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Breaking News — Third Confirmed Case of Ebola in Dallas, Texas, Airborne Ebola Spreading Through Tiny Aerosolized Droplets in Sneezes and Coughs — Time To Send Ebola Patients to A Biosafety Level 4 Safety Hospitals with A Total of 19 Beds — Videos

Posted on October 16, 2014. Filed under: American History, Biology, Blogroll, British History, Chemistry, Climate, College, Communications, Culture, Demographics, Diasters, Disease, Documentary, Ebola, Economics, Education, Employment, European History, Federal Government, Federal Government Budget, Fiscal Policy, Foreign Policy, government spending, Health Care, history, Law, liberty, Life, media, Medical, Medicine, Obamacare, People, Politics, Radio, Rants, Raves, Regulations, Resources, Science, Talk Radio, Terrorism, Unemployment, Video, Volcano, War, Wealth, Weapons of Mass Destruction, Welfare, Wisdom | Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |

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The Pronk Pops Show Podcasts

Pronk Pops Show 349: October 15, 2014

Pronk Pops Show 348: October 14, 2014

Pronk Pops Show 347: October 13, 2014

Pronk Pops Show 346: October 9, 2014

Pronk Pops Show 345: October 8, 2014

Pronk Pops Show 344: October 6, 2014

Pronk Pops Show 343: October 3, 2014

Pronk Pops Show 342: October 2, 2014

Pronk Pops Show 341: October 1, 2014

Pronk Pops Show 340: September 30, 2014

Pronk Pops Show 339: September 29, 2014

Pronk Pops Show 338: September 26, 2014

Pronk Pops Show 337: September 25, 2014

Pronk Pops Show 336: September 24, 2014

Pronk Pops Show 335: September 23 2014

Pronk Pops Show 334: September 22 2014

Pronk Pops Show 333: September 19 2014

Pronk Pops Show 332: September 18 2014

Pronk Pops Show 331: September 17, 2014

Pronk Pops Show 330: September 16, 2014

Pronk Pops Show 329: September 15, 2014

Pronk Pops Show 328: September 12, 2014

Pronk Pops Show 327: September 11, 2014

Pronk Pops Show 326: September 10, 2014

Pronk Pops Show 325: September 9, 2014

Pronk Pops Show 324: September 8, 2014

Pronk Pops Show 323: September 5, 2014

Pronk Pops Show 322: September 4, 2014

Pronk Pops Show 321: September 3, 2014

Pronk Pops Show 320: August 29, 2014

Pronk Pops Show 319: August 28, 2014

Pronk Pops Show 318: August 27, 2014 

Pronk Pops Show 317: August 22, 2014

Pronk Pops Show 316: August 20, 2014

Pronk Pops Show 315: August 18, 2014

Pronk Pops Show 314: August 15, 2014

Pronk Pops Show 313: August 14, 2014

Pronk Pops Show 312: August 13, 2014

Pronk Pops Show 311: August 11, 2014

Pronk Pops Show 310: August 8, 2014

Pronk Pops Show 309: August 6, 2014

Pronk Pops Show 308: August 4, 2014

Pronk Pops Show 307: August 1, 2014 

Pronk Pops Show 306: July 31, 2014

Pronk Pops Show 305: July 30, 2014

Pronk Pops Show 304: July 29, 2014

Pronk Pops Show 303: July 28, 2014

Pronk Pops Show 302: July 24, 2014

Pronk Pops Show 301: July 23, 2014

Pronk Pops Show 300: July 22, 2014

Pronk Pops Show 299: July 21, 2014

Pronk Pops Show 298: July 18, 2014

Pronk Pops Show 297: July 17, 2014

Pronk Pops Show 296: July 16, 2014

Pronk Pops Show 295: July 15, 2014

Pronk Pops Show 294: July 14, 2014

Pronk Pops Show 293: July 11, 2014

Pronk Pops Show 292: July 9, 2014

Pronk Pops Show 291: July 7, 2014

Pronk Pops Show 290: July 3, 2014

Pronk Pops Show 289: July 2, 2014

Story 1: Breaking News — Third Confirmed Case of Ebola in Dallas, Texas,  Airborne Ebola Spreading Through Tiny Aerosolized Droplets in Sneezes and Coughs — Time To Send Ebola Patients to A Biosafety Level 4 Safety Hospitals with A Total of 19  Beds — Videos

“We shall not grow wiser before we learn that much that we have done was very foolish.”

Friedrich August von Hayek

Obama Calls for CDC ‘SWAT’ Team for Ebola Virus

Response Team to Be Sent for Any Ebola Case: Obama

Experts: Ebola Could Go Airborne, Kill Millions

Expert Doctor says CDC is lying about Ebola virus

Ebola strain appears to be different

Second Health Care Worker Tests Positive For Ebola In Texas

Dallas Mayor: ‘It May Get Worse Before it Gets Better’

Texas officials confirm second healthcare worker has Ebola

CDC: Ebola patient flew on plane before diagnosis

CDC Set To Slow Large Ebola Outbreak by Placing Doctors At Risk

BioContainment Unit at The Nebraska Medical Center

USAMRIID The US Army Medical Research Institute of Infectious Disease

USAMRIID Overview

Activation- A Nebraska Medical Center Biocontainment Unit Story

US Army: Ebola like FLU needs Winter Weather to go AIRBORNE

Max Alert! EBOLA Bodily Fluids Readily Airborne Weaponizable

Aerosolizing ONE DROP of EBOLA = 1/2 MILLION DEAD

Ebola – The Truth About the Outbreak (Documentary)

Why Do Viruses Kill

MicroKillers: Super Flu

The Influenza Pandemic of 1918

We Heard the Bells: The Influenza of 1918 (full documentary)

In 1918-1919, the worst flu in recorded history killed an estimated 50 million people worldwide. The U.S. death toll was 675,000 – five times the number of U.S. soldiers killed in World War I. Where did the 1918 flu come from? Why was it so lethal? What did we learn?

RED ALERT: TOP GENERAL WARNS EBOLA WILL NOT STAY IN WEST AFRICA!!!!

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.

http://www.weeklystandard.com/blogs/dallas-mayor-it-may-get-worse-it-gets-better_816316.html

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.”

http://houston.cbslocal.com/2014/10/15/nurses-union-ebola-patient-left-in-open-area-of-er-for-hours/

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.

Complete Coverage Of Ebola In North Texas

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.”

http://dfw.cbslocal.com/2014/10/15/ebola-patient-traveled-day-before-diagnosis/

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.

cComments
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.

http://www.latimes.com/business/la-fi-frontier-airline-ebola-patient-20141015-story.html

There are only 19 level 4 bio-containment beds in the whole of the United States…and four in the UK

Story

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.

Take Care

http://undergroundmedic.com/?p=6990#sthash.wfb8elnm.dpuf

The Ebola Outbreak in West Africa

Samuel Aranda for The New York Times

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

  1. 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

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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

  10. 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

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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

  16. OCT. 13, 2014

    The topic everyone on Wall Street is discussing urgently but quietly isn’t the volatile stock market. It is Ebola. MORE

  17. 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

  18. 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

  19. 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

  20. 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

  21. 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

  22. 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

  23. 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

  24. 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

  25. 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

  26. 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

  27. 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

  28. 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

  29. 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

  30. 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

  31. 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

  32. 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

  33. 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

  34. 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

  35. 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

  36. 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

  37. 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

  38. 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

  39. 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

  40. 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

  41. 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

  42. 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

http://topics.nytimes.com/top/reference/timestopics/subjects/e/ebola/index.html

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Breaking News: Second Confirmed Ebola Case of Health Care Worker in Dallas Texas Health Presbyterian Hospital — Ebola Is Airborne and Spreading — Center for Disease Control (CDC) Blames It on Breach of Protocol — CDC’s Deep Denial Delusions — World Health Organization (WHO): Aerosolized Ebola Virus droplets produced from coughing or sneezing. –Videos

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Story 1: Breaking News: Second Confirmed Ebola Case of Health Care Worker in Dallas Texas Health Presbyterian Hospital  — Ebola Is Airborne and Spreading — Center for Disease Control (CDC) Blames It on Breach of Protocol — CDC’s Deep Denial Delusions — World Health Organization (WHO): Aerosolised Ebola Virus droplets produced from coughing or sneezing. –Videos

Texas-Hospital-Patient-Confirmed

I beseech you, in the bowels of Christ, think it possible you may be mistaken.

Oliver Cromwell

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SouthCom Issues Stark Ebola Warning: “Katie Bar the Door”

Marine Corps general who leads America’s Southern Command warned Tuesday that the U.S. could face an unprecedented flood of immigrants from the south if the Ebola virus epidemic hits Central America.

‘If it breaks out, it’s literally, “Katie bar the door”,’ Gen John Kelly told said during a public discussion at the National Defense University. ‘And there will be mass migration into the United States.’

US Army: Ebola like FLU needs Winter Weather to go AIRBORNE

CDC Warns On AIRBORNE EBOLA

Max Alert! EBOLA Bodily Fluids Readily Airborne Weaponizable

Second CONFIRMED Case Of Ebola In The U.S. Texas hospital worker tests positive for Ebola

Pestilence : Health Care worker at Dallas Texas Hospital tests positive for Ebola (Oct 12, 2014)

Ebola Health care worker tests positive at Texas hospital

Pestilence : Press Conference of Second Confirmed Diagnosed Case in Texas (Oct 12, 2014)

Ebola – The Truth About the Outbreak (Documentary)

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Science Today: Virus Mutation | California Academy of Sciences

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Ebola: The world’s most dangerous Virus (full documentary)

Texas nurse fighting Ebola receives blood transfusion from survivor Dr Kent Brantly – who also matched blood types with two others struck by the deadly virus in the U.S.

  • Nina Pham, 26, has received blood transfusion from Dr Kent Brantly
  • Survivor Brantly also donated to Dr Nick Sacra and NBC’s Ashoka Mukpo
  • Antibodies in his blood could help the patients fight the disease
  • Pham caught the Ebola virus while treating Thomas Eric Duncan in Dallas
  • Second person who some identified as Miss Pham’s boyfriend is being monitored for symptoms  
  • Miss Pham raised in Vietnamese family in Fort Worth and graduated from Texas Christian University in 2010 with Bachelor of Science in Nursing 
  • HazChem teams spent the weekend fumigating her Dallas apartment 
  • Authorities have blamed a ‘breach of protocol’ – but nursing leaders have criticized the CDC for making her a scapegoat 
  • About 70 staff members at Texas hospital were involved in the care of first Ebola patient Thomas Eric Duncan after he was hospitalized

The Texan nurse diagnosed with Ebola has received a blood transfusion from survivor Dr Kent Brantly.

It is the third time Dr Brantly has donated blood to an Ebola victim after medics discovered he had the same blood type as previous patient Dr Nick Sacra and NBC cameraman Ashoka Mukpo, who is still being treated.

Incredibly, nurse Nina Pham, 26, has also matched with Dr Brantly and on Monday received a transfusion of his blood in a move that doctors believe could save her life.

Lifeline: Dr Kent Brantly (left), who has been cleared of Ebola, has match blood types with Nina Pham (right) and donated so she can receive a blood transfusion to battle the deadly virus she caught treating a patient

Lifeline: Dr Kent Brantly (left), who has been cleared of Ebola, has match blood types with Nina Pham (right) and donated so she can receive a blood transfusion to battle the deadly virus she caught treating a patient

Lifeline: Dr Kent Brantly (left), who has been cleared of Ebola, has match blood types with Nina Pham (right) and donated so she can receive a blood transfusion to battle the deadly virus she caught treating a patient

Miss Pham has been in quarantine since Friday after catching the disease from ‘patient zero’ Thomas Eric Duncan – the man who brought the deadly virus to America.

About 70 staff members at Texas Health Presbyterian Hospital were involved in the care of Mr Duncan after he was hospitalized, including the 26-year-old.

Brantly is believed to have traveled to Texas Health Presbyterian Hospital, where Pham worked, to make the donation on Sunday night.

Miss Pham’s condition was described as ‘clinically stable’ on Tuesday morning. She is believed to be in good spirits and had spoken to her mother via Skype.

A second person who came in contact with the nurse is being monitored for Ebola symptoms in an isolation unit at Texas Presbyterian. He is reportedly Miss Pham’s boyfriend according to Dallas News.

The individual works at Alcon in Fort Worth, according to a staff email seen by CBS. MailOnline was awaiting confirmation from the global eye care products company.

Those who have survived Ebola have antibodies in their blood which can help new sufferers beat the disease.

Dr Kent Brantly was flown back from Liberia to the U.S. after contracting Ebola during his missionary work for Samaritan’s Purse.

He survived after receiving a dose of the experimental serum Z-Mapp and round-the-clock care at Emory University Hospital in Atlanta, Georgia.

On September 10, Dr Brantly donated blood to a fellow doctor, Dr Rick Sacra, who also contracted Ebola during his work in West Africa and survived the disease.

Last Tuesday, he was on a road trip from Indiana to Texas when he received a call from Ashoka Mukpo’s medical center in Nebraska telling him his blood type matched Mukpo’s.

He also offered his blood to Thomas Eric Duncan but their blood types didn’t match.

Cured: Dr Nick Sacra was cleared of Ebola after receiving a blood transfusion from Dr Kent Brantly

Being treated: On Tuesday, Dr Brantly pulled over during a road trip to give blood to NBC's Ashoka Mukpo

Being treated: On Tuesday, Dr Brantly pulled over during a road trip to give blood to NBC’s Ashoka Mukpo

Within minutes, he stopped off at the Community Blood Center in Kansas City, Missouri, and his donation was flown to Omaha.

Pham was diagnosed after admitting herself to hospital on Friday when her temperature spiked – one of the first symptoms of the deadly virus. 

HOW COMMON IS IT FOR TWO PEOPLE TO MATCH BLOOD TYPE?

There are four major blood types: A, B, AB, and O. They divide into positive and negative categories.

It is not known what blood type the four Ebola patients have in common.

The most common blood type in the US is O positive, although ethnic groups normally differ.

The majority of African Americans and Hispanics have O positive.

Around 37 per cent of Caucasians do too, but 33 per cent have A positive.

There is more variety among Asian people. A quarter are listed as B positive, according to the Red Cross, but many also have a high number of Os and As.

A blood test confirmed she had the disease and she is now being treated in an isolation ward.

The Emergency Room where she was admitted was cleared and decontaminated.

Nina Pham’s uncle confirmed to MailOnline that she is the nurse who has contracted Ebola while treating patient zero Thomas Eric Duncan.

Jason Nguyen told MailOnline: ‘Nina has contracted Ebola, she is my niece. Her mother called me on Saturday and told me; ‘Nina has caught Ebola.’

‘My sister is very upset, we all are. She said she was going up to the hospital in Dallas and I haven’t heard from her since. I’ve tried to call but I can’t get through. It’s very shocking. I don’t know any of the details, only what I hear on the news. It’s frightening.’

He added: ‘Nina is very hard working. She is always up at the hospital in Dallas.’

A friend added: ‘You always hear it on the news, but you don’t expect someone you know so well to have it.’

HazChem teams spent the weekend fumigating her apartment in Dallas while health officials have ordered an investigation into how she contracted the disease.

Texas nurse with Ebola identified as 26-yr-old Nina Pham

Tragic: Nina Pham, 26, is fighting for her life after contracting Ebola from Thomas Eric Duncan. Here she is pictured with her beloved King Charles Spaniel clled Bentley who is not expected to be destroyed

Tragic: Nina Pham, 26, is fighting for her life after contracting Ebola from Thomas Eric Duncan. Here she is pictured with her beloved King Charles Spaniel clled Bentley who is not expected to be destroyed

Kind-hearted: Raised in Vietnamese family in Fort Worth, Miss Pham graduated from Texas Christian University in 2010 with a Bachelor of Science in Nursing

Kind-hearted: Raised in Vietnamese family in Fort Worth, Miss Pham graduated from Texas Christian University in 2010 with a Bachelor of Science in Nursing

Kind-hearted: Raised in Vietnamese family in Fort Worth, Miss Pham graduated from Texas Christian University in 2010 with a Bachelor of Science in Nursing

Her beloved King Charles Spaniel Bentley will not be destroyed and is being quarantined, Dallas mayor Mike Rawlings has assured.

Director of the Centers for Disease Control and Protection (CDC) Dr Thomas Frieden has blamed a ‘breach in protocol’ of infection control lead Miss Pham to catch Ebola.

Mr Duncan arrived in Texas from Liberia on September 20. He began showing symptoms of Ebola three days after his arrival and was admitted to Texas Presbyterian Hospital on Sunday 28. He died on Wednesday October 8.

Presbyterian’s chief clinical officer, Dr Dan Varga, said all staff had followed CDC recommended precautions – ‘gown, glove, mask and shield’ – while treating Mr Duncan.

CDC chief backtracks after blaming nurse who got Ebola

And on Monday the CDC said that a critical moment may have come when Miss Pham took off her equipment.

Ebola victims suffer chronic diarrhea and bleeding. But blood and feces from an Ebola patient are considered the most infectious bodily fluids.

Mr Duncan also underwent two surgical procedures in a bid to keep him alive but which are particularly high-risk for transmitting the virus – kidney dialysis and intubation to help him to breathe – due to the spread of blood and saliva.

Nurses’ leader Bonnie Castillo has criticized the CDC for blaming the nurse for the spread of the disease.

Ms Castillo, of the National Nurses United, said: ‘You don’t scapegoat and blame when you have a disease outbreak. We have a system failure. That is what we have to correct.’

In response to the criticism, Frieden clarified his comments to say that he did not mean it was an error on Miss Pham’s part that led to the ‘breach of protocol.’

Hazard: Protect Environmental workers move disposal barrels to a staging area outside the Dallas apartment of Miss Pham

Clean up: A  man in full hazmat clothing walks in front of Pham's home after disinfecting the front porch

Clean up: A man in full hazmat clothing walks in front of Pham’s home after disinfecting the front porch

Compassion: Tom Ha, who taught Miss Pham bible class said: 'I expect, with the big heart she has, she went beyond what she was supposed to do to help anyone in need'

The CDC said on Monday it has launched a wholesale review of the procedures and equipment used by healthcare workers.

Dr Frieden added that the case ‘substantially’ changes how medical staff approach the control of the virus, adding that: ‘We have to rethink how we address Ebola control, because even a single infection is unacceptable.’

When she got accepted into nursing school she was really excited. Her mom would tell how it’s really hard and a bunch of her friends quit doing it because it was so stressful. But she was like, “This is what I want to do”
- Friend of Miss Pham

Friends and well-wishers have paid tribute to Miss Pham and praised her as a big-hearted, compassionate nurse dedicated to caring for other.

Raised in Vietnamese family in Fort Worth, she graduated from Texas Christian University in 2010 with a Bachelor of Science in Nursing.

She obtained her nursing license in August 2010 and recently qualified as a critical care nurse.

A friend told the Dallas Morning News: ‘When she got accepted into nursing school she was really excited. Her mom would tell how it’s really hard and a bunch of her friends quit doing it because it was so stressful. But she was like, “This is what I want to do”.’

A devout Christian she regularly attends mass at the Lady of Fatima Church.

Tom Ha, who taught her bible class, told the paper: ‘The family is very dedicated and go out of their way to help people. I expect, with the big heart she has, she went beyond what she was supposed to do to help anyone in need.’

Aid:  Miss Pham had treated Mr Duncan multiple times after he was diagnosed with the disease and the CDC has claimed that a 'breach of protocol' meant the nurse contracted Ebola. However, nursing leaders attacked the authorities for apparently making Miss Pham a scapegoat

Aid:  Miss Pham had treated Mr Duncan multiple times after he was diagnosed with the disease and the CDC has claimed that a ‘breach of protocol’ meant the nurse contracted Ebola. However, nursing leaders attacked the authorities for apparently making Miss Pham a scapegoat

Hung Le, who is president and counselor at Our Lady of Fatima, said parishioners are uniting in prayer for Miss Pham.

He said: ‘Our most important concern as a church is to help the family as they are coping with this. As a parish, we are praying for them.’

Ha, who taught the woman in Bible classes, said he and others are translating health information into Vietnamese to help others learn about the illness.

‘People are more worried for the family than for themselves, but some have questions because they don’t really understand what it is or how it is transmitted.’

SPREAD OF A DEADLY PLAGUE: HOW WILL AMERICA CONTAIN EBOLA?

WHEN IS EBOLA CONTAGIOUS?

Only when someone is showing symptoms, which can start with vague symptoms including a fever, flu-like body aches and abdominal pain, and then vomiting and diarrhea.

HOW DOES EBOLA SPREAD?

Through close contact with a symptomatic person’s bodily fluids, such as blood, sweat, vomit, feces, urine, saliva or semen. Those fluids must have an entry point, like a cut or scrape or someone touching the nose, mouth or eyes with contaminated hands, or being splashed. That’s why health care workers wear protective gloves and other equipment.

The World Health Organization says blood, feces and vomit are the most infectious fluids, while the virus is found in saliva mostly once patients are severely ill and the whole live virus has never been culled from sweat.

WHAT ABOUT MORE CASUAL CONTACT?

Ebola isn’t airborne. Dr. Tom Frieden, director of the Centers for Disease Control and Prevention, has said people don’t get exposed by sitting next to someone on the bus.

‘This is not like flu. It’s not like measles, not like the common cold. It’s not as spreadable, it’s not as infectious as those conditions,’ he added.

WHO GETS TESTED WHEN EBOLA IS SUSPECTED?

Hospitals with a suspected case call their health department or the CDC to go through a checklist to determine the person’s level of risk. Among the questions are whether the person reports a risky contact with a known Ebola patient, how sick they are and whether an alternative diagnosis is more likely. Most initially suspicious cases in the U.S. haven’t met the criteria for testing.

HOW IS IT CLEANED UP?

The CDC says bleach and other hospital disinfectants kill Ebola. Dried virus on surfaces survives only for several hours.

The World Health Organization on Monday called the Ebola outbreak ‘the most severe, acute health emergency seen in modern times’.

It added that economic disruption can be curbed if people are educated so they don’t make any irrational moves to dodge infection.

WHO Director-General Margaret Chan, citing World Bank figures, said 90 per cent of economic costs of any outbreak ‘come from irrational and disorganised efforts of the public to avoid infection.’

‘We are seeing, right now, how this virus can disrupt economies and societies around the world,’ she said, but added that adequately educating the public was a ‘good defense strategy’ and would allow governments to prevent economic disruptions.

Ebola screening of passengers arriving from three West African countries began at New York’s JFK airport on Saturday.

Medical teams equipped with temperature guns and questionnaires are monitoring arrivals from Guinea, Liberia and Sierra Leone – countries at the centre of the Ebola outbreak.

Screening at Newark Liberty, Washington Dulles, Chicago O’Hare and Hartsfield-Jackson Atlanta will begin later this week.

http://www.dailymail.co.uk/news/article-2791089/first-picture-devoted-texas-nurse-fighting-life-catching-ebola-treating-man-brought-dreaded-virus-america-beloved-dog-s-quarantine.html

Key Question: How Did Dallas Worker Contract Ebola?

How did it happen?

That’s the big question as U.S. health officials investigate the case of a Dallas health worker who treated an Ebola patient and ended up with the disease herself.

These are professionals and this is the United States, where the best conditions and protective gear are available, unlike in West Africa, where the Ebola epidemic is raging in much poorer conditions.

Ebola-Nurse

The health worker wore protective gear while having extensive contact with Thomas Eric Duncan, the Liberian man who died Wednesday of Ebola at Texas Health Presbyterian Hospital.

Officials say she has not been able to pinpoint any breach in infection control protocols, although there apparently was a breach, they say.

 

Experience shows that health workers can safely care for Ebola patients, “but we also know that it’s hard and that even a single breach can result in contamination,” Dr. Thomas Frieden, director of the federal Centers for Disease Control and Prevention, said Sunday on CBS’ “Face the Nation.”

The situation also raises fresh concerns about whether any U.S. hospital can safely handle Ebola patients, as health officials have insisted is possible.

“A breach in protocol could be anything from not taking your gloves off the right way to taking a dialysis catheter out of a dialysis patient and not disposing of it the right way,” explains Dr. Darrin D’Agostino, Chair of Internal Medicine UNT.

According to Dr. D’Agostino those are just some of the multitude of scenarios.
He says these incidents don’t happen often, but accidents do occur.

“We can be as diligent and meticulous as we want to be but occasionally things happen that expose to risk,” said Dr. D’Agostino.

While the fight to eradicate Ebola in Dallas and internationality Dr. D’Agostino is reminding us the battle will be long.

“The fact of the matter is that we do have a lot to learn about this virus and all the viruses that are in this family…this one is particularly infectious.”

Despite the uncertainty Dr. D’Agostino says he is confident that we have the proper infrastructure and resources to handle these cases.

 

Some questions and answers about the new case.

Q: What protection do health workers have?

A: The exact gear can vary. A hazardous material type suit usually includes a gown, two sets of gloves, a face mask, and an eye shield. There are strict protocols for how to use it correctly.

“When you put on your garb and you take off your garb, it’s a buddy system,” with another health worker watching to make sure it’s done right, said Dr. Dennis Maki, University of Wisconsin-Madison infectious disease specialist and former head of hospital infection control.

Q: How might infection have occurred?

A: Officials are focusing on two areas: How the garb was removed, and the intensive medical procedures Duncan received, which included kidney dialysis and a breathing machine. Both involve inserting tubes — into blood vessels or an airway. That raises the risk a health worker will have contact with the patient’s bodily fluids, which is how Ebola spreads.

“Removing the equipment can really be the highest risk. You have to be extremely careful and have somebody watching you to make sure you remember all the steps,” said Dr. Eileen Farnon, a Temple University doctor who formerly worked at the CDC and led teams investigating past Ebola outbreaks in Africa.

“After every step you usually would do hand hygiene,” washing your hands with antiseptic or being sprayed with a chlorine spray, she said.

Q: How else could infection have happened?

A: Some of the garb the health worker takes off might brush against a surface and contaminate it. New data suggest that even tiny droplets of a patient’s body fluids can contain the virus, Maki said.

“I can have on the suit and be very careful, but I can pick up some secretions or body fluids on a surface” and spread it that way, he said.

Q: Can any U.S. hospital safely treat Ebola patients?

A: Frieden and other health officials say yes, but others say the new case shows the risks.

“We can’t control where the Ebola patient appears,” so every hospital’s emergency room needs to be prepared to isolate and take infection control precautions, Maki said.

That said, “I don’t think we should expect that small hospitals take care of Ebola patients. The challenge is formidable,” and only large hospitals like those affiliated with major universities truly have enough equipment and manpower to do it right, Maki said.

“If we allow it to be taken care of in hospitals that have less than optimal resources, we will promote the spread,” he warned.

The case heightens concern for health workers’ safety, and nurses at many hospitals “are alarmed at the inadequate preparation they see,” says a statement from Rose Ann DeMoro, executive director of the trade union, National Nurses United.

Q: Should Ebola patients be transferred to one of the specialized centers that have treated others in the U.S.?

A: Specialized units are the ideal, but there are fewer than half a dozen in the nation and they don’t have unlimited beds. “It is also a high-risk activity to transfer patients,” potentially exposing more people to the virus, Farnon said.

Q. What is CDC recommending that a hospital do?

A. Training has been ramped up, and the CDC now recommends that a hospital minimize the number of people caring for an Ebola patient, perform only procedures essential to support the patient’s care, and name a fulltime infection control supervisor while any Ebola patient is being cared for. Frieden also said the agency was taking a new look at personal protective equipment, “understanding that there is a balance and putting more on isn’t always safer — it may make it harder to provide effective care.”

http://dfw.cbslocal.com/2014/10/12/key-question-how-did-dallas-worker-contract-ebola/

 

Health care worker at Presbyterian Hospital in Dallas tests positive for Ebola

A Texas Health Presbyterian Hospital health care worker in Dallas who had “extensive contact” with the first Ebola patient to die in the United States has contracted the disease.

The Centers for Disease Control and Prevention in Atlanta confirmed the news Sunday afternoon after an official test.

The infected person detected a fever Friday night and drove herself to the Presbyterian emergency room, where she was placed in isolation 90 minutes later. A blood sample sent to the state health lab in Austin confirmed Saturday night that she had Ebola — the first person to contract the disease in the United States.

The director for the Centers for Disease Control and Prevention said Sunday that the infection in the health care worker, who was not on the organization’s watch list for people who had contact with Ebola patient Thomas Eric Duncan, resulted from a “breach in protocol.”

“We have spoken with the health care worker,” who cannot “identify the specific breach” that allowed the infection to spread, said CDC director Dr. Tom Frieden. The CDC has sent additional staff members to Dallas to “assist with the response,” he said.

Frieden said exposure can result from a “single inadvertent slip.” He cautioned: “Unfortunately it is possible in the coming days we will see additional cases of Ebola” in health care workers.

Texas health commissioner David Lakey said the health care worker had “extensive contact” with Duncan. The nurse, who missed two days of work before going to the emergency room, is believed to have had contact with one person while symptomatic. Ebola, which is spread through direct contact with bodily fluids of a sick person, can only be transmitted from infected people showing symptoms.

“We have been preparing for an event like this,” Lakey said.

Presbyterian chief clinical officer Daniel Varga said the exposure occurred during Duncan’s second visit to the hospital. Duncan, the first person to die of Ebola in the United States, went to the Presbyterian emergency room Sept. 25 and was sent home with antibiotics only to return to the hospital on Sept. 28. He was diagnosed with Ebola and died Oct. 8.

It is not clear how the health care provider contracted Ebola. According to Duncan’s patient records released by the family to The Associated Press, this is what happened at Presbyterian:

— On Sept. 28, an ambulance with Duncan arrived at the hospital’s emergency bay shortly after 10 a.m.

— Doctors performed tests on Duncan, who told them he had recently arrived from Africa, and determined he had sinusitis.

— Now in isolation, Duncan was projectile vomiting, having explosive diarrhea and his temperature was 103.1 degrees.

— On Sept. 29, as his condition worsened, Duncan asked the nurse to put him in a diaper.

— On Sept. 30, tests results confirmed Duncan had Ebola. Only then did staff treating Duncan trade their gowns and scrubs for hazmat suits, and the room was cleaned with bleach.

Varga at Presbyterian said the worker was wearing protective gear, including a gown, glove, mask and shield, when she came into contact with Duncan. “This individual was following full CDC precautions,” Varga said

Officials haven’t released the name of the health care worker or her job description. Dallas County Judge Clay Jenkins said he has spoken to the health care worker’s parents, who have asked for privacy.

“Let’s remember that this is a real person who is going through a great ordeal. So is that person’s family,” Jenkins said.

The second Ebola patient lives in the 5700 block of  Marquita Avenue in East Dallas, where the person’s apartment was going to be decontaminated Sunday. While the CDC didn’t consider the person to be at “high risk” of contracting Ebola, the health care worker had been monitoring for signs of the disease, including checking for fever twice daily.

The person’s car was decontaminated and the common area of an apartment complex was going to be cleaned by a hazardous-material team Sunday.

A crew of 15 people from the Cleaning Guys was going to decontaminate the person’s apartment Sunday afternoon, said company owner Erick McCallum. “Our main objective is for this to go away and to be eradicated,” he said.

Staff writers Melissa Repko, Sherry Jacobson, Claire Cardona, Eva-Marie Ayala and Matthew Haag contributed to this report.

=====

Update at 2:59 p.m.

Brad Smith, Vice President of CG Environmental-Cleaning Guys, a hazardous material company, was hired to clean the apartment unit of the ill health care worker.

He said the hazmat crew will begin cleaning in the next hour or two. They are not sure how long it will take. The crew will include up to 15 people.

He said he’s not concerned about the safety of the crew. He heard the health care worker contracted Ebola after “there was something that went wrong in her PPE” or “personal protective equipment.”

“I’m not sure how it happened,” he said. “But we will not let that happen to our guys.”Smith said the company was hoping not to get any more calls about an Ebola case.

“I was speechless. I don’t know what my thoughts were,” he said. “I just knew we had to react and gear up and do it again.”

Smith said the crew plans to clean the exterior today and clean the interior tomorrow. It will be similar to the cleanup of the apartment where Thomas Eric Duncan stayed.

“We won’t do anything different,” he said. “We think the last time we went out we were successful in cleaning it up. We will continue to so the same thing.”

Update at 12:21 p.m.

At the end of Marquita, morning services were underway at Skillman Church of Christ. The congregation first became aware of the deadly disease when medical missionary Dr. Kent Brantly, who many congregants know, contracted the illness.

Then many became close to the son of Thomas Eric Duncan, who died of the disease. Now pastor Joel Sanchez was telling the church that a healthcare worker just a few blocks away has Ebola.

“As much as we are connected to the world, it’s easy to see something on the television and think of it as happening over yonder, over there,” he said. “But when it hits close to home, it becomes real.”

The congregation prayed for the healthcare worker who Sanchez said put another in front of herself because he had a need. They prayed for the family of Duncan. But then Sanchez asked his congregation not to forget the thousands suffering in West Africa, an area with limited medical resources  where nearly 4,000 people have died from Ebola.

“We can’t forget those people whose only course of action is to pray that they don’t get it,” Sanchez said.

Dallas County Judge Clay Jenkins, Mayor Mike Rawlings and Dr. Daniel Varga held a news conference Sundaymorning to inform the public that a health care worker at Texas Health Presbyterian Hospital in Dallas test positive for the Ebola virus after coming in close contact with Ebola patient Thomas Eric Duncan.

 http://www.dallasnews.com/news/local-news/20141012-health-care-worker-at-presbyterian-hospital-tests-positive-for-ebola.ece

Health care worker at Presbyterian Hospital in Dallas tests positive for Ebola

Police guard the residence at 5700 block of Marquita, where reportedly a person diagnosed with Ebola lived, photographed in Dallas on Sunday, October 12, 2014. (Louis DeLuca/The Dallas Morning News)
Louis DeLuca/Staff Photographer
Police guard the residence at 5700 block of Marquita, where reportedly a person diagnosed with Ebola lived, photographed in Dallas on Sunday, October 12, 2014. (Louis DeLuca/The Dallas Morning News)

The infected person detected a fever Friday night and drove herself to the Presbyterian emergency room, where she was placed in isolation 90 minutes later. A blood sample sent to the state health lab in Austin confirmedSaturday night that she had Ebola — the first person to contract the disease in the United States.

The director for the Centers for Disease Control and Prevention said Sunday that the infection in the health care worker, who was not on the organization’s watch list for people who had contact with Ebola patient Thomas Eric Duncan, resulted from a “breach in protocol.”

“We have spoken with the health care worker,” who cannot “identify the specific breach” that allowed the infection to spread, said CDC director Dr. Tom Frieden. The CDC has sent additional staff members to Dallas to “assist with the response,” he said.

Frieden said exposure can result from a “single inadvertent slip.” He cautioned: “Unfortunately it is possible in the coming days we will see additional cases of Ebola” in health care workers.

Texas health commissioner David Lakey said the health care worker had “extensive contact” with Duncan. The nurse, who missed two days of work before going to the emergency room, is believed to have had contact with one person while symptomatic. Ebola, which is spread through direct contact with bodily fluids of a sick person, can only be transmitted from infected people showing symptoms.

“We have been preparing for an event like this,” Lakey said.

Presbyterian chief clinical officer Daniel Varga said the exposure occurred during Duncan’s second visit to the hospital. Duncan, the first person to die of Ebola in the United States, went to the Presbyterian emergency room Sept. 26 and was sent home with antibiotics only to return to the hospital on Sept. 28. He was diagnosed with Ebola and died Oct. 8

Officials haven’t released the name of the health care worker or her job description. Dallas County Judge Clay Jenkins said he has spoken to the health care worker’s parents, who have asked for privacy.

“Let’s remember that this is a real person who is going through a great ordeal. So is that person’s family,” Jenkins said.

The second Ebola patient lives in the 5700 block of  Marquita Avenue in East Dallas, where the person’s apartment was decontaminated Sunday. While the CDC didn’t consider the person to be at “high risk” of contracting Ebola, the health care worker had been monitoring for signs of the disease, including checking for fever twice daily.

The person’s car was decontaminated and the common area of an apartment complex was cleaned by a hazardous-material team Sunday. A pet also lived in the person’s apartment.

Dallas police have cordoned off the East Dallas apartment, where a frenzy of news media and helicopters circling above have drawn neighbors outside. Police officers and a CDC representative talked to residents Sundaymorning and distributing papers about Ebola symptoms. Dallas Mayor Mike Rawlings also visited with residents.

“It just breaks my heart. … She was just an innocent woman who took care of someone who was sick,” said neighbor Colleen Watson said. “She did her job, and probably with full empathy and kindness, and for this to happen to her is so much sadder than any other case.”

Dina Smith was holding her 3-year-old daughter, still in disbelief that the first contracted case was just a block away. She said Mayor Mike Rawlings and staff members from the mayor’s office visited Sunday morning and talked to residents.

“I’m not particularly concerned because from everything I heard, she was a nurse and took every precaution,” Smith said. “But you hear the helicopters overhead and see the news, and it makes you pay more attention.”

Lindsey Carpenter, 33, said her roommate had searched on the Internet to find out why news helicopters were flying over their neighborhood. He barged into her room at 9:30 a.m. when he found an answer: “There’s an Ebola patient in the neighborhood.”

Carpenter, who works in a hospital in Lewisville, said she hopes Presbyterian investigates how the nurse contracted Ebola — especially because she was exposed to Duncan during his second visit to the hospital.

“They were prepared with hazmat suits and everything,” she said. “I wonder how she got it. It’s really puzzling. There’s probably more to the story that we don’t know.”

Texas Health says “the Emergency Department at Texas Health Dallas is diverting ambulance traffic with the exception of patients showing symptoms of  Ebola Virus Disease. The ED is open and seeing patients arriving by any other means.”

Staff writers Melissa Repko, Sherry Jacobson, Claire Cardona, Eva-Marie Ayala and Matthew Haag contributed to this report.

Update at 12:21 p.m.

At the end of Marquita, morning services were underway at Skillman Church of Christ. The congregation first became aware of the deadly disease when medical missionary Dr. Kent Brantly, who many congregants know, contracted the illness.

Then many became close to the son of Thomas Eric Duncan, who died of the disease. Now pastor Joel Sanchez was telling the church that a healthcare worker just a few blocks away has Ebola.

“As much as we are connected to the world, it’s easy to see something on the television and think of it as happening over yonder, over there,” he said. “But when it hits close to home, it becomes real.”

The congregation prayed for the healthcare worker who Sanchez said put another in front of herself because he had a need. They prayed for the family of Duncan. But then Sanchez asked his congregation not to forget the thousands suffering in West Africa, an area with limited medical resources  where nearly 4,000 people have died from Ebola.

“We can’t forget those people whose only course of action is to pray that they don’t get it,” Sanchez said.

WATCH: Dallas mayor, hospital doctors give details on Ebola patient No. 2

Dallas County Judge Clay Jenkins, Mayor Mike Rawlings and Dr. Daniel Varga held a news conference Sundaymorning to inform the public that a health care worker at Texas Health Presbyterian Hospital in Dallas test positive for the Ebola virus after coming in close contact with Ebola patient Thomas Eric Duncan.

http://www.dallasnews.com/news/local-news/20141012-health-care-worker-at-presbyterian-hospital-in-dallas-tests-positive-for-ebola.ece

TEXAS EBOLA HOSPITAL CAFETERIA BECOMES GHOST TOWN

 By Bob Price

The cafeteria, where employees and patients at Texas Health Presbyterian Hospital normally take a meal break, is looking more like a ghost town since the outbreak of Ebola. A cafeteria worker said their business had taken a major hit in the wake of Nina Pham’s becoming symptomatic after treating Thomas Eric Duncan while he was ill at this hospital.

Breitbart Texas visited Texas Health Presbyterian Hospital on Monday to check out the mood of workers in the hospital. While visiting the various café’s throughout the hospital, there was a severe shortage of customers. A worker in “Café Presby” said their business is down by 25 percent over the past two weeks.

“I am concerned for our workers,” the employee said. “I hope we don’t have to lay anyone off or cut their hours because of this.”

A nurse who spoke with Breitbart Texas said they are very concerned for Nina Pham. “We aren’t as concerned for ourselves as we are for her. Exposure is one of the risks that comes with our job. We take all the precautions we can but there is always a risk of exposure.”

Another nurse who works for a different hospital but was visiting Texas Health Presbyterian said Nina Pham is a friend of one of her friends. “We are all praying for Nina,” she said. “She is a very sweet and caring nurse. We know she is strong and will recover from this.”

Breitbart Texas spoke with a doctor in the hospital about employee morale. “We are doing fine,” the doctor said. “The real enemy here is the media.” He expressed concern about some outlets sensationalized coverage of the Texas Ebola cases.

While exiting the hospital’s parking lot, the parking toll attendant wore protective gloves while handling the cash handed to her by people leaving the hospital.\

http://www.breitbart.com/Breitbart-Texas/2014/10/14/Texas-Ebola-Hospital-Cafeteria-Becomes-Ghost-Town

WHO: EBOLA IS MODERN ERA’S WORST HEALTH EMERGENCY

BY JIM GOMEZ

The World Health Organization called the Ebola outbreak “the most severe, acute health emergency seen in modern times” on Monday but also said that economic disruptions can be curbed if people are adequately informed to prevent irrational moves to dodge infection.

WHO Director-General Margaret Chan, citing World Bank figures, said 90 percent of economic costs of any outbreak “come from irrational and disorganized efforts of the public to avoid infection.”

Staffers of the global health organization “are very well aware that fear of infection has spread around the world much faster than the virus,” Chan said in a statement read out to a regional health conference in the Philippine capital, Manila.

“We are seeing, right now, how this virus can disrupt economies and societies around the world,” she said, but added that adequately educating the public was a “good defense strategy” and would allow governments to prevent economic disruptions.

The Ebola epidemic has killed more than 4,000 people, mostly in the West African countries of Liberia, Sierra Leone and Guinea, according to WHO figures published last week.

Chan did not specify those steps but praised the Philippines for holding an anti-Ebola summit last week which was joined by government health officials and private sector representatives, warning that the Southeast Asian country was vulnerable due to the large number of Filipinos working abroad.

While bracing for Ebola, health officials should continue to focus on major health threats, including non-communicable diseases, she said.

Philippine Health Secretary Enrique Ona said authorities will ask more than 1,700 Filipinos working in Liberia, Sierra Leone and Guinea to observe themselves for at least 21 days for Ebola symptoms in those countries first if they plan to return home.

Once home, they should observe themselves for another 21 days and then report the result of their self-screening to health authorities to be doubly sure they have not been infected, he said, adding that hospitals which would deal with any Ebola patients have already been identified in the Philippines.

Last month, U.N. Secretary-General Ban Ki-moon urged leaders in the most affected countries to establish special centers that aim to isolate infected people from non-infected relatives in an effort to stem the spread of Ebola.

Ban has also appealed for airlines and shipping companies not to suspend services to countries affected by Ebola. Doing so, he said, hinders delivery of humanitarian and medical assistance.

http://hosted.ap.org/dynamic/stories/A/AS_WHO_EBOLA?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT&CTIME=2014-10-13-07-29-36

U.S. lacks a single standard for Ebola response

Larry Copeland

As Thomas Eric Duncan’s family mourns the USA’s first Ebola death in Dallas, one question reverberates over a series of apparent missteps in the case: Who is in charge of the response to Ebola?

The answer seems to be — there really isn’t one person or agency. There is not a single national response.

The Atlanta-based Centers for Disease Control and Prevention has emerged as the standard-bearer — and sometimes the scapegoat — on Ebola.

Public health is the purview of the states, and as the nation anticipates more Ebola cases, some experts say the way the United States handles public health is not up to the challenge.

“One of the things we have to understand is the federal, state and local public health relationships,” says Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “Public health is inherently a state issue. The state really is in charge of public health at the state and local level. It’s a constitutional issue. The CDC can’t just walk in on these cases. They have to be invited in.”

The CDC deployed a team of 10 — three senior epidemiologists, a communication officer, a public health adviser and five epidemic intelligence officers, or “disease detectives” — to Dallas on the night of Sept. 30, hours after the agency announced that Duncan, a Liberian national who traveled to Dallas, had the Ebola virus. The next afternoon, Dallas County Judge Clay Jenkins, head of the Dallas County Office of Homeland Security and Emergency Management; CDC director Tom Frieden; and David Lakey, commissioner of the Texas Department of State Health Services, agreed during a conference call to set up an Emergency Operations Center in Dallas County with Jenkins in charge.

The EOC was staffed by officials from Dallas County, the city of Dallas, the CDC, the county and state health departments and the Dallas County Sheriff’s Department, among others.

This was the team that made decisions on matters such as isolating people who had been in direct contact with Duncan, including his fiancée, Louise Troh, her teenage son and two other male relatives. Because they were not sick, they couldn’t technically be quarantined, Jenkins said Friday. Instead, Lakey issued a “control order” to keep them at home, where they could be monitored for signs of Ebola. Jenkins and Texas Gov. Rick Perry agreed to the order.

Texas officials were criticized for keeping the family inside the apartment where Duncan first showed signs of the disease, potentially exposing them to the virus. The family worried about Duncan’s soiled sheets and other waste in the apartment. The response team located a private home where the family could move and got permits to clean the apartment and truck 140 55-gallon barrels of waste to an incinerator 400 miles away.

Jenkins says he has a working model for how to respond to Ebola cases. Others aren’t so confident.

“In Texas, they really were slow to the plate,” said Robert Murphy, director of the Center for Global Health at Northwestern University Feinberg School of Medicine. “Texas is going to be the example of what not to do.”

Duncan, who arrived in Dallas on Sept. 20, somehow slipped through a Liberian airport screening process that allowed him into the country. He became ill several days later and went to the emergency room at Texas Health Presbyterian hospital Sept. 25; he was prescribed antibiotics, told to take Tylenol and sent home early on the morning of Sept. 26..

According to medical records provided to the Associated Press by Duncan’s family, his temperature spiked at 103 degrees during that visit. Duncan told a nurse that he had recently been in Africa, and he showed symptoms that can indicate Ebola: fever, sharp headache and abdominal pain. He was given a battery of tests and sent to his sister’s apartment with antibiotics. He returned by ambulance Sept. 28, was admitted to the hospital and placed in isolation. On Sept. 30, the CDC confirmed that he had Ebola.

In a statement Friday, the hospital said it had made procedural changes and continues to “review and evaluate” decisions surrounding Duncan’s case.

Murphy says some of the issues in Texas stem from a “system problem” in the way public health care is managed in the USA. The Centers for Disease Control provides only guidance for infection prevention and management. “What they do in Texas, what they do in Illinois, it’s up to the state,” he says.

“The question is, who’s in charge?” Murphy says. “The states can follow all the guidelines and take the advice, which they usually do, but they don’t have to. It’s not a legal requirement. So there really is no one entity that’s controlling things.”

Though the CDC is tasked with readying the nation for an Ebola outbreak, then leading the national response, the Department of Homeland Security is responsible for protecting the borders, according to Thomas Skinner, a spokesman for the CDC, which is under the auspices of the Department of Health and Human Services.

The CDC collaborates with health departments and laboratories around the USA to make sure they are able to test for Ebola and respond rapidly if there is a case in their state, CDC spokeswoman Kirsten Nordlund said.

The agency is working to educate U.S. health care workers on how to isolate patients and protect themselves from infection; it developed a Web-based document that identifies rapidly emerging CDC guidelines for Ebola applicable to public health preparedness national standards for state and local planning.

The agency developed an introductory training course for licensed clinicians who intend to work in Ebola treatment units in Africa, and at any given time, it has 300-500 people working at CDC headquarters to support its Ebola response, Nordlund said.

Homeland Security “is focused on protecting the air traveling public and is taking steps to ensure that passengers with communicable diseases like Ebola are screened, isolated and quickly and safely referred to medical personnel,” deputy secretary Alejandro Mayorkas said Thursday.

That includes issuing “do not board” orders to airlines if the CDC and State Department determine a passenger is a risk to the traveling public; providing information and guidance about Ebola to the airlines; posting notices at airports to raise awareness about Ebola; and providing a health notice called a care sheet to travelers entering the USA that have traveled from or through affected countries.

In addition, Health and Human Services has the authority to suspend the entry of persons into the USA based on outbreaks of disease in other countries and when necessary to protect public health.

Screening started Saturday at New York’s John F. Kennedy airport. Medical workers will take the temperature of airline passengers originating from Guinea, Liberia and Sierra Leone, and Customs and Border Protection staffers will ask questions about their health and possible exposure to Ebola. Those suspected of possible Ebola exposure will be referred to a CDC public health officer for additional screening.

The testing will expand in the next few days to four more airports: Washington Dulles, Newark, Chicago’s O’Hare and Atlanta’s Hartsfield-Jackson airports.

Osterholm and Murphy say the nation’s public health system leaves room for a broad array of Ebola responses from state to state.

“We have to have more clarity,” Osterholm says. “We have to have a level of excellence. If that means putting the CDC in charge of these departments of public health, that means we have to find a way to do that. We can have agreements (between the states and the CDC). … We can’t leave it up to the whims of the state to do it right or not do it right.”

He acknowledges that no one has called for such a change.

“Not yet,” he says. “But we need it, though. Texas was an example of how not to do it.”

Contributing: Rick Jervis in Dallas, Gregory Korte

W.H.O. contradicts CDC, admits Ebola can spread via coughing, sneezing and by touching contaminated surfaces

The World Health Organization has issued a bulletin which confirms what Natural News has been asserting for weeks: that Ebola can spread via indirect contact with contaminated surfaces and aerosolized droplets produced from coughing or sneezing.

“…wet and bigger droplets from a heavily infected individual, who has respiratory symptoms caused by other conditions or who vomits violently, could transmit the virus — over a short distance — to another nearby person,” says a W.H.O. bulletin released this week. [1] “This could happen when virus-laden heavy droplets are directly propelled, by coughing or sneezing…”

That same bulletin also says, “The Ebola virus can also be transmitted indirectly, by contact with previously contaminated surfaces and objects.”

In other words, the WHO just confirmed what the CDC says is impossible — that Ebola can be acquired by touching a contaminated surface.

CDC remains in total denial, spreading dangerous disinformation about Ebola transmission vectors

This information published by the WHO directly contradicts the ridiculous claims of the CDC which continues to insist Ebola cannot spread through “indirect” means.

According to the CDC, Ebola can only spread via “direct contact,” but the CDC is basing this assumption on the behavior of the Ebola outbreak from 1976 — nearly four decades ago.

The CDC, in fact, continues to push five deadly assumptions about Ebola, endangering the lives of Americans in the process by failing to communicate accurate safety information to health professionals and the public.

Because of the CDC’s lackadaisical attitude about Ebola transmission, the Dallas Ebola outbreak may have been made far worse by people walking in and out of the Ebola-contaminated Duncan apartment while wearing no protective gear whatsoever.

Because the CDC sets the standards for dealing with infectious disease in the United States, when the CDC claims Ebola can only spread via “direct contact,” that causes emergency responders, Red Cross volunteers and even family members to conclude, “Then we don’t even need to wear latex gloves as long as we’re not touching the patient!”

Not “airborne” but can spread through the air

Both the CDC and the WHO continue to aggressively insist that Ebola is not an “airborne” disease. “Ebola virus disease is not an airborne infection,” says the WHO bulletin. But that same bulletin describes the ability of Ebola to spread through the air via aerosolized droplets.

The medical definition of “airborne,” it turns out, is a specific, narrow definition that defies the common understanding of the term. To most people, “airborne” means it can spread through the air, and Ebola most certainly can spread through the air when it is attached to aerosolized particles of spit, saliva, mucus, blood or other body fluids.

The CDC has now admitted there is a slight possibility of Ebola mutating to become “airborne” but says that chance is very small. [2] However, all honest virologists agree that the longer Ebola remains in circulation in West Africa, replicating among human hosts, the more chances it has to mutate into an airborne strain.

But the virus doesn’t need to mutate to continue to spread. It has already proven quite capable of spreading via indirect contact in a way that all the governments of the world have been utterly unable to stop. Despite the best efforts of the CDC and WHO, Ebola continues to replicate out of control across West African nations. Even in the United States, the Dallas “patient zero” incident has reportedly caused 100 people to be monitored for possible Ebola infections.

This is why government claims that “we have this under control” are just as much hogwash as the claim that Ebola can only spread via “direct contact.”

But that seems to be the default response of government to all legitimate threats: first, deny reality and misinform the public. Keep people in the dark and maybe the whole thing can be swept under the rug… at least until the mid-term elections.

Learn more: http://www.naturalnews.com/047177_ebola_transmission_direct_contact_aerosolized_particles.html##ixzz3FxuMpXzU

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Is The Ebola Dallas Strain (EDS), an airborne, contagious, incurable and lethal virus mutation, now the source of a world-wide pandemic? — The American People Demand To Be Told The Truth — Videos

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Story 1: Is The Ebola Dallas Strain (EDS), an airborne, contagious, incurable and lethal virus mutation, now the source of a world-wide pandemic? — The American People Demand To Be Told The Truth — Videos

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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.

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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.

http://thehill.com/policy/healthcare/220046-cdc-airborne-ebola-possible-but-unlikely

 

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.

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“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.”

http://www.latimes.com/nation/la-na-ebola-questions-20141007-story.html#page=2

No gloves, no masks: Dallas officials send a message of calm amid Ebola fears

By Abby Phillip

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.”

http://www.washingtonpost.com/news/to-your-health/wp/2014/10/06/no-gloves-no-masks-dallas-officials-send-a-message-of-calm-amid-ebola-fears/

 

‘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
Peter Piot
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.

Suspected Ebola patient in MonroviaA 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!

http://www.theguardian.com/world/2014/oct/04/ebola-zaire-peter-piot-outbreak

Ebola virus disease

From Wikipedia, the free encyclopedia
“Ebola” redirects here. For other uses, see Ebola (disambiguation).
Ebola virus disease
Classification and external resources
7042 lores-Ebola-Zaire-CDC Photo.jpg

A 1976 photograph of two nurses standing in front of Mayinga N., a person with Ebola virus disease; she died only a few days later due to severe internal hemorrhaging.
ICD-10 A98.4
ICD-9 065.8
DiseasesDB 18043
MedlinePlus 001339
eMedicine med/626
MeSH D019142

Ebola virus disease (EVD), Ebola hemorrhagic fever (EHF), or simply Ebola is a disease of humans and other primates caused by an ebolavirus. Symptoms start two days to three weeks after contracting the virus, with afever, sore throat, muscle pain, and headaches. Typically, vomiting, diarrhea, and rash follow, along with decreased function of the liver and kidneys. Around this time, affected people may begin to bleed both within the bodyand externally.[1]

The virus may be acquired upon contact with blood or bodily fluids of an infected human or other animal.[1] Spreading through the air has not been documented in the natural environment.[2] 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.[1]

Outbreak control require community engagement, case management, surveillance and contact tracing, a good laboratory service, and safe burials.[1] 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.[1]

No specific treatment for the disease is yet available.[1] Efforts to help those who are infected are supportive and include giving either oral rehydration therapy (slightly sweet and salty water to drink) or intravenous fluids.[1] This supportive care improves outcomes.[1] The disease has a high risk of death, killing between 50% and 90% of those infected with the virus.[1][3] EVD was first identified in an area of Sudan that is now part of South Sudan, as well as in Zaire (now the Democratic Republic of the Congo). The disease typically occurs in outbreaks in tropical regions of sub-Saharan Africa.[1] From 1976 (when it was first identified) through 2013, the World Health Organization reported a total of 1,716 cases.[1][4] The largest outbreak to date is the ongoing 2014 West African Ebola outbreak, which is affecting Guinea, Sierra Leone, Liberia, and Nigeria.[5][6] As of 28 September 2014, 7,157 suspected cases resulting in the deaths of 3,330 have been reported.[7] Efforts are under way to develop a vaccine; however, none yet exists.[1]

Signs and symptoms

Signs and symptoms of Ebola.[8]

Signs and symptoms of Ebola usually begin suddenly with an influenza-like stage characterized by fatigue, fever, headaches, joint, muscle, and abdominal pain.[9][10] Vomiting, diarrhea, and loss of appetite are also common.[10]Less common symptoms include the following: sore throat, chest pain, hiccups, shortness of breath, and trouble swallowing.[10] The average time between contracting the infection and the start of symptoms (incubation period) is 8 to 10 days, but it can vary between 2 and 21 days.[10][11] Skin manifestations may include a maculopapular rash (in about 50% of cases).[12] Early symptoms of EVD may be similar to those of malaria, dengue fever, or other tropical fevers, before the disease progresses to the bleeding phase.[9]

In 40–50% of cases, bleeding from puncture sites and mucous membranes (e.g., gastrointestinal tract, nose, vagina, and gums) has been reported.[13] In the bleeding phase, which typically begins five to seven days after first symptoms,[14] internal and subcutaneous bleeding may present itself in the form of reddened eyes and bloody vomit.[9] Bleeding into the skin may create petechiae, purpura, ecchymoses, and hematomas (especially around needle injection sites). Sufferers may cough up blood, vomit it, or excrete it in their stool.

Heavy bleeding is rare and is usually confined to the gastrointestinal tract.[12][15] In general, the development of bleeding symptoms often indicates a worse prognosis and this blood loss can result in death.[9] All people infected show some signs of circulatory system involvement, including impaired blood clotting.[12] 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.[14]

Causes

Life cycles of the Ebolavirus

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.[16] 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.

Transmission

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.[17] 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.[18] 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.[17] The symptoms limit a person’s ability to spread the disease as they are often too sick to travel.[19] 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.[20][21] Semen may be infectious in survivors for up to 7 weeks.[1] It is not entirely clear how an outbreak is initially started.[22] 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.[23] Medical workers who do not wear appropriate protective clothing may contract the disease.[24] Hospital-acquired transmission has occurred in African countries due to the reuse of needles and lack of universal precautions.[25][26] Some healthcare centers caring for people with the disease do not have running water.[27]

Airborne transmission has not been documented during EVD outbreaks.[2] They are, however, infectious as breathable 0.8– to 1.2-μm laboratory-generated droplets.[28] 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.[29]

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.[30]

Reservoir

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.[31]

Bats are considered the most likely natural reservoir of the EBOV. Plants, arthropods, and birds were also considered.[1][32] 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.[33] Of 24 plant species and 19 vertebrate species experimentally inoculated with EBOV, only bats became infected.[34] 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.[35] 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.[36][37] 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.[38]

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.[33][39] 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.[33]

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.[40] Fruit bats are also eaten by people in parts of West Africa where they are smoked, grilled or made into a spicy soup.[37][41]

Virology

Genome

Electron micrograph of an Ebola virus virion

Like all mononegaviruses, ebolavirions contain linear nonsegmented, single-strand, non-infectious RNA genomes 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.[42] 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.[43] The genomes of the five different ebolaviruses (BDBV, EBOV, RESTV, SUDV, and TAFV) differ in sequence and the number and location of gene overlaps.

Structure

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.[43] 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.[44]

Replication

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.[45]

Pathophysiology

Pathogenesis schematic

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.[46]

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.[47]

Diagnosis

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.[48]

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.[49] 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.[44]

Phylogenetic tree comparing the Ebolavirus and Marburgvirus. Numbers indicate percent confidence of branches.

Classification

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.[50]

Rates of genetic change are 100 times slower than influenza A in humans, but on the same magnitude as those of hepatitis B. Extrapolating backwards using these rates indicates that Ebolavirus and Marburgvirus diverged several thousand years ago.[51] However, paleoviruses (genomic fossils) of filoviruses (Filoviridae) found in mammals indicate that the family itself is at least tens of millions of years old.[52] Fossilized viruses that are closely related to ebolaviruses have been found in the genome of the Chinese hamster.[53]

Differential diagnosis

The symptoms of EVD are similar to those of Marburg virus disease.[54] It can also easily be confused with many other diseases common in Equatorial Africa such as other viral hemorrhagic fevers, falciparum malaria, typhoid fever, shigellosis, rickettsial diseases such astyphus, cholera, gram-negative septicemia, borreliosis such as relapsing fever or EHEC enteritis. Other infectious diseases that should be included in the differential diagnosis include the following: leptospirosis, scrub typhus, plague, Q fever, candidiasis, histoplasmosis,trypanosomiasis, visceral leishmaniasis, hemorrhagic smallpox, measles, and fulminant viral hepatitis.[55] Non-infectious diseases that can be confused with EVD are acute promyelocytic leukemia, hemolytic uremic syndrome, snake envenomation, clotting factordeficiencies/platelet disorders, thrombotic thrombocytopenic purpura, hereditary hemorrhagic telangiectasia, Kawasaki disease, and even warfarin poisoning.[56][57][58][59]

Prevention

A researcher working with the Ebola virus while wearing a BSL-4 positive pressure suit to avoid infection

Infection control and containment

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.[22] If a person with Ebola dies, direct contact with the body of the deceased patient should be avoided.[22]

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.[60] These include avoiding contact with infected people and regular hand washing using soap and water.[61] Traditional burial rituals, especially those requiring washing or embalming of bodies, should be discouraged or modified.[62][63] Social anthropologists may help find alternatives to traditional rules for burials.[64] Airline crews are instructed to isolate anyone who has symptoms resembling Ebola virus.[65]

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.[66][67]

In laboratories where diagnostic testing is carried out, biosafety level 4-equivalent containment is required, since Ebola viruses are World Health Organization Risk Group 4 pathogens. Laboratory researchers must be properly trained in BSL-4 practices and wear proper personal protective equipment.

Quarantine

Quarantine, also known as enforced isolation, is usually effective in decreasing spread.[68][69] Governments often quarantine areas where the disease is occurring or individuals who may be infected.[70] In the United States, the law allows quarantine of those infected with Ebola.[71] During the 2014 outbreak, Liberia closed schools.[72]

Contact tracing

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.[73][74]

Treatment

Standard support

A hospital isolation ward in Gulu, Uganda, during the October 2000 outbreak

No ebolavirus-specific treatment is currently approved.[75] However, survival is improved by early supportive care with rehydration and symptomatic treatment.[1] Treatment is primarily supportive in nature.[76] These measures may include management of pain, nausea, fever and anxiety, as well as rehydration via the oral or by intravenous route.[76] Blood products such as packed red blood cells, platelets or fresh frozen plasma may also be used.[76] Other regulators of coagulation have also been tried including heparin in an effort to prevent disseminated intravascular coagulation and clotting factors to decrease bleeding.[76] Antimalarial medications and antibiotics are often used before the diagnosis is confirmed,[76] though there is no evidence to suggest such treatment is in any way helpful.

Intensive care

Intensive care is often used in the developed world.[77] This may include maintaining blood volume and electrolytes (salts) balance as well as treating any bacterial infections that may develop.[77] Dialysis may be needed for kidney failure while extracorporeal membrane oxygenation may be used for lung dysfunction.[77]

Prognosis

The disease has a high mortality rate: often between 25 percent and 90 percent.[1][3] As of September 2014, information from WHO across all occurrences to date puts the overall fatality rate at 50%.[1] 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.[78] 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.[1]

Epidemiology

For more about specific outbreaks and their descriptions, see List of Ebola outbreaks.

CDC worker incinerates medical waste from Ebola patients in Zaire in 1976

The disease typically occurs in outbreaks in tropical regions of Sub-Saharan Africa.[1] From 1976 (when it was first identified) through 2013, the World Health Organization reported 1,716 confirmed cases.[1][4] The largest outbreak to date is the ongoing 2014 West Africa Ebola virus outbreak, which is affecting Guinea, Sierra Leone, Liberia and Nigeria.[5][6] As of 13 August, 2,127 cases have been identified, with 1,145 deaths.[5]

1976

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).[79] 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.[80] Subsequently a number of other cases were reported, almost all centered on the Yambuku mission hospital or having close contact with another case.[80] 318 cases and 280 deaths (a 88% fatality rate) occurred in the DRC.[81] 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.[82]

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.[83] 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.[84]

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.[83][85][86] The 2007 outbreak eventually affected 264 individuals and resulted in the deaths of 187.[1]

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.[87] The WHO reported 149 cases of this new strain and 37 of those led to deaths.[1]

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.[1]

On 17 August 2012, the Ministry of Health of the Democratic Republic of the Congo reported an outbreak of the Ebola-Bundibugyo variant[88] in the eastern region.[89][90] 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.[1][91]

2014 outbreak

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.[92] Researchers traced the outbreak to a two-year old child who died on 28 December 2013.[93][94] 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.[92]

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.”[95] 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.[96] By late August 2014, the disease had spread to Nigeria, and one case was reported in Senegal.[97][98] [99][100] On 30 September 2014, the first confirmed case of Ebola was diagnosed in the United States at Texas Health Presbyterian Hospital in Dallas, Texas.[101]

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.”[102]

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.[103] The WHO reports that more than 216 healthcare workers are among the dead, partly due to the lack of equipment and long hours.[104][105]

History

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).[106] Virus isolated from both outbreaks was named “Ebola virus” by Belgian researchers[107] after the Ebola River, located near the Zaire outbreak.[108] 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.[106]

In late 1989, Hazelton Research Products’ Reston Quarantine Unit in Reston, Virginia suffered a mysterious outbreak of fatal illness (initially diagnosed as Simian hemorrhagic fever virus (SHFV)) among a shipment of crab-eating macaque monkeys imported from the Philippines. Hazelton’s veterinary pathologist sent tissue samples from dead animals to the United States Army Medical Research Institute of Infectious Diseases (USAMRIID) at Fort Detrick, Maryland, where a laboratory test known as an ELISA assay showed antibodies to Ebola virus.[109] An electron microscopist from USAMRIID discoveredfiloviruses similar in appearance to Ebola in the tissue samples sent from Hazelton Research Products’ Reston Quarantine Unit.[110]

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.[109]

Blood samples were taken from 178 animal handlers during the incident.[111] Of those, six animal handlers eventually seroconverted, including one who had cut himself with a bloody scalpel.[46][112] When the handlers did not become ill, the CDC concluded that the virus had a very low pathogenicity to humans.[112]

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.[109]

Society and culture

Ebolavirus is classified as a biosafety level 4 agent, as well as a Category A bioterrorism agent by the Centers for Disease Control and Prevention. It has the potential to be weaponized for use in biological warfare,[113][114] and was investigated by the Biopreparat for such use, but might be difficult to prepare as a weapon of mass destruction because the virus becomes ineffective quickly in open air.[115]

Literature

Richard Preston‘s 1995 best-selling book, The Hot Zone, dramatized the Ebola outbreak in Reston, Virginia.[116]

William Close‘s 1995 Ebola: A Documentary Novel of Its First Explosion and 2002 Ebola: Through the Eyes of the People focused on individuals’ reactions to the 1976 Ebola outbreak in Zaire.[117]

Tom Clancy‘s 1996 novel, Executive Orders, involves a Middle Eastern terrorist attack on the United States using an airborne form of a deadly Ebola virus strain named “Ebola Mayinga” (see Mayinga N’Seka).[118]

Other animals

Wild animals

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.[119]

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.[120]

Ebola has a high mortality among primates.[121] Frequent outbreaks of Ebola may have resulted in the deaths of 5,000 gorillas.[122] 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.[120] Transmission among chimpanzees through meat consumption constitutes a significant risk factor, while contact between individuals, such as touching dead bodies and grooming, is not.[123]

Domesticated animals

Reston ebolavirus (REBOV) can be transmitted to pigs.[124] 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,[70] where the virus had infected pigs.[125] Despite its status as a Level‑4organism and its apparent pathogenicity in monkeys, REBOV has not caused disease in exposed human laboratory workers.[126] 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.[124] 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.[82]

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.[127]

Research

A number of experimental treatments are being studied.[128] 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”.[129] 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.[130]

Medications

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.[131] 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.[132][133]

The FDA has allowed three drugs: ZMapp, an RNA interference drug called TKM-Ebola, and brincidofovir to be used in people infected with Ebola under these programs during the 2014 outbreak.[134][135] BioCryst’s BCX4430 small molecule is undergoing further animal testing as a possible therapy in humans.[136] Another drug favipiravir has been used with apparent success in a patient medically evacuated to France.[137]

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.[138] ZMapp has proved effective in a trial involving Rhesus macaque monkeys.[139]

Antivirals

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.[9][140] On 4 October 2014, it was reported that a French nun who contracted Ebola while volunteering in Liberia was cured with Favipiravir treatment.[141] BCX4430 is a broad-spectrum antiviral drug developed by BioCryst Pharmaceuticals and currently being researched as a potential treatment for Ebola by USAMRIID.[142] The drug has been approved to progress to Phase 1 trials, expected late in 2014.[143] 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.[144] It has subsequently been used to treat the first patient diagnosed with Ebola in the USA, after he had recently returned from Liberia.[145] 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.[146] 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.[147]

Antisense technology

Other promising treatments rely on antisense technology. Both small interfering RNAs (siRNAs) and phosphorodiamidate morpholino oligomers (PMOs) targeting the Zaire Ebola virus (ZEBOV) RNA polymerase L protein could prevent disease in nonhuman primates.[148][149] TKM-Ebola is a small-interfering RNA compound, currently being tested in a Phase I clinical trial in humans.[134][150] Sarepta Therapeutics has completed a Phase I clinical trial with its Morpholino oligo targeting Ebola.[151]

Other

Two selective estrogen receptor modulators used to treat infertility and breast cancer (clomiphene and toremifene) have been found to inhibit the progress of Ebola virus in infected mice. Ninety percent of the mice treated with clomiphene and fifty percent of those treated with toremifene survived the tests.[152]

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.[153] 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.[154]

Blood products

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.[155] At the end of September, WHO issued an interim guideline for this therapy.[156] The blood serum from those who have survived an infection is currently being studied to see if it is an effective treatment.[157] During a meeting arranged by WHO this research was deemed to be a top priority.[157] 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.[76][158] 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.[76] Thus this potential treatment remains controversial.[77] Intravenous antibodies appear to be protective in non-human primates who have been exposed to large doses of Ebola.[159]The World Health Organisation has approved the use of convalescent serum and whole blood products to treat people with Ebola.[160]

Vaccine

As of September 2014, no vaccine was approved for clinical use in humans.[131][157] It was hoped that one would be initially available by November 2014.[157] The most promising candidates are DNA vaccines[161] or vaccines derived from adenoviruses,[162] vesicular stomatitis Indiana virus (VSIV)[163][164][165] or filovirus-like particles (VLPs)[166] because these candidates could protect nonhuman primates from ebolavirus-induced disease. DNA vaccines, adenovirus-based vaccines, and VSIV-based vaccines have entered clinical trials.[167][168][169][170]

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.[162] 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,[171] opening clinical trials in humans.[167] 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.[168] Trying the vaccine on a strain of Ebola that more resembles one that infects humans is the next step.[172] 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.[173] 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.[174] However, actual EBOV infection was never demonstrated beyond doubt.[175] 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.[176][177] The CDC’s recommendations are currently under review.[citation needed]

Simultaneous phase 1 trials of an experimental vaccine known as the NIAID/GSK vaccine commenced in September 2014.[178] GlaxoSmithKline and the NIH jointly developed the vaccine,[178] based on a modified chimpanzee adenovirus, and contains parts of the Zaireand Sudan ebola strains.[178] 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.[179][180]

See also

References

Notes

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  175. Jump up^ Tuffs A (March 2009). “Experimental vaccine may have saved Hamburg scientist from Ebola fever”. BMJ 338: b1223.doi:10.1136/bmj.b1223. PMID 19307268.
  176. Jump up^ Feldmann H, Jones SM, Daddario-DiCaprio KM, Geisbert JB, Ströher U, Grolla A, Bray M, Fritz EA, Fernando L, Feldmann F, Hensley LE, Geisbert TW (January 2007). “Effective post-exposure treatment of Ebola infection”. PLoS Pathogens 3 (1): e2. doi:10.1371/journal.ppat.0030002. PMC 1779298.PMID 17238284.
  177. Jump up^ Geisbert TW, Daddario-DiCaprio KM, Williams KJ, Geisbert JB, Leung A, Feldmann F, Hensley LE, Feldmann H, Jones SM (June 2008). “Recombinant vesicular stomatitis virus vector mediates postexposure protection against Sudan Ebola hemorrhagic fever in nonhuman primates”. Journal of Virology 82 (11): 5664–5668. doi:10.1128/JVI.00456-08. PMC 2395203.PMID 18385248.
  178. ^ Jump up to:a b c “Experimental Ebola Vaccine Processed in Maryland”.Drug Discov. Dev. Associated Press. 2 October 2014.
  179. Jump up^ “First British volunteer injected with trial Ebola vaccine in Oxford”. Guardian. 17 September 2014. Retrieved 17 September 2014.
  180. Jump up^ “An Ebola vaccine was given to 10 volunteers, and there are ‘no red flags’ yet”. Washington Post. 16 September 2014. Retrieved 17 September 2014.

Bibliography

External links

http://en.wikipedia.org/wiki/Ebola_virus_disease

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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

Posted on October 5, 2014. Filed under: Agriculture, Airplanes, American History, Banking, Biology, Blogroll, Business, Chemistry, College, Communications, Constitution, Crisis, Demographics, Diasters, Economics, Education, Employment, Energy, Family, Federal Government, Federal Government Budget, Fiscal Policy, Freedom, government, government spending, Health Care, history, Illegal, Immigration, Inflation, Investments, IRS, Law, Legal, liberty, Life, Links, Macroeconomics, media, Medical, Medicine, Microeconomics, Monetary Policy, Money, Natural Gas, Natural Gas, Oil, People, Politics, Psychology, Public Sector, Rants, Raves, Regulations, Resources, Science, Security, Strategy, Talk Radio, Tax Policy, Taxes, Technology, Terrorism, Transportation, Unemployment, Unions, Video, War, Water, Wealth, Welfare, Wisdom | Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |

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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

sgs-emp

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JEC Chair Brady discusses the importance of declining labor force participation rate

Labor participation rate is down to unprecedented levels

What The Six-Year Unemployment Low Means For U.S. Economy

Ebola ;could wreck W Africa economies, #; warns World Bank

BBC News – Ebola crisis: Toll on regional economies

Counting the Cost – Ebola: The Economic Fallout

 

 

 

Employment Situation Summary

Transmission of material in this release is embargoed until                 USDL-14-1796
8:30 a.m. (EDT) Friday, October 3, 2014

Technical information:
 Household data:	(202) 691-6378  •  cpsinfo@bls.gov  •  www.bls.gov/cps
 Establishment data:	(202) 691-6555  •  cesinfo@bls.gov  •  www.bls.gov/ces

Media contact:		(202) 691-5902  •  PressOffice@bls.gov


                        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
change.

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
50,000 jobs.

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

HOUSEHOLD DATA
Summary table A. Household data, seasonally adjusted

[Numbers in thousands]
Category Sept.
2013
July
2014
Aug.
2014
Sept.
2014
Change from:
Aug.
2014-
Sept.
2014

Employment status

Civilian noninstitutional population

246,168 248,023 248,229 248,446 217

Civilian labor force

155,473 156,023 155,959 155,862 -97

Participation rate

63.2 62.9 62.8 62.7 -0.1

Employed

144,270 146,352 146,368 146,600 232

Employment-population ratio

58.6 59.0 59.0 59.0 0.0

Unemployed

11,203 9,671 9,591 9,262 -329

Unemployment rate

7.2 6.2 6.1 5.9 -0.2

Not in labor force

90,695 92,001 92,269 92,584 315

Unemployment rates

Total, 16 years and over

7.2 6.2 6.1 5.9 -0.2

Adult men (20 years and over)

7.0 5.7 5.7 5.3 -0.4

Adult women (20 years and over)

6.2 5.7 5.7 5.5 -0.2

Teenagers (16 to 19 years)

21.3 20.2 19.6 20.0 0.4

White

6.3 5.3 5.3 5.1 -0.2

Black or African American

13.0 11.4 11.4 11.0 -0.4

Asian (not seasonally adjusted)

5.3 4.5 4.5 4.3 -

Hispanic or Latino ethnicity

8.9 7.8 7.5 6.9 -0.6

Total, 25 years and over

5.9 5.0 5.1 4.7 -0.4

Less than a high school diploma

10.4 9.6 9.1 8.4 -0.7

High school graduates, no college

7.5 6.1 6.2 5.3 -0.9

Some college or associate degree

6.1 5.3 5.4 5.4 0.0

Bachelor’s degree and higher

3.7 3.1 3.2 2.9 -0.3

Reason for unemployment

Job losers and persons who completed temporary jobs

5,803 4,859 4,836 4,530 -306

Job leavers

984 862 860 829 -31

Reentrants

3,165 2,848 2,845 2,809 -36

New entrants

1,211 1,087 1,066 1,105 39

Duration of unemployment

Less than 5 weeks

2,571 2,587 2,609 2,383 -226

5 to 14 weeks

2,685 2,431 2,449 2,508 59

15 to 26 weeks

1,802 1,412 1,486 1,416 -70

27 weeks and over

4,125 3,155 2,963 2,954 -9

Employed persons at work part time

Part time for economic reasons

7,914 7,511 7,277 7,103 -174

Slack work or business conditions

4,955 4,609 4,261 4,162 -99

Could only find part-time work

2,548 2,519 2,587 2,562 -25

Part time for noneconomic reasons

18,919 19,662 19,526 19,561 35

Persons not in the labor force (not seasonally adjusted)

Marginally attached to the labor force

2,302 2,178 2,141 2,226 -

Discouraged workers

852 741 775 698 -

- 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

ESTABLISHMENT DATA
Summary table B. Establishment data, seasonally adjusted
Category Sept.
2013
July
2014
Aug.
2014(p)
Sept.
2014(p)

EMPLOYMENT BY SELECTED INDUSTRY
(Over-the-month change, in thousands)

Total nonfarm

164 243 180 248

Total private

153 239 175 236

Goods-producing

22 63 14 29

Mining and logging

6 9 2 9

Construction

13 30 16 16

Manufacturing

3 24 -4 4

Durable goods(1)

9 27 0 7

Motor vehicles and parts

2.9 13.7 -4.5 3.3

Nondurable goods

-6 -3 -4 -3

Private service-providing(1)

131 176 161 207

Wholesale trade

11.3 3.0 2.5 1.8

Retail trade

27.3 25.4 -4.7 35.3

Transportation and warehousing

23.1 21.1 8.5 1.9

Information

13 10 5 12

Financial activities

-1 15 12 12

Professional and business services(1)

37 50 63 81

Temporary help services

19.7 15.7 24.6 19.7

Education and health services(1)

9 37 42 32

Health care and social assistance

14.5 40.7 40.7 22.7

Leisure and hospitality

9 10 20 33

Other services

2 3 10 0

Government

11 4 5 12

WOMEN AND PRODUCTION AND NONSUPERVISORY EMPLOYEES(2)
AS A PERCENT OF ALL EMPLOYEES

Total nonfarm women employees

49.5 49.4 49.4 49.3

Total private women employees

48.1 47.9 47.9 47.9

Total private production and nonsupervisory employees

82.6 82.6 82.6 82.6

HOURS AND EARNINGS
ALL EMPLOYEES

Total private

Average weekly hours

34.5 34.5 34.5 34.6

Average hourly earnings

$24.06 $24.46 $24.54 $24.53

Average weekly earnings

$830.07 $843.87 $846.63 $848.74

Index of aggregate weekly hours (2007=100)(3)

99.1 101.0 101.2 101.7

Over-the-month percent change

0.1 0.2 0.2 0.5

Index of aggregate weekly payrolls (2007=100)(4)

113.8 117.9 118.5 119.0

Over-the-month percent change

0.3 0.3 0.5 0.4

HOURS AND EARNINGS
PRODUCTION AND NONSUPERVISORY EMPLOYEES

Total private

Average weekly hours

33.6 33.7 33.8 33.7

Average hourly earnings

$20.21 $20.61 $20.67 $20.67

Average weekly earnings

$679.06 $694.56 $698.65 $696.58

Index of aggregate weekly hours (2002=100)(3)

106.3 108.7 109.2 109.1

Over-the-month percent change

-0.2 0.2 0.5 -0.1

Index of aggregate weekly payrolls (2002=100)(4)

143.5 149.7 150.8 150.6

Over-the-month percent change

0.0 0.3 0.7 -0.1

DIFFUSION INDEX(5)
(Over 1-month span)

Total private (264 industries)

59.8 67.8 62.7 57.8

Manufacturing (81 industries)

54.9 56.2 54.9 51.9

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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Illegal Alien Invasion of The United States of America — Videos

Posted on August 2, 2014. Filed under: Agriculture, American History, Beef, Blogroll, College, Communications, Crime, Demographics, Drug Cartels, Economics, Education, Employment, Family, Farming, Federal Government, Food, Foreign Policy, Fraud, Freedom, Friends, government spending, history, Homicide, Illegal, Immigration, Inflation, Language, Law, Legal, liberty, Life, Links, media, People, Philosophy, Photos, Politics, Public Sector, Resources, Terrorism, Unemployment, Unions, Video, War, Water, Weather, Wisdom | Tags: , , , , , |

The Illegal Invasion of America

The Illegal Invasion From Ground Zero

Obama’s Border Crisis Could Result In The Deaths Of Millions Of Americans

Illegal Invasion Destroying Small Town America

A once prosperous Texas town is now drowning in debt due to the swarm of illegals destroying property,spreading disease and filling up mass graves on the taxpayer’s dime. Infowars reporter Jon bowne speaks with Falfurrias Texas judge Raul Ramirez about the red level warning signs for main street America.

Tidal Wave of Illegals Overrun Brownsville, Texas

Judge Jeanine Pirro Opening Statement – Illegal Alien Released Kills US Citizen – Obama’s Crisis

TV In Central America Telling Illegals To Go The US With Your Child – “You Won’t Be Turned Away”

 

 

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Peter Brimelow — Alien Nation: Common Sense About America’s Immigration Disaster — Videos

Posted on July 21, 2014. Filed under: American History, Blogroll, Books, British History, Business, Catholic Church, Communications, Computers, Demographics, Diasters, Economics, Employment, Family, Federal Government, Foreign Policy, Freedom, Friends, government spending, history, Illegal, Immigration, IRS, Islam, Language, Law, Legal, liberty, Life, Links, Literacy, media, Medicine, Natural Gas, Non-Fiction, Oil, People, Philosophy, Photos, Politics, Press, Psychology, Public Sector, Rants, Raves, Regulations, Religion, Resources, Reviews, Security, Shite, Strategy, Sunni, Talk Radio, Taxes, Technology, Terrorism, Unemployment, Unions, Video, War, Water, Wealth, Weather, Welfare, Wisdom | Tags: , , , , , , , |

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peter_brimelow

VDARE.com

What Price Mass Immigration – Peter Brimelow Introduction

 

Peter Brimelow of VDare on How Republican Party Has to be More White

Alien Nation: America’s Immigration Disaster

Mr. Brimelow discussed his book Alien Nation: Common Sense About America’s Immigration Disaster, published by Random House. The book focuses on U.S. immigration policy and cycles of control on immigration. Mr. Brimelow argues that legislation passed in 1965 has resulted in negative trends in immigration to the United States, including an influx of immigrants from a very few countries that he says are engulfing America. The author says that the latest immigration wave consists of immigrants who are less educated, less skilled, and less likely to share American ideals, which he argues is a detriment to American culture.

Peter Brimelow Reflects on Immigration in America, Post-Alien Nation

Michael Coren Interviews Peter Brimelow

Peter Brimelow, Immigration Road to Hell

Peter Brimelow speaks CPAC 2012

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Inequality and Immigration (2 of 3)

Inequality & Immigration (3 of 3)

Peter Brimelow On Western Culture At The Thomas Jefferson Club

The Libertarian Case Against Open Immigration | Peter Brimelow

Related Articles and Videos

George J. Borjas: Costs of Immigration – Economics Roundtable

 

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Militarization of Police Departments and SWAT Team in America — Who is the enemy? The American People — War on Drugs — War on Terror — War on Americans — Videos

Posted on June 28, 2014. Filed under: American History, Blogroll, Business, College, Communications, Computers, Drones, Economics, Education, Employment, Family, Federal Government, Federal Government Budget, Fiscal Policy, Freedom, government spending, history, Investments, Law, liberty, Life, media, People, Philosophy, Pistols, Politics, Psychology, Rants, Raves, Regulations, Resources, Rifles, Talk Radio, Tax Policy, Technology, Terrorism, Unemployment, Video, War, Weapons, Welfare, Wisdom, Writing | Tags: , , , , , , , , |

 

Obama Expands Militarization of Police

Are Police Declaring War on Americans?

RISE Of The WARRIOR COP: The Militarization Of America’s Police Forces

Radley Balko on The Militarized Police State

MILITARIZATION OF POLICE – PENTAGON is ARMING the U.S. POLICE with MRAP Military COMBAT VEHICLE’s

 

Barney Fife Meets Delta Force 

Hypermilitarized police departments are more dangerous than whatever they fight. 

 

Nestled awkwardly among the usual guff, the outrage website Salon this week took a welcome flyer and accorded space to something genuinely alarming. “A SWAT team,” the headline screamed, “blew a hole in my 2-year-old son.” For once, this wasn’t hyperbole.

The piece’s author, Alecia Phonesavanh, described what it felt like to be on the business end of an attack that was launched in error by police who believed a drug dealer to be living and operating in her house. They “threw a flashbang grenade inside,” she reported. It “landed in my son’s crib.” Now, her son is “covered in burns” and has “a hole in his chest that exposes his ribs.” So badly injured was he by the raid that he was “placed into a medically induced coma.” “They searched for drugs,” Phonesavanh confirmed, but they “never found any.” Nor, for that matter, did they find the person they were looking for. He doesn’t live there. “All of this,” she asks, “to find a small amount of drugs?”

 

Historians looking back at this period in America’s development will consider it to be profoundly odd that at the exact moment when violent crime hit a 50-year low, the nation’s police departments began to gear up as if the country were expecting invasion — and, on occasion, to behave as if one were underway. The ACLU reported recently that SWAT teams in the United States conduct around 45,000 raids each year, only 7 percent of which have anything whatsoever to do with the hostage situations with which those teams were assembled to contend. Paramilitary operations, the ACLU concluded, are “happening in about 124 homes every day — or more likely every night” — and four in five of those are performed in order that authorities might “search homes, usually for drugs.” Such raids routinely involve “armored personnel carriers,” “military equipment like battering rams,” and “flashbang grenades.”

 

Were the military being used in such a manner, we would be rightly outraged. Why not here? Certainly this is not a legal matter. The principle of posse comitatus draws a valuable distinction between the national armed forces and parochial law enforcement, and one that all free people should greatly cherish. Still, it seems plain that the potential threat posed by a domestic standing army is not entirely blunted just because its units are controlled locally. To add the prefix “para” to a problem is not to make it go away, nor do legal distinctions change the nature of power. Over the past two decades, the federal government has happily sent weapons of war to local law enforcement, with nary a squeak from anyone involved with either political party. Are we comfortable with this?

The Right’s silence on the issue is vexing indeed, the admirable attempts of a few libertarians notwithstanding. Here, conservatives seem to be conflicted between their rightful predilection for law and order — an instinct that is based upon an accurate comprehension of human nature and an acknowledgment of the existence of evil — and a well-developed and wholly sensible fear of state power, predicated upon precisely the same thing. As of now, the former is rather dramatically winning out, leading conservatives to indulge — or at least tacitly to permit — excuses that they typically reject elsewhere. Much as the teachers’ unions invariably attempt to justify their “anything goes” contracts by pointing to the ends that they ostensibly serve (“Well you do want schools for the children or don’t you? Sign here”), the increasingly muscular behavior of local police departments is often shrugged off as a by-product of the need to fight crime. This, if left unchecked, is a recipe for precisely the sort of carte blanche that conservatives claim to fear.

Leaving aside the central moral question of the War on Drugs — which is whether the state should be responding to peaceful transactions and consensual behavior with violence — there is, it seems, considerable room between law enforcement’s turning a blind eye to the law and its aping the military in its attempt to uphold it. The cartels of Mexico and drug lords of America’s larger cities are one thing; but two-bit dealers and consumers of illicit substances are quite another. In the instance that Salon recorded, the person that authorities “were looking for, wasn’t there.” “He doesn’t even live in that house,” Phonesavanh confirmed. But suppose that he had, and that he’d been dealing drugs as charged? Does this alone make the case for the tactics? I suspect not. Instead, attempting to catch a violator in the act by releasing military vehicles full of machine-gun-wielding men, storming a home in the dead of night, and performing a no-knock raid that results in a two-year-old’s being pushed into a coma might, one suspects, be overkill — in many similar cases, literally so. The question for conservatives should be this: If cowboy poetry is no justification for federal intrusion, can drug dealing be said to serve as an open invitation for the deployment of the ersatz 101st?

In the more febrile of the Right’s quarters, the sight of MRAPs being delivered to the chief of police in Westington, Mont., has given rise to all forms of regrettable silliness — to visions of black helicopters and reeducation camps and an America on the verge of being taken by force by the gun-toting rangers of the Fish and Wildlife Service. Nevertheless, a small amount of latent paranoia has served America well, and Chekhov’s advice that “one must not put a loaded rifle on the stage if no one is thinking of firing it” should be applied to governments as rigorously as to aspiring playwrights. Once the holders of the monopoly on violence are accorded the latest weaponry, there will always be the temptation to use it. Likewise, once one has taken the mental and linguistic leap of ascribing to domestic law enforcement the imprimatur of “war,” one may be inclined to reach for the trigger that little bit more quickly. The disaster at Waco, Texas, was, it seems, more cock-up than conspiracy. But the recognition in the aftermath that the whole bloody mess could have been avoided if local officers had taken the time to chat with the victims should haunt us to this day. Rushing in at 100 miles per hour rarely works out, whatever the ill that one is attempting to resolve.

The Left’s current inclination is to spin offenses out of straw — having no major battles left to fight, it seeks to detect microaggressions; with overt bigotry so thin on the ground, the dog whistles have come out; and with the barriers to the Declaration’s maxim having been largely removed, the focus has shifted to the structural and the invisible. But first-degree burns and holes in the chest are different things altogether — not to be dismissed or downplayed — and that the issue is being raised by an outlet known for its absurdity should not dull its impact. Will the Right wake up to the threat, applying its usual mistrust of power to a favored group, or will its usually alert advocates leave themselves willfully in the dark until, one day, a flashbang with their name on it is tossed through the window to wake them up with a start?

 

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State and Central Banking: Killing and Fleecing The People Massively — Financing War — Videos

Posted on June 18, 2014. Filed under: American History, Banking, Blogroll, Communications, Constitution, Diasters, Economics, Education, Employment, Faith, Family, Federal Government, Federal Government Budget, Fiscal Policy, Foreign Policy, Freedom, Genocide, government, government spending, history, History of Economic Thought, Investments, Language, Law, liberty, Life, Links, Literacy, Macroeconomics, Microeconomics, Monetary Policy, Money, People, Philosophy, Rants, Raves, Regulations, Resources, Tax Policy, Taxes, Technology, Unemployment, Video, War, Wealth, Weapons, Welfare, Wisdom | Tags: , , , , , |

lew_rockwell

lew_rockwell

Mises

War and the Fed | Lew Rockwell

Lew Rockwell explains how the Federal Reserve Enables War, Empire, and Destroys the Middle Class

Economics and Moral Courage | Llewellyn H. Rockwell, Jr.

The Misesian Vision | Llewellyn H. Rockwell, Jr.

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Kurdistan — A New Nation In The Making With 40 Million Kurds — Turkey (15 Million +), Iran (7 Million +), Iraq (6 Million +), and Syria (3 Million +) — No Friends But The Mountains — Videos

Posted on June 14, 2014. Filed under: American History, Blogroll, College, Communications, Constitution, Demographics, Economics, Education, Employment, Energy, Federal Government, Federal Government Budget, Fiscal Policy, Foreign Policy, Freedom, Genocide, government, history, Illegal, Immigration, Language, Law, Legal, liberty, Life, Literacy, media, Natural Gas, Nuclear Power, Oil, People, Philosophy, Photos, Politics, Rants, Raves, Regulations, Talk Radio, Terrorism, Video, War, Wealth, Weapons, Welfare, Wisdom, Writing | Tags: , , , , , , , , , , , |

contemporarykurdistanmap-kurdistan-official-map-Washington-Report-Middle-East-Affairs

 

kurdistan_map

Kurdistan-Map2

Kurdistan-Map

kurdistan3

kurdistan_map

free-kurdistan-map

Flag_of_Kurdistan.svg

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Kurdish Exodess in 1991 part 2

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Female Fighters of Kurdistan (Part 2/3)

Female Fighters of Kurdistan (Part 3/3)

Women fighters in kurdistan 2013 (documentary)

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26 years of Kurdish struggle in Turkey 

DN! US Journalist (1) on Plight of Kurds Deported from Turkey

DN! US Journalist (2) on Plight of Kurds Deported from Turkey

Documentary: Good Kurds, Bad Kurds 1/8

Documentary: Good Kurds, Bad Kurds 2/8

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Documentary: Good Kurds, Bad Kurds 6/8

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Documentary: Good Kurds, Bad Kurds 8/8

 

 

 

 

 

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Noam Chomsky (July, 2013) “On the Kurds”

Kurdish oil upsets Washington and Baghdad

Kurdish population

From Wikipedia, the free encyclopedia

The Kurdish people are an Indo-European ethnic group, whose origins are in the Middle East.[1] They are the largest ethnic group in the world that do not have a state of their own.[2] The region of Kurdistan, the original geographic region of the Kurdish people and the home to the majority of Kurds today, covers contemporary TurkeyIraqIran, and Syria. This geo-cultural region means “Land of the Kurds”. Kurdish populations occupy the territory in and around the Zagros mountains. These arid unwelcoming mountains have been a geographic buffer to cultural and political dominance from neighboring empires.[2] Persians,Arabs and Ottomans were kept away, and a space was carved out to develop Kurdish culture, language and identity.[2]

 

Turkey[edit]

According to a report by Turkish agency KONDA, in 2006, out of the total population of 73 million people in Turkey there were 11.4 million Kurds and Zazas living in Turkey (close to 15.68% of the total population).[3]The Turkish newspaper Milliyet has reported in 2008 that the Kurdish population in Turkey is 12.6 million; although this also includes 3 million Zazas.[4] According to the World Factbook, Kurdish people make up 18% of Turkey’s population (about 14 million, out of 77.8 million people).[5] Kurdish sources put the figure at 20[6] to 25 million Kurds in Turkey.[7]

Kurds mostly live in southeastern and eastern parts of Anatolia. But large Kurdish populations can be found in western Turkey due to internal migration. According to Rüstem Erkan, Istanbul is the province with the largest Kurdish population in Turkey.[8]

Iran[edit]

Main articles: Kurds in Iran and Kurds of Khorasan

From the 7 million Iranian Kurds, a significant portion are Shia.[9] Shia Kurds inhabit Kermanshah Province, except for those parts where people are Jaff, and Ilam Province; as well as some parts of Kurdistan,Hamadan and Zanjan provinces. The Kurds of Khorasan Province in northeastern Iran are also adherents of Shia Islam. During the Shia revolution in Iran the major Kurdish political parties were unsuccessful in absorbing Shia Kurds, who at that period had no interest in autonomy.[10][11][12] However, since the 1990s Kurdish nationalism has seeped into the Shia Kurdish area partly due to outrage against government’s violent suppression of Kurds farther north.[13]

Iraq[edit]

Main article: Kurds in Iraq

Kurds constitute approximately 17% of Iraq’s population. They are the majority in at least three provinces in northern Iraq which are together known as Iraqi Kurdistan. Kurds also have a presence in KirkukMosul,Khanaqin, and Baghdad. Around 300,000 Kurds live in the Iraqi capital Baghdad, 50,000 in the city of Mosul and around 100,000 elsewhere in southern Iraq.[14]

Kurds led by Mustafa Barzani were engaged in heavy fighting against successive Iraqi regimes from 1960 to 1975. In March 1970, Iraq announced a peace plan providing for Kurdish autonomy. The plan was to be implemented in four years.[15] However, at the same time, the Iraqi regime started an Arabization program in the oil-rich regions of Kirkuk and Khanaqin.[16] The peace agreement did not last long, and in 1974, the Iraqi government began a new offensive against the Kurds. Moreover in March 1975, Iraq and Iran signed the Algiers Accord, according to which Iran cut supplies to Iraqi Kurds. Iraq started another wave of Arabization by moving Arabs to the oil fields in Kurdistan, particularly those around Kirkuk.[17] Between 1975 and 1978, 200,000 Kurds were deported to other parts of Iraq.[18]

Syria[edit]

Main article: Kurds in Syria

Kurds are the largest ethnic minority in Syria and make up nine percent of the country’s population.[19] Syrian Kurds have faced routine discrimination and harassment by the government.[20][21]

Syrian Kurdistan is an unofficial name used by some to describe the Kurdish inhabited regions of northern and northeastern Syria.[22] The northeastern Kurdish inhabited region covers the greater part of Hasakah Governorate. The main cities in this region are Qamishli and Hasakah. Another region with significant Kurdish population is Kobanê (Ayn al-Arab) in the northern part of Syria near the town of Jarabulus and also the city of Afrin and its surroundings along the Turkish border.

Many Kurds seek political autonomy for the Kurdish inhabited areas of Syria, similar to Iraqi Kurdistan in Iraq, or outright independence as part of Kurdistan. The name “Western Kurdistan” (Kurdish: Rojavayê Kurdistanê) is also used by Kurds to name the Syrian Kurdish inhabited areas in relation to Kurdistan.[23][24][25] Since the Syrian civil war, Syrian government forces have abandoned many Kurdish-populated areas, leaving the Kurds to fill the power vacuum and govern these areas autonomously.[26]

Armenia[edit]

According to the 2011 Armenian Census, 37,470 Kurds live in Armenia, mainly Yazidi.[27] They mainly live in the western parts of Armenia. The Kurds of the former Soviet Union first began writing Kurdish in the Armenian alphabet in the 1920s, followed by Latin in 1927, then Cyrillic in 1945, and now in both Cyrillic and Latin. The Kurds in Armenia established a Kurdish radio broadcast from Yerevan and the first Kurdish newspaper Riya Teze. There is a Kurdish Department in the Yerevan State Institute of Oriental studies. The Kurds of Armenia were the first exiled country to have access to media such as radio, education and press in their native tongue[28] but many Kurds, from 1939 to 1959 were listed as the Azeri population or even as Armenians.[29]

Georgia[edit]

According to the 2000 Georgian Census, 20,843 Kurds live in Georgia.[30] The Kurds in Georgia mainly live in the capital of Tbilisi and Rustavi.[31] According to a United Nations High Commissioner for Refugeesrerport from 1998, about 80% of the Kurdish population in Georgia are Yazidi Kurds.[31]

Russia[edit]

According to the 2010 Russian Census, 63,818 Kurds live in Russia. Russia has maintained warm relations with the Kurds for a long time, During the early 19th century, the main goal of the Russian Empire was to ensure the neutrality of the Kurds, in the wars against Persia and the Ottoman Empire.[32] In the beginning of the 19th century, Kurds settled in Transcaucasia, at a time when Transcaucasia was incorporated into the Russian Empire. In the 20th century, Kurds were persecuted and exterminated by the Turks and Persians, a situation that led Kurds to move to Russia.[33]

Lebanon[edit]

Main article: Kurds in Lebanon

The existence of a community of at least 100,000 Kurds is the product of several waves of immigrants, the first major wave was in the period of 1925-1950 when thousands of Kurds fled violence and poverty in Turkey.[34] Kurds in Lebanon go back far as the twelfth century A.D. when the Ayyubids arrived there. Over the next few centuries, several other Kurdish families were sent to Lebanon by a number of powers to maintain rule in those regions, others moved as a result of poverty and violence in Kurdistan. These Kurdish groups settled in and ruled many areas of Lebanon for a long period of time.[35]:27 Kurds of Lebanon settled in Lebanon because of Lebanon’s pluralistic society.[36]

Western Europe[edit]

The Kurdish diaspora in Western Europe is most significant in Germany, France, Sweden and the UK. Kurds from Turkey went to Germany and France during the 1960s as immigrant workers. Thousands of Kurdish refugees and political refugees fled from Turkey to Sweden during the 1970s and onward, and from Iraq during the 1980s and 1990s.

In France, the Iranian Kurds make up the majority of the community.[37] However, thousands of Iraqi Kurds also arrived in the mid 1990s.[38] More recently, Syrian Kurds have been entering France illegally[39]

In the United Kingdom, Kurds first began to immigrate between 1974-75 when the rebellion of Iraqi Kurds against the Iraqi government was repressed. The Iraqi government began to destroy Kurdish villages and forced many Kurds to move to barren land in the south.[40] These events resulted in many Kurds fleeing to the United Kingdom. Thus, the Iraqi Kurds make up a large part of the community.[37] In 1979, Ayatollah Khomeini came to power in Iran and installed Islamic law. There was widespread political oppression and persecution of the Kurdish community. Since the late 1970s the number of people from Iran seeking asylum in Britain has remained high.[40] In 1988, Saddam Hussein launched the Anfal campaign in the northern Iraq. This included mass executions and disappearances of the Kurdish community. The use of chemical weapons against thousands of towns and villages in the region, as well as the town of Halabja increased the number of Iraq Kurds entering the United Kingdom.[40] A large number of Kurds also came to the United Kingdom following the 1980 military coup in Turkey.[40] More recently, immigration has been due to the continued political oppression and the repression of ethnic and religious minorities in Iraq and Iran.[40] Estimates of the Kurdish population in the United Kingdom are as high as 200-250,000.[40]

In Denmark, there is a significant number of Iraqi political refugees, many of which are actually Kurds.[41]

In Finland, most Kurds arrived in the 1990s as Iraqi refugees.[42] Kurds in Finland have no great attachment to the Iraqi state because of their position as a persecuted minority. Thus, they feel more accepted and comfortable in Finland, many wanting to get rid of their Iraqi citizenship.[43]

North America[edit]

In the United States, it is believed that the Kurdish population is approximately 58,000,[44] the large majority of which come from Iran.[45] It is estimated that some 23,000 Iranian Kurds are living in the United States.[45]During the 1991 Persian Gulf War, about 10,000 Iraqi refugees were admitted to the United States, most of which were Kurds and Shiites who had assisted or were sympathisers of the U.S –led war.[46] Nashville, Tennessee has the nation’s largest population of Kurdish people, with an estimated 8,000-11,000. There are also Kurds in Southern CaliforniaLos Angeles, and San Diego.[47]

In Canada, Kurdish immigration was largely the result of the Iran-Iraq War and the Gulf War. Thus, many Iraqi Kurds immigrated to Canada due to the constant wars and suppression of Kurds and Shiites by the Iraqi government.[48]

Oceania[edit]

In Australia, Kurdish migrants first arrived in the second half of the 1960s, mainly from Turkey.[49] However, in the late 1970s families from Syria and Lebanon were also present in Australia.[49] Since the second half of the 1980s, the majority of Kurds arriving in Australia have been from Iraq and Iran; many of them were accepted under the Humanitarian Programme.[49] However, Kurds from Lebanon, Armenia and Georgia have also migrated to Australia. The majority live in Melbourne and Sydney.[49]

Statistics by country[edit]

Traditional areas of Kurdish settlement[edit]

Country Official figures Official figures in % Current est. Kurdish population Further information
 Turkey 2,819,727 (1965 census, Kurdish speakers)a 8.98% 13,261,000 (18.3%)e Kurds in Turkey
 Iran N/A N/A approx. 6,500,000[50] Kurds in Iran
 Iraq N/A N/A approx. 5,000,000[51] Kurds in Iraq
 Syria N/A N/A approx. 2,200,000[52] Kurds in Syria
 Armenia 37,470 (2011 census)d 1.24% Kurds in Armenia

 Azerbaijan6,073 (2009 census)b0.07%150,000–180,000[59][60]Kurds in Azerbaijan

 Russia63,818 (2010 census)c0.04%—Kurds in Russia

 Georgia20,843 (2002 census)[63]0.48%—Kurds in Georgia

Other countries[edit]

Country Official figures Official figures in % Current est. Kurdish population Further information
 Germany N/A N/A approx. 800,000[64]
 Israel N/A N/A approx. 150,000[65] Kurds in Israel
 France N/A N/A approx. 150,000[66]
 Sweden N/A N/A approx. 90,000[67] Kurds in Sweden
 Lebanon N/A N/A approx. 80,000[68] Kurds in Lebanon
 Netherlands N/A N/A approx. 70,000[69]
 Belgium N/A N/A approx. 80,000[70]
 United Kingdom 49,921 (2011 census)[71][72][73] 0.08% Kurds in the United Kingdom

 Kazakhstan 41,431 (2013 annual statistics)[74] 0.25% Kurds in Kazakhstan
 Jordan N/A N/A 30,000[75]–100,000[76] Kurds in Jordan
 Denmark N/A N/A 30,000[77]
 Greece N/A N/A 28,000[78]
 United States 15,361 (2006-2010 ACS)[79] 0.01% Kurds in the United States

  Switzerland 14,699 (2012 statistics, Kurdish speakers)[80] 0.22% N/A
 Kyrgyzstan 13,171 (2009 census)[81][82] 0.25%
 Canada 11,685 (2011 census)[83] 0.04%
 Finland 10,075 (2013 annual statistics, Kurdish speakers)[84] 0.18%
 Australia 6,991 (2011 census)[85]
4,586 (2011 census, Kurdish speakers)[85]
0.03%
0.02%
 Turkmenistan 6,097 (1995 census)[89] 0.14% Kurds in Turkmenistan
 Kuwait N/A N/A 5,000[90]
 Norway N/A N/A 5,000[70]
 Italy N/A N/A 4,000[70]
 Romania N/A N/A 3,000[91]
 Austria 2,133 (2001 census, Kurdish speakers)[92] 0.03% N/A
 Ukraine 2,088 (2001 census)[93] 0%
 Uzbekistan 1,839 (1989 census)[94] 0.01%
 Ireland 128 (2011 census)[95] 0% 1,500[96]
 Cyprus N/A N/A 1,500[97]
 South Korea N/A N/A 1,000[98]
 Spain N/A N/A 1,000[99]
 New Zealand 720 (2013 census)[100]
828 (2013 census, Kurdish speakers)[100]
0.02%
0.02%
 Japan N/A N/A 300–400[101] Kurds in Japan
 Poland 224 (2011 census)[102] 0%
 Hungary 149 (2011 census)[103] 0%
 Bulgaria 147 (2011 census)[104] 0%
 Moldova (1989 census)[105]
132 (Immigrants 1993-2013)[106]
0%
0%
 Czech Republic 100 (2011 census)[107] 0%
 Belarus 81 (2009 census)[108] 0%
 Abkhazia 29 (1989 census)[109] 0.01%
 Latvia 29 (2014 annual statistics)[110] 0%
 Estonia 23 (2011 census)[111] 0%
 Serbia <12 (2011 census)[112] 0%
 Lithuania <10 (2011 census)[113] 0%
 Croatia (2011 census)[114][115] 0%
 Tajikistan (2010 census)[116] 0%
 South Ossetia (1989 census)[109] 0%
Notes
^a According to the Turkish 1965 census, 2,219,502 people indicated Kurdish as their mother language and 429,168 as their second best language spoken. 150,644 people indicated Zaza as their mother language and 20,413 as their second best language spoken.[117]
^b Official Azerbaijani records claim only 6,073 Kurds in 2009,[61] while Kurdish leaders estimate as much as 200,000. The problem is that the historical record of the Kurds in Azerbaijan is filled with lacunae.[118]For instance, in 1979 there was according to the census no Kurds recorded.[119] Not only did Turkey and Azerbaijan pursue an identical policy against the Kurds, they even employed identical techniques like forced assimilation, manipulation of population figures, settlement of non-Kurds in areas predominantly Kurdish, suppression of publications and abolition of Kurdish as a medium of instruction in schools.[119]
^c In the 2010 Russian Census, 23,232 people indicated Kurdish (Курды) as their ethnicity, while 40,586 chose Yazidi (Езиды) as their ethnicity.[120]
^d In the 2011 Armenian Census, 2,131 people indicated Kurdish (Քրդեր) as their ethnicity, while 35,272 indicated Yazidi (Եզդիներ) as their ethnicity.[27]
^e 2006 Konda survey.[121]
http://en.wikipedia.org/wiki/Kurdish_population
Kurds
The Kurdish people, or Kurds (Kurdishکورد, Kurd), are an ethnic group in Western Asia, mostly inhabiting a region known as Kurdistan, which includes adjacent parts of IranIraqSyria, and Turkey.They are an Iranian people and speak the Kurdish languages, which are members of the Iranian branch of Indo-European languages.[31] The Kurds number about 30 million, the majority living in West Asia, with significant Kurdish diaspora communities in the cities of western Turkey, in Armenia, Georgia, Israel, Azerbaijan, Russia, Lebanon and, in recent decades, some European countries and the United States.

The Kurds have had partial autonomy in Iraqi Kurdistan since 1991. Nationalist movements in the other Kurdish-populated countries (TurkeySyriaIran) push for Kurdish regional autonomy or the creation of a sovereign state.

 

 

Etymology

The exact origins of the name “Kurd” are unclear.[32] Though it is believed that the term precedes the formation of the ethnic group by centuries or even millennia.

G.S. Reynolds believes that the term Kurd is most likely related to the ancient term Qardu. The common root of Kurd and Qardu is first mentioned in a Sumeriantablet from the third millennium BC as the “land of Kar-da.”[33] Similarly, Hennerbichler believes the term Kurd and similar ethnic labels to have been derived from the Sumerian word stem “kur”, meaning mountain.[34]

The term Qardu however, appears in Assyrian sources, where it refers to the contemporary Mount Judi, and which derived its name from the people inhabiting the region, the Carduchi,[35] mentioned by Xenophon as the tribe who opposed the retreat of the Ten Thousand through the mountains north of Mesopotamia in the 4th century BC. However, according to G. Asatrian, the most reasonable explanation of the ethnonym is its possible connections with the Cyrtii (Cyrtaei).[36]

The word Kurd was first written in sources in the form of Kurt(kwrt-) in the Middle Persian treatise (Karnamak Ardashir Papakan and the Matadakan i Hazar Dastan), used to describe a social group or tribes that existed before the development of the modern ethnic nation.[37] The term was adopted by Arabic writers of the early Islamic era and gradually became associated with an amalgamation of Iranian and Iranicized nomadic tribes and groups in the region[38][39][40] Sherefxan Bidlisi states that there are four division of Kurds: KurmanjLurKalhor and Guran, each of which speak a different dialect or language variation. Of these, according to Ludwig Paul, only Kurmanji and possibly the Kalhuri correspond to the Kurdish language, while Luri and Gurani are linguistically distinct. Nonetheless, Ludwig writes that linguistics does not provide a definition for when a language becomes a dialect, and thus, non-linguistic factors contribute to the ethnic unity of some of the said groups, namely the Kurmanj, Kalhur, and Guran.[41]

Language

Main article: Kurdish languages

Kurdish area in the Middle East(2007)

The Kurdish language (Kurdish: Kurdî or کوردی) refers collectively to the related dialects spoken by the Kurds.[42] It is mainly spoken in those parts of IranIraq,Syria and Turkey which comprise Kurdistan.[43] Kurdish holds official status in Iraq as a national language alongside Arabic, is recognized in Iran as a regional language, and in Armenia as a minority language.

The Kurdish languages belong to the northwestern sub‑group of the Iranian languages, which in turn belongs to the Indo-Iranian branch of the Indo-Europeanfamily.

Most Kurds are either bilingual or multilingual, speaking the language of their respective nation of origin, such as ArabicPersian, and Turkish as a second language alongside their native Kurdish, while those in diaspora communities often speak 3 or more languages. Kurdish Jews and some Kurdish Christians (not be confused with ethnic Assyrians) usually speak Aramaic (for example: Lishana Deni) as their first language. Aramaic is a Semitic language related to Hebrew andArabic rather than Kurdish.[44]

According to Mackenzie, there are few linguistic features that all Kurdish dialects have in common and that are not at the same time found in other Iranian languages.[45]

The Kurdish dialects according to Mackenzie are classified as:[46]

  • Northern group (The Kurmanji dialect group.)
  • Central group (Part of the Sorani dialect group)
  • Southern group (Part of the Sorani dialect group) including Kermanshahi, Ardalani and Laki

The Zaza and Gorani are ethnic Kurds,[citation needed] but the Zaza–Gorani languages are not classified as Kurdish.

Commenting on the differences between the dialects of Kurdish, Kreyenbroek clarifies that in some ways, Kurmanji and Sorani are as different from each other as English and German, giving the example that Kurmanji has grammatical gender and case endings, but Sorani does not, and observing that referring to Sorani and Kurmanji as “dialects” of one language is supported only by “their common origin…and the fact that this usage reflects the sense of ethnic identity and unity of the Kurds.”[47]

Population

Main article: Kurdish population

The number of Kurds living in Southwest Asia is estimated at 26-34 million, with another one or two million living in diaspora. Kurds are the fourth largest ethnicity in Western Asia after the ArabsPersians, and Turks.

Kurds comprise anywhere from 18% to 25% of the population in Turkey,[3][48] 15-20% in Iraq, 9% in Syria,[49][50] 7% in Iran and 1.3% in Armenia. In all of these countries except Iran, Kurds form the second largest ethnic group. Roughly 55% of the world’s Kurds live in Turkey, about 18% each in Iran and Iraq, and a bit over 5% in Syria.[51]

McDowall has estimated that in 1991 the Kurds comprised 19% of the population in Turkey, 23% in Iraq, 10% in Iran, and 8% in Syria. The total number of Kurds in 1991 was in this estimate placed at 22.5 million, with 48% of this number living in Turkey, 18% in Iraq, 24% in Iran, and 4% in Syria.[52]

History

The greatest extent of the Median Empire

Origins

Further information: Gutian peopleMedesCyrtii and Carduchi

The Kurds as an ethnic group appear in the medieval period. The Kurdish people are believed to be of heterogenous origins[53][54] combining a number of earlier tribal or ethnic groups[55] including Median,[54][55][56][57] Lullubi,[58] Guti,[58] Cyrtians,[59] Carduchi.[60] They have also absorbed some elements from Semitic,[55][61][62][63][64]Turkic[65][66][67][68] and Armenian people.[55][69][70][71][72][73] According to J.P. Mallory, the original Gutians precede the arrival of Indo-Iranian peoples (of which the Kurds are one) by some 1500 years.[74] This argument is seconded by F. Hennerbichlers theory which reassigns the ethnic Iranian origin of Kurds (traditionally considered Indo-European) to a people of predominantly unknown ancient Middle Eastern stock, in particular to indigenous Neolithic Northern Fertile Crescent aborigines.[75] This hypothesis is supported by the tentative linguistic identification of Kurds as a people “Iranianized in several waves by militarily organized elites of immigrants from Central Asia”, tentatively ascribing it to carriers of the Y-Dna haplogroup R1a1.[75]

Additionally Minorsky states that there is an “ethno-geographical identification” of present day Kurds as descendent of ancient Medes, an idea based on his “historical, linguistic, and philological” arguments.[76] This was further advanced by I. Gershevitch who provided first “a piece of linguistic confirmation” of Minorsky’s identification and then another “sociolinguistic” argument. Those works of Minorsky were the base of yet another and different approach by Mackenzie. He argued that in contrast to Minorsky (and precisely Gershevitch’s advancement) the evolution of the present day Kurdish language as a Northwestern Iranian language was to “lean more toward Persian” and in turn “marked off from Median”.[76] These disagreements of scholars caused bitter reactions.[76] Dandamaev considers Carduchi (who were from the upper Tigris near the Assyrian and Median borders) less likely than Cyrtians as ancestors of modern Kurds.[77] However according to McDowall, the term Cyrtii was first applied to Seleucid or Parthian mercenary slingers from Zagros, and it is not clear if it denoted a coherent linguistic or ethnic group.[78] Gershevitch and Fisher consider the independent Kardouchoi or Carduchi as the ancestors of the Kurds, or at least the original nucleus of the Iranian-speaking people in what is now Kurdistan.[60]

Legends

Depiction of Noah’s ark landing on the mountain top, from the North French Hebrew Miscellany (13th century)

There are multiple legends that detail the origins of the Kurds. One details the Kurds as being the descendants of King Solomon’s angelic servants (Djinn). These were sent to Europe to bring him five-hundred beautiful maidens, for the king’s harem. However, when these had done so and returned to Israel the king had already passed away. As such, the Djinn settled in the mountains, married the women themselves, and their offspring came to be known as the Kurds.[79]

Additionally, in the legend of Newroz, an evil Assyrian king named Zahak, who had two snakes growing out of his shoulders, had conquered Iran, and terrorized its subjects; demanding daily sacrifices in the form of young men’s brains. Unknowingly to Zahak, the cooks of the palace saved one of the men, and mixed the brains of the other with those of a sheep. The men that were saved were told to flee to the mountains. Hereafter, Kaveh the Blacksmith, who had already lost several of his children to Zahak, trained the men in the mountains, and stormed Zahak’s palace, severing the heads of the snakes and killing the tyrannical king. Kaveh was instilled as the new king, and his followers formed the beginning of the Kurdish people.[80][81]

In the writings of the Ottoman Turkish traveller Evliya Çelebi, there’s also a legend concerning the Kurds to be found. He states to have learned of this legend from a certainMighdisî, an Armenian historian:

According to the chronicler Mighdisî, the first town to be built after Noah’s Flood was the town of Judi, followed by the fortresses of Sinjar and Mifariqin. The town of Judi was ruled by Melik Kürdim of the Prophet Noah’s community, a man who lived no less than 600 years and who travelled the length and width of Kurdistan. Coming to Mifariqin he liked its climate and settled there, begetting many children and descendants. He invented a language of his own, independent of Hebrew. It is neither Hebrew nor Arabic, Farsi, Dari or Pahlavi; they still call it the language of Kürdim. So the Kurdish language, which was invented in Mifariqin and is now used throughout Kurdistan, owes its name to Melik Kürdim of the community of the Prophet Noah. Because Kurdistan is an endless stony stretch of mountains, there are no less than twelve varieties of Kurdish, differing from one another in pronunciation and vocabulary, so that they often have to use interpreters to understand one another’s words.[82]

Ancient Period

Artistic rendition of Ardashir I

The first attestation of the Kurds was during the time of rule of the Sassanids. In the Kar-Namag i Ardashir i Pabagan, a short prose work written in Middle Persian, Ardashir I is depicted as having battled the Kurds and their leader, Madig. After initially sustaining a heavy defeat, Ardashir I was successful in subjugating the Kurds.[83] In a letter Ardashir I received from his foe, Ardavan V, which is also featured in the same work, he’s referred to as being a Kurd himself.

You’ve bitten off more than you can chew
and you have brought death to yourself.
O son of a Kurd, raised in the tents of the Kurds,
who gave you permission to put a crown on your head?[84]

The usage of the term Kurd during this time period most likely was a social term, designating Iranian nomads, rather than a concrete ethnic group.[85][86] At least one author believes Ardashir I to have actually descended from a Kurdish tribe.[87]

Similarly, in 360 CE, the Sassanid king Shapur II marched into the Roman province Zabdicene, to conquer its chief city, Bezabde, present-day Cizre. He found it heavily fortified, and guarded by three legions and a large body of Kurdish archers.[88] After a long and hard-fought siege, Shapur II breached the walls, conquered the city and massacred all its defenders. Hereafter he had the strategically located city repaired, provisioned and garrisoned with his best troops.[88]

There is also a 7th-century text by an unidentified author, written about the legendary Christian martyr Mar Qardagh. He lived in the 4th century, during the reign of Shapur II, and during his travels is said to have encountered Mar Abdisho, a deacon and martyr, who, after having been questioned of his origins by Mar Qardagh and his Marzobans, stated that his parents were originally from an Assyrian village called Hazza, but were driven out and subsequently settled in Tamanon, a village in the land of the Kurds, identified as being in the region of Mount Judi.[89]

Medieval period

Ṣalāḥ ad-Dīn Yūsuf ibn Ayyūb, orSaladin, founder of the Ayyubid dynastyin Egypt and Syria

In the early Middle Ages, the Kurds sporadically appear in Arabic sources, though the term was still not being used for a specific people; instead it referred to an amalgam of nomadic western Iranic tribes, who were distinct from Persians. However, in the High Middle Ages, the Kurdish ethnic identity gradually materialized, as one can find clear evidence of the Kurdish ethnic identity and solidarity in texts of the 12th and 13th century,[90] though, the term was also still being used in the social sense.[91]

Al-Tabari wrote that in 639, Hormuzan, a Sasanian general originating from a noble family, battled against the Islamic invaders in Khuzestan, and called upon the Kurds to aid him in battle.[92] They were defeated however, and brought under Islamic rule.

In 838, a Kurdish leader based in Mosul, named Mir Jafar, revolted against the Caliph Al-Mu’tasim who sent the commander Itakh to combat him. Itakh won this war and executed many of the Kurds.[93][94] Eventually Arabs conquered the Kurdish regions and gradually converted the majority of Kurds to Islam, often incorporating them into the military, such as the Hamdanids whose dynastic family members also frequently intermarried with Kurds.[95][96]

In 934 the Daylamite Buyid dynasty was founded, and subsequently conquered most of present-day Iran and Iraq. During the time of rule of this dynasty, Kurdish chief and ruler, Badr ibn Hasanwaih, established himself as one of the most important emirs of the time.[97]

In the 10th-12th centuries, a number of Kurdish principalities and dynasties were founded, ruling Kurdistan and neighbouring areas:

Due to the Turkic invasion of Anatolia, the 11th century Kurdish dynasties crumbled and became incorporated into the Seljuk Dynasty. Kurds would hereafter be used in great numbers in the armies of theZengids.[106] Succeeding the Zengids, the Kurdish Ayyubids established themselves in 1171, first under the leadership of Saladin. Saladin led the Muslims to recapture the city of Jerusalem from the Crusaders at theBattle of Hattin; also frequently clashing with the Hashashins. The Ayyubid dynasty lasted until 1341 when the Ayyubid sultanate fell to Mongolian invasions.

Safavid period

The Safavid Dynasty, established in 1501, also established its rule over Kurdish territories. The paternal line of this family actually had Kurdish roots, tracing back to Firuz-Shah Zarrin-Kolah, a dignitary who moved from Kurdistan to Ardabil in the 11th century.[107][108]

Nevertheless, the Kurds would revolt several times against the Safavids. Shah Ismail I put down a Yezidi rebellion which went on from 1506-1510. A century later, the year-long Battle of Dimdim took place, wherein Shah Abbas I succeeded in putting down the rebellion led by Amir Khan Lepzerin. Hereafter, a large number of Kurds was deported to Khorasan, not only to weaken the Kurds, but also to protect the eastern border from invading Afghan and Turkmen tribes. Others migrated to Afghanistan where they took refuge.[109] Kurds were found in great numbers at the slave markets of Khiva and Bukhara, being sold by the Turkmens. The Kurds of Khorasan, numbering around 700,000, still use the Kurmanji Kurdish dialect.[8][110]

Zand Period

Karim Khan, the Laki ruler of the Zand Dynasty

After the fall of the Safavids, Iran fell into civil war, with multiple leaders trying to gain control over the country. Ultimately, it was Karim Khan, a Laki general of the Zand tribe (perhaps of Kurdish origin)[111] One of the contenders for power was Karim Khan Zand, a member of the Lak tribe near Shiraz.[112][113][114][115][116] who proved to be superiour, and became ruler of Iran with the exception of the Khorasan region.[117]

The country would flourish during Karim Khan’s reign; a strong resurgence of the arts would take place, the economy was restored and international ties were strengthened.[117] Karim Khan was portrayed as being a ruler who truly cared about his subjects, thereby gaining the title Vakil e-Ra’aayaa (Representative of the People).[117]

After Karim Khan’s death, the dynasty would decline in favor of the rivaling Qajars due to infighting between the Khan’s incompetent offspring. It wasn’t until Lotf Ali Khan, 10 years later, that the dynasty would once again be led by an adept ruler. By this time however, the Qajars had already progressed greatly, having taken a number of Zand territories. Lotf Ali Khan made multiple successes before ultimately succumbing to the rivaling faction. Iran and all its Kurdish territories would hereby be incorporated in the Qajar Dynasty.

The Kurdish tribes present in Baluchistan and some of those in Fars are believed to be remnants of those that assisted and accompanied Lotf Ali Khan and Karim Khan, respectively.[118]

Ottoman period

Further information: Sheik Ubeydullah

When Sultan Selim I, after defeating Shah Ismail I in 1514, annexed Armenia and Kurdistan, he entrusted the organisation of the conquered territories to Idris, the historian, who was a Kurd of Bitlis. He divided the territory into sanjaks or districts, and, making no attempt to interfere with the principle of heredity, installed the local chiefs as governors. He also resettled the rich pastoral country between Erzerum and Erivan, which had lain in waste since the passage of Timur, with Kurds from the Hakkari and Bohtan districts.

The Ottoman centralist policies in the beginning of the 19th century aimed to remove power from the principalities and localities, which directly affected the Kurdish emirs. Bedirhan Bey was the last emir of the Cizre Bohtan Emirate after initiating an uprising in 1847 against the Ottomans to protect the current structures of the Kurdish principalities. Although his uprising is not classified as a nationalist one, his children played significant roles in the emergence and the development of Kurdish nationalism through the next century.[119]

The first modern Kurdish nationalist movement emerged in 1880 with an uprising led by a Kurdish landowner and head of the powerful Shemdinan family, Sheik Ubeydullah, who demanded political autonomy or outright independence for Kurds as well as the recognition of a Kurdistan state without interference from Turkish or Persian authorities.[120] The uprising against Qajar Persia and the Ottoman Empire was ultimately suppressed by the Ottomans and Ubeydullah, along with other notables, were exiled to Istanbul.

20th century

2Provisions of the Treaty of Sèvresfor an independent Kurdistan (in 1920).

Kurdish nationalism emerged after World War I with the dissolution of the Ottoman Empire which had historically successfully integrated (but not assimilated) the Kurds, through use of forced repression of Kurdish movements to gain independence. Revolts did occur sporadically but only in 1880 with the uprising led by Sheik Ubeydullah were demands as an ethnic group or nation made. Ottoman sultan Abdul Hamid responded by a campaign of integration by co-opting prominent Kurdish opponents to strong Ottoman power with prestigious positions in his government. This strategy appears successful given the loyalty displayed by the Kurdish Hamidiye regiments during World War I.[121]

The Kurdish ethnonationalist movement that emerged following World War I and end of the Ottoman empire was largely reactionary to the changes taking place in mainstream Turkey, primarily radical secularization which the strongly Muslim Kurds abhorred, centralization of authority which threatened the power of local chieftains and Kurdish autonomy, and rampant Turkish nationalism in the new Turkish Republic which obviously threatened to marginalize them.[122]

Kurdish Cavalry in the passes of the Caucasus mountains (The New York Times, January 24, 1915).

Jakob Künzler, head of a missionary hospital in Urfa, has documented the large scale ethnic cleansing of both Armenians and Kurds by the Young Turks during World War I.[123] He has given a detailed account of deportation of Kurds from Erzurum and Bitlis in winter of 1916. The Kurds were perceived to be subversive elements that would take the Russian side in the war. In order to eliminate this threat, Young Turks embarked on a large scale deportation of Kurds from the regions of DjabachdjurPaluMuschErzurum and Bitlis. Around 300,000 Kurds were forced to move southwards to Urfa and then westwards to Aintab and Marasch. In the summer of 1917, Kurds were moved to the Konya region in central Anatolia. Through this measures, the Young Turk leaders aimed at eliminating the Kurds by deporting them from their ancestral lands and by dispersing them in small pockets of exiled communities. By the end of World War I, up to 700,000 Kurds were forcibly deported and almost half of the displaced perished.[124]

Some of the Kurdish groups sought self-determination and the championing in the Treaty of Sèvres of Kurdish autonomy in the aftermath of World War I, Kemal Atatürk prevented such a result. Kurds backed by the United Kingdom declared independence in 1927 and established so-called Republic of AraratTurkey suppressed Kurdist revolts in 1925, 1930, and 1937–1938, while Iran did the same in the 1920s to Simko Shikak at Lake Urmia and Jaafar Sultan of Hewraman region who controlled the region betweenMarivan and north of Halabja. A short-lived Soviet-sponsored Kurdish Republic of Mahabad in Iran did not long outlast World War II.

Kurdish-inhabited areas of the Middle East and the Soviet Union in 1986.

From 1922–1924 in Iraq a Kingdom of Kurdistan existed. When Ba’athist administrators thwarted Kurdish nationalist ambitions in Iraq, war broke out in the 1960s. In 1970 the Kurds rejected limited territorial self-rule within Iraq, demanding larger areas including the oil-richKirkuk region.

During the 1920s and 1930s, several large scale Kurdish revolts took place in Kurdistan Following these rebellions, the area of Turkish Kurdistan was put under martial law and a large number of the Kurds were displaced. Government also encouraged resettlement of Albanians from Kosovo and Assyrians in the region to change the population makeup. These events and measures led to a long-lasting mutual distrust between Ankara and the Kurds .[125] During the relatively open government of the 1950s, Kurds gained political office and started working within the framework of the Turkish Republic to further their interests but this move towards integration was halted with the 1960 Turkish coup d’état.[121] The 1970s saw an evolution in Kurdish nationalism as Marxist political thought influenced a new generation of Kurdish nationalists opposed to the localfeudal authorities who had been a traditional source of opposition to authority, eventually they would form the militant separatist PKK – listed as a terrorist organization by the United Nations, European Union, NATO and many states that includes United States), or Kurdistan Workers Party in English.

Kurds are often regarded as “the largest ethnic group without a state”,[126][127][128][129][130][131] although larger stateless nations exist. Such periphrasis is rejected by leading Kurdologists like Martin van Bruinessen[132] and other scholars who agree that claim obscures Kurdish cultural, social, political and ideological heterogeneity.[133][134][135]Michael Radu argues such meaningless claims mostly come from Western human rights militants, leftists and Kurdish nationalists in Europe.[133]

Kurdish communities

Further information: Kurdistan and Kurdish refugees

Turkey

According to CIA Factbook, Kurds formed approximately 18% of the population in Turkey (approximately 14 million) in 2008. One Western source estimates that up to 25% of the Turkish population is Kurdish (approximately 18-19 million people).[3] Kurdish sources claim there are as many as 20 or 25 million Kurds in Turkey.[136] In 1980, Ethnologue estimated the number of Kurdish-speakers in Turkey at around five million,[137] when the country’s population stood at 44 million.[138] Kurds form the largest minority group in Turkey, and they have posed the most serious and persistent challenge to the official image of a homogeneous society. This classification was changed to the new euphemism of Eastern Turk in 1980.[139]

Several large scale Kurdish revolts in 1925, 1930 and 1938 were suppressed by the Turkish government and more than one million Kurds were forcibly relocated between 1925 and 1938. The use of Kurdish language, dress, folklore, and names were banned and the Kurdish-inhabited areas remained under martial law until 1946.[140] The Ararat revolt, which reached its apex in 1930, was only suppressed after a massive military campaign including destruction of many villages and their populations. In quelling the revolt, Turkey was assisted by the close cooperation of its neighboring states such as Soviet UnionIran and Iraq.[141] The revolt was organized by a Kurdish party called Khoybun which signed a treaty with the Dashnaksutyun (Armenian Revolutionary Federation) in 1927.[141] By the 1970s, Kurdish leftist organizations such as Kurdistan Socialist Party-Turkey (KSP-T) emerged in Turkey which were against violence and supported civil activities and participation in elections. In 1977, Mehdi Zana a supporter of KSP-T won the mayoralty of Diyarbakir in the local elections. At about the same time, generational fissures gave birth to two new organizations: the National Liberation of Kurdistan and the Kurdistan Workers Party.[142]

Kurdish boys in Diyarbakir.

The Partiya Karkerên Kurdistan (PKK), also known as KADEK and Kongra-Gel, is considered by the US, the EU, and NATO to be a terrorist organization.[143] It is an ethnicsecessionist organization using violence for the purpose of achieving its goal of creating an independent Kurdish state in parts of southeastern Turkey, northeastern Iraq, northeastern Syria and northwestern Iran.

Between 1984 and 1999, the PKK and the Turkish military engaged in open war, and much of the countryside in the southeast was depopulated, as Kurdish civilians moved to local defensible centers such as DiyarbakırVan, and Şırnak, as well as to the cities of western Turkey and even to western Europe. The causes of the depopulation included PKK atrocities against Kurdish clans they could not control, the poverty of the southeast, and the Turkish state’s military operations.[144] State actions also included forced inscription, forced evacuation, destruction of villages, severe harassment and extrajudicial executions.[145][146]

Leyla Zana, the first Kurdish female MP from Diyarbakir, caused an uproar in Turkish Parliament after adding the following sentence inKurdish to her parliamentary oath during the swearing-in ceremony in 1994:[147]

I take this oath for the brotherhood of the Turkish and Kurdish peoples. —

In March 1994, the Turkish Parliament voted to lift the immunity of Zana and five other Kurdish DEP members: Hatip Dicle, Ahmet Turk, Sirri Sakik, Orhan Dogan and Selim Sadak. Zana, Dicle, Sadak and Dogan were sentenced to 15 years in jail by the Supreme Court in October 1995. Zana was awarded the Sakharov Prize for human rights by theEuropean Parliament in 1995. She was released in 2004 amid warnings from European institutions that the continued imprisonment of the four Kurdish MPs would affect Turkey’s bid to join the EU.[148][149] The 2009 local elections resulted in 5.7% for Kurdish political party DTP.[150]

Officially protected death squads are accused of disappearance of 3,200 Kurds and Assyrians in 1993 and 1994 in the so-called mystery killings. Kurdish politicians, human-rights activists, journalists, teachers and other members of intelligentsia were among the victims. Virtually none of the perpetrators were investigated nor punished. Turkish government also encouraged Islamic extremist group Hezbollah to assassinate suspected PKK members and often ordinary Kurds.[151] Azimet Köylüoğlu, the state minister of human rights, revealed the extent of security forces’ excesses in autumn 1994: While acts of terrorism in other regions are done by the PKK; in Tunceli it is state terrorism. In Tunceli, it is the state that is evacuating and burning villages. In the southeast there are two million people left homeless.[152]

Iran

A view of Sanandaj, a major city inIranian Kurdistan.

The Kurdish region of Iran has been a part of the country since ancient times. Nearly all Kurdistan was part of Iranian Empire until its Western part was lost during wars against the Ottoman Empire.[153] Following dissolution of the Ottoman Empire, at Paris Conferences of 1919 Tehran has demanded all lost territories including Turkish Kurdistan,Mosul, and even Diyarbakır, but demands were quickly rejected by Western powers.[154] This area has been divided by modern TurkeySyria and Iraq.[155] Today, the Kurds inhabit mostly north western territories known as Iranian Kurdistan but also north eastern region of Khorasan, and constitute approximately 7-10%[156] of Iran’s overall population (6.5–7.9 million), comparing to 10.6% (2 million) in 1956 or 8% (800 thousand) in 1850.[157]

Major Ethnic Groups of Iran

Unlike in other Kurdish-populated countries, there are strong ethnolinguistical and cultural ties between Kurds, Persians and others as Iranian peoples.[156] Some of modern Iranian dynasties like Safavids and Zands are considered to be partly of Kurdish origin. Kurdish literature in all of its forms (KurmanjiSorani and Gorani) has been developed within historical Iranianboundaries under strong influence of Persian language.[155] Fact that Kurds share much of their history with the rest of Iran is seen as reason why Kurdish leaders in Iran do not want a separate Kurdish state[156][158][159]

The government of Iran has never employed the same level of brutality against its own Kurds like Turkey or Iraq, but it has always been implacably opposed to any suggestion of Kurdish separatism.[156] During and shortly after First World War the government of Iran was ineffective and had very little control over events in the country and several Kurdish tribal chiefs gained local political power, even established large confederations.[158] In the same time, wave of nationalism from disintegrating Ottoman Empire has partly influenced some Kurdish chiefs in border region, and they posed as Kurdish nationalist leaders.[158] Prior to this, identity in both countries largely relied upon religion i.e. Shia Islam in the particular case of Iran.[159][160] In 19th century IranShia–Sunni animosity and describing Sunni Kurds as Ottoman fifth column was quite frenquent.[161]

During late 1910’s and early 1920’s, tribal revolt led by Kurdish chieftain Simko Shikak stroke north western Iran. Although elements of Kurdish nationalism were present in this movement, historians agree these were hardly articulate enough to justify a claim that recognition of Kurdish identity was a major issue in Simko’s movement, and he had to rely heavily on conventional tribal motives.[158] Government forces and non-Kurds were not the only ones to suffer in the attacks, theKurdish population was also robbed and assaulted.[158][162] Rebels do not appear to have felt any sense of unity or solidarity with fellow Kurds.[158] Kurdish insurgency and seasonal migrations in late 1920’s, along with long-running tensions between Tehran and Ankara, resulted in border clashes and even military penetrations in both Iranian and Turkish territory.[154] Two regional powers have used Kurdish tribes as tool for own political benefits: Turkey has provided military help and refuge for anti-Iranian Turcophone Shikak rebels in 1918-1922,[163] while Iran did the same during Ararat rebellion against Turkey in 1930. Reza Shah‘s military victory over Kurdish and Turkic tribal leaders initiaded with repressive era toward non-Iranian minorities.[162] Government’s forced detribalization andsedentarization in 1920’s and 1930’s resulted with many other tribal revolts in Iranian regions of AzerbaijanLuristan and Kurdistan.[164] In particular case of the Kurds, this repressive policies partly contributed to developing nationalism among some tribes.[158]

As a response to growing Pan-Turkism and Pan-Arabism in region which were seen as potential threats to the territorial integrity of Iran, Pan-Iranist ideology has been developed in the early 1920s.[160] Some of such groups and journals openly advocated Iranian support to the Kurdish rebellion against Turkey.[165] Secular Pahlavi dynasty has endorsed Iranian ethnic nationalism[160] which seen the Kurds as integral part of the Iranian nation.[159] Mohammad Reza Pahlavi has personally praised the Kurds as “pure Iranians” or “one of the most noble Iranian peoples“.[166] Another significant ideology during this period was Marxism which arose among Kurds under influence of USSR. It culminated in the Iran crisis of 1946 which included a separatist attempt of KDP-I and communist groups[167] to establish the Soviet puppet government[168][169][170]called Republic of Mahabad. It arose along with Azerbaijan People’s Government, another Soviet puppet state.[156][171] The state itself encompassed a very small territory, including Mahabad and the adjacent cities, unable to incorporate the southern Iranian Kurdistan which fell inside the Anglo-American zone, and unable to attract the tribes outside Mahabad itself to the nationalist cause.[156] As a result, when the Soviets withdrew from Iran in December 1946, government forces were able to enter Mahabad unopposed.[156]

Several Marxist insurgencies continuted for decades (196719791989–96) led by KDP-I and Komalah, but those two organization have never advocated a separate Kurdish state or greater Kurdistan as did the PKK in Turkey.[158][173][174][175] Still, many of dissident leaders, among others Qazi Muhammad and Abdul Rahman Ghassemlou, were executed or assassinated.[156] During Iran–Iraq War, Tehran has provided support for Iraqi-based Kurdish groups like KDP or PUK, along with asylum for 1,400,000 Iraqi refugees, mostly Kurds. Although Kurdish Marxist groups have been marginalized in Iran since the dissolution of the Soviet Union, in 2004 new insurrection has been started by PJAK, separatist organization affiliated with the Turkey-based PKK[176] and designated as terrorist by Iran, Turkey and the USA.[176] Some analysts claim PJAK do not pose any serious threat to the government of Iran.[177] Cease-fire has been established on September 2011 following the Iranian offensive on PJAK bases, but several clashes between PJAK and IRGC took place after it.[134]Since the Iranian Revolution of 1979, accusations of “discrimination” by Western organizations and of “foreign involvement” by Iranian side have become very frequent.[134]

Kurds have been well integrated in Iranian political life during reign of various governments.[158] Kurdish liberal political Karim Sanjabi has served as minister of education underMohammad Mossadegh in 1952.[166] During the reign of Mohammad Reza Pahlavi some members of parliament and high army officers were Kurds, and there was even a Kurdish Cabinet Minister.[158] During the reign of the Pahlavis Kurds received many favours from the authorities, for instance to keep their land after the land reforms of 1962.[158] In early 2000’s, presence of thirty Kurdish deputies in the 290-strong parliament has also helped to undermine claims of discrimination.[178] Some of influential Kurdish politicians during recent years include former first vice president Mohammad Reza Rahimi and Mohammad Bagher GhalibafMayor of Tehran and second-placed presidential candidate in 2013. Kurdish language is today used more than at any other time since the Revolution, including in several newspapers and among schoolchildren.[178] Large number of Kurds in Iran show no interest in Kurdish nationalism,[156] especially Shia Kurds who even vigorously reject idea of autonomy, preferring direct rule from Tehran.[156][173] Iranian national identity is questioned only in the peripheral Kurdish Sunni regions.[179]

Iraq

The President of Iraq, Jalal Talabani, meeting with U.S. officials inBaghdad, Iraq, on April 26, 2006.

Kurds constitute approximately 17% of Iraq’s population. They are the majority in at least three provinces in northern Iraq which are together known as Iraqi Kurdistan. Kurds also have a presence in KirkukMosulKhanaqin, and Baghdad. Around 300,000 Kurds live in the Iraqi capital Baghdad, 50,000 in the city of Mosul and around 100,000 elsewhere in southern Iraq.[180]

Kurds led by Mustafa Barzani were engaged in heavy fighting against successive Iraqi regimes from 1960 to 1975. In March 1970, Iraq announced a peace plan providing for Kurdish autonomy. The plan was to be implemented in four years.[181] However, at the same time, the Iraqi regime started an Arabization program in the oil-rich regions ofKirkuk and Khanaqin.[182] The peace agreement did not last long, and in 1974, the Iraqi government began a new offensive against the Kurds. Moreover in March 1975, Iraq and Iran signed the Algiers Accord, according to which Iran cut supplies to Iraqi Kurds. Iraq started another wave of Arabization by moving Arabs to the oil fields in Kurdistan, particularly those around Kirkuk.[183] Between 1975 and 1978, 200,000 Kurds were deported to other parts of Iraq.[184]

During the Iran-Iraq War in the 1980s, the regime implemented anti-Kurdish policies and a de facto civil war broke out. Iraq was widely condemned by the international community, but was never seriously punished for oppressive measures such as the mass murder of hundreds of thousands of civilians, the wholesale destruction of thousands of villages and the deportation of thousands of Kurds to southern and central Iraq.

The genocidal campaign, conducted between 1986 and 1989 and culminating in 1988, carried out by the Iraqi government against the Kurdish population was called Anfal (“Spoils of War”). The Anfal campaign led to destruction of over two thousand villages and killing of 182,000 Kurdish civilians.[185] The campaign included the use of ground offensives, aerial bombing, systematic destruction of settlements, mass deportation, firing squads, and chemical attacks, including the most infamous attack on the Kurdish town of Halabja in 1988 that killed 5000 civilians instantly.

After the collapse of the Kurdish uprising in March 1991, Iraqi troops recaptured most of the Kurdish areas and 1.5 million Kurds abandoned their homes and fled to the Turkish and Iranian borders. It is estimated that close to 20,000 Kurds succumbed to death due to exhaustion, lack of food, exposure to cold and disease. On 5 April 1991, UN Security Council passed resolution 688 which condemned the repression of Iraqi Kurdish civilians and demanded that Iraq end its repressive measures and allow immediate access to international humanitarian organizations.[186] This was the first international document (since the League of Nationsarbitration of Mosul in 1926) to mention Kurds by name. In mid-April, the Coalition established safe havens inside Iraqi borders and prohibited Iraqi planes from flying north of 36th parallel.[187] In October 1991, Kurdish guerrillas captured Erbil and Sulaimaniyah after a series of clashes with Iraqi troops. In late October, Iraqi government retaliated by imposing a food and fuel embargo on the Kurds and stopping to pay civil servants in the Kurdish region. The embargo, however, backfired and Kurds held parliamentary elections in May 1992 and established Kurdistan Regional Government (KRG).[188]

The Kurdish population welcomed the American troops in 2003 by holding celebrations and dancing in the streets.[189][190][191][192] The area controlled by peshmerga was expanded, and Kurds now have effective control in Kirkuk and parts of Mosul. The authority of the KRG and legality of its laws and regulations were recognized in the articles 113 and 137 of the new Iraqi Constitution ratified in 2005.[193] By the beginning of 2006, the two Kurdish administrations of Erbil and Sulaimaniya were unified. On August 14, 2007 Yazidis were targeted in a series of bombings that became the deadliest suicide attack since the Iraq War began, killing 796 civilians, wounding 1,562.[194]

Syria

Main article: Kurds in Syria

PYD militiaman manning acheckpoint in AfrinSyria, during the2012 Syrian Kurdistan rebellion

Kurds account for 9% of Syria‘s population, a total of around 1.6 million people.[195] This makes them the largest ethnic minority in the country. They are mostly concentrated in the northeast and the north, but there are also significant Kurdish populations in Aleppo and Damascus. Kurds often speak Kurdish in public, unless all those present do not. According to Amnesty International, Kurdish human rights activists are mistreated and persecuted.[196] No political parties are allowed for any group, Kurdish or otherwise.

Techniques used to suppress the ethnic identity of Kurds in Syria include various bans on the use of the Kurdish language, refusal to register children with Kurdish names, the replacement of Kurdish place names with new names in Arabic, the prohibition of businesses that do not have Arabic names, the prohibition of Kurdish private schools, and the prohibition of books and other materials written in Kurdish.[197][198] Having been denied the right to Syrian nationality, around 300,000 Kurds have been deprived of any social rights, in violation of international law.[199][200] As a consequence, these Kurds are in effect trapped within Syria. In March 2011, in part to avoid further demonstrations and unrest from spreading across Syria, the Syrian government promised to tackle the issue and grant Syrian citizenship to approximately 300,000 Kurds who had been previously denied the right.[201]

On March 12, 2004, beginning at a stadium in Qamishli (a largely Kurdish city in northeastern Syria), clashes between Kurds and Syrians broke out and continued over a number of days. At least thirty people were killed and more than 160 injured. The unrest spread to other Kurdish towns along the northern border with Turkey, and then to Damascus and Aleppo.[202][203]

As a result of Syrian civil war, since July 2012, Kurds were able to take control of large parts of Syrian Kurdistan from Andiwar in extreme northeast to Jindires in extreme northwest Syria.

Armenia

Between the 1930s and 1980s, Armenia was a part of the Soviet Union, within which Kurds, like other ethnic groups, had the status of a protected minority. Armenian Kurds were permitted their own state-sponsored newspaper, radio broadcasts and cultural events. During the conflict in Nagorno-Karabakh, many non-Yazidi Kurds were forced to leave their homes since both the Azeri and non-Yazidi Kurds were Muslim.

Azerbaijan

Main article: Kurds in Azerbaijan

In 1920, two Kurdish-inhabited areas of Jewanshir (capital Kalbajar) and eastern Zangazur (capital Lachin) were combined to form the Kurdistan Okrug (or “Red Kurdistan”). The period of existence of the Kurdish administrative unit was brief and did not last beyond 1929. Kurds subsequently faced many repressive measures, including deportations, imposed by the Soviet government. As a result of the conflict in Nagorno-Karabakh, many Kurdish areas have been destroyed and more than 150,000 Kurds have been deported since 1988 by separatist Armenian forces.[204]

Diaspora

Hamdi Ulukaya, Kurdish-American billionaire, founder and CEO ofChobani.

According to a report by the Council of Europe, approximately 1.3 million Kurds live in Western Europe. The earliest immigrants were Kurds from Turkey, who settled inGermanyAustria, the Benelux countries, Great BritainSwitzerland and France during the 1960s. Successive periods of political and social turmoil in the region during the 1980s and 1990s brought new waves of Kurdish refugees, mostly from Iran and Iraq under Saddam Hussein, came to Europe.[8] In recent years, many Kurdish asylum seekers from both Iran and Iraq have settled in the United Kingdom (especially in the town of Dewsbury and in some northern areas of London), which has sometimes caused media controversy over their right to remain.[205] There have been tensions between Kurds and the established Muslim community in Dewsbury,[206][207] which is home to very traditional mosques such as the Markazi. There was substantial immigration of Kurds into North America, who are mainly political refugees and immigrants seeking economic opportunity. Kurdish immigrants started to settle in large numbers in Nashville in 1976,[208] which is now home to the largest Kurdish community in the United States and is nicknamed Little Kurdistan.[209] Kurdish population in Nashville is estimated to be around 11,000.[210] Total number of ethnic Kurds residing in the United States is estimated by the U.S. Census Bureau to be around 15,000.[211] According to the 2006 Canadian Census, there were over 9,000 people of Kurdish ethnic background living in Canada[212]and according to the 2011 Census, more than 10,000 Canadians spoke Kurdish language.[213]

 

Religion

As a whole, the Kurdish people are adherents to a large amount of different religions and creeds, perhaps constituting the most religiously diverse people of West Asia. Traditionally, Kurds have been known to take great liberties with their practices. This sentiment is reflected in the saying “Compared to the unbeliever, the Kurd is a Muslim”.[214]

Islam

Main articles: Islam and Alevi

The Zulfiqar, symbol for the Shia Muslims and Alevis.

Today, the majority of Kurds are Sunni Muslim, belonging to the Shafi school.

There is also a minority of Kurds who are Shia Muslims, primarily living in the Ilam and Kermanshah provinces of Iran, Central and south eastern Iraq (Fayli Kurds)

Mystical practices and participation in Sufi orders are also widespread among Kurds.[215]

The Alevis (usually considered adherents of a branch of Shia Islam) are another religious minority among the Kurds, living in Eastern Anatolia. Alevism developed out of the teachings of Haji Bektash Veli, a 13th-century mystic from Khorasan. Among the Qizilbash, the militant groups which predate the Alevis and helped establish the Safavid Dynasty, there were numerous Kurdish tribes. The American missionary Trowbridge, working at Aintab (present Gaziantep) reported that his Alevi acquaintances considered as their highest spiritual leaders an Ahl-i Haqq sayyid family in the Guran district.[216]

Ahl-i Haqq (Yarsan)

Main article: Yârsânism

Ahl-i Haqq is a syncretic religion founded by Sultan Sahak in the late 14th century in western Iran. Most of its adherents, totaling around 1,000,000, are Kurds. Its central religious text is the Kalâm-e Saranjâm, written in Gurani.

In this text, the religion’s basic pillars are summarized as such:

The Yarsan should strive for these four qualities: purity, rectitude, self-effacement and self-abnegation.[217]

The Yârsân faith’s unique features include millenarismnativismegalitarianismmetempsychosisangelology, divine manifestation and dualism. Many of these features are found in Yazidism, another Kurdish faith, in the faith of Zoroastrians and in Shī‘ah extremist groups; certainly, the names and religious terminology of the Yârsân are often explicitly of Muslim origin. Unlike other indigenous Persianate faiths, the Yârsân explicitly reject class, caste and rank, which sets them apart from the Yezidis and Zoroastrians.[218]

The Ahl-i Haqq consider the Bektashi and Alevi as kindred communities.[216]

Yazidis

Main article: Yazidis

Melek Taus, the central figure of Yezidism.

Yazidism is another syncretic religion practiced among Kurdish communities, founded by Sheikh Adi ibn Musafir, an 12th-century mystic from Lebanon. Their numbers exceed 500,000. Its central religious texts are the Kitêba Cilwe and Meshaf Resh

According to Yazidi beliefs, God created the world but left it in the care of a heptad of holy beings or angels. The most prominent angel is Melek Taus (Kurdish: Tawûsê Melek), the Peacock Angel, God’s representative on earth. Yazidis believe in the periodic reincarnation of the seven holy beings in human form.

Their holiest shrine and the tomb of the faith’s founder is located in Lalish, in northern Iraq.[219]

Zoroastrianism

Main article: Zoroastrianism

Presently, there are a small number of Zoroastrian Kurds, most of which are recent converts. These communities have established new temples and have been attempting to recruit new members to their faith.[220] The Kurdish philosopher Sohrevardi drew heavily from Zoroastrian teachings.[221]

Judaism

Main article: Kurdish Jews