to 1 million people living in Ebola quarantine zones cordoned off by local security forces in a border zone of Guinea, Liberia and Sierra Leone.

"Providing regular food supplies is a potent means of limiting unnecessary movement," it said in a statement.

Besides infection in border zones, Liberia is fighting to stop the spread of the virus in the poorest neighborhoods of its capital, such as the West Point slum where at the weekend a rock-throwing crowd attacked and looted a temporary holding center for suspected Ebola cases, 17 of whom fled.

As fears of wider contagion increased - Ebola is spread by contact with the bodily fluids of infected persons - Liberia sent police to track down the fugitive suspected cases.

"We are glad to confirm that all of the 17 individuals have been accounted for and have now been transferred to JFK Ebola specialist treatment center," Liberia's Information Minister Lewis Brown told Reuters on Tuesday.

He added that after meetings with religious and community leaders, a task force was being set up to go door-to-door through West Point, a labyrinth of muddy alleys, to explain the risks of the disease and the need to isolate infected patients.

"I know that Monrovia is really of concern to WHO," WHO spokeswoman Fadela Chaib said in Geneva.

Lewis said the Liberian authorities were considering imposing even tougher restrictions on movements.

Liberia and Sierra Leone's weak health systems have been overwhelmed by the multiplying numbers of cases and deaths.

WHO has said it is coordinating a "massive scaling up" of international assistance to the worst affected countries.

But a Liberian health ministry report for Aug. 17 said its Ebola-hit Lofa County had stopped burials due to a lack of body bags. "Absolutely no body bags," the report said.

It said the ministry warehouse had only three pairs of rubber boots remaining and no more bottles of hand sanitizers.

"I am sorry to say the government has lost the fight against Ebola. It is out of control now," said student Samuel Zorh.

On Friday, the Liberian and Sierra Leonean governments and a medical charity chided the WHO for its slow response, saying more action was needed to save victims threatened by the disease and hunger.

"IMPROVEMENT" AFTER RARE DRUG USED

The WHO declared the West African Ebola outbreak a "public health emergency of international concern" on Aug. 8, triggering global alarm as countries stepped up precautions and testing.

Reflecting this, emergency services in Berlin on Tuesday cordoned off a job center and took a woman with Ebola-like symptoms including high fever to hospital.

The U.N. health agency this month gave the green light to use untested pharmaceuticals to treat Ebola patients.

In Monrovia, three African healthcare workers were given the rare experimental ZMapp drug, which has already been used on two American aid workers being treated in the United States after being evacuated from Liberia with Ebola.

Lewis said the three Africans treated with ZMapp were showing "remarkable signs of improvement".

However, the manufacturer of the drug, California-based Mapp Biopharmaceutical, has already said its scarce supplies have been exhausted. Officials have cautioned the public not to place too much hope in untested and scarce treatments.

As part of the increased international response, WFP is stepping up emergency food deliveries to the quarantined areas, which include severely-affected cities such as Gueckedou in Guinea, Kenema and Kailahun in Sierra Leone and Foya in Liberia.

Fears of the disease and quarantine measures like military and police roadblocks have stopped farmers from reaching their fields, and as a result food output has dropped, raising fears that a famine could set in on top of the deadly illness.

"We think that even beyond the control of the outbreak there will be severe food shortage," said Gon Myers, WFP country director for Sierra Leone. The extra food deliveries would be trying to reach 400,000 people in Sierra Leone alone.

The WHO has told countries affected by the outbreak to screen people departing at airports, seaports and major land border points and stop any with signs of the virus.

It has argued against further travel restrictions, but several international and regional airlines have canceled services to Liberia, Sierra Leone and Guinea.

Shipping companies operating on Africa's west coast, as well as port authorities, were also on high alert.

"We sense a certain amount of concern out there in the industry," Ian Millen, Chief Operating Officer of Dryad Maritime, a maritime operations company, told Reuters, but he said he had not seen widespread cancellations of services.

Nigeria said on Monday its confirmed Ebola cases had reached 12, up from 10 last week, but five had almost fully recovered. Four people have died from the virus in Lagos, where it was transferred by a U.S. citizen who arrived by plane from Liberia.

Although WHO said the situation in Lagos looks "reassuring", Cameroon closed its borders with Nigeria on Tuesday as a precaution.

source: interaksyon.com

At frontline in fight vs Ebola, a doctor finds grief and inspiration

LONDON -- After a month on the frontline battling Ebola in a hospital in Sierra Leone, the memories that both haunt and inspire British doctor Tim O'Dempsey are of the children.

Many memories of children dying in isolation wards while their parents wailed outside. And one of a small girl who fought her way out of a coma and was reunited with her father.

"Seeing a mother come in with a little baby, and within a few days the baby die -- it's very difficult," he told Reuters. "What you do is just get on with it. There are lots and lots of patients that need to be attended to. Occasionally, entire families would be admitted. You can't stop."

O'Dempsey, a doctor with three decades' experience studying and fighting tropical diseases, was seconded to Sierra Leone by the World Health Organization to help battle the biggest outbreak of the deadly hemorrhagic fever in history.

He ended up as part of a team of between two and four doctors, plus a handful of nurses, caring for 40-60 patients a day with one of the most lethal known diseases.

Kenema hospital's three Ebola wards -- one for suspected cases, the other two for confirmed infections -- had barely 10 or 12 beds each, so patients lay on mattresses on the floors and in the corridors.

Many of the staff themselves became ill, and many died, including the head nurse on the Ebola wards, Mballu Fonnie, and the doctor in charge of the unit, Sheik Umar Khan -- declared a national hero by the government when he passed away last month at 39 after treating more than 100 Ebola sufferers.

Amid the misery, it was the small triumphs that made the work worth doing, like that of a girl aged around six or seven.

‘Stormy course’

"Her father had brought her in, but because he wasn't a suspect case he had to leave, so she was on her own," O'Dempsey said. The girl was soon confirmed with Ebola and moved to the isolation wards.

There, she had "a pretty stormy course" with high fever, vomiting and diarrhea. She slipped into a coma and was close to death.

"But we managed her as best we could, and she came out of her coma, and very, very slowly we were able to encourage her to drink, and then begin feeding her," he said.

"Just before I left -- four weeks later -- I arranged for her to go into a side room so her father could see her and look after her again. I hear that she is getting stronger every day."

Such stories, he said, are important because they encourage people to come forward and seek the medical attention that can save lives and prevent the disease from spreading. They are also a blessing for staff who risk their own lives to provide succor.

"It's quite fantastic to see people convalescent and waiting to be discharged -- walking around the place, joking, singing and looking remarkably well."

WHO Director General Margaret Chan said last week that one of the most important factors in being able to bring the outbreak under control was to ensure healthcare workers were cared for and respected.

"Governments affected need to send a very strong signal that the local healthcare workers' contribution is appreciated, they are properly paid, and security is provided to make sure they can work quietly and do what they are best at," Chan said.

Infected health workers

O'Dempsey saw the struggle faced by local doctors and nurses at first hand.

"When I arrived the nurses had been on strike since the previous day. There were no nurses inside the wards at all, so conditions were really pretty grim," said O'Dempsey. "There was a high infection rate among healthcare workers and nursing staff. It was very difficult for people to see their colleagues becoming ill and in some cases dying."

The death toll in this Ebola epidemic -- the largest and most deadly ever seen -- reached 961 on Aug. 8 from a total of 1,779 cases, according to WHO data. In the four countries hit so far, Guinea, Sierra Leone, Liberia and Nigeria, the virus has infected some 140 or 150 healthcare workers, killing around 80 of them, WHO Director General Margaret Chan said last week.

Many epidemiologists and infectious disease specialists -- including O'Dempsey, a senior lecturer at the Liverpool School of Tropical Medicine -- fear it could get far worse.

"It's unlikely we've seen the peak," he said. A lot more needs to be done to improve and expand treatment facilities to ensure all patients who need to be contained and isolated can be, and to make sure fear and stigma were not made worse, he added.

Nurses and other health workers were not only exhausted and fearful for their lives, he said, but are also shunned by family, friends, landlords and other members of the community, some of whose traditional beliefs lead them to see Ebola infection as a punishment for doing something wrong.

"We need enough nurses who are properly trained and we need clinicians able to offer support and expertise," he said. "You can't have nurses working 12, 14 hours a day, seven days a week for months without a break."

source: interaksyon.com

Death toll from Ebola in W. Africa hits 887: WHO

ABUJA, Nigeria — The doctor who treated a man who flew to Nigeria and died of Ebola now has contracted the disease, authorities said Monday, presenting a dire challenge to Africa's most populous nation as the regional toll for the outbreak grew to 887 dead.

As Nigerian health authorities rushed to quarantine others who had been exposed, a special plane left Liberia to evacuate the second American missionary who fell ill with Ebola. Nancy Writebol, 59, is expected to arrive in Atlanta on Tuesday, where she will be treated at a special isolation ward.

The second confirmed case in Nigeria is a doctor who treated Patrick Sawyer, the Liberian-American man who died July 25 days after arriving in Nigeria from Liberia, said Nigerian Health Minister Onyebuchi Chukwu.

Three others who also treated Sawyer now show symptoms of Ebola and their test results are pending, he said. Authorities are trying to trace and quarantine others in Lagos, sub-Saharan Africa's largest city of 21 million people.

"This cluster of cases in Lagos, Nigeria is very concerning," said Dr. Tom Frieden, director of the U.S. Centers for Disease Controls and Prevention, which is dispatching 50 experienced disease control specialists to West Africa.

"It shows what happens if meticulous infection control, contact tracing, and proper isolation of patients with suspected Ebola is not done. Stopping the spread in Lagos will be difficult but it can be done," he said.


The World Health Organization announced Monday that the death toll has increased from 729 to 887 deaths in Guinea, Sierra Leone, Liberia and Nigeria.

Cases in Liberia jumped from 156 to 255, WHO said, as the government ordered that all Ebola victims must now be cremated because of rising opposition to burials in neighborhoods around the capital. Over the weekend, police were called in amid a standoff over whether health authorities could bury nearly two dozen victims in a neighborhood on the outskirts of the capital, Monrovia.

Sierra Leone marked a national stay-at-home day Monday in an effort to halt the disease's spread. A documentary film of the first outbreak of the Ebola disease in Congo was being shown intermittently throughout the day by the national broadcaster.

The emergence of a second case in Nigeria raises serious concerns about the infection control practices there, and also raises 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 severe internal and external bleeding in advanced stages of the disease.

"This fits exactly with the pattern that we've seen in the past. Either someone gets sick and infects their relatives, or goes to a hospital and health workers get sick," said Gregory Hartl, World Health Organization spokesman in Geneva. "It's extremely unfortunate but it's not unexpected. This was a sick man getting off a plane and unfortunately no one knew he had Ebola."

Doctors and other health workers on the front lines of the Ebola crisis have been among the most vulnerable to infection as they are in direct physical contact with patients. The disease is not airborne, and only transmitted through contact with bodily fluids such as saliva, blood, vomit, sweat or feces.

Sawyer, who was traveling to Nigeria on business, became ill while aboard a flight and Nigerian authorities immediately took him into isolation upon arrival in Lagos. They did not quarantine his fellow passengers, and have insisted that the risk of additional cases was minimal.

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.

Tracking down all the people who came into contact with Sawyer and his caregivers could prove difficult at this late stage, said Ben Neuman, a virologist and Ebola expert at Britain's University of Reading.

"Contact tracing is essential but it's very hard to get enough people to do that," he said. "For the average case, you want to look back and catch the 20 to 30 people they had closest contact with and that takes a lot of effort and legwork ... The most important thing now is to do the contact tracing and quarantine any contacts who may be symptomatic."

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Paye-Layleh reported from Monrovia, Liberia. Associated Press Medical Writer Maria Cheng reported from London. Krista Larson in Dakar, Senegal; Clarence Roy-Macaulay in Freetown, Sierra Leone; and Maram Mazen in Lagos, Nigeria contributed to this report.

source: philstar.com

W. Africa's Ebola outbreak still manageable -- WHO

GENEVA – The World Health Organization on Friday denied the ongoing Ebola outbreak in West Africa is already out of control.

"The situation's not out of hand and a lot of work has been done in the three affected countries -- Guinea, Sierra Leone, and Liberia -- to tackle the situation and stop transmission of Ebola virus," assured Dr. Pierre Formenty, an expert from WHO's Department of Communicable Diseases Surveillance and Response, speaking during a press conference.

He said WHO and local authorities were able to control the outbreak in different places like Telimele and Dabola in Guinea.

There are places where WHO was not totally successful.

In other places, however, WHO was successful in stopping the chain of transmission.

However, difficulties in identifying cases, tracing the point of contact, and informing people about the infection that still exist in the affected countries particularly in forest areas there.

"Given the recent outbreak of the virus in Sierra Leone, and with people traveling to Liberia and elsewhere, WHO needs to address the possibility of continuous transmission between countries," the expert said.

He warned the other West African border countries like Cote d'Ivoire, Mali, Senegal, and Guinea-Bissau must be prepared in case people infected with the disease traveled to these areas.

As of Thursday, authorities confirmed a total of 386 Ebola cases.

Probable and suspected cases were reported in Guinea, including 280 deaths.

Sierra Leone reported 176 cases including 78 deaths.

Liberia reported 63 cases including 41 deaths.

In an effort to address further spread of the virus in the shortest possible time, WHO will convene in Ghana a special meeting between July 2 and 3 to discuss the best way of tackling the crisis collectively as well as to develop a comprehensive inter-country operational response plan.

source: interaksyon.com