Ebola news 11/14

[Buster's Uncle]

MSF should have called for Ebola vaccine earlier, says aid group veteran
Reuters
By Daniel Flynn and Robert-Jan Bartunek  14 hours ago



DAKAR/BRUSSELS (Reuters) - Medecins Sans Frontiers "wasted time" by waiting too long to call for vaccines to fight an unprecedented outbreak of Ebola in West Africa, a veteran of the medical charity told Reuters.

The group's response to the epidemic which has so far killed more than 5,000 people has been widely praised by governments and the World Health Organization. While Western donors dithered and other aid groups pulled out, MSF deployed hundreds to the Ebola "hot zones" and treated more than 3,000 patients.

But the emergency group relied too much on strategies it developed during smaller previous eruptions of the virus, leading it to make mistakes as this year's rampant multi-country epidemic pushed it to its limits, said Jean-Herve Bradol, a member of MSF's internal think-tank.

"Our response was too orientated toward the management of previous outbreaks," Bradol, of the Paris-based Centre For Reflection on Humanitarian Action (CRASH), told Reuters, adding that MSF's public appeal for vaccine development in September came months too late.

"We wasted time before speaking about a vaccine and treatments...It's very hard to imagine controlling this epidemic now without a vaccine."

MSF, known also as Doctors Without Borders, is the only organisation to have worked extensively with Ebola in the last 20 years. When the outbreak, first identified in March, started to spread, the group focused on established protocols of isolating patients and tracing their contacts.

At the same time, the group - treating patients at its six centres in Guinea, neighbouring Liberia and Sierra Leone - criticised the slowness of the international response and clashed publicly with the Guinean government and the World Health Organization (WHO), which accused it of alarmism.

Since then the WHO has been widely criticised for its slow response to the epidemic and its early reassurances, despite warnings from MSF. The United Nations health agency has said it will publish a full review of its handling of the epidemic once it is under control.

Several companies are now accelerating vaccine trials. Two leading candidates, made by GlaxoSmithKline and NewLinkGenetics, have already started trials in Africa and Europe.

Separately, MSF said on Thursday that clinical trials of three potential new drugs would begin in December in Guinea and Liberia at medical centres it runs.

The West Africa Ebola epidemic has now infected more than 13,000 people.


ETHICAL TESTS

MSF was founded in 1971 by a group of French doctors and journalists outraged by the aid community's silence at Nigeria's blockade and starvation of separatist Biafra.

It prides itself on its speed and independence: with 90 percent of its $1.3 billion global budget funded by a legion of small individual donors MSF does not have to seek permission from any single major backer before acting.

The group has made 'bearing witness' a key part of its remit, from criticism of the military junta during the 1985 Ethiopian famine to calls for armed intervention to halt the Rwandan genocide in 1994.

That same attitude extends to self-criticism, said Bradol, noting that the remit of CRASH is to look at what MSF could have done better itself.

The current Ebola outbreak has brought ethical challenges for the group. When Sierra Leone’s foremost Ebola specialist, Dr. Sheik Umar Khan, lay dying in July, MSF doctors decided after fraught discussions not to treat him with an experimental drug, arguing its effects were unknown and supplies were scarce so it would be unfair to give him privileged care.

But when international healthcare workers fell ill - including two European members of MSF's staff - they were evacuated and given such treatments.

Such incidents sparked debate within MSF over why experimental treatments were not being offered to patients and its local staff, an unprecedented 15 of whom have died.

“The CRASH said...if you argue the drugs are not safe because they are experimental but you give them to the expatriates, that makes no sense," Bradol said.


FROM ALOOF TO INNOVATIVE

MSF staff complained at the start of the outbreak that other aid organisations failed to help treat Ebola. But the other aid groups complained that MSF refused to water down its rigorous safety protocols by training others.

Since then MSF has shared its blueprint for treatment centres and is training non-MSF workers in its centre in Brussels. It also allowed staff from other NGOs to shadow its workers and use its logistics infrastructure.

Henry Gray, an operations coordinator for MSF-Brussels who worked for two months in Liberia and Sierra Leone, says the outbreak has also forced the group to innovate, developing watertight body bags to stop leakage of infected bodily fluids and climate controlled tents to allow doctors to work longer wearing heavy protective suits.

MSF has deployed more than 700 foreign staff in total to fight Ebola, rotating people through on six week stints. With the operation run at a cost of $50 million MSF staff are paid just $2,800 for a country manager.

"Nobody does this for the money," said Dr. Darin Portnoy, a long-time MSF volunteer from New York working at an MSF treatment centre in Monrovia.


http://news.yahoo.com/msf-called-ebola-vaccine-earlier-says-aid-group-061102146--business.html

[Buster's Uncle]

Worst Ebola outbreak on record tests global response
Reuters  2 hours ago



(Reuters) - Global health authorities are struggling to contain the world's worst Ebola epidemic since the disease was identified in 1976. The virus has killed at least 5,160 people.

Here is a timeline of the outbreak:

March 22: Guinea confirms a hemorrhagic fever that killed more than 50 people is Ebola.

March 30: Liberia reports two cases; Ebola suspected in Sierra Leone.

April 1: Medical charity Medicins Sans Frontieres (MSF) warns Ebola's spread is "unprecedented." A World Health Organization (WHO) spokesman calls it "relatively small still."

April 4: Mob attacks Ebola treatment center in Guinea. Health workers there and in Sierra Leone and Liberia face hostility from fearful, suspicious people.

May 26: WHO confirms first Ebola deaths in Sierra Leone.

June 17: Liberia reports Ebola in its capital, Monrovia.

June 23: With deaths above 350, West Africa outbreak is worst on record, MSF says it is "out of control," calls for massive resources.

July 25: Nigeria confirms its first Ebola case.

July 29: Dr. Sheik Umar Khan, who was leading Sierra Leone's fight against the epidemic, dies of Ebola.

July 30: Liberia shuts schools, quarantines worst-affected communities, using troops for enforcement.

Aug. 2: U.S. missionary physician infected with Ebola in Liberia is flown to Atlanta in the United States for treatment.

Aug. 5: Second U.S. missionary with Ebola is flown from Liberia to Atlanta for treatment.

Aug. 8: WHO declares epidemic an "international public health emergency."

Aug. 12: WHO says death toll tops 1,000, approves use of unproven drugs or vaccines.

Spanish priest with Ebola dies in Madrid hospital.

Aug. 15: MSF says epidemic will take about six months to control.

Aug. 20: Monrovia security forces fire shots, tear gas to disperse crowd trying to break out of quarantine, killing teen.

Aug. 21: Two U.S. missionary aid workers treated in Atlanta are released from hospital August 19 and 21 free of the virus.

Aug. 24: Democratic Republic of Congo declares Ebola outbreak; it is believed separate from West Africa epidemic.

Infected British medical worker is flown home from Sierra Leone for treatment.

Aug. 28: WHO puts death toll above 1,550, warns outbreak could infect more than 20,000.

Aug. 29: Senegal reports first confirmed Ebola case.

Sept 2: MSF president tells United Nations the world is losing battle to contain Ebola, slams "global inaction".

Sept. 3: Epidemic accelerates; deaths top 1,900. Officials cite close to 400 deaths in past week.

Third U.S. missionary doctor with Ebola flown from Liberia for treatment in Omaha, Nebraska.

Sept. 5: Latest WHO tally: more than 2,100 dead out of about 4,000 people thought to have been infected.

Sept. 7: President Barack Obama says United States needs to do more to help prevent Ebola from becoming global crisis.

Sept. 8: Britain to send military and humanitarian experts to Sierra Leone to set up treatment center; United States to send field hospital to Liberia to care for health workers.

Fourth Ebola patient will be flown to United States for treatment in Atlanta.

Sept. 9: WHO says at least 2,296 dead out of 4,293 cases in five countries.

Sept. 12: Cuba to send 165 doctors and nurses to Sierra Leone.

Sept. 13: Liberia appeals to Obama for aid to fight Ebola.

Sept. 16: United States promises 3,000 military engineers and medical personnel to West Africa to build clinics, train health workers.

WHO says 2,461 dead out of 4,985 infected, doubling death toll in past month.

Sept. 17: MSF says French nurse volunteer in Liberia has Ebola.

Sept. 18: WHO says 2,630 dead out of 5,357 thought infected.

United Nations special mission to combat Ebola will deploy staff in Liberia, Guinea, Sierra Leone. Security Council adopts resolution calling for lifting travel, border restrictions.

French President Francois Hollande says military hospital will be set up in Guinea.

Sept. 19: Streets in Sierra Leone's capital, Freetown, are deserted under three-day lockdown to try to halt Ebola's spread.

Sept. 20: Liberian Thomas Eric Duncan flies from Liberia to Dallas via Brussels and Washington after trying to help woman with Ebola in his home country.

Sept. 22: WHO says outbreak largely contained in Senegal and Nigeria; says Ebola has killed more than 2,811 in West Africa.

Sept. 23: U.S. Centers for Disease Control and Prevention (CDC) estimates between 550,000 and 1.4 million people in West Africa may have Ebola by January.

Sept. 25: Duncan goes to Dallas hospital with fever, abdominal pain. He is sent back to apartment where he is staying despite telling a nurse he traveled from West Africa.

Sept. 26: New WHO tally: 3,091 dead out of 6,574 probable, suspected and confirmed cases.

Cuba says training 296 more doctors and nurses to treat West Africa Ebola patients, in addition to 165 preparing to go to Sierra Leone.

Sept. 28: Duncan returns by ambulance to Dallas hospital.

Sept. 30: CDC confirms Duncan has Ebola; first case diagnosed in United States.

Oct. 1: WHO says 3,338 dead out of 7,178 West Africa cases.

Cuba sends 165 doctors and nurses to Sierra Leone, the first group of volunteers from the Caribbean island.

Oct. 2: Britain pleads at London conference for international help to fight epidemic.

NBC News says American freelance cameraman, Ashoka Mukpo, has Ebola; he will be flown to United States for treatment.

Oct. 3: WHO says 3,439 dead out of 7,492 suspected, probable and confirmed cases in West Africa and United States, which has one.

Ugandan doctor with Ebola arrives in Frankfurt from Sierra Leone for treatment.

Oct. 4: Volunteer nurse in Liberia who was first French national to contract Ebola leaves hospital outside Paris after being successfully treated.

Oct. 6: Spanish nurse is infected with Ebola; she treated infected Spanish priest who was repatriated to Madrid and died.

Cameraman Mukpo in Omaha; taken to Nebraska Medical Center.

Oct. 8: Duncan, the first person diagnosed with Ebola in the United States, dies in Dallas hospital.

U.S. government orders five major airports to screen passengers from West Africa for fever.

Oct. 9: WHO revises Ebola death toll to 3,865 out of 8,033 cases, says there is no evidence epidemic is being brought under control in West Africa.

Britain to screen passengers entering country through London's two main airports and Eurostar rail link with Europe.

Some lawmakers want United States to ban travelers from West African countries hit hardest by Ebola.

Oct. 10: WHO ups deaths to 4,033 out of 8,399 cases in seven countries. Most fatalities in Liberia, Sierra Leone and Guinea.

Oct. 11: New York's John F. Kennedy International Airport begins screening travelers from three West African countries for Ebola symptoms.

Oct. 12: Dallas nurse tests positive for Ebola, becoming first person to contract it in the United States. Nina Pham was infected while caring for Duncan.

Oct. 14: At Heathrow, London's busiest airport, Britain begins screening travelers from West Africa.

Sudanese U.N. medical official who contracted Ebola in Liberia dies in German hospital.

Oct. 15: Second Texas nurse who treated Duncan is diagnosed with Ebola. Amber Vinson will be treated at Atlanta's Emory University Hospital. Authorities say she took flight from Cleveland to Dallas/Fort Worth International Airport while running slight fever.

WHO raises death toll to 4,493 out of 8,997 cases; says epidemic still spreading in West Africa.

Oct. 16: U.S. congressional subcommittee sharply questions health officials about response to Ebola in United States.

U.S. National Institutes of Health says nurse Pham will be moved to NIH isolation unit in Bethesda, Maryland, from Dallas.

Oct. 17: WHO raises death toll to 4,546 out of 9,191 cases.

Senegal declared free of Ebola.

Obama appoints Ebola response coordinator.

Oct. 19: Nigeria declared free of Ebola.

Spanish nurse appears to be free of Ebola.

Oct. 20: In Texas, 43 people taken off Ebola watch lists.

United States issues stricter guidelines for health workers treating Ebola victims.

Oct. 21: Medicins Sans Frontieres says will start trials of experimental Ebola drugs at its treatment centers in West Africa next month.

Cuba sends 53 doctors and nurses to Liberia and 38 to Guinea to treat Ebola patients, the second group from that country.

U.S. says as of Oct. 22 travelers to the United States from Liberia, Sierra Leone and Guinea must fly into one of five designated airports for enhanced screening.

Oct. 22: United States will monitor for 21 days anyone entering the country from three nations at center of epidemic.

NBC freelance cameraman, Ashoka Mukpo, is declared free of Ebola; leaves hospital in Nebraska.

Oct. 23: New York City doctor Craig Spencer, who treated patients in Guinea, tests positive for Ebola.

Mali becomes sixth West African country hit by Ebola.

Oct. 24: Dallas nurse Pham is Ebola-free; leaves hospital.

New York and New Jersey order quarantine of all medical workers returning from Ebola-hit West Africa countries. Nurse Kaci Hickox tests negative and is quarantined, under protest, for two days in New Jersey. She goes to Maine, where she is ordered isolated in her home. She challenges that order.

Oct. 25: WHO raises death toll to 4,922 out of 10,141 cases.

Illinois orders quarantine of all high-risk travelers returning from Ebola-hit West Africa countries.

Oct. 26: Florida will monitor for 21 days people returning from Ebola-hit countries and quarantine "high-risk" individuals.

Oct. 27: U.S. Army begins isolating personnel returning from Ebola missions in West Africa.

Australia becomes first developed country to shut its borders to areas hardest hit by Ebola; bans visas for citizens of Sierra Leone, Liberia and Guinea.

Oct. 28: Dallas nurse Vinson is free of Ebola; leaves Emory University Hospital.

Oct. 29: Ebola appears to be slowing in Liberia, WHO says.

Quarantine-like monitoring expanded to all U.S. military personnel returning from Ebola relief efforts in West Africa.

California enacts 21-day quarantine of travelers who had contact with Ebola patients but policy more flexible than rules in New York, New Jersey and Maine.

Oct. 31: Canada stops issuing visas to people from Sierra Leone, Liberia and Guinea.

Nov. 3: Mali is thought to be Ebola free, but officials searching for 39 people who traveled on buses with toddler who died from virus.

Maine and nurse Hickox reach agreement allowing her to travel freely in public and not be quarantined at home.

Nov. 5: WHO revises deaths downward for second week running, puts toll at 4,818 out of 13,042 cases as of Nov. 2. Says still seeing slowdown in weekly cases in Liberia, Guinea is stable, incidence of Ebola rising in Sierra Leone.

Obama will ask Congress for $6.2 billion in new funds in U.S. fiscal year to fight Ebola in West Africa and United States, according to officials familiar with request.

China plans to send some 1,000 medical workers and experts to West Africa, state-run Xinhua news agency reports.

Australian Prime Minister Tony Abbott says his country will fund a treatment clinic in Sierra Leone, responding to pressure from United States and others to do more.

Nov. 7: Death toll rises to 4,950 out of 13,241 cases in the three worst-hit countries of West Africa.

Dallas declared Ebola-free after first transmission within United States.

Nov. 11: Mali confirms second Ebola case; locks down clinic.

New York doctor Craig Spencer is Ebola free, leaves hospital.

Nov. 12: Death toll rises to 5,147 out of 14,068 cases in Guinea, Liberia and Sierra Leone with 13 deaths and 30 cases in five other countries.

Mali's death toll rises to four; more than 90 quarantined.

To win approval of $6.2 billion in emergency funds, Obama administration tries to assure senators its efforts to contain Ebola at home and abroad are making progress.

U.S. nurses protest over Ebola protection; 400 health workers strike in Sierra Leone over pay.

Nov. 13: Mali announces tougher health checks at border crossings after its second outbreak.

Liberia's President Ellen Johnson Sirleaf will not seek extension to state of emergency imposed in August over Ebola, a sign of progress in fight against the virus.

Eighty U.S. troops return to United States from Liberia and begin 21-day period of monitored isolation.

MSF says will begin in December clinical trials of potential treatments at medical centers it runs in Guinea and Liberia.

Nov. 14: WHO's latest tally puts death toll at 5,177, predominantly in Liberia, Sierra Leone and Guinea, out of at least 14,133 cases in those and five other countries.

WHO assessing more than 120 potential Ebola treatments; finds some that definitely do not work, none that definitely work.

Health officials in Mali tracing up to 343 people linked to confirmed and probable Ebola victims.

An MSF veteran says the charity waited too long to call for vaccines to fight the epidemic.

(Writing by Jonathan Oatis; Editing by Toni Reinhold)


http://news.yahoo.com/worst-ebola-outbreak-record-tests-global-response-231832743.html

[Buster's Uncle]

In Ebola-hit SLeone, dignity in death protects the living
AFP
By Anne Chaon  20 hours ago



Gains made since Sierra Leone's ruinous civil war face being reversed by the Ebola virus (AFP Photo/Francisco Leong)



Freetown (AFP) - Sierra Leone's Ebola burial boys wrap the highly-infectious body and present it to the family for dignified last goodbyes before it is taken gently away.

Removal of the dead is a necessarily traumatic experience for those left behind, but the process is a far cry from the way things used to be done.

In the panicked early days of the outbreak, when the only consideration was sanitation, teams of what looked to shellshocked relatives like space men would come to pick up the dead.

Armed with disinfectant hoses that looked like weapons, they would bag the body without ceremony, driving off before the relatives could ask where they were going.

In recent weeks the emphasis has shifted and "dignity" is as much the mantra as "safety" in a country where locals are deeply reluctant to give up their dead.

Traditional funeral rites involving washing bodies are particularly important in the culture of Muslim-majority Sierra Leone.

But Ebola spreads through contact with infected bodily fluids and the World Health Organization (WHO) estimates that these practises are responsible for 20 percent of new infections.

In rural areas and even in Freetown, local authorities estimate that the figure might be as high as 60 percent.

Keen to persuade families to give up their dead, but aware of their fear of cold, clinical Ebola burials, the WHO issued guidelines on "Safe and Dignified Burial" last week, backed for the first time by Muslim and Christian leaders.


- 'Less sinister' -

It is early morning in Freetown and the Red Cross has been called to remove a number of bodies in the Wellington neighbourhood, where cases are on the rise, operations director Thomas Abu tells AFP.

Relatives line the potholed road leading up to the first house, and men with grave expressions take the team to one of the victims, a 43-year-old-woman who has just died.

Mustapha Rogers -- whose nebulous job title is "beneficiary communicator" -- stops his co-workers and approaches the relatives on his own.

"I'm in charge of relations with the families," he explains, before painstakingly setting out the process of removing the dead.

He satisfies himself that no one has touched the victim in the two weeks before death or washed her since, explaining that men fully equipped with biohazard gear will be the only people allowed anywhere near.

The body will be placed in white tarpaulin, deemed less sinister than the black plastic they used to use.

If the victim is Muslim, the team will wrap the body in white cloth, in a nod to Islamic tradition which is valued enormously by grieving relatives.

The body is wrapped and disinfected out of sight and only then presented to the family, who are invited to accompany the Red Cross to the cemetery to make a note of the burial plot.

"If he is a Christian, a pastor is called. If he's Muslim, an imam," Rogers tells AFP.

As he explains the protocol, the burial experts approach clutching their biohazard suits, which they put on in full view of the family.

The idea is that relatives are not suddenly confronted by the intimidating and sinister approach of the "spacemen".

"This shows them that this is about human beings," says Abu, the operations director.


- Seventy bodies -

Rogers takes a telephone number and notes down how many relatives are present, the beginnings of a survey of nearest and dearest that will come in handy for quarantine purposes should the victim test positive for Ebola.

Meanwhile a woman approaches, telling him she rang 117, the emergency hotline, and asking if he has come to pick up her sick relative.

A brother of the dead woman flies suddenly into a rage, shouting that he also rang 117, and the ambulance refused to take his sister because her name didn't match the information the paramedics had.

"They have no mercy. This lady suffered terribly and nobody could help her. We just watched her suffering and now she is dead," he wails.

The 10 Red Cross burial teams -- each with 10 members -- are the only workers picking up bodies in Freetown. All day, every day, they race around the capital collecting the dead.

Nearly 70 bodies will be buried by the charity in the late afternoon at King Tom Cemetery, a repurposed military graveyard.

In the absence of clear information to the contrary, all will be treated as Ebola victims.

Rage having given way to grief, the brother, now dressed in a suit, plants a shrub on the grave of his sister and takes a picture of the plot number so that, at least, he will know how to find her.


http://news.yahoo.com/ebola-hit-sleone-dignity-death-protects-living-044845658.html