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American People Will Push-back on Election Day November 4 — Democrat Party Candidates Will Lose Due To Job Insecurity, The Economy, Obama-care, Amnesty for Illegal Aliens, Tax Hikes, Failed Economic and Foreign Policies in Libya, Syria, Iraq and Iran, and Scandals Including Benghazi, Fast and Furious, NSA, IRS, Veterans Administration and Now Ebola — Democrats On Verge of Losing Massively Including Control of The Senate — Obama is An Epic Failure and Loser That Buried The Democratic Party — Rest In Peace — Videos

Posted on October 23, 2014. Filed under: American History, Banking, Blogroll, Business, College, Communications, Computers, Constitution, Demographics, Diasters, Disease, Documentary, Ebola, Economics, Education, Employment, Energy, Faith, Federal Government, Federal Government Budget, Fiscal Policy, Foreign Policy, government spending, history, Language, Law, Life, Links, Literacy, Macroeconomics, Microeconomics, Monetary Policy, Money, People, Philosophy, Photos, Politics, Press, Programming, Psychology, Rants, Raves, Regulations, Resources, Security, Talk Radio, Tax Policy, Taxes, Unemployment, Video, Wealth, Welfare, Wisdom | Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |

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The Pronk Pops Show Podcasts

Pronk Pops Show 354: October 22, 2014

Pronk Pops Show 353: October 21, 2014

Pronk Pops Show 352: October 20, 2014

Pronk Pops Show 351: October 17, 2014

Pronk Pops Show 350: October 16, 2014

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: American People Will Push-back on Election Day November 4 — Democrat Party Candidates  Will Lose Due To Job Insecurity, The Economy, Obama-care, Amnesty for Illegal Aliens, Tax Hikes, Failed Economic and Foreign Policies in Libya, Syria, Iraq and Iran, and Scandals Including Benghazi, Fast and Furious, NSA, IRS, Veterans Administration and Now Ebola  —  Democrats On Verge of Losing Massively Including Control of The Senate — Obama is An Epic Failure and Loser That Buried The Democratic Party — Rest In Peace — Videos 

the failure

Obama-Failuredemocrat-economic-success-obama-politicstransformedburyObama-ScandalsCartoon - Obama Scandals and CorruptionYes-Obama-Can-Bankrupt-Americacartoon-they-opted-out-500trick or treat

 

Mid-term elections forecast

Who Will Control The Senate? Election Is ‘Neck And Neck’

Midterm Elections 2014: Here are the Key Senate Races

Ann Coulter: GOP Should Stop ‘Constantly Sucking Up’ to Hispanic Voters

New Fox Poll: 58% Say Things In World Going To Hell In A Handbasket – America’s Newsroom

Poll: Democrat Voters Less Interested In Midterm Elections – America’s Election HQ

Poll shows only 14 percent of Americans approve the way Congress handling its job

Stewart: Midterms 2014, We’ve Got Nothing To Fear, But Fear Itself, So We’re Going To Go With Fear

Which Party Should Control Congress? AP/Gallup POLL Results

 

 

Latest AP National Poll Is a Nightmare for Democrats

By Jim Geraghty

This new poll from the Associated Press is about as dire a poll as Democrats could imagine two weeks before Election Day.

Democrats are more trusted than the GOP on just two of nine top issues, the poll showed.

The economy remains the top issue for likely voters — 91 percent call it “extremely” or “very” important. And the GOP has increased its advantage as the party more trusted to handle the issue to a margin of 39 percent to 31 percent.

With control of the Senate at stake, both parties say they are relying on robust voter-turnout operations — and monster campaign spending — to lift their candidates in the final days. But the poll suggests any appeals they’ve made so far haven’t done much to boost turnout among those already registered. The share who report that they are certain to vote in this year’s contests has risen just slightly since September, and interest in news about the campaign has held steady.

Now brace yourself:

The GOP holds a significant lead among those most likely to cast ballots: 47 percent of these voters favor a Republican controlled-Congress, 39 percent a Democratic one. That’s a shift in the GOP’s favor since an AP-GfK poll in late September, when the two parties ran about evenly among likely voters.

Women have moved in the GOP’s direction since September. In last month’s AP-GfK poll, 47 percent of female likely voters said they favored a Democratic-controlled Congress while 40 percent wanted the Republicans to capture control. In the new poll, the two parties are about even among women, 44 percent prefer the Republicans, 42 percent the Democrats.

The gender gap disappearing almost entirely would be a shocking development; at this point, it’s just one poll, but it’s something to look for in future polls. Democrats can console themselves that this is a national poll, and the biggest fights of the midterm — the Senate races — are occurring in about a dozen states. Having said that, almost all of those states are Republican-leaning ones that Romney won. If the national electorate is sour on Democrats, it’s extremely difficult to envision a scenario where Arkansas’s Mark Pryor hangs on despite the pro-GOP atmosphere,and Alaska’s Mark Begich, and Louisiana’s Mary Landrieu, and so on for the other endangered red-state Democratic senators. One or two might survive, but the rest . . .

The polls are grim, Mr. President.

America’s Anxious Mood and What it Means for Republicans

Obama’s Gift to Republicans

The Pronk Pops Show Podcasts Portfolio

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Tyrant Obama’s October Surprise Shafts American People: Permanent Resident Cards (PRC) and Employment Authorization Document (EAD) cards (green cards and work permit cards) — The requirement is for an estimated minimum of 4 million cards annually with the potential to buy as many as 34 million cards total! — Illegal, Unconstitutional and Impeachable — Throw The Tyrant Out — Deport 30-50 Million Illegal Aleins — Videos

Posted on October 21, 2014. Filed under: Agriculture, American History, Biology, Blogroll, Business, Chemistry, College, Communications, Constitution, Diasters, Disease, Documentary, Ebola, Economics, Education, Employment, Federal Government, Federal Government Budget, Fiscal Policy, Foreign Policy, government, government spending, history, Illegal, Immigration, Law, Legal, Life, Links, Literacy, media, Medical, Medicine, People, Philosophy, Photos, Politics, Private Sector, Psychology, Radio, Rants, Raves, Resources, Science, Strategy, Talk Radio, Terrorism, Unemployment, Unions, Video, Wealth, Welfare, Wisdom | Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |

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The Pronk Pops Show Podcasts

Pronk Pops Show 352: October 20, 2014

Pronk Pops Show 351: October 17, 2014

Pronk Pops Show 350: October 16, 2014

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: Tyrant Obama’s October Surprise Shafts American People: Permanent Resident Cards (PRC) and Employment Authorization Document (EAD) cards (green cards and work permit cards) — The requirement is for an estimated minimum of 4 million cards annually with the potential to buy as many as 34 million cards total! — Illegal, Unconstitutional and Impeachable — Throw The Tyrant Out — Deport 30-50 Million Illegal Aleins — VideosPRCpermanent resident cardEmployment Authorization card

Rpt: Obama Admin May Planning Executive Action On Amnesty – 34M Green Cards? – America’s Newsroom

Obama Says He Will Unilaterally Legalize Illegal Aliens but n0t Until After the Next Elections

Ted Cruz Calls On Harry Reid To Bring Bill Defunding DACA To Senate Floor

Stop President Obama’s Amnesty!

Rush Limbaugh – Amnesty Is The Reason Obama Won’t Stop Ebola Fights From Africa

White House Tells Latino Lawmakers President Obama Will Take Executive Action After Midterms

Senate Republican: US Immigration System ‘Unlawful,’ Lacks ‘Integrity’

Mark Levin Obama Will Use Executive Fiat to Grant Amnesty

2014 August Breaking News USA Barack Obama White House Hid Huge Spike Of Families Crossing Border

Foreign Children At Mexican Border Creating Humanitarian Crisis For U.S.

Obama Eases Deportation Rules – Obama halts deportations – immigration

Permanent residence (United States)

5 Harmful Mistakes to Avoid in Your Immigration Case

Tips for Understanding the Green Card Process in the U.S.

9 Misconceptions about the Green Card

The Citizenship Interview and Test

H-1B Work Visas: Basic Requirements

H-1B Work Visa, The Main Way to Get a Work Permit in the USA, Part 1, Basic Requirements

Immigration Professor, De-Stressing Deportation, Part 2, Cancellation of Removal

Immigration Professor, Unlawful Presence and Unlawful Presence Waivers, Part 1 of 3

Immigration Professor, Unlawful Presence and Unlawful Presence Waivers, Part 2 of 3

Immigration Professor, Unlawful Presence and Unlawful Presence Waivers, Part 3 of 3

EXCLUSIVE: OBAMA ADMINISTRATION QUIETLY PREPARES ‘SURGE’ OF MILLIONS OF NEW IMMIGRANT IDS

Despite no official action from the president ahead of the election, the Obama administration has quietly begun preparing to issue millions of work authorization permits, suggesting the implementation of a large-scale executive amnesty may have already begun.

Unnoticed until now, a draft solicitation for bids issued by U.S. Citizenship and Immigration Services (USCIS) Oct. 6 says potential vendors must be capable of handling a “surge” scenario of 9 million id cards in one year “to support possible future immigration reform initiative requirements.”

The request for proposals says the agency will need a minimum of four million cards per year. In the “surge,” scenario in 2016, the agency would need an additional five million cards – more than double the baseline annual amount for a total of 9 million.

“The guaranteed minimum for each ordering period is 4,000,000 cards. The estimated maximum for the entire contract is 34,000,000 cards,” the document says.

The agency is buying the materials need to construct both Permanent Residency Cards (PRC), commonly known as green cards, as well as Employment Authorization Documentation (EAD) cards which have been used to implement President Obama’s “Deferred Action for Childhood Arrivals” (DACA) program. The RFP does not specify how many of each type of card would be issued.

Jessica Vaughan, an immigration expert at the Center for Immigration Studies and former State Department official, said the document suggests a new program of remarkable breadth.

The RFP “seems to indicate that the president is contemplating an enormous executive action that is even more expansive than the plan that Congress rejected in the ‘Gang of Eight’ bill,” Vaughan said.

Last year, Vaughan reviewed the Gang of Eight’s provisions to estimate that it would have roughly doubled legal immigration. In the “surge” scenario of this RFP, even the relatively high four million cards per year would be more than doubled, meaning that even on its own terms, the agency is preparing for a huge uptick of 125 percent its normal annual output.

It’s not unheard of for federal agencies to plan for contingencies, but the request specifically explains that the surge is related to potential changes in immigration policy.

“The Contractor shall demonstrate the capability to support potential ‘surge’ in PRC and EAD card demand for up to 9M cards during the initial period of performance to support possible future immigration reform initiative requirements,” the document says.

A year ago, such a plan might have been attributed to a forthcoming immigration bill. Now, following the summer’s border crisis, the chances of such a new law are extremely low, giving additional credence to the possibility the move is in preparation for an executive amnesty by Obama.

Even four million combined green cards and EADs is a significant number, let alone the “surge” contemplated by USCIS. For instance, in the first two years after Obama unilaterally enacted DACA, about 600,000 people were approved by USCIS under the program. Statistics provided by USCIS on its website show that the entire agency had processed 862,000 total EADs in 2014 as of June.

Vaughan said EADs are increasingly coming under scrutiny as a tool used by the Obama administration to provide legalization for groups of illegal aliens short of full green card status.

In addition to providing government approval to work for illegal aliens, EADs also cost significantly less in fees to acquire, about $450 compared to more than $1000. In many states, EADs give aliens rights to social services and the ability to obtain drivers’ licenses.

Vaughan noted there are currently about 4.5 million individuals waiting for approval for the green cards having followed immigration law and obtained sponsorships from relatives in the U.S. or otherwise, less than the number of id cards contemplated by the USCIS “surge.”

USCIS officials did not provide additional information about the RFP by press time.

Card Consumables

Solicitation Number: HSSCCG-14-R-00028
Agency: Department of Homeland Security
Office: Citizenship & Immigration Services
Location: USCIS Contracting Office

Note:

There have been modifications to this notice. You are currently viewing the original synopsis. To view the most recent modification/amendment, click here

Solicitation Number:
HSSCCG-14-R-00028
Notice Type:
Presolicitation
Synopsis:
Added: Oct 03, 2014 4:47 pm

USCIS Contracting will be posting a solicitation for the requirement of Card Stock used by the USCIS Document Management Division. The objective of this procurement is to provide card consumables for the Document Management Division (DMD) that will be used to produce Permanent Resident Cards (PRC) and Employment Authorization Documentation (EAD) cards. The requirement is for an estimated 4 million cards annually with the potential to buy as many as 34 million cards total. The ordering periods for this requirement shall be for a total of five (5) years. This is a Firm Fixed Price (FFP) supply purchase for commercial items, utilizing North American Industry Classification System (NAICS) code 325211 and Product / Service Code (PSC) 9330. This requirement is for the acquisition of 100% polycarbonate solid body card stock with Radio Frequency Identification (RFID) and holographic images embedded within the card construction substrate layers, card design service, and storage.

The solicitation will be posted at this FedBidOpps webpage.

Contracting Office Address:
70 Kimball Avenue
Burlington, Vermont 05403

https://www.fbo.gov/index?s=opportunity&mode=form&id=20bc202b0a49bbe9f2a705782dba0090&tab=core&tabmode=list&=

United States Citizenship and Immigration Services

United States Citizenship and Immigration Services (USCIS) is a component of the United States Department of Homeland Security (DHS). It performs many administrative functions formerly carried out by the former United States Immigration and Naturalization Service (INS), which was part of the Department of Justice. The stated priorities of the USCIS are to promote national security, to eliminate immigration case backlogs, and to improve customer services. USCIS is headed by a director, currently Leon Rodriguez, who reports directly to the Deputy Secretary for Homeland Security.[1]

Functions

Atlanta, Georgia

USCIS is charged with processing immigrant visa petitions, naturalization petitions, and asylum and refugeeapplications, as well as making adjudicative decisions performed at the service centers, and managing all other immigration benefits functions (i.e., not immigration enforcement) performed by the former INS. Other responsibilities include:

  • Administration of immigration services and benefits
  • Adjudicating asylum claims
  • Issuing employment authorization documents (EAD)
  • Adjudicating petitions for non-immigrant temporary workers (H-1B, O-1, etc.)
  • Granting lawful permanent resident status
  • Granting United States citizenship

While core immigration benefits functions remain the same as under the INS, a new goal is to process applications efficiently and effectively. Improvement efforts have included attempts to reduce the applicant backlog, as well as providing customer service through different channels, including the National Customer Service Center (NCSC) with information in English and Spanish, Application Support Centers (ASCs), the Internet and other channels. The enforcement of immigration laws remain under CBP and ICE.

USCIS focuses on two key points on the immigrant’s journey towards civic integration: when they first become permanent residents and when they are ready to begin the formal naturalization process. A lawful permanent resident is eligible to become a citizen of the United States after holding the Permanent Resident Card for at least five continuous years, with no trips out of the United States that last for 180 days or more. If, however, the lawful permanent resident marries a U.S. citizen, eligibility for U.S. citizenship is shortened to three years so long as the resident has been living with the spouse continuously for at least three years and the spouse has been a citizen for at least three years.

Forms

USCIS handles all forms and processing materials related to immigration and naturalization. This is evident from USCIS’s predecessor, the INS, (Immigration and Naturalization Service) which is defunct as of May 9, 2003.

USCIS currently handles two kinds of forms: those relating to immigration, and those related to naturalization. Forms are designated by a specific name, and an alphanumeric sequence consisting of one letter, followed by two or three digits. Forms related to immigration are designated with an I (for example, I-551, Permanent Resident Card) and forms related to naturalization are designated by an N (for example, N-400, Application for Naturalization).

Immigrations courts and judges

The United States immigration courts and immigration judges, and the Board of Immigration Appeals which hears appeals from them, are part of the Executive Office for Immigration Review (EOIR) within the United States Department of Justice. (USCIS is part of the Department of Homeland Security.)

Operations]

Internet presence]

USCIS’ official website is USCIS.gov. The site was redesigned in 2009 and unveiled on September 22, 2009.[2]

The redesign made the web page interface more similar to the Department of Homeland Security’s official website. The last major redesign before 2009 took place in October 2006.

Also, USCIS runs an online appointment scheduling service known as INFOPASS. This system allows people with questions about immigration to come into their local USCIS office and speak directly with a government employee about their case and so on. This is an important way in which USCIS serves the public. USCIS maintains a blog entitled “The Beacon” as well as the “@uscis” Twitter account.

Funding

Unlike most other federal agencies, USCIS is funded almost entirely by user fees.[3] Under President George W. Bush’s FY2008 budget request, direct congressional appropriations made about 1% of the USCIS budget and about 99% of the budget was funded through fees. The total USCIS FY2008 budget was projected to be $2.6 billion.[4]

Staffing

USCIS consists of 18,000 federal employees and contractors working at 250 offices around the world.[5]

History

The INS was widely seen as ineffective, particularly after scandals that arose after September 11, 2001.[6] On November 25, 2002, President George W. Bush signed the Homeland Security Act of 2002 into law. This law transferred the Immigration and Naturalization Service (INS) functions to the Department of Homeland Security(DHS). Immigration enforcement functions were placed within the U.S. Customs and Border Protection (CBP) at the border and Ports-of-Entry while U.S. Immigration and Customs Enforcement (ICE) within land. The immigration service functions were placed into the separate USCIS. USCIS was formerly and briefly named the U.S. Bureau of Citizenship and Immigration Services (BCIS), before becoming USCIS.[7]

On March 1, 2003, the INS ceased to exist and services provided by that organization transitioned into USCIS. Eduardo Aguirre was appointed the first USCIS Director by President Bush. In December 2005, Emilio T. Gonzalez, Ph. D., was confirmed by the U.S. Senate as the Director of USCIS, and he held this position until April 2008.[8] Nominated by President Barack Obama on April 24 and unanimously confirmed on August 7 by the U.S. Senate, Alejandro Mayorkas was sworn in as USCIS Director on August 12, 2009.

See also

References

 This article incorporates public domain material from websites or documents of the United States Department of Homeland Security.

  1. Jump up^ “U.S. Citizenship and Immigration Services”. United States Citizenship and Immigration Services. Department of Homeland Security. Retrieved 1 May 2014.
  2. Jump up^ “Secretary Napolitano and USCIS Director Mayorkas Launch Redesigned USCIS Website” (Press release). United States Department of Homeland Security. September 22, 2009. Retrieved April 10, 2010.
  3. Jump up^ CIS Ombudsman’s 2007 Annual Report, pages 46-47
  4. Jump up^ USCIS FY2008 budget request fact sheet
  5. Jump up^ USCIS website
  6. Jump up^ Special report “The INS’s Contacts With Two September 11 Terrorists” by the U.S. DOJ Inspector General, May 20, 2002, at http://www.usdoj.gov
  7. Jump up^ Name Change From the Bureau of Citizenship and Immigration Services to U.S. Citizenship and Immigration Services [69 FR 60938] [FR 39-04]. Uscis.gov. Retrieved on 2013-07-23.
  8. Jump up^ Leadership info at http://www.uscis.gov

External links

Employment authorization document

From Wikipedia, the free encyclopedia

An employment authorization document (EAD, Form I-766), EAD card, known popularly as a “work permit”, is a document issued by United States Citizenship and Immigration Services (USCIS) that provides its holder a legal right to work in the US. It is similar to, but should not be confused with the green card.

Certain ‘aliens’ (non-residents) who are temporarily in the United States may file a Form I-765, application for employment authorization, to request an EAD. An EAD is issued for a specific period of time based on alien’s immigration situation. Foreign nationals with an EAD can lawfully work in the United States for any employer.

Aliens who are sponsored by US employers and issued temporary work visas for such as H, I, L-1 or O-1 visas are authorized to work for the sponsoring employer, through the duration of the visa . This is known as ‘employment incident to status’. Aliens on such work visas do not qualify for an EAD according to the US Citizenship and Immigration Service regulations (8 CFR Part 274a).[1]

Currently the EAD is issued in the form of a standard credit card-size plastic card enhanced with multiple security features. The EAD card contains some basic information about alien: name, birth date, sex, immigrant category, country of birth, photo, alien registration number (also called “A-number”), card number, restrictive terms and conditions, and dates of validity.

Restriction

The eligibility for employment authorizations are detailed in the Federal Regulations at 8 C.F.R. §274a.12.[2] Only aliens who fall under the enumerated categories are eligible for an employment authorization document.

There are more than 40 types of immigration status that make their holders eligible to apply for an EAD.[3] Some are nationality-based and apply to a very small number of people. Others are much broader, such as those covering the spouses of E-1, E-2, E-3 or L-1 visa holders.

USCIS issues EADs in the following categories:

  • Renewal EAD: Renewal cannot be filed more than 120 days before the current employment authorization expires.
  • Replacement EAD: Replaces a lost, stolen, or mutilated EAD. A replacement EAD also replaces an EAD that was issued with incorrect information, such as a misspelled name.

Obtaining an EAD

Applicants would file Form I-765 (application for employment authorization) by mail with the USCIS Regional Service Center that serves the area where they live. They may also be eligible to file Form I-765 electronically (see USCIS Electronic Filing). For employment based green card applicants, your priority date needs to be current to apply for Adjustment of Status (I485) at which time you can apply for EAD. Typically, it is recommended to apply for Advance Parole (AP) at the same time so that you do not have to get a visa stamping when re-entering US from a foreign country.

Interim EAD

An interim EAD is an EAD issued to an eligible applicant when USCIS has failed to adjudicate an application within 90 days of receipt of a properly filed EAD application or within 30 days of a properly filed initial EAD application based on an asylum application filed on or after January 4, 1995. The interim EAD will be granted for a period not to exceed 240 days and is subject to the conditions noted on the document.

An interim EAD is no longer issued by local service centers. One can however take an INFOPASS appointment and place a service request at local centers, explicitly asking for it if the application exceeds 90 days and 30 days for asylum applicants without an adjudication .

See also

References

  1. Jump up^ http://www.uscis.gov/portal/site/uscis/menuitem.f6da51a2342135be7e9d7a10e0dc91a0/?vgnextoid=fa7e539dc4bed010VgnVCM1000000ecd190aRCRD&vgnextchannel=fa7e539dc4bed010VgnVCM1000000ecd190aRCRD&CH=8cfr
  2. Jump up^ “Classes of aliens authorized to accept employment”. Government Printing Office. Retrieved 17 November 2011.
  3. Jump up^ ‘Work Permits: An Overview,’ http://www.usvisalawyers.co.uk/article18.htm

External links

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

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Obama Spreads Suspected Ebola Travelers To 5 Large U.S. Cities– New York, Newark, Washington D.C., Atlanta, Chicago — Sanctuary Cities For Illegal Aliens From Ebola Infected Liberia, Sierra Leone, Guinea — Ebola Czar Ron Klain Says “Overpopulation” Top Concern — Spreading Ebola Virus Would Reduce World Population In Africa And USA Sanctuary Cities? — Eugenics Redux — Videos

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Story 1: Obama Spreads Suspected Ebola Travelers To 5 Large U.S. Cities– New York, Newark, Washington D.C., Atlanta, Chicago — Sanctuary Cities For Illegal Aliens From Ebola Infected Liberia, Sierra Leone, Guinea — Ebola Czar Ron Klain Says “Overpopulation” Top Concern — Spreading Ebola Virus Would Reduce World Population In Africa And USA Sanctuary Cities? — Eugenics Redux — Videos

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Gov. Perry Announces North Texas Infectious Disease Bio Containment Facility

Gov. Rick Perry today announced the creation of a state-of-the-art Ebola treatment and infectious disease bio containment facility in North Texas. Creation of such facilities was among the first recommendations made by the governor’s recently named Texas Task Force on Infectious Disease Preparedness and Response in order to better protect health care workers and the public from the spread of pandemic diseases.

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Americans want flight restrictions from Ebola countries. And it’s not close.

By Aaron Blake

Nearly two-thirds of Americans say they are concerned about an Ebola outbreak in the United States, and about the same amount say they want flight restrictions from the countries in West Africa where the disease has quickly spread.

A new poll from the Washington Post and ABC News shows 67 percent of people say they would support restricting entry to the United States from countries struggling with Ebola. Another 91 percent would like to see stricter screening procedures at U.S. airports in response to the disease’s spread.

Thus far, some countries in Europe have restricted flights from these countries in West Africa, and an increasing number of U.S. lawmakers are calling for similar bans. The White House has yet to increase restrictions, with federal officials saying such a move could actually increase the spread of the disease by hampering the movement of aid workers and supplies.
Concern about Ebola, at this point, is real but not pervasive. About two-thirds (65 percent) say they are concerned about an Ebola outbreak in the United States. But while people are broadly concerned about an outbreak, they are not necessarily worried about that potential outbreak directly affecting them. Just 43 percent of people are worried about themselves or someone in their family becoming infected – including 20 percent who are “very worried.”

That finding echoes a Pew poll from last week which showed just 11 percent were “very worried” about themselves or their families becoming infected. Since that survey, Dallas Ebola patient Thomas Eric Duncan died, and news that a nurse who provided care for him became infected broke on the final day of the Post-ABC poll.

By comparison, slightly more Americans said they were worried about the H1N1 virus – a.k.a. the swine flu – in October 2009 (52 percent). Concern about Ebola is about on-par with concern about Avian influenza – a.k.a. the bird flu – in 2006 (41 percent) and slightly higher than concern about Sudden Acute Respiratory Syndrome (SARS) in 2003 (as high as 38 percent).
The support for increasing restrictions puts the White House in a tough spot. Given the moves by other countries and the American public’s stance, there is increasing pressure to act. And given the very real — but still somewhat muted — concerns about the disease, that’s significant, especially if the disease continues to expand.

http://www.washingtonpost.com/blogs/the-fix/wp/2014/10/14/americans-want-flight-restrictions-from-ebola-countries-and-its-not-close/

West Africa travelers must go to 1 of 5 airports

The Department of Homeland Security announced Tuesday that all travelers from Ebola outbreak countries in West Africa will be funneled through one of five U.S. airports with enhanced screening starting Wednesday.

Customs and Border Protection within the department began enhanced screening — checking the traveler’s temperature and asking about possible exposure to Ebola — at New York’s John F. Kennedy International Airport on Oct. 11.

Enhanced screening for travelers from Liberia, Sierra Leone and Guinea was expanded Oct. 16 to Washington Dulles, Chicago O’Hare, New Jersey’s Newark and Hartsfield-Jackson Atlanta international airports.

Those airports were supposed to screen 94% of the average 150 people per day arriving from the three countries. Lawmakers from other states asked for enhanced screening at their airports, too.

Some lawmakers have called for more restrictions, such as suspending visas or denying entry at ports for citizens from the three countries.

Jeh Johnson, secretary of Homeland Security, announced that travelers from West Africa must arrive at one of the five airports starting Wednesday.

“We are working closely with the airlines to implement these restrictions with minimal travel disruption,” Johnson said. “If not already handled by the airlines, the few impacted travelers should contact the airlines for rebooking as needed.”

The enhanced screening will apply to anyone who traveled recently to, from or through the three outbreak countries, according to the department’s announcement to be published Thursday in the Federal Register. Customs and Border Protection will work with airlines to identify potential travelers before they board, but airlines will be obligated to comply with the rule for carrying to the USA any passengers who recently traveled through the region, according to the filing.

The restrictions should affect only about nine travelers per day who would have arrived at other airports. Katie Cody, a spokeswoman for American Airlines, which serves Europe from hubs such as Philadelphia and Charlotte, said the airline has no concerns about the change.

“We have been tracking that, and we don’t have any concerns because the numbers are so small,” Cody said.

British Airways, which serves a variety of U.S. destinations other than the five targeted airports, said it would comply with the measures.

“Customers affected will be offered a refund or will be rerouted if there is availability,” spokeswoman Michele Kropf said.

Republican lawmakers offered muted praise but pressed for stricter travel restrictions.

“In addition to requiring all travelers from at-risk countries to fly through airports with enhanced screening measures in place, I continue to call on the administration to suspend all visas from Liberia, Sierra Leone and Guinea,” said Rep. Michael McCaul, R-Texas, the head of the House Homeland Security Committee.

The head of the House Judiciary Committee, Rep. Bob Goodlatte, R-Va., said a “real solution” is to deny entry to anyone from the three countries under a provision of the 1952 Immigration and Nationality Act.

“President Obama has a real solution at his disposal under current law and can use it at any time to temporarily ban foreign nationals from entering the United States from Ebola-ravaged countries,” Goodlatte said. “The vast majority of Americans strongly support such a travel moratorium, and I urge the president to take every step possible to protect the American people from danger.”

Rep. John Conyers of Michigan, the top Democrat on the House Judiciary Committee, said steering travelers through the five airports is a sensible precaution.

“As agreed upon by experts in both the public health and transportation communities, issuing a blanket travel ban would not only be counterproductive, but it would also irresponsibly impede getting much-needed supplies and relief to the countries that need it most,” Conyers said.

Roger Dow, CEO of the U.S. Travel Association, a trade group for all aspects of travel, praised the move to calm travel concerns while avoiding a travel ban.

“The Obama administration continues to heed the counsel of an overwhelming consensus of health and security experts and resist calls for any sort of travel ban on the grounds that it will be counterproductive to efforts to contain Ebola,” Dow said.

A Liberian national, Thomas Eric Duncan, who became the first person diagnosed with the disease in the USA after arriving in Dallas on Sept. 20, had a temperature of 97.3 degrees but didn’t tell airport officials in Monrovia, Liberia, that he had cared for a pregnant woman suffering from Ebola. He died Oct. 8, and two nurses who treated him have become infected.

Sen. Charles Schumer, D-N.Y., said the enhanced screening adds a layer of protection against Ebola entering the country.

“The Department of Homeland Security’s policy to funnel all passengers arriving from Ebola hot spots to one of these five equipped airports is a good and effective step towards tightening the net and further protecting our citizens,” Schumer said.

Obama and Johnson have said they will continue to monitor travel restrictions for possible changes.

“We are continually evaluating whether additional restrictions or added screening and precautionary measures are necessary to protect the American people and will act accordingly,” Johnson said.

http://www.wtsp.com/story/news/nation/2014/10/21/ebola-travel-restrictions-dhs-screening-jfk-dulles-ohare-newark-atlanta/17655889/

 

Gabbard Calls On CDC To Increase Incubation Period To Prevent Ebola Spread

 By Chad Blair

Rep. Tulsi Gabbard (D-HI) has called on the Center for Disease Control to implement stricter incubation guidelines for people who have been in contact with patients “confirmed or suspected” to have the Ebola virus.

According to a press release from her office, Gabbard is calling on the CDC to increase the quarantine and restriction period from the 21-day standard to 42 days, “based on the latest scientific studies and the World Health Organization report that the incubation period for the deadly Ebola virus can extend as long as 42 days.”

On Friday, Gabbard called for the “immediate suspension” of visas for citizens of Ebola-stricken West African nations as well as flights from those countries into the United States.

“Recent mistakes have revealed that the U.S. public health system is clearly not fully prepared to combat Ebola and prevent its spread in the United States,” she said in a statement.

Democrats like Gabbard are among a growing number who are “beginning to sound more like Republicans when they talk about Ebola. And Republicans are moving into overdrive with their criticism of the government’s handling of the deadly virus,” according to The Washington Post.

“The sharpened rhetoric, strategists say, suggests Democrats fear President Obama’s response to Ebola in the United States could become a political liability in the midterm election and Republicans see an opportunity to tie increasing concerns about the disease to the public’s broader worries about Obama’s leadership.”

The Washington Post notes, however, that Gabbard is “a liberal Democrat who is not in any danger of losing reelection.” It also reports that a Washington Post-ABC News poll showed that “67 percent of Americans would support restricting entry to the United States from countries fighting dealing with an Ebola crisis.”

The Associated Press is also reporting that moderate Democrats are joining the callfor a flight ban, even ones not in tough re-election battles.

http://www.huffingtonpost.com/2014/10/20/gabbard-ebola-incubation-period_n_6017290.html

 

How is the end of an Ebola outbreak decided and declared?

Information note – October 2014

Who decides the date?

The WHO Ebola outbreak response team is responsible for establishing the date of the end of the outbreak in collaboration with the affected country’s subcommittee for surveillance, epidemiology and laboratory.

How is the date determined?

An Ebola virus disease outbreak in a country can be declared over once 42 days have passed and no new cases have been detected. The 42 days represents twice the maximum incubation period for Ebola (21 days). This 42-day period starts from the last day that any person in the country had contact with a confirmed or probable Ebola case.

This includes health care workers who have been exposed to patients with Ebola virus disease, even if the health worker was wearing personal protective equipment and followed infection control procedures since such a person could be exposed accidentally without realizing it. In the setting of an Ebola treatment centre, the date of the last infectious contact is defined as the day when the last patient in the treatment centre tested negative for Ebola virus disease, using a real-time reverse-transcriptase polymerase chain reaction (RT-PCR) test.

If no new case has been detected at the end of this 42-day period, the risk of a further case is very low, and the outbreak is declared over.

Why 42 days?

The maximum incubation period for Ebola virus disease is 21 days. The 42-day period set by WHO (twice the maximum incubation period) provides a margin of security to cover any possible missed cases, uncertainty in reporting dates or hidden chains of transmission. (*)

During the 42-day period, the surveillance system should be fully functional, so that all contacts of the last patient are followed to detect possible chains of transmission.

What is the procedure to make the declaration?

The WHO Ebola outbreak response team in collaboration with the affected country’s subcommittee for surveillance, epidemiology and laboratory determines the date of the end of the epidemic. The government of the affected country, in collaboration with WHO and international partners, makes an official declaration of the end of the epidemic.

http://www.who.int/csr/disease/ebola/declaration-ebola-end/en/

Reversal: Obama sets Ebola travel restrictions

BY PAUL BEDARD

The Obama administration has reversed course on putting travel restrictions on those coming from three West African nations tainted with Ebola and is putting in place demands that they enter only through five U.S. airports prepared to screen for the virus.

Homeland Security Secretary Jeh Johnson said in a statement that the new rules will take effect Wednesday, bowing to demands from both parties that the U.S. do a better job so secure the border from Ebola.

“Today, as part of the Department of Homeland Security’s ongoing response to prevent the spread of Ebola to the United States, we are announcing travel restrictions in the form of additional screening and protective measures at our ports of entry for travelers from the three West African Ebola-affected countries,” said Johnson.

He said the rules require that anyone coming from Liberia, Sierra Leone or Guinea enter the U.S. only through the five airports where special Ebola screenings have been set up: New York’s John F. Kennedy, Newark Liberty, Washington Dulles, Atlanta’s Hartsfield-Jackson and Chicago’s O’Hare.

“All passengers arriving in the United States whose travel originates in Liberia, Sierra Leone or Guinea will be required to fly into one of the five airports that have the enhanced screening and additional resources in place. We are working closely with the airlines to implement these restrictions with minimal travel disruption. If not already handled by the airlines, the few impacted travelers should contact the airlines for rebooking, as needed,” said the statement.

He said that passengers flying into those airports on flights originating in Liberia, Sierra Leone and Guinea “are subject to secondary screening and added protocols, including having their temperature taken, before they can be admitted into the United States. These airports account for about 94 percent of travelers flying to the United States from these countries.”

There are no direct, non-stop commercial flights from Liberia, Sierra Leone or Guinea to the U.S.

http://www.washingtonexaminer.com/reversal-obama-sets-ebola-travel-restrictions/article/2555074

 

NIH unit treating Dallas nurse for Ebola is one of 4 special isolation facilities in U.S.

By Lena H. Sun

It has a specially designed air-flow system to prevent contaminated air from leaving the patient room. It requires anyone who enters to be buzzed in. Personnel who work there receive special training in infection control to prevent the spread of bio­terror agents, natural or man-made. It also has a tiny gym.

Welcome to the Special Clinical Studies Unit at the National Institutes of Health in Bethesda, Md. It is a 4,000-square-foot unit inside the NIH Clinical Center, the nation’s only hospital dedicated to research, which provides free state-of-the-art care to very sick patients from all over the world.

Now it’s home to its first confirmed Ebola patient, Nina Pham.
Pham is the first patient with a confirmed infectious disease to be cared for in the special seven-bed unit, center director John Gallin said in an interview Friday. Opened in 2010 for patients who need advanced isolation and extended stays, the unit was initially designed to take care of personnel working at the U.S. Army Medical Research Institute of Infectious Diseases in case they were exposed to infectious agents. In more recent years, it has been used to house healthy volunteers participating in live vaccine trials. The volunteers need to be monitored in a place where they can be safely quarantined, Gallin said. To accommodate those healthy volunteers, the unit has a dining room and a “tiny fitness area,” he said.

Pham, the first nurse diagnosed with Ebola after caring for a patient in Dallas, is in fair and stable condition, officials said Friday morning.
What does an Ebola isolation ward look like?
“We are giving her the best possible care on a symptomatic and systemic basis,” Anthony Fauci, director of NIH’s National Institute of Allergy and Infectious Diseases, said during a news conference.

Pham, 26, was transferred to the facility, one of four in the country with a special bio­containment unit, late Thursday. She was diagnosed with Ebola on Sunday, becoming the first person to contract the disease on U.S. soil. Pham had been part of the team that treated Thomas Eric Duncan, a Liberian man who flew to Dallas last month before being diagnosed with Ebola. Duncan died last week, four days before it was announced that Pham had contracted the disease.

“There is no specific therapy that has been proven to be effective against Ebola, and that’s why excellent medical care is critical,” Fauci said. He said Pham was “very, very tired” from her trip.

Patients infected with the Ebola virus require a large number of staffers to provide care around-the-clock. At NIH, that comes out to about 27 people a week — doctors, nurses, support staff — for one patient, Gallin said. With about 50 to 60 such personnel specially trained for infectious disease and critical care, NIH can only care for two Ebola patients at a time, he said.

The four facilities that provide such care were designed in the aftermath of the Sept. 11, 2001, terrorist attacks to protect against bio­terrorism. Two of them, Emory University Hospital in Atlanta and the Nebraska Medical Center, are each treating one Ebola patient. The other facility is St. Patrick Hospital in Missoula, Mont.

They require staff to undergo more rigorous training in infection control, and staff must follow strict protocol for putting on and taking off personal protective equipment in a separate anteroom. Officials say meticulous attention to detail in following protocols is what sets them apart from other facilities.
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Emory has treated three Ebola patients, all of whom have recovered. The University of Nebraska treated one patient who recovered and is now caring for a freelance NBC cameraman. St. Patrick has not yet treated an Ebola patient. The hospital has received so many inquiries that it has set up a special hotline where they are transcribed and forwarded to the appropriate departments.
Bruce Ribner gives a tour of the Emory University Hospital isolation unit which has been used for treatment of patients infected with the Ebola virus. (Emory University via YouTube)
Unlike the Dallas hospital where Pham and another nurse were infected, which officials said most likely occurred because of a breach of protocol involving personal protective equipment, no health workers taking care of the Ebola patients at the special facilities have become infected.

“There is a step-by-step, checklisted procedure to putting on your personal protective equipment for when you go in to the patient’s room to perform your duties and when you come out,” said Mark Rupp, medical director of Nebraska Medical Center’s infection control department, which includes the special unit. “That’s the big difference with what goes on in our unit and what goes on in a regular intensive-care unit.”

The facilities have one person whose only job is to make sure health-care workers put on and take off their protective equipment correctly. At NIH, this person is dubbed “the Watson,” Gallin said, for the sidekick to Sherlock Holmes.

The Watson “has the authority to stop everything at any moment if someone looks like they’re breaking protocol,” Gallin said. The Watson has a checklist, like a pilot’s preflight checklist, and everything has to be done in that order. If not, the Watson can “scream at them and tell them to stop,” Gallin said, which apparently happened at least once Thursday night when doctors and staff were admitting Pham.

The protective gear that health-care workers take off is autoclaved (sanitized via pressurized steam) and then incinerated. Equipment that is not disposable is disinfected according to the manufacturer’s directions. The units also have negative air pressure to prevent germs from spreading beyond patient rooms. For Ebola patients, contaminated air is not such a concern because the disease is not transmitted through the air, but through contact with bodily fluids.

 

What does an Ebola isolation ward look like?

The seven-bed, 4,000-square-foot biocontainment unit at the National Institutes of Health Clinical Center in Bethesda, Md., is a state-of-the-art facility built to keep the world’s scariest pathogens from escaping. The four U.S. facilities are all different — NIH’s even has a gym — but they contain many of the same things. This layout is based on the unit at Emory University in Atlanta.

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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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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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The Pronk Pops Show 348, October 14, 2014, Story 1: Story 1: Stop The Ebola Illegal Alien Invasion/Pandemic — Secure The U.S./Mexican Border — Videos

Posted on October 14, 2014. Filed under: American History, Biology, Blogroll, Business, Chemistry, Communications, Computers, Demographics, Diasters, Ebola, Federal Communications Commission, Federal Government, Food, Foreign Policy, Freedom, government spending, history, Illegal, Immigration, Language, Law, Legal, liberty, Life, Links, Literacy, media, Medical, National Security Agency (NSA_, Natural Gas, Oil, People, Philosophy, Photos, Politics, Radio, Rants, Raves, Regulations, Resources, Science, Security, Talk Radio, Technology, Terrorism, Unemployment, Video, War, Wealth, Weapons of Mass Destruction, Welfare, Wisdom, Writing | Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |

Project_1

The Pronk Pops Show Podcasts

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

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Pronk Pops Show 335: September 23 2014

Pronk Pops Show 334: September 22 2014

Pronk Pops Show 333: September 19 2014

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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

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Story 1: Stop The Ebola Illegal Alien Invasion/Pandemic — Secure The U.S./Mexican Border — Videos

USA Invaded by Central America….

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

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?

After Armageddon  (when deadly virus strikes)

SOMETHING ‘NEVER SEEN BEFORE’ IS COMING TO AMERICA (GLOBAL PANDEMIC)

Video: Ebola patient escapes quarantine, spreads panic in Monrovia (Liberia)

Judge Jeanine Pirro – Hidden Danger? – Could Illegal Immigrant Kids Bring Diseases To U.S.?

Obama Triggers a Massive Surge of Illegal Immigrant Children(90,000!)

Reporters Confront U.S. Border Patrol Over Illegal Immigration Stand-Down

Pestilence : Illegal Aliens bringing serious diseases across the U.S. Border (Aug 01, 2014)

\

immigrants bring in serious, contagious diseases

PJTV – Illegal Immigrants Being Illegally Dumped in Arizona…Illegally

Gen. Kelly at University of South Florida

 

 

The Pronk Pops Show Podcasts Portfolio

Listen To Pronk Pops Podcast or Download Show 346-348

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Number of Biosafety Level 4 Bio-containment Facilities in The United States 4– Number of Hospital Beds 19 — United States Not Prepared for Ebola Outbreak and Pandemic — Videos

Posted on October 10, 2014. Filed under: American History, Biology, Blogroll, Chemistry, College, Communications, Crime, Diasters, Documentary, Economics, Education, Foreign Policy, Fraud, government spending, Health Care, history, Law, liberty, Life, Links, Medical, People, Photos, Politics, Rants, Raves, Regulations, Resources, Science, Talk Radio, Technology, Transportation, Video, War, Weapons, Welfare, Wisdom, Writing | Tags: , , , , , , , , |

 

USAMRIID The US Army Medical Research Institute of Infectious Disease

USAMRIID Overview

BioContainment Unit at The Nebraska Medical Center

Activation- A Nebraska Medical Center Biocontainment Unit Story

Max Alert! EBOLA Bodily Fluids Readily Airborne Weaponizable

Aerosolizing ONE DROP of EBOLA = 1/2 MILLION DEAD

 

The Secret Ebola Open Border Connection Revealed: Special Report

Ebola – The Truth About the Outbreak (Documentary)

What Pisses Me Off About Ebola

 

germs gerns_2

 

The ominous math of the Ebola epidemic

By Joel Achenbach, Lena H. Sun and Brady Dennis

When the experts describe the Ebola disaster, they do so with numbers. The statistics include not just the obvious ones, such as caseloads, deaths and the rate of infection, but also the ones that describe the speed of the global response.

Right now, the math still favors the virus.

Global health officials are looking closely at the “reproduction number,” which estimates how many people, on average, will catch the virus from each person stricken with Ebola. The epidemic will begin to decline when that number falls below one. A recent analysis estimated the number at 1.5 to 2.

The number of Ebola cases in West Africa has been doubling about every three weeks. There is little evidence so far that the epidemic is losing momentum.

“The speed at which things are moving on the ground, it’s hard for people to get their minds around. People don’t understand the concept of exponential growth,” said Tom Frieden, director of the U.S. Centers for Disease Control and Prevention. “Exponential growth in the context of three weeks means: ‘If I know that X needs to be done, and I work my butt off and get it done in three weeks, it’s now half as good as it needs to be.’ ”

Frieden warned Thursday that without immediate, concerted, bold action, the Ebola virus could become a global calamity on the scale of HIV. He spoke at a gathering of global health officials and government leaders at the World Bank headquarters in Washington. The president of Guinea was at the table, and the presidents of Liberia and Sierra Leone joined by video link. Amid much bureaucratic talk and table-thumping was an emerging theme: The virus is still outpacing the efforts to contain it.
“The situation is worse than it was 12 days ago. It’s entrenched in the capitals. Seventy percent of the people [who become infected] are definitely dying from this disease, and it is accelerating in almost all settings,” Bruce Aylward, assistant director general of the World Health Organization, told the group.

Aylward had come from West Africa only hours earlier. He offered three numbers: 70, 70 and 60. To bring the epidemic under control, officials should ensure that at least 70 percent of Ebola-victim burials are conducted safely, and that at least 70 percent of infected people are in treatment, within 60 days, he said.

More numbers came from Ernest Bai Koroma, president of Sierra Leone: The country desperately needs 750 doctors, 3,000 nurses, 1,500 hygienists, counselors and nutritionists.

The numbers in this crisis are notoriously squishy, however. Epidemiological data is sketchy at best. No one really knows exactly how big the epidemic is, in part because there are areas in Liberia, Sierra Leone and Guinea where disease detectives cannot venture because of safety concerns.

The current assumption is that for every four known Ebola cases, about six more go unreported.

The latest World Health Organization statistics, published Wednesday, show 8,033 cases of suspected or confirmed Ebola in the West Africa outbreak, with 3,865 deaths. That figure does not include Thomas Eric Duncan, a Liberian man who died Wednesday in Dallas.

How quickly Ebola spreads compared to other diseases VIEW GRAPHIC
“This has been a particularly difficult outbreak because of the difficulty getting a lot of data quickly out of the countries,” said Martin Meltzer, a CDC researcher who models epidemics. “My crystal ball is painted a deep black. It’s like tracking a hurricane.”

Meltzer helped produce a report in late September that said that at current rates of infection, as many as 1.4 million people would become infected by January. That number, officials stressed, was a straight extrapolation of the explosive spread of Ebola at a time when the world had managed to mount only a feeble response. The more vigorous response underway is designed to bend that curve.

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The U.S. military is building 17 treatment centers that can hold 100 people each, but the top military commander in Africa said Tuesday that they won’t be ready until mid-November. Liberia and Sierra Leone have a particularly keen need for more hospital beds. The two countries currently have 924 beds between them, but they need 4,078, according to the WHO.

“The virus is moving on virus time; we’re moving on bureaucracy or program time,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “The virus is actually picking up the pace. Even as we add resources, we get farther behind.”

Aylward, the WHO official, pointed to some bright spots in the response in recent weeks. Liberia has gone from just six burial teams to 54. Officials are working with religious leaders to enable safe burials while respecting cultural traditions. “There’s a way to observe most of the ritual while keeping safe,” Aylward said in an interview.

But he said that overall, the countries in West Africa still lack a coordinated response.

“What is needed in every country is a list, an Excel spreadsheet. It’s not complicated. Here is every district, every county, here is burials and who is going to lead them, here is case finding and contact tracing, here is behavioral change,” Aylward said. In effect, the countries need better numbers.

The latest data from the WHO show hints of progress in bringing Ebola under control in certain rural areas stricken by the disease earlier this year. Seven provinces in Guinea that previously reported Ebola cases saw no new infections in the most recent three-week period covered in Wednesday’s WHO update. Two districts in Sierra Leone and one in Liberia showed a decline in infections.

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But experts caution against reading too much into small fluctuations that may simply reflect an increase or decrease in surveillance or a reappraisal of older data. This cautious attitude toward lower numbers particularly applies to a reported drop in new cases in Liberia in the past three weeks, which the WHO said is “unlikely to be genuine” and more likely reflects “a deterioration in the ability of overwhelmed responders to record accurate epidemiological data.”

Gerardo Chowell, a mathematical epidemiologist at Arizona State University, used data compiled through the end of August to estimate the reproduction number of 1.5 to 2 for this Ebola epidemic. Chowell said that even modest gains in lowering that number could give health officials and the military a better chance of controlling the epidemic.

“Maybe we can bring it from two to 1.2 or 1.3, which would indicate that the number of new cases will be dramatically reduced, and that will give you time,” he said.

Another key number: how many days elapse between the time symptoms occur (which is when a person becomes contagious) and when health officials diagnose the disease in that person. Driving that number down is critical to containing the virus.

The incubation period for Ebola is usually about a week to 10 days, although it can last as long as 21 days. That creates obvious challenges for health workers who have to do contact tracing — they have to repeatedly knock on doors and take the temperatures of people who weeks earlier were potentially exposed to the virus. But it also gives those same workers a decent interval of time to track down people who may be infected before they start shedding the virus and potentially spreading the disease.

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There are several scenarios for how this plays out. One is that the conventional methods of containing Ebola — isolating patients and doing contact tracing of people who might be exposed — lower the rate of new infections until finally the epidemic burns itself out. That has been the case in all previous outbreaks of Ebola, although no outbreak has ever been nearly as extensive as this one.

A second scenario is more dire: The conventional methods come too late, the epidemic keeps spreading, and the virus is beaten back only when vaccines can be developed and scaled up to the point where they can be widely distributed.

As the number of infections increases, so does the possibility that a person with Ebola will carry it to another country. This is known as an export.

“So we had two exports in the first 2,000 patients,” Frieden said in a recent interview. “Now we’re going to have 20,000 cases, how many exports are we going to have?”

http://www.washingtonpost.com/national/health-science/the-ominous-math-of-the-ebola-epidemic/2014/10/09/3cad9e76-4fb2-11e4-8c24-487e92bc997b_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. The scenario for the 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.

http://undergroundmedic.com/?p=6990

 

BSL-4 Laboratories in the United States

There are currently 13 operational or planned BSL-4 facilities within the United States of America. These are listed below.
*Operates two facilities

Biosafety Level-4 Laboratories
Operational
Centers for Disease Control and Prevention*
Atlanta, GA
Center for Biodefense and Emerging Infectious Diseases
University of Texas Medical Branch
Galveston, TX
Center for Biotechnology and Drug Design
Georgia State University
Atlanta, GA
Southwest Foundation for Biomedical Research
San Antonio, TX
Rocky Mountain Laboratories Integrated Research Facility
National Institute of Allergy and Infectious Diseases
Hamilton, MT
Expanding
United States Army Medical Research Institute for Infectious Diseases
Department of Defense
Frederick, MD
Planned or Under Construction
Integrated Research Facility
National Institute of Allergy and Infectious Diseases
Ft. Detrick, MD
Galveston National Laboratory
University of Texas Medical Branch
Galveston, TX
National Biodefense Analysis and Countermeasures Center
Department of Homeland Security
Frederick, MD
National Bio- and Agro-Defense Facility (NBAF)
Department of Homeland Security
Manhattan, KS
National Biocontainment Laboratory (NBL)
Boston University
Boston, MA
Virginia Division of Consolidated Laboratory Services
Department of General Services of the Commonwealth of Virginia
Richmond, VA

National & Regional Biocontainment Laboratories

In February 2002, consultations between the National Institute of Allergy and Infectious Diseases (NIAID) and its Blue Ribbon Panel on Bioterrorism produced several recommendations for NIAID to better protect people from the threat of bioterrorism. Fulfilling some of those recommendations required more laboratory space for working with dangerous pathogens than was previously available in the United States. In September 2003 and September 2005, NIAID announced the recipients of grants partially funding the construction of two National Biocontainment Laboratories (NBLs) and thirteen Regional Biocontainment Laboratories (RBLs), increasing Biosafety Level-4 (BSL-4) and BSL-3 lab space nationwide.

The NBLs and RBLs are operated by the grant recipients, research institutions across the country. These labs support biodefense and emerging infectious diseases research as resources that provide lab space for basic research of dangerous pathogens and development of new vaccines and treatments. The NBLs are required to have BSL-4, BSL-3, and BSL-2 labs, animal facilities, insectary facilities, clinical facilities, and research support space. The RBLs are required to have BSL-3 and BSL-2 labs, animal facilities, and research support space. While fulfilling the need of researchers occupying the facility, the NBLs and RBLs can be used by other biodefense researchers within the region, particularly those within the Regional Centers of Excellence in Biodefense and Emerging Infectious Diseases. In addition, these labs are available to provide assistance to national, state, and local public health efforts during a biological attack.

Biocontainment Laboratories
National Biocontainment Laboratories
Galveston National Laboratory
University of Texas Medical Branch
Galveston, TX
National Emerging Infectious Diseases Laboratory
Boston University
Boston, MA
Regional Biocontainment Laboratories
Tufts Regional Biosafety Laboratory
Tufts University
North Grafton, MA
Regional Biocontainment Laboratory at Biomedical Science Tower III
Univeristy of Pittsburgh
Pittsburgh, PA
Center for Predictive Medicine
University of Louisville
Louisville, KY
Colorado State University Regional Biocontainment Laboratory
Colorado State University
Ft. Collins, CO
George Mason University Regional Biocontainment Laboratory
George Mason University
Manassas, VA
Global Health Research Building
Duke University
Durham, NC
Howard T. Ricketts Laboratory Regional Biocontainment Laboratory
University of Chicago
Chicago, IL
Pacific Regional Biocontainment Laboratory
University of Hawaii at Manoa
Honolulu, HI
Southeast Biosafety Laboratory Alabama Birmingham
University of Alabama at Birmingham
Birmingham, AL
Tulane National Primate Research Center
Tulane University
Covington, LA
University of Missouri-Columbia Regional Biocontainment Laboratory
University of Missouri-Columbia
Columbia, MO
University of Tennessee Regional Biocontainment Laboratory
Univeristy of Tennessee Health Science Center
Memphis, TN

Regional Centers of Excellence

The Regional Centers of Excellence for Biodefense and Emerging Infectious Diseases (RCEs) are consortia of universities and research institutions that pursue research with the intentions of producing therapeutics, vaccines, and diagnostics for pathogens that could be used in a bioterrorist attack or could become more widespread. Activities within the RCEs include developing and conducting research programs, training new scientists in research activities, and developing and maintaining facilities and services supportive of activities of the RCEs and other regional biodefense investigators. The RCEs also develop effective treatments and treatment strategies from basic research findings and provide first-line responders with facilities and support during a biological attack.

The National Institute of Allergy and Infectious Diseases (NIAID) created the RCE program in response to a recommendation from meetings between the NIAID and its Blue Ribbon Panel on Bioterrorism in February 2002. By June 2005, NIAID had established a total of ten RCEs in ten geographical regions across the country. Each RCE is composed of the investigators from the lead institution that submitted the application and collaborating investigators at universities and research institutions within the consortium. The consortia have access to resources such as facilities and services within the RCE and the National Biocontainment Laboratories and the Regional Biocontainment Laboratories.

Regional Centers of Excellence for Biodefense and Emerging Infectious Diseases
Region I: New England Regional Center of Excellence for Biodefense and Emerging Infectious Diseases
Harvard University
Boston, MA
Region II: Northeast Biodefense Center
Wadsworth Center of the New York State Department of Health
Albany, NY
Region III: Middle-Atlantic Regional Center of Excellence for Biodefense and Emerging Infectious Diseases Research
University of Maryland, Baltimore
Baltimore, MD
Region IV: Southeast Regional Center of Excellence for Biodefense and Emerging Infections
Duke University
Durham, NC
Region V: Great Lakes Regional Center of Excellence for Biodefense and Emerging Infectious Diseases Research
University of Chicago
Chicago, IL
Region VI: Western Regional Center of Excellence for Biodefense and Emerging Infectious Diseases
University of Texas Medical Branch
Galveston, TX
Region VII: Midwest Regional Center of Excellence for Biodefense and Emerging Infectious Diseases Research
Washington University in St. Louis
St. Louis, MO
Region VIII: Rocky Mountain Regional Center of Excellence for Biodefense and Emerging Infectious Diseases Research
Colorado State University
Fort Collins, CO
Region IX: Pacific Southwest Regional Center of Excellence for Biodefense and Emerging Infectious Diseases
University of California, Irvine
Irvine, CA
Region X: Northwest Regional Center of Excellence for Biodefense and Emerging Infectious Diseases Research
University of Washington, Seattle
Seattle, WA

 

 

Biosafety Level 4 Labs and BSL Information

This map displays major Biosafety Level 4 (BSL-4) facilities around the world according to data collected by FAS in 2010 and 2011. These high-containment facilities are used to conduct beneficial research on dangerous and emerging pathogens.

http://fas.org/programs/bio/biosafetylevels.html
The data behind this map of BSL-4 labs worldwide is freely available on Google Fusion Tables. Looking for the old map that also conatined some BSL-3 Labs? View it here. There are many thousands of BSL-3-capable labs worldwide, so they have been left off this new version of the map to focus on BSL-4 labs and enchance its usefulness.

Biosafety Level Information

BSL-4, Biosafety Level 4

Required for work with dangerous and exotic agents which pose a high individual risk of life-threatening disease. The facility is either in a separate building or in a controlled area within a building, which is completely isolated from all other areas of the building. Walls, floors, and ceilings of the facility are constructed to form a sealed internal shell which facilitates fumigation and is animal and insect proof. A dedicated non-recirculating ventilation system is provided. The supply and exhaust components of the system are balanced to assure directional airflow from the area of least hazard to the area(s) of greatest potential hazard. Within work areas of the facility, all activities are confined to Class III biological safety cabinets, or Class II biological safety cabinets used with one-piece positive pressure personnel suits ventilated by a life support system. The Biosafety Level 4 laboratory has special engineering and design features to prevent microorganisms from being disseminated into the environment. Personnel enter and leave the facility only through the clothing change and shower rooms, and shower each time they leave the facility. Personal clothing is removed in the outer clothing change room and kept there. A specially designed suit area may be provided in the facility to provide personnel protection equivalent to that provided by Class III cabinets. The exhaust air from the suit area is filtered by two sets of HEPA filters installed in series. Supplies and materials needed in the facility are brought in by way of double-doored autoclave, fumigation chamber, or airlock, which is appropriately decontaminated between each use. Viruses assigned to Biosafety Level 4 include Crimean-Congo hemorrhagic fever, Ebola, Junin, Lassa fever, Machupo, Marburg, and tick-borne encephalitis virus complex (including Absettarov, Hanzalova, Hypr, Kumlinge, Kyasanur Forest disease, Omsk hemorrhagic fever, and Russian Spring-Summer encephalitis).

BSL-3, Biosafety Level 3

Applicable to clinical, diagnostic, teaching, and research or production facilities involving indigenous or exotic strains of agents which may cause serious or potentially lethal disease as a result of exposure by inhalation. All procedures involving the manipulation of infectious material are conducted within biological safety cabinets or other physical containment devices, or by personnel wearing appropriate personal protective clothing and equipment. The laboratory has special engineering and design features. A ducted exhaust air ventilation system is provided. This system creates directional airflow that draws air from “clean” areas toward “contaminated” areas. The High Efficiency Particulate Air (HEPA)-filtered exhaust air from Class II or Class III biological safety cabinets is discharged directly to outside or through the building exhaust system. The typical HEPA filter removes 99.97% of all particles that are 0.3 micron or larger in size, which means that all microbial agents will be trapped in the filter. Biosafety Level 3 practices, containment equipment, and facilities are recommended for manipulations of cultures or work involving production volumes or concentrations of cultures associated with most biological warfare agents.

 

BSL-2, Biosafety Level 2

Suitable for work involving agents of moderate potential hazard to personnel and the environment. Agents which may produce disease of varying degrees of severity from exposure by injection, ingestion, absorption, and inhalation, but which are contained by good laboratory techniques are included in this level. Biosafety Level 2 practices, containment equipment, and facilities are recommended for activities using clinical materials and diagnostic quantities of infectious cultures associated with most biological warfare agents.

 

BSL-1, Biosafety Level 1

Suitable for work involving well-characterized agents of no known or of minimal potential hazard to laboratory personnel and the environment. The laboratory is not necessarily separated from the general traffic patterns in the building. Work is generally conducted on open bench tops using standard microbiological practices. Special containment equipment is not required or generally used. This is the type of laboratory found in municipal water- ing laboratories, in high schools, and in some community colleges.

 

Biosafety Level Information
For more information about BSL facilities in the United States and worldwide, please see the links below. 

 

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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

Posted on October 7, 2014. Filed under: Biology, Blogroll, Business, Chemistry, Communications, Demographics, Diasters, Documentary, Economics, Employment, Faith, Family, government spending, Health Care, Medical, Medicine, National Security Agency (NSA_, People, Philosophy, Photos, Politics, Raves, Science, Security, Strategy, Talk Radio, Video, Welfare, Wisdom | Tags: , , , , , , , , , , , , , , , , , , , , |

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The Pronk Pops Show Podcasts

Pronk Pops Show 344: October 6, 2014

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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

The_Hot_Zone_(cover)f and b cover of book1coming-plague-side

How Flu Viruses Attack National Geographic

Ebola could be spread through air in tight quarters, some scientists fear

Max Alert! EBOLA Bodily Fluids Readily Airborne Weaponizable

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

Inhalation Ebola: Governments Ready For World War Ebola

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

Threading the NEIDL – Inside a BSL-4 Lab (OFFICIAL TRAILER)

What Happens When You Are Infected With The Ebola Virus? Common Cold,Bleeding Out The Ears And Eyes

Judge Jeanine Pirro Opening Statement – Ebola In The U.S.A. – Are Americans Safe?

Judge Jeanine Pirro – The Ebola Threat – Report Of Possible Cases Grow In The U.S.

Obama says US working on new ways to screen passengers for Ebola Daily Mail Online

Pandemic Infectious Diseases: Bacteria Viruses Parasites BBC Horizon Documentary

The Pandemic’s First Casualty — The Truth

Spanish nurse first to contract Ebola outside West Africa

Reckless Judge & 2 Women went in Ebola Infected Dallas Apartment

County Judge Clay Jenkins Stupidest Dumbest Politician in Texas Dallas Ebola Clueless

Clay Jenkins on Ebola

Dallas County Judge Clay Jenkins Weighs in on Ebola – Why? October 1, 2014

Family of Dallas Ebola patient not showing symptoms but has been quarantined

EXCLUSIVE VIDEO: Judge Clay Jenkins Explains Border Children Decision

Dallas County Judge Clay Jenkins: We can show compassion for illegals by throwing billions of dollar

Ebola Virus Outbreaks – WARNING

Ebola Outbreak: Propaganda Decoded

What is a Pandemic?

Hospitals “Full-Up”: The 1918 Influenza Pandemic

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

Spanish Flu: The Forgotten Fallen

The world’s deadliest virus Ebola Plague Fighters Nova Documentary

Ebola – What You’re Not Being Told

Dallas Ebola Victim Acquired His Infection On His Aircraft +50% Probability

Aerosolizing ONE DROP of EBOLA = 1/2 MILLION DEAD

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

CDC Warns On AIRBORNE EBOLA

Tracking the travel of Ebola patient

How the CDC uses contact tracing to stop Ebola’s spread

‘Contact tracing': Tracking Ebola in the U.S. | USA NOW

Has The Ebola Pandemic Started?

Ebola in Dallas: Here’s Why This Case is Different

Laurie Garrett: What can we learn from the 1918 flu?

Should an experimental drug be used to treat Ebola?

Unprecedented Ebola outbreak crosses borders in West Africa

Author tracks Ebola outbreaks over decades, calls virus “Jack The Ripper”

Ebola Virus Symptoms | Ebola Virus effects on Human Body

What is Ebola? – Truthloader

The Hot Zone by Richard Preston Audiobook 1 of 8

Pandemic Education and Prevention (w/ CC)

CDC’s Ebola Containment Failure by Design

CDC Director: Ebola Travel Ban Will Only Make It Worse

Ebola Rolls Out Exactly As Predicted

the Ebola hot zone

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

Fuel Air Bomb Outbreak 1995

Outbreak, biological weapon scene

 

 

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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    (3) Stone, Oliver (1996-09-02). “Who’s That in the Oval Office?”. Books News & Reviews. The New York Times Company. Archived from the original on 2009-04-10. Retrieved 2014-09-10.
  119. Jump up^ Rouquet P, Froment JM, Bermejo M, Kilbourn A, Karesh W, Reed P, Kumulungui B, Yaba P, Délicat A, Rollin PE, Leroy EM (Feb 2005). “Wild animal mortality monitoring and human Ebola outbreaks, Gabon and Republic of Congo, 2001–2003″ (Free full text). Emerging Infectious Diseases 11 (2): 283–290.doi:10.3201/eid1102.040533. ISSN 1080-6040.PMC 3320460. PMID 15752448.
  120. ^ Jump up to:a b Leroy EM, Rouquet P, Formenty P, Souquière S, Kilbourne A, Froment JM, Bermejo M, Smit S, Karesh W, Swanepoel R, Zaki SR, Rollin PE (2004). “Multiple Ebola virus transmission events and rapid decline of central African wildlife”. Science 303(5656): 387–390. Bibcode:2004Sci…303..387L.doi:10.1126/science.1092528. PMID 14726594.
  121. Jump up^ Choi JH, Croyle MA (2013). “Emerging targets and novel approaches to Ebola virus prophylaxis and treatment”. BioDrugs27 (6): 565–83. doi:10.1007/s40259-013-0046-1.PMID 23813435.
  122. Jump up^ Ebola ‘kills over 5,000 gorillas’. BBC. 2006-12-08. Retrieved 2009-05-31.
  123. Jump up^ Formenty P, Boesch C, Wyers M, Steiner C, Donati F, Dind F, Walker F, Le Guenno B (1999). “Ebola virus outbreak among wild chimpanzees living in a rain forest of Côte d’Ivoire”. The Journal of infectious diseases. 179. Suppl 1 (s1): S120–S126.doi:10.1086/514296. PMID 9988175.
  124. ^ Jump up to:a b Weingartl HM, Nfon C, Kobinger G (2013). “Review of Ebola virus infections in domestic animals”. Dev Biol (Basel) 135: 211–8.doi:10.1159/000178495. PMID 23689899.
  125. Jump up^ McNeil Jr, Donald G. (2009-01-24). “Pig-to-Human Ebola Case Suspected in Philippines”. New York Times. Retrieved 2009-01-26.
  126. Jump up^ McCormick & Fisher-Hoch 1999, p. 300
  127. Jump up^ Allela L, Boury O, Pouillot R, Délicat A, Yaba P, Kumulungui B, Rouquet P, Gonzalez JP, Leroy EM (2005). “Ebola virus antibody prevalence in dogs and human risk”. Emerging Infect. Dis. 11(3): 385–90. doi:10.3201/eid1103.040981. PMC 3298261.PMID 15757552.
  128. Jump up^ Briggs H. “BBC News – Ebola: Experimental drugs and vaccines”. BBC News. Retrieved 2014-08-08.
  129. Jump up^ Gaffney A (2014-08-07). “Regulatory Explainer: What You Need to Know About the Regulation of Ebola Treatments”. Regulatory Affairs Professionals Society (RAPS).
  130. Jump up^ “Ethical considerations for use of unregistered interventions for Ebola virus disease (EVD)”. WHO. Retrieved 20 August 2014.
  131. ^ Jump up to:a b “FDA warns consumers about fraudulent Ebola treatment products”. Retrieved 20 August 2014.
  132. Jump up^ “Three leading Ebola experts call for release of experimental drug”. Los Angeles Times. 2014-08-06.
  133. Jump up^ “In Ebola Outbreak, Who Should Get Experimental Drug?”. The New York Times. 2014-08-08.
  134. ^ Jump up to:a b Pollack, Andrew (07 August 2014). “Second drug is allowed for treatment of Ebola”. The New York Times. Retrieved 8 August 2014.
  135. Jump up^ Perrone, Matthew (10/6/14). “Experimental Drug Provided to Dallas Ebola Patient”. ABC. AP. Retrieved 10/6/14.
  136. Jump up^ “Forbes – BioCryst to Launch NHP Ebola Drug Safety, Efficacy Studies ‘Within Weeks'”. Forbes. 29 August 2014. Retrieved 7 October 2014.
  137. Jump up^ “French nurse cured of Ebola contracted in Liberia”. MSN. Retrieved 7 October 2014.
  138. Jump up^ Kroll, David (26 August 2014). “How will we know if the Ebola drugs worked?”. Forbes. Retrieved 1 October 2014.
  139. Jump up^ Nathan Seppa (29 August 2014). “ZMapp drug fully protects monkeys against Ebola virus”. Science News (Society for Science & the Public). Retrieved 1 October 2014.
  140. Jump up^ Oestereich L, Lüdtke A, Wurr S, Rieger T, Muñoz-Fontela C, Günther S (2014). “Successful treatment of advanced Ebola virus infection with T-705 (favipiravir) in a small animal model”. Antiviral Res. 105: 17–21. doi:10.1016/j.antiviral.2014.02.014.PMID 24583123.
  141. Jump up^ “French nurse cured of Ebola contracted in Liberia”. MSN. Retrieved 7 October 2014.
  142. Jump up^ “BioCryst to Launch NHP Ebola Drug Safety, Efficacy Studies ‘Within Weeks’. David Kroll, Forbes Magazine. 29 August 2014″. Forbes. 29 August 2014. Retrieved 5 October 2014.
  143. Jump up^ “DURHAM: BioCryst receives additional funding for Ebola drug – WNCN: News, Weather”. WNCN. 18 September 2014. Retrieved 5 October 2014.
  144. Jump up^ WNCN Staff (3 September 2014). “Chimerix experimental drug shows promise in fighting Ebola virus. WNCN News, 4 September 2014″. Retrieved 7 October 2014.
  145. Jump up^ “Chimerix Announces Emergency Investigational New Drug Applications for Brincidofovir Authorized by FDA for Patients With Ebola Virus Disease”. Retrieved 7 October 2014.
  146. Jump up^ “Doctor treats Ebola with HIV drug in Liberia — seemingly successfully. Elizabeth Cohen, CNN news. 29 September 2014″. CNN. 27 September 2014. Retrieved 7 October 2014.
  147. Jump up^ “A Liberian doctor is using HIV drugs to treat Ebola victims. The NIH is intrigued. Elahe Izadi, Washington Post. 2 October 2014″. Washington Post. Retrieved 7 October 2014.
  148. Jump up^ Geisbert TW, Lee AC, Robbins M, Geisbert JB, Honko AN, Sood V, Johnson JC, de Jong S, Tavakoli I, Judge A, Hensley LE, Maclachlan I (29 May 2010). “Postexposure protection of non-human primates against a lethal Ebola virus challenge with RNA interference: A proof-of-concept study”. The Lancet 375 (9729): 1896–1905. doi:10.1016/S0140-6736(10)60357-1.PMID 20511019.
  149. Jump up^ Warren TK, Warfield KL, Wells J, Swenson DL, Donner KS, Van Tongeren SA, Garza NL, Dong L, Mourich DV, Crumley S, Nichols DK, Iversen PL, Bavari S (September 2010). “Advanced antisense therapies for postexposure protection against lethal filovirus infections”. Nature Medicine 16 (9): 991–994.doi:10.1038/nm.2202. PMID 20729866.
  150. Jump up^ Helen Branswell (3 August 2014). “Nancy Writebol, U.S. missionary, didn’t get TKM-Ebola drug, Tekmira says”. CBC News. Canadian Press.
  151. Jump up^ Heald AE, Iversen PL, Saoud JB, Sazani P, Charleston JS, Axtelle T, Wong M, Smith WB, Vutikullird A, Kaye E (25 August 2014). “Safety and pharmacokinetic profiles of phosphorodiamidate morpholino oligomers with activity against Ebola virus and Marburg virus: results of two single ascending dose studies”. Antimicrobial Agents and Chemotherapy.doi:10.1128/AAC.03442-14. PMID 25155593.
  152. Jump up^ Johansen LM, Brannan JM, Delos SE, Shoemaker CJ, Stossel A, Lear C, Hoffstrom BG, Dewald LE, Schornberg KL, Scully C, Lehár J, Hensley LE, White JM, Olinger GG (2013). “FDA-approved selective estrogen receptor modulators inhibit Ebola virus infection”. Sci Transl Med 5 (190): 190ra79.doi:10.1126/scitranslmed.3005471. PMC 3955358.PMID 23785035. Lay summaryHealthline Networks, Inc.
  153. Jump up^ Gehring G, Rohrmann K, Atenchong N, Mittler E, Becker S, Dahlmann F, Pöhlmann S, Vondran FW, David S, Manns MP, Ciesek S, von Hahn T (2014). “The clinically approved drugs amiodarone, dronedarone and verapamil inhibit filovirus cell entry”. J. Antimicrob. Chemother. 69 (8): 2123–31.doi:10.1093/jac/dku091. PMID 24710028.
  154. Jump up^ Tan, DX; Reiter, RJ; Manchester, LC (2014 Sep 27). “Ebola virus disease: Potential use of melatonin as a treatment.”. Journal of pineal research. PMID 25262626.
  155. Jump up^ “Blood transfusion named as priority treatment for Ebola”. Nature. Retrieved 11 September 2014.
  156. Jump up^ “Use of convalescent whole blood or plasma collected from patients recovered from Ebola virus disease Empirical treatment during outbreaks”. WHO. Retrieved 4 October 2014.
  157. ^ Jump up to:a b c d “Statement on the WHO Consultation on potential Ebola therapies and vaccines”. WHO. 5 September 2014. Retrieved 1 October 2014.
  158. Jump up^ Mupapa K, Massamba M, Kibadi K, Kuvula K, Bwaka A, Kipasa M, Colebunders R, Muyembe-Tamfum JJ (1999). “Treatment of Ebola hemorrhagic fever with blood transfusions from convalescent patients. International Scientific and Technical Committee”. J. Infect. Dis. 179 Suppl 1: S18–23.doi:10.1086/514298. PMID 9988160.
  159. Jump up^ Saphire EO (2013). “An update on the use of antibodies against the filoviruses”. Immunotherapy 5 (11): 1221–33.doi:10.2217/imt.13.124. PMID 24188676.
  160. Jump up^ Gulland, A. (8 September 2014). “First Ebola treatment is approved by WHO”. BMJ 349 (sep08 7): g5539–g5539.doi:10.1136/bmj.g5539. PMID 25200068.
  161. Jump up^ Xu L, Sanchez A, Yang Z, Zaki SR, Nabel EG, Nichol ST, Nabel GJ (January 1998). “Immunization for Ebola virus infection”.Nature Medicine 4 (1): 37–42. doi:10.1038/nm0198-037.PMID 9427604.
  162. ^ Jump up to:a b Sullivan NJ, Geisbert TW, Geisbert JB, Xu L, Yang ZY, Roederer M, Koup RA, Jahrling PB, Nabel GJ (7 August 2003). “Accelerated vaccination for Ebola virus haemorrhagic fever in non-human primates”. Nature 424 (6949): 681–684.doi:10.1038/nature01876. PMID 12904795.
  163. Jump up^ Geisbert TW, Daddario-Dicaprio KM, Geisbert JB, Reed DS, Feldmann F, Grolla A, Ströher U, Fritz EA, Hensley LE, Jones SM, Feldmann H (9 December 2008). “Vesicular stomatitis virus-based vaccines protect nonhuman primates against aerosol challenge with Ebola and Marburg viruses”. Vaccine 26 (52): 6894–6900. doi:10.1016/j.vaccine.2008.09.082.PMC 3398796. PMID 18930776.
  164. Jump up^ Geisbert TW, Daddario-Dicaprio KM, Lewis MG, Geisbert JB, Grolla A, Leung A, Paragas J, Matthias L, Smith MA, Jones SM, Hensley LE, Feldmann H, Jahrling PB (November 2008).“Vesicular stomatitis virus-based Ebola vaccine is well-tolerated and protects immunocompromised nonhuman primates”. In Kawaoka, Yoshihiro. PLoS Pathogens 4 (11): e1000225.doi:10.1371/journal.ppat.1000225. PMC 2582959.PMID 19043556.
  165. Jump up^ Geisbert TW, Geisbert JB, Leung A, Daddario-DiCaprio KM, Hensley LE, Grolla A, Feldmann H (2009). “Single-injection vaccine protects nonhuman primates against infection with Marburg virus and three species of Ebola virus”. Journal of Virology 83 (14): 7296–7304. doi:10.1128/JVI.00561-09.PMC 2704787. PMID 19386702.
  166. Jump up^ Warfield KL, Swenson DL, Olinger GG, Kalina WV, Aman MJ, Bavari S (2007). “Ebola virus‐like particle–based vaccine protects nonhuman primates against lethal ebola virus challenge”. The Journal of Infectious Diseases 196: S430–S437.doi:10.1086/520583. PMID 17940980.
  167. ^ Jump up to:a b Oplinger, Anne A. (2003-11-18). NIAID Ebola vaccine enters human trial. Bio-Medicine.
  168. ^ Jump up to:a b “Ebola/Marburg vaccine development” (Press release). National Institute of Allergy and Infectious Diseases. 15 September 2008.
  169. Jump up^ Martin JE, Sullivan NJ, Enama ME, Gordon IJ, Roederer M, Koup RA, Bailer RT, Chakrabarti BK, Bailey MA, Gomez PL, Andrews CA, Moodie Z, Gu L, Stein JA, Nabel GJ, Graham BS (November 2006). “A DNA vaccine for Ebola virus is safe and immunogenic in a phase I clinical trial”. Clinical and Vaccine Immunology 13 (11): 1267–1277. doi:10.1128/CVI.00162-06.PMC 1656552. PMID 16988008.
  170. Jump up^ Bush, L (21 April 2005). “Crucell and NIH sign Ebola vaccine manufacturing contract”. Pharmaceutical Technology 29. p. 28.
  171. Jump up^ Jones SM, Feldmann H, Ströher U, Geisbert JB, Fernando L, Grolla A, Klenk HD, Sullivan NJ, Volchkov VE, Fritz EA, Daddario KM, Hensley LE, Jahrling PB, Geisbert TW (July 2005). “Live attenuated recombinant vaccine protects nonhuman primates against Ebola and Marburg viruses”. Nature Medicine 11 (7): 786–790. doi:10.1038/nm1258. PMID 15937495.
  172. Jump up^ “Viral Hemorrhagic Fever”. Infectious Disease Emergencies. San Francisco Department of Public Health. Ribavirin Therapy. Retrieved 24 October 2014.
  173. Jump up^ Phoolcharoen W, Dye JM, Kilbourne J, Piensook K, Pratt WD, Arntzen CJ, Chen Q, Mason HS, Herbst-Kralovetz MM (2011). “A nonreplicating subunit vaccine protects mice against lethal Ebola virus challenge”. Proc. Natl. Acad. Sci. U.S.A. 108 (51): 20695–700. Bibcode:2011PNAS..10820695P.doi:10.1073/pnas.1117715108. PMC 3251076.PMID 22143779. Lay summaryBBC News.
  174. Jump up^ “Canadian-made Ebola vaccine used after German lab accident”. CBCNews (Canadian Broadcasting Corporation). Canadian Press. 20 March 2009. Retrieved 2 August 2014.
  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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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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Obama Spreading Communicable Diseases Across United States With Illegal Aliens in Schools and Communities– TB, Virus, Ebola — What’s Next? — Pandemic! — Videos

Posted on October 5, 2014. Filed under: Airplanes, American History, Biology, Blogroll, Business, Chemistry, Communications, Computers, Diasters, Documentary, Economics, Family, Federal Government, Food, Foreign Policy, Freedom, government, government spending, Health Care, history, Illegal, Immigration, liberty, Life, Links, Meat, media, Medical, Photos, Politics, Psychology, Rants, Raves, Resources, Science, Security, Strategy, Talk Radio, Terrorism, Transportation, Video, Water, Wealth, Welfare, Wisdom | Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |

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Story 1: Obama Spreading Communicable Diseases Across United States With Illegal Aliens in Schools and Communities– TB, Virus, Ebola — What’s Next? — Pandemic! — Videos

graphic_InfectiousCommunication Diseases - Dayssymptoms-bloody-noseRhoVictim.003ebola-symptoms1Ebola-outbreak-graphicWhat-are-the-symptoms-of-Ebolaillness-flu3EbolaSymptoms3ebola-united-states-dallas-texas-meme-3

symptoms of tbtuberculosis-of-the-lungsCOMMUNICABLEfunny-pictures-barack-obama-talking-about-illegal-aliens-are-now-called-undocumented-democratsobama_bull

Story 1: When Will Obama Close United States Airports and Borders To Flights and Travelers From Ebola Virus Disease Infected Countries Such As Liberia, Guinea, Sierra Leone and Nigeria? Time To Follow Saudi Arabia’s Stringent Ebola Checks! — Videos

 

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Michael Osterholm on the Bird Flu in China

Pandemic Influenza: Science, Economics, and Foreign Policy: Session Two: The Economics

Watch experts analyze the economic effects of pandemic influenza including on the labor force and trade.
This session was part of a CFR symposium, Pandemic Influenza: Science, Economics, and Foreign Policy, which was cosponsored with Science Magazine.

SPEAKERS:
Yanzhong Huang, Director, Center for Global Health Studies, Seton Hall University
Andrew Jack, Pharmaceutical Correspondent, Financial Times
Michael T. Osterholm, Director, Center for Infectious Disease Research and Policy (CIDRAP), University of Minnesota (via teleconference)
PRESIDER:
Robert E. Rubin, Co-Chair, Council on Foreign Relations; Former U.S. Secretary of the Treasury

 

Saudi Arabia bans Ebola-stricken countries from hajj pilgrimage

With the arrival of approximately two million people from around the world in Saudi Arabia for the annual hajj pilgrimage, there are a group of pilgrims who were not welcomed.

The Saudi government has banned the entry of travelers from three countries currently dealing with the Ebola epidemic: Liberia, Guinea and Sierra Leone. The decision to reject visa requests from these countries has affected 7,400 people, according to the Associated Press.

Hospitals in Saudi Arabia are also preparing in the event of an outbreak by setting up isolation and surgery units as well as dispatching medical staff to airports.

Despite banning pilgrim seekers from West Africa, Saudi officials are granting visas to pilgrims travelling from Nigeria. Saudi Arabia’s King Abdulaziz International Airport has provided them with two exclusive lounges as a precaution.

“So far 118,000 pilgrims have arrived by air from Nigeria. There was not a single suspected case of the deadly virus among anyone of them,” said Abdul Ghani Al-Malki, supervisor of hajj affairs at the airport.

Saudi officials have also been closely monitoring incoming flights from Kenya, Congo and other countries with reported cases of Ebola. Al-Malki told the local Saudi Gazettethat airport’s health inspection center ensured that planes and their passengers were not only free of Ebola, but other contagious diseases as well. “We have double-checked the papers that prove the airplanes had been sprayed twice before taking off to their destinations.”

The current death toll from Ebola in West Africa rose to 3,338, according to the World Health Organization report released Wednesday.

http://www.pbs.org/newshour/rundown/saudi-arabia-bans-pilgrims-ebola-stricken-countriespilgrims-ebola-stricken-countries-banned-hajj/

 

Saudi Arabia plays down Ebola concern for Hajj pilgrimage

Some in the crowd wore face masks – a possible precaution over Ebola fears

Two million Muslims have begun the annual Hajj pilgrimage, a five-day ritual central to Islam.

This year there have been concerns pilgrims may spread the contagious diseases Ebola and MERS.

Saudi Arabia, where the Hajj takes place, played down fears on Ebola, having banned pilgrims from Sierra Leone, Guinea and Liberia.

Their decision has excluded 7,400 Muslims, though it is estimated that 1.4m of the pilgrims are international.

Some of the numbers involved in 2014’s Hajj – in 60 seconds

Saudi Arabia has claimed this year’s Hajj is Ebola free as pilgrims flooded into Mina, 5km (three miles) from the holy city of Mecca, for the start of the pilgrimage.

As well as refusing visas to those from the three countries worst hit by Ebola, Saudi authorities asked all visitors to fill out medical screening cards and detail their travels over the past three weeks.

But Ebola is not the only disease concerning the Saudi government.

MERS, or Middle East Respiratory Syndrome, hit Saudi Arabia badly in the spring of this year.

Since 2012, there have been more than 750 cases of MERS in the country. Of this total 319 people died, some of whom were health workers.

Grey line

The meaning of Hajj

Pilgrims walk around the Kaaba in Mecca, Saudi Arabia, archivePilgrims walk around the Kaaba in Mecca, the building is the most sacred place in Islam and the direction of prayer for Muslims
  • Hajj is an annual five-day pilgrimage which all able-bodied Muslims are required to perform at least once in their lives, if they can afford it
  • It is the fifth and final pillar of Islam and is supposed to cleanse Muslims of sin and bring them closer to each other and God
  • The pilgrims, or Hajjis, wear simple white garments called “ihram” which give them all equal status
  • Those going on the hajj are required to abstain from sex, not to argue, kill anything or hunt and to avoid shaving and cutting their nails
  • Pilgrims perform several rituals during the hajj including walking counter-clockwise seven times around the Kaaba in Mecca, drinking from the Zam Zam Well and performing a symbolic stoning of the devil.

http://www.bbc.com/news/world-middle-east-29461229

Will Airborne Ebola Become A Modern Global Plague?

The last several months have led to much confusion about the spread of the Ebola virus. Health officials and governments first denied that a serious threat existed and took no significant action to prevent its spread outside of West Africa. Then, after it had made it’s way to six different countries in the region, officials at the World Health Organization and the U.S. Centers for Disease Control started to panic. Apathy gave way to the real fear that we were facing a virus on a whole different scale than ever before.

At its current rate, some mathematical models show that the virus could infect anywhere from 20,000 to 100,000 by the end of the year, with over 4,000 people worldwide having been infected thus far. About 2,300 people, over 50% of those who have contracted it, have died.

Fired Up Obama to Immigration Activists: ‘No Force On Earth Can Stop Us’

‘Si se puede, si votamos! Yes, we can, if we vote!’

 BY DANIEL HALPER

A fired up President Barack Obama had a message to immigration activists at a dinner this evening in Washington, D.C.: “no force on earth can stop us.”

 

“The clearest path to change is to change [the voter turnout] number,” said Obama “Si se puede, si votamos! Yes, we can, if we vote!”

“You know, earlier this year, I had a chance to host a screening of the film Cesar Chavez at the White House, and I was reminded that Cesar organized for nearly 20 years before his first major victory. He never saw that time as a failure. Looking back, he said, I remember the families who joined our movement and paid dues long before there was any hope of winning contracts. I remember thinking then that with spirit like that, no force on earth could stop us.

“That’s the promise of America then and that’s the promise of America now. People who love this country can change it. America isn’t Congress. America isn’t Washington. America is the striving immigrant who starts a business or the mom who works two low-wage jobs to give her kids a better life. America is the union leader and the CEO who put aside their differences to make the economy stronger. America is the student who defies the odds to become the first in the family to go to college. The citizen who defies the cynics and goes out there and votes. The young person who comes out of the shadows to demand the right to dream. That’s what America is about.

“And six years ago, I asked you to believe, and tonight, I ask you to keep believing, not just in my ability to bring about change, but in your ability to bring about change. Because in the end, DREAMer is more than just a title, it’s a pretty good description of what it means to be an American.

http://engine.4dsply.com/Bridge/Index?width=850&height=650&url=%2FRedirect.engine%3FPerformanceTest%3Dnull%26MediaId%3D15307%26PId%3D17982%26MediaSegmentId%3D11932%26PoolId%3D26%26SiteId%3D523%26ZoneId%3D2029%26Country%3DUnited%20States%26Bid%3D10.57807%26MaxBid%3D16%26currentUrl%3Dhttp%253A%252F%252Fwww.weeklystandard.com%252Fblogs%252Ffired-obama-immigration-activists-no-force-earth-can-stop-us_808488.html

 

Patient Being Evaluated for Possible Ebola at D.C.’s Howard University Hospital

A patient with Ebola-like symptoms who had recently traveled to Nigeria is being treated at Howard University Hospital in Washington, D.C., a hospital spokesperson confirmed late Friday morning.

That person has been admitted to the hospital in stable condition and is isolated. The medical team is working with the CDC and other authorities to monitor the patient’s condition.

“In an abundance of caution, we have activated the appropriate infection control protocols, including isolating the patient,” said hospital spokesperson Kerry-Ann Hamilton in a statement. “Our medical team continues to evaluate and monitor progress in close collaboration with the CDC and the Department of Health.”

Hamilton did not share further details about the patient, citing privacy reasons, but said the hospital will provide updates as warranted.

The D.C. Department of Health released a statement shortly before 1 p.m. Wednesday, saying that the department has been working with the CDC and Howard University Hospital to monitor “any patients displaying symptoms associated with the Ebola virus.”

There are no confirmed cases of Ebola in D.C., said the statement.

At Shady Grove Adventist Hospital in Rockville, Maryland, a patient is in isolation with “flu-like symptoms and a travel history that matches criteria for possible Ebola,” according to a statement from the hospital. Lab results indicate the patient has another illness.

“We are working closely with the Montgomery County Health Department and State Department of Health and Mental Hygiene (DHMH) as well as the CDC to manage this case and to ensure we continue to be prepared to care for patients with Ebola symptoms,” the statement said.

“We will only be making an announcement if and when there is a laboratory confirmed case, and that announcement would be made in conjunction with the Maryland Department of Health and Mental Hygiene and the CDC,” Montgomery County Department of Health and Human Services spokesperson Mary Anderson said.

The White House announced Friday that senior administration officials will hold a briefing on the U.S. government’s response to the Ebola pandemic at 4:30 p.m., NBC News reported.

As public health advocates had warned, the raging Ebola outbreak in West Africa has begun to affect Westerners, though the disease is difficult to spread casually.

Thursday, news broke that a freelance NBC cameraman covering the outbreak in Monrovia, Liberia had tested positive for Ebola after experiencing symptoms of the disease.

The cameraman, Ashoka Mukpo, had been working with chief medical correspondent Dr. Nancy Snyderman. NBC News is flying Mukpo and the entire team back to the U.S. so Mukpo can be treated and the team can be quarantined for 21 days.

Snyderman told MSNBC’s Rachel Maddow that she and the rest of her crew have shown no signs of the disease and have taken precautions while covering the outbreak, including washing their hands with bleach.

The crew are quarantining themselves as a precaution.

Ebola is contagious only when infected people are showing symptoms, according to the Centers for Disease Control and Prevention. People who have been exposed to Ebola will show signs of it within 21 days of exposure, the CDC said.

“There is no risk to people who have been in contact with those who have been sick with Ebola and recovered, or people who have been exposed and have not yet shown symptoms,” said Dr. Thomas Frieden of the CDC.

On Tuesday, the CDC confirmed the first case of Ebola to be diagnosed in the United States. The patient, Thomas Eric Duncan, flew from his hometown of Monrovia, Liberia, and through Brussels, Belgium on Sept. 20 before entering the United States via Washington Dulles International Airport in Virginia. He then traveled on to Dallas-Fort Worth.

Duncan, a Liberian man with family in the United States, first went to Texas Health Presbyterian Hospital Sept. 25 but was sent home. He returned to the hospital via ambulance Sunday.

On Friday, he was listed in serious but stable condition.

http://www.nbcwashington.com/news/local/Patient-With-Ebola-Like-Symptoms-Being-Treated-at-Howard-University-Hospital-278025181.html

U.S. Ebola Screening Widens

Officials Say About 100 Individuals Will Be Monitored for Potential Exposure

The number of people in Texas who are being screened for potential exposure to Ebola expanded to approximately 100, and four members of a family close to the U.S. patient were ordered to remain in their Dallas home. (Photo: AP)

The number of people in Texas who are being screened for potential exposure to Ebola expanded Thursday to roughly 100, as health officials cast a wide net to try to prevent the one confirmed case of the disease from sparking an outbreak.

Four members of a family close to Thomas Eric Duncan, the Liberian man diagnosed with the virus, were ordered to remain in their Dallas home and not receive any visitors until at least Oct. 19, to pass the 21-day maximum incubation period for the often-deadly disease.

The 100 people being screened represent a “very wide net,” including some who possibly had brief encounters with Mr. Duncan, Texas health officials said. They added that the number is likely to drop as they narrow the list to those actually at potential risk of infection.

Thursday, an American freelance journalist in Liberia tested positive for the disease, his father and his employer, NBC News, said. The 33-year-old man is tentatively scheduled to be transported back to the U.S. on Sunday.

In Mr. Duncan’s case, Tom Frieden, director of the Centers for Disease Control and Prevention, said officials so far have identified only “a handful” of individuals who may have had close contact with him.

The public health search comes as authorities in Liberia grapple with how Mr. Duncan managed to leave their country and bring Ebola to the U.S. despite government efforts to stop transmission of the virus, a journey that took him from a neighborhood of tin-roof houses in a West African capital to an isolation ward at a Dallas hospital.

Before traveling to Texas via Belgium, Mr. Duncan escorted a woman to a treatment ward in Liberia’s capital, Monrovia, where she was turned away and died of the virus within hours, said Irene Seyou, Mr. Duncan’s next-door neighbor.

In a community near where U.S. victim Thomas Eric Duncan lived in Monrovia, many have died and children are worried they will be taken away. Glenna Gordon for The Wall Street Journal

On Sept. 16, several health workers arrived in Mr. Duncan’s neighborhood in Monrovia to investigate a report that a pregnant 18-year-old woman, recently sent home from a nearby clinic, had shown Ebola symptoms that included vomiting, diarrhea and bleeding, said Prince Toe and other members of the Ebola Response Team in the capital’s 72nd community.

But when the team arrived in the neighborhood, residents insisted the pregnant teenager had been in a car accident, said Mr. Toe, the unit’s supervisor. When the neighbors grew rowdy at being pressed for information, the team turned back, he said.

At Liberia’s airport, the temperatures of arriving and departing passengers are checked three times by security guards—at the entrance, before the check-in desk and at the metal detectors—to screen out those who display Ebola’s hallmark early symptom, a fever.

Passengers are asked to fill out questionnaires about whether they had been in contact with any Ebola victims. Mr. Duncan lied on those forms—and would be prosecuted for doing so if he returns to Liberia—the Associated Press reported Liberia’s government as saying Thursday.

Mr. Duncan is in an isolation unit at Texas Health Presbyterian Hospital in Dallas, which initially sent him home with antibiotics after he complained of illness, only to accept him on Sunday after he returned in an ambulance. Hospital officials have since conceded that they erred by not taking him in initially after he mentioned his symptoms and country of origin.

Hospital officials said Thursday that Mr. Duncan’s condition continued to be serious. Dr. Frieden of the CDC said Mr. Duncan’s physicians were discussing the possible use of experimental treatments with his family.

Edward Goodman, Texas Health Presbyterian Hospital’s epidemiologist, said the team of doctors treating Mr. Duncan has received guidelines from the CDC but that there is no specific treatment for Ebola other than supportive measures, such as keeping the patient well hydrated to avoid organ damage and supplying oxygen.

Most of the 100 people Texas is tracking for potential Ebola exposure haven’t been ordered to stay home. Officials said they ordered four of Mr. Duncan’s family members to remain in their home because the family disobeyed their request to stay there. They said the family, which was examined Thursday, hadn’t developed any symptoms. A law enforcement official is stationed outside their apartment to make sure they don’t leave.

Ebola is a highly contagious virus, but only if you come into contact with certain bodily fluids of those infected. What do scientists know about how it’s transmitted? WSJ’s Jason Bellini has #TheShortAnswer.

Judge Clay Jenkins, the highest elected official in Dallas County, said there were no plans to issue similar orders for other people. Local and state health officials said they had delivered groceries to the family and were arranging for a contractor to clean the apartment. Mr. Jenkins said it appeared that sealed bags filled with Mr. Duncan’s belongings, including his clothes and sheets, were still inside, and that the family had pushed mattresses against the wall.

Dallas Mayor Mike Rawlings sought to assure the public that the risk of contagion was minimal. “We’re getting the word out and people are starting to understand what has happened,” he said.

Still, at schools attended by five children who came into contact with Mr. Duncan, attendance was down to 86% from the 95% level that is normal, said Mike Miles, superintendent of the Dallas Independent School District, who added that custodians were doing extra cleaning.

While officials sought to control the panic over Ebola in Texas, some people who had come into contact with Mr. Duncan wondered why he hadn’t received treatment sooner.

Joe Joe Jallah said he met Mr. Duncan last week when visiting Mr. Jallah’s former wife, Louise Troh, the same woman Mr. Duncan had come to see in the U.S.

Ms. Troh declined to speak about the situation when reached by phone.

Mr. Jallah, who has a daughter with Ms. Troh, said he listened as Mr. Duncan described how dire things had become in Liberia, and how rigorous the health screenings were during his trip to the U.S.

Several days later, on Saturday, Mr. Jallah said he heard that Mr. Duncan had fallen ill at Ms. Troh’s apartment. Concerned, Mr. Jallah went back.

“He was lying down on the floor with a comforter. He said he was sick and that he had no appetite,” Mr. Jallah said.

“I said, ‘Did you go to the hospital?’ He said, ‘Yes, but they did nothing for me,’” Mr. Jallah recalled. “I said, ‘You should eat so you can gain strength.’”

The next day, Mr. Jallah said he returned after his daughter, Youngor Jallah, a nurse’s aide who visits her mother frequently, called, sounding frantic and saying that Mr. Duncan was still sick.

Ms. Jallah said Mr. Duncan had been up all night with diarrhea. His eyes were red, he seemed exhausted and had no appetite for the breakfast she made. He tried to drink some tea. Ms. Jallah took his temperature and it was 104, she said.

Ms. Jallah decided to call an ambulance. When emergency workers came, she informed them that Mr. Duncan was sick and had traveled to Dallas from a virus stricken-region in Africa. The workers put masks over their faces.

Ms. Jallah said she has since been told she and her family must stay in their home for 17 more days.

“I am concerned for myself. When I took his blood pressure, I never had no protection. I worry about my kids. My kids were over there with my mom,” she said.

“I am worried about him too,” she added.

http://online.wsj.com/articles/u-s-ebola-screening-grows-1412293227?mod=WSJ_hpp_sections_health

Michael Osterholm

From Wikipedia, the free encyclopedia

Michael T. Osterholm, Ph.D., M.P.H., is a prominent public health scientist and a nationally recognized biosecurity expert in the United States.[1] Osterholm is the director of the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota, a professor in the School of Public Health, and an adjunct professor in the University of Minnesota Medical School.[2]

Career

From 1975 to 1999, Osterholm served in various roles at the Minnesota Department of Health (MDH), including as state epidemiologist and Chief of the Acute Disease Epidemiology Section from 1984 to 1999. While at the MDH, Osterholm strengthened the departments role in infectious disease epidemiology, notably including numerous foodborne disease outbreaks, the association between tampons and toxic shock syndrome (TSS), and the transmission of hepatitis B and human immunodeficiency virus (HIV) in healthcare workers. Other work included studies regarding the epidemiology of infectious diseases in child-care settings, vaccine-preventable diseases (particularly Haemophilus influenzae type b and hepatitis B), Lyme disease, and other emerging and re-emerging infections.

From 2001 through early 2005, Osterholm, in addition to his role at CIDRAP, served as a Special Advisor to then–HHS Secretary Tommy G. Thompson on issues related to bioterrorism and public health preparedness. In April 2002, Osterholm was appointed to the interim management team to lead the Centers for Disease Control and Prevention (CDC), until the eventual appointment of Julie Gerberding as director.

Osterholm was appointed by Michael Leavitt, Secretary of the Department of Health and Human Services (HHS), to the National Science Advisory Board on Biosecurity in 2005.

Biosecurity

Osterholm has been particularly outspoken on the lack of international prepardness for an influenza pandemic.[3][4] Osterholm has also been an international leader against the use of biological agents as weapons targeted toward civilians.

Other

Osterholm serves on the editorial boards of five journals, and is a reviewer for another two dozen. He is a past president of the Council of State and Territorial Epidemiologists (CSTE) and has served on the CDC National Center for Infectious Diseases Board of Scientific Counselors from 1992 to 1997.

Osterholm serves on the IOM Forum on Emerging Infections. He has served on the IOM Committee on Emerging Microbial Threats to Health in the 21st Century and the IOM Committee on Food Safety, Production to Consumption, and he was a reviewer for the IOM Report on Chemical and Biological Terrorism. He is a frequent consultant to the World Health Organization (WHO), the National Institutes of Health (NIH), the Food and Drug Administration (FDA), the Department of Defense, and the CDC.

Honors

Osterholm has received numerous honors for his work, including an honorary doctorate from Luther College, and is a member of the Institute of Medicine of theNational Academy of Sciences.

References

  1. Jump up^ “Plague War: Interviews: Michael Osterholm”. Frontline. PBS. 1998-10-01. Retrieved 2008-07-02.
  2. Jump up^ “Global Conference 2006″. Milken Institute. 2006-04-24. Retrieved 2008-07-01.
  3. Jump up^ “Renewed warning over flu pandemic”. BBC News. 2005-05-25. Retrieved 2008-07-01.
  4. Jump up