Ebola News 12/2

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Liberia, Guinea On Track to Contain Ebola
LiveScience.com
By Sara Goudarzi  1 hour ago



The West African nations of Liberia and Guinea have achieved a goal of isolating at least 70 percent of people infected with Ebola, and safely burying at least 70 percent of the people who have died of the disease, according to the World Health Organization.

If the efforts to contain the spread of Ebola in these countries continue at the same level, both could stomp out this current outbreak within the next few months, said Gerardo Chowell-Puente, a mathematical epidemiologist at Arizona State University in Phoenix, who has studied the outbreak's dynamics.

But this doesn't mean people all over the world should relax their efforts.

"This is exactly the time when the effort needs to continue, and maybe even push harder, to be able to track the last chain of transmission in Liberia and get rid of Ebola," Chowell-Puente told Live Science.


Transmission rate

Early models predicted that as many as 1.4 million people in West Africa could contract Ebola if efforts to contain the virus weren't ramped up. But those models were "pretty rough approximations of what's really going on in the field," said Chowell-Puente, who in October published a review in the journal BMC Medicine on Ebola disease transmission.

The Ebola outbreak in West Africa has now sickened nearly 16,000 people and killed at least 5,674 in Guinea, Liberia and Sierra Leone, according to the Centers for Disease Control and Prevention.

The United Nations set the targets of getting 70 percent of sick people isolated and 70 percent of the dead buried based on mathematical models of what researchers call the "basic reproduction number," or R0, for Ebola, which is a measure of how many people will be infected with Ebola from each case of the disease. If the R0 for a disease is greater than 1, the number of cases will grow; an R0 of less than 1 means the disease will eventually be extinguished, Chowell-Puente said. In the case of Ebola, researchers predicted that meeting these 70 percent goals would bring the R0 below 1.

Several factors affect whether the R0 is greater or less than 1. One is the transmissibility of the virus, meaning how likely it is that a person who has close contact with an Ebola patient will also become sick. Another factor is how many people actually come into contact with a sick patient.


Quick changes

These numbers are fluid and have changed as the epidemic has progressed. Ebola is spread only through contact with infected bodily fluids, and most victims are caregivers who are in close contact with the sick. People are less infectious when they first show symptoms of illness and the amount of virus circulating in their body is low; they grow more infectious as their symptoms worsen. (The corpses of Ebola victims are incredibly infectious because they are teeming with billions of virus particles.)

By increasing the number of beds and ambulances available to transport the sick, Liberia and Guinea increased the fraction of Ebola patients that are put in isolation quickly, meaning fewer people are in contact with highly infectious patients.

In addition, after people in the affected areas learned how Ebola spreads, they dramatically changed their practices by both avoiding the sick and altering their burial customs to avoid contact with infectious corpses. These changes quickly lowered the number of people who had contact with each Ebola patient, Chowell-Puente said.

Improved access to protective gear, such as gowns and gloves, also helps reduce transmission in health care settings, Chowell-Puente said.

And now that the number of new cases has dropped so dramatically, health care workers can further drive down transmission by resuming contract tracing, or tracking all the people who have had contact with an Ebola victim and monitoring them twice daily for symptoms, Chowell-Puente said. In all past outbreaks, when this approach has been used, it has eradicated the disease.


Eradication

If the current downward trend continues, Liberia and Guinea are on track to see their last case as early as a month from now. After that time, the countries would need to pass 42 days (or twice Ebola's maximum incubation period) without any new cases of the disease to be declared "Ebola free," Chowell-Puente said.

The disease is still raging in Sierra Leone, where more efforts are needed, he added. But an increase in available beds and treatment centers in Sierra Leone could help that country reach the safe burial and isolation target in a few weeks.

Still, until all the countries in the region have eradicated the disease, a new flare-up is always a possibility.

"You can have new reintroductions from Guinea or Sierra Leone and start new chains of transmission," Chowell-Puente said.


http://news.yahoo.com/liberia-guinea-track-contain-ebola-152507448.html

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Ebola batters Liberia, Guinea, Sierra Leone economies: World Bank
Reuters  10 hours ago



A member of a burial team sprays a colleague with chlorine disinfectant in Monrovia October 20, 2014. REUTERS/James Giahyue



WASHINGTON (Reuters) - The Ebola outbreak in West Africa is taking a heavy toll on the economies of Liberia, Sierra Leone and Guinea, all of which face negative or slower growth next year because of the virus, the World Bank said on Tuesday.

The bank said growth estimates for the three countries hardest hit by Ebola had tumbled since its previous analysis in October, and that projections showed the outbreak costing them more than $2 billion in lost income over the 2014-2015 period.

For this year, gross domestic product growth estimates in Liberia were projected to fall to 2.2 percent, compared with forecasts of 2.5 percent in October and 5.9 percent pre-crisis. In Sierra Leone, 2014 growth was now forecast at 4 percent, down from previous estimates of 8 percent in October and 11.3 percent pre-crisis, the World Bank said.

It lowered its 2014 growth forecast for Guinea to 0.5 percent, compared with 2.4 percent in October and 4.5 percent pre-crisis. It said all three countries had been growing rapidly in recent years and through the first half of 2014.

The bank added that, for 2015, it was projecting negative growth of minus 2.0 percent in Sierra Leone, down from a 7.7 percent growth forecast in October and 8.9 percent before the crisis. It also forecast negative 2015 growth for Guinea of minus 0.2 percent versus October's estimate of 2 percent growth and a pre-outbreak forecast of 4.3 percent.

"In Liberia, where there are signs of progress in containing the epidemic and some increasing economic activity, the updated 2015 growth estimate is 3.0 percent, an increase from 1.0 percent in October, but still less than half the pre-crisis estimate of 6.8 percent," the bank said.

The report comes as the World Bank Group's president, Jim Yong Kim, begins a two-day visit to West Africa to discuss ways of addressing the outbreak.

“This report reinforces why zero Ebola cases must be our goal," Kim said in a statement. "While there are signs of progress, as long as the epidemic continues, the human and economic impact will only grow more devastating."

The World Health Organization said on Monday that some 5,987 people had died of Ebola in Liberia, Sierra Leone and Guinea.


http://news.yahoo.com/ebola-batters-liberia-guinea-sierra-leone-economies-world-060605547--business.html

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Sierra Leone lags in Ebola fight, but prognosis is "very good"
Reuters
By Umaru Fofana and Tom Miles  11 hours ago



FREETOWN/GENEVA (Reuters) - Sierra Leone does not yet have enough beds in treatment centres to isolate Ebola patients, but overall, the tide of the disease is being turned, the United Nations and World Health Organization said on Monday.

"The global response to the Ebola crisis has succeeded in turning this crisis around," Anthony Banbury, head of the U.N. Ebola Emergency Response Mission, told reporters in Freetown. "But clearly there are places that are still in serious crisis."

WHO Assistant Director-General Bruce Aylward said too few Ebola beds were available in western Sierra Leone, adding that the geographical spread of Ebola in Guinea, where many beds were concentrated in just a few big centres, was "a real concern".

But the prognosis for Sierra Leone, which will open many new facilities in the next few weeks, was "very good", he said.

Two months ago, the United Nations set a target of having 70 percent of Ebola victims buried safely and 70 percent of Ebola patients treated in isolation beds within 60 days. Those two goals are seen as the key to halting the spread of the epidemic.

Guinea and Liberia have met both targets, but some areas in Sierra Leone have still not done so, which Aylward said accounted for the continued spread of the disease there.

It would be a "stretch" to hit 100 percent of both targets by the end of the year, he said.

David Nabarro, who is heading the U.N. response to the Ebola epidemic, said the disease was "slowing down in some districts and increasing in others. The distribution changes from week to week. And the situation can worsen unexpectedly."

"Our fundamental goal is to try to make sure that Ebola actually disappears and does not become a reality of life for people in West Africa or anywhere else in the world," he said.

The World Health Organization said on Monday that some 5,987 people had died of Ebola in the three West African countries worst hit by the epidemic -- Liberia, Sierra Leone and Guinea.

Aylward said the nature of the response would shift as the spread of the disease slowed. With beds and safe burials in place, the next problem was to overcome mistrust and traditional beliefs to ensure that people actually used them.

Meanwhile, thousands of locals have been mobilised to try to track down everyone who has had contact with each Ebola patient.

Such efforts helped shut down outbreaks in Nigeria and Senegal but the worst-hit countries still have deeply unreliable data, with Liberia erroneously adding about 1,000 deaths to the latest figures published at the weekend.

"We're planning on a full-on six-month effort to really get this thing to zero," said Aylward. "If you can bring rigour to this contact tracing, you can drive this thing to zero. You have to hunt the virus."


http://news.yahoo.com/sierra-leone-lags-ebola-fight-prognosis-very-good-061709267.html

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Sierra Leone doctor who got Ebola is not relenting
Associated Press
By SARAH DiLORENZO  1 hour ago



In this photo taken on Monday, Dec. 1, 2014, Ebola virus survivor Doctor Komba Songu-M’briwa poses for a photo at the Hastings Ebola Treatment Centre on the outskirts of the capital city of Freetown, Sierra Leone. For eight weeks, Dr. Komba Songu-M’briwa worked at the understaffed Hastings Ebola Treatment Center outside Sierra Leone’s capital and when he began feeling sick, he thought it might be exhaustion but on Nov. 26 he got chilling news: He had tested positive for Ebola. (AP Photo/Bob Swaray)



DAKAR, Senegal (AP) — For eight weeks, Dr. Komba Songu-M'briwa worked at the understaffed Hastings Ebola Treatment Center outside Sierra Leone's capital. When he began feeling sick, he thought it might be exhaustion but on Nov. 26 he got dreadful news: He had tested positive for Ebola.

Songu-M'briwa and just two other doctors, along with 77 nurses, work at the 120-bed treatment center. It was the "most difficult, most pitiful" work of his life, the 32-year-old said in a telephone interview with The Associated Press from his isolation room. Even so, he vowed to return to that crucial work if he recovered.

"I do enjoy the work here and I hope and pray once I'm out of here, I'll take a bit of rest, and I'll come back and fight," Songu-M'briwa said on Sunday.

On Monday, Chief Medical Officer Dr. Brima Kargbo announced that Songu-M'briwa had tested "completely negative" for Ebola. An earlier test result had also come back negative.

Songu-M'briwa — Ksong to his friends — doesn't know when or how he became infected. Sierra Leone has lost seven doctors to the disease. The country had only about 135 doctors to begin with, serving 6 million people. Denmark, with roughly as many citizens, has nearly 19,000 doctors, according to the Africa Health, Human & Social Development Information Service.

Health care workers treating Ebola are supposed to spend only about an hour inside a treatment unit because of the dehydration and exhaustion that comes from wearing a sealed protective suit and the focus required to take care of the patients. But there are too many patients to take one-hour shifts at Hastings, Songu-M'briwa said, so he and his colleagues labored for three or four hours at a time.

"We're stretched out, three of us cannot do all the work here," he said.

He and his colleagues have enough supplies, enough protective suits, enough chlorine, enough food and enough gloves. What they need are more colleagues. Foreign doctors had come to Sierra Leone — their precise number is unclear — but many more are needed.

The staff relies on patients to help keep an eye on one another and call for help as needed, he said. Ebola is spread through contact with bodily fluids, and often whole families are brought in at the same time. When one's condition worsens, a relative is often the one who sounds the alarm, calling doctors back to the ward to attend to the patient.

Most nights, Songu-M'briwa slept at the facility but he tried to go home to see his wife and two children a couple times a week. When he initially started feeling under the weather, he thought the pace had just gotten to him and went home to rest. But his symptoms worsened and when he got a fever he was pretty sure it was Ebola. He called his treatment center to come get him.

Songu-M'briwa was given his own room at Hastings, but he received treatment similar to that of other patients: general antibiotics to keep other diseases at bay, intravenous fluids to replace fluids lost through diarrhea and vomiting and good nutrition to keep strength up.

He noted that Hastings doesn't have access to experimental drugs or techniques, but that these basic interventions help a lot of people, especially when the infection is caught early, as his was.

"I don't have regrets because I'm enjoying my job, and I think it's been a blessing to other people," he said with an easy laugh.

Sierra Leone's acute lack of doctors and the crumbling health system are partially a legacy of a decade of civil war. Growing up, Songu-M'briwa was good at math and physics and he thought he would be an engineer. But his mother wanted him to be a doctor. As many former classmates went into private practice in Sierra Leone or left the country, Songu-M'briwa joined the military where he is a captain. He was working at the 34 Military Hospital in Freetown until he volunteered for duty at Hastings.

"When Ebola broke out, I felt it was a fight for all of us to try to contain," he said.

Before contracting Ebola, he had tried rallying his colleagues at 34 Military Hospital to volunteer for Ebola duty and thought he was succeeding. Now his illness "has sent shockwaves," making that effort harder, Songu-M'briwa said.

"But I still tell them, 'don't worry,'" he said. "If I have become infected, I'm going through it ... we can all go through it.

"It's not going to stop me. I am not going to relent."

___

Associated Press writer Clarence Roy-Macaulay in Freetown, Sierra Leone contributed to this report.


http://news.yahoo.com/sierra-leone-doctor-got-ebola-not-relenting-155526368.html

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U.S. designates 35 hospitals as Ebola treatment centers
Reuters  1 hour ago



A general view of Emory University Hospital in Atlanta, Georgia August 1, 2014. REUTERS/Tami Chappell



(Reuters) - U.S. health officials have designated 35 hospitals nationwide as Ebola treatment centers and expects to name more in coming weeks deemed capable of treating patients while minimizing risk to staff, the U.S. Centers for Disease Control and Prevention said on Tuesday.

The list includes those that have already treated patients with the virus, such as Emory University Hospital in Atlanta, and other prominent hospitals, including Johns Hopkins in Baltimore, Mayo Clinic Hospital in Minnesota, Children's Hospital of Philadelphia and New York-Presbyterian.

More than 80 percent of returning travelers from Ebola-stricken countries in West Africa live within 200 miles (320 km) of a designated Ebola treatment center, the CDC said.

"As long as Ebola is spreading in West Africa, we must prepare for the possibility of additional cases in the United States," CDC Director Tom Frieden said in a statement.

More than 6,000 people have died out of more than 17,000 Ebola cases in the three hardest hit countries of Liberia, Sierra Leone and Guinea, according to the World Health Organization.

Each U.S. hospital with an Ebola treatment center has been assessed onsite by a CDC Rapid Ebola Preparedness team, the agency said. CDC said it has conducted assessments of more than 50 hospitals in 15 states and Washington.

CDC has taken a far more active role in assessing Ebola treatment preparation after two nurses at a Dallas hospital contracted the virus while treating Liberian Thomas Eric Duncan, who later died from the disease. Both nurses recovered.

There are currently no known patients being treated for Ebola in the United States.

(Reporting by Michele Gershberg and Bill Berkrot; Editing by Jonathan Oatis)


http://news.yahoo.com/u-designates-35-hospitals-ebola-treatment-centers-171920063.html

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Ebola response too slow: Doctors Without Borders
Associated Press
By JONATHAN PAYE-LAYLEH and SARAH DiLORENZO  1 hour ago



MONROVIA, Liberia (AP) — The international response to Ebola is still too slow and piecemeal, Doctors Without Borders warned Tuesday, as officials said the disease is crippling the economies of the three West African countries hardest hit.

The number of people infected with Ebola has passed, 17,000, according to data published Tuesday by the World Health Organization. Of those, more than 6,000 have died. Emphasizing the severity of the outbreak, Sierra Leone announced that another doctor, its 10th, has tested positive for Ebola.

The vast majority of Ebola infections are in Guinea, Liberia and Sierra Leone, poor countries that have been left to handle the crisis without sufficient help, said Doctors Without Borders. It said foreign donors had concentrated on building clinics but did not provide medics to staff the centers. The group repeated its call for countries to deploy biological-disaster response teams.

In response to the crisis, the World Bank lowered again on Tuesday growth projections for the hardest-hit countries.

Guinea's economy will grow just 0.5 percent this year, down from an expected 4.5 percent before the crisis, the bank said. Sierra Leone is expected to register 4 percent economic growth, down from a pre-crisis expectation of 11.3 percent, while Liberia will see 2.2 percent growth, down from 5.9 percent.

"We don't need to wait till we get to zero (cases) to start working on the economic recovery," World Bank President Jim Yong Kim said during a visit to Liberia Tuesday. The bank will support the farm sector to offset a drop in production.

Kim also plans to visit Sierra Leone and Guinea. The World Bank has pledged nearly $1 billion for the three countries.

In Sierra Leone Dr. Thomas Rogers has tested positive for the disease, said health ministry spokesman Jonathan Abass Kamara. Rogers was working at Connaught Hospital in Freetown.

He is being cared for at a special clinic in the Kerry Town treatment center for infected health care workers that is staffed by British army medics.

___

DiLorenzo reported from Dakar, Senegal. Associated Press writer Clarence Roy-Macaulay contributed from Freetown, Sierra Leone.


http://news.yahoo.com/revises-down-liberia-ebola-death-toll-3-145-102222517.html