Story 1: Black Chicago Activists Attack Democratic Party, Black Leadership and Barack Obama — The Real Oppressors Are The Democrats — They Are Pushing a Neoliberal Agenda Not A Black Agenda — Emancipation Proclamation — I Have A Dream — “I’ve Been To The Mountaintop” — The Democrats Wipe Out Elections of 2014 — Videos
Chicago Activists Unchained, Destroy Black Leadership
http://www.RebelPundit.com Chicago activists Paul McKinley, Mark Carter, Joseph Watkins and Harold “Noonie” Ward recently went on the record with RebelPundit to deliver a message to black communities across the country.
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Economic, Political Discontent Make for a Midterm Double Punch
By Gary Langer
Oct 28, 2014 7:00am
A double punch of economic and political dissatisfaction marks public attitudes in the closing week of the 2014 midterm campaign – a dynamic that reflects poorly on the president’s performance, bolstering his Republican opponents.
The discontent in the latest ABC News/Washington Post poll is palpable. Despite its fitful gains, seven in 10 Americans rate the nation’s economy negatively and just 28 percent say it’s getting better. In a now-customary result, 68 percent say the country’s seriously off on the wrong track.
There’s no respite politically. Six in 10 express little or no trust in the federal government to do what’s right. Fifty-three percent think its ability to deal with the country’s problems has worsened in the last few years; among likely voters that rises to 63 percent.
Views of the president’s performance suffer in kind. Barack Obama’s job approval rating, 43 percent overall, is virtually unchanged from his career-low 40 percent two weeks ago. A steady 51 percent disapprove, essentially the same all year. His ratings on the economy – still the country’s prime concern, albeit one of many – are similarly weak, a 10-point net negative score.
These elements appear poised to depress voting by dispirited Democrats, tipping the scale to customarily higher-turnout Republicans. Disapproval of Obama reaches 56 percent among likely voters, and three in 10 say they’ll show up at the polls to express opposition to him – twice as many as say they’ll vote to show him support.
The result is a 50-44 percent Republican advantage among likely voters in preference for U.S. House seats in this poll, produced for ABC by Langer Research Associates. That compares with a +3-point Democratic tally among all registered voters, showing how differential turnout shifts the balance.
EXPECTATIONS and DISAFFECTION
Other results may be equally cheering to the GOP. While the unpredictable nature of key Senate races makes it premature to be measuring for drapes in leadership offices, Americans by 13 points, 46-33 percent, expect the Republicans to win control. By nine points, 32-24 percent, more also call a good rather than a bad thing.
Four in 10, though, say who’s in control won’t make much difference – one sign of the more general public annoyance any incoming leaders are likely to face.
Disaffection may impact participation, as well. Just 68 percent of registered voters say they’re closely following the midterms, well down from 76 percent at about this time in 2010 and 80 percent in 2006. The share saying they’re certain to vote (or already voted), 65 percent, likewise is down, from 71 percent in 2010 and 76 percent in 2006. Actual turnout is lower still.
There’s another turn-off for prospective voters: the tone of the midterm campaigns. Americans by 2-1, 50 vs. 26 percent say the candidates in their congressional district have been mainly attacking each other rather than discussing the issues. The remaining quarter has no opinion, suggesting they’ve just tuned it all out.
When not firing salvos, campaigns have been working the phones: About one in four likely voters, 27 percent, say they’ve been personally contacted by an individual or organization working to support a House or Senate candidate. About equal numbers say they’ve been contacted on behalf of Republican vs. Democratic candidates; most by far have been contacted by both. No partisan advantage is apparent, suggesting a stalemate, at least overall, in this element of political trench warfare.
Midterms often are seen as referendums on the president, especially given the customary six-year itch. So it is with Obama: This year on average has been his worst in overall job approval since he took office, and it’s the first year a majority has disapproved.
Among groups, 2014 marks the first year Obama has averaged less-than-majority approval among moderates (48 percent this year so far), as well as approval only in the 30s among independents (37 percent on average). He’s averaged 33 percent approval among whites and 65 percent among nonwhites in 2014 – a vast difference, but both annual lows since he took office.
Obama’s troubles help explain another result – a 42-37 percent edge among likely voters for the Republican Party over the Democrats to handle the country’s main problems. Even among all adults, there’s just a 2-point gap between the parties on this question.
The results in congressional vote preference include notable divisions among groups. While Democratic candidates are a scant +5 among women, that turns to a 17-point Republican lead among men. Republican candidates likewise lead by a hefty 17 points among political independents. And while Democrats are +12 points among moderates, the GOP comes back with a vast 61-point advantage among conservatives, who rival moderates in their share of likely voters.
The Democrats have a typical lead among nonwhites, but they often also look to college-educated white women as key supporters. This year they’re only running evenly in that group, while losing 66 percent of white men and 57 percent of white women who lack a college degree.
Attitudinal groups also mark the GOP advantage. Democratic candidates lead by 71-24 percent among those who say the government’s ability to deal with problems has held steady or improved in recent years – but Republicans have nearly as large an advantage among those who say this has worsened, and there are far more of them. Republican candidates lead broadly, as well, among those who rate economic conditions negatively – again, the predominant group.
For all this, another result points to a lost opportunity for the Democrats. Seventy-one percent of all adults in this survey, and two-thirds of likely voters, think the U.S. economic system favors the wealthy rather than treating most people fairly. And likely voters who see a systemic bias for the wealthy prefer Democratic candidates over Republicans by a 20-point margin.
The tide turns because the minority who thinks the system is fair favors Republican candidates far more broadly – by 47 points, 72-25 percent. It’s an issue on which Democrats may find room to push back – if not this year, then in the presidential election two years off.
This ABC News/Washington Post poll was conducted by telephone Oct. 23-26, 2014, in English and Spanish, among a random national sample of 1,204 adults, including 1,032 registered voters and 758 likely voters, including landline and cell-phone-only respondents. Results have a margin of sampling error of 3.0, 3.5 and 4.0 points for the general population, registered voters and likely voters, respectively, including the design effect.
Partisan divisions in this survey, Democrats-Republicans-independents, are 32-24-36 percent among the general population, 35-26-33 percent among registered voters and 33-30-31 percent among likely voters.
Kent D. Johnson/Atlanta Journal-Constitution/AP Photo
The survey was produced for ABC News by Langer Research Associates of New York, N.Y., with sampling, data collection and tabulation by Abt-SRBI of New York, N.Y.
Story 1: Good News and Bad News Concerning Ebola — 2 Nurses Ebola Free and 1 Doctor Has Confirmed Case of Ebola in New York City — Ebola Infected Dr. Craig Spencer Took A-Train, L-Train and High-Line – Went Bowling — Contact Tracing Begins — Airborne Ebola Theme Song — If I can make it there, I can make it anywhere, New York, New York — Videos
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New York City, Bellevue Hospital nurse Belkys Fortune, left, and Teressa Celia, Associate Director of Infection Prevention and Control, pose in protective suits in an isolation room, in the Emergency Room of Bellevue Hospital.
Note: They are not wearing a
Biosafety Level 4 Positive Pressure Spacesuit!
(See above photos)
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Frank Sinatra-New York,New York
Frank Sinatra-New York,New York-Lyrics
Start spreadin’ the news, I’m leavin’ today
I want to be a part of it
New York, New York
These vagabond shoes, are longing to stray
Right through the very heart of it
New York, New YorkI want to wake up, in a city that never sleeps
And find I’m king of the hill
Top of the heapThese little town blues, are melting away
I’ll make a brand new start of it
In old New York
If I can make it there, I’ll make it anywhere
It’s up to you, New York..New YorkNew York…New York
I want to wake up, in a city that never sleeps
And find I’m A number one, top of the list
King of the hill, A number one….These little town blues, are melting away
I’ll make a brand new start of it
In old New York
If I can make it there, I’ll make it anywhere
It’s up to you, New York..New York New York!!!
Frank Sinatra – New York New York Song **Lyrics** [HD]
My Kind of Town (Chicago) – Frank Sinatra
“My Kind Of Town”
Now this could only happen to a guy like me
And only happen in a town like this
So may I say to each of you most gratef’lly
As I throw each one of you a kissThis is my kind of town, Chicago is
My kind of town, Chicago is
My kind of people, too
People who smile at youAnd each time I roam, Chicago is
Calling me home, Chicago is
Why I just grin like a clown
It’s my kind of town[brief instrumental]My kind of town, Chicago is
My kind of town, Chicago is
My kind of razzmatazz
And it has all that jazzAnd each time I leave, Chicago is
Tuggin’ my sleeve, Chicago is
The Wrigley Building, Chicago is
The Union Stockyard, Chicago is
One town that won’t let you down
It’s my kind of town
New York, New Jersey Set Up Mandatory Quarantine Requirement Amid Ebola Threat Christie: New Policy Has Already Been Used At Newark Liberty International Airport
As CBS 2’s Alice Gainer reported, no other states have yet set up increased screening procedures for Ebola.
“We believe it’s appropriate to increase the current screening procedures from people coming from affected countries from the current (Centers for Disease Control and Prevention screening procedures),” Gov. Andrew Cuomo said Friday afternoon. “We believe it within the State of New York and the State of New Jersey’s legal rights.”
Under the new rules, state officials will establish a risk level by considering the countries that people have visited and their level of possible exposure to Ebola.
The patients with the highest level of possible exposure will be automatically quarantined for 21 days at a government-regulated facility. Those with a lower risk will be monitored for temperature and symptoms, Cuomo explained.
The New York and New Jersey health departments will determine their own specific procedures for hospitalization and quarantine, and will provide a daily recap to state officials on the status of screening, New York State Health Commissioner Dr. Howard Zucker said at the news conference.
The new procedures already have been put into use at Newark Liberty International Airport.
On Friday, a health care worker landed at Newark after treating Ebola patients in West Africa, New Jersey Gov. Chris Christie said at the news conference. A legal quarantine was issued for the woman, who was not a New Jersey resident and was set to go on to New York afterward.
“This woman, while her home residence is outside the area, said her next stop was going to be here in New York,” Christie said. “Governor Cuomo and I discussed it before we came out here, and a quarantine order will be issued.”
The woman will be quarantined in either New York or New Jersey, Christie said.
In discussing the new plan, Cuomo and Christie said a policy of voluntary quarantine simply does not go far enough.
“Voluntary quarantine – you know it’s almost an oxymoron. This is a very serious situation.” Cuomo said. “Voluntary quarantine – raise your right hand and promise you’re going to stay home for 21 days. We’ve seen what happens.”
The new rules were announced a day after Dr. Craig Spencer, a member of Doctors Without Borders, became New York City’s first Ebola patient.
He reported Thursday morning coming down with a fever and diarrhea and is being treated in an isolation ward at Bellevue Hospital, a designated Ebola center.
Spencer returned from West Africa last Friday after treating Ebola patients in Guinea with Doctors Without Borders. He arrived at John F. Kennedy International Airport, passing the extensive CDC screening process.
“When he arrived in the United States, he was also well with no symptoms,” said New York City Health Commissioner Mary Travis Bassett.
Doctors Without Borders said per the guidelines it provides its staff members on their return from Ebola assignments, “the individual engaged in regular health monitoring and reported this development immediately.” But Spencer also took the subway, walked the High Line, and went bowling in Williamsburg, Brooklyn the day before he became sick.
“He was a doctor, and even he didn’t follow the guidelines,” Cuomo said.
With that in mind, the states have to lay down the law, the governors said.
“It’s too serious a situation to leave it to the honor system,” Cuomo said.
The CDC is reviewing its policy for health care workers returning from West Africa, but anyone flying into a Port Authority of New York and New Jersey airport will need to abide by the new procedures.
Ebola Arrives in New York. How Prepared Is the City to Handle It?
Dr. Craig Spencer, the health care worker who recently returned from Guinea and tested positivefor the Ebola virus, is now the first patient to be treated at New York’s Bellevue Hospital.
But the hospital, as well as city, state and federal officials, have been working for weeks or more to ensure the city is ready to identify and treat Ebola cases.
This preparation reflects the now-proven fact that the longer the outbreak rages on in West Africa, the more likely it was that a patient would wind up in Western cities, including New York.
On Oct. 15, the state designated Bellevue Hospital Center as the facility to receive Ebola patients from among the city’s 11 public hospitals, and to receive transferred patients from other hospitals as well, in the event that any Ebola cases occur in the city.
According to a statement from the New York City Health and Hospitals Corporation, the hospital has four single-bed rooms in its infectious disease ward to treat “high probability or confirmed Ebola cases.” This part of the hospital also has a new laboratory that can test for Ebola, separate from the rest of the hospital’s labs, to handle Ebola blood samples.
Because the virus can be spread through contact with an infected person’s bodily fluids, careful handling of blood and other samples is necessary.
The hospital is particularly well suited due to its long history of being on the front lines of epidemics and emerging public health threats, and managing an isolation unit for diseases, such as TB, for many years with support from and collaboration with the City Health Department.
Three other hospitals in New York City have also been designated by the state to treat suspected and confirmed Ebola cases, including Mt. Sinai and New York Presbyterian in Manhattan and Montefiore in the Bronx, according to Governor Cuomo’s Ebola preparedness plan.
None of these hospitals, including Bellevue, has an isolated biocontainment unit like those that have treated patients at Emory University Hospital in Atlanta, Georgia, and Nebraska Medical Center in Omaha, Nebraska.
The American public may not have much faith in ordinary hospitals to treat Ebola, considering that the only non-specialized hospital to treat Ebola patients, Texas Health Presbyterian Hospital Dallas, allowed the virus to spread to two nurses who worked on the original patient, Thomas Eric Duncan, who died of Ebola on Oct. 8. Both of the nurses are now being treated in a biocontainment unit.
The probability of an Ebola case in New York was always considerably higher than it was for many other cities in the U.S., given that two of the city’s international airports — JFK and Newark — are key gateways for travelers to and from West Africa, via stops in Europe or elsewhere in Africa.
“New York City is a frequent port of entry for travelers from West Africa, a home to communities of West African immigrants who travel back to their home countries, and a home to health care workers who travel to West Africa to treat Ebola patients,” The Centers for Disease Control and Prevention (CDC) said in a report on Oct. 17.
“Ongoing transmission of Ebola virus in West Africa could result in an infected person arriving in NYC,” the report said. However, the chance that a New Yorker who has not traveled to an Ebola hotspot would come down with the virus is “extremely slim,” since the disease is only spread through direct contact with an infectious person’s bodily fluids.
Ultimately, it was a doctor who lived in the city who would bring the virus home.
In recent weeks, the New York Health Commissioner issued a “Commissioner’s Order” to all hospitals and ambulance services in the state, “requiring that they follow protocols for identification, isolation and medical evaluation of patients requiring care.”
The state has been conducting “unannounced drills” at hospitals and health care facilities to test preparedness for handling possible Ebola cases. The state has also involved the Metropalitan Transit Authority, which operates the city’s subways and buses, in training for encountering possible Ebola patients.
And a mass Ebola training for health care workers, which included demonstrations for putting on and taking off protective equipment, took place in the city on Oct. 21.
According to new guidelines the CDC issued on Monday, there are now 30 steps health care workers have to take every time they treat a patient with Ebola or Ebola-like symptoms.
At hospitals like Bellevue, actors have played the role of patients with Ebola symptoms have been part of the drills, and the city’s 911 operators have been told to ask people who call in with Ebola-like symptoms if they have recently traveled to West Africa, according to the Guardian.
As of Thursday, there have been nearly 10,000 cases of Ebola in West Africa, along with about 4,900 deaths. However, these figures are likely to be underestimates, since the lack of treatment facilities and other circumstances are causing many patients to go uncounted.
A doctor in New York City who recently returned from treating Ebola patients in Guinea became the first person in the city to test positive for the virus Thursday, setting off a search for anyone who might have come into contact with him.
The doctor, Craig Spencer, was rushed to Bellevue Hospital Center and placed in isolation at the same time as investigators sought to retrace every step he had taken over the past several days.
At least three people he had contact with in recent days have been placed in isolation. The federal Centers for Disease Control and Prevention, which dispatched a team to New York, is conducting its own test to confirm the positive test on Thursday, which was performed by a city lab.
While officials have said they expected isolated cases of the disease to arrive in New York eventually, and had been preparing for this moment for months, the first case highlighted the challenges involved in containing the virus, especially in a crowded metropolis. Dr. Spencer, 33, had traveled on the A and L subway lines Wednesday night, visited a bowling alley in Williamsburg, and then took a taxi back to Manhattan.
The next morning, he reported having a fever, raising questions about his health while he was out in public. The authorities have interviewed Dr. Spencer several times and are also looking at information from his credit cards and MetroCard to determine his movements.
Health officials initially said that Dr. Spencer had a 103-degree fever when he reported his symptoms to authorities at around 11 a.m. on Thursday. But on Friday, health officials said that was incorrect and that Dr. Spencer reported having a 100.3-degree fever. They said the mistake was because of a transcription error.
People infected with Ebola cannot spread the disease until they begin to display symptoms, and it cannot be spread through the air. As people become sicker, the viral load in the body builds, and they become increasingly contagious.
Mayor Bill de Blasio, speaking at a news conference at Bellevue on Thursday night, sought to reassure New Yorkers that there was no reason to be alarmed.
“Being on the same subway car or living near a person with Ebola does not in itself put someone at risk,” he said.
Dr. Spencer’s work in Africa and the timing of the onset of his symptoms led health officials to dispatch disease detectives, who “immediately began to actively trace all of the patient’s contacts to identify anyone who may be at potential risk,” according to a statement released by the health department.
Dr. Spencer’s fiancée has also been quarantined at Bellevue. Two other friends, who had contact with him on Tuesday and Wednesday, have been told by the authorities that they too will be quarantined but whether they will isolate themselves in their homes or be relocated was still under discussion, according to a person briefed on the investigation. None of the three were showing signs of illness.
The driver of the taxi, arranged through the online service Uber, did not have direct contact with Dr. Spencer and was not considered to be at risk, officials said.
Speaking at the news conference, city officials said that while they were still investigating, they did not believe Dr. Spencer was symptomatic while he traveled around the city on Wednesday and therefore had not posed a risk to the public.
“He did not have a stage of disease that creates a risk of contagiousness on the subway,” Dr. Mary Bassett, the city health commissioner, said. “We consider it extremely unlikely, the probability being close to nil, that there will be any problem related to his taking the subway system.”
Still, out of an abundance of caution, officials said, the bowling alley in Williamsburg that he visited, the Gutter, was closed on Thursday night, and a scheduled concert there, part of the CMJ music festival, was canceled. Health workers were scheduled to visit the alley on Friday.
At Dr. Spencer’s apartment building, his home was sealed off and workers distributed informational fliers about the disease.
Dr. Spencer had been working with Doctors Without Borders in Guinea treating Ebola patients, and completed his work on Oct. 12, Dr. Bassett said. He flew out of the country on Oct. 14, traveling via Europe, and arrived in New York on Oct. 17.
Since returning, he had been taking his temperature twice a day, Dr. Bassett said.
He told the authorities that he did not believe the protective gear he wore while working with Ebola patients had been breached but had been monitoring his own health.
Doctors Without Borders, in a statement, said it provides guidelines for its staff members to follow when they return from Ebola assignments, but did not elaborate on the protocols.
“The individual engaged in regular health monitoring and reported this development immediately,” the group said in a statement.
Dr. Spencer began to feel sluggish on Tuesday but did not develop a feveruntil Thursday morning, he told the authorities. At 11 a.m., he found that he had a 100.3-degree temperature and alerted the staff of Doctors Without Borders, according to the official.
The staff called the city’s health department, which in turn called the Fire Department.
Emergency medical workers, wearing full personal protective gear, rushed to Dr. Spencer’s apartment, on West 147th Street. He was transported to Bellevue and arrived shortly after 1 p.m.
He was placed in a special isolation unit and is being seen by the designated medical critical care team. Team members wear personal protective equipment with undergarment air ventilation systems.
Bellevue doctors have been preparing to deal with an Ebola patient with numerous drills and tests as well as actual treatment of suspected cases that turned out to be false alarms.
A health care worker at the hospital said that Dr. Spencer seemed very sick, and it was unclear to the medical staff why he had not gone to the hospital earlier, since his fever was high.
Dr. Spencer is a fellow of international emergency medicine at NewYork-Presbyterian Hospital/Columbia University Medical Center, and an instructor in clinical medicine at Columbia University.
“He is a committed and responsible physician who always puts his patients first,” the hospital said in a statement. “He has not been to work at our hospital and has not seen any patients at our hospital since his return from overseas.”
Before Thursday, more than 30 people had gone to city hospitals and raised suspicions of Ebola, but in all those cases health workers were able to rule out the virus without performing blood tests.
While the city has stepped up its laboratory capacity so it can get test results within four to six hours, the precautions required when drawing blood and treating a person possibly sick with Ebola meant that it took until late in the evening to confirm Dr. Spencer’s diagnosis.
Doctors said that even before the results came in, it seemed likely that he had been infected. Symptoms usually occur within eight to 10 days of infection. Dr. Spencer stopped working with Ebola patients 11 days ago and returned home six days ago.
Ebola is transmitted through bodily fluids and secretions, including blood, mucus, feces and vomit.
Because of its high mortality rate — Ebola kills more than half the people it infects — the disease spreads fear along with infection.
The authorities have been on high alert ever since Thomas Eric Duncan traveled to the United States in September from Liberia, and was later given a diagnosis of Ebola.
Several days after his death, a nurse who helped care for Mr. Duncan learned she had Ebola. Two nurses who treated Mr. Duncan fell ill, but are recovering.
That single case led to hundreds of people being quarantined or being asked to remain isolated from the general public.
The missteps by both local and federal authorities in handling the nation’s first Ebola case raised questions about the ability of health care workers to safely treat those with the disease.
In the New York City region, hospitals and emergency workers have been preparing for the appearance of the virus for months.
Dr. Irwin Redlener, the director of the National Center for Disaster Preparedness at Columbia University and a special adviser to Mayor de Blasio, said that the risk to the general public was minimal, but depended on the city moving swiftly.
“New York has mobilized not only a world-class health department, but has full engagement of many other agencies that need to be on the response team,” he said.
The new Ebola infection in New York City exposed flaws in the system and raised new concerns, lawmakers said Friday, as they criticised the U.S. government response to the outbreak and questioned top officials’ credibility.
“I can tell you it’s not working. All you need to do is look at Craig Spencer,” said Rep. John Mica, a Republican, naming the doctor in New York who was diagnosed with Ebola late Thursday a week after returning from Guinea. “He was tested there, it’s not working.”
Spencer, the fourth person diagnosed in the U.S., did not exhibit symptoms until Thursday and so the temperature screening in place at the five U.S. airports that receive passengers from Sierra Leone, Guinea and Liberia, the three West African countries that have borne the worst of the outbreak, would not have caught him. Some lawmakers questioning administration officials at a House Oversight and Government Reform Committee hearing said that just showed that a new approach was needed.
Less than two weeks before hard-fought elections, many lawmakers, especially Republicans, have called for a travel ban from the hot spots in West Africa where the deadly disease has infected roughly 10,000 people and killed about half of them. Others have suggested quarantining people for the 21-day incubation period once they arrive.
The Obama administration has resisted, saying such an approach could make things worse by limiting sorely needed supplies and medical workers to West Africa and encouraging travelers to hide their travel histories. Instead the administration has implemented new guidelines for screening all people arriving here from the hot zones and ensuring they’re all monitored by medical experts for 21 days.
Rep. Stephen Lynch, a Democrat, said Friday that anyone who travels here from West Africa should be quarantined for 21 days in their home country before even boarding a plane to the U.S.
“This can’t just be about ideology and happy talk,” Lynch said. “We need to be very deliberate (and) take it much more seriously than I’m hearing today.”
The committee’s chairman, Rep. Darrell Issa, a Republican, complained about wrong information and shifting standards coming from the Centers for Disease Control and Prevention about the first case diagnosed in the U.S., a man who traveled from Sierra Leone to Texas and later died. He infected two nurses who cared for him. As of Friday both nurses have been declared free of the virus.
“We said we were planning to deal with infectious diseases, prepare our health care system and our doctors and nurses,” Issa said. “And in fact it appears as though we trained them but not trained them to the level we should.”
Dr. Nicole Lurie, assistant HHS secretary for preparedness and response, defended the government’s response.
“I think our failures largely relate to the fact that we’re learning some new things about Ebola,” she said. “Ebola’s never been in this hemisphere before, and as we’re learning those things we’re tightening up our policies and procedures as quickly as possible.”
In her prepared testimony, Lurie assured lawmakers that a large-scale outbreak of Ebola is unlikely in this country. “There is an epidemic of fear, but not of Ebola, in the United States,” she said.
New York City police officers enter the building where Dr. Craig Spencer (inset with fiancée Morgan Dixon) lives in New York on Oct. 24.Photo: Reuters/Mike Segar
Efforts are under way to decontaminate the apartment building of the Big Apple’s first Ebola patient.
Cops moved people back around 9:15 am as two officers with the Sanitation Department’s Environmental Police Unit arrived on the scene and entered the building through a side entrance.
They were later joined by several people in plain-clothes who exited out of a truck belonging to the Bio-Recovery Corporation — a full service crime scene cleanup and bio remediation company.
“Today we’re expecting a specialized crew [to] come in full protective gear and will clean and sterilize Dr. [Craig] Spencer’s apartment for signs of bodily fluid,” said City Council member Mark Levine, adding that officials would “confiscate material that might have come into contact with his body such as sheets and pillowcases and bath towels and toothbrushes.”
The 7th District councilman was on the scene Friday morning, giving updates specifically aimed at people in the community whose fears were heightened Thursday when Spencer, a Doctors Without Borders volunteer, tested positive for the Ebola virus.
“We’ve had neighbors understandably concerned that live right across the street, maybe they live down the hall, maybe they’ve seen him in the local bodega and they’re worried,” he told the crowd. “But the truth is and the facts they need to understand are they’re really not at risk.”
Police and health officials enter the New York apartment building of Dr. Craig Spencer, who has been diagnosed with the Ebola virus, on Oct. 24.
Levine made it clear that while fear of catching the disease was high, the actual possibility that Spencer could have spread the illness before being hospitalized was minimal.
“If he was well enough to go for a run, then he was almost certainly not sick enough to be contagious,” he said. “Frankly, if he was well enough to go bowling, he was probably not sick enough to be contagious, so people should not worry.”
When Spencer first reported his elevated temperature to officials, firefighters worked quickly to make sure the risk of infection was extremely low.
“The first thing they did was seal off the apartment,” he said. “That happened immediately after Dr. Spencer was taken to the ambulance.”
The ambulance carrying Dr. Craig Spencer arrives at Bellevue Hospital.
A neighbor who lives across from Spencer told The Post that four of his relatives panicked shortly after the Harlem doctor was picked up and eventually left the apartment.
“They’re gone, they weren’t moved by the authorities, they left on their own because of the scare, because they were frightened,” said Stan Malone, 45. “This really hits home … I believe it’s gonna get worse.”
Malone added that while he thought Spencer had only come in contact with a few people, he felt the city wasn’t doing enough to ensure the safety of New Yorkers.
“I think this whole building should be quarantined now,” he said. “What’s taking the city so long to do that?”
A physician who treated dying Ebola patients in Liberia flew in to JFK on Thursday night — and stayed at an airport hotel, a source told The Post.
Colin Bucks, a clinical assistant professor at Stanford University’s medical school, arrived on a Royal Moroccan Air flight, sources said.
He spent the night at the Hilton Garden Inn in Jamaica, Queens, where Centers for Disease Control workers also stay, according to a source.
On Friday, he was cleared to travel home to Northern California, where he will “be monitored by CDC there,” the source said.
“He is asymptomatic and he’s being allowed to leave the hotel and fly home,” a source added.
Sources said that Bucks, who works with International Medical Corps, was told to self-quarantine at the hotel, but he told The Post he merely missed a connecting flight. He said he was screened at the airport in Africa and again upon arrival at Kennedy airport.
“If there had been a flight yesterday, I would’ve not spent the night here,” he said in a telephone interview.
Bucks is strictly following the CDC’s recommendations and self-monitoring, he said. The CDC is also keeping track of his whereabouts, as standard protocol dictates, he added.
“I worked for over a month with no national staff or ex-patriot staff showing any signs of illness,” he said. “In general I’m amazed by the national staff I was working with. I really want them to be viewed as the heroes of Ebola response.
Bucks didn’t know Spencer, but said, “It sounds like this is someone who’s cut from the same cloth as me who followed all the rules and has not put other people at risk.”
He’s confident that by following proper guidelines, health care workers can do life-saving work abroad and stay safe.
“I have every confidence that [by] following CDC return recommendations, nurses, doctors, lab technicians can go to West Africa and do what’s necessary to protect the rest of the world and not come back and be the ones that need protection.”
On Friday afternoon, the governors of New York and New Jersey announced extra measures that will require all at-risk passengers touching down at JFK and Newark Liberty airports from Ebola-stricken countries to be quarantined for 21 days.
Because the natural reservoir host of Ebola viruses has not yet been identified, the way in which the virus first appears in a human at the start of an outbreak is unknown. However, scientists believe that the first patient becomes infected through contact with an infected animal, such as a fruit bat or primate (apes and monkeys), which is called a spillover event. Person-to-person transmission follows and can lead to large numbers of affected people. In some past Ebola outbreaks, primates were also affected by Ebola, and multiple spillover events occurred when people touched or ate infected primates.
When an infection does occur in humans, the virus can be spread in several ways to others. Ebola is spread through direct contact (through broken skin or mucous membranes in, for example, the eyes, nose, or mouth) with
blood or body fluids (including but not limited to urine, saliva, sweat, feces, vomit, breast milk, and semen) of a person who is sick with Ebola
objects (like needles and syringes) that have been contaminated with the virus
infected fuit bats or primates (apes and monkeys)
Ebola is not spread through the air or by water, or in general, by food. However, in Africa, Ebola may be spread as a result of handling bushmeat (wild animals hunted for food) and contact with infected bats. There is no evidence that mosquitos or other insects can transmit Ebola virus. Only a few species of mammals (for example, humans, bats, monkeys, and apes) have shown the ability to become infected with and spread Ebola virus.
Healthcare providers caring for Ebola patients and the family and friends in close contact with Ebola patients are at the highest risk of getting sick because they may come in contact with infected blood or body fluids of sick patients.
During outbreaks of Ebola, the disease can spread quickly within healthcare settings (such as a clinic or hospital). Exposure to Ebola can occur in healthcare settings where hospital staff are not wearing appropriate protective equipment, including masks, gowns, and gloves and eye protection.
Dedicated medical equipment (preferable disposable, when possible) should be used by healthcare personnel providing patient care. Proper cleaning and disposal of instruments, such as needles and syringes, is also important. If instruments are not disposable, they must be sterilized before being used again. Without adequate sterilization of the instruments, virus transmission can continue and amplify an outbreak.
Once someone recovers from Ebola, they can no longer spread the virus. However, Ebola virus has been found in semen for up to 3 months. Abstinence from sex (including oral sex) is recommended for at least 3 months. If abstinence is not possible, condoms may help prevent the spread of disease.
As the death toll from Ebola reaches 3,800, experts are warning that the virus could mutate and become airborne, meaning that it could be caught by breathing it in.
The public is being told by health officials that the virus that causes Ebola cannot be transmitted through the air and can only be spread through direct contact with bodily fluids – blood, sweat, vomit, feces, urine, saliva or semen – of an infected person who is showing symptoms.
However, several leading Ebola researchers claim that the virus mutating and spreading through the air should not be ruled out.
As the death toll from Ebola reaches 3,800, experts are warning that the virus could mutate and become airborne
Virus expert Charles L. Bailey, who in 1989 helped the American government tackle an outbreak of Ebola among rhesus monkeys being used for research, told the LA Times: ‘We know for a fact that the virus occurs in sputum and no one has ever done a study [disproving that] coughing or sneezing is a viable means of transmitting.
‘Unqualified assurances that Ebola is not spread through the air are “misleading”.’
Dr C J Peters, who has undertaken research into Ebola for America’s Centers for Disease Control and Prevention, told the paper: ‘We just don’t have the data to exclude it [becoming airborne].’
Meanwhile virologist Dr Philip K Russell, a former head of the U.S Army’s Medical Research and Development Command, told the paper: ‘I see the reasons to dampen down public fears. But scientifically, we’re in the middle of the first experiment of multiple, serial passages of Ebola virus in man…. God knows what this virus is going to look like. I don’t.’
In September, Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, writing in the New York Times, said experts who believe that Ebola could become airborne are loathed to discuss their concerns in public, for fear of whipping up hysteria.
Discussing the possible future course of the current outbreak, he said: ‘The second possibility is one that virologists are loath to discuss openly but are definitely considering in private: that an Ebola virus could mutate to become transmissible through the air.’
The public is being told by health officials that the virus that causes Ebola cannot be transmitted through the air and can only be spread through direct contact with bodily fluids
Defence Secretary won’t talk about UK airport Ebola screening
Dr Osterholm warns viruses similar to Ebola are notorious for replicating and reinventing themselves.
It means the virus that first broke out in Guinea in February may be very different to the one now invading other parts of West Africa.
Pointing to the example of the H1N1 influenza virus that saw bird flu sweep the globe in 2009, Dr Osterholm said: ‘If certain mutations occurred, it would mean that just breathing would put one at risk of contracting Ebola.’
Dr Osterholm said public health officials, while discussing the possibility in private, are reluctant to air their concerns.
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‘They don’t want to be accused of screaming “Fire!” in a crowded theater – as I’m sure some will accuse me of doing.
‘But the risk is real, and until we consider it, the world will not be prepared to do what is necessary to end the epidemic.’
He called for the United Nations to mobilise medical, public health and humanitarian aid to ‘smother the epidemic’.
The chair of the UK’s Health Protection Agency, Professor David Heymann of the London School of Hygiene of Tropical Medicine, said it is impossible to predict how any virus will mutate.
He said scientists across the world do not know enough about genetics to be able to say how the Ebola virus will change over time.
He told MailOnline: ‘No one can predict what will happen with the mutation of the virus. I would like to see the evidence that this could become a respiratory virus.’
The first person diagnosed with Ebola in the U.S. died on Wednesday despite intense but delayed treatment, and the government announced it was expanding airport examinations to guard against the spread of the deadly disease.
The checks will include taking the temperatures of hundreds of travelers arriving from West Africa at five major American airports.
The new screenings will begin Saturday at New York’s JFK International Airport and then expand to Washington Dulles and the international airports in Atlanta, Chicago and Newark. An estimated 150 people per day will be checked, using high-tech thermometers that don’t touch the skin.
The White House said the fever checks would reach more than 9 of 10 travelers to the U.S. from the three heaviest-hit countries – Liberia, Sierra Leone and Guinea.
President Barack Obama called the measures ‘really just belt and suspenders’ to support protections already in place. Border Patrol agents now look for people who are obviously ill, as do flight crews, and in those cases the Centers for Disease Control and Prevention is notified.
As of Wednesday, Ebola has killed about 3,800 people in West Africa and infected at least 8,000, according to the World Health Organization.
A medical official with the U.N. Mission in Liberia who tested positive for Ebola arrived in the German city of Leipzig on Thursday to be treated at a local clinic with specialist facilities, authorities said.
The unidentified medic infected in Liberia is the second member of the U.N. mission, known as UNMIL, to contract the virus. The first died on September 25. He is the third Ebola patient to arrive in Germany for treatment.
The virus has taken an especially devastating toll on health care workers, sickening or killing more than 370 of them in the hardest-hit countries of Liberia, Guinea and Sierra Leone – places that already were short on doctors and nurses.
There are no approved medications for Ebola, so doctors have tried experimental treatments in some cases, including drugs and blood transfusions from others who have recovered from Ebola.
The survivor’s blood could carry antibodies for the disease that will help a patient fight off the virus.
Experts raise specter of more-contagious Ebola virus
Osterholm mentioned the risk of Ebola migrating to developing-world megacities like Nairobi, Kenya.
Amid fears that West Africa’s Ebola epidemic may spiral out of control, two experts are using the pages of leading newspapers to raise the specter of a mutant Ebola virus that could become airborne, and appealing for massive interventions to preclude that nightmare scenario.
Michael T. Osterholm, PhD, MPH, wrote in a New York Times commentary today that the scale of the epidemic is offering the virus unprecedented opportunities to evolve toward greater transmissibility, which could give it the capability to spread worldwide. He is director of the University of Minnesota’s Center for Infectious Disease Research and Policy, publisher of CIDRAP News.
Richard E. Besser, MD, chief health editor at ABC News and a former acting director at the Centers for Disease Control and Prevention (CDC), wrote in the Washington Post last night that a more-contagious Ebola virus could threaten the United States and said the crisis warrants the deployment of thousands of American troops to the affected countries.
What virologists don’t like to talk about
The possibility of an airborne-transmissible Ebola virus is one “that virologists are loath to discuss openly but are definitely considering in private,” wrote Osterholm. In its current form, the virus spreads only through contact with bodily fluids, he noted, but with more human transmission in the past few months than probably occurred in the past 500 years, the virus is getting plenty of chances to evolve.
“Each new infection represents trillions of throws of the genetic dice,” he said.
“If certain mutations occurred, it would mean that just breathing would put one at risk of contracting Ebola. Infections could spread quickly to every part of the globe, as the H1N1 influenza virus did in 2009, after its birth in Mexico.”
Osterholm added that public officials are reluctant to talk about this risk because they fear being accused of screaming “Fire!” in a crowded theater. “But the risk is real, and until we consider it, the world will not be prepared to do what is necessary to end the epidemic.”
As evidence of the risk, he noted that Canadian researchers in 2012 showed that Ebola Zaire, the species in the West African epidemic, could spread by the respiratory route from pigs to monkeys.
Even without airborne Ebola contagion, there’s a risk of Ebola migrating to developing-world megacities such as Nairobi, Kinshasa, or Karachi, possibly touching off new epidemics, Osterholm wrote.
In the face of the grave risks, someone needs to exercise “command and control,” and the best candidate is the United Nations, he asserted.
The UN “is the only international organization that can direct the immense amount of medical, public health, and humanitarian aid that must come from many different countries and nongovernmental groups to smother this epidemic. Thus far it has played at best a collaborating role, and with everyone in charge, no one is in charge.”
Besser: US must take the lead
Besser, in appealing for a vastly greater Ebola response from the United States, sketched bleak scenes of sick people in Monrovia, Liberia, waiting to get into overcrowded treatment centers and burial teams trying to collect bodies from the homes of terrified people who deny that their loved ones died of Ebola.
Recalling the warning last week from current CDC Director Tom Frieden, MD, MPH, that the window of opportunity to stop the epidemic is closing, Besser wrote, “I don’t think the world is getting the message. The magnitude of the response needed for a deadly outbreak like this in a staggeringly poor country demands both dollars and people.”
He said his CDC experience taught him that “a military-style response during a major health crisis saves lives.” In foreign public health emergencies, the CDC usually provides technical support to governments, but “this crisis calls for much more.”
Noting that the epidemic is threatening the stability of the affected countries, Besser asserted that an expanded American response would improve both global security and health security.
“While one Ebola case in the United States is unlikely to spark an outbreak, things could change if the virus becomes more easily transmittable,” he added. “We already know it’s mutating.” He called the outbreak more disturbing than anything he witnessed in 13 years at the CDC.
Besser welcomed recent moves to scale up US aid to West Africa, including the Obama administration’s request for more funds, but he said much more is needed.
He called for large field hospitals staffed by Americans to treat Ebola patients, plus active US involvement in strengthening infection control, staffing burial teams, and detecting new cases.
“A few thousand U.S. troops could provide the support that is so desperately needed,” he added. “There could be casualties, but what military operation is ruled out solely because it is dangerous?”
“We know how to control Ebola. It’s time to step up and get the job done,” he concluded.
MSF president speaks out
Some similar points were made in another Washington Post commentary, this one from Joanne Liu, MD, president of Doctors without Borders (MSF), the leading private aid group fighting Ebola in West Africa.
Using words similar to those she used at a UN briefing last week, Liu described the grim situation in West Africa and said MSF has been “completely overwhelmed.”
“We need a large-scale deployment of highly trained personnel who know the protocols for protecting themselves against highly contagious diseases and who have the necessary logistical support to be immediately operational. Private aid groups simply cannot confront this alone,” she wrote.
THE Ebola epidemic in West Africa has the potential to alter history as much as any plague has ever done.
There have been more than 4,300 cases and 2,300 deaths over the past six months. Last week, theWorld Health Organization warned that, by early October, there may be thousands of new cases per week in Liberia, Sierra Leone, Guinea and Nigeria. What is not getting said publicly, despite briefings and discussions in the inner circles of the world’s public health agencies, is that we are in totally uncharted waters and that Mother Nature is the only force in charge of the crisis at this time.
There are two possible future chapters to this story that should keep us up at night.
The first possibility is that the Ebola virus spreads from West Africa to megacities in other regions of the developing world. This outbreak is very different from the 19 that have occurred in Africa over the past 40 years. It is much easier to control Ebola infections in isolated villages. But there has been a 300 percent increase in Africa’s population over the last four decades, much of it in large city slums. What happens when an infected person yet to become ill travels by plane to Lagos, Nairobi, Kinshasa or Mogadishu — or even Karachi, Jakarta, Mexico City or Dhaka?
The second possibility is one that virologists are loath to discuss openly but are definitely considering in private: that an Ebola virus could mutate to become transmissible through the air. You can now get Ebola only through direct contact with bodily fluids. But viruses like Ebola are notoriously sloppy in replicating, meaning the virus entering one person may be genetically different from the virus entering the next. The current Ebola virus’s hyper-evolution is unprecedented; there has been more human-to-human transmission in the past four months than most likely occurred in the last 500 to 1,000 years. Each new infection represents trillions of throws of the genetic dice.
If certain mutations occurred, it would mean that just breathing would put one at risk of contracting Ebola. Infections could spread quickly to every part of the globe, as the H1N1 influenza virus did in 2009, after its birth in Mexico.
Why are public officials afraid to discuss this? They don’t want to be accused of screaming “Fire!” in a crowded theater — as I’m sure some will accuse me of doing. But the risk is real, and until we consider it, the world will not be prepared to do what is necessary to end the epidemic.
In 2012, a team of Canadian researchers proved that Ebola Zaire, the same virus that is causing the West Africa outbreak, could be transmitted by the respiratory route from pigs to monkeys, both of whose lungs are very similar to those of humans. Richard Preston’s 1994 best seller “The Hot Zone” chronicled a 1989 outbreak of a different strain, Ebola Reston virus, among monkeys at a quarantine station near Washington. The virus was transmitted through breathing, and the outbreak ended only when all the monkeys were euthanized. We must consider that such transmissions could happen between humans, if the virus mutates.
First, we need someone to take over the position of “command and control.” The United Nations is the only international organization that can direct the immense amount of medical, public health and humanitarian aid that must come from many different countries and nongovernmental groups to smother this epidemic. Thus far it has played at best a collaborating role, and with everyone in charge, no one is in charge.
A Security Council resolution could give the United Nations total responsibility for controlling the outbreak, while respecting West African nations’ sovereignty as much as possible. The United Nations could, for instance, secure aircraft and landing rights. Many private airlines are refusing to fly into the affected countries, making it very difficult to deploy critical supplies and personnel. The Group of 7 countries’ military air and ground support must be brought in to ensure supply chains for medical and infection-control products, as well as food and water for quarantined areas.
The United Nations should provide whatever number of beds are needed; the World Health Organization has recommended 1,500, but we may need thousands more. It should also coordinate the recruitment and training around the world of medical and nursing staff, in particular by bringing in local residents who have survived Ebola, and are no longer at risk of infection. Many countries are pledging medical resources, but donations will not result in an effective treatment system if no single group is responsible for coordinating them.
Finally, we have to remember that Ebola isn’t West Africa’s only problem. Tens of thousands die there each year from diseases like AIDS, malaria and tuberculosis. Liberia, Sierra Leone and Guinea have among the highest maternal mortality rates in the world. Because people are now too afraid of contracting Ebola to go to the hospital, very few are getting basic medical care. In addition, many health care workers have been infected with Ebola, and more than 120 have died. Liberia has only 250 doctors left, for a population of four million.
This is about humanitarianism and self-interest. If we wait for vaccines and new drugs to arrive to end the Ebola epidemic, instead of taking major action now, we risk the disease’s reaching from West Africa to our own backyards.
Story 1: American People Will Push-back on Election Day November 4 — Democrat Party Candidates Will Lose Due To Job Insecurity, The Economy, Obama-care, Amnesty for Illegal Aliens, Tax Hikes, Failed Economic and Foreign Policies in Libya, Syria, Iraq and Iran, and Scandals Including Benghazi, Fast and Furious, NSA, IRS, Veterans Administration and Now Ebola — Democrats On Verge of Losing Massively Including Control of The Senate — Obama is An Epic Failure and Loser That Buried The Democratic Party — Rest In Peace — Videos
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Which Party Should Control Congress? AP/Gallup POLL Results
Latest AP National Poll Is a Nightmare for Democrats
Democrats are more trusted than the GOP on just two of nine top issues, the poll showed.
The economy remains the top issue for likely voters — 91 percent call it “extremely” or “very” important. And the GOP has increased its advantage as the party more trusted to handle the issue to a margin of 39 percent to 31 percent.
With control of the Senate at stake, both parties say they are relying on robust voter-turnout operations — and monster campaign spending — to lift their candidates in the final days. But the poll suggests any appeals they’ve made so far haven’t done much to boost turnout among those already registered. The share who report that they are certain to vote in this year’s contests has risen just slightly since September, and interest in news about the campaign has held steady.
Now brace yourself:
The GOP holds a significant lead among those most likely to cast ballots: 47 percent of these voters favor a Republican controlled-Congress, 39 percent a Democratic one. That’s a shift in the GOP’s favor since an AP-GfK poll in late September, when the two parties ran about evenly among likely voters.
Women have moved in the GOP’s direction since September. In last month’s AP-GfK poll, 47 percent of female likely voters said they favored a Democratic-controlled Congress while 40 percent wanted the Republicans to capture control. In the new poll, the two parties are about even among women, 44 percent prefer the Republicans, 42 percent the Democrats.
The gender gap disappearing almost entirely would be a shocking development; at this point, it’s just one poll, but it’s something to look for in future polls. Democrats can console themselves that this is a national poll, and the biggest fights of the midterm — the Senate races — are occurring in about a dozen states. Having said that, almost all of those states are Republican-leaning ones that Romney won. If the national electorate is sour on Democrats, it’s extremely difficult to envision a scenario where Arkansas’s Mark Pryor hangs on despite the pro-GOP atmosphere,and Alaska’s Mark Begich, and Louisiana’s Mary Landrieu, and so on for the other endangered red-state Democratic senators. One or two might survive, but the rest . . .
The polls are grim, Mr. President.
America’s Anxious Mood and What it Means for Republicans
Every political and presidential election takes place within a context and environment. And while it’s impossible to know what things will look like two Novembers from now, the overall mood of the nation then is bound to have some similarities to the mood of the nation now.
So what is the mood at this moment? The predominant feeling of Americans, according to polling data, is deeply unsettled and anxious, the product in large part of the multiplying failures of the Obama administration.
Think of the list from just the last year, from the disastrous rollout of healthcare.gov to the VA scandal, the flood of immigrants (many of them children) crossing the southern border, the Russian invasion of Crimea and its destabilization of Ukraine, Islamist advances in Libya, the colossal misjudgment about ISIS and the half-hearted air campaign the president is waging against it, and now the string of mistakes by the CDC in dealing with the Ebola virus.
Given all of this, and assuming that in two years the political environment and psychological state of Americans is roughly what it is now, it’s interesting to contemplate some of the qualities they may be looking for in a GOP nominee.
My guess: A conservative who radiates competence, steadiness, and reassurance; who is perceived as principled, reform-minded, and reality-based; and who’s comfortably associated with a middle-class governing agenda. “Our main task is not to see that people of great wealth add to it but that those without much money have a greater chance to earn some,” is how former Indiana Governor Mitch Daniels put it in 2011, and his critique still holds. This can be done while also focusing needed attention on those living in the shadows of society.
In the aftermath of the Obama era, Americans will be a good deal more skeptical ofempty, extravagant rhetoric. The public can also do without political figures comparing themselves to Michael Jordan, LeBron James, and Jesus (all of whom Obama or his closest aides have compared Mr. Obama to). A modesty about what government can accomplish would be most welcomed; so would distrust of those who cling to ideology even when facts argue the contrary.
Voters are likely to trust individuals who have demonstrated a mastery of governing and can identify with, and have something to say about, the challenges facing many Americans. (One example is soaring higher education costs, a subject very few Republicans talk about and even fewer Republicans have solutions for.) The Republican Party’s standard-bearer certainly needs to be perceived as modern, future-oriented, and understanding the ways the world is changing.
A GOP nominee will also have to speak more to people’s aspirations than to their fears. A campaign that could be symbolized by an angry, clenched fist won’t work. Demonstrating touches of grace and winsomeness probably will. And because Republicans are on a long-term losing streak at the presidential level, including having lost the popular vote in five of the last six elections, they’ll need to find someone who is able to do more than rally the faithful. They’ll have to win over a significant number of people who are not now voting Republican but are persuadable. Which means Republicans might want to look to someone characterized by intellectual depth and calm purpose rather than stridency. In a recent speech, Tony Blair said, “In the end parties can please themselves or please the people.” He contrasted those who have the character of a governing party with those who seem like the shriekers at the gates outside. That’s a distinction worth bearing in mind.
To be sure, no single individual will embody all these qualities, and someone may well come along who personifies other characteristics in a way that is highly appealing. In addition, of course, politics is never static. But my guess is that given the mood and attitudes of Americans right now, some combination of the traits I’ve sketched out will be needed if Republicans hope to win.
While I fully expect Republicans to do quite well in the mid-term elections 15 days from now, it’s worth recalling that Republicans did historically well in 2010 (adding 63 seats in the House and six seats in the Senate) yet lost the presidency and House and Senate seats in 2012. And like it or not, we’re in a period when the Republican Party’s image has reached a historic low; when a majority of Americans said last year that the GOP is out of touch (62 percent), not open to change (56 percent), and too extreme (52 percent); and when, at the presidential level at least, the GOP faces an uphill climb.
President Obama’s cascading failures will make things easier for Republicans in 2016, but it still won’t be easy.
One of the more amusing things to observe as we get closer to the midterm elections is the great push-and-pull that’s going on between Democratic candidates and the president.
A nearly endless number of Democrats are distancing themselves from Mr. Obama, including those who have voted with him 99 percent of the time. Perhaps the most comical performance so far was by Alison Lundergan Grimes, the Democrat in Kentucky who’s challenging Mitch McConnell. Ms. Grimes has repeatedly refused to say whether she voted for Mr. Obama in 2008 and 2012, including invoking a high constitutional principle to keep her sacred little secret.
It’s now gotten to the point where even the chairwoman of the DNC, Debbie Wasserman Schultz, distanced herself from the president of her own party. And here’s what really wonderful about this: Mr. Obama won’t let Democrats run from him. He’s like their hound of heaven.
Earlier this month, in a speech to Northwestern University, the president said, “I am not on the ballot this fall. Michelle’s pretty happy about that. But make no mistake: These policies are on the ballot. Every single one of them.” And just in case that message was lost on folks, earlier this week, in an interview on Al Sharpton’s radio show, Mr. Obama said this:
some of the candidates there, you know, it is difficult for them to have me in the state because the Republicans will use that to try to fan Republican turnout. The bottom line is, though, these are all folks who vote with me — they have supported my agenda in Congress.
This isn’t about my feelings being hurt. These are folks who are strong allies and supporters of me. And I tell them, I said, you know what, you do what you need to win. I will be responsible for making sure that our voters turn up.
Now in this case, the president is absolutely right; every one of the Democratic incumbents on the ballot this November is a stalwart supporter of the Obama agenda. But they’re frantically trying to pretend they’re not; and the president, in denying them this fiction, is complicating their lives immeasurably.
AP-GfK Poll: 4 factors shaping the upcoming midterm election, and another that’s not
Someone has to win.
Most Americans say they dislike both the Republicans and the Democrats, but a new Associated Press-GfK poll finds more of them now say they would like the GOP to control Congress over the Democrats. That’s in part because, on major issues including the economy and protecting the country, Republicans have gained an edge as the more trusted party among likely voters. But one major issue making headlines recently does not appear to be making much difference in how Americans are viewing the election, a new Associated Press-GfK poll shows.
Five things to know from the AP-GfK poll: Four that are shaping the contest, and one that likely won’t.
THE ECONOMY, STILL TOPS
Most Americans remain deeply concerned about the direction of the economy, and the GOP is in a position to take advantage of that concern. Sixty-one percent of Americans describe the economy as poor, while only 38 percent say that it is good. Nine in 10 likely voters call the economy an extremely or very important issue, topping all other issues tested in the poll by more than 10 percentage points.
The new poll shows the two parties about even on which one adults trust to handle the economy, but among those most likely to cast a ballot in November, Republicans have the edge, 39 percent to 31 percent. The Republican advantage on the economy is more pronounced among men (14 points) than among women (3 points).
TERRORISM AND THE ISLAMIC STATE
Fears of terrorism, as well as the threat posed by the Islamic State group in Iraq and Syria, continue to be top issues for Americans, and Republicans have an edge on handling both issues. Likely voters trust Republicans more than Democrats on protecting the country, 42 percent to 20 percent, and on handling international crises, 35 percent to 25 percent. Republicans also hold a smaller lead on handling the U.S. image abroad, 33 percent to 27 percent.
As airstrikes in Syria and Iraq continue, the poll suggests concerns about the Islamic State group may be retreating in importance. The percentage of likely voters saying the threat posed by the Islamic State is an extremely or very important issue fell 6 points to 73 percent, while the share calling terrorism (76 percent) or the U.S. role in world affairs (66 percent) important issues held steady.
THE EXPECTATIONS GAME
Most likely voters now say they think the Republican Party will capture control of Congress, putting the voting public largely in line with the most prominent election forecasters.
Voters’ expectations aren’t quite as black and white as those of electoral prognosticators, however. Combining a question about which party voters think will win the Senate with one on who they think will win the House, half of likely voters (50 percent) predict the Republicans will both capture the Senate and retain the House, while 22 percent think things will stay just as they are. Those who think the election will result in both a Democratic takeover of the House and a hold in the Senate make up 23 percent of likely voters. And a scant 5 percent think both houses of Congress will change hands, an outcome predicted by roughly zero election-watchers. Among those likely voters who say they are paying “a great deal” of attention to news about the election, just 2 percent foresee that outcome.
PREFERRED DOESN’T MEAN LOVED
Likely voters in the new poll say they would prefer to have the Republicans win control of Congress (47 percent) in greater numbers than favor the Democrats (39 percent). But there are few signs in the poll that the preference extends beyond the ballot box.
Majorities have unfavorable opinions of each party: 57 percent dislike the Democrats (including 13 percent of Democrats) while 54 percent are repelled by the Republicans (17 percent of Republicans report unfavorable views of their own party). Seventy percent say they’re angry or dissatisfied with the Republican leaders in Congress, 62 percent with the Obama administration.
And none of either party’s congressional leaders generates much love among the likely electorate. On the House side, both Nancy Pelosi (61 percent unfavorable) and John Boehner (55 percent unfavorable) inspire more dislike than affection, and in the Senate, Mitch McConnell and Harry Reid merit favorable reviews from just 22 percent each. McConnell is a bit less well-known and generates fewer unfavorable reviews (40 percent see him unfavorably) than his Democratic peer (50 percent unfavorable).
Although three-quarters of Americans see the U.S. response to the Ebola outbreak as an important issue, neither party stands out to most voters as more trustworthy than the other on handling public health issues like it.
The Ebola outbreak is one of the top issues on voters’ minds as Election Day approaches, with 74 percent saying it is a very or extremely important issue. And likely voters aren’t happy with the administration’s response, as 56 percent say they disapprove of Obama’s handling of the U.S. response to the Ebola outbreak.
But that doesn’t mean either party is poised to take advantage of Ebola fears come Nov. 4. More than half of likely voters say either that they trust both parties equally (29 percent) or that they trust neither party (24 percent) to address public health issues like Ebola. Respondents who do have a favored party on the issue are about evenly divided between Republicans and Democrats, 25 percent to 22 percent. Among those likely voters who call the issue “extremely important,” Republicans do have an edge, 31 percent to 19 percent, yet 49 percent decline to choose one over the other.
The AP-GfK Poll was conducted Oct. 16-20, using KnowledgePanel, GfK’s probability-based panel designed to be representative of the U.S. population. It involved online interviews with 1,608 adults, and has a margin of sampling error of plus or minus 2.8 percentage points for all respondents. Among 968 likely voters, the margin of sampling error is plus or minus 3.6 points.
Respondents were first selected randomly using phone or mail survey methods, and later interviewed online. People selected for KnowledgePanel who didn’t otherwise have access to the Internet were provided with the ability to access the Internet at no cost to them.
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Americans want flight restrictions from Ebola countries. And it’s not close.
By Aaron Blake
Nearly two-thirds of Americans say they are concerned about an Ebola outbreak in the United States, and about the same amount say they want flight restrictions from the countries in West Africa where the disease has quickly spread.
A new poll from the Washington Post and ABC News shows 67 percent of people say they would support restricting entry to the United States from countries struggling with Ebola. Another 91 percent would like to see stricter screening procedures at U.S. airports in response to the disease’s spread.
Thus far, some countries in Europe have restricted flights from these countries in West Africa, and an increasing number of U.S. lawmakers are calling for similar bans. The White House has yet to increase restrictions, with federal officials saying such a move could actually increase the spread of the disease by hampering the movement of aid workers and supplies.
Concern about Ebola, at this point, is real but not pervasive. About two-thirds (65 percent) say they are concerned about an Ebola outbreak in the United States. But while people are broadly concerned about an outbreak, they are not necessarily worried about that potential outbreak directly affecting them. Just 43 percent of people are worried about themselves or someone in their family becoming infected – including 20 percent who are “very worried.”
That finding echoes a Pew poll from last week which showed just 11 percent were “very worried” about themselves or their families becoming infected. Since that survey, Dallas Ebola patient Thomas Eric Duncan died, and news that a nurse who provided care for him became infected broke on the final day of the Post-ABC poll.
By comparison, slightly more Americans said they were worried about the H1N1 virus – a.k.a. the swine flu – in October 2009 (52 percent). Concern about Ebola is about on-par with concern about Avian influenza – a.k.a. the bird flu – in 2006 (41 percent) and slightly higher than concern about Sudden Acute Respiratory Syndrome (SARS) in 2003 (as high as 38 percent).
The support for increasing restrictions puts the White House in a tough spot. Given the moves by other countries and the American public’s stance, there is increasing pressure to act. And given the very real — but still somewhat muted — concerns about the disease, that’s significant, especially if the disease continues to expand.
The Department of Homeland Security announced Tuesday that all travelers from Ebola outbreak countries in West Africa will be funneled through one of five U.S. airports with enhanced screening starting Wednesday.
Customs and Border Protection within the department began enhanced screening — checking the traveler’s temperature and asking about possible exposure to Ebola — at New York’s John F. Kennedy International Airport on Oct. 11.
Enhanced screening for travelers from Liberia, Sierra Leone and Guinea was expanded Oct. 16 to Washington Dulles, Chicago O’Hare, New Jersey’s Newark and Hartsfield-Jackson Atlanta international airports.
Those airports were supposed to screen 94% of the average 150 people per day arriving from the three countries. Lawmakers from other states asked for enhanced screening at their airports, too.
Some lawmakers have called for more restrictions, such as suspending visas or denying entry at ports for citizens from the three countries.
Jeh Johnson, secretary of Homeland Security, announced that travelers from West Africa must arrive at one of the five airports starting Wednesday.
“We are working closely with the airlines to implement these restrictions with minimal travel disruption,” Johnson said. “If not already handled by the airlines, the few impacted travelers should contact the airlines for rebooking as needed.”
The enhanced screening will apply to anyone who traveled recently to, from or through the three outbreak countries, according to the department’s announcement to be published Thursday in the Federal Register. Customs and Border Protection will work with airlines to identify potential travelers before they board, but airlines will be obligated to comply with the rule for carrying to the USA any passengers who recently traveled through the region, according to the filing.
The restrictions should affect only about nine travelers per day who would have arrived at other airports. Katie Cody, a spokeswoman for American Airlines, which serves Europe from hubs such as Philadelphia and Charlotte, said the airline has no concerns about the change.
“We have been tracking that, and we don’t have any concerns because the numbers are so small,” Cody said.
British Airways, which serves a variety of U.S. destinations other than the five targeted airports, said it would comply with the measures.
“Customers affected will be offered a refund or will be rerouted if there is availability,” spokeswoman Michele Kropf said.
Republican lawmakers offered muted praise but pressed for stricter travel restrictions.
“In addition to requiring all travelers from at-risk countries to fly through airports with enhanced screening measures in place, I continue to call on the administration to suspend all visas from Liberia, Sierra Leone and Guinea,” said Rep. Michael McCaul, R-Texas, the head of the House Homeland Security Committee.
The head of the House Judiciary Committee, Rep. Bob Goodlatte, R-Va., said a “real solution” is to deny entry to anyone from the three countries under a provision of the 1952 Immigration and Nationality Act.
“President Obama has a real solution at his disposal under current law and can use it at any time to temporarily ban foreign nationals from entering the United States from Ebola-ravaged countries,” Goodlatte said. “The vast majority of Americans strongly support such a travel moratorium, and I urge the president to take every step possible to protect the American people from danger.”
Rep. John Conyers of Michigan, the top Democrat on the House Judiciary Committee, said steering travelers through the five airports is a sensible precaution.
“As agreed upon by experts in both the public health and transportation communities, issuing a blanket travel ban would not only be counterproductive, but it would also irresponsibly impede getting much-needed supplies and relief to the countries that need it most,” Conyers said.
Roger Dow, CEO of the U.S. Travel Association, a trade group for all aspects of travel, praised the move to calm travel concerns while avoiding a travel ban.
“The Obama administration continues to heed the counsel of an overwhelming consensus of health and security experts and resist calls for any sort of travel ban on the grounds that it will be counterproductive to efforts to contain Ebola,” Dow said.
A Liberian national, Thomas Eric Duncan, who became the first person diagnosed with the disease in the USA after arriving in Dallas on Sept. 20, had a temperature of 97.3 degrees but didn’t tell airport officials in Monrovia, Liberia, that he had cared for a pregnant woman suffering from Ebola. He died Oct. 8, and two nurses who treated him have become infected.
Sen. Charles Schumer, D-N.Y., said the enhanced screening adds a layer of protection against Ebola entering the country.
“The Department of Homeland Security’s policy to funnel all passengers arriving from Ebola hot spots to one of these five equipped airports is a good and effective step towards tightening the net and further protecting our citizens,” Schumer said.
Obama and Johnson have said they will continue to monitor travel restrictions for possible changes.
“We are continually evaluating whether additional restrictions or added screening and precautionary measures are necessary to protect the American people and will act accordingly,” Johnson said.
Gabbard Calls On CDC To Increase Incubation Period To Prevent Ebola Spread
By Chad Blair
Rep. Tulsi Gabbard (D-HI) has called on the Center for Disease Control to implement stricter incubation guidelines for people who have been in contact with patients “confirmed or suspected” to have the Ebola virus.
According to a press release from her office, Gabbard is calling on the CDC to increase the quarantine and restriction period from the 21-day standard to 42 days, “based on the latest scientific studies and the World Health Organization report that the incubation period for the deadly Ebola virus can extend as long as 42 days.”
On Friday, Gabbard called for the “immediate suspension” of visas for citizens of Ebola-stricken West African nations as well as flights from those countries into the United States.
“Recent mistakes have revealed that the U.S. public health system is clearly not fully prepared to combat Ebola and prevent its spread in the United States,” she said in a statement.
Democrats like Gabbard are among a growing number who are “beginning to sound more like Republicans when they talk about Ebola. And Republicans are moving into overdrive with their criticism of the government’s handling of the deadly virus,” according to The Washington Post.
“The sharpened rhetoric, strategists say, suggests Democrats fear President Obama’s response to Ebola in the United States could become a political liability in the midterm election and Republicans see an opportunity to tie increasing concerns about the disease to the public’s broader worries about Obama’s leadership.”
The Washington Post notes, however, that Gabbard is “a liberal Democrat who is not in any danger of losing reelection.” It also reports that a Washington Post-ABC News poll showed that “67 percent of Americans would support restricting entry to the United States from countries fighting dealing with an Ebola crisis.”
How is the end of an Ebola outbreak decided and declared?
Information note – October 2014
Who decides the date?
The WHO Ebola outbreak response team is responsible for establishing the date of the end of the outbreak in collaboration with the affected country’s subcommittee for surveillance, epidemiology and laboratory.
How is the date determined?
An Ebola virus disease outbreak in a country can be declared over once 42 days have passed and no new cases have been detected. The 42 days represents twice the maximum incubation period for Ebola (21 days). This 42-day period starts from the last day that any person in the country had contact with a confirmed or probable Ebola case.
This includes health care workers who have been exposed to patients with Ebola virus disease, even if the health worker was wearing personal protective equipment and followed infection control procedures since such a person could be exposed accidentally without realizing it. In the setting of an Ebola treatment centre, the date of the last infectious contact is defined as the day when the last patient in the treatment centre tested negative for Ebola virus disease, using a real-time reverse-transcriptase polymerase chain reaction (RT-PCR) test.
If no new case has been detected at the end of this 42-day period, the risk of a further case is very low, and the outbreak is declared over.
Why 42 days?
The maximum incubation period for Ebola virus disease is 21 days. The 42-day period set by WHO (twice the maximum incubation period) provides a margin of security to cover any possible missed cases, uncertainty in reporting dates or hidden chains of transmission. (*)
During the 42-day period, the surveillance system should be fully functional, so that all contacts of the last patient are followed to detect possible chains of transmission.
What is the procedure to make the declaration?
The WHO Ebola outbreak response team in collaboration with the affected country’s subcommittee for surveillance, epidemiology and laboratory determines the date of the end of the epidemic. The government of the affected country, in collaboration with WHO and international partners, makes an official declaration of the end of the epidemic.
The Obama administration has reversed course on putting travel restrictions on those coming from three West African nations tainted with Ebola and is putting in place demands that they enter only through five U.S. airports prepared to screen for the virus.
Homeland Security Secretary Jeh Johnson said in a statement that the new rules will take effect Wednesday, bowing to demands from both parties that the U.S. do a better job so secure the border from Ebola.
“Today, as part of the Department of Homeland Security’s ongoing response to prevent the spread of Ebola to the United States, we are announcing travel restrictions in the form of additional screening and protective measures at our ports of entry for travelers from the three West African Ebola-affected countries,” said Johnson.
He said the rules require that anyone coming from Liberia, Sierra Leone or Guinea enter the U.S. only through the five airports where special Ebola screenings have been set up: New York’s John F. Kennedy, Newark Liberty, Washington Dulles, Atlanta’s Hartsfield-Jackson and Chicago’s O’Hare.
“All passengers arriving in the United States whose travel originates in Liberia, Sierra Leone or Guinea will be required to fly into one of the five airports that have the enhanced screening and additional resources in place. We are working closely with the airlines to implement these restrictions with minimal travel disruption. If not already handled by the airlines, the few impacted travelers should contact the airlines for rebooking, as needed,” said the statement.
He said that passengers flying into those airports on flights originating in Liberia, Sierra Leone and Guinea “are subject to secondary screening and added protocols, including having their temperature taken, before they can be admitted into the United States. These airports account for about 94 percent of travelers flying to the United States from these countries.”
There are no direct, non-stop commercial flights from Liberia, Sierra Leone or Guinea to the U.S.
NIH unit treating Dallas nurse for Ebola is one of 4 special isolation facilities in U.S.
By Lena H. Sun
It has a specially designed air-flow system to prevent contaminated air from leaving the patient room. It requires anyone who enters to be buzzed in. Personnel who work there receive special training in infection control to prevent the spread of bioterror agents, natural or man-made. It also has a tiny gym.
Welcome to the Special Clinical Studies Unit at the National Institutes of Health in Bethesda, Md. It is a 4,000-square-foot unit inside the NIH Clinical Center, the nation’s only hospital dedicated to research, which provides free state-of-the-art care to very sick patients from all over the world.
Now it’s home to its first confirmed Ebola patient, Nina Pham.
Pham is the first patient with a confirmed infectious disease to be cared for in the special seven-bed unit, center director John Gallin said in an interview Friday. Opened in 2010 for patients who need advanced isolation and extended stays, the unit was initially designed to take care of personnel working at the U.S. Army Medical Research Institute of Infectious Diseases in case they were exposed to infectious agents. In more recent years, it has been used to house healthy volunteers participating in live vaccine trials. The volunteers need to be monitored in a place where they can be safely quarantined, Gallin said. To accommodate those healthy volunteers, the unit has a dining room and a “tiny fitness area,” he said.
Pham, the first nurse diagnosed with Ebola after caring for a patient in Dallas, is in fair and stable condition, officials said Friday morning.
What does an Ebola isolation ward look like?
“We are giving her the best possible care on a symptomatic and systemic basis,” Anthony Fauci, director of NIH’s National Institute of Allergy and Infectious Diseases, said during a news conference.
Pham, 26, was transferred to the facility, one of four in the country with a special biocontainment unit, late Thursday. She was diagnosed with Ebola on Sunday, becoming the first person to contract the disease on U.S. soil. Pham had been part of the team that treated Thomas Eric Duncan, a Liberian man who flew to Dallas last month before being diagnosed with Ebola. Duncan died last week, four days before it was announced that Pham had contracted the disease.
“There is no specific therapy that has been proven to be effective against Ebola, and that’s why excellent medical care is critical,” Fauci said. He said Pham was “very, very tired” from her trip.
Patients infected with the Ebola virus require a large number of staffers to provide care around-the-clock. At NIH, that comes out to about 27 people a week — doctors, nurses, support staff — for one patient, Gallin said. With about 50 to 60 such personnel specially trained for infectious disease and critical care, NIH can only care for two Ebola patients at a time, he said.
The four facilities that provide such care were designed in the aftermath of the Sept. 11, 2001, terrorist attacks to protect against bioterrorism. Two of them, Emory University Hospital in Atlanta and the Nebraska Medical Center, are each treating one Ebola patient. The other facility is St. Patrick Hospital in Missoula, Mont.
They require staff to undergo more rigorous training in infection control, and staff must follow strict protocol for putting on and taking off personal protective equipment in a separate anteroom. Officials say meticulous attention to detail in following protocols is what sets them apart from other facilities.
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Emory has treated three Ebola patients, all of whom have recovered. The University of Nebraska treated one patient who recovered and is now caring for a freelance NBC cameraman. St. Patrick has not yet treated an Ebola patient. The hospital has received so many inquiries that it has set up a special hotline where they are transcribed and forwarded to the appropriate departments.
Bruce Ribner gives a tour of the Emory University Hospital isolation unit which has been used for treatment of patients infected with the Ebola virus. (Emory University via YouTube)
Unlike the Dallas hospital where Pham and another nurse were infected, which officials said most likely occurred because of a breach of protocol involving personal protective equipment, no health workers taking care of the Ebola patients at the special facilities have become infected.
“There is a step-by-step, checklisted procedure to putting on your personal protective equipment for when you go in to the patient’s room to perform your duties and when you come out,” said Mark Rupp, medical director of Nebraska Medical Center’s infection control department, which includes the special unit. “That’s the big difference with what goes on in our unit and what goes on in a regular intensive-care unit.”
The facilities have one person whose only job is to make sure health-care workers put on and take off their protective equipment correctly. At NIH, this person is dubbed “the Watson,” Gallin said, for the sidekick to Sherlock Holmes.
The Watson “has the authority to stop everything at any moment if someone looks like they’re breaking protocol,” Gallin said. The Watson has a checklist, like a pilot’s preflight checklist, and everything has to be done in that order. If not, the Watson can “scream at them and tell them to stop,” Gallin said, which apparently happened at least once Thursday night when doctors and staff were admitting Pham.
The protective gear that health-care workers take off is autoclaved (sanitized via pressurized steam) and then incinerated. Equipment that is not disposable is disinfected according to the manufacturer’s directions. The units also have negative air pressure to prevent germs from spreading beyond patient rooms. For Ebola patients, contaminated air is not such a concern because the disease is not transmitted through the air, but through contact with bodily fluids.
The seven-bed, 4,000-square-foot biocontainment unit at the National Institutes of Health Clinical Center in Bethesda, Md., is a state-of-the-art facility built to keep the world’s scariest pathogens from escaping. The four U.S. facilities are all different — NIH’s even has a gym — but they contain many of the same things. This layout is based on the unit at Emory University in Atlanta.
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Dallas Mayor: ‘It May Get Worse Before it Gets Better’
“There are two things that I harken back to this. The only way that we are going to beat this is person by person, moment by moment, detail by detail. We have those protocols in place, the city and county, working closely with the CDC and the hospital. The second is we want to minimize rumors and maximize facts. We want to deal with facts, not fear. And I continue to believe that while Dallas is anxious about this and with this news this morning, the anxiety level goes up a level, we are not fearful and I’m pleased and proud of the citizens that I talk to day in and day out knowing that there is hope if we take care and do what is right in these details. It may get worse before it gets better. But it will get better.”
The comments were given at a news conference in Dallas this morning announcing that another hospital worker in Dallas has been diagnosed with Ebola.
Nurses’ Union: Ebola Patient Left In Open Area Of ER For Hours
A Liberian Ebola patient was left in an open area of a Dallas emergency room for hours, and nurses treating him worked without proper protective gear and faced constantly changing protocols, according to a statement released by the nation’s largest nurses’ union.
Among those nurses was Nina Pham, 26, who has been hospitalized since Friday after catching Ebola while caring for Thomas Eric Duncan, the first person diagnosed with the virus in the U.S. He died last week.
Public-health authorities announced Wednesday that a second Texas Health Presbyterian Hospital health care worker had tested positive for Ebola, raising more questions about whether American hospitals and their staffs are adequately prepared to contain the virus.
The CDC has said some breach of protocol probably sickened Pham, but National Nurses United contends the protocols were either non-existent or changed constantly after Duncan arrived in the emergency room by ambulance on Sept. 28.
Medical records provided to The Associated Press by Duncan’s family show that Pham helped care for him throughout his hospital stay, including the day he arrived in intensive care with diarrhea, abdominal pain, nausea and vomiting, and the day before he died.
When Pham’s mother learned she was caring for Duncan, she tried to reassure her that she would be safe.
Pham told her: “Mom, no. Don’t worry about me,” family friend Christina Tran told The Associated Press.
Duncan’s medical records make numerous mentions of protective gear worn by hospital staff, and Pham herself notes wearing the gear in visits to Duncan’s room. But there is no indication in the records of her first encounter with Duncan, on Sept. 29, that Pham donned any protective gear.
Deborah Burger of National Nurses United, who convened a conference call with reporters to relay what she said were concerns of nurses at the hospital, said they were forced to use medical tape to secure openings in their flimsy garments and worried that their necks and heads were exposed as they cared for Duncan.
RoseAnn DeMoro, executive director of Nurses United, said the statement came from “several” and “a few” nurses, but she refused repeated inquiries to state how many. She said the organization had vetted the claims, and that the nurses cited were in a position to know what had occurred at the hospital. She did not specify whether they were among the nurses caring for Duncan.
The nurses allege that his lab samples were allowed to travel through the hospital’s pneumatic tubes, possibly risking contaminating of the specimen-delivery system. They also said that hazardous waste was allowed to pile up to the ceiling.
Wendell Watson, a Presbyterian spokesman, did not respond to specific claims by the nurses but said the hospital has not received similar complaints.
“Patient and employee safety is our greatest priority, and we take compliance very seriously,” he said in a statement. He said the hospital would “review and respond to any concerns raised by our nurses and all employees.”
The nurses’ statement said they had to “interact with Mr. Duncan with whatever protective equipment was available,” even as he produced “a lot of contagious fluids.” Duncan’s medical records underscore that concern. They also say nurses treating Duncan were also caring for other patients in the hospital and that, in the face of constantly shifting guidelines, they were allowed to follow whichever ones they chose.
When Ebola was suspected but unconfirmed, a doctor wrote that use of disposable shoe covers should also be considered. At that point, by all protocols, shoe covers should have been mandatory to prevent anyone from tracking contagious body fluids around the hospital.
A few days later, however, entries in the hospital charts suggest that protection was improving.
“RN entered room in Tyvek suits, triple gloves, triple boots, and respirator cap in place,” a nurse wrote.
The Presbyterian nurses are not represented by Nurses United or any other union. DeMoro and Burger said the nurses claimed they had been warned by the hospital not to speak to reporters or they would be fired.
The AP has attempted since last week to contact dozens of individuals involved in Duncan’s care. Those who responded to reporters’ inquiries have so far been unwilling to speak.
David R. Wright, deputy regional administrator for the U.S. Centers for Medicare & Medicaid Services, which monitors patient safety and has the authority to withhold federal funding, said his agency is going to want to get all of the information the nurses provided.
“We can’t talk about whether we’re going to investigate or not, but we’d be interested in hearing that information,” he said.
CDC officials did not immediately respond to requests for comment.
Duncan first sought care at the hospital’s ER late on Sept. 25 and was sent home the next morning. He was rushed by ambulance back to the hospital on Sept. 28. Unlike his first visit, mention of his recent arrival from Liberia immediately roused suspicion of an Ebola risk, records show.
The CDC said 76 staff members at the hospital could have been exposed to Duncan after his second ER visit. Another 48 people who may have had contact with him before he was isolated are being monitored. Pham remained hospitalized Tuesday in good condition and said in a statement that she was doing well.
The Rev. Jim Khoi, pastor at Our Lady of Fatima Church in Fort Worth, which Pham’s family attends, said the 2010 Texas Christian University nursing school graduate appeared to be in good spirits when she spoke to her mother via video chat.
Pham’s mother, Ngoc Pham, is “calm,” Khoi said. “She trusts in God. And she asks for prayers.”
CDC: Ebola Patient Traveled By Air With “Low-Grade” Fever
The CDC has announced that the second healthcare worker diagnosed with Ebola — now identified as Amber Joy Vinson of Dallas — traveled by air Oct. 13, with a low-grade fever, a day before she showed up at the hospital reporting symptoms.
The CDC is now reaching out to all passengers who flew on Frontier Airlines flight 1143 Cleveland to Dallas/Fort Worth. The flight landed at 8:16 p.m. CT.
All 132 passengers on the flight are being asked to call 1 800-CDC INFO (1 800 232-4636). Public health professionals will begin interviewing passengers about the flight Wednesday afternoon.
“Although she (Vinson) did not report any symptoms and she did not meet the fever threshold of 100.4, she did report at that time she took her temperature and found it to be 99.5,” said CDC Director Tom Frieden. Her temperature coupled with the fact that she had been exposed to the virus should have prevented her from getting on the plane, he said. “I don’t think that changes the level of risk of people around her. She did not vomit, she was not bleeding, so the level of risk of people around her would be extremely low.”
Vinson first reported a fever to the hospital on Tuesday (Oct. 14) and was isolated within 90 minutes, according to officials. She did not exhibit symptoms while on the Monday flight, according to crew members. However, the CDC says passenger notification is needed as an “extra level of safety” due to the proximity in time between the flight and the first reported symptoms.
“Those who have exposures to Ebola, she should not have traveled on a commercial airline,” said Dr. Frieden. “The CDC guidance in this setting outlines the need for controlled movement. That can include a charter plane; that can include a car; but it does not include public transport. We will from this moment forward ensure that no other individual who is being monitored for exposure undergoes travel in any way other than controlled movement.”
Frieden specifically noted that the remaining 75 healthcare workers who treated Thomas Duncan at Texas Health Presbyterian Hospital will not be allowed to fly. The CDC will work with local and state officials to accomplish this.
Frontier Airlines is working closely with the CDC to identify and notify all passengers on the flight. The airline also says the plane has been thoroughly cleaned and was removed from service following CDC notification early Wednesday morning.
However, according to Flighttracker, the plane was used for five additional flights on Tuesday before it was removed from service. Those flights include a return flight to Cleveland, Cleveland to Fort Lauderdale–Hollywood International Airport (FLL), FLL to Cleveland, Cleveland to Hartsfield–Jackson Atlanta International Airport (ATL), and ATL to Cleveland.
While in Ohio, Vinson visited relatives, who are employees at Kent State University. The university is now asking Vinson’s three relatives stay off campus and self-monitor per CDC protocol for the next 21 days out of an “abundance of caution.”
“It’s important to note that the patient was not on the Kent State campus,” said Kent State President Beverly Warren. “She stayed with her family at their home in Summit County and did not step foot on our campus. We want to assure our university community that we are taking this information seriously, taking steps to communicate what we know,” said Dr. Angela DeJulius, director of University Health Services at Kent State.
Vinson is a Kent State graduate. She received degrees from there in 2006 and 2008.
Cleveland’s Public Health Director, Toinette Parrilla, said Vinson was visiting in preparation for her wedding. While there, she visited her mother and her fiance.
The latest Ebola diagnosis was announced by the Texas Department of State Health Services early Wednesday morning.
Vinson is the second worker at Presbyterian Hospital to be diagnosed after providing health care to Duncan, the first person to be diagnosed with Ebola in the United States. He died last week.
Medical records provided to The Associated Press by Thomas Eric Duncan’s family show Amber Joy Vinson was actively engaged in caring for Duncan in the days before his death. The records show she inserted catheters, drew blood, and dealt with Duncan’s body fluids.
Dallas Mayor Mike Rawlings addressed the media on Wednesday, saying the patient lives alone and has no pets.
“It may get worse before it gets better,” Rawlings said, “but it will get better.”
Crews worked to decontaminate the common areas of Vinson’s Dallas apartment building Tuesday morning. The apartment unit will be decontaminated by contractors starting early Wednesday afternoon.
The CDC announced that Vinson will be transported to Emory Hospital in Atlanta for further treatment. Two previous American Ebola patients, Dr. Kent Brantly and Nancy Writebol, were treated at Emory and were the first Ebola patients to be treated in the United States. They were released in August.
Nina Pham was diagnosed with the virus over the weekend and remains isolated in good condition. Pham’s dog — a Cavalier King Charles Spaniel named Bentley — has been taken into custody and is being cared for at an undisclosed location.
Frontier Airlines released the following statement:
“At approximately 1:00 a.m. MT on October 15, Frontier was notified by the CDC that a customer traveling on Frontier Airlines flight 1143 Cleveland to Dallas/Fort Worth on Oct. 13 has since tested positive for the Ebola virus. The flight landed in Dallas/Fort Worth at 8:16 p.m. local and remained overnight at the airport having completed its flying for the day at which point the aircraft received a thorough cleaning per our normal procedures which is consistent with CDC guidelines prior to returning to service the next day. It was also cleaned again in Cleveland last night. Previously the customer had traveled from Dallas Fort Worth to Cleveland on Frontier flight 1142 on October 10.
Customer exhibited no symptoms or sign of illness while on flight 1143, according to the crew. Frontier responded immediately upon notification from the CDC by removing the aircraft from service and is working closely with CDC to identify and contact customers who may traveled on flight 1143.
Customers who may have traveled on either flight should contact CDC at 1 800 CDC-INFO.
The safety and security of our customers and employees is our primary concern. Frontier will continue to work closely with CDC and other governmental agencies to ensure proper protocols and procedures are being followed.”
Frontier jet made 5 flights before taken out of service in Ebola scare
The Frontier Airlines jet that carried a Dallas healthcare worker diagnosed with Ebola made five additional flights after her trip before it was taken out of service, according to a flight-monitoring website.
Denver-based Frontier said in a statement that it grounded the plane immediately after the carrier was notified late Tuesday night by the Centers for Disease Control and Prevention about the Ebola patient.
Ebola patient flew day before symptoms surfaced
Amber Joy Vinson of Dallas, traveled by air on Oct. 13, the day before she first reported symptoms.
Flight 1143, on which the woman flew from Cleveland to Dallas/Fort Worth, was the last trip of the day Monday for the Airbus A320. But Tuesday morning the plane was flown back to Cleveland and then to Fort Lauderdale, Fla., back to Cleveland and then to Atlanta and finally back to Cleveland again, according to Daniel Baker, chief executive of the flight-monitoring site Flightaware.com.
He said his data did not include any passenger manifests, so he could not tell how many total passengers flew on the plane Tuesday.
The airline said it is working with the CDC to contact all 132 passengers on the Monday flight that carried the Ebola patient.
Frontier could not be reached to confirm the FlightAware data, and it was unclear if passengers on the additional flights were being contacted.
The passenger “exhibited no symptoms or sign of illness while on Flight 1143, according to the crew,” Frontier said.
The plane went through a routine but “thorough” cleaning Monday night, Frontier said. Airline industry experts said routine overnight cleaning includes wiping down tray tables, vacuuming carpet and disinfecting restrooms.
The healthcare worker also had flown to Cleveland from Dallas three days earlier on Frontier Flight 1142, the airline reported.
In response to the news that another Ebola patient flew on a commercial flight, the union that represents 60,000 flight attendants on 19 airlines is asking the CDC to monitor and care for the four flight attendants who were on flight from Cleveland to Dallas/Fort Worth.
whats it going to take to close the border to people from africa? 10 dead? 100 dead? 1000 dead? we know obumma doesnt give a flying fluke about the american citizens, but isn’t there someone in the government with an ounce of brains? or is this part of obumma’s scheme to declare martial law?…
The Assn. of Flight Attendants “will continue to press that crew members are regularly monitored and provided with any additional resources that may be required,” the group said.
The Ebola scare prompted the union last week to call for better measures to protect flight attendants from exposure to the deadly virus.
The group’s international president, Sara Nelson, suggested that flight attendants are being asked to do too much in the fight against Ebola.
“We are not, however, professional healthcare providers and our members have neither the extensive training nor the specialized personal protective equipment required for handling an Ebola patient,” she said in a statement.
Earlier this month, United Airlines was rushing to contact passengers who flew on two flights that carried a Liberian man infected with Ebola from Brussels to Washington, D.C., and then to Dallas.
The Ebola-stricken healthcare worker who flew on Frontier had been treating the Liberian man, Thomas Eric Duncan, who has since died.
Airline-industry stock prices have taken a beating in recent weeks, with some analysts blaming the Ebola scare.
On Wednesday, stocks of Delta Air Lines and American Airlines fell more than 6% in early trading before partially recovering. With less than 90 minutes remaining in the regular trading session, the two stocks were each down about 2% from Tuesday’s closes. Frontier is privately held.
There are only 19 level 4 bio-containment beds in the whole of the United States…and four in the UK
The UK is well set for an Ebola outbreak (sarcasm alert) We have TWO isolation units, but one is getting ‘redeveloped’ so it’s not available right now. Called High Security Infectious Diseases Units there are two in the country, each capable of taking two patients. One is at The Royal Free Hospital in Hampstead North London, the other, the one getting a bit of a make-over, is at The Royal Victoria Infirmary in Newcastle, up in the north-east of England.
Four level 4 bio-containment beds between 69,000,000 people
In the US there are 4 units geared up to handle Ebola. The National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, has 3 beds. Nebraska Medical Center, Omaha, has 10 beds. Emory Hospital, Atlanta has 3 beds and St Patricks Hospital, Missoula has 3 beds (source)
19 level four biocontainment beds for 317,000,000 people
I think we just found out why the government(s) are under-playing the situation. They simply do not have the facilities to cope with even a small outbreak. They are, in fact in exactly the same position as the dirt-poor hospitals in West Africa…there are not enough facilities to stop the spread of the disease if it gets out. The quality of care is better, but the availability of containment most likely isn’t.
I am sure ‘regular’ isolation units will be pressed into use but they are not designed to handle level 4 biohazards, they are nowhere near as secure medically speaking, as biocontainment units.
A couple of days ago I explained how exponential spread works. You can read that article here if you like. As a quick recap. Once a disease is at the point where every carrier infects 2 more people,(exponential spread) it will continue until it:
A) runs out of hosts
B) is stopped by medical science or
C) mutates into something less harmful.
What follows will show you how woefully inadequately our governments have prepared for something as lethal as Ebola.
In the flu pandemic of 1918-1920 28% of Americans were infected with the disease…try to remember I am talking numbers here not HOW disease spreads or any medical similarities between diseases, 625,000 Americans lost their lives out of some 29,400,000 infections. The population of the United States at that time was 105,000,000 people. (source)
Fast forward to today. If that flu pandemic had hit the United States in 2014, when the population stands at 317,000,000 people 88,760,000 people would have been infected and 2,130,240 of them would have died.
Now, let’s try this with Ebola. I have picked Liberia just because it is in the news due to the Thomas Duncan case.
Liberia has a population of 4,290,000 people, as of the latest figures there have been 3692 cases of Ebola, this represents 0.0086% of the population.Of those infections, 1998 people have died that’s a fatality rate of 54%. (source)
If that same infection and death rate were applied to the United States Ebola would infect 269,000 people and of those 156,281 would die.
Now, if as doctors and scientists fear the basic reproduction rate rises to 2 in Liberia the numbers change very quickly. Using the mean average incubation time of 9 days it would take around 13 weeks for the entire population of Liberia to become infected. (10 doublings starting with 3692 = just under the population of Liberia. This multiplied by 9 days gives us 90 days which divided by 7 gives 12.85 weeks.) Of the 4,290,000 people infected 2,316,000 would lose their lives.
This is just Liberia, not the other affected countries in West Africa.
Translated to an equivalent outbreak in the United States, where the basic reproduction rate is also 2, the numbers are horrifying. Starting with patient zero it would take around 245 days, 35 weeks for every person in the United States to become infected. Of those 17,118,000 people would die. (27.17 doublings x 9 days = 245 days =35 weeks)
Please remember the figures for Liberia are pulled from the CDC website, the percentages are correct.
United States was based on exactly the same parameters as for Liberia…a like for like comparison.
The CDC could be spending their time educating people, advising people to stock up, get ready for the possibility of staying in their homes. Self imposed isolation, or if need be state imposed isolation, that may last for an extended time period may become a reality. They’re not doing it though are they? They are sprouting figures and applying them to West Africa, and they can’t even get that right. They are saying that there could be 1.4 deaths in West Africa in a worst case scenario. When actually applying the figures they supplied with some simple mathematics we can see that 1.4 million deaths is a gross understatement.
Even a basic reproduction rate of 1.7, the latest figure for Liberia it will only take around 30 weeks to get to the same point as the above scenario, over 2,000,000 dead.
Don’t get me wrong, I am not saying that the UK government is any better, if anything they are worse, they don’t even try to do the maths. Most of them went to Eton (a very expensive school that churns out politicians) so it’s unlikely they would be capable of it even if they wanted to. You only have to look at our national finances to see they are no good at sums. They send out press briefings that there will be an emergency COBRA meeting, do you have any clue what that stands for? Let me enlighten you, Cabinet Office Briefing Room A. COBRA is not an emergency planning group, it’s an effing office.
Although I am loathed to say it, it’s time that our governments started worrying about the facilities at home rather than worrying about the facilities abroad. Stopping the disease in Africa does not mean we are out of the woods. There are so many unreported cases, people turned away from medica facilities in West Africa that nobody has the slightest idea how many cases of Ebola are actually out there. The porous borders of the region mean that people move around without the controls that are usually exercised in the west. There has to be a travel ban on non-US citizens entering the United States from these areas, the same applies from the UK.
Border control has to be improved in both countries if we have any hope of halting the spread of this terrible disease. The west is going to be the destination for anyone from Ebola hit areas that can afford to make their way from Africa. Many West Africans have contacts in the west who will help them get out, and shelter them when they arrive. As harsh as it seems this has to be stopped, it’s time for governments to put their own citizens first. Repatriation of your own is one thing, risking millions of lives at home because you won’t man up and prevent foreigners entering is quite another.
Guinea, Liberia and Sierra Leone have been struggling since March to stop what has become the largest Ebola outbreak ever recorded. The disease is causing widespread fear and disruption in West Africa, and shows no signs of being brought under control.
CHRONOLOGY OF COVERAGE
OCT. 15, 2014
Spain’s ad hoc, improvisational response to citizens infected by Ebola virus and brought back to the country underscores holes in West’s readiness to confront wider outbreak; cases of Ebola in Spain have raised urgent questions about risks of disease spreading even in developed countries, particularly among health care workers. MORE
OCT. 15, 2014
Doctors Without Borders criticizes lack of reliable evacuation systems from West Africa, saying that more would volunteer to fight Ebola in region if it were not so difficult to leave in case of emergency; cites fact that it took 50 hours to evacuate French nurse to Paris after she tested positive for virus. MORE
OCT. 15, 2014
Bellevue Hospital is designated as center for treatment of the Ebola virus should it emerge in New York City; announcement comes amid widespread concerns that disease may not be so easily contained by every hospital that has an isolation unit. MORE
OCT. 15, 2014
World Health Organization warns new cases of Ebola virus could reach 10,000 a week in West Africa by December, nearly 10 times the current rate; reports none of the three most heavily affected countries, Liberia, Sierra Leone and Guinea, are adequately prepared for epidemic; comments come in report before the United Nations Security Council, which voices fear that epidemic could renew the risk of political instability in a region barely recovering from civil war.MORE
OCT. 15, 2014
Dr Thomas R Frieden, Centers for Disease Control and Prevention director, acknowledges for first time that quicker and more concerted action on agency’s part might have kept Dallas nurse from contracting Ebola virus; says agency plans a more robust response to any future Ebola cases in American hospitals. MORE
OCT. 15, 2014
Frank Bruni Op-Ed column contends other, more common ailments deserve more concern and attention in United States than Ebola; points out influenza kills between 3,000 and 50,000 Americans per year, and skin cancer kills 10,000 per year; lists other common, and much-researched, illnesses that Americans should vaccinate and protect themselves against. MORE
OCT. 15, 2014
Jere Longman On Soccer column examines plight of SIerra Leone’s national soccer team, caught amid self-destructive feud between nation’s soccer federation and sports ministry; observes that team was already exhausted from playing road-only games due to Ebola outbreak. MORE
OCT. 14, 2014
Transmission of Ebola virus to Dallas nurse Nina Pham forces Centers for Disease Control and Prevention to reconsider its approach to containing the disease; state and federal officials are re-examining whether equipment and procedures are adequate or too loosely followed, and whether more decontamination steps are necessary when health workers leave isolation units. MORE
OCT. 14, 2014
Experience of Emory University Hospital in Atlanta in caring for three Ebola patients calls into question oft repeated assurances from federal health officials that most American hospitals can safely treat disease; transmission of virus to Dallas nurse Nina Pham has also raised questions about general level of preparedness in hospitals around the country; medical experts have begun to suggest it may be better to transfer patients to designated centers with expertise in treating Ebola. MORE
OCT. 14, 2014
Public health concerns about Ebola virus have spread to both political parties, which are engaged in finger-pointing debate that could jar midterm elections; Republicans blame the Obama administration for failing to protect the United States, and Democrats are saying it is GOP budget cutting that has put Americans at risk. MORE
OCT. 14, 2014
Experts rule out notion that Ebola virus has become a super-pathogen and raise doubts that it will evolve into one; say virus is not fundamentally different from those in previous outbreaks dating back to 1976, and it is highly unlikely that natural selection will give it ability to spread more easily, particularly by becoming airborne. MORE
OCT. 14, 2014
Friends of Dallas nurse Nina Pham describe the 26-year-old, part of the team that treated Thomas Eric Duncan, as conscientious and caring, and from a very private family. MORE
OCT. 14, 2014
Editorial warns effort to combat the Ebola virus in Western Africa is lagging dangerously behind; contends the international community must dramatically step up aid if epidemic is to be controlled; holds obligation is particularly strong for the United Sates as it faces first case of patient who contracted the virus domestically. MORE
OCT. 14, 2014
Sierra Leone’s national soccer team is enduring a series of demeaning and discouraging indignities since outbreak of Ebola in West Africa; team is barred from playing in its own stricken country and it must play every match on the road as it struggles to qualify for the 2015 Africa Cup of Nations, continent’s biennial championship. MORE
OCT. 14, 2014
World Bank president Dr Jim Yong Kim, frustrated with slow global response to Ebola outbreak, has made fighting epidemic his mission, driving bank to act on Ebola with uncharacteristic speed; bank has committed $400 million to fighting disease. MORE
OCT. 13, 2014
The topic everyone on Wall Street is discussing urgently but quietly isn’t the volatile stock market. It is Ebola. MORE
OCT. 13, 2014
News that a nurse at Texas Health Presbyterian Hospital has contracted Ebola virus transforms part of Dallas into scene of concern and contamination; residents in victim’s neighborhood are filled with anxiety, while hazardous-materials crews scramble to clean her apartment building. MORE
OCT. 13, 2014
Nurse at Texas Presbyterian Hospital in Dallas becomes first person to contract Ebola within United States; development prompts local, state and federal officials to scramble to determine how she became infected, despite wearing protective gear, and to monitor others potentially at risk; news further stokes fears among health care workers across country. MORE
OCT. 13, 2014
Centers for Disease Control and Prevention say agency will take new steps to help hospital workers protect themselves, providing more training and urging hospitals to practice dealing with potential Ebola patients. MORE
OCT. 13, 2014
Op-Ed article by Prof Siddhartha Mukherjee contends Ebola case of Thomas Eric Duncan in Dallas shows that medical community must rethink concept of quarantine, in light of the absence of any established anti-viral treatment; calls for development of pilot program for rapid-testing quarantine. MORE
OCT. 12, 2014
Liberian Army has suddenly become linchpin in fight against Ebola virus rampaging the country; for decades, Liberians viewed the armed forces with fear due to atrocities committed during civil war. MORE
OCT. 11, 2014
Doctors Without Borders, first to respond to Ebola crisis in West Africa, remains primary international medical aid group battling disease there; strained and overworked charity has erected six treatment centers in West Africa, with plans for more, and has treated the majority of patients, just as they have in previous Ebola outbreaks and some other epidemics in the developing world. MORE
OCT. 10, 2014
Health workers at International Medical Corps treatment center in Liberia face dilemma of how to care for newborn whose mother may have died of Ebola; many health workers have contracted Ebola while attending to births and being exposed to blood and other body fluids, provoking fears of providing maternity care; doctors speculate that Ebola can be transmitted from mother to baby (Series: The Ebola Ward). MORE
OCT. 10, 2014
Britain says it will introduce measures at airports and rail terminals to screen passengers from affected countries as concerns over Ebola grow in Europe. MORE
OCT. 10, 2014
Presidents of Guinea, Liberia and Sierra Leone, nations most affected by the Ebola outbreak, implore world leaders to increase their support to fight the disease; speak at meeting of the World Bank and the International Monetary Fund in Washington. MORE
OCT. 10, 2014
Nebraska Biocontainment Patient Care Unit in Omaha, with arrival of two Ebola patients in last six weeks, is at forefront of the nation’s response to the disease; unit’s 10 beds sat empty for years. MORE
OCT. 10, 2014
Dallas officials say Sgt Michael Monnig, local shefiff’s deputy examined for possible infection with Ebola virus, has tested negative and is sent home from hospital; many in city remain uneasy. MORE
OCT. 9, 2014
Thomas Eric Duncan dies of Ebola in Dallas, renewing questions about whether delay in receiving treatment could have played a role in his death and what role it played in the possibility of his spreading the disease to others; it remains unclear why, and how, Texas Health Presbyterian Hospital did not initially view the Liberian man as a potential Ebola case; nearly 50 people who came into contact with Duncan when he was experiencing active symptoms are being monitored. MORE
OCT. 9, 2014
Federal health officials will require temperature checks for the first time at five major American airports for people arriving from three West African countries hardest hit by Ebola epidemic; however, health experts say measures are more likely to calm worried public than to prevent people with Ebola from entering country; move comes after death of Thomas Eric Duncan, Liberian man who was the first person diagnosed with Ebola in the United States. MORE
OCT. 9, 2014
Bellevue Hospital Center in Manhattan shows off its isolation rooms and its leave-no-skin-cell-uncovered precautions in an attempt to reassure New Yorkers that should the Ebola virus arrive in the city, its premier public hospital could handle it. MORE
OCT. 9, 2014
European leaders are scrambling to upgrade their response to Ebola crisis after Pres Obama’s announcement that he will send 3,000 troops to West Africa to build hospitals and otherwise help in fight against the disease. MORE
OCT. 9, 2014
Spanish health officials explain how auxiliary nurse Maria Teresa Romero Ramos became the first Ebola case in Western Europe, saying that it was likely she became infected when she touched her face with the gloves she had worn while tending to a Spanish missionary with Ebola at a Madrid hospital. MORE
OCT. 9, 2014
Dog named Excalibur who belonged to Ebola-infected nurse Maria Teresa Romero Ramos is destroyed by Spanish health officials, even as protesters and animal rights activists surround Madrid home of the nurse and her husband; online petition calling for dog’s life to be spared drew hundreds of thousands of signatures. MORE
OCT. 9, 2014
Editorial notes new screening procedures directed at travelers entering United States from Guinea, Liberia or Sierra Leone, center of the Ebola epidemic in West Africa; holds screenings, while burdensome and possibly of little practical value, may ease public anxieties about keeping virus out of country and assure people that risks are being minimized. MORE
OCT. 8, 2014
Schedule for a single day at newly opened Ebola treatment center in Suakoko, Liberia, run by International Medical Corps charity, offers portrait of efforts to halt spread of virus; center is both ordinary and otherwordly, where health workers tend to those infected and those quarantined while awaiting test results (Series: The Ebola Ward).MORE
OCT. 8, 2014
Spain’s government comes under heavy criticism for its handling of Western Europe’s first Ebola case, as health care workers argue that they have not been given proper training or equipment to handle the disease; government quarantines three more people and monitors dozens who had come into contact with infected nurse. MORE
OCT. 8, 2014
Centers for Disease Control and Prevention scrambles to address concerns from health workers nationwide as anxiety mounts over Ebola virus; agency has scheduled two nationwide conference calls, but has so far not changed its recommendations on protective gear.MORE
OCT. 8, 2014
Doctors report first positive signs in recovery of Thomas Eric Duncan, Liberian man battling Ebola virus in Dallas hospital; Duncan’s temperature and blood pressure have normalized, though he remains on a ventilator and is still receiving kidney dialysis. MORE
OCT. 8, 2014
Centers for Disease Control and Prevention officials promise additional measures to screen airline passengers arriving in United States for Ebola virus; remain opposed to draconian travel restrictions such as outright bans, saying that they would cause more problems than they would solve. MORE
OCT. 7, 2014
Nurse in Spain becomes first health worker to be infected with Ebola virus outside West Africa, raising serious concerns about how prepared Western nations are to safely treat people with the deadly illness; nurse contracted the illness while treating a Spanish missionary who was infected in Sierra Leone and flown to Madrid, where he died; infection exposes weak spots in Spain’s highly praised health care defense systems. MORE
OCT. 7, 2014
Adel Faqih, Saudi Arabia’s acting health minister, says this year’s hajj has been free of Ebola and other contagious diseases like Middle East Respiratory Syndrome because of measures taken to protect more than two million Muslim pilgrims. MORE
OCT. 7, 2014
Pres Obama says screening for Ebola virus at airports both in the United States and West Africa will increase, but does not offer specifics; Dallas residents remain on edge as they await to learn if those who came into contact with Ebola patient Thomas Eric Duncan became infected. MORE
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Video: Ebola patient escapes quarantine, spreads panic in Monrovia (Liberia)
Judge Jeanine Pirro – Hidden Danger? – Could Illegal Immigrant Kids Bring Diseases To U.S.?
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CDC: Airborne Ebola possible but unlikely
By Elise Viebeck
The Ebola virus becoming airborne is a possible but unlikely outcome in the current epidemic, Centers for Disease Control and Prevention (CDC) Director Tom Frieden said Tuesday.
The outbreak involves Ebola Zaire, a strain that is passed through bodily fluids, not the air. But some experts have expressed fear about viral mutations due to the unprecedented — and rising — number of Ebola cases.
Frieden sought to allay those fears during a call with reporters.
“The rate of change [with Ebola] is slower than most viruses, and most viruses don’t change how they spread,” he said. Frieden is unofficially spearheading the U.S. response to Ebola.
“That is not to say it’s impossible that it could change [to become airborne],” he continued. “That would be the worst-case scenario. We would know that by looking at … what is happening in Africa. That is why we have scientists from the CDC on the ground tracking that.”
A change in the way Ebola spreads would make the virus significantly more dangerous. The disease kills roughly half the people it infects, and lacking a vaccine or cure, its traceable chain of transmission through bodily fluids is one reason officials believe they can contain it.
Still, there is almost no precedent for a human virus mutating to become transmissible in a different way, a key piece of evidence in weighing whether that kind of shift is likely for Ebola.
“We have so many problems with Ebola, let’s not make another one that, of course, is theoretically possible but is pretty way down on the list of likely issues,” infectious diseases expert William Schaffner of Vanderbilt University told Scientific American.
Frieden touted new progress against Ebola in West Africa and Dallas, where a Liberian man remains in critical condition, but warned that “globally, this is going to be a long, hard fight.”
The Dallas patient interacted with 10 definite and 38 possible interlocturos who are now being monitored, he said. None have shown symptoms.
Some Ebola experts worry virus may spread more easily than assumed
Ebola could be spread through air in tight quarters, some scientists fear
Some Ebola experts worry that the virus may spread more easily than thought — through the air in small spaces, for example.
By DAVID WILLMAN contact the reporter NationMedical ResearchAfricaScientific ResearchDiseases and IllnessesEbolaU.S. Centers for Disease Control and Prevention
Ebola researcher says he would not rule out possibility that the virus spreads through air in tight quarters
‘There are too many unknowns here,’ a virologist says of how Ebola may spread
Ebola researcher says he thinks there is a chance asymptomatic people could spread the virus
U.S. officials leading the fight against history’s worst outbreak of Ebola have said they know the ways the virus is spread and how to stop it. They say that unless an air traveler from disease-ravaged West Africa has a fever of at least 101.5 degrees or other symptoms, co-passengers are not at risk.
“At this point there is zero risk of transmission on the flight,” Dr. Thomas Frieden, director of the federal Centers for Disease Control and Prevention, said after a Liberian man who flew through airports in Brussels and Washington was diagnosed with the disease last week in Dallas.
First Ebola infection outside West Africa
Three more people have been hospitalized in Madrid for possible exposure to the Ebola virus after a Spanish nurse tested positive for the virus.
Other public health officials have voiced similar assurances, saying Ebola is spread only through physical contact with a symptomatic individual or their bodily fluids. “Ebola is not transmitted by the air. It is not an airborne infection,” said Dr. Edward Goodman of Texas Health Presbyterian Hospital in Dallas, where the Liberian patient remains in critical condition.
Yet some scientists who have long studied Ebola say such assurances are premature — and they are concerned about what is not known about the strain now on the loose. It is an Ebola outbreak like none seen before, jumping from the bush to urban areas, giving the virus more opportunities to evolve as it passes through multiple human hosts.
Dr. C.J. Peters, who battled a 1989 outbreak of the virus among research monkeys housed in Virginia and who later led the CDC’s most far-reaching study of Ebola’s transmissibility in humans, said he would not rule out the possibility that it spreads through the air in tight quarters.
“We just don’t have the data to exclude it,” said Peters, who continues to research viral diseases at the University of Texas in Galveston.
Dr. Philip K. Russell, a virologist who oversaw Ebola research while heading the U.S. Army’s Medical Research and Development Command, and who later led the government’s massive stockpiling of smallpox vaccine after the Sept. 11 terrorist attacks, also said much was still to be learned. “Being dogmatic is, I think, ill-advised, because there are too many unknowns here.”
If Ebola were to mutate on its path from human to human, said Russell and other scientists, its virulence might wane — or it might spread in ways not observed during past outbreaks, which were stopped after transmission among just two to three people, before the virus had a greater chance to evolve. The present outbreak in West Africa has killed approximately 3,400 people, and there is no medical cure for Ebola.
“I see the reasons to dampen down public fears,” Russell said. “But scientifically, we’re in the middle of the first experiment of multiple, serial passages of Ebola virus in man…. God knows what this virus is going to look like. I don’t.”
A resident looks from behind a gate during the Liberian government’s 11-day Ebola quarantine in the West Point district of Monrovia.
Tom Skinner, a spokesman for the CDC in Atlanta, said health officials were basing their response to Ebola on what has been learned from battling the virus since its discovery in central Africa in 1976. The CDC remains confident, he said, that Ebola is transmitted principally by direct physical contact with an ill person or their bodily fluids.
Skinner also said the CDC is conducting ongoing lab analyses to assess whether the present strain of Ebola is mutating in ways that would require the government to change its policies on responding to it. The results so far have not provided cause for concern, he said.
The researchers reached in recent days for this article cited grounds to question U.S. officials’ assumptions in three categories.
One issue is whether airport screenings of prospective travelers to the U.S. from West Africa can reliably detect those who might have Ebola. Frieden has said the CDC protocols used at West African airports can be relied on to prevent more infected passengers from coming to the U.S.
“One hundred percent of the individuals getting on planes are screened for fever before they get on the plane,” Frieden said Sept. 30. “And if they have a fever, they are pulled out of the line, assessed for Ebola, and don’t fly unless Ebola is ruled out.”
Individuals who have flown recently from one or more of the affected countries suggested that travelers could easily subvert the screening procedures — and might have incentive to do so: Compared with the depleted medical resources in the West African countries of Liberia, Sierra Leone and Guinea, the prospect of hospital care in the U.S. may offer an Ebola-exposed person the only chance to survive.
U.S. To Increase Airport Screening For Ebola
The deteriorating conditions in Africa make it more likely additional cases of Ebola will appear in the United States and officials are pushing for increased screenings at airports.
A person could pass body temperature checks performed at the airports by taking ibuprofen or any common analgesic. And prospective passengers have much to fear from identifying themselves as sick, said Kim Beer, a resident of Freetown, the capital of Sierra Leone, who is working to get medical supplies into the country to cope with Ebola.
“It is highly unlikely that someone would acknowledge having a fever, or simply feeling unwell,” Beer said via email. “Not only will they probably not get on the flight — they may even be taken to/required to go to a ‘holding facility’ where they would have to stay for days until it is confirmed that it is not caused by Ebola. That is just about the last place one would want to go.”
Liberian officials said last week that the patient hospitalized in Dallas, Thomas Eric Duncan, did not report to airport screeners that he had had previous contact with an Ebola-stricken woman. It is not known whether Duncan knew she suffered from Ebola; her family told neighbors it was malaria.
The potential disincentive for passengers to reveal their own symptoms was echoed by Sheka Forna, a dual citizen of Sierra Leone and Britain who manages a communications firm in Freetown. Forna said he considered it “very possible” that people with fever would medicate themselves to appear asymptomatic.
It would be perilous to admit even nonspecific symptoms at the airport, Forna said in a telephone interview. “You’d be confined to wards with people with full-blown disease.”
On Monday, the White House announced that a review was underway of existing airport procedures. Frieden and President Obama’s assistant for homeland security and counter-terrorism, Lisa Monaco, said Friday that closing the U.S. to passengers from the Ebola-affected countries would risk obstructing relief efforts.
CDC officials also say that asymptomatic patients cannot spread Ebola. This assumption is crucial for assessing how many people are at risk of getting the disease. Yet diagnosing a symptom can depend on subjective understandings of what constitutes a symptom, and some may not be easily recognizable. Is a person mildly fatigued because of short sleep the night before a flight — or because of the early onset of disease?
Moreover, said some public health specialists, there is no proof that a person infected — but who lacks symptoms — could not spread the virus to others.
“It’s really unclear,” said Michael Osterholm, a public health scientist at the University of Minnesota who recently served on the U.S. government’s National Science Advisory Board for Biosecurity. “None of us know.”
Russell, who oversaw the Army’s research on Ebola, said he found the epidemiological data unconvincing.
“The definition of ‘symptomatic’ is a little difficult to deal with,” he said. “It may be generally true that patients aren’t excreting very much virus until they become ill, but to say that we know the course of [the virus' entry into the bloodstream] and the course of when a virus appears in the various secretions, I think, is premature.”
The CDC’s Skinner said that while officials remained confident that Ebola can be spread only by the overtly sick, the ongoing studies would assess whether mutations that might occur could increase the potential for asymptomatic patients to spread it.
Finally, some also question the official assertion that Ebola cannot be transmitted through the air. In late 1989, virus researcher Charles L. Bailey supervised the government’s response to an outbreak of Ebola among several dozen rhesus monkeys housed for research in Reston, Va., a suburb of Washington.
What Bailey learned from the episode informs his suspicion that the current strain of Ebola afflicting humans might be spread through tiny liquid droplets propelled into the air by coughing or sneezing.
“We know for a fact that the virus occurs in sputum and no one has ever done a study [disproving that] coughing or sneezing is a viable means of transmitting,” he said. Unqualified assurances that Ebola is not spread through the air, Bailey said, are “misleading.”
Peters, whose CDC team studied cases from 27 households that emerged during a 1995 Ebola outbreak in Democratic Republic of Congo, said that while most could be attributed to contact with infected late-stage patients or their bodily fluids, “some” infections may have occurred via “aerosol transmission.”
Ailing in Monrovia, Liberia
Relatives pray over a weak Siata Johnson, 23, outside the Ebola treatment center at a hospital on the outskirts of Monrovia, Liberia. (John Moore / Getty Images)
Skinner of the CDC, who cited the Peters-led study as the most extensive of Ebola’s transmissibility, said that while the evidence “is really overwhelming” that people are most at risk when they touch either those who are sick or such a person’s vomit, blood or diarrhea, “we can never say never” about spread through close-range coughing or sneezing.
“I’m not going to sit here and say that if a person who is highly viremic … were to sneeze or cough right in the face of somebody who wasn’t protected, that we wouldn’t have a transmission,” Skinner said.
Peters, Russell and Bailey, who in 1989 was deputy commander for research of the Army’s Medical Research Institute of Infectious Diseases, in Frederick, Md., said the primates in Reston had appeared to spread Ebola to other monkeys through their breath.
The Ebola strain found in the monkeys did not infect their human handlers. Bailey, who now directs a biocontainment lab at George Mason University in Virginia, said he was seeking to research the genetic differences between the Ebola found in the Reston monkeys and the strain currently circulating in West Africa.
Though he acknowledged that the means of disease transmission among the animals would not guarantee the same result among humans, Bailey said the outcome may hold lessons for the present Ebola epidemic.
“Those monkeys were dying in a pattern that was certainly suggestive of coughing and sneezing — some sort of aerosol movement,” Bailey said. “They were dying and spreading it so quickly from cage to cage. We finally came to the conclusion that the best action was to euthanize them all.”
Dallas County Judge Clay Jenkins pulled into the Ivy Apartments community late in the evening Friday wearing suit pants and a lavender dress shirt.
There were hazardous materials trucks all around, as cleaning crews had arrived to remove materials that might have been touched by Thomas Duncan, a Liberian man who is hospitalized in Texas with Ebola. The hazmat workers were covered from head to toe in bright yellow body suits, green gloves and breathing masks.
Jenkins walked into the apartment in building No. 6 to greet Louise Troh, her family and others who live with her and had been court-ordered to stay in their home because they were considered high risk after coming into contact with Duncan.
It was time to move, and Troh, her 13-year old son, a relative of Duncan’s and another man — all of whom lived in the apartment — got into the judge’s car for the 45-minute drive to their new, temporary home, in an undisclosed part of Dallas.
Jenkins, the judge, never covered up.
“I’m a married man with a little girl,” Jenkins told reporters later that night. “I’m wearing the same shirt I was when I was in the car with that family.
“I was in their house next to those materials, meeting with them, listening to them, and assuring them last night and again of course today. If there were any risk, I would not expose myself or my family to that risk.”
He added: “There is zero risk.”
In the face of widespread fear — and in some cases misinformation — about Ebola following the first diagnosis of the virus in the United States, Dallas officials have taken a notable visual approach to make the point that, at least right now, the city is safe.
The Ebola outbreak in West Africa has reached the United States, as officials confirm one case in Dallas. Here’s how U.S. health officials plan to stop the virus. (Gillian Brockell and Jorge Ribas/The Washington Post)
On a daily basis, workers monitoring the temperatures and health of as many as nine individuals who they believe might have had direct contact with Duncan have entered those people’s homes with no gloves, no masks and no personal protective equipment whatsoever.
And city officials including Jenkins, Dallas Mayor Mike Rawlings and Dallas County Health and Human Services Director Zachary Thompson have interacted with the family no differently that they might have if the four people who are in a state of semi-isolation had been suspected of having come into contact with somebody sick with the flu.
“Based on our assessment, they were asymptomatic; therefore, I didn’t feel they posed any threat to me,” Thompson said in an interview with The Washington Post on Monday. “There is a standard procedure for when they should be using the PPE’s (personal protective equipment). In this case we knew our nurses, our staff, had assessed that they were asymptomatic.”
So far, none of the people who have potentially had contact with Duncan are showing any symptoms, Thompson said.
Yet concern and stigma are widespread in Dallas.
Photographs from Liberia, Sierra Leone and Guinea — where the epidemic is spiraling out of control — frequently show fully masked health workers carrying infected people to hospitals or burial sites. Those images have become closely associated with the virus and the outbreak in the public’s mind.
And for one day, similar images briefly appeared in Dallas as cleaning crews removed materials from Troh’s apartment that might have come into contact with the virus.
A hazmat team arrives on Oct. 3 to clean a unit at the Dallas apartment complex where the confirmed Ebola patient was staying. (Joe Raedle/Getty Images)
The decision for the crew to wear personal protective equipment was made by the company, the “Cleaning Guys,” according to Dallas officials.
“We train for this type of thing,” company executive Brad Smith told ABC News. “Obviously, we haven’t trained for Ebola because there hasn’t been a situation in Texas until now.”
The Ebola virus is not very hearty outside of the human body.
Still, touching and destroying potentially infected materials is far different from speaking to or being in the same room with people who might have been exposed to the virus.
And public health expert Gavin Macgregor-Skinner, who worked in Nigeria to end that country’s outbreak, said that treating people with a sense of humanity and not feeding hysteria is critical to managing the Dallas Ebola case and others that might occur around the world.
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“Even in West Africa when we do contact tracing, we don’t put on personal protective equipment,” said Macgregor-Skinner, an assistant professor in the Department of Public Health Sciences at the Penn State Milton S. Hershey Medical Center. “We have the six-feet rule: We stay about six feet away from people and I can interview them and I can make them feel like people.
“If they have no symptoms, we need to make them feel normal, like they’re part of the community, like they are still loved.”
Dallas officials have also urged residents to go about their normal activities and attend community gatherings and fairs without fear.
“The broader perspective is that we had done immediate disease tracking and contact tracing and the family had been identified who had had close contact and they had not shown any symptoms,” said Thompson. “Other than that one case, basically, his virus has been contained.”
‘In 1976 I discovered Ebola – now I fear an unimaginable tragedy’
Peter Piot was a researcher at a lab in Antwerp when a pilot brought him a blood sample from a Belgian nun who had fallen mysteriously ill in Zaire
Professor Peter Piot, the Director of the London School of Hygiene and Tropical Medicine: ‘Around June it became clear to me there was something different about this outbreak. I began to get really worried’ Photograph: Leon Neal/AFP
Professor Piot, as a young scientist in Antwerp, you were part of the team that discovered the Ebola virus in 1976. How did it happen?
I still remember exactly. One day in September, a pilot from Sabena Airlines brought us a shiny blue Thermos and a letter from a doctor in Kinshasa in what was then Zaire. In the Thermos, he wrote, there was a blood sample from a Belgian nun who had recently fallen ill from a mysterious sickness in Yambuku, a remote village in the northern part of the country. He asked us to test the sample for yellow fever.
These days, Ebola may only be researched in high-security laboratories. How did you protect yourself back then?
We had no idea how dangerous the virus was. And there were no high-security labs in Belgium. We just wore our white lab coats and protective gloves. When we opened the Thermos, the ice inside had largely melted and one of the vials had broken. Blood and glass shards were floating in the ice water. We fished the other, intact, test tube out of the slop and began examining the blood for pathogens, using the methods that were standard at the time.
But the yellow fever virus apparently had nothing to do with the nun’s illness.
No. And the tests for Lassa fever and typhoid were also negative. What, then, could it be? Our hopes were dependent on being able to isolate the virus from the sample. To do so, we injected it into mice and other lab animals. At first nothing happened for several days. We thought that perhaps the pathogen had been damaged from insufficient refrigeration in the Thermos. But then one animal after the next began to die. We began to realise that the sample contained something quite deadly.
But you continued?
Other samples from the nun, who had since died, arrived from Kinshasa. When we were just about able to begin examining the virus under an electron microscope, the World Health Organisation instructed us to send all of our samples to a high-security lab in England. But my boss at the time wanted to bring our work to conclusion no matter what. He grabbed a vial containing virus material to examine it, but his hand was shaking and he dropped it on a colleague’s foot. The vial shattered. My only thought was: “Oh, shit!” We immediately disinfected everything, and luckily our colleague was wearing thick leather shoes. Nothing happened to any of us.
In the end, you were finally able to create an image of the virus using the electron microscope.
Yes, and our first thought was: “What the hell is that?” The virus that we had spent so much time searching for was very big, very long and worm-like. It had no similarities with yellow fever. Rather, it looked like the extremely dangerous Marburg virus which, like ebola, causes a haemorrhagic fever. In the 1960s the virus killed several laboratory workers in Marburg, Germany.
Were you afraid at that point?
I knew almost nothing about the Marburg virus at the time. When I tell my students about it today, they think I must come from the stone age. But I actually had to go the library and look it up in an atlas of virology. It was the American Centres for Disease Control which determined a short time later that it wasn’t the Marburg virus, but a related, unknown virus. We had also learned in the meantime that hundreds of people had already succumbed to the virus in Yambuku and the area around it.
A few days later, you became one of the first scientists to fly to Zaire.
Yes. The nun who had died and her fellow sisters were all from Belgium. In Yambuku, which had been part of the Belgian Congo, they operated a small mission hospital. When the Belgian government decided to send someone, I volunteered immediately. I was 27 and felt a bit like my childhood hero, Tintin. And, I have to admit, I was intoxicated by the chance to track down something totally new.
A girl is led to an ambulance after showing signs of Ebola infection in the village of Freeman Reserve, 30 miles north of the Liberian capital, Monrovia. Photograph: Jerome Delay/APWas there any room for fear, or at least worry?
Of course it was clear to us that we were dealing with one of the deadliest infectious diseases the world had ever seen – and we had no idea that it was transmitted via bodily fluids! It could also have been mosquitoes. We wore protective suits and latex gloves and I even borrowed a pair of motorcycle goggles to cover my eyes. But in the jungle heat it was impossible to use the gas masks that we bought in Kinshasa. Even so, the Ebola patients I treated were probably just as shocked by my appearance as they were about their intense suffering. I took blood from around 10 of these patients. I was most worried about accidentally poking myself with the needle and infecting myself that way.
But you apparently managed to avoid becoming infected.
Well, at some point I did actually develop a high fever, a headache and diarrhoea …
… similar to Ebola symptoms?
Exactly. I immediately thought: “Damn, this is it!” But then I tried to keep my cool. I knew the symptoms I had could be from something completely different and harmless. And it really would have been stupid to spend two weeks in the horrible isolation tent that had been set up for us scientists for the worst case. So I just stayed alone in my room and waited. Of course, I didn’t get a wink of sleep, but luckily I began feeling better by the next day. It was just a gastrointestinal infection. Actually, that is the best thing that can happen in your life: you look death in the eye but survive. It changed my whole approach, my whole outlook on life at the time.
You were also the one who gave the virus its name. Why Ebola?
On that day our team sat together late into the night – we had also had a couple of drinks – discussing the question. We definitely didn’t want to name the new pathogen “Yambuku virus”, because that would have stigmatised the place forever. There was a map hanging on the wall and our American team leader suggested looking for the nearest river and giving the virus its name. It was the Ebola river. So by around three or four in the morning we had found a name. But the map was small and inexact. We only learned later that the nearest river was actually a different one. But Ebola is a nice name, isn’t it?
In the end, you discovered that the Belgian nuns had unwittingly spread the virus. How did that happen?
In their hospital they regularly gave pregnant women vitamin injections using unsterilised needles. By doing so, they infected many young women in Yambuku with the virus. We told the nuns about the terrible mistake they had made, but looking back I would say that we were much too careful in our choice of words. Clinics that failed to observe this and other rules of hygiene functioned as catalysts in all additional Ebola outbreaks. They drastically sped up the spread of the virus or made the spread possible in the first place. Even in the current Ebola outbreak in westAfrica, hospitals unfortunately played this ignominious role in the beginning.
After Yambuku, you spent the next 30 years of your professional life devoted to combating Aids. But now Ebola has caught up to you again. American scientists fear that hundreds of thousands of people could ultimately become infected. Was such an epidemic to be expected?
No, not at all. On the contrary, I always thought that Ebola, in comparison to Aids or malaria, didn’t present much of a problem because the outbreaks were always brief and local. Around June it became clear to me that there was something fundamentally different about this outbreak. At about the same time, the aid organisation Médecins Sans Frontières sounded the alarm. We Flemish tend to be rather unemotional, but it was at that point that I began to get really worried.
Why did WHO react so late?
On the one hand, it was because their African regional office isn’t staffed with the most capable people but with political appointees. And the headquarters in Geneva suffered large budget cuts that had been agreed to by member states. The department for haemorrhagic fever and the one responsible for the management of epidemic emergencies were hit hard. But since August WHO has regained a leadership role.
There is actually a well-established procedure for curtailing Ebola outbreaks: isolating those infected and closely monitoring those who had contact with them. How could a catastrophe such as the one we are now seeing even happen?
I think it is what people call a perfect storm: when every individual circumstance is a bit worse than normal and they then combine to create a disaster. And with this epidemic there were many factors that were disadvantageous from the very beginning. Some of the countries involved were just emerging from terrible civil wars, many of their doctors had fled and their healthcare systems had collapsed. In all of Liberia, for example, there were only 51 doctors in 2010, and many of them have since died of Ebola.
The fact that the outbreak began in the densely populated border region between Guinea, Sierra Leone and Liberia …
… also contributed to the catastrophe. Because the people there are extremely mobile, it was much more difficult than usual to track down those who had had contact with the infected people. Because the dead in this region are traditionally buried in the towns and villages they were born in, there were highly contagious Ebola corpses travelling back and forth across the borders in pickups and taxis. The result was that the epidemic kept flaring up in different places.
For the first time in its history, the virus also reached metropolises such as Monrovia and Freetown. Is that the worst thing that can happen?
In large cities – particularly in chaotic slums – it is virtually impossible to find those who had contact with patients, no matter how great the effort. That is why I am so worried about Nigeria as well. The country is home to mega-cities like Lagos and Port Harcourt, and if the Ebola virus lodges there and begins to spread, it would be an unimaginable catastrophe.
Have we completely lost control of the epidemic?
I have always been an optimist and I think that we now have no other choice than to try everything, really everything. It’s good that the United States and some other countries are finally beginning to help. But Germany or even Belgium, for example, must do a lot more. And it should be clear to all of us: This isn’t just an epidemic any more. This is a humanitarian catastrophe. We don’t just need care personnel, but also logistics experts, trucks, jeeps and foodstuffs. Such an epidemic can destabilise entire regions. I can only hope that we will be able to get it under control. I really never thought that it could get this bad.
What can really be done in a situation when anyone can become infected on the streets and, like in Monrovia, even the taxis are contaminated?
We urgently need to come up with new strategies. Currently, helpers are no longer able to care for all the patients in treatment centres. So caregivers need to teach family members who are providing care to patients how to protect themselves from infection to the extent possible. This on-site educational work is currently the greatest challenge. Sierra Leone experimented with a three-day curfew in an attempt to at least flatten out the infection curve a bit. At first I thought: “That is totally crazy.” But now I wonder, “why not?” At least, as long as these measures aren’t imposed with military power.
A three-day curfew sounds a bit desperate.
Yes, it is rather medieval. But what can you do? Even in 2014, we hardly have any way to combat this virus.
Do you think we might be facing the beginnings of a pandemic?
There will certainly be Ebola patients from Africa who come to us in the hopes of receiving treatment. And they might even infect a few people here who may then die. But an outbreak in Europe or North America would quickly be brought under control. I am more worried about the many people from India who work in trade or industry in west Africa. It would only take one of them to become infected, travel to India to visit relatives during the virus’s incubation period, and then, once he becomes sick, go to a public hospital there. Doctors and nurses in India, too, often don’t wear protective gloves. They would immediately become infected and spread the virus.
The virus is continually changing its genetic makeup. The more people who become infected, the greater the chance becomes that it will mutate …
… which might speed its spread. Yes, that really is the apocalyptic scenario. Humans are actually just an accidental host for the virus, and not a good one. From the perspective of a virus, it isn’t desirable for its host, within which the pathogen hopes to multiply, to die so quickly. It would be much better for the virus to allow us to stay alive longer.
Could the virus suddenly change itself such that it could be spread through the air?
Like measles, you mean? Luckily that is extremely unlikely. But a mutation that would allow Ebola patients to live a couple of weeks longer is certainly possible and would be advantageous for the virus. But that would allow Ebola patients to infect many, many more people than is currently the case.
But that is just speculation, isn’t it?
Certainly. But it is just one of many possible ways the virus could change to spread itself more easily. And it is clear that the virus is mutating.
You and two colleagues wrote a piece for the Wall Street Journalsupporting the testing of experimental drugs. Do you think that could be the solution?
Patients could probably be treated most quickly with blood serum from Ebola survivors, even if that would likely be extremely difficult given the chaotic local conditions. We need to find out now if these methods, or if experimental drugs like ZMapp, really help. But we should definitely not rely entirely on new treatments. For most people, they will come too late in this epidemic. But if they help, they should be made available for the next outbreak.
Testing of two vaccines is also beginning. It will take a while, of course, but could it be that only a vaccine can stop the epidemic?
I hope that’s not the case. But who knows? Maybe.
In Zaire during that first outbreak, a hospital with poor hygiene was responsible for spreading the illness. Today almost the same thing is happening. Was Louis Pasteur right when he said: “It is the microbes who will have the last word”?
Of course, we are a long way away from declaring victory over bacteria and viruses. HIV is still here; in London alone, five gay men become infected daily. An increasing number of bacteria are becoming resistant to antibiotics. And I can still see the Ebola patients in Yambuku, how they died in their shacks and we couldn’t do anything except let them die. In principle, it’s still the same today. That is very depressing. But it also provides me with a strong motivation to do something. I love life. That is why I am doing everything I can to convince the powerful in this world to finally send sufficient help to west Africa. Now!
The virus may be acquired upon contact with blood or bodily fluids of an infected human or other animal. Spreading through the air has not been documented in the natural environment.Fruit bats are believed to be a carrier and may spread the virus without being affected. Once human infection occurs, the disease may spread between people, as well. Male survivors may be able to transmit the disease via semen for nearly two months. To make the diagnosis, typically other diseases with similar symptoms such as malaria, cholera and other viral hemorrhagic fevers are first excluded. To confirm the diagnosis, blood samples are tested for viral antibodies, viralRNA, or the virus itself.
Outbreak control require community engagement, case management, surveillance and contact tracing, a good laboratory service, and safe burials. Prevention includes decreasing the spread of disease from infected animals to humans. This may be done by checking such animals for infection and killing and properly disposing of the bodies if the disease is discovered. Properly cooking meat and wearing protective clothing when handling meat may also be helpful, as are wearing protective clothing and washing hands when around a person with the disease. Samples of bodily fluids and tissues from people with the disease should be handled with special caution.
Heavy bleeding is rare and is usually confined to the gastrointestinal tract. In general, the development of bleeding symptoms often indicates a worse prognosis and this blood loss can result in death. All people infected show some signs of circulatory system involvement, including impaired blood clotting. If the infected person does not recover, death due to multiple organ dysfunction syndrome occurs within 7 to 16 days (usually between days 8 and 9) after first symptoms.
EVD is caused by four of five viruses classified in the genus Ebolavirus, family Filoviridae, order Mononegavirales. The four disease-causing viruses are Bundibugyo virus (BDBV), Sudan virus (SUDV), Taï Forest virus (TAFV), and one called, simply, Ebola virus (EBOV, formerly Zaire Ebola virus)). Ebola virus is the sole member of the Zaire ebolavirus species and the most dangerous of the known Ebola disease-causing viruses, as well as being responsible for the largest number of outbreaks. The fifth virus, Reston virus (RESTV), is not thought to be disease-causing in humans. These five viruses are closely related to the Marburg viruses.
Human-to-human transmission can occur via direct contact with blood or bodily fluids from an infected person (including embalming of an infected dead person) or by contact with objects contaminated by the virus, particularly needles and syringes. Other body fluids with ebola virus include saliva, mucus, vomit, feces, sweat, tears, breast milk, urine, and semen. Entry points include the nose, mouth, eyes, or open wounds, cuts and abrasions. The potential for widespread EVD infections is considered low as the disease is only spread by direct contact with the secretions from someone who is showing signs of infection. The symptoms limit a person’s ability to spread the disease as they are often too sick to travel. Because dead bodies are still infectious, traditional burial rituals may spread the disease. Nearly two thirds of the cases of Ebola in Guinea during the 2014 outbreak are believed to be due to burial practices. Semen may be infectious in survivors for up to 7 weeks. It is not entirely clear how an outbreak is initially started. The initial infection is believed to occur after ebola virus is transmitted to a human by contact with an infected animal’s body fluids.
One of the primary reasons for spread is that the health systems in the part of Africa where the disease occurs function poorly. Medical workers who do not wear appropriate protective clothing may contract the disease.Hospital-acquired transmission has occurred in African countries due to the reuse of needles and lack of universal precautions. Some healthcare centers caring for people with the disease do not have running water.
Airborne transmission has not been documented during EVD outbreaks. They are, however, infectious as breathable 0.8– to 1.2-μm laboratory-generated droplets. The virus has been shown to travel, without contact, from pigs to primates, although the same study failed to demonstrate similar transmission between non-human primates.
Bats drop partially eaten fruits and pulp, then land mammals such as gorillas and duikers feed on these fallen fruits. This chain of events forms a possible indirect means of transmission from the natural host to animal populations, which has led to research towards viral shedding in the saliva of bats. Fruit production, animal behavior, and other factors vary at different times and places that may trigger outbreaks among animal populations.
Bushmeat being prepared for cooking in Ghana, 2013. Human consumption of equatorial animals in Africa in the form of bushmeat has been linked to the transmission of diseases to people, including Ebola.
Bats are considered the most likely natural reservoir of the EBOV. Plants, arthropods, and birds were also considered. Bats were known to reside in the cotton factory in which the first cases for the 1976 and 1979 outbreaks were observed, and they have also been implicated in Marburg virus infections in 1975 and 1980. Of 24 plant species and 19 vertebrate species experimentally inoculated with EBOV, only bats became infected. The absence of clinical signs in these bats is characteristic of a reservoir species. In a 2002–2003 survey of 1,030 animals including 679 bats from Gabon and the Republic of the Congo, 13 fruit bats were found to contain EBOV RNA fragments. As of 2005, three types of fruit bats (Hypsignathus monstrosus, Epomops franqueti, and Myonycteris torquata) have been identified as being in contact with EBOV. They are now suspected to represent the EBOV reservoir hosts. Antibodies against Zaire and Reston viruses have been found in fruit bats in Bangladesh, thus identifying potential virus hosts and signs of the filoviruses in Asia.
Between 1976 and 1998, in 30,000 mammals, birds, reptiles, amphibians and arthropods sampled from outbreak regions, no ebolavirus was detected apart from some genetic traces found in six rodents (Mus setulosus andPraomys) and one shrew (Sylvisorex ollula) collected from the Central African Republic. Traces of EBOV were detected in the carcasses of gorillas and chimpanzees during outbreaks in 2001 and 2003, which later became the source of human infections. However, the high lethality from infection in these species makes them unlikely as a natural reservoir.
Transmission between natural reservoir and humans is rare, and outbreaks are usually traceable to a single case where an individual has handled the carcass of gorilla, chimpanzee or duiker. Fruit bats are also eaten by people in parts of West Africa where they are smoked, grilled or made into a spicy soup.
Like all mononegaviruses, ebolavirions contain linear nonsegmented, single-strand, non-infectious RNAgenomes of negative polarity that possesses inverse-complementary 3′ and 5′ termini, do not possess a 5′ cap, are notpolyadenylated, and are not covalently linked to a protein. Ebolavirus genomes are approximately 19 kilobase pairs long and contain seven genes in the order 3′-UTR-NP-VP35-VP40-GP-VP30-VP24-L-5′-UTR. The genomes of the five different ebolaviruses (BDBV, EBOV, RESTV, SUDV, and TAFV) differ in sequence and the number and location of gene overlaps.
Like all filoviruses, ebolavirions are filamentous particles that may appear in the shape of a shepherd’s crook or in the shape of a “U” or a “6”, and they may be coiled, toroid, or branched. In general, ebolavirions are 80 nm in width, but vary somewhat in length. In general, the median particle length of ebolaviruses ranges from 974 to 1,086 nm (in contrast to marburgvirions, whose median particle length was measured at 795–828 nm), but particles as long as 14,000 nm have been detected in tissue culture.
The ebolavirus life cycle begins with virion attachment to specific cell-surface receptors, followed by fusion of the virion envelope with cellular membranes and the concomitant release of the virus nucleocapsid into the cytosol. The viral RNA polymerase, encoded by the L gene, partially uncoats the nucleocapsid and transcribes the genes into positive-strand mRNAs, which are then translated into structural and nonstructural proteins. Ebolavirus RNA polymerase (L) binds to a single promoter located at the 3′ end of the genome. Transcription either terminates after a gene or continues to the next gene downstream. This means that genes close to the 3′ end of the genome are transcribed in the greatest abundance, whereas those toward the 5′ end are least likely to be transcribed. The gene order is, therefore, a simple but effective form of transcriptional regulation. The most abundant protein produced is the nucleoprotein, whose concentration in the cell determines when L switches from gene transcription to genome replication. Replication results in full-length, positive-strand antigenomes that are, in turn, transcribed into negative-strand virus progeny genome copy. Newly synthesized structural proteins and genomes self-assemble and accumulate near the inside of the cell membrane. Virions bud off from the cell, gaining their envelopes from the cellular membrane they bud from. The mature progeny particles then infect other cells to repeat the cycle. The Ebola virus genetics are difficult to study due to its virulent nature.
Endothelial cells, macrophages, monocytes, and liver cells are the main targets of infection. After infection, a secreted glycoprotein (sGP) known as the Ebola virus glycoprotein (GP) is synthesized. Ebola replication overwhelms protein synthesis of infected cells and host immune defenses. The GP forms a trimeric complex, which binds the virus to the endothelial cells lining the interior surface of blood vessels. The sGP forms a dimeric protein that interferes with the signaling of neutrophils, a type of white blood cell, which allows the virus to evade the immune system by inhibiting early steps of neutrophil activation. These white blood cells also serve as carriers to transport the virus throughout the entire body to places such as the lymph nodes, liver, lungs, and spleen.
The presence of viral particles and cell damage resulting from budding causes the release of chemical signals (to be specific, TNF-α, IL-6, IL-8, etc.), which are the signaling molecules for fever and inflammation. The cytopathic effect, from infection in the endothelial cells, results in a loss of vascular integrity. This loss in vascular integrity is furthered with synthesis of GP, which reduces specific integrins responsible for cell adhesion to the inter-cellular structure, and damage to the liver, which leads to improper clotting.
The travel and work history along with exposure to wildlife are important to consider when the diagnosis of EVD is suspected. The diagnosis is confirmed by isolating the virus, detecting its RNA or proteins, or detecting antibodiesagainst the virus in a person’s blood. Isolating the virus by cell culture, detecting the viral RNA by polymerase chain reaction (PCR) and detecting proteins by enzyme-linked immunosorbent assay (ELISA) works best early and in those who have died from the disease. Detecting antibodies against the virus works best late in the disease and in those who recover.
During an outbreak, virus isolation is often not feasible. The most common diagnostic methods are therefore real-time PCR and ELISA detection of proteins, which can be performed in field or mobile hospitals. Filovirions can be seen and identified in cell culture by electron microscopy due to their unique filamentous shapes, but electron microscopy cannot tell the difference between the various filoviruses despite there being some length differences.
Phylogenetic tree comparing the Ebolavirus and Marburgvirus. Numbers indicate percent confidence of branches.
The genera Ebolavirus and Marburgvirus were originally classified as the species of the now-obsolete Filovirus genus. In March 1998, the Vertebrate Virus Subcommittee proposed in the International Committee on Taxonomy of Viruses (ICTV) to change the Filovirus genus to the Filoviridae family with two specific genera: Ebola-like viruses andMarburg-like viruses. This proposal was implemented in Washington, DC, on April 2001 and in Paris on July 2002. In 2000, another proposal was made in Washington, D.C., to change the “-like viruses” to “-virus” resulting in today’s Ebolavirus and Marburgvirus.
The risk of transmission is increased among those caring for people infected. Recommended measures when caring for those who are infected include isolating them, sterilizing equipment and surfaces, and wearing protective clothing including masks, gloves, gowns, and goggles. If a person with Ebola dies, direct contact with the body of the deceased patient should be avoided.
In order to reduce the spread, the World Health Organization recommends raising community awareness of the risk factors for Ebola infection and the protective measures individuals can take. These include avoiding contact with infected people and regular hand washing using soap and water. Traditional burial rituals, especially those requiring washing or embalming of bodies, should be discouraged or modified. Social anthropologists may help find alternatives to traditional rules for burials. Airline crews are instructed to isolate anyone who has symptoms resembling Ebola virus.
The Ebola virus can be eliminated with heat (heating for 30 to 60 minutes at 60 °C or boiling for 5 minutes). On surfaces, some lipid solvents such as some alcohol-based products, detergents, sodium hypochlorite (bleach) or calcium hypochlorite (bleaching powder), and other suitable disinfectants at appropriate concentrations can be used as disinfectants.
Quarantine, also known as enforced isolation, is usually effective in decreasing spread. Governments often quarantine areas where the disease is occurring or individuals who may be infected. In the United States, the law allows quarantine of those infected with Ebola. During the 2014 outbreak, Liberia closed schools.
Contact tracing is regarded as important to contain an outbreak. It involves finding everyone who had close contact with infected individuals and watching for signs of illness for 21 days. If any of these contacts comes down with the disease, they should be isolated, tested, and treated. Then repeat the process by tracing the contacts’ contacts.
A hospital isolation ward in Gulu, Uganda, during the October 2000 outbreak
The disease has a high mortality rate: often between 25 percent and 90 percent. As of September 2014, information from WHO across all occurrences to date puts the overall fatality rate at 50%. There are indications based on variations in death rate between countries that early and effective treatment of symptoms (e.g., supportive care to prevent dehydration) may reduce the fatality rate significantly. If an infected person survives, recovery may be quick and complete. Prolonged cases are often complicated by the occurrence of long-term problems, such as inflammation of the testicles, joint pains, muscle pains, skin peeling, or hair loss. Eye symptoms, such as light sensitivity, excess tearing, iritis, iridocyclitis, choroiditis, and blindness have also been described. EBOV and SUDV may be able to persist in the semen of some survivors for up to seven weeks, which could give rise to infections and disease via sexual intercourse.
The first identified case of Ebola was on 26 August 1976, in Yambuku, a small rural village in Mongala District in northern Democratic Republic of the Congo (then known as Zaire). The first victim, and the index case for the disease, was village school headmaster Mabalo Lokela, who had toured an area near the Central African Republic border along the Ebola river between 12–22 August. On 8 September he died of what would become known as the Ebola virus species of the ebolavirus. Subsequently a number of other cases were reported, almost all centered on the Yambuku mission hospital or having close contact with another case. 318 cases and 280 deaths (a 88% fatality rate) occurred in the DRC. The Ebola outbreak was contained with the help of the World Health Organization and transport from the Congolese air force, by quarantining villagers, sterilizing medical equipment, and providing protective clothing. The virus responsible for the initial outbreak, first thought to be Marburg virus, was later identified as a new type of virus related to Marburg, and named after the nearby Ebola river. Another ebolavirus, the Sudan virus species, was also identified that same year when an outbreak occurred in Sudan, affecting 284 people and killing 151.
1995 to 2013
The second major outbreak occurred in 1995 in the Democratic Republic of Congo, affecting 315 and killing 254. The next major outbreak occurred in Uganda in 2000, affecting 425 and killing 224; in this case the Sudan virus was found to be the ebolavirus species responsible for the outbreak. In 2003 there was an outbreak in the Republic of Congo that affected 143 and killed 128, a death rate of 90%, the highest to date.
In August 2007, 103 people were infected by a suspected hemorrhagic fever outbreak in the village of Kampungu, Democratic Republic of the Congo. The outbreak started after the funerals of two village chiefs, and 217 people in four villages fell ill. The 2007 outbreak eventually affected 264 individuals and resulted in the deaths of 187.
On 30 November 2007, the Uganda Ministry of Health confirmed an outbreak of Ebola in the Bundibugyo District in Western Uganda. After confirmation of samples tested by the United States National Reference Laboratories and the Centers for Disease Control, the World Health Organization confirmed the presence of a new species of Ebolavirus, which was tentatively named Bundibugyo. The WHO reported 149 cases of this new strain and 37 of those led to deaths.
The WHO confirmed two small outbreaks in Uganda in 2012. The first outbreak affected 7 people and resulted in the death of 4 and the second affected 24, resulting in the death of 17. The Sudan variant was responsible for both outbreaks.
On 17 August 2012, the Ministry of Health of the Democratic Republic of the Congo reported an outbreak of the Ebola-Bundibugyo variant in the eastern region. Other than its discovery in 2007, this was the only time that this variant has been identified as the ebolavirus responsible for an outbreak. The WHO revealed that the virus had sickened 57 people and claimed 29 lives. The probable cause of the outbreak was tainted bush meat hunted by local villagers around the towns of Isiro and Viadana.
Increase over time in the cases and deaths during the 2014 outbreak
In March 2014, the World Health Organization (WHO) reported a major Ebola outbreak in Guinea, a western African nation. Researchers traced the outbreak to a two-year old child who died on 28 December 2013. The disease then rapidly spread to the neighboring countries of Liberia and Sierra Leone. It is the largest Ebola outbreak ever documented, and the first recorded in the region.
On 8 August 2014, the WHO declared the epidemic to be an international public health emergency. Urging the world to offer aid to the affected regions, the Director-General said, “Countries affected to date simply do not have the capacity to manage an outbreak of this size and complexity on their own. I urge the international community to provide this support on the most urgent basis possible.” By mid-August 2014, Doctors Without Borders reported the situation in Liberia’s capital Monrovia as “catastrophic” and “deteriorating daily”. They reported that fears of Ebola among staff members and patients had shut down much of the city’s health system, leaving many people without treatment for other conditions. By late August 2014, the disease had spread to Nigeria, and one case was reported in Senegal. On 30 September 2014, the first confirmed case of Ebola was diagnosed in the United States at Texas Health Presbyterian Hospital in Dallas, Texas.
Aside from the human cost, the outbreak has severely eroded the economies of the affected countries. A Financial Times report suggested the economic impact of the outbreak could kill more people than the virus itself. As of 23 September, in the three hardest hit countries, Liberia, Sierra Leone, and Guinea, there were only 893 treatment beds available while the current need was 2122. In a 26 September statement, the WHO said, “The Ebola epidemic ravaging parts of West Africa is the most severe acute public health emergency seen in modern times. Never before in recorded history has a biosafety level four pathogen infected so many people so quickly, over such a broad geographical area, for so long.”
By 29 September 2014, 7,192 suspected cases and 3,286 deaths had been reported, however the World Health Organization has said that these numbers may be vastly underestimated. The WHO reports that more than 216 healthcare workers are among the dead, partly due to the lack of equipment and long hours.
For more about the outbreak in Virginia, US, see Reston virus.
Cases of ebola fever in Africa from 1979 to 2008.
The first recorded outbreak of EBD occurred in Southern Sudan in June 1976. A second outbreak soon followed in the Democratic Republic of the Congo (then Zaire). Virus isolated from both outbreaks was named “Ebola virus” by Belgian researchers after the Ebola River, located near the Zaire outbreak. Although it was assumed that the two outbreaks were connected, scientists later realized that they were caused by distinct species of filoviruses, Sudan virus and Ebola virus.
Shortly afterward, a US Army team headquartered at USAMRIID went into action to euthanize the monkeys which had not yet died, bringing those monkeys and those which had already died of the disease toFt. Detrick for study by the Army’s veterinary pathologists and virologists, and eventual disposal under safe conditions.
Blood samples were taken from 178 animal handlers during the incident. Of those, six animal handlers eventually seroconverted, including one who had cut himself with a bloody scalpel. When the handlers did not become ill, the CDC concluded that the virus had a very low pathogenicity to humans.
The Philippines and the United States had no previous cases of Ebola infection, and upon further isolation, researchers concluded it was another strain of Ebola, or a new filovirus of Asian origin, which they named Reston ebolavirus (REBOV) after the location of the incident.
It is widely believed that outbreaks of EVD among human populations result from handling infected wild animal carcasses. Some research suggests that an outbreak in the wild animals used for consumption, bushmeat, may result in a corresponding human outbreak. Since 2003, such outbreaks have been monitored through surveillance of animal populations with the aim of predicting and preventing Ebola outbreaks in humans.
Recovered carcasses from gorillas contain multiple Ebola virus strains, which suggest multiple introductions of the virus. Bodies decompose quickly and carcasses are not infectious after three to four days. Contact between gorilla groups is rare, suggesting transmission among gorilla groups is unlikely, and that outbreaks result from transmission between viral reservoir and animal populations.
Ebola has a high mortality among primates. Frequent outbreaks of Ebola may have resulted in the deaths of 5,000 gorillas. Outbreaks of Ebola may have been responsible for an 88% decline in tracking indices of observed chimpanzee populations in 420 square kilometer Lossi Sanctuary between 2002 and 2003. Transmission among chimpanzees through meat consumption constitutes a significant risk factor, while contact between individuals, such as touching dead bodies and grooming, is not.
Reston ebolavirus (REBOV) can be transmitted to pigs. This virus was discovered during an outbreak of what at the time was thought to be simian hemorrhagic fever virus (SHFV) in crab-eating macaques in Reston, Virginia (hence the name Reston elabavirus) in 1989. Since the initial outbreak it has since been found in nonhuman primates in Pennsylvania, Texas, and Italy. In each case, the affected animals had been imported from a facility in the Philippines, where the virus had infected pigs. Despite its status as a Level‑4organism and its apparent pathogenicity in monkeys, REBOV has not caused disease in exposed human laboratory workers. In 2012 it was demonstrated that the virus can travel without contact from pigs to nonhuman primates, although the same study failed to achieve transmission in that manner between primates. According to the WHO, routine cleaning and disinfection of pig (or monkey) farms with sodium hypochlorite or other detergents should be effective in inactivating the Reston ebolavirus. If an outbreak is suspected, the area must be immediately quarantined.
While pigs that have been infected with REBOV tend to show symptoms of the disease, it has been shown that dogs may become infected with EBOV and remain asymptomatic. Dogs in some parts of Africa scavenge for their food and it is known that they sometimes eat infected animals and the corpses of humans. Although they remain asymptomatic, a 2005 survey of dogs during an EBOV outbreak found that over 31.8% showed a seroprevalence for EBOV closest to an outbreak versus 9% a farther distance away.
A number of experimental treatments are being studied. In the United States, the Food and Drug Administration (FDA)’s animal efficacy rule is being used to demonstrate reasonable safety to obtain permission to treat people who are infected with Ebola. It is being used as the normal path for testing drugs is not possible for diseases caused by dangerous pathogens or toxins. Experimental drugs are made available for use with the approval of regulatory agencies under named patient programs, known in the US as “expanded access”. On 12 August 2014 the WHO released a statement that the use of not yet proven treatments is ethical in certain situations in an effort to treat or prevent the disease.
Researchers looking at slides of cultures of cells that make monoclonal antibodies. These are grown in a lab and the researchers are analyzing the products to select the most promising of them.
As of August 14, 2014, the United States Food and Drug Administration (FDA) has not approved any drugs to treat or prevent Ebola and advises people to watch out for fraudulent products. The unavailability of experimental treatments in the most affected regions during the 2014 outbreak spurred controversy, with some calling for experimental drugs to be made more widely available in Africa on a humanitarian basis, and others warning that making unproven experimental drugs widely available would be unethical, especially in light of past experimentation conducted in developing countries by Western drug companies.
ZMapp is a monoclonal antibody vaccine. The limited supply of the drug has been used to treat a small number of individuals infected with the Ebola virus. Although some of these have recovered the outcome is not consideredstatistically significant. ZMapp has proved effective in a trial involving Rhesus macaque monkeys.
A number of antiviral medications are being studied. Favipiravir, an anti-viral drug approved in Japan for stockpiling against influenza pandemics, appears to be useful in a mouse model of Ebola. On 4 October 2014, it was reported that a French nun who contracted Ebola while volunteering in Liberia was cured with Favipiravir treatment.BCX4430 is a broad-spectrum antiviral drug developed by BioCryst Pharmaceuticals and currently being researched as a potential treatment for Ebola by USAMRIID. The drug has been approved to progress to Phase 1 trials, expected late in 2014.Brincidofovir, another broad-spectrum antiviral drug, has been granted an emergency FDA approval as an investigational new drug for the treatment of Ebola, after it was found to be effective against Ebolavirus in in vitro tests. It has subsequently been used to treat the first patient diagnosed with Ebola in the USA, after he had recently returned from Liberia. The antiviral drug lamivudine, which is usually used to treat HIV / AIDS, was reported in September 2014 to have been used successfully to treat 13 out of 15 Ebola-infected patients by a doctor in Liberia, as part of a combination therapy also involving intravenous fluids and antibiotics to combat opportunistic bacterial infection of Ebola-compromised internal organs. Western virologists have however expressed caution about the results, due to the small number of patients treated and confounding factors present. Researchers at the NIH stated that lamivudine had so far failed to demonstrate anti-Ebola activity in preliminary in vitro tests, but that they would continue to test it under different conditions and would progress it to trials if even slight evidence for efficacy is found.
A 2014 study found that three ion channel blockers used in the treatment of heart arrhythmias, amiodarone, dronedarone and verapamil, block the entry of Ebolavirus into cells in vitro. Given their oral availability and history of human use, these drugs would be candidates for treating Ebola virus infection in remote geographical locations, either on their own or together with other antiviral drugs.
Melatonin has also been suggested as a potential treatment for Ebola based on promising in vitro results.
The WHO has stated that transfusion of whole blood or purified serum from Ebola survivors is the therapy with the greatest potential to be implemented immediately, although there is little information as to its efficacy. At the end of September, WHO issued an interim guideline for this therapy. The blood serum from those who have survived an infection is currently being studied to see if it is an effective treatment. During a meeting arranged by WHO this research was deemed to be a top priority. Seven of eight people with Ebola survived after receiving a transfusion of blood donated by individuals who had previously survived the infection in an 1999 outbreak in the Democratic Republic of the Congo. This treatment, however, was started late in the disease meaning they may have already been recovering on their own and the rest of their care was better than usual. Thus this potential treatment remains controversial.Intravenous antibodies appear to be protective in non-human primates who have been exposed to large doses of Ebola.The World Health Organisation has approved the use of convalescent serum and whole blood products to treat people with Ebola.
Vaccines have protected nonhuman primates. Immunization takes six months, which impedes the counter-epidemic use of the vaccines. Searching for a quicker onset of effectiveness, in 2003, a vaccine using an adenoviral (ADV) vector carrying the Ebola spike protein was tested on crab-eating macaques. Twenty-eight days later, they were challenged with the virus and remained resistant. A vaccine based on attenuated recombinant vesicular stomatitis virus (VSV) vector carrying either the Ebola glycoprotein or the Marburg glycoprotein in 2005 protected nonhuman primates, opening clinical trials in humans. The study by October completed the first human trial, over three months giving three vaccinations safely inducing an immune response. Individuals for a year were followed, and, in 2006, a study testing a faster-acting, single-shot vaccine began; this new study was completed in 2008. Trying the vaccine on a strain of Ebola that more resembles one that infects humans is the next step. On 6 December 2011, the development of a successfulvaccine against Ebola for mice was reported. Unlike the predecessors, it can be freeze-dried and thus stored for long periods in wait for an outbreak. An experimental vaccine made by researchers at Canada’s national laboratory in Winnipeg was used, in 2009, to pre-emptively treat a German scientist who might have been infected during a lab accident. However, actual EBOV infection was never demonstrated beyond doubt. Experimentally, recombinant vesicular stomatitis Indiana virus (VSIV) expressing the glycoprotein of EBOV or SUDV has been used successfully in nonhuman primate models as post-exposure prophylaxis. The CDC’s recommendations are currently under review.
Simultaneous phase 1 trials of an experimental vaccine known as the NIAID/GSK vaccine commenced in September 2014.GlaxoSmithKline and the NIH jointly developed the vaccine, based on a modified chimpanzee adenovirus, and contains parts of the Zaireand Sudan ebola strains. If this phase is completed successfully, the vaccine will be fast tracked for use in West Africa. In preparation for this, GSK is preparing a stockpile of 10,000 doses.
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Story 2: 315,000 More Americans Have Left Labor Force in September 2014 Bringing Total To 92,584,000 — Nearly Seven Years Later The Number of Employed Hits 146.6 Million Last Seen In November 2007 — Labor Participation Rate At 62.7% Should Be At 67% — The Ebola Income and Jobs Effect Will Hit In The November 7 Jobs Report After Elections — Videos
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Employment Situation Summary
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THE EMPLOYMENT SITUATION -- SEPTEMBER 2014
Total nonfarm payroll employment increased by 248,000 in September, and the
unemployment rate declined to 5.9 percent, the U.S. Bureau of Labor Statistics
reported today. Employment increased in professional and business services,
retail trade, and health care.
Household Survey Data
In September, the unemployment rate declined by 0.2 percentage point to 5.9
percent. The number of unemployed persons decreased by 329,000 to 9.3 million.
Over the year, the unemployment rate and the number of unemployed persons were
down by 1.3 percentage points and 1.9 million, respectively. (See table A-1.)
Among the major worker groups, unemployment rates declined in September for
adult men (5.3 percent), whites (5.1 percent), and Hispanics (6.9 percent). The
rates for adult women (5.5 percent), teenagers (20.0 percent), and blacks (11.0
percent) showed little change over the month. The jobless rate for Asians was
4.3 percent (not seasonally adjusted), little changed from a year earlier.
(See tables A-1, A-2, and A-3.)
Among the unemployed, the number of job losers and persons who completed temporary
jobs decreased by 306,000 in September to 4.5 million. The number of long-term
unemployed (those jobless for 27 weeks or more) was essentially unchanged at 3.0
million in September. These individuals accounted for 31.9 percent of the unemployed.
Over the past 12 months, the number of long-term unemployed is down by 1.2 million.
(See tables A-11 and A-12.)
The civilian labor force participation rate, at 62.7 percent, changed little in
September. The employment-population ratio was 59.0 percent for the fourth
consecutive month. (See table A-1.)
The number of persons employed part time for economic reasons (sometimes referred
to as involuntary part-time workers) was little changed in September at 7.1 million.
These individuals, who would have preferred full-time employment, were working part
time because their hours had been cut back or because they were unable to find a
full-time job. (See table A-8.)
In September, 2.2 million persons were marginally attached to the labor force,
essentially unchanged from a year earlier. (The data are not seasonally adjusted.)
These individuals were not in the labor force, wanted and were available for work,
and had looked for a job sometime in the prior 12 months. They were not counted as
unemployed because they had not searched for work in the 4 weeks preceding the survey.
(See table A-16.)
Among the marginally attached, there were 698,000 discouraged workers in September,
down by 154,000 from a year earlier. (The data are not seasonally adjusted.) Discouraged
workers are persons not currently looking for work because they believe no jobs are
available for them. The remaining 1.5 million persons marginally attached to the labor
force in September had not searched for work for reasons such as school attendance or
family responsibilities. (See table A-16.)
Establishment Survey Data
Total nonfarm payroll employment rose by 248,000 in September, compared with an
average monthly gain of 213,000 over the prior 12 months. In September, job growth
occurred in professional and business services, retail trade, and health care.
(See table B-1.)
Professional and business services added 81,000 jobs in September, compared with an
average gain of 56,000 per month over the prior 12 months. In September, job gains
occurred in employment services (+34,000), management and technical consulting
services (+12,000), and architectural and engineering services (+6,000). Employment
in legal services declined by 5,000 over the month.
Employment in retail trade rose by 35,000 in September. Food and beverage stores
added 20,000 jobs, largely reflecting the return of workers who had been off payrolls
in August due to employment disruptions at a grocery store chain in New England.
Employment in retail trade has increased by 264,000 over the past 12 months.
Health care added 23,000 jobs in September, in line with the prior 12-month average
gain of 20,000 jobs per month. In September, employment rose in home health care
services (+7,000) and hospitals (+6,000).
Employment in information increased by 12,000 in September, with a gain of 5,000
in telecommunications. Over the year, employment in information has shown little net
Mining employment rose by 9,000 in September, with the majority of the increase
occurring in support activities for mining (+7,000). Over the year, mining has added
Within leisure and hospitality, employment in food services and drinking places
continued to trend up in September (+20,000) and is up by 290,000 over the year.
In September, construction employment continued on an upward trend (+16,000).
Within the industry, employment in residential building increased by 6,000. Over
the year, construction has added 230,000 jobs.
Employment in financial activities continued to trend up in September (+12,000) and
has added 89,000 jobs over the year. In September, job growth occurred in insurance
carriers and related activities (+6,000) and in securities, commodity contracts,
and investments (+5,000).
Employment in other major industries, including manufacturing, wholesale trade,
transportation and warehousing, and government, showed little change over the month.
In September, the average workweek for all employees on private nonfarm payrolls
edged up by 0.1 hour to 34.6 hours. The manufacturing workweek was unchanged at
40.9 hours, and factory overtime edged up by 0.1 hour to 3.5 hours. The average
workweek for production and nonsupervisory employees on private nonfarm payrolls
edged down by 0.1 hour to 33.7 hours. (See tables B-2 and B-7.)
Average hourly earnings for all employees on private nonfarm payrolls, at $24.53,
changed little in September (-1 cent). Over the year, average hourly earnings
have risen by 2.0 percent. In September, average hourly earnings of private-sector
production and nonsupervisory employees were unchanged at $20.67.
(See tables B-3 and B-8.)
The change in total nonfarm payroll employment for July was revised from +212,000
to +243,000, and the change for August was revised from +142,000 to +180,000.
With these revisions, employment gains in July and August combined were 69,000 more
than previously reported.
The Employment Situation for October is scheduled to be released on Friday,
November 7, 2014, at 8:30 a.m. (EST).
Employment Situation Summary Table A. Household data, seasonally adjusted
Summary table A. Household data, seasonally adjusted
[Numbers in thousands]
Civilian noninstitutional population
Civilian labor force
Not in labor force
Total, 16 years and over
Adult men (20 years and over)
Adult women (20 years and over)
Teenagers (16 to 19 years)
Black or African American
Asian (not seasonally adjusted)
Hispanic or Latino ethnicity
Total, 25 years and over
Less than a high school diploma
High school graduates, no college
Some college or associate degree
Bachelor’s degree and higher
Reason for unemployment
Job losers and persons who completed temporary jobs
Duration of unemployment
Less than 5 weeks
5 to 14 weeks
15 to 26 weeks
27 weeks and over
Employed persons at work part time
Part time for economic reasons
Slack work or business conditions
Could only find part-time work
Part time for noneconomic reasons
Persons not in the labor force (not seasonally adjusted)
Marginally attached to the labor force
- Over-the-month changes are not displayed for not seasonally adjusted data.
NOTE: Persons whose ethnicity is identified as Hispanic or Latino may be of any race. Detail for the seasonally adjusted data shown in this table will not necessarily add to totals because of the independent seasonal adjustment of the various series. Updated population controls are introduced annually with the release of January data.
Employment Situation Summary Table B. Establishment data, seasonally adjusted
Summary table B. Establishment data, seasonally adjusted
Footnotes (1) Includes other industries, not shown separately. (2) Data relate to production employees in mining and logging and manufacturing, construction employees in construction, and nonsupervisory employees in the service-providing industries. (3) The indexes of aggregate weekly hours are calculated by dividing the current month’s estimates of aggregate hours by the corresponding annual average aggregate hours. (4) The indexes of aggregate weekly payrolls are calculated by dividing the current month’s estimates of aggregate weekly payrolls by the corresponding annual average aggregate weekly payrolls. (5) Figures are the percent of industries with employment increasing plus one-half of the industries with unchanged employment, where 50 percent indicates an equal balance between industries with increasing and decreasing employment. (p) Preliminary
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