Ebola news 3/14

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Watch closely and explain frequently: Liberia's Ebola lessons
Reuters
By James Harding Giahyue and Emma Farge  23 hours ago



MONROVIA/DAKAR (Reuters) - Seven months after Ebola paralysed Liberia's capital, Friday marked 21 days since the country registered a case of the virus - offering lessons to its neighbors on the importance of surveillance and education in beating the deadly epidemic.

At the peak of Liberia's outbreak, the world watched in alarm as patients died on the pavement outside hospitals in the capital Monrovia while the government failed to build treatment centers and recruit staff fast enough.

With hundreds of new Ebola cases each week, overstretched officials worked hard to respond to the unprecedented epidemic.

By January the country was just days away from declaring its ocean-front capital free from the virus.

Then officials discovered an itinerant charcoal trader had brought it back to the sprawling suburbs.

A series of mistakes in the immediate aftermath of her arrival in St. Paul's Bridge, mostly by frightened patients, led to more than 100 contacts dispersed across three counties. Health officials intervened quickly to address them, preventing another major flare-up of the epidemic.

It required "a combination of detective work and an almost military element," said Dr. Philippe Maughan, senior operations administrator at the humanitarian branch of the European Commission. "Getting from 100 to ten cases is much easier than getting from ten to zero."

Liberia has accounted for more than 4,000 of the 10,000 dead from Ebola across West Africa. It will not officially be declared Ebola-free by the World Health Organization (WHO) until it goes 42 days without a case.

But the 21-day period is important because it spans the incubation period of the virus. And last week the country released its last known patient, a resident of Monrovia's riverside St. Paul's Bridge community where the virus once spread quickly among narrow streets.

A massive influx of international aid, including crucial U.S. military assistance, helped Liberia to turn the tide of the outbreak.

But, notes Tariq Riebl, Oxfam's Ebola response manager in Liberia, "What got us to the endgame is that communities took things into their own hands."


FIRST RUNNING, NOW REPORTING

Liberian health reports reviewed by Reuters show the behavior of some residents of St. Paul's Bridge was partly behind the explosion in contacts.

Among the most notorious incidents was a policewoman, referred to only as "VZ" in official reports, who helped her son skip quarantine. In another incident, an Ebola-positive man evaded officials and remained at large until he was stabbed in a robbery in Monrovia's Red Light District, leaving a trail of police officers and gangsters at risk of contamination.

"They did not trust anyone and did not believe they were carriers of Ebola," said Reverend John Sumo, head of social mobilization in the Ebola response, adding the problem was exacerbated by a leadership struggle in the local community that distracted officials from providing support to families and food to those quarantined, the reports showed.

When alarming reports began to circulate, government and international health officials quickly provided faster and closer surveillance, as well as prioritizing the education of locals about the disease.

They worked with police officials, village chiefs, elders and international aid workers to get people talking to each other, and also appointed a local "contact tracer" - responsible for tracking down people close to the latest cases - for blocks of the St Paul's Bridge community.

Thanks to this success, Liberia's last eight cases all came from established contacts, the aid officials said.

Oxfam's Riebl noted that in recent months the rising number of Ebola patients referring themselves as authorities had more success in engaging communities.

By contrast, although the epidemic is waning in neighboring Sierra Leone and Guinea, contact tracing there remains weak. Last week, only 14 percent of new cases in Guinea came from established contacts and resistance to healthcare workers is commonplace.

However, even if Liberia is declared Ebola-free, imported cases are possible from the region's poorly-policed borders where communities that have not so far been exposed to the disease still have misconceptions about it.

The World Health Organization also warns that only 40 percent of non-Ebola health facilities in the capital have an effective system of "triage" – the process by which highly-contagious Ebola patients are safely identified.

"It is important to invest in preparedness for a possible reappearance," said Dr. Matshidiso Moeti, WHO's regional director for Africa.

(Writing by Emma Farge; Editing by Sophie Walker)


http://news.yahoo.com/watch-closely-explain-frequently-liberias-ebola-lessons-184507811.html

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Nancy Snyderman Exiting NBC News
The Hollywood Reporter  March‎ ‎12‎, ‎2015






Nancy Snyderman is exiting NBC News as Chief Medical Editor.

She came under fire after violating quarantine guidelines after traveling to Liberia to cover the Ebola outbreak in 2014.

“I stepped out of the OR a few years ago and it is now time for me to return to my roots, so I am stepping down from my position as Chief Medical Editor at NBC News,” Snyderman said in a statement. “Covering the Ebola epidemic last fall in Liberia, and then becoming part of the story upon my return to the U.S., contributed to my decision that now is the time to return to academic medicine. I will be shortly taking up a faculty position at a major U.S. medical school.”

NBC News thanked her for her service.

“Throughout her career with NBC News, Dr. Nancy Snyderman has provided her expertise on countless health and medical topics that are vitally important to our audience. She’s been a valuable voice both on air and in our newsroom, and we wish her all the best,” NBC News said in a statement.

In October, Snyderman returned home from Liberia, during a trip which saw Ashoka Mukpo, a 33-year-old NBC News freelance cameraman, diagnosed with the Ebola virus. Snyderman and three other crewmembers remained symptomless, but were placed under quarantine by the New Jersey Department of Health on Oct. 11, after the department said Snyderman and the crew violated an agreement to quarantine themselves for 21 days after returning to the United States.

Snyderman apologized during an appearance on Today in December. She said she had been confident she was not contagious when she broke quarantine 72 hours after returning to the U.S.

"When I came back from Liberia with my team, we’d already been taking our temperatures four, five, six times a day, and we knew our risks in our heads, but didn’t really appreciate, and frankly we were not sensitive to how absolutely frightened Americans were," she said on Today.


https://www.yahoo.com/tv/nancy-snyderman-exiting-nbc-news-113458893215.html

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Measles Threat Looms After Ebola Outbreak
LiveScience.com
By Rachael Rettner  March 13, 2015 11:05 AM



The Ebola outbreak in West Africa is disrupting the region's health care system, and one consequence is a dramatic drop in measles vaccinations, leaving millions of children potentially at risk for catching the disease, a new study suggests.

If efforts are not made to increase vaccinations there, a measles outbreak in the region could claim as many lives as the Ebola outbreak, or perhaps even more, the researchers said.

The Ebola epidemic has not only sickened tens of thousands of people and killed thousands, but it also has "caused severe disruption to health care services in the affected countries, including childhood vaccination programs, thus creating a second public health risk," study author Andy Tatem, a geographer at the University of Southampton in the United Kingdom, said in a statement.

Measles is one of the most transmittable infectious diseases, and outbreaks of the disease often follow humanitarian crises, such as war and natural disasters, the researchers said.

The researchers estimated that the Ebola outbreak has led to a 75-percent drop in childhood vaccination rates in Guinea, Liberia and Sierra Leone. The researchers projected that this summer, when it will have been 18 months since the Ebola outbreak began, more than 1 million children under age 5 in the three countries will be unvaccinated, compared with about 770,000 unvaccinated children before the Ebola outbreak.

The researchers estimate that, if a measles outbreak were to occur in the region, it would cause more than 227,000 measles cases, and 5,000 deaths. In a worst-case scenario, a measles outbreak could cause as many as 16,000 deaths, which is more than the current number of Ebola deaths, they added. (Today, the World Health Organization said that the number of Ebola deaths have passed 10,000, according to the Associated Press.)

"It is crucial to have an aggressive regional vaccination program ready to run, as soon as the threat of Ebola begins to recede, to help counter the steep downturn in immunization rates," Tatem said.

A coordinated campaign across the three countries to provide children with measles vaccines and other childhood vaccinations "could thwart a second public health disaster," the researchers said.

"While the downstream effects of Ebola are many, we can actually do something about measles relatively cheaply and easily, saving many lives by restarting derailed vaccination campaigns," Justin Lessler, an assistant professor at the Johns Hopkins Bloomberg School of Public Health and one of the researchers on the new study, said in a statement.

It's important to note that the study results are estimates — only limited data are available on the actual rates of vaccination in Guinea, Liberia and Sierra Leone because of the rapidly changing Ebola situation, the researchers said. But the researches' estimation that there has been a 75-percent drop in vaccination rates is consistent with surveys of health care providers in the region, they said.

The study will be published in the March 13 issue of the journal Science.


http://news.yahoo.com/measles-threat-looms-ebola-outbreak-150538343.html

[Buster's Uncle]

US Ebola Patient to Be Admitted to Maryland Hospital
LiveScience.com
By Karen Rowan  March 12, 2015 6:08 PM



 A U.S. health care worker who was volunteering in Africa has tested positive for Ebola, and is returning to the United States for treatment, health officials say.

The patient will be admitted to the National Institutes of Health Clinical Center in Bethesda, Maryland — a high-level containment facility — tomorrow (March 13), the NIH said in a statement today. The patient was working in Sierra Leone and will be flown to the United States in isolation on a chartered aircraft.

This will be the second patient with Ebola admitted to the NIH Clinical Center. Nurse Nina Pham, who became infected with Ebola while treating a patient at the Texas hospital where she worked, was treated at the NIH center last October, and recovered from the disease.

The ongoing Ebola outbreak in West Africa has now sickened nearly 25,000 people in Guinea, Liberia and Sierra Leone, according to the Centers for Disease Control and Prevention. And the number of deaths from the disease has now reached 10,000, according to a report that the CDC posted earlier today (March 12). [Where Did Ebola Come From?]

Ebola can be spread only through contact with a sick person or their bodily fluids. Health care workers are at higher risk of contracting the virus because they are on the front lines of treatment. As they care for patients, these health care workers may perform procedures that bring a higher risk of contact with bodily fluids, such as inserting a tube to help a patient breathe intubation. They also typically care for patients whohave reached the stage of the infection with the most symptoms, including vomiting, diarrhea and bleeding.

The NIH hospital also admitted two people who were exposed to the Ebola virus while working in West Africa, but those people were later found to not be infected. The staff at the hospital is highly trained in how to prevent the spread of infections in a health care setting, and access to the unit is strictly controlled, the NIH said.


http://news.yahoo.com/us-ebola-patient-admitted-maryland-hospital-220815506.html

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At least 10 Americans being flown to U.S. after possible Ebola exposure
Reuters  10 minutes ago



(Reuters) - At least 10 Americans possibly exposed to the deadly Ebola virus were being flown to the United States from Sierra Leone for observation, the U.S. Centers for Disease Control and Prevention said on Saturday.

They will be transported by non-commercial air transport and will be housed near the University of Nebraska Medical Center in Omaha, the National Institutes of Health in Maryland, or Emory University Hospital in Atlanta, the CDC said.

All of the individuals who are being flown back to the United States are free of symptoms, the CDC said.

A U.S. healthcare worker who tested positive for Ebola while in Sierra Leone arrived at the NIH on Friday and was in serious condition, the NIH said.

It is not clear how the person became infected with Ebola, CDC said.

While the virus has killed about 10,000 people in Sierra Leone, Liberia and Guinea, only a handful of cases have been seen in the United States, Spain and Britain.

CDC spokesman Thomas Skinner said 10 people who may have been exposed to the unidentified Ebola patient or who had a similar exposure to the virus as the patient were being flown to the United States. But he said the investigation was continuing and there may be more Americans evacuated from Africa.

A CDC statement said the 10 individuals will follow the center's recommended monitoring and movement guidelines during the 21-day incubation period.

If someone shows symptoms, they will be transported to an Ebola treatment center for evaluation and care, the CDC said.

On Friday, CDC sent a team to Sierra Leone to investigate how the healthcare worker became exposed, and determine who might have been in contact with the infected person.

CDC spokesman Benjamin Haynes did not know where all of the patients would be sent, but he said the CDC is working out a plan with the U.S. State Department to determine who is coming back and where they will be sent.

The CDC said one patient was being sent to Emory University Hospital's special isolation unit, where several Ebola patients have already been treated.

Four others are being sent to Nebraska Medical Center to be near their special isolation unit in case they develop Ebola symptoms.

(Reporting by Eric Beech in Washington and Julie Steenhuysen in Chicago; Editing by Marguerita Choy and Paul Simao)


http://news.yahoo.com/least-10-people-flown-u-possible-ebola-exposure-195234152.html

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U.S. healthcare worker with Ebola in 'serious' condition, NIH says
Reuters
By Susan Heavey  March 13, 2015 3:49 PM



In this photo taken on Monday, March 2, 2015, a health care worker prepares a colleague's virus protective gear before entering a high risk zone at an Ebola virus clinic operated by the International Medical Corps in Makeni, Sierra Leone. According to the head of the national Ebola response Centre, complacent behavior in Sierra Leone has led to a worrying spike in confirmed Ebola cases over the past week in four districts, Alfred Palo Conteh said Thursday, March 12, 2015. (AP Photo/ Michael Duff)



WASHINGTON (Reuters) - A U.S. healthcare worker who tested positive for Ebola while in Sierra Leone was in serious condition at a Maryland hospital, and a second American who may have been exposed to that patient was being flown back to the United States, U.S. health officials said on Friday.

The National Institutes of Health said the U.S. Ebola patient was flown into the United States earlier on Friday and admitted to the NIH's high-security containment facility in Maryland. The patient is the 11th person with the deadly virus treated in the United States.

The NIH said the patient was in serious condition. The NIH did not release any more details.

The aid group Partners In Health said in a statement that the clinician was working for them in Sierra Leone, and noted their colleague "remains in good spirits."

The U.S. Centers for Disease Control and Prevention said another American volunteering in Sierra Leone had "potential exposure" to that patient and was being transported to the Atlanta area to be near Emory University Hospital, which has treated other Ebola patients.

The developments followed a relatively quiet period for Ebola in the United States, a reminder that while the spread of the virus has eased somewhat in West Africa, it still remains dangerous.

The CDC said that as a result of the latest case it is working to trace the contacts of volunteers combating Ebola in Sierra Leone, including several other Americans, who may have been exposed to the healthcare worker now at the NIH.

The CDC said none of these other people, including the one headed to Atlanta, has tested positive.

However, the CDC said it was working with the State Department to develop plans to return those Americans with potential exposure to the United State, where they will isolate themselves and be under direct CDC monitoring 21 days.

A British healthcare worker who tested positive for Ebola while in Sierra Leone was flown back this week to Britain, along with four others who are being monitored for possible infection.

CDC spokesman Benjamin Haynes said the agency's team in Sierra Leone is still gathering information but said there is no evidence so far that the U.S. and British cases are related.

While the virus has killed about 10,000 people in Sierra Leone, Liberia and Guinea, only a handful of cases have been seen in the United States, Spain and Britain.

(Additional reporting by Julie Steenhuysen, Will Dunham and Emily Stephenson; Editing by Doina Chiacu, Bernadette Baum and Jonathan Oatis)


http://news.yahoo.com/u-healthcare-worker-ebola-arrives-u-nbc-112200277.html

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America Has Another Ebola Patient
The Atlantic
By Adam Chandler  March 13, 2015 12:42 PM






On Thursday, health officials confirmed that an American volunteer in Sierra Leone had contracted Ebola and would be flown to a National Institutes of Health facility in Maryland for treatment. The unidentified patient is the first American to be diagnosed with the virus since October, when a New York doctor's case was confirmed.


The Context

Despite a precipitous drop in cases—the latest Ebola report by the World Health Organization counted fewer than 60 new confirmed cases in Sierra Leone and Guinea in March and none in Liberia—the death toll in the largest-ever outbreak also passed a grim benchmark on Thursday with 10,000 recorded deaths in West Africa.

"This thing isn’t over yet," former Ebola Czar Ron Klain told Vox last week. "Even though we got cases down in Liberia, Ebola could come back so building the Ebola treatment units for future outbreaks of Ebola ostensibly is a very useful thing."

The United Nations maintains hope that with sustained funding and efforts, the outbreak will be over by the summer.


Possible Implications

According to some researchers, the campaign to battle Ebola in West Africa has diverted resources and focus from child immunization programs that could lead to a surge in measles cases. "For every extra month that health-care systems are disrupted," Reuters reported, "international researchers said up to 20,000 children aged between nine months and five years were put at risk."

Measles, as we learned earlier this year, is much more easily transmitted than Ebola.


http://news.yahoo.com/america-another-ebola-patient-164207839--politics.html

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Americans returning from Africa for Ebola monitoring
Associated Press  2 hours ago



ATLANTA (AP) — Public health officials said Saturday that a number of Americans will return from west Africa to be monitored after possibly being exposed to Ebola.

The Centers for Disease Control and Prevention said several Americans who may have been exposed to Ebola in Sierra Leone would be monitored. The CDC did not specify how many Americans are coming back, but University of Nebraska Medical Center officials say's they'll be monitoring four Americans.

"In the unlikely instance that one of them does develop symptoms, we would take them to the Biocontainment Unit immediately for evaluation and treatment," Biocontainment Unit Director Phil Smith said in a statement. "Because we have individuals to monitor simultaneously, the safest and most efficient way to do that is in a group setting." Smith said the patients would be quarantined and kept away from other patients, students and staff.

Earlier this week, an American health care worker who contracted Ebola while volunteering in Sierra Leone was brought to the National Institutes of Health in Bethesda, Maryland, for treatment. The patient is a clinician working with Partners in Health, a Boston-based nonprofit organization, according to a statement on the group's website.

The CDC on Friday said another American would be brought to Atlanta for monitoring. On Saturday, officials said several Americans would be monitored near Emory University Hospital in Atlanta, the University of Nebraska Medical Center in Omaha, and the National Institutes of Health in Bethesda.

Americans returning from Africa may have come into contact with the patient who was brought to Maryland, "or exposures similar to those that resulted in the infection of the index patient," the CDC said in a statement.

Earlier this week the World Health Organization estimated that Ebola has killed more than 10,000 people, mostly in the West African nations of Guinea, Liberia and Sierra Leone. The current outbreak is the largest ever for the disease. Deaths have slowed dramatically in recent months but the virus appears stubbornly entrenched in parts of Guinea and Sierra Leone.


http://news.yahoo.com/americans-returning-africa-ebola-monitoring-220554985.html

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U.S. healthcare worker with Ebola in 'serious' condition, NIH says
Reuters
By Susan Heavey  16 hours ago



The patient's entrance at the National Institutes of Health is shown in Bethesda, Maryland, in this file photo taken October 16, 2014. REUTERS/Gary Cameron/Files



WASHINGTON (Reuters) - A U.S. healthcare worker who tested positive for Ebola while in Sierra Leone was in serious condition at a Maryland hospital, and a second American who may have been exposed to that patient was being flown back to the United States, U.S. health officials said on Friday.

The National Institutes of Health said the U.S. Ebola patient was flown into the United States earlier on Friday and admitted to the NIH's high-security containment facility in Maryland. The patient is the 11th person with the deadly virus treated in the United States.

The NIH said the patient was in serious condition. The NIH did not release any more details.

The aid group Partners In Health said in a statement that the clinician was working for them in Sierra Leone, and noted their colleague "remains in good spirits."

The U.S. Centers for Disease Control and Prevention said another American volunteering in Sierra Leone had "potential exposure" to that patient and was being transported to the Atlanta area to be near Emory University Hospital, which has treated other Ebola patients.

The developments followed a relatively quiet period for Ebola in the United States, a reminder that while the spread of the virus has eased somewhat in West Africa, it still remains dangerous.

The CDC said that as a result of the latest case it is working to trace the contacts of volunteers combating Ebola in Sierra Leone, including several other Americans, who may have been exposed to the healthcare worker now at the NIH.

The CDC said none of these other people, including the one headed to Atlanta, has tested positive.

However, the CDC said it was working with the State Department to develop plans to return those Americans with potential exposure to the United State, where they will isolate themselves and be under direct CDC monitoring 21 days.

A British healthcare worker who tested positive for Ebola while in Sierra Leone was flown back this week to Britain, along with four others who are being monitored for possible infection.

CDC spokesman Benjamin Haynes said the agency's team in Sierra Leone is still gathering information but said there is no evidence so far that the U.S. and British cases are related.

While the virus has killed about 10,000 people in Sierra Leone, Liberia and Guinea, only a handful of cases have been seen in the United States, Spain and Britain.


http://news.yahoo.com/u-healthcare-worker-ebola-serious-condition-nih-says-080303592.html

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More Americans may have been exposed to Ebola in Sierra Leone
AFP  March 13, 2015 3:03 PM



Health workers put on protective equipment at an Ebola treatment centre on November 15, 2014 in Kenema, Sierra Leone (AFP Photo/Francisco Leong)



Washington (AFP) - Several American healthcare workers who may have come in contact with a US volunteer who tested positive for Ebola in Sierra Leone are being monitored for signs of illness, officials said Friday.

The patient, whose identity has not been revealed, was in serious condition after arriving by private charter plane at the National Institutes of Health Clinical Center near the US capital early Friday.

No others have tested positive so far, but at least one other American is being flown from Sierra Leone to Atlanta, Georgia as a precautionary measure, the Centers for Disease Control and Prevention said.

Out of an abundance of caution, authorities are tracking down people who came in contact with the patient in Sierra Leone, "including several other American citizens, who may have had potential exposure to this index patient," the CDC said in a statement.

"At this time, none of these individuals have tested positive for Ebola. These individuals are volunteers in the Ebola response and are currently being monitored in Sierra Leone."

The CDC and the US State Department "are developing contingency plans for returning those Americans with potential exposure to the US by non-commercial air transport," it added.

Upon return, they will "voluntarily self-isolate and be under direct active monitoring for the 21-day incubation period."

Already, one of the Americans with possible exposure is "currently being transported via charter to the Atlanta area to be close to Emory University Hospital," which has treated US patients with Ebola in the past.

"The individual has not shown symptoms of Ebola and has not been diagnosed with Ebola. Upon arrival in Atlanta, the individual will voluntarily self-isolate and be under direct active monitoring for the 21-day incubation period," the CDC said.

Ebola is spread through close contact with the bodily fluids of an infected person. The virus can cause lethal bleeding, muscle aches, severe vomiting and diarrhea.

The illness usually takes hold two to 10 days after exposure, but the full inoculation period is considered to last 21 days.

The index patient -- whose identity has not been revealed -- is at the NIH Clinical Center in Bethesda, Maryland, which has a high-level isolation unit and a staff of infectious disease specialists.

The same facility treated US nurse Nina Pham, who was infected while caring for a Liberian man at a Texas hospital.

The man, Thomas Eric Duncan, died. Pham and another nurse who was also infected have since recovered.

On Thursday, the World Health Organization announced that the death toll from the world's largest Ebola outbreak had topped 10,000.

Most of the deaths in the outbreak, which began in late 2013, have been in the West African nations of Sierra Leone, Guinea and Liberia.


http://news.yahoo.com/american-ebola-patient-admitted-us-hospital-001540534.html

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NIH center to admit U.S. healthcare worker with Ebola
Reuters  March 13, 2015 2:55 AM



The patient's entrance at the National Institutes of Health is shown in Bethesda, Maryland, in this file photo taken October 16, 2014. REUTERS/Gary Cameron/Files



(Reuters) - The U.S. National Institutes of Health will admit to its hospital on Friday a U.S. healthcare worker who tested positive for the Ebola virus while working in Sierra Leone.

The NIH said the patient will be transported in isolation by chartered aircraft to its high-security containment facility on its Maryland campus.

Earlier on Thursday, a British military healthcare worker infected with the Ebola virus in Sierra Leone was flown to London for treatment, and health officials said four more workers were being assessed for possible infection.

The unidentified American will be admitted and treated at the NIH Clinical Center's Special Clinical Studies Unit. The patient will be the second confirmed Ebola patient to be treated at the facility, which also took care of Texas nurse Nina Pham, who became infected with Ebola while treating a patient at Texas Health Presbyterian Hospital in Dallas.

In addition to the two confirmed patients, NIH has also cared for two individuals who experienced high-risk exposures to Ebola while working in West Africa, but who were subsequently found not to be infected.

The NIH said it is not releasing any more details about the patient at this time.

Ebola has now killed nearly 10,000 people in the three worst-affected countries, Sierra Leone, Liberia and Guinea.

Rates of new infections have come down quickly in recent months, however. Liberia last week released its last known Ebola patient from hospital, but Sierra Leone still had 127 patients in Ebola treatment centers as of March 10.


http://news.yahoo.com/nih-center-admit-u-healthcare-worker-ebola-065559610.html