Saturday, 18 October 2014

WHO calls for international response to Ebola outbreak

World steps up Ebola action as infections soar

Europe said on Thursday (Oct 16) it will review how passengers leaving Ebola-hit African countries are screened for infection, as it seeks to contain the escalating spread of a virus recognised as the worst global health emergency in years.

The World Health Organisation also said it was ramping up its efforts to help 15 African countries defend themselves against the virus.

The European Commission "will immediately undertake an audit of exit screening systems in place in the affected countries ... to check their effectiveness and reinforce them as necessary," the bloc's health commissioner, Tonio Borg, said.


The World Health Organisation said on Tuesday (Oct 14) the Ebola infection rate could soon reach 10,000 a week as world leaders prepared to hold talks on the crisis at the United Nations.

WHO assistant director general Bruce Aylward, describing his figures as a working forecast, said the epidemic "could reach 5,000 to 10,000 cases per week by the first week of December".

The latest death toll is 4,447, from 8,914 recorded cases of infection, Aylward said as the epidemic spirals in the three hardest-hit west African countries of Liberia, Sierra Leone and Guinea. While the figures suggest a survival rate of 50 percent, they mask the true picture, Aylward said, adding: "What we're finding is 70 percent mortality" in all three countries


US, UN leaders urge 'more robust' fight against Ebola

The US and UN leaders on Monday (Oct 13) called for "more robust" international efforts to tackle Ebola, after medics in Liberia demanded danger money to treat patients in what officials termed the worst health crisis of modern times.

The call from US President Barack Obama and UN Secretary General Ban Ki-moon came as doctors and nurses in Liberia, one of the worst-hit countries, went on strike to demand higher pay to care for Ebola patients there.

Health care workers in west Africa are on the frontline of the Ebola outbreak - branded by the World Health Organization as "the most severe acute public health emergency in modern times". The epidemic has killed more than 4,000 people this year, mostly in Guinea, Sierra Leone and Liberia.


MOH steps up screening measures to guard against Ebola

From noon on Wednesday (Oct 15), the Ministry of Health will be introducing additional screening measures to guard against the deadly Ebola virus.

The move is a response to the spread of Ebola cases to Spain and the United States, following an outbreak of the epidemic in West Africa. These latest cases "show that an imported case and the potential for community exposure from imported cases cannot be ruled out”, stated a MOH news release on Tuessday (Oct 14). 

All hospitals have also been reminded about the importance of vigilance against possible suspect cases and strict infection control practices, and public hospitals have appropriate infection control measures in place, said the Health Ministry.


Ebola toll passes 4,000 as fears grow worldwide
Cases and deaths from Ebola; countries carrying out airport checks

The death toll from Ebola has passed 4,000, the World Health Organization said Friday, while a Madrid nurse was fighting for her life and authorities worldwide tried to prevent panic over the deadly disease.

The WHO said 4,033 people have died from Ebola as of October 8 out of a total of 8,399 registered cases in seven countries. The sharp rise in deaths came as the UN said aid pledges to fight the outbreak have fallen well short of the $1 billion (800 million euros) needed. Beyond west Africa, where almost all the deaths have occurred, fears grew about the worst-ever Ebola epidemic.

From Australia to Zimbabwe, and Macedonia to Spain, people who showed signs of fever or had recent contact with Ebola victims were whisked into isolation units or ordered to stay in their homes.

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Authorities try to prevent panic as Ebola toll passes 4,000
Authorities worldwide try to prevent panic as the death toll from Ebola passes 4,000 and a Madrid nurse fights for her life Saturday

The WHO said 4,033 people have died from Ebola as of October 8 out of a total of 8,399 registered cases in seven countries. The sharp rise in deaths came as the UN said aid pledges to fight the outbreak have fallen well short of the $1 billion (800 million euros) needed.

Spanish government officials were due to meet on Saturday morning for a gathering of their new crisis committee to tackle the crisis after a Madrid nurse became the first person to get infected with the haemorrhagic fever outside of Africa.

They have called for calm and vowed to boost health safety protocol and investigate what failings led to the nurse, Teresa Romero, getting infected.


World's worst Ebola outbreak tests global response

International agencies and governments are struggling to contain the world's worst epidemic of the Ebola hemorrhagic virus, which has killed over 1,900 people in West Africa.

Here is a timeline of the main developments in the outbreak:

March 22 - Guinea confirms that a previously unidentified hemorrhagic fever, which killed over 50 people in its southeast Forest Region, is the Ebola virus. One study traces the suspected original source to a 2-year-old boy in the town of Gueckedou. Cases are also reported in the capital, Conakry.

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World's worst Ebola outbreak tests global response
Responding to Ebola
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Here's A Breakdown Of The Ebola Treatments Used So Far In This Outbreak

As the Ebola outbreak rages on in West Africa and begins to slowly spread in the United States, the race for a cure or vaccine for the deadly virus is more pressing than ever.

Because of relatively few Ebola patients (2,418 cases in total before this current outbreak) scientists simply didn't know enough about how the rare virus works in the human body, or have access to enough patients to learn from and treat with experimental drugs, to perfect a cure or vaccine. And given the small number of people who would have benefitted from an Ebola cure before this outbreak, experts say big pharmaceutical companies didn't see much of a profit to be made by pursuing lengthy, costly drug research.

Ideally, untested drugs would undergo years of randomized, controlled trials -- first in animals, then in small groups of human beings. But at this late stage in the outbreak, with thousands of people suffering, medical ethicists say placebo groups in Ebola trials would be unfair, Reuters reported. As long as there are certain standards for the trials, World Health Organization officials also agreed that using untested drugs on suffering Ebola patients is ethical.

related: Ebola-Infected Nurse Says She's Doing Well
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5 steps to beat Ebola

Today's world is more interconnected than ever, making the transmission of communicable diseases that originate abroad easier to reach our shores. And the ongoing Ebola outbreak is simply the latest unsettling reminder that all the benefits of an interconnected world also come with significant risks that must be addressed and mitigated.

This Ebola outbreak likely began with a 2-year-old in the rain forest of Guéckédou, Guinea, and it has now reached halfway around the world to Dallas, Texas, where this terrible disease claimed its first victim in the United States, Thomas Eric Duncan, last Wednesday. We have the ability to prevent a significant outbreak of the virus here in the United States, but President Obama must act much more quickly and effectively if we are going to combat the disease at its source, and thus hinder further overseas transmission and ultimately prevent the spread of the disease outside Africa.

This challenge will only be made more difficult because many Americans lack confidence in our government's ability to effectively confront crises like this one.

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Ebola victim diagnosed day after flight


Fears of the ebola virus have deepened with word that a second US nurse caught the disease from a patient and flew across the country’s mid-west aboard an airliner the day before she was diagnosed.

It’s not clear how the nurse contracted the virus, though the second case among health workers pointed to lapses beyond how one individual may have donned and removed protective clothing.

Authorities declined to say what type of care the nurse provided to Thomas Eric Duncan, who was diagnosed with ebola after coming to the US from Liberia. He died on October 8.

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How to Keep Ebola Out of Your Neighborhood
There’s a way to prevent the virus from spreading, but the answer isn’t travel bans

Given the danger of coming into contact with Ebola-contaminated blood, the test should avoid needles, syringes, and other devices that might accidentally poke health workers. I suggest the use of self-administered implements commonly used by diabetics to make a finger prick and squeeze out a droplet of blood. That droplet would go into a tiny plastic well -- an object about an inch in size that is internally coated with either DNA or antibodies that recognize specific genes or proteins found exclusively in the Ebola virus.

If those viral markers are present, the device would glow with bioluminescence or change color -- the result would be observable with the naked eye.

Some such quick tests have been developed for clinical settings, intended to provide results after a day of lab work on a battery of blood hormones and infection. In contrast, the Ebola test must be very rapid -- results should be present within an hour.

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IS EBOLA LIKELY TO ARRIVE IN SINGAPORE? 5 THINGS TO KNOW

  1. How is the Ebola virus transmitted? By coming into direct contact with infected body fluids, e.g. blood, saliva, urine, or stools.
  2. Can someone get it just by standing near an infected person or animal? Ebola is not spread through the air, but it may be dangerous to stand near enough to receive the contaminated body fluid. For example, within the distance of an infected person’s vomit, urine, or respiratory secretions such as mucus.
  3. What precautions should be taken to prevent infection? - Do not come into contact with an infected person without adequate protection. Avoid travelling to areas with active disease transmission. If in an affected area, avoid coming into contact with, handling, or consuming wildlife – for example, infected fruit bats or monkeys. Maintain good personal hygiene such as washing hands regularly and covering the nose and mouth while sneezing or coughing. If in doubt, seek early treatment.
  4. Is Ebola likely to arrive in Singapore, given that it is a global air travel hub? Singapore is currently a low risk because of low population movement between Singapore and affected West African countries. However, the situation needs to be monitored closely, paying attention to the potential global transmission.
  5. If an infected person arrives in Singapore, is Ebola likely to spread here, given the isolation facilities in place

MOH PUTS OUT HEALTH ADVISORIES ON EBOLA TO TRAVELERS FROM AFFECTED AREAS

The Ministry of Health in Singapore has said that it will start to implement precautionary measures against Ebola starting today especially as the number of reported cases are rising globally.

However MOH repeated that currently, Ebola poses a low public health risk to Singapore and its actions are purely preventative. The MOH explained that they have been watching the situation carefully and they are in touch with the World Health Organisation.

MOH is working with the Civil Aviation Authority of Singapore and the ICA as well as Changi Airport Group to distribute health advisory notices to people coming from Ebola-affected areas.


Use of placebos in Ebola drug trials unethical: experts
An ambulance is readied by technicians wearing bio-hazard protective clothing, to transport a Guinean patient suspected of having Ebola, in Cascavel, October 10, 2014. (Photo: AFP/Luiz Carlos Cruz)

PARIS: Health experts from around the globe said on Friday (Oct 10) it would be unethical in drug trials to give non-active placebos to people infected with the killer Ebola virus.

The disease is so deadly, with mortality rate as high as 70 per cent, that doing so would amount to withholding "at least the possibility" of a cure, said the experts including Peter Piot, who co-discovered the Ebola virus in 1976.

Randomised control trials in which one group of people get the experimental drug and others a placebo or dummy drug, would not be ethical under the circumstances, they stated in a letter published by The Lancet.

related:
Ebola toll passes 4,000 as fears grow worldwide
Liberia bans journalists from Ebola centres


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Is Ebola Scaring You? 5 Reasons You Don't Have to Worry

It seems like every time you turn on the news, you hear something about Ebola: The Texas victim has died. A sheriff's deputy has been hospitalized. He has Ebola! It's panic time!

Actually, no, it isn't. Depending on where you've been getting your facts on this disease, you may be operating on some gross misinformation. Why am I writing this? Because, quite frankly, I am sick and tired of reading about all the misinformation and outright lies I see being bandied about.

Consider the Sources - First, before we conquer how Ebola actually spreads and how, ahem, *fast* it spreads, let's discuss your "news" sources. Most of the lies the Centers for Disease Control, Department of Homeland Security and hospitals have been dealing with come from sources skilled in employing yellow journalism -- that is, sensationalized, hyped-up "news" meant to increase ratings, page views and... wait for it... panic.

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Ebola is highly contagious … plus seven other myths about the virus
A volunteer doctor travelling to west Africa to help care for Ebola patients takes off an isolation suit during during training offered by the German Red Cross. Photograph: Timm Schamberger/Getty Images

The Ebola outbreak has been claiming lives in Africa for many months now, but following the first Ebola death from a case diagnosed outside the continent, coverage – and concern – in the west has stepped up yet another notch. The outbreak is certainly a grave issue for west Africa, a public health priority, and has been exacerbated by a slow response from international bodies and rich nations. It has already claimed more than 3,800 lives, and could claim far more without an appropriate international response. But it is also not the species-ending disaster some fear it could be.

Below are eight Ebola myths, and an attempt to set out the real position.
1. Ebola is highly contagious
2. You can catch Ebola from someone who looks perfectly healthy
3. If you catch Ebola, you’ll almost certainly die
4. We should quarantine anyone with ‘Ebola-like symptoms’
5. We should screen everyone for Ebola at our airports
6. We are not ready for Ebola in the west
7. Ebola has brought Africa to its knees
8. Ebola is the biggest public health disaster imaginable

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Why Ebola is so dangerous
Healthcare workers are among those most at risk of catching Ebola

The Ebola outbreak in West Africa is the world's deadliest to date and the World Health Organization has declared an international health emergency as more than 3,850 people have died of the virus in Guinea, Liberia, Sierra Leone and Nigeria this year.

What is Ebola? Ebola is a viral illness of which the initial symptoms can include a sudden fever, intense weakness, muscle pain and a sore throat, according to the World Health Organization (WHO). And that is just the beginning: subsequent stages are vomiting, diarrhoea and - in some cases - both internal and external bleeding. The current outbreak is the deadliest since Ebola was discovered in 1976

The disease infects humans through close contact with infected animals, including chimpanzees, fruit bats and forest antelope. It then spreads between humans by direct contact with infected blood, bodily fluids or organs, or indirectly through contact with contaminated environments. Even funerals of Ebola victims can be a risk, if mourners have direct contact with the body of the deceased.

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Ailing health systems

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Ebola virus disease

Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, is a severe, often fatal illness in humans. The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission. The average EVD case fatality rate is around 50%. Case fatality rates have varied from 25% to 90% in past outbreaks.

The first EVD outbreaks occurred in remote villages in Central Africa, near tropical rainforests, but the most recent outbreak in west Africa has involved major urban as well as rural areas. Community engagement is key to successfully controlling outbreaks. Good outbreak control relies on applying a package of interventions, namely case management, surveillance and contact tracing, a good laboratory service, safe burials and social mobilisation.

Early supportive care with rehydration, symptomatic treatment improves survival. There is as yet no licensed treatment proven to neutralise the virus but a range of blood, immunological and drug therapies are under development. There are currently no licensed Ebola vaccines but 2 potential candidates are undergoing evaluation.

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Help in the time of Ebola

This is the largest outbreak of Ebola in history and the first in west Africa. The disease is transmitted by body fluids, and may have originated in bats. Official figures suggest that almost 5,000 people have been infected and more than 2,400 have died, mainly in Liberia, Sierra Leone and Guinea. These figures underestimate the problem, given that many patients are thought to be unaccounted for. Roughly half of those who become infected go on to die.

Across the continent, Ebola barely rates among big killers, with far more deaths attributable to malaria or even diarrhoea. But the exponential spread of infections means that, unchecked, it could quickly grow extremely large. The World Health Organisation (WHO) last month said it hoped to control the outbreak within nine months and at 20,000 cases, but other experts think it may take 12 to 18 months—and infect hundreds of thousands of people—before it is brought under control.

More significantly, the disease has devastated the weak health-care systems of already fragile countries, some of which are recovering from civil wars. The collapse is sometimes called an “emergency within the emergency”. Many of the 144 health-care workers who have died from Ebola (an unprecedented number) were not working in infection-control facilities but rather in general hospitals that lacked any protective gear.


How not to catch Ebola

As the outbreak continues to spread, the fear of catching the disease is rising.

Experts are learning more about how to contain the virus that has infected around 7,500 people in West Africa.

The race is on to stop this deadly disease that kills more than half of those it infects.

related:
BBC Ebola podcast


Gut-Wrenching Images Show The Brutal Reality Of The Ebola Outbreak In Liberia
A woman throws a handful of soil towards the body of her sister as Ebola burial team members take her Mekie Nagbe, 28, for cremation on October 10, 2014 in Monrovia, Liberia. Nagbe, a market vendor, collapsed and died outside her home earlier in the morning while leaving to walk to a treatment center, according to her relatives. The burial of loved ones is important in Liberian culture, making the removal of infected bodies for cremation all the more traumatic for surviving family members. (John Moore/Getty Images)
Sophia Doe (R), and her grand daughters Arthuneh Qunoh (C), 9, and Beauty Mandi, 9 months (2nd R) weep as an Ebola burial team arrives to take away her daughter Mekie Nagbe, 28, for cremation on October 10, 2014 in Monrovia, Liberia. The children seen in the photo are daughters of the deceased. (John Moore/Getty Images)
Varney Jonson, 46, grieves as an Ebola burial team takes away the body of his wife Nama Fambule for cremation on October 10, 2014 in Monrovia, Liberia. He and his family said that she had been sick for more than a year with an undiagnosed illness and protested her body being taken away as an Ebola victim. (John Moore/Getty Images)
Relatives of Hanfen John who died due to the Ebola virus, mourn for him in Monrovia, Liberia on 10 October, 2014. (Photo by Mohammed Elshamy/Anadolu Agency/Getty Images)
Relative of Hanfen John who died due to the Ebola virus, mourns for him in Monrovia, Liberia on 10 October, 2014. (Photo by Mohammed Elshamy/Anadolu Agency/Getty Images)
An Ebola burial team collects the body of a four-year-old girl from a one-room apartment on October 10, 2014 in Monrovia, Liberia.(John Moore/Getty Images)
An Ebola burial team, dressed in protective clothing, carries the body of a woman, 54, from the bedroom where she died in the New Kru Town suburb on October 10, 2014 of Monrovia, Liberia. (John Moore/Getty Images)

WHO declares Ebola outbreak an international public health emergency
WHO director general Dr Margaret Chan called for an international response to Ebola outbreak

The World Health Organisation has declared the Ebola outbreak an international public health emergency, but it is not recommending general bans on travel or trade.

The global body said the Ebola outbreak – the largest and longest in history – was happening in countries without the resources to manage the infections, some with devastated healthcare systems still recovering from war, and called on the international community to help.

"Countries affected to date simply do not have the capacity to manage an outbreak of this size and complexity on their own," said Margaret Chan, the WHO's director general. "I urge the international community to provide this support on the most urgent basis possible."

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