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 — Videos
Rpt: Obama Admin May Planning Executive Action On Amnesty – 34M Green Cards? – America’s Newsroom
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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.
Solicitation Number: HSSCCG-14-R-00028
Agency: Department of Homeland Security
Office: Citizenship & Immigration Services
Location: USCIS Contracting Office
There have been modifications to this notice. You are currently viewing the original synopsis. To view the most recent modification/amendment, click here
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.
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.)
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.
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).
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.
Unlike most other federal agencies, USCIS is funded almost entirely by user fees. 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.
USCIS consists of 18,000 federal employees and contractors working at 250 offices around the world.
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. 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.
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).
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.
The eligibility for employment authorizations are detailed in the Federal Regulations at 8 C.F.R. §274a.12. 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. 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 (seeUSCIS 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.
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 .
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
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.
The Department of Homeland Security announced Tuesday that all travelers from Ebola outbreak countries in West Africa will be funneled through one of five U.S. airports with enhanced screening starting Wednesday.
Customs and Border Protection within the department began enhanced screening — checking the traveler’s temperature and asking about possible exposure to Ebola — at New York’s John F. Kennedy International Airport on Oct. 11.
Enhanced screening for travelers from Liberia, Sierra Leone and Guinea was expanded Oct. 16 to Washington Dulles, Chicago O’Hare, New Jersey’s Newark and Hartsfield-Jackson Atlanta international airports.
Those airports were supposed to screen 94% of the average 150 people per day arriving from the three countries. Lawmakers from other states asked for enhanced screening at their airports, too.
Some lawmakers have called for more restrictions, such as suspending visas or denying entry at ports for citizens from the three countries.
Jeh Johnson, secretary of Homeland Security, announced that travelers from West Africa must arrive at one of the five airports starting Wednesday.
“We are working closely with the airlines to implement these restrictions with minimal travel disruption,” Johnson said. “If not already handled by the airlines, the few impacted travelers should contact the airlines for rebooking as needed.”
The enhanced screening will apply to anyone who traveled recently to, from or through the three outbreak countries, according to the department’s announcement to be published Thursday in the Federal Register. Customs and Border Protection will work with airlines to identify potential travelers before they board, but airlines will be obligated to comply with the rule for carrying to the USA any passengers who recently traveled through the region, according to the filing.
The restrictions should affect only about nine travelers per day who would have arrived at other airports. Katie Cody, a spokeswoman for American Airlines, which serves Europe from hubs such as Philadelphia and Charlotte, said the airline has no concerns about the change.
“We have been tracking that, and we don’t have any concerns because the numbers are so small,” Cody said.
British Airways, which serves a variety of U.S. destinations other than the five targeted airports, said it would comply with the measures.
“Customers affected will be offered a refund or will be rerouted if there is availability,” spokeswoman Michele Kropf said.
Republican lawmakers offered muted praise but pressed for stricter travel restrictions.
“In addition to requiring all travelers from at-risk countries to fly through airports with enhanced screening measures in place, I continue to call on the administration to suspend all visas from Liberia, Sierra Leone and Guinea,” said Rep. Michael McCaul, R-Texas, the head of the House Homeland Security Committee.
The head of the House Judiciary Committee, Rep. Bob Goodlatte, R-Va., said a “real solution” is to deny entry to anyone from the three countries under a provision of the 1952 Immigration and Nationality Act.
“President Obama has a real solution at his disposal under current law and can use it at any time to temporarily ban foreign nationals from entering the United States from Ebola-ravaged countries,” Goodlatte said. “The vast majority of Americans strongly support such a travel moratorium, and I urge the president to take every step possible to protect the American people from danger.”
Rep. John Conyers of Michigan, the top Democrat on the House Judiciary Committee, said steering travelers through the five airports is a sensible precaution.
“As agreed upon by experts in both the public health and transportation communities, issuing a blanket travel ban would not only be counterproductive, but it would also irresponsibly impede getting much-needed supplies and relief to the countries that need it most,” Conyers said.
Roger Dow, CEO of the U.S. Travel Association, a trade group for all aspects of travel, praised the move to calm travel concerns while avoiding a travel ban.
“The Obama administration continues to heed the counsel of an overwhelming consensus of health and security experts and resist calls for any sort of travel ban on the grounds that it will be counterproductive to efforts to contain Ebola,” Dow said.
A Liberian national, Thomas Eric Duncan, who became the first person diagnosed with the disease in the USA after arriving in Dallas on Sept. 20, had a temperature of 97.3 degrees but didn’t tell airport officials in Monrovia, Liberia, that he had cared for a pregnant woman suffering from Ebola. He died Oct. 8, and two nurses who treated him have become infected.
Sen. Charles Schumer, D-N.Y., said the enhanced screening adds a layer of protection against Ebola entering the country.
“The Department of Homeland Security’s policy to funnel all passengers arriving from Ebola hot spots to one of these five equipped airports is a good and effective step towards tightening the net and further protecting our citizens,” Schumer said.
Obama and Johnson have said they will continue to monitor travel restrictions for possible changes.
“We are continually evaluating whether additional restrictions or added screening and precautionary measures are necessary to protect the American people and will act accordingly,” Johnson said.
Gabbard Calls On CDC To Increase Incubation Period To Prevent Ebola Spread
By Chad Blair
Rep. Tulsi Gabbard (D-HI) has called on the Center for Disease Control to implement stricter incubation guidelines for people who have been in contact with patients “confirmed or suspected” to have the Ebola virus.
According to a press release from her office, Gabbard is calling on the CDC to increase the quarantine and restriction period from the 21-day standard to 42 days, “based on the latest scientific studies and the World Health Organization report that the incubation period for the deadly Ebola virus can extend as long as 42 days.”
On Friday, Gabbard called for the “immediate suspension” of visas for citizens of Ebola-stricken West African nations as well as flights from those countries into the United States.
“Recent mistakes have revealed that the U.S. public health system is clearly not fully prepared to combat Ebola and prevent its spread in the United States,” she said in a statement.
Democrats like Gabbard are among a growing number who are “beginning to sound more like Republicans when they talk about Ebola. And Republicans are moving into overdrive with their criticism of the government’s handling of the deadly virus,” according to The Washington Post.
“The sharpened rhetoric, strategists say, suggests Democrats fear President Obama’s response to Ebola in the United States could become a political liability in the midterm election and Republicans see an opportunity to tie increasing concerns about the disease to the public’s broader worries about Obama’s leadership.”
The Washington Post notes, however, that Gabbard is “a liberal Democrat who is not in any danger of losing reelection.” It also reports that a Washington Post-ABC News poll showed that “67 percent of Americans would support restricting entry to the United States from countries fighting dealing with an Ebola crisis.”
How is the end of an Ebola outbreak decided and declared?
Information note – October 2014
Who decides the date?
The WHO Ebola outbreak response team is responsible for establishing the date of the end of the outbreak in collaboration with the affected country’s subcommittee for surveillance, epidemiology and laboratory.
How is the date determined?
An Ebola virus disease outbreak in a country can be declared over once 42 days have passed and no new cases have been detected. The 42 days represents twice the maximum incubation period for Ebola (21 days). This 42-day period starts from the last day that any person in the country had contact with a confirmed or probable Ebola case.
This includes health care workers who have been exposed to patients with Ebola virus disease, even if the health worker was wearing personal protective equipment and followed infection control procedures since such a person could be exposed accidentally without realizing it. In the setting of an Ebola treatment centre, the date of the last infectious contact is defined as the day when the last patient in the treatment centre tested negative for Ebola virus disease, using a real-time reverse-transcriptase polymerase chain reaction (RT-PCR) test.
If no new case has been detected at the end of this 42-day period, the risk of a further case is very low, and the outbreak is declared over.
Why 42 days?
The maximum incubation period for Ebola virus disease is 21 days. The 42-day period set by WHO (twice the maximum incubation period) provides a margin of security to cover any possible missed cases, uncertainty in reporting dates or hidden chains of transmission. (*)
During the 42-day period, the surveillance system should be fully functional, so that all contacts of the last patient are followed to detect possible chains of transmission.
What is the procedure to make the declaration?
The WHO Ebola outbreak response team in collaboration with the affected country’s subcommittee for surveillance, epidemiology and laboratory determines the date of the end of the epidemic. The government of the affected country, in collaboration with WHO and international partners, makes an official declaration of the end of the epidemic.
The Obama administration has reversed course on putting travel restrictions on those coming from three West African nations tainted with Ebola and is putting in place demands that they enter only through five U.S. airports prepared to screen for the virus.
Homeland Security Secretary Jeh Johnson said in a statement that the new rules will take effect Wednesday, bowing to demands from both parties that the U.S. do a better job so secure the border from Ebola.
“Today, as part of the Department of Homeland Security’s ongoing response to prevent the spread of Ebola to the United States, we are announcing travel restrictions in the form of additional screening and protective measures at our ports of entry for travelers from the three West African Ebola-affected countries,” said Johnson.
He said the rules require that anyone coming from Liberia, Sierra Leone or Guinea enter the U.S. only through the five airports where special Ebola screenings have been set up: New York’s John F. Kennedy, Newark Liberty, Washington Dulles, Atlanta’s Hartsfield-Jackson and Chicago’s O’Hare.
“All passengers arriving in the United States whose travel originates in Liberia, Sierra Leone or Guinea will be required to fly into one of the five airports that have the enhanced screening and additional resources in place. We are working closely with the airlines to implement these restrictions with minimal travel disruption. If not already handled by the airlines, the few impacted travelers should contact the airlines for rebooking, as needed,” said the statement.
He said that passengers flying into those airports on flights originating in Liberia, Sierra Leone and Guinea “are subject to secondary screening and added protocols, including having their temperature taken, before they can be admitted into the United States. These airports account for about 94 percent of travelers flying to the United States from these countries.”
There are no direct, non-stop commercial flights from Liberia, Sierra Leone or Guinea to the U.S.
NIH unit treating Dallas nurse for Ebola is one of 4 special isolation facilities in U.S.
By Lena H. Sun
It has a specially designed air-flow system to prevent contaminated air from leaving the patient room. It requires anyone who enters to be buzzed in. Personnel who work there receive special training in infection control to prevent the spread of bioterror agents, natural or man-made. It also has a tiny gym.
Welcome to the Special Clinical Studies Unit at the National Institutes of Health in Bethesda, Md. It is a 4,000-square-foot unit inside the NIH Clinical Center, the nation’s only hospital dedicated to research, which provides free state-of-the-art care to very sick patients from all over the world.
Now it’s home to its first confirmed Ebola patient, Nina Pham.
Pham is the first patient with a confirmed infectious disease to be cared for in the special seven-bed unit, center director John Gallin said in an interview Friday. Opened in 2010 for patients who need advanced isolation and extended stays, the unit was initially designed to take care of personnel working at the U.S. Army Medical Research Institute of Infectious Diseases in case they were exposed to infectious agents. In more recent years, it has been used to house healthy volunteers participating in live vaccine trials. The volunteers need to be monitored in a place where they can be safely quarantined, Gallin said. To accommodate those healthy volunteers, the unit has a dining room and a “tiny fitness area,” he said.
Pham, the first nurse diagnosed with Ebola after caring for a patient in Dallas, is in fair and stable condition, officials said Friday morning.
What does an Ebola isolation ward look like?
“We are giving her the best possible care on a symptomatic and systemic basis,” Anthony Fauci, director of NIH’s National Institute of Allergy and Infectious Diseases, said during a news conference.
Pham, 26, was transferred to the facility, one of four in the country with a special biocontainment unit, late Thursday. She was diagnosed with Ebola on Sunday, becoming the first person to contract the disease on U.S. soil. Pham had been part of the team that treated Thomas Eric Duncan, a Liberian man who flew to Dallas last month before being diagnosed with Ebola. Duncan died last week, four days before it was announced that Pham had contracted the disease.
“There is no specific therapy that has been proven to be effective against Ebola, and that’s why excellent medical care is critical,” Fauci said. He said Pham was “very, very tired” from her trip.
Patients infected with the Ebola virus require a large number of staffers to provide care around-the-clock. At NIH, that comes out to about 27 people a week — doctors, nurses, support staff — for one patient, Gallin said. With about 50 to 60 such personnel specially trained for infectious disease and critical care, NIH can only care for two Ebola patients at a time, he said.
The four facilities that provide such care were designed in the aftermath of the Sept. 11, 2001, terrorist attacks to protect against bioterrorism. Two of them, Emory University Hospital in Atlanta and the Nebraska Medical Center, are each treating one Ebola patient. The other facility is St. Patrick Hospital in Missoula, Mont.
They require staff to undergo more rigorous training in infection control, and staff must follow strict protocol for putting on and taking off personal protective equipment in a separate anteroom. Officials say meticulous attention to detail in following protocols is what sets them apart from other facilities.
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Emory has treated three Ebola patients, all of whom have recovered. The University of Nebraska treated one patient who recovered and is now caring for a freelance NBC cameraman. St. Patrick has not yet treated an Ebola patient. The hospital has received so many inquiries that it has set up a special hotline where they are transcribed and forwarded to the appropriate departments.
Bruce Ribner gives a tour of the Emory University Hospital isolation unit which has been used for treatment of patients infected with the Ebola virus. (Emory University via YouTube)
Unlike the Dallas hospital where Pham and another nurse were infected, which officials said most likely occurred because of a breach of protocol involving personal protective equipment, no health workers taking care of the Ebola patients at the special facilities have become infected.
“There is a step-by-step, checklisted procedure to putting on your personal protective equipment for when you go in to the patient’s room to perform your duties and when you come out,” said Mark Rupp, medical director of Nebraska Medical Center’s infection control department, which includes the special unit. “That’s the big difference with what goes on in our unit and what goes on in a regular intensive-care unit.”
The facilities have one person whose only job is to make sure health-care workers put on and take off their protective equipment correctly. At NIH, this person is dubbed “the Watson,” Gallin said, for the sidekick to Sherlock Holmes.
The Watson “has the authority to stop everything at any moment if someone looks like they’re breaking protocol,” Gallin said. The Watson has a checklist, like a pilot’s preflight checklist, and everything has to be done in that order. If not, the Watson can “scream at them and tell them to stop,” Gallin said, which apparently happened at least once Thursday night when doctors and staff were admitting Pham.
The protective gear that health-care workers take off is autoclaved (sanitized via pressurized steam) and then incinerated. Equipment that is not disposable is disinfected according to the manufacturer’s directions. The units also have negative air pressure to prevent germs from spreading beyond patient rooms. For Ebola patients, contaminated air is not such a concern because the disease is not transmitted through the air, but through contact with bodily fluids.
The seven-bed, 4,000-square-foot biocontainment unit at the National Institutes of Health Clinical Center in Bethesda, Md., is a state-of-the-art facility built to keep the world’s scariest pathogens from escaping. The four U.S. facilities are all different — NIH’s even has a gym — but they contain many of the same things. This layout is based on the unit at Emory University in Atlanta.
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Weekly Examiner: Obama appoints Ebola czar
Obama Appoints Ebola ‘czar’ As Anxiety Mounts
Source: Obama to name Ron Klain as Ebola czar
President Obama appoints Ron Klain as Ebola “czar”
Remarks of Ron Klain
Actor Kevin Spacey, Georgetown’s Ron Klain Discuss Politics and Ethics
Obama’s New Ebola ‘Czar’ Has NO Health or Medical Background!
Krauthammer: Obama Is a Narcissist ‘Surrounded by Sycophants’
President Obama Speaks on Ebola
Fast Facts on US Hospitals
The American Hospital Association conducts an annual survey of hospitals in the United States. The data below, from the 2012 AHA Annual Survey, are a sample of what you will find in AHA Hospital Statistics, 2014 edition. The definitive source for aggregate hospital data and trend analysis, AHA Hospital Statistics includes current and historical data on utilization, personnel, revenue, expenses, managed care contracts, community health indicators, physician models, and much more.
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For further information or customized data and research, contact the AHA Resource Center at (312) 422-2050 or email@example.com.
*Registered hospitals are those hospitals that meet AHA’s criteria for registration as a hospital facility. Registered hospitals include AHA member hospitals as well as nonmember hospitals. For a complete listing of the criteria used for registration, please see Registration Requirements for Hospitals.
**Community hospitals are defined as all nonfederal, short-term general, and other special hospitals. Other special hospitals include obstetrics and gynecology; eye, ear, nose, and throat; rehabilitation; orthopedic; and other individually described specialty services. Community hospitals include academic medical centers or other teaching hospitals if they are nonfederal short-term hospitals. Excluded are hospitals not accessible by the general public, such as prison hospitals or college infirmaries.
***System is defined by AHA as either a multihospital or a diversified single hospital system. A multihospital system is two or more hospitals owned, leased, sponsored, or contract managed by a central organization. Single, freestanding hospitals may be categorized as a system by bringing into membership three or more, and at least 25 percent, of their owned or leased non-hospital preacute or postacute health care organizations. System affiliation does not preclude network participation.
**** Network is a group of hospitals, physicians, other providers, insurers and/or community agencies that work together to coordinate and deliver a broad spectrum of services to their community. Network participation does not preclude system affiliation.
Ebola has officially made it to the US, but there is absolutely no reason to freak out. That’s in large part thanks to Emory University Hospital’s state-of-the-art isolation ward, which is better-equipped to field Ebola cases than any ordinary hospital in the country. Here’s a look at the tech that keeps doctors and nurses safe.
Emory is one of four high-level biocontainment patient care units in the US; the others are located at the National Institutes of Health in Maryland, Rocky Mountain Laboratories in Montana, and the University of Nebraska Medical Center. We spoke with Dr. Angela Hewlett, associate medical director at the Nebraska Biocontainment Patient Care Unit — the largest of the four facilities — about biocontainment suits, wearing three pairs of gloves, and custom air pressure systems.
Perhaps the most comfort Hewlett was able to provide is that none of the super-fancy tech that these four high-level isolation wards have at their disposal is even necessary for Ebola. “There’s a big fear factor with this illness but really, these types of patients can taken care of at any good healthcare facility,” says Dr. Hewlett.
That’s because the Ebola virus easily dies outside of the human body, so unless you’ve been handling a sick person’s blood or feces, you are almost certainly A-OK. Ebola is pretty darn hard to get compared to an airborne disease like SARS or even the regular old flu. But with a mortality rate of up to 90 per cent — and over 50 per cent with the strain in the current outbreak — we still need to keep doctors and nurses as safe as we can. Here’s how Nebraska Biocontainment Unit keeps diseases like Ebola — and much, much worse — from spreading in the hospital.
Negative air pressure. As with Emory in Atlanta, the isolation unit in Nebraska is isolated from the rest of the general hospital. It runs on its own air circulation system, and the air is passed through a high-efficiency particulate air (HEPA) filter before it is vented outside of the building. That’s the same kind of precautions that you would see in a biosafety level 4 lab (the highest) that works with deadly or highly contagious diseases.
In addition, the biocontainment unit has negative air pressure, which means that air pressure inside the isolation rooms is slightly lower than that outside. Essentially, air is gently sucked into the room, so particles from inside the room can’t float out when you open a door. As another line of protection, ultraviolet lights zap any viruses or bacteria in the air or on surfaces.
Full-body suits and THREE pairs of gloves. The Biocontainment Unit is equipped with gear that covers you head to toe, in some places three times over. That includes personal respirators, headgear, full-body suits and gloves. Healthcare workers wear three pairs, including one thick pair that protects against needle accidents, and then two pairs of ordinary gloves so they have an extra pair to work with patients.
Entering and exiting the room becomes an elaborate production because putting on and taking off all the gear can take more than 10 minutes each way. A second person assists to make sure every piece of equipment is put on right and there are no rips or tears in any of the protective gear. Afterwards, every piece of equipment is wiped down to kill the pathogen; in the case of Ebola, simple bleach is enough to do the trick. The full-body suit is discarded after each use.
Training and training and training. Having fancy technology is great but not if you don’t know how to use it properly. “They have to go through really extensive training,” says Hewlett of the the 30-person team that works in the unit. They get 80 hours of training before they can begin, followed by monthly meetings and quarterly drills, where the photos in this post were taken.
It’s worth reiterating that most of this equipment and these procedures go above and beyond protecting for Ebola. The air systems and full-body suits are really there to guard against possible airborne diseases, like smallpox or SARS or some highly contagious avian flu viruses that may emerge in the future.
In fact, the CDC’s current guidelines for treating Ebola in U.S. hospitals require only gloves, goggles, a facemask, and a gown in most situations. Even if someone inadvertently brings Ebola to other hospitals, it’s highly unlikely to spread in the U.S. The situation is different in Africa, where inadequate equipment and fear of healthcare workers has contributed to the worsening situation.
A State Department official did visit Nebraska to see whether the unit would be ready to accept any Ebola patients in the future, though the facility hasn’t yet been used despite being open for nine years. There hasn’t been a disease serious enough to merit it. “This is good thing,” says Dr. Hewlett, “However with world travel the way it is, it is inevitable these things are going to come eventually.” If and when Ebola does come to the U.S. again, we are definitely prepared, which is not something we can say about what else may be coming down the line.
Pictures: University of Nebraska Medical Center
Obama names Ron Klain as Ebola ‘czar’
President Obama tapped veteran government insider Ron Klain to coordinate his administration’s efforts to contain the Ebola virus Friday.
Klain, a former chief of staff to Vice Presidents Joe Biden and Al Gore, is well-known by Obama and White House aides. He was selected for his management experience and contacts throughout the government, White House spokesman Josh Earnest said.
“He is the right person for the job,” Earnest said, particularly the challenge of “integrating the interagency response.”
Klain’s appointment marks a swift turnabout for Obama, who until Thursday had resisted calls to appoint a single official to run the government’s response to Ebola.
Asked Thursday about the prospect of an “Ebola czar,” Obama said, “It may make sense for us to have one person, in part just so that after this initial surge of activity, we can have a more regular process just to make sure that we’re crossing all the t’s and dotting all the i’s going forward.”
From recounts to stimulus to Ebola: Ron Klain’s resume
Obama did not mention Klain’s appointment during a speech Friday to the Consumer Financial Protection Bureau, but he said his administration is taking an “all-hands-on-deck” approach to fighting Ebola.
The administration has come under increased pressure to name an anti-Ebola coordinator in the wake of news that two nurses in Dallas contracted the deadly virus. Both had treated a man who died of Ebola.
Klain played a high-profile file in Gore’s 2000 presidential campaign. Oscar-winning actor Kevin Spacey portrayed him in an HBO movie on that year’s Florida recount.
The Ebola response includes efforts to screen travelers from West African nations where Ebola has reached epidemic proportions and killed more than 4,500 people. Klain will help coordinate the assistance the U.S. military provides in West Africa.
Some Republican lawmakers criticized Obama for entrusting the job to a former government manager rather than a professional.
Rep. Andy Harris, R-Md., tweeted, “Worst ebola epidemic in world history and Pres. Obama puts a government bureaucrat with no healthcare experience in charge. Is he serious?”
Members of the public health community expressed surprise.
“When are they going to stop making mistakes?” said Robert Murphy, the director of the Center for Global Health at Northwestern University’s Feinberg School of Medicine. “We need a czar, but optimally a strong public health expert. I am so disappointed. This is not what we need.”
Physician Amesh Adalja, a spokesman for the Infectious Diseases Society of America, said, “It’s clear that there’s a desperate desire for an organized approach to dealing with this outbreak. I don’t necessarily think we need a disease-specific czar — we have one for HIV — but more of an emerging infectious diseases/biosecurity coordinator who reports to the president.”
The Ebola position is designed to be more managerial in nature, involving an array of government agencies ranging from the Pentagon to Health and Human Services.
“This is much broader than a medical response,” Earnest said.
As for Republican criticism, Earnest joked, “That’s a shocking development.” He noted that national elections are less than three weeks away.
Klain may weigh in on another question facing the administration: the prospect of a U.S. travel ban from West African nations where there have been Ebola outbreaks.
Obama and aides have disputed the need for a travel ban, questioning whether it would work and arguing that it might create unintended problems.
Thursday, Obama said experts in infectious diseases have told him “a travel ban is less effective than the measures that we are currently instituting that involve screening passengers who are coming from West Africa.”
Klain is likely to take a low key role publicly.
Earnest said Obama wasn’t looking for an Ebola expert but “an implementation expert.”
He confirmed Klain’s title: “Ebola response coordinator.”
Klain will report to two officials involved in the anti-Ebola effort: homeland security adviser Lisa Monaco and national security adviser Susan Rice.
Obama is pleased with the work of Monaco and Rice, but “given their management of other national and homeland security priorities, additional bandwidth will further enhance the government’s Ebola response,” a White House official said, speaking on condition of anonymity.
The president has long known Klain, who helped prepare him for debates with Mitt Romney during the 2012 presidential campaign.
Klain has been out of government since leaving Biden’s staff during Obama’s first term.
The administration’s Ebola evasions reveal its disdain for the American people.
The administration’s handling of the Ebola crisis continues to be marked by double talk, runaround and gobbledygook. And its logic is worse than its language. In many of its actions, especially its public pronouncements, the government is functioning not as a soother of public anxiety but the cause of it.
An example this week came in the dialogue between Megyn Kelly of Fox News andThomas Frieden, director of the Centers for Disease Control.
Their conversation focused largely on the government’s refusal to stop travel into the United States by citizens of plague nations. “Why not put a travel ban in place,” Ms. Kelly asked, while we shore up the U.S. public-health system?
Dr. Frieden replied that we now have screening at airports, and “we’ve already recommended that all nonessential travel to these countries be stopped for Americans.” He added: “We’re always looking at ways that we can better protect Americans.”
“But this is one,” Ms. Kelly responded.
Dr. Frieden implied a travel ban would be harmful: “If we do things that are going to make it harder to stop the epidemic there, it’s going to spread to other parts of—”
Ms. Kelly interjected, asking how keeping citizens from the affected regions out of America would make it harder to stop Ebola in Africa.
“Because you can’t get people in and out.”
“Why can’t we have charter flights?”
“You know, charter flights don’t do the same thing commercial airliners do.”
“What do you mean? They fly in and fly out.”
Dr. Frieden replied that limiting travel between African nations would slow relief efforts. “If we isolate these countries, what’s not going to happen is disease staying there. It’s going to spread more all over Africa and we’ll be at higher risk.”
Later in the interview, Ms. Kelly noted that we still have airplanes coming into the U.S. from Liberia, with passengers expected to self-report Ebola exposure.
Dr. Frieden responded: “Ultimately the only way—and you may not like this—but the only way we will get our risk to zero here is to stop the outbreak in Africa.”
Ms. Kelly said yes, that’s why we’re sending troops. But why can’t we do that and have a travel ban?
“If it spreads more in Africa, it’s going to be more of a risk to us here. Our only goal is protecting Americans—that’s our mission. We do that by protecting people here and by stopping threats abroad. That protects Americans.”
Dr. Frieden’s logic was a bit of a heart-stopper. In fact his responses were more non sequiturs than answers. We cannot ban people at high risk of Ebola from entering the U.S. because people in West Africa have Ebola, and we don’t want it to spread. Huh?
In testimony before Congress Thursday, Dr. Frieden was not much more straightforward. His answers often sound like filibusters: long, rolling paragraphs of benign assertion, advertising slogans—“We know how to stop Ebola,” “Our focus is protecting people”—occasionally extraneous data, and testimony to the excellence of our health-care professionals.
It is my impression that everyone who speaks for the government on this issue has been instructed to imagine his audience as anxious children. It feels like how the pediatrician talks to the child, not the parents. It’s as if they’ve been told: “Talk, talk, talk, but don’t say anything. Clarity is the enemy.”
The language of government now is word-spew.
Dr. Frieden did not explain his or the government’s thinking on the reasons for opposition to a travel ban. On the other hand, he noted that the government will consider all options in stopping the virus from spreading here, so perhaps that marks the beginning of a possible concession.
It is one thing that Dr. Frieden, and those who are presumably making the big decisions, have been so far incapable of making a believable and compelling case for not instituting a ban. A separate issue is how poor a decision it is. To call it childish would be unfair to children. In fact, if you had a group of 11-year-olds, they would surely have a superior answer to the question: “Sick people are coming through the door of the house, and we are not sure how to make them well. Meanwhile they are starting to make us sick, too. What is the first thing to do?”
The children would reply: “Close the door.” One would add: “Just for a while, while you figure out how to treat everyone getting sick.” Another might say: “And keep going outside the door in protective clothing with medical help.” Eleven-year-olds would get this one right without a lot of struggle.
If we don’t momentarily close the door to citizens of the affected nations, it is certain that more cases will come into the U.S. It is hard to see how that helps anyone. Closing the door would be no guarantee of safety—nothing is guaranteed, and the world is porous. But it would reduce risk and likelihood, which itself is worthwhile.
Africa, by the way, seems to understand this. The Associated Press on Thursday reported the continent’s health-care officials had limited the threat to only five countries with the help of border controls, travel restrictions, and aggressive and sophisticated tracking.
All of which returns me to my thoughts the past few weeks. Back then I’d hear the official wordage that doesn’t amount to a logical thought, and the unspoken air of “We don’t want to panic you savages,” and I’d look at various public officials and muse: “Who do you think you are?”
Now I think, “Who do they think we are?”
Does the government think if America is made to feel safer, she will forget the needs of the Ebola nations? But Americans, more than anyone else, are the volunteers, altruists and in a few cases saints who go to the Ebola nations to help. And they were doing it long before the Western media was talking about the disease, and long before America was experiencing it.
At the Ebola hearings Thursday, Rep. Henry Waxman (D., Calif.) said, I guess to the American people: “Don’t panic.” No one’s panicking—except perhaps the administration, which might explain its decisions.
Is it always the most frightened people who run around telling others to calm down?
This week the president canceled a fundraiser and returned to the White House to deal with the crisis. He made a statement and came across as about three days behind the story—“rapid response teams” and so forth. It reminded some people of the statement in July, during another crisis, of the president’s communications director, who said that when a president rushes back to Washington, it “can have the unintended consequence of unduly alarming the American people.” Yes, we’re such sissies. Actually, when Mr. Obama eschews a fundraiser to go to his office to deal with a public problem we are not scared, only surprised.
But again, who do they think we are? You gather they see us as poor, panic-stricken people who want a travel ban because we’re beside ourselves with fear and loathing. Instead of practical, realistic people who are way ahead of our government.
Klain’s early experience on Capitol Hill included serving as Legislative Director for U.S. RepresentativeEd Markey. From 1989 to 1992, he served as Chief Counsel to the U.S. Senate Committee on the Judiciary, overseeing the legal staff’s work on matters of constitutional law, criminal law, antitrust law, and Supreme Court nominations. In 1995, Senator Tom Daschle appointed him the Staff Director of the Senate Democratic Leadership Committee.
Klain joined the Clinton-Gore campaign in 1992. He ultimately was involved in both of Bill Clinton‘s campaigns, oversaw Clinton’s judicial nominations, and was General Counsel to Al Gore’s recount committee in the 2000 election aftermath. Some published reports have given him credit for Clinton’s “100,000 cops” proposal during the 1992 campaign; at a minimum, he worked closely with Clinton aide Bruce Reed in formulating it. In the White House, he was Associate Counsel to the President, directing judicial selection efforts, and led the team that won confirmation of Supreme Court Associate Justice Ruth Bader Ginsburg. Klain left the judicial selection role in 1994 to become Chief of Staff and Counselor to Attorney General Janet Reno. In 1995, he became Assistant to the President, and Chief of Staff and Counselor to Al Gore.
During Klain’s tenure as Gore’s Chief of Staff, Gore consolidated his position as the likely Democratic nominee in 2000. Still, Klain was seen as too loyal to Clinton by some longtime Gore advisors. Feuding broke out between Clinton and Gore loyalists in the White House in 1999, and Klain was ousted by Gore campaign chairmanTony Coelho in August of that year. In October 1999, he joined the Washington, D.C. office of the law firm of O’Melveny & Myers. A year later, Klain returned to the Gore campaign, once Coelho was replaced by William M. Daley. Daley hired Klain for a senior position in the Gore campaign and then named him General Counsel of Gore’s Recount Committee.
In 1994, Time named Klain one of the “50 most promising leaders in America” under the age of 40. In 1999, Washingtonian magazine named him the top lawyer in Washington under the age of 40, and the American Bar Association’s Barrister magazine named him one of the top 20 young lawyers nationwide. The National Law Journal named him one of its Lawyers of the Year for 2000.
Klain helped Fannie Mae overcome “regulatory issues”.Lobbying on “regulatory issues concerning Fannie Mae” in 2004, as disclosure forms indicate Klain did, involved convincing Congress and Fannie Mae’s regulators that Fannie Mae wasn’t doing anything dangerous, and wasn’t exposing taxpayers to risk. In other words, Ron Klain got paid to help fuel the housing bubble up until a couple of years before it popped.
During the 2004 Presidential campaign, Klain worked as an adviser to Wesley Clark in the early primaries. Later, during the General Election, Klain was heavily involved behind the scenes in John Kerry‘s campaign and is widely credited for his role in preparing Senator Kerry for a strong performance in the debates against President George W. Bush, which gave Kerry a significant boost in the polls. He then acted as an informal adviser to Evan Bayh, who is from Klain’s home state of Indiana. Klain has also commented on matters of law and policy on televised programs such as the Today Show, Good Morning America, Nightline, Capital Report,NewsHour with Jim Lehrer, and Crossfire.
In 2005, Klain left his partnership at O’Melveny & Myers to serve as Executive Vice President and General Counsel of a new investment firm, Revolution LLC, launched by AOL co-founder Steve Case.
Klain was mentioned as a possible replacement for White House Chief of Staff Rahm Emanuel, but opted to leave the White House for a position in the private sector in January 2011.
Klain apparently signed off on President Obama’s support of a $535 million loan guarantee for now-defunct solar-panel company Solyndra. Despite concerns about whether the company was viable, Klain approved an Obama visit, stating, “The reality is that if POTUS visited 10 such places over the next 10 months, probably a few will be belly-up by election day 2012.”
Dr. Lurie is the Assistant Secretary for Preparedness and Response (ASPR) at the US Department of Health and Human Services (HHS).
The mission of her office is to lead the nation in preventing, responding to and recovering from the adverse health effects of public health emergencies and disasters, ranging from hurricanes to bioterrorism.
Dr. Lurie was previously Senior Natural Scientist and the Paul O’ Neill Alcoa Professor of Health Policy at the RAND Corporation. There she directed RAND’s public health and preparedness work as well as RAND’s Center for Population Health and Health Disparities. She also served as Principal Deputy Assistant Secretary of Health in the US Department of Health and Human Services; in state government, as Medical Advisor to the Commissioner at the Minnesota Department of Health; and in academia, as Professor in the University of Minnesota Schools of Medicine and Public Health. Dr. Lurie has a long history in the health services research field, primarily in the areas of access to and quality of care, mental health, prevention, public health infrastructure and preparedness and health disparities.
Dr. Lurie attended college and medical school at the University of Pennsylvania, and completed her residency and MSPH at UCLA, where she was also a Robert Wood Johnson Foundation Clinical Scholar. She is the recipient of numerous awards, and is a member of the Institute of Medicine.
Finally, Dr. Lurie continues to practice clinical medicine in the health care safety net in Washington, DC. She has three sons.
The Assistant Secretary for Preparedness and Response serves as the Secretary’s principal advisor on matters related to bioterrorism and other public health emergencies. The ASPR also coordinates interagency activities between HHS, other Federal departments, agencies, and offices, and State and local officials responsible for emergency preparedness and the protection of the civilian population from acts of bioterrorism and other public health emergencies. The mission of her office is to lead the nation in preventing, responding to and recovering from the adverse health effects of public health emergencies and disasters. Dr. Lurie was nominated to the position by President Obama on May 12, 2009 and her confirmation by the U.S. Senate was announced by HHS Secretary Kathleen Sebelius on July 10, 2009.
Dr. Lurie has served as the Senior Natural Scientist and the Paul O’ Neill Alcoa Professor of Health Policy at the RAND Corporation. There she directed RAND’s public health and preparedness work as well as RAND’s Center for Population Health and Health Disparities. She has previously served in federal government, as Principal Deputy Assistant Secretary of Health in the US Department of Health and Human Services; in state government, as Medical Advisor to the Commissioner at the Minnesota Department of Health; and in academia, as Professor in the University of Minnesota School of Medicine and the University of Minnesota School of Public Health. Dr. Lurie has a long history in the health services research field, primarily in the areas of access to and quality of care, managed care, mental health, prevention, public health infrastructure and preparedness and health disparities.
Lurie has served as the Senior Editor for Health Services Research and has served on editorial boards and as a reviewer for numerous journals. She has served on the council and was President of the Society of General Internal Medicine, and on the board of directors for Academy Health, and has served on multiple other national committees.
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
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.
Nurses’ Union: Ebola Patient Left In Open Area Of ER For Hours
A Liberian Ebola patient was left in an open area of a Dallas emergency room for hours, and nurses treating him worked without proper protective gear and faced constantly changing protocols, according to a statement released by the nation’s largest nurses’ union.
Among those nurses was Nina Pham, 26, who has been hospitalized since Friday after catching Ebola while caring for Thomas Eric Duncan, the first person diagnosed with the virus in the U.S. He died last week.
Public-health authorities announced Wednesday that a second Texas Health Presbyterian Hospital health care worker had tested positive for Ebola, raising more questions about whether American hospitals and their staffs are adequately prepared to contain the virus.
The CDC has said some breach of protocol probably sickened Pham, but National Nurses United contends the protocols were either non-existent or changed constantly after Duncan arrived in the emergency room by ambulance on Sept. 28.
Medical records provided to The Associated Press by Duncan’s family show that Pham helped care for him throughout his hospital stay, including the day he arrived in intensive care with diarrhea, abdominal pain, nausea and vomiting, and the day before he died.
When Pham’s mother learned she was caring for Duncan, she tried to reassure her that she would be safe.
Pham told her: “Mom, no. Don’t worry about me,” family friend Christina Tran told The Associated Press.
Duncan’s medical records make numerous mentions of protective gear worn by hospital staff, and Pham herself notes wearing the gear in visits to Duncan’s room. But there is no indication in the records of her first encounter with Duncan, on Sept. 29, that Pham donned any protective gear.
Deborah Burger of National Nurses United, who convened a conference call with reporters to relay what she said were concerns of nurses at the hospital, said they were forced to use medical tape to secure openings in their flimsy garments and worried that their necks and heads were exposed as they cared for Duncan.
RoseAnn DeMoro, executive director of Nurses United, said the statement came from “several” and “a few” nurses, but she refused repeated inquiries to state how many. She said the organization had vetted the claims, and that the nurses cited were in a position to know what had occurred at the hospital. She did not specify whether they were among the nurses caring for Duncan.
The nurses allege that his lab samples were allowed to travel through the hospital’s pneumatic tubes, possibly risking contaminating of the specimen-delivery system. They also said that hazardous waste was allowed to pile up to the ceiling.
Wendell Watson, a Presbyterian spokesman, did not respond to specific claims by the nurses but said the hospital has not received similar complaints.
“Patient and employee safety is our greatest priority, and we take compliance very seriously,” he said in a statement. He said the hospital would “review and respond to any concerns raised by our nurses and all employees.”
The nurses’ statement said they had to “interact with Mr. Duncan with whatever protective equipment was available,” even as he produced “a lot of contagious fluids.” Duncan’s medical records underscore that concern. They also say nurses treating Duncan were also caring for other patients in the hospital and that, in the face of constantly shifting guidelines, they were allowed to follow whichever ones they chose.
When Ebola was suspected but unconfirmed, a doctor wrote that use of disposable shoe covers should also be considered. At that point, by all protocols, shoe covers should have been mandatory to prevent anyone from tracking contagious body fluids around the hospital.
A few days later, however, entries in the hospital charts suggest that protection was improving.
“RN entered room in Tyvek suits, triple gloves, triple boots, and respirator cap in place,” a nurse wrote.
The Presbyterian nurses are not represented by Nurses United or any other union. DeMoro and Burger said the nurses claimed they had been warned by the hospital not to speak to reporters or they would be fired.
The AP has attempted since last week to contact dozens of individuals involved in Duncan’s care. Those who responded to reporters’ inquiries have so far been unwilling to speak.
David R. Wright, deputy regional administrator for the U.S. Centers for Medicare & Medicaid Services, which monitors patient safety and has the authority to withhold federal funding, said his agency is going to want to get all of the information the nurses provided.
“We can’t talk about whether we’re going to investigate or not, but we’d be interested in hearing that information,” he said.
CDC officials did not immediately respond to requests for comment.
Duncan first sought care at the hospital’s ER late on Sept. 25 and was sent home the next morning. He was rushed by ambulance back to the hospital on Sept. 28. Unlike his first visit, mention of his recent arrival from Liberia immediately roused suspicion of an Ebola risk, records show.
The CDC said 76 staff members at the hospital could have been exposed to Duncan after his second ER visit. Another 48 people who may have had contact with him before he was isolated are being monitored. Pham remained hospitalized Tuesday in good condition and said in a statement that she was doing well.
The Rev. Jim Khoi, pastor at Our Lady of Fatima Church in Fort Worth, which Pham’s family attends, said the 2010 Texas Christian University nursing school graduate appeared to be in good spirits when she spoke to her mother via video chat.
Pham’s mother, Ngoc Pham, is “calm,” Khoi said. “She trusts in God. And she asks for prayers.”
CDC: Ebola Patient Traveled By Air With “Low-Grade” Fever
The CDC has announced that the second healthcare worker diagnosed with Ebola — now identified as Amber Joy Vinson of Dallas — traveled by air Oct. 13, with a low-grade fever, a day before she showed up at the hospital reporting symptoms.
The CDC is now reaching out to all passengers who flew on Frontier Airlines flight 1143 Cleveland to Dallas/Fort Worth. The flight landed at 8:16 p.m. CT.
All 132 passengers on the flight are being asked to call 1 800-CDC INFO (1 800 232-4636). Public health professionals will begin interviewing passengers about the flight Wednesday afternoon.
“Although she (Vinson) did not report any symptoms and she did not meet the fever threshold of 100.4, she did report at that time she took her temperature and found it to be 99.5,” said CDC Director Tom Frieden. Her temperature coupled with the fact that she had been exposed to the virus should have prevented her from getting on the plane, he said. “I don’t think that changes the level of risk of people around her. She did not vomit, she was not bleeding, so the level of risk of people around her would be extremely low.”
Vinson first reported a fever to the hospital on Tuesday (Oct. 14) and was isolated within 90 minutes, according to officials. She did not exhibit symptoms while on the Monday flight, according to crew members. However, the CDC says passenger notification is needed as an “extra level of safety” due to the proximity in time between the flight and the first reported symptoms.
“Those who have exposures to Ebola, she should not have traveled on a commercial airline,” said Dr. Frieden. “The CDC guidance in this setting outlines the need for controlled movement. That can include a charter plane; that can include a car; but it does not include public transport. We will from this moment forward ensure that no other individual who is being monitored for exposure undergoes travel in any way other than controlled movement.”
Frieden specifically noted that the remaining 75 healthcare workers who treated Thomas Duncan at Texas Health Presbyterian Hospital will not be allowed to fly. The CDC will work with local and state officials to accomplish this.
Frontier Airlines is working closely with the CDC to identify and notify all passengers on the flight. The airline also says the plane has been thoroughly cleaned and was removed from service following CDC notification early Wednesday morning.
However, according to Flighttracker, the plane was used for five additional flights on Tuesday before it was removed from service. Those flights include a return flight to Cleveland, Cleveland to Fort Lauderdale–Hollywood International Airport (FLL), FLL to Cleveland, Cleveland to Hartsfield–Jackson Atlanta International Airport (ATL), and ATL to Cleveland.
While in Ohio, Vinson visited relatives, who are employees at Kent State University. The university is now asking Vinson’s three relatives stay off campus and self-monitor per CDC protocol for the next 21 days out of an “abundance of caution.”
“It’s important to note that the patient was not on the Kent State campus,” said Kent State President Beverly Warren. “She stayed with her family at their home in Summit County and did not step foot on our campus. We want to assure our university community that we are taking this information seriously, taking steps to communicate what we know,” said Dr. Angela DeJulius, director of University Health Services at Kent State.
Vinson is a Kent State graduate. She received degrees from there in 2006 and 2008.
Cleveland’s Public Health Director, Toinette Parrilla, said Vinson was visiting in preparation for her wedding. While there, she visited her mother and her fiance.
The latest Ebola diagnosis was announced by the Texas Department of State Health Services early Wednesday morning.
Vinson is the second worker at Presbyterian Hospital to be diagnosed after providing health care to Duncan, the first person to be diagnosed with Ebola in the United States. He died last week.
Medical records provided to The Associated Press by Thomas Eric Duncan’s family show Amber Joy Vinson was actively engaged in caring for Duncan in the days before his death. The records show she inserted catheters, drew blood, and dealt with Duncan’s body fluids.
Dallas Mayor Mike Rawlings addressed the media on Wednesday, saying the patient lives alone and has no pets.
“It may get worse before it gets better,” Rawlings said, “but it will get better.”
Crews worked to decontaminate the common areas of Vinson’s Dallas apartment building Tuesday morning. The apartment unit will be decontaminated by contractors starting early Wednesday afternoon.
The CDC announced that Vinson will be transported to Emory Hospital in Atlanta for further treatment. Two previous American Ebola patients, Dr. Kent Brantly and Nancy Writebol, were treated at Emory and were the first Ebola patients to be treated in the United States. They were released in August.
Nina Pham was diagnosed with the virus over the weekend and remains isolated in good condition. Pham’s dog — a Cavalier King Charles Spaniel named Bentley — has been taken into custody and is being cared for at an undisclosed location.
Frontier Airlines released the following statement:
“At approximately 1:00 a.m. MT on October 15, Frontier was notified by the CDC that a customer traveling on Frontier Airlines flight 1143 Cleveland to Dallas/Fort Worth on Oct. 13 has since tested positive for the Ebola virus. The flight landed in Dallas/Fort Worth at 8:16 p.m. local and remained overnight at the airport having completed its flying for the day at which point the aircraft received a thorough cleaning per our normal procedures which is consistent with CDC guidelines prior to returning to service the next day. It was also cleaned again in Cleveland last night. Previously the customer had traveled from Dallas Fort Worth to Cleveland on Frontier flight 1142 on October 10.
Customer exhibited no symptoms or sign of illness while on flight 1143, according to the crew. Frontier responded immediately upon notification from the CDC by removing the aircraft from service and is working closely with CDC to identify and contact customers who may traveled on flight 1143.
Customers who may have traveled on either flight should contact CDC at 1 800 CDC-INFO.
The safety and security of our customers and employees is our primary concern. Frontier will continue to work closely with CDC and other governmental agencies to ensure proper protocols and procedures are being followed.”
Frontier jet made 5 flights before taken out of service in Ebola scare
The Frontier Airlines jet that carried a Dallas healthcare worker diagnosed with Ebola made five additional flights after her trip before it was taken out of service, according to a flight-monitoring website.
Denver-based Frontier said in a statement that it grounded the plane immediately after the carrier was notified late Tuesday night by the Centers for Disease Control and Prevention about the Ebola patient.
Ebola patient flew day before symptoms surfaced
Amber Joy Vinson of Dallas, traveled by air on Oct. 13, the day before she first reported symptoms.
Flight 1143, on which the woman flew from Cleveland to Dallas/Fort Worth, was the last trip of the day Monday for the Airbus A320. But Tuesday morning the plane was flown back to Cleveland and then to Fort Lauderdale, Fla., back to Cleveland and then to Atlanta and finally back to Cleveland again, according to Daniel Baker, chief executive of the flight-monitoring site Flightaware.com.
He said his data did not include any passenger manifests, so he could not tell how many total passengers flew on the plane Tuesday.
The airline said it is working with the CDC to contact all 132 passengers on the Monday flight that carried the Ebola patient.
Frontier could not be reached to confirm the FlightAware data, and it was unclear if passengers on the additional flights were being contacted.
The passenger “exhibited no symptoms or sign of illness while on Flight 1143, according to the crew,” Frontier said.
The plane went through a routine but “thorough” cleaning Monday night, Frontier said. Airline industry experts said routine overnight cleaning includes wiping down tray tables, vacuuming carpet and disinfecting restrooms.
The healthcare worker also had flown to Cleveland from Dallas three days earlier on Frontier Flight 1142, the airline reported.
In response to the news that another Ebola patient flew on a commercial flight, the union that represents 60,000 flight attendants on 19 airlines is asking the CDC to monitor and care for the four flight attendants who were on flight from Cleveland to Dallas/Fort Worth.
whats it going to take to close the border to people from africa? 10 dead? 100 dead? 1000 dead? we know obumma doesnt give a flying fluke about the american citizens, but isn’t there someone in the government with an ounce of brains? or is this part of obumma’s scheme to declare martial law?…
The Assn. of Flight Attendants “will continue to press that crew members are regularly monitored and provided with any additional resources that may be required,” the group said.
The Ebola scare prompted the union last week to call for better measures to protect flight attendants from exposure to the deadly virus.
The group’s international president, Sara Nelson, suggested that flight attendants are being asked to do too much in the fight against Ebola.
“We are not, however, professional healthcare providers and our members have neither the extensive training nor the specialized personal protective equipment required for handling an Ebola patient,” she said in a statement.
Earlier this month, United Airlines was rushing to contact passengers who flew on two flights that carried a Liberian man infected with Ebola from Brussels to Washington, D.C., and then to Dallas.
The Ebola-stricken healthcare worker who flew on Frontier had been treating the Liberian man, Thomas Eric Duncan, who has since died.
Airline-industry stock prices have taken a beating in recent weeks, with some analysts blaming the Ebola scare.
On Wednesday, stocks of Delta Air Lines and American Airlines fell more than 6% in early trading before partially recovering. With less than 90 minutes remaining in the regular trading session, the two stocks were each down about 2% from Tuesday’s closes. Frontier is privately held.
There are only 19 level 4 bio-containment beds in the whole of the United States…and four in the UK
The UK is well set for an Ebola outbreak (sarcasm alert) We have TWO isolation units, but one is getting ‘redeveloped’ so it’s not available right now. Called High Security Infectious Diseases Units there are two in the country, each capable of taking two patients. One is at The Royal Free Hospital in Hampstead North London, the other, the one getting a bit of a make-over, is at The Royal Victoria Infirmary in Newcastle, up in the north-east of England.
Four level 4 bio-containment beds between 69,000,000 people
In the US there are 4 units geared up to handle Ebola. The National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, has 3 beds. Nebraska Medical Center, Omaha, has 10 beds. Emory Hospital, Atlanta has 3 beds and St Patricks Hospital, Missoula has 3 beds (source)
19 level four biocontainment beds for 317,000,000 people
I think we just found out why the government(s) are under-playing the situation. They simply do not have the facilities to cope with even a small outbreak. They are, in fact in exactly the same position as the dirt-poor hospitals in West Africa…there are not enough facilities to stop the spread of the disease if it gets out. The quality of care is better, but the availability of containment most likely isn’t.
I am sure ‘regular’ isolation units will be pressed into use but they are not designed to handle level 4 biohazards, they are nowhere near as secure medically speaking, as biocontainment units.
A couple of days ago I explained how exponential spread works. You can read that article here if you like. As a quick recap. Once a disease is at the point where every carrier infects 2 more people,(exponential spread) it will continue until it:
A) runs out of hosts
B) is stopped by medical science or
C) mutates into something less harmful.
What follows will show you how woefully inadequately our governments have prepared for something as lethal as Ebola.
In the flu pandemic of 1918-1920 28% of Americans were infected with the disease…try to remember I am talking numbers here not HOW disease spreads or any medical similarities between diseases, 625,000 Americans lost their lives out of some 29,400,000 infections. The population of the United States at that time was 105,000,000 people. (source)
Fast forward to today. If that flu pandemic had hit the United States in 2014, when the population stands at 317,000,000 people 88,760,000 people would have been infected and 2,130,240 of them would have died.
Now, let’s try this with Ebola. I have picked Liberia just because it is in the news due to the Thomas Duncan case.
Liberia has a population of 4,290,000 people, as of the latest figures there have been 3692 cases of Ebola, this represents 0.0086% of the population.Of those infections, 1998 people have died that’s a fatality rate of 54%. (source)
If that same infection and death rate were applied to the United States Ebola would infect 269,000 people and of those 156,281 would die.
Now, if as doctors and scientists fear the basic reproduction rate rises to 2 in Liberia the numbers change very quickly. Using the mean average incubation time of 9 days it would take around 13 weeks for the entire population of Liberia to become infected. (10 doublings starting with 3692 = just under the population of Liberia. This multiplied by 9 days gives us 90 days which divided by 7 gives 12.85 weeks.) Of the 4,290,000 people infected 2,316,000 would lose their lives.
This is just Liberia, not the other affected countries in West Africa.
Translated to an equivalent outbreak in the United States, where the basic reproduction rate is also 2, the numbers are horrifying. Starting with patient zero it would take around 245 days, 35 weeks for every person in the United States to become infected. Of those 17,118,000 people would die. (27.17 doublings x 9 days = 245 days =35 weeks)
Please remember the figures for Liberia are pulled from the CDC website, the percentages are correct.
United States was based on exactly the same parameters as for Liberia…a like for like comparison.
The CDC could be spending their time educating people, advising people to stock up, get ready for the possibility of staying in their homes. Self imposed isolation, or if need be state imposed isolation, that may last for an extended time period may become a reality. They’re not doing it though are they? They are sprouting figures and applying them to West Africa, and they can’t even get that right. They are saying that there could be 1.4 deaths in West Africa in a worst case scenario. When actually applying the figures they supplied with some simple mathematics we can see that 1.4 million deaths is a gross understatement.
Even a basic reproduction rate of 1.7, the latest figure for Liberia it will only take around 30 weeks to get to the same point as the above scenario, over 2,000,000 dead.
Don’t get me wrong, I am not saying that the UK government is any better, if anything they are worse, they don’t even try to do the maths. Most of them went to Eton (a very expensive school that churns out politicians) so it’s unlikely they would be capable of it even if they wanted to. You only have to look at our national finances to see they are no good at sums. They send out press briefings that there will be an emergency COBRA meeting, do you have any clue what that stands for? Let me enlighten you, Cabinet Office Briefing Room A. COBRA is not an emergency planning group, it’s an effing office.
Although I am loathed to say it, it’s time that our governments started worrying about the facilities at home rather than worrying about the facilities abroad. Stopping the disease in Africa does not mean we are out of the woods. There are so many unreported cases, people turned away from medica facilities in West Africa that nobody has the slightest idea how many cases of Ebola are actually out there. The porous borders of the region mean that people move around without the controls that are usually exercised in the west. There has to be a travel ban on non-US citizens entering the United States from these areas, the same applies from the UK.
Border control has to be improved in both countries if we have any hope of halting the spread of this terrible disease. The west is going to be the destination for anyone from Ebola hit areas that can afford to make their way from Africa. Many West Africans have contacts in the west who will help them get out, and shelter them when they arrive. As harsh as it seems this has to be stopped, it’s time for governments to put their own citizens first. Repatriation of your own is one thing, risking millions of lives at home because you won’t man up and prevent foreigners entering is quite another.
Guinea, Liberia and Sierra Leone have been struggling since March to stop what has become the largest Ebola outbreak ever recorded. The disease is causing widespread fear and disruption in West Africa, and shows no signs of being brought under control.
CHRONOLOGY OF COVERAGE
OCT. 15, 2014
Spain’s ad hoc, improvisational response to citizens infected by Ebola virus and brought back to the country underscores holes in West’s readiness to confront wider outbreak; cases of Ebola in Spain have raised urgent questions about risks of disease spreading even in developed countries, particularly among health care workers. MORE
OCT. 15, 2014
Doctors Without Borders criticizes lack of reliable evacuation systems from West Africa, saying that more would volunteer to fight Ebola in region if it were not so difficult to leave in case of emergency; cites fact that it took 50 hours to evacuate French nurse to Paris after she tested positive for virus. MORE
OCT. 15, 2014
Bellevue Hospital is designated as center for treatment of the Ebola virus should it emerge in New York City; announcement comes amid widespread concerns that disease may not be so easily contained by every hospital that has an isolation unit. MORE
OCT. 15, 2014
World Health Organization warns new cases of Ebola virus could reach 10,000 a week in West Africa by December, nearly 10 times the current rate; reports none of the three most heavily affected countries, Liberia, Sierra Leone and Guinea, are adequately prepared for epidemic; comments come in report before the United Nations Security Council, which voices fear that epidemic could renew the risk of political instability in a region barely recovering from civil war.MORE
OCT. 15, 2014
Dr Thomas R Frieden, Centers for Disease Control and Prevention director, acknowledges for first time that quicker and more concerted action on agency’s part might have kept Dallas nurse from contracting Ebola virus; says agency plans a more robust response to any future Ebola cases in American hospitals. MORE
OCT. 15, 2014
Frank Bruni Op-Ed column contends other, more common ailments deserve more concern and attention in United States than Ebola; points out influenza kills between 3,000 and 50,000 Americans per year, and skin cancer kills 10,000 per year; lists other common, and much-researched, illnesses that Americans should vaccinate and protect themselves against. MORE
OCT. 15, 2014
Jere Longman On Soccer column examines plight of SIerra Leone’s national soccer team, caught amid self-destructive feud between nation’s soccer federation and sports ministry; observes that team was already exhausted from playing road-only games due to Ebola outbreak. MORE
OCT. 14, 2014
Transmission of Ebola virus to Dallas nurse Nina Pham forces Centers for Disease Control and Prevention to reconsider its approach to containing the disease; state and federal officials are re-examining whether equipment and procedures are adequate or too loosely followed, and whether more decontamination steps are necessary when health workers leave isolation units. MORE
OCT. 14, 2014
Experience of Emory University Hospital in Atlanta in caring for three Ebola patients calls into question oft repeated assurances from federal health officials that most American hospitals can safely treat disease; transmission of virus to Dallas nurse Nina Pham has also raised questions about general level of preparedness in hospitals around the country; medical experts have begun to suggest it may be better to transfer patients to designated centers with expertise in treating Ebola. MORE
OCT. 14, 2014
Public health concerns about Ebola virus have spread to both political parties, which are engaged in finger-pointing debate that could jar midterm elections; Republicans blame the Obama administration for failing to protect the United States, and Democrats are saying it is GOP budget cutting that has put Americans at risk. MORE
OCT. 14, 2014
Experts rule out notion that Ebola virus has become a super-pathogen and raise doubts that it will evolve into one; say virus is not fundamentally different from those in previous outbreaks dating back to 1976, and it is highly unlikely that natural selection will give it ability to spread more easily, particularly by becoming airborne. MORE
OCT. 14, 2014
Friends of Dallas nurse Nina Pham describe the 26-year-old, part of the team that treated Thomas Eric Duncan, as conscientious and caring, and from a very private family. MORE
OCT. 14, 2014
Editorial warns effort to combat the Ebola virus in Western Africa is lagging dangerously behind; contends the international community must dramatically step up aid if epidemic is to be controlled; holds obligation is particularly strong for the United Sates as it faces first case of patient who contracted the virus domestically. MORE
OCT. 14, 2014
Sierra Leone’s national soccer team is enduring a series of demeaning and discouraging indignities since outbreak of Ebola in West Africa; team is barred from playing in its own stricken country and it must play every match on the road as it struggles to qualify for the 2015 Africa Cup of Nations, continent’s biennial championship. MORE
OCT. 14, 2014
World Bank president Dr Jim Yong Kim, frustrated with slow global response to Ebola outbreak, has made fighting epidemic his mission, driving bank to act on Ebola with uncharacteristic speed; bank has committed $400 million to fighting disease. MORE
OCT. 13, 2014
The topic everyone on Wall Street is discussing urgently but quietly isn’t the volatile stock market. It is Ebola. MORE
OCT. 13, 2014
News that a nurse at Texas Health Presbyterian Hospital has contracted Ebola virus transforms part of Dallas into scene of concern and contamination; residents in victim’s neighborhood are filled with anxiety, while hazardous-materials crews scramble to clean her apartment building. MORE
OCT. 13, 2014
Nurse at Texas Presbyterian Hospital in Dallas becomes first person to contract Ebola within United States; development prompts local, state and federal officials to scramble to determine how she became infected, despite wearing protective gear, and to monitor others potentially at risk; news further stokes fears among health care workers across country. MORE
OCT. 13, 2014
Centers for Disease Control and Prevention say agency will take new steps to help hospital workers protect themselves, providing more training and urging hospitals to practice dealing with potential Ebola patients. MORE
OCT. 13, 2014
Op-Ed article by Prof Siddhartha Mukherjee contends Ebola case of Thomas Eric Duncan in Dallas shows that medical community must rethink concept of quarantine, in light of the absence of any established anti-viral treatment; calls for development of pilot program for rapid-testing quarantine. MORE
OCT. 12, 2014
Liberian Army has suddenly become linchpin in fight against Ebola virus rampaging the country; for decades, Liberians viewed the armed forces with fear due to atrocities committed during civil war. MORE
OCT. 11, 2014
Doctors Without Borders, first to respond to Ebola crisis in West Africa, remains primary international medical aid group battling disease there; strained and overworked charity has erected six treatment centers in West Africa, with plans for more, and has treated the majority of patients, just as they have in previous Ebola outbreaks and some other epidemics in the developing world. MORE
OCT. 10, 2014
Health workers at International Medical Corps treatment center in Liberia face dilemma of how to care for newborn whose mother may have died of Ebola; many health workers have contracted Ebola while attending to births and being exposed to blood and other body fluids, provoking fears of providing maternity care; doctors speculate that Ebola can be transmitted from mother to baby (Series: The Ebola Ward). MORE
OCT. 10, 2014
Britain says it will introduce measures at airports and rail terminals to screen passengers from affected countries as concerns over Ebola grow in Europe. MORE
OCT. 10, 2014
Presidents of Guinea, Liberia and Sierra Leone, nations most affected by the Ebola outbreak, implore world leaders to increase their support to fight the disease; speak at meeting of the World Bank and the International Monetary Fund in Washington. MORE
OCT. 10, 2014
Nebraska Biocontainment Patient Care Unit in Omaha, with arrival of two Ebola patients in last six weeks, is at forefront of the nation’s response to the disease; unit’s 10 beds sat empty for years. MORE
OCT. 10, 2014
Dallas officials say Sgt Michael Monnig, local shefiff’s deputy examined for possible infection with Ebola virus, has tested negative and is sent home from hospital; many in city remain uneasy. MORE
OCT. 9, 2014
Thomas Eric Duncan dies of Ebola in Dallas, renewing questions about whether delay in receiving treatment could have played a role in his death and what role it played in the possibility of his spreading the disease to others; it remains unclear why, and how, Texas Health Presbyterian Hospital did not initially view the Liberian man as a potential Ebola case; nearly 50 people who came into contact with Duncan when he was experiencing active symptoms are being monitored. MORE
OCT. 9, 2014
Federal health officials will require temperature checks for the first time at five major American airports for people arriving from three West African countries hardest hit by Ebola epidemic; however, health experts say measures are more likely to calm worried public than to prevent people with Ebola from entering country; move comes after death of Thomas Eric Duncan, Liberian man who was the first person diagnosed with Ebola in the United States. MORE
OCT. 9, 2014
Bellevue Hospital Center in Manhattan shows off its isolation rooms and its leave-no-skin-cell-uncovered precautions in an attempt to reassure New Yorkers that should the Ebola virus arrive in the city, its premier public hospital could handle it. MORE
OCT. 9, 2014
European leaders are scrambling to upgrade their response to Ebola crisis after Pres Obama’s announcement that he will send 3,000 troops to West Africa to build hospitals and otherwise help in fight against the disease. MORE
OCT. 9, 2014
Spanish health officials explain how auxiliary nurse Maria Teresa Romero Ramos became the first Ebola case in Western Europe, saying that it was likely she became infected when she touched her face with the gloves she had worn while tending to a Spanish missionary with Ebola at a Madrid hospital. MORE
OCT. 9, 2014
Dog named Excalibur who belonged to Ebola-infected nurse Maria Teresa Romero Ramos is destroyed by Spanish health officials, even as protesters and animal rights activists surround Madrid home of the nurse and her husband; online petition calling for dog’s life to be spared drew hundreds of thousands of signatures. MORE
OCT. 9, 2014
Editorial notes new screening procedures directed at travelers entering United States from Guinea, Liberia or Sierra Leone, center of the Ebola epidemic in West Africa; holds screenings, while burdensome and possibly of little practical value, may ease public anxieties about keeping virus out of country and assure people that risks are being minimized. MORE
OCT. 8, 2014
Schedule for a single day at newly opened Ebola treatment center in Suakoko, Liberia, run by International Medical Corps charity, offers portrait of efforts to halt spread of virus; center is both ordinary and otherwordly, where health workers tend to those infected and those quarantined while awaiting test results (Series: The Ebola Ward).MORE
OCT. 8, 2014
Spain’s government comes under heavy criticism for its handling of Western Europe’s first Ebola case, as health care workers argue that they have not been given proper training or equipment to handle the disease; government quarantines three more people and monitors dozens who had come into contact with infected nurse. MORE
OCT. 8, 2014
Centers for Disease Control and Prevention scrambles to address concerns from health workers nationwide as anxiety mounts over Ebola virus; agency has scheduled two nationwide conference calls, but has so far not changed its recommendations on protective gear.MORE
OCT. 8, 2014
Doctors report first positive signs in recovery of Thomas Eric Duncan, Liberian man battling Ebola virus in Dallas hospital; Duncan’s temperature and blood pressure have normalized, though he remains on a ventilator and is still receiving kidney dialysis. MORE
OCT. 8, 2014
Centers for Disease Control and Prevention officials promise additional measures to screen airline passengers arriving in United States for Ebola virus; remain opposed to draconian travel restrictions such as outright bans, saying that they would cause more problems than they would solve. MORE
OCT. 7, 2014
Nurse in Spain becomes first health worker to be infected with Ebola virus outside West Africa, raising serious concerns about how prepared Western nations are to safely treat people with the deadly illness; nurse contracted the illness while treating a Spanish missionary who was infected in Sierra Leone and flown to Madrid, where he died; infection exposes weak spots in Spain’s highly praised health care defense systems. MORE
OCT. 7, 2014
Adel Faqih, Saudi Arabia’s acting health minister, says this year’s hajj has been free of Ebola and other contagious diseases like Middle East Respiratory Syndrome because of measures taken to protect more than two million Muslim pilgrims. MORE
OCT. 7, 2014
Pres Obama says screening for Ebola virus at airports both in the United States and West Africa will increase, but does not offer specifics; Dallas residents remain on edge as they await to learn if those who came into contact with Ebola patient Thomas Eric Duncan became infected. MORE
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
Story 1: Breaking News: Second Possible Case of Ebola in Dallas, Texas — How many Biosafety Level 4 Hospital Beds are there in the United States? — 22 Hospital Beds — Too few for An Airborne Ebola Pandemic! — Center for Disease Control (CDC) Sacrifices Hospital and Medical Staff To Open Borders And Amnesty For Illegal Aliens! — Will The Ebola Dallas Strain Jump To Another Human Host? — Breaking News — Videos
Second patient in Texas showing signs consistent with Ebola
EBOLA IN AMERICA – WE’RE SCREWED Says Major Garrett in OPEN MIC at Press Conference (Full)
EBOLA IN AMERICA – WE’RE SCREWED! Says Major Garrett in OPEN MIC
Texas EBOLA PATIENT Thomas Eric Duncan DIED (Video) First Ebola Patient Diagnosed In The U.S Dies
CDC: New Ebola situation in Texas being…
Soon: Frisco Texas Officials To Update On Possible Second Ebola Case – Fox News Reporting
Author tracks Ebola outbreaks over decades, calls virus “Jack The Ripper”
Elbows-Deep in Ebola Virus – Richard Preston
In the Hot Zone with Virus X – Richard Preston
USAMRIID The US Army Medical Research Institute of Infectious Disease
Jerry & Nancy Jaax discuss biosafety facilities
The Jaax’s worked in biocontainment facilities for years and discuss safety measures used.
State of Tomorrow Interview – CJ Peters: Wake Up Call
UTHSC Regional Biocontainment Laboratory
Ebola & Emerging Viral Diseases: Overview of the Science
Ebola & Emerging Viral Diseases: How the Virus Attacks Us
Ebola and Emerging Viral Diseases: New Drug Therapy
Suspect in the 2001 Anthrax Attacks Gets $5.8 Million!
Steven Hatfill Anthrax Denial
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
MWV Episode 68 – Threading the NEIDL: TWiV Goes Inside a BSL-4
Aerosolizing ONE DROP of EBOLA = 1/2 MILLION DEAD
NEIDL: Biosafety Level 4
MWV Episode 68 – Threading the NEIDL: TWiV Goes Inside a BSL-4
How scientists enter and exit BSL-4 laboratories
Ebola Spreads, Worst Outbreak In History
Obama’s Border Crisis Could Result In The Deaths Of Millions Of Americans
Dallas County Ebola press conference
‘A Virus Walks Into a Bar…’ and Other Science Jokes – Brian Malow
Science comedian Brian Malow jokes that a virus is “the ultimate David and Goliath” when compared with humans. He then rattles off a series of science-related jokes. “Schrodinger’s cat walks into a bar, and doesn’t.”
Could take 48 hours to confirm if deputy has Ebola
Marjorie Owens, Jason Whitely, Tanya Eiserer and David Schechter, WFAA
rews transported a patient exhibiting “signs and symptoms of Ebola” from a Frisco CareNow clinic to Texas Health Presbyterian Hospital Dallas.
“Right now, there are more questions than answers about this case,” said Wendell Watson, a spokesman with the hospital.
The patient was identified as Dallas County Sheriff’s Department Sgt. Michael Monnig, who accompanied county health officials Zachary Thompson and Christopher Perkins into the Dallas apartment where Thomas Eric Duncan had been staying when he fell ill with Ebola.
“Initial reports from the urgent care facility indicated the patient had direct contact with the Dallas ‘patient zero'; however, Frisco firefighter-paramedics now report the patient says he had contact with the apartment and family members related to the Dallas ‘patient zero’ prior to the apartment being decontaminated,” said city of Frisco spokesperson Dana Baird.
The deputy had been ordered to go inside the unit with officials to get a quarantine order signed. No one who went inside the unit that day wore protective gear.
According to Christopher Dyer, president of the Dallas County Sheriff’s Association, Monnig said he was feeling sick to his stomach before his visit to the clinic. Dyer expressed concern for Monnig and his family.
“He’s doing exactly basically what we told him to do: If at any time you don’t feel well, go seek some medical attention,” Dyer said. “I’m being told that he’s not exhibiting classic signs of the Ebola virus. It’s just a matter that he doesn’t feel well, and because he had contact with Mr. Duncan’s apartment, they’re taking every precaution.”
That view was echoed by Frisco Fire Department Chief Mark Piland. “This patient was not experiencing all of those [Ebola] symptoms, just a few,” he said. “Based upon screening criteria from the CDC, the treatment tends to be a little bit more conservative at first.”
Complete coverage of the death of Dallas Ebola patient Thomas Eric Duncan. WFAA
A staff member at CareNow called 911 to report Monnig as a possible Ebola patient.
“The CareNow staff, following [Centers for Disease Control and Prevention] recommended screening protocol, contacted Frisco 911 and a fire department EMS crew was dispatched to the scene,” a CareNow statement said. It went on to say health officials, including those from the CDC, went to the clinic and — after interviews — cleared it to be reopened for patients.
Including staff, there were 14 people inside the CareNow clinic when Monnig arrived. The fire department released all of them to go home.
Frisco Mayor Maher Maso said “risk is minimal” from the new potential Ebola case. Frisco Fire Chief Mark Piland said the patient was transported because he had “a few” symptoms that matched those in the CDC guidelines, but not all of the symptoms.
“At this point, I think we need to take every precaution,” Dyer said. “The hospital will get his blood work tested and we will know whether he is positive or negative for it, so until we know precisely whether he has it or not, we need to take every precaution.”
It will take up to 48 hours to get test results back to determine if Monnig tests positive for the Ebola virus.
The CareNow is located in the 300 block of Main Street. Patients were held inside the clinic as crews at the scene examined staff and others inside the building, but they have since been released.
Frisco’s fire chief said he was still figuring out how to decontaminate the department’s people and gear. “We have calls in to the Centers for Disease Control,” Piland said. “We’re also working with our public health officials here in Denton County. We’re going to get their recommendations on the proper decontamination procedures for the ambulances.”
Health officials said the transportation of the patient was done out of an abundance of caution.
“We are being very cautious and are in contact with the health department to ensure we follow proper protocol,” said Vicki Johns, with CareNow. “Our concern is for the safety and well being of everyone in our clinic.”
News 8’s Jason Whitely spoke to Chuck Moreno, who had gone into the CareNow facility with his 15-year-old son to get a flu shot Wednesday. Moreno said he saw a patient, whose skin was flushed and who was hunched over but walking, enter the clinic with his wife.
Within minutes, police and fire units surrounded the facility, taped off a gray SUV, and isolated other patients at the facility.
Moreno asked a CareNow employee if it was related to Ebola, and he said the employee nodded her head “yes.”
Moreno said he and his son quarantined themselves into an examination room, put on surgical masks they found in the room and sprayed disinfectant on themselves. Moreno said staff told them he and his son couldn’t leave the clinic and would be transferred to a major medical center, but he was unsure which one at the time.
Dallas County Sheriff’s Association President Christopher Dyer has repeatedly said that he did not believe that deputies should have been sent inside the quarantined apartment.
“This is a federal issue,” he said. “The CDC should have come in and taken care of this. A local department is not equipped to deal with a virus that is potentially this deadly.”
Monnig had planned to come back to work Wednesday, Dyer said. A couple of the other deputies have returned to work, he said.
SOUTHCOM Commander: Ebola Outbreak in Central America Could Cause Mass Migration to U.S.
By: Sam LaGrone
Published: October 7, 2014 5:14 PM
Updated: October 7, 2014 10:26 PM
WASHINGTON, D.C. — The head of U.S. Southern Command (SOUTHCOM) warned an Ebola outbreak in Central America or the Caribbean could trigger a mass migration to the U.S. of people fleeing the disease and implied established Central American illegal trafficking networks could introduce the infected into the U.S., during remarks at a Tuesday panel on security issues in the Western Hemisphere at the National Defense University.
“If it comes to the Western Hemisphere, the countries that we’re talking about have almost no ability to deal with it — particularly in Haiti and Central America,” SOUTHCOM Commander, Marine Gen. John F. Kelly, said in response to a question of his near term concerns in the region.
“It will make the 68,000 unaccompanied minors look like a small problem.”
An Ebola outbreak could encourage the poor and increasingly desperate populations in Central American countries — like Honduras, Guatemala and El Salvador — to leave in droves.
“I think you’ve seen this so many times in the past, when in doubt, take off,” he said.
Though an ocean away from Ebola hotspots in Africa, a growing numbers of West Africans are using the illicit trafficking routes through Central America to enter the U.S. illegally and could introduce the disease in the U.S.
Kelly stressed through out the panel session at NDU how effective the criminal transportation networks were at moving people and material into the U.S.
“We see a lot of West Africans moving in that network,” he said.
Kelly passed on a story from a border checkpoint in Costa Rica — told to him by an American embassy official — in which five or six men from Liberia were waiting to cross into Nicaragua.
The group had flown into Trinidad and then traveled to Costa Rica hoping to travel up the Central American isthmus and into the U.S.
Given the length of the journey, “they could have been in New York City well within the incubation period for Ebola,” Kelly said.
The realities of a potential outbreak caused Kelly to ask his staff to start thinking about the affects to the SOUTHCOM area of operations (AO) and pay attention to the response of U.S. Africa Command (AFRICOM).
The U.S. has sent 4,000 troops to West Africa to assist countries in dealing with the Ebola outbreaks in the region.
“The five services of the U.S. military will get it done and be a large solution to this problem,” Kelly said.
In the meantime, SOUTHCOM is regular contact with AFRICOM in the event of the worst-case outcome.
“We’re watching what AFRICOM is doing and their plan will be our plan,” Kelly said.
“The nightmare scenario, I think, is right around the corner.”
October 8, 2014 The first patient to be diagnosed with Ebola in the United States has died, Texas Health Presbyterian Hospital said Wednesday.
The news of Thomas Eric Duncan’s passing comes as those he came into contact with enter a critical period this week in determining whether they have also contracted the deadly virus.
Duncan, 42, was diagnosed with Ebola on Sept. 30, after arriving in the U.S. from Liberia on Sept. 20. He first went to the Dallas hospital with a fever on Sept. 26, but was sent home,despite telling a nurse he came from the Ebola-stricken country. The information did not reach doctors at the hospital, and he was discharged with antibiotics. He returned to the hospital two days later and was placed in isolation.
Texas officials continue to monitor 10 people who had direct contact with him while he was symptomatic, as well as 38 others who may have had contact. None have shown symptoms of the disease up to this point.
The incubation period of Ebola is a maximum of 21 days, with symptoms commonly beginning to present eight to 10 days after exposure. If Duncan passed the virus onto anyone else, that would likely become evident this week.
If any show signs of a fever, or other symptoms, health officials plan to immediately isolate and test those individuals for the virus.
Duncan was in serious condition until this past weekend, when his condition was changed to critical, and he was given the experimental drug brincidofovir, an oral medicine developed by Chimerix. The Food and Drug Administration granted emergency authorization for the treatment; it had previously been tested against Ebola only in test-tube studies.
Duncan is the first patient to die of Ebola in the U.S. At least five patients already diagnosed with Ebola in West Africa had been taken to the U.S. for treatment. Two were treated and released from Emory University Hospital, one was treated and released from Nebraska Medical Center in Omaha, a fourth is currently in treatment at Emory, and a fifth is in treatment in Nebraska.
The current Ebola outbreak has killed more than 2,000 people in Duncan’s native Liberia, according to the latest estimates from the World Health Organization. There have been more than 3,400 total deaths in Liberia, Sierra Leone, and Guinea, and more than twice as many reported cases.
“It is with profound sadness and heartfelt disappointment that we must inform you of the death of Thomas Eric Duncan this morning at 7:51 a.m.,” the hospital said in a statement. “Mr. Duncan succumbed to an insidious disease, Ebola. He fought courageously in this battle. Our professionals, the doctors and nurses in the unit, as well as the entire Texas Health Presbyterian Hospital Dallas community, are also grieving his passing. We have offered the family our support and condolences at this difficult time.”
Duncan had reportedly come to the U.S. to marry his girlfriend, Louise Troh, from whom he had been separated for nearly two decades. Troh and three others who live in the apartment where Duncan stayed in Dallas remain in isolation.
Officials continue to closely monitor those who came into contact with Duncan, and they remain confident that an outbreak in the U.S. is unlikely.
The recent expansion of biocontainment laboratory capacity in the United States has drawn attention to the possibility of occupational exposures to BSL-3 and -4 agents and has prompted a reassessment of medical management procedures and facilities to deal with these contingencies. A workshop hosted by the National Interagency Biodefense Campus was held in October 2007 and was attended by representatives of all existing and planned BSL-4 research facilities in the U.S. and Canada. This report summarizes important points of discussion and recommendations for future coordinated action, including guidelines for the engineering and operational controls appropriate for a hospital care and isolation unit. Recommendations pertained to initial management of exposures (ie, immediate treatment of penetrating injuries, reporting of exposures, initial evaluation, and triage). Isolation and medical care in a referral hospital (including minimum standards for isolation units), staff recruitment and training, and community outreach also were addressed. Workshop participants agreed that any unit designated for the isolation and treatment of laboratory employees accidentally infected with a BSL-3 or -4 pathogen should be designed to maximize the efficacy of patient care while minimizing the risk of transmission of infection. Further, participants concurred that there is no medically based rationale for building care and isolation units to standards approximating a BSL-4 laboratory. Instead, laboratory workers accidentally exposed to pathogens should be cared for in hospital isolation suites staffed by highly trained professionals following strict infection control procedures.
The construction of a number of new federally funded biocontainment laboratories in response to the 2001 terror attacks, in compliance with Homeland Security Presidential Directives 10 and 18,1,2 has raised concerns that a significant expansion in the laboratory workforce will result in an increased number of accidental exposures, some of which might lead to actual infection.3 While it is true that accidental infections of laboratory workers studying pathogenic bacteria and viruses were at one time fairly common, their incidence has been markedly reduced as a result of the standardization of laboratory design, biosafety practices, and employee training, so that only a handful of cases have occurred in the past few decades.4
Much of this new capacity in Biosafety Level-4 (BSL-4) biocontainment laboratories will be centered on the National Interagency Biodefense Campus (NIBC) at Fort Detrick, which includes the existing United States Army Medical Research Institute of Infectious Diseases (USAMRIID) and a planned expansion, plus the National Institute of Allergy and Infectious Diseases (NIAID) Integrated Research Facility (NIAID-IRF) and a new Department of Homeland Security (DHS) laboratory, the National Biodefense Analysis and Countermeasures Center (NBACC). NIH also has upgraded the laboratory capacity at its Rocky Mountain Laboratories in Hamilton, Montana, by expanding the amount of Biosafety Level-3 (BSL-3) space and adding a new BSL-4 lab, and it is supporting the construction of National Biocontainment Laboratories at Boston University and at the University of Texas Medical Branch, Galveston, both of which will contain BSL-3 and -4 units. In anticipation of public concerns, the NIBC Executive Steering Committee tasked its Scientific Interactions Subcommittee with organizing a workshop to review procedures for dealing with accidental exposures in laboratories currently conducting research on highly pathogenic (BSL-3 and -4) agents and to recommend optimal strategies for their detection and management in the future expanded biodefense research community.
The first prototype Class III (maximum containment) biosafety cabinet was fashioned in 1943 by Hubert Kaempf Jr., then a U.S. Army soldier, under the direction of Dr. Arnold G. Wedum, Director (1944–69) of Industrial Health and Safety at the United States Army Biological Warfare Laboratories, Camp Detrick, Maryland. Kaempf was tired of his MP duties at Detrick and was able to transfer to the sheet metal department working with the contractor, the H.K. Ferguson Co.
On 18 April 1955, fourteen representatives met at Camp Detrick in Frederick, Maryland. The meeting was to share knowledge and experiences regarding biosafety, chemical, radiological, and industrial safety issues that were common to the operations at the three principal biological warfare (BW) laboratories of the U.S. Army.Because of the potential implication of the work conducted at biological warfare laboratories, the conferences were restricted to top level security clearances. Beginning in 1957, these conferences were planned to include non-classified sessions as well as classified sessions to enable broader sharing of biological safety information. It was not until 1964, however, that conferences were held in a government installation not associated with a biological warfare program.
Over the next ten years, the biological safety conferences grew to include representatives from all federal agencies that sponsored or conducted research with pathogenic microorganisms. By 1966 it began to include representatives from universities, private laboratories, hospitals, and industrial complexes. Throughout the 1970s, participation in the conferences continued to expand and by 1983 discussions began regarding the creation of a formal organization. The American Biological Safety Association (ABSA) was officially established in 1984 and a constitution and bylaws were drafted the same year. As of 2008, ABSA includes some 1,600 members in its professional association.
CDC technician dons an older-model positive-pressure suit before entering one of the CDC’s earlier maximum containment labs.
Biocontainment can be classified by the relative danger to the surrounding environment as biological safety levels (BSL). As of 2006, there are four safety levels. These are called BSL1 through BSL4, with one anomalous level BSL3-ag for agricultural hazards between BSL3 and BSL4. Facilities with these designations are also sometimes given as P1 through P4 (for Pathogen or Protection level), as in the term P3 laboratory. Higher numbers indicate a greater risk to the external environment. Seebiological hazard.
At the lowest level of biocontainment, the containment zone may only be a chemical fume hood. At the highest level the containment involves isolation of an organism by means of building systems, sealed rooms, sealed containers, positive pressure personnel suits (sometimes referred to as “space suits”) and elaborate procedures for entering the room, and decontamination procedures for leaving the room. In most cases this also includes high levels of security for access to the facility, ensuring that only authorized personnel may be admitted to any area that may have some effect on the quality of the containment zone. This is considered a hot zone.
Biosafety level 1
This level is suitable for work involving well-characterized agents not known to consistently cause disease in healthy adult humans, and of minimal potential hazard to laboratory personnel and the environment (CDC,1997).
It includes several kinds of bacteria and viruses including canine hepatitis, non-pathogenic Escherichia coli, as well as some cell cultures and non-infectious bacteria. At this level, precautions against the biohazardous materials in question are minimal and most likely involve gloves and some sort of facial protection. 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. Usually, contaminated materials are left in open (but separately indicated) waste receptacles. Decontamination procedures for this level are similar in most respects to modern precautions against everyday microorganisms (i.e., washing one’s hands with anti-bacterial soap, washing all exposed surfaces of the lab with disinfectants, etc.). In a lab environment all materials used for cell and/or bacteria cultures are decontaminated via autoclave. Laboratory personnel have specific training in the procedures conducted in the laboratory and are supervised by a scientist with general training in microbiology or a related science.
Laboratory personnel have specific training in handling pathogenic and potentially lethal agents, and are supervised by competent scientists who are experienced in working with these agents. This is considered a neutral or warm zone.
All procedures involving the manipulation of infectious materials are conducted within biological safety cabinets, specially designed hoods, or other physical containment devices, or by personnel wearing appropriate personal protective clothing and equipment. The laboratory has special engineering and design features.
It is recognized, however, that some existing facilities may not have all the facility features recommended for Biosafety Level 3 (i.e., double-door access zone and sealed penetrations). In this circumstance, an acceptable level of safety for the conduct of routine procedures, (e.g., diagnostic procedures involving the propagation of an agent for identification, typing, susceptibility testing, etc.), may be achieved in a biosafety level 2 (P2) facility, providing
the filtered exhaust air from the laboratory room is discharged to the outdoors,
the ventilation to the laboratory is balanced to provide directional airflow into the room,
access to the laboratory is restricted when work is in progress, and
the recommended Standard Microbiological Practices, Special Practices, and Safety Equipment for Biosafety Level 3 are rigorously followed.
The decision to implement this modification of biosafety level 3 recommendations is made only by the laboratory director.
This level is required for work with dangerous and exotic agents that pose a high individual risk of aerosol-transmitted laboratory infections, agents which cause severe to fatal disease in humans for which vaccines or other treatments are notavailable, such as Bolivian and Argentine hemorrhagic fevers, Marburg virus, Ebola virus, Lassa virus, Crimean-Congo hemorrhagic fever, and various other hemorrhagic diseases. This level is also used for work with agents such as smallpox that are considered dangerous enough to require the additional safety measures, regardless of vaccination availability. When dealing with biological hazards at this level the use of a positive pressure personnel suit, with a segregated air supply is mandatory. The entrance and exit of a level four biolab will contain multiple showers, a vacuum room, an ultraviolet light room, and other safety precautions designed to destroy all traces of the biohazard. Multiple airlocks are employed and are electronically secured to prevent both doors from opening at the same time. All air and water service going to and coming from a biosafety level 4 (or P4) lab will undergo similar decontamination procedures to eliminate the possibility of an accidental release.
Agents with a close or identical antigenic relationship to biosafety level 4 agents are handled at this level until sufficient data are obtained either to confirm continued work at this level, or to work with them at a lower level.
Members of the laboratory staff have specific and thorough training in handling extremely hazardous infectious agents and they understand the primary and secondary containment functions of the standard and special practices, the containment equipment, and the laboratory design characteristics. They are supervised by qualified scientists who are trained and experienced in working with these agents. Access to the laboratory is strictly controlled by the laboratory director.
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. A specific facility operations manual is prepared or adopted. Building protocols for preventing contamination often use negatively pressurized facilities, which, even if compromised, would severely inhibit an outbreak of aerosol pathogens.
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.
According to the U.S. Government Accountability Office (GAO) report published on October 4, 2007, a total of 1,356 CDC/USDA registered BSL-3 facilities were identified throughout the United States (GAO-08-108T ). This represents a very conservative estimate of the number of facilities in the US in 2007. Approximately 36% of these laboratories are located in academia. Only 15 BSL-4 facilities were identified in the U.S. in 2007, including nine at federal labs.
The following is a list of existing BSL-4 facilities worldwide.
Virology Laboratory of the Queensland Department of Health
Wuhan Institute of Virology already hosts a BSL-3 laboratory. A distinct BSL-4 facility is currently being built based on P4 standards, the original technology for confinement developed by France. It will be the first at level 4 in China, under the direction of Shi Zhengli.
The “National Institute of Infectious Diseases” used to operate within the Lazzaro Spallanzani hospital; the facility is now independent and is home to five BSL-3 labs as well as a single BSL-4 laboratory, which was completed in 1997. 
Located at National Institute for Infectious Diseases, Department of Virology I; this lab has the potential of operating as a BSL-4, however it is limited to perform work on only BSL-3 agents due to opposition from local residents and communities.
(CNN) — [Breaking news update, posted at 3:28 p.m. ET]
The body of Thomas Eric Duncan, who died in Texas from Ebola, will be cremated, state health officials said Wednesday.
Pastor George Mason of Wilshire Baptist Church in Dallas said Wednesday that he told Duncan’s partner of his death. “It was a painful and difficult time for her. She reacted as almost anyone would, with great shock and despair. She expressed that in her own personal way, with great emotion,” Mason told reporters.
Duncan’s family members were devastated upon learning of his death, Mason said, and worried that “this will be the course that their life will take next.”
Duncan’s partner responded with many “what ifs” about his care when she learned about his death from Ebola, Mason said.
“She is not seeking to create any kinds of divisions in our community over this. She certainly, like all of us, would want to see justice done. She wants to see that people are treated well and treated fairly, and that includes Mr. Duncan. But this is a human drama. It’s not a political drama. … It is a drama of human grief,” Mason said.
A memorial for Duncan be held Wednesday evening, Mason said. The event was originally planned as a prayer vigil, but will now be a memorial for Duncan, Mason said.
[Previous story, posted at 2:49 p.m. ET]
(CNN) — Thomas Eric Duncan, a man with Ebola who traveled to the United States from Liberia, died Wednesday morning at Texas Health Presbyterian Hospital in Dallas, the hospital said.
He had been in critical condition after being diagnosed with the virus in mid-September. People who had contact with the 42-year-old Liberian national are being monitored for symptoms.
Louise Troh, Duncan’s longtime partner, said through a public relations firm that she believes “a thorough examination will take place regarding all aspects of his care.”
“I am now dealing with the sorrow and anger that his son was not able to see him before he died,” Troh said. “This will take some time, but in the end, I believe in a merciful God.”
Did Duncan know he had Ebola?
U.S. to check travelers for fevers
Some members of Duncan’s family are being monitored for the virus — their temperatures taken twice daily — to make sure they don’t have symptoms. Ebola can take 21 days to show itself. The U.S. Centers for Disease Control and Prevention said that as of Tuesday, they had not shown any symptoms.
Several who have had contact with him were moved to a secure location Friday.
After word of the death, CNN correspondent Gary Tuchman went to a Dallas apartment where Duncan’s family members were previously and spoke with the adult daughter of Duncan’s partner.
The daughter, Youngor Jallah, is not considered to have come into contact with Duncan. She was crying and declined to speak, though she did say the family had received a call from the hospital and knew that Duncan had died.
Five Dallas schoolchildren who possibly had contact with Duncan remain on the school district’s homebound program during the 21-day wait, and none are showing symptoms, the district said Wednesday.
It has just been a little over a week since Duncan was hospitalized for treatment.
Those days have been an “enormous test of our health system,” said Dr. David Lakey, the commissioner of the Texas Department of State Health Services.
“For one family it has been far more personal,” he said in a statement. “Today they lost a dear member of their family. They have our sincere condolences, and we are keeping them in our thoughts.”
He vowed that health care workers will continue to try to stop the spread of the virus “and protect people from this threat.”
The Ebola virus can live in dead bodies, the CDC says, and it can be transmitted after death if the body is cut, body fluids are splashed, or if the body is handled. Only personnel trained in handling infected human remains, wearing protective gear, should touch or move Ebola-infected remains, the agency says. An autopsy should be avoided, it says, but if one is necessary, the CDC should be consulted.
New measures at U.S. airports to screen for people possibly carrying the Ebola virus will include taking passengers’ temperatures and handing them questionnaires, according to a federal official and a second person briefed on an announcement the federal government plans to make Wednesday.
The enhanced methods, focused on people coming from West African nations hit by the Ebola crisis, will begin soon at New York’s JFK airport and then expand to four other major international airports: Newark, Chicago, Washington Dulles and Atlanta.
A federal official says the enhanced screening will apply only to passengers arriving from Sierra Leone, Guinea and Liberia.
The new measures at U.S. airports come a day after Dr. Thomas Frieden, the director of the CDC, told reporters that devising travel guidelines was in the works but nothing had yet been finalized enough to announce.
The Ebola virus can spread through contact with bodily fluids — blood, sweat, feces, vomit, semen and saliva — and only by someone who is showing symptoms, according to the CDC.
People with Ebola may not be symptomatic for up to 21 days.
Symptoms generally occur abruptly eight to 10 days after infection, though that period can range from two to 21 days, health officials say.
Air travelers must keep in mind that Ebola is not transmitted through the air, said Dr. Marty Cetron, director of the CDC’s Division of Global Migration and Quarantine.
“There needs to be direct contact frequently with body fluids or blood,” he stressed.
Questions about Duncan’s case
Duncan came to the U.S. to visit family and friends, departing Liberia on September 19, according to the CDC. It was his first trip to America, his half-brother Wilfred Smallwood said. Liberian authorities said he was screened for Ebola before flying.
It’s unclear how he got Ebola, but witnesses have said that he had been helping victims of the virus in Liberia, and The New York Times said he’d had direct contact with an Ebola-stricken pregnant woman. Duncan answered “no” to questions about whether he’d cared for someone with the virus.
His symptoms first appeared “four to five days” after he landed in the U.S., Frieden said.
Duncan went to Texas Health Presbyterian Hospital after 10 p.m. on September 25 and was treated for a fever, vomiting and abdominal pain — all symptoms of Ebola — but he was sent home with antibiotics and a pain reliever and was not screened for Ebola.
He returned two days later and was then tested for Ebola, after which his treatment at the hospital began.
There are a lot of questions about the handling of Duncan’s case.
Dr. Alex Van Tulleken, an expert in tropical diseases at Fordham University in New York who is not involved in the case, said on CNN on Wednesday that the two-day lag time could have been “significant.”
Cases in Europe
Meanwhile, Frederic Vincent, a spokesman for the European Commission, told CNN on Wednesday that there have been eight confirmed cases of Ebola in European countries. There is one case in the United Kingdom that has been treated and the person has recovered; one case in France like that; two cases in Germany in which patients are receiving treatment; and three cases in Spain: two deceased Spanish missionaries and a nurse’s assistant who is being treated.
There is also a case in which a Norwegian staffer with Doctors Without Borders is being treated, he said.
Also in Spain, health officials said four more potential Ebola cases — in addition to the nurse’s assistant — are under observation.
The nurse’s assistant said that she had no idea how she had contracted the virus, but a doctor treating her said that she may have been exposed while she removed her protective suit.
Dr. German Ramirez said the assistant, who is in isolation at Madrid’s Carlos III Hospital, had told him it was possible that a part of the suit — possibly the gloves — touched her face.
On Wednesday, top British officials discussed ways to contain the virus. Prime Minister David Cameron, who led the meeting, received the latest updates about the United Kingdom’s efforts in Sierra Leone, where it has provided support. The UK will also deploy 750 defense personnel to help establish the Ebola treatment centers.
The globe’s largest outbreak of Ebola has killed more than 3,400 people in Guinea, Liberia and Sierra Leone. Since March, more than 7,400 people have contracted Ebola in those nations, according to the World Health Organization.
Steven Jay Hatfill (born October 24, 1953) is an American physician, virologist and bio-weapons expert who underwent what was considered by many[who?] to be a trial by media with great toll on his personal and professional life. After eight months of pressure from the media and amateur detectives, the US Department of Justice identified the former government scientist as a “person of interest” in its investigation of the 2001 anthrax attacks. FBIsearches of his apartment in July and August 2002 were well-attended by journalists, many of whom had been pointing at Hatfill for months. Hatfill later sued the government for ruining his reputation, a case which the government settled for US$ 5.8 million. He also filed lawsuits against several periodicals that had identified him as a figure warranting further investigation. Hatfill’s lawsuit against The New York Times was dismissed on the grounds that he was a “public figure” and malice had not been proven. His lawsuit against Vanity Fair and Reader’s Digest was settled out of court, and the details were not disclosed. FBI and DOJ officials later blamed another government scientist, Bruce Edwards Ivins, although questions about the validity of that assertion have persisted.
Hatfill was enlisted as a private in the U.S. Army from 1975 to 1977. (In 1999, he would tell a journalist during an interview that he had been a “captain in the U.S. Special Forces“, but in a subsequent investigation the Army stated that he had never served with the Special Forces.) Following his Army discharge, Hatfill qualified and worked as a medical laboratory technician, but soon resolved to become a doctor.
By this time there had been a number of hoax anthrax mailings in the United States. Hatfill and his collaborator, SAIC vice president Joseph Soukup, commissioned William C. Patrick, retired head of the old US bioweapons program (who had also been a mentor of Hatfill) to write a report on the possibilities of terrorist anthrax mailing attacks. Barbara Hatch Rosenberg (director of the Federation of American Scientists‘ biochem weapons working group in 2002) said that the report was commissioned “under a CIA contract to SAIC”. However, SAIC said Hatfill and Soukup commissioned it internally — there was no outside client.
The resulting report, dated February 1999, was subsequently seen by some as a “blueprint” for the 2001 anthrax attacks. Amongst other things, it suggested the maximum amount of anthrax powder – 2.5 grams – that could be put in an envelope without making a suspicious bulge. The quantity in the envelope sent to Senator Patrick Leahy in October 2001 was .871 grams. After the attacks, the report drew the attention of the media and others, and led to their investigation of Patrick and Hatfill.
Assertions by Rosenberg
In October 2001, as soon as it became known that the Ames strain of anthrax had been used in the attacks, Dr. Barbara Hatch Rosenberg and others began suggesting that the attack might be the work of a “rogue CIA agent”, and they provided the name of the “most likely” person to the FBI. On November 21, 2001, Rosenberg made similar statements to the Biological and Toxic Weapons convention in Geneva. In December 2001, she published “A Compilation of Evidence and Comments on the Source of the Mailed Anthrax” via the web site of the Federation of American Scientists (FAS) suggesting the attacks were “perpetrated with the unwitting assistance of a sophisticated government program”.
Rosenberg discussed the case with reporters from the New York Times. On January 4, 2002, Nicholas Kristof of the New York Times published a column titled “Profile of a Killer” stating “I think I know who sent out the anthrax last fall.” For months, Rosenberg gave speeches and stated her beliefs to many reporters from around the world. She posted “Analysis of the Anthrax Attacks” to the FAS web site on January 17, 2002. On February 5, 2002 she published an article called “Is the FBI Dragging Its Feet?” At the time, the FBI denied reports that investigators had identified a chief suspect, saying “There is no prime suspect in this case at this time.”The Washington Post reported that “FBI officials over the last week have flatly discounted Dr. Rosenberg’s claims.”
On June 13, 2002, Rosenberg posted “The Anthrax Case: What the FBI Knows” to the FAS site. On June 18, 2002, Rosenberg presented her theories to senate staffers working for Senators Daschle and Leahy. One week later, on June 25, the FBI publicly searched Hatfill’s apartment, turning him into a household name. “The FBI also pointed out that Hatfill had agreed to the search and is not considered a suspect.” Both The American Prospect and Salon.com reported that “Hatfill is not a suspect in the anthrax case, the FBI says.” On August 3, 2002, Rosenberg told the media that the FBI asked her if “a team of government scientists could be trying to frame Steven J. Hatfill.”
Person of interest
In August 2002, Attorney GeneralJohn Ashcroft labeled Hatfill a “person of interest” in a press conference, although no charges were brought against him. Hatfill, a virologist, vehemently denied he had anything to do with the anthrax (bacteria) mailings and sued the FBI, the Justice Department, John Ashcroft, Alberto Gonzales, and others for violating his constitutional rights and for violating the Privacy Act. On June 27, 2008, the Department of Justice announced it would settle Hatfill’s case for $5.8 million.
Hatfill later went to work at Pennington Biomedical Research Center in Baton Rouge, LA. In September 2001 SAIC was commissioned by the Pentagon to create a replica of a mobile WMD “laboratory”, alleged to have been used by Saddam Hussein, who was President of Iraq at the time. The Pentagon claimed the trailer was to be used as a training aid for teams seeking weapons of mass destruction in Iraq.
His lawyer, Victor M. Glasberg, stated: “Steve’s life has been devastated by a drumbeat of innuendo, implication and speculation. We have a frightening public attack on an individual who, guilty or not, should not be exposed to this type of public opprobrium based on speculation.”
In an embarrassing incident, FBI agents trailing Hatfill in a motor vehicle ran over his foot when he attempted to approach them in May 2003. Police responding to the incident did not cite the driver, but issued Hatfill a citation for “walking to create a hazard”. He and his attorneys fought the ticket, but a hearing officer upheld the ticket and ordered Hatfill to pay the requisite $5 fine.
FBI Director Robert S. Mueller III changed leadership of the investigation in late 2006, and at that time another suspect, USAMRIIDbacteriologistBruce Ivins, became the main focus of the investigation. Considerable questions have been raised, however, about the credibility of the case against Ivins as well.
60 Minutes interview
Hatfill’s lawyer, Tom Connolly, was featured in a CBS News60 Minutes interview about the anthrax incidents on March 11, 2007. In the interview it was revealed that Hatfill forged a Ph.D. degree certificate. “It is true. It is true that he has puffed on his resume. Absolutely”, Connolly acknowledged. “Forged a diploma. Yes, that’s true.” He went on to state, “Listen, if puffing on your resume made you the anthrax killer, then half this town should be suspect.”
The New York Times stated in their paper that Hatfill had obtained an anti-anthrax medicine (ciprofloxacin) immediately prior to the anthrax mailings. Connolly explained, “Before the attacks he had surgery. So yes, he’s on Cipro. But the fuller truth is in fact he was on Cipro because a doctor gave it to him after sinus surgery”. Hatfill had previously said the antibiotic was for a lingering sinus infection. The omission in the Times’ article, of the reason why he had been taking Cipro, is one reason Hatfill sued the newspaper. The newspaper won a summary judgment ruling in early 2007, squelching the libel suit that had been filed by Steven Hatfill against it and columnist Nicholas Kristof.
On March 30, 2007, US District Judge Reggie Walton issued an order warning Hatfill that he could lose his civil lawsuit over the leaks if he did not compel journalists to name their sources. He gave Hatfill until April 16 to decide whether to press the journalists to give up their sources.
On April 16, Hatfill gave notice that he would “proceed with discovery to attempt to obtain the identity of the alleged source or sources at the Department of Justice and the Federal Bureau of Investigation who allegedly provided information to news reporters concerning the criminal investigation of Dr. Hatfill.”
On April 27, 2007, in the U.S. District Court for the District of Columbia, federal prosecutors[clarification needed] wrote that Steven Hatfill had overstepped court orders allowing him to compel testimony from reporters whom he had already questioned and had instead “served a new round of subpoenas” on organizations “that he failed to question during the discovery period.”
The Justice Department responded to Hatfill’s subpoenas, saying that they went too far. “The court should reject this attempt to expand discovery,” prosecutors wrote. In a status conference on Friday 11 January 2008, U.S. District Judge Reggie B. Walton ordered the attorneys for the government and for Hatfill to seek mediation over the next two months. According to the Scheduling Order, the parties will be in mediation from January 14 until May 14, 2008. The prospects of a mediated settlement notwithstanding, Walton said he expected that a trial on the lawsuit could begin in December. Afterward, Hatfill’s attorney Mark A. Grannis said: “The court has set a schedule for bringing this case to trial this year, and we’re very pleased at the prospect that Dr. Hatfill will finally have his day in court.”
On March 7, 2008, Toni Locy of USA Today was ordered to personally pay contempt of court fines of up to $5,000 a day which begin the following Tuesday, until she identifies her sources.
On June 27, 2008 Hatfill was exonerated by the government and a settlement was announced in which the Justice Department has agreed to pay $4.6 million (consisting of $2.825 million in cash and an annuity paying $150,000 a year for 20 years) to settle the lawsuit in which Hatfill claimed the Justice Department violated his privacy rights by speaking with reporters about the case.
In a sealed motion on December 29, 2006, The New York Times argued that the classification restrictions imposed on the case were tantamount to an assertion of the state secrets privilege. Times attorneys cited the case law on state secrets to support their argument that the case should be dismissed. The “state secrets” doctrine, they said, “precludes a case from proceeding to trial when national security precludes a party from obtaining evidence that is… necessary to support a valid defense. Dismissal is warranted in this case because the Times has been denied access to such evidence, specifically documents and testimony concerning the work done by plaintiff [Hatfill] on classified government projects relating to bioweapons, including anthrax.”
A redacted copy of the December 29, 2006 New York Times Memorandum of Law in Support of Defendant’s Motion for an Order Dismissing the Complaint Under the “State Secrets” Doctrine was obtained by Secrecy News.
Attorneys for Hatfill filed a sealed response on January 12, 2007 in opposition to the motion for dismissal on state secrets grounds. A redacted copy of their opposition has been made available by Secrecy News.
On January 12, 2007, a judge dismissed a lawsuit filed by Hatfill against The New York Times.
On January 30, 2007, Judge Hilton’s order dismissing the Hatfill v. The New York Times was made public, along with a Memorandum Opinion explaining his ruling.Kenneth A. Richieri, Vice President and General Counsel of The New York Times scored what he called a “very satisfying win” at the beginning of 2007 in the Eastern District of Virginia. The newspaper won a summary judgment ruling squelching a libel suit that had been filed by anthrax poisoning “person of interest” Steven Hatfill against it and columnist Nicholas Kristof.
The US Court of Appeals for the Fourth Circuit reversed the trial court, ruling that a jury should decide that issue. In March 2008, the Supreme Court refused to grant certiorari in the case, effectively leaving the appeals court decision in place.
The case was dismissed in a Summary Judgment on January 12, 2007. The appeals were heard on March 21, 2008, and the dismissal was upheld by the appeals court on July 14, 2008. The case was appealed to the U.S. Supreme Court and was rejected by the Supreme Court on Dec. 15, 2008. The basis for the dismissal was that Dr. Hatfill was a “public figure”, and he had not proved malice on the part of The New York Times.
Hatfill v. Foster
Donald Foster, an expert in forensic linguistics, advised the FBI during the investigation of the anthrax attacks. He later wrote an article for Vanity Fair about his investigation of Hatfill. In the October 2003 article Foster described how he had tried to match up Hatfill’s travels with the postmarks on the anthrax letters, and analyzed old interviews and an unpublished novel by Hatfill about a bioterror attack on the United States. Foster wrote that “When I lined up Hatfill’s known movements with the postmark locations of reported biothreats, those hoax anthrax attacks appeared to trail him like a vapor cloud”.
Story 1: Is The Ebola Dallas Strain (EDS), an airborne, contagious, incurable and lethal virus mutation, now the source of a world-wide pandemic? — The American People Demand To Be Told The Truth — Videos
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CDC: Airborne Ebola possible but unlikely
By Elise Viebeck
The Ebola virus becoming airborne is a possible but unlikely outcome in the current epidemic, Centers for Disease Control and Prevention (CDC) Director Tom Frieden said Tuesday.
The outbreak involves Ebola Zaire, a strain that is passed through bodily fluids, not the air. But some experts have expressed fear about viral mutations due to the unprecedented — and rising — number of Ebola cases.
Frieden sought to allay those fears during a call with reporters.
“The rate of change [with Ebola] is slower than most viruses, and most viruses don’t change how they spread,” he said. Frieden is unofficially spearheading the U.S. response to Ebola.
“That is not to say it’s impossible that it could change [to become airborne],” he continued. “That would be the worst-case scenario. We would know that by looking at … what is happening in Africa. That is why we have scientists from the CDC on the ground tracking that.”
A change in the way Ebola spreads would make the virus significantly more dangerous. The disease kills roughly half the people it infects, and lacking a vaccine or cure, its traceable chain of transmission through bodily fluids is one reason officials believe they can contain it.
Still, there is almost no precedent for a human virus mutating to become transmissible in a different way, a key piece of evidence in weighing whether that kind of shift is likely for Ebola.
“We have so many problems with Ebola, let’s not make another one that, of course, is theoretically possible but is pretty way down on the list of likely issues,” infectious diseases expert William Schaffner of Vanderbilt University told Scientific American.
Frieden touted new progress against Ebola in West Africa and Dallas, where a Liberian man remains in critical condition, but warned that “globally, this is going to be a long, hard fight.”
The Dallas patient interacted with 10 definite and 38 possible interlocturos who are now being monitored, he said. None have shown symptoms.
Some Ebola experts worry virus may spread more easily than assumed
Ebola could be spread through air in tight quarters, some scientists fear
Some Ebola experts worry that the virus may spread more easily than thought — through the air in small spaces, for example.
By DAVID WILLMAN contact the reporter NationMedical ResearchAfricaScientific ResearchDiseases and IllnessesEbolaU.S. Centers for Disease Control and Prevention
Ebola researcher says he would not rule out possibility that the virus spreads through air in tight quarters
‘There are too many unknowns here,’ a virologist says of how Ebola may spread
Ebola researcher says he thinks there is a chance asymptomatic people could spread the virus
U.S. officials leading the fight against history’s worst outbreak of Ebola have said they know the ways the virus is spread and how to stop it. They say that unless an air traveler from disease-ravaged West Africa has a fever of at least 101.5 degrees or other symptoms, co-passengers are not at risk.
“At this point there is zero risk of transmission on the flight,” Dr. Thomas Frieden, director of the federal Centers for Disease Control and Prevention, said after a Liberian man who flew through airports in Brussels and Washington was diagnosed with the disease last week in Dallas.
First Ebola infection outside West Africa
Three more people have been hospitalized in Madrid for possible exposure to the Ebola virus after a Spanish nurse tested positive for the virus.
Other public health officials have voiced similar assurances, saying Ebola is spread only through physical contact with a symptomatic individual or their bodily fluids. “Ebola is not transmitted by the air. It is not an airborne infection,” said Dr. Edward Goodman of Texas Health Presbyterian Hospital in Dallas, where the Liberian patient remains in critical condition.
Yet some scientists who have long studied Ebola say such assurances are premature — and they are concerned about what is not known about the strain now on the loose. It is an Ebola outbreak like none seen before, jumping from the bush to urban areas, giving the virus more opportunities to evolve as it passes through multiple human hosts.
Dr. C.J. Peters, who battled a 1989 outbreak of the virus among research monkeys housed in Virginia and who later led the CDC’s most far-reaching study of Ebola’s transmissibility in humans, said he would not rule out the possibility that it spreads through the air in tight quarters.
“We just don’t have the data to exclude it,” said Peters, who continues to research viral diseases at the University of Texas in Galveston.
Dr. Philip K. Russell, a virologist who oversaw Ebola research while heading the U.S. Army’s Medical Research and Development Command, and who later led the government’s massive stockpiling of smallpox vaccine after the Sept. 11 terrorist attacks, also said much was still to be learned. “Being dogmatic is, I think, ill-advised, because there are too many unknowns here.”
If Ebola were to mutate on its path from human to human, said Russell and other scientists, its virulence might wane — or it might spread in ways not observed during past outbreaks, which were stopped after transmission among just two to three people, before the virus had a greater chance to evolve. The present outbreak in West Africa has killed approximately 3,400 people, and there is no medical cure for Ebola.
“I see the reasons to dampen down public fears,” Russell said. “But scientifically, we’re in the middle of the first experiment of multiple, serial passages of Ebola virus in man…. God knows what this virus is going to look like. I don’t.”
A resident looks from behind a gate during the Liberian government’s 11-day Ebola quarantine in the West Point district of Monrovia.
Tom Skinner, a spokesman for the CDC in Atlanta, said health officials were basing their response to Ebola on what has been learned from battling the virus since its discovery in central Africa in 1976. The CDC remains confident, he said, that Ebola is transmitted principally by direct physical contact with an ill person or their bodily fluids.
Skinner also said the CDC is conducting ongoing lab analyses to assess whether the present strain of Ebola is mutating in ways that would require the government to change its policies on responding to it. The results so far have not provided cause for concern, he said.
The researchers reached in recent days for this article cited grounds to question U.S. officials’ assumptions in three categories.
One issue is whether airport screenings of prospective travelers to the U.S. from West Africa can reliably detect those who might have Ebola. Frieden has said the CDC protocols used at West African airports can be relied on to prevent more infected passengers from coming to the U.S.
“One hundred percent of the individuals getting on planes are screened for fever before they get on the plane,” Frieden said Sept. 30. “And if they have a fever, they are pulled out of the line, assessed for Ebola, and don’t fly unless Ebola is ruled out.”
Individuals who have flown recently from one or more of the affected countries suggested that travelers could easily subvert the screening procedures — and might have incentive to do so: Compared with the depleted medical resources in the West African countries of Liberia, Sierra Leone and Guinea, the prospect of hospital care in the U.S. may offer an Ebola-exposed person the only chance to survive.
U.S. To Increase Airport Screening For Ebola
The deteriorating conditions in Africa make it more likely additional cases of Ebola will appear in the United States and officials are pushing for increased screenings at airports.
A person could pass body temperature checks performed at the airports by taking ibuprofen or any common analgesic. And prospective passengers have much to fear from identifying themselves as sick, said Kim Beer, a resident of Freetown, the capital of Sierra Leone, who is working to get medical supplies into the country to cope with Ebola.
“It is highly unlikely that someone would acknowledge having a fever, or simply feeling unwell,” Beer said via email. “Not only will they probably not get on the flight — they may even be taken to/required to go to a ‘holding facility’ where they would have to stay for days until it is confirmed that it is not caused by Ebola. That is just about the last place one would want to go.”
Liberian officials said last week that the patient hospitalized in Dallas, Thomas Eric Duncan, did not report to airport screeners that he had had previous contact with an Ebola-stricken woman. It is not known whether Duncan knew she suffered from Ebola; her family told neighbors it was malaria.
The potential disincentive for passengers to reveal their own symptoms was echoed by Sheka Forna, a dual citizen of Sierra Leone and Britain who manages a communications firm in Freetown. Forna said he considered it “very possible” that people with fever would medicate themselves to appear asymptomatic.
It would be perilous to admit even nonspecific symptoms at the airport, Forna said in a telephone interview. “You’d be confined to wards with people with full-blown disease.”
On Monday, the White House announced that a review was underway of existing airport procedures. Frieden and President Obama’s assistant for homeland security and counter-terrorism, Lisa Monaco, said Friday that closing the U.S. to passengers from the Ebola-affected countries would risk obstructing relief efforts.
CDC officials also say that asymptomatic patients cannot spread Ebola. This assumption is crucial for assessing how many people are at risk of getting the disease. Yet diagnosing a symptom can depend on subjective understandings of what constitutes a symptom, and some may not be easily recognizable. Is a person mildly fatigued because of short sleep the night before a flight — or because of the early onset of disease?
Moreover, said some public health specialists, there is no proof that a person infected — but who lacks symptoms — could not spread the virus to others.
“It’s really unclear,” said Michael Osterholm, a public health scientist at the University of Minnesota who recently served on the U.S. government’s National Science Advisory Board for Biosecurity. “None of us know.”
Russell, who oversaw the Army’s research on Ebola, said he found the epidemiological data unconvincing.
“The definition of ‘symptomatic’ is a little difficult to deal with,” he said. “It may be generally true that patients aren’t excreting very much virus until they become ill, but to say that we know the course of [the virus' entry into the bloodstream] and the course of when a virus appears in the various secretions, I think, is premature.”
The CDC’s Skinner said that while officials remained confident that Ebola can be spread only by the overtly sick, the ongoing studies would assess whether mutations that might occur could increase the potential for asymptomatic patients to spread it.
Finally, some also question the official assertion that Ebola cannot be transmitted through the air. In late 1989, virus researcher Charles L. Bailey supervised the government’s response to an outbreak of Ebola among several dozen rhesus monkeys housed for research in Reston, Va., a suburb of Washington.
What Bailey learned from the episode informs his suspicion that the current strain of Ebola afflicting humans might be spread through tiny liquid droplets propelled into the air by coughing or sneezing.
“We know for a fact that the virus occurs in sputum and no one has ever done a study [disproving that] coughing or sneezing is a viable means of transmitting,” he said. Unqualified assurances that Ebola is not spread through the air, Bailey said, are “misleading.”
Peters, whose CDC team studied cases from 27 households that emerged during a 1995 Ebola outbreak in Democratic Republic of Congo, said that while most could be attributed to contact with infected late-stage patients or their bodily fluids, “some” infections may have occurred via “aerosol transmission.”
Ailing in Monrovia, Liberia
Relatives pray over a weak Siata Johnson, 23, outside the Ebola treatment center at a hospital on the outskirts of Monrovia, Liberia. (John Moore / Getty Images)
Skinner of the CDC, who cited the Peters-led study as the most extensive of Ebola’s transmissibility, said that while the evidence “is really overwhelming” that people are most at risk when they touch either those who are sick or such a person’s vomit, blood or diarrhea, “we can never say never” about spread through close-range coughing or sneezing.
“I’m not going to sit here and say that if a person who is highly viremic … were to sneeze or cough right in the face of somebody who wasn’t protected, that we wouldn’t have a transmission,” Skinner said.
Peters, Russell and Bailey, who in 1989 was deputy commander for research of the Army’s Medical Research Institute of Infectious Diseases, in Frederick, Md., said the primates in Reston had appeared to spread Ebola to other monkeys through their breath.
The Ebola strain found in the monkeys did not infect their human handlers. Bailey, who now directs a biocontainment lab at George Mason University in Virginia, said he was seeking to research the genetic differences between the Ebola found in the Reston monkeys and the strain currently circulating in West Africa.
Though he acknowledged that the means of disease transmission among the animals would not guarantee the same result among humans, Bailey said the outcome may hold lessons for the present Ebola epidemic.
“Those monkeys were dying in a pattern that was certainly suggestive of coughing and sneezing — some sort of aerosol movement,” Bailey said. “They were dying and spreading it so quickly from cage to cage. We finally came to the conclusion that the best action was to euthanize them all.”
Dallas County Judge Clay Jenkins pulled into the Ivy Apartments community late in the evening Friday wearing suit pants and a lavender dress shirt.
There were hazardous materials trucks all around, as cleaning crews had arrived to remove materials that might have been touched by Thomas Duncan, a Liberian man who is hospitalized in Texas with Ebola. The hazmat workers were covered from head to toe in bright yellow body suits, green gloves and breathing masks.
Jenkins walked into the apartment in building No. 6 to greet Louise Troh, her family and others who live with her and had been court-ordered to stay in their home because they were considered high risk after coming into contact with Duncan.
It was time to move, and Troh, her 13-year old son, a relative of Duncan’s and another man — all of whom lived in the apartment — got into the judge’s car for the 45-minute drive to their new, temporary home, in an undisclosed part of Dallas.
Jenkins, the judge, never covered up.
“I’m a married man with a little girl,” Jenkins told reporters later that night. “I’m wearing the same shirt I was when I was in the car with that family.
“I was in their house next to those materials, meeting with them, listening to them, and assuring them last night and again of course today. If there were any risk, I would not expose myself or my family to that risk.”
He added: “There is zero risk.”
In the face of widespread fear — and in some cases misinformation — about Ebola following the first diagnosis of the virus in the United States, Dallas officials have taken a notable visual approach to make the point that, at least right now, the city is safe.
The Ebola outbreak in West Africa has reached the United States, as officials confirm one case in Dallas. Here’s how U.S. health officials plan to stop the virus. (Gillian Brockell and Jorge Ribas/The Washington Post)
On a daily basis, workers monitoring the temperatures and health of as many as nine individuals who they believe might have had direct contact with Duncan have entered those people’s homes with no gloves, no masks and no personal protective equipment whatsoever.
And city officials including Jenkins, Dallas Mayor Mike Rawlings and Dallas County Health and Human Services Director Zachary Thompson have interacted with the family no differently that they might have if the four people who are in a state of semi-isolation had been suspected of having come into contact with somebody sick with the flu.
“Based on our assessment, they were asymptomatic; therefore, I didn’t feel they posed any threat to me,” Thompson said in an interview with The Washington Post on Monday. “There is a standard procedure for when they should be using the PPE’s (personal protective equipment). In this case we knew our nurses, our staff, had assessed that they were asymptomatic.”
So far, none of the people who have potentially had contact with Duncan are showing any symptoms, Thompson said.
Yet concern and stigma are widespread in Dallas.
Photographs from Liberia, Sierra Leone and Guinea — where the epidemic is spiraling out of control — frequently show fully masked health workers carrying infected people to hospitals or burial sites. Those images have become closely associated with the virus and the outbreak in the public’s mind.
And for one day, similar images briefly appeared in Dallas as cleaning crews removed materials from Troh’s apartment that might have come into contact with the virus.
A hazmat team arrives on Oct. 3 to clean a unit at the Dallas apartment complex where the confirmed Ebola patient was staying. (Joe Raedle/Getty Images)
The decision for the crew to wear personal protective equipment was made by the company, the “Cleaning Guys,” according to Dallas officials.
“We train for this type of thing,” company executive Brad Smith told ABC News. “Obviously, we haven’t trained for Ebola because there hasn’t been a situation in Texas until now.”
The Ebola virus is not very hearty outside of the human body.
Still, touching and destroying potentially infected materials is far different from speaking to or being in the same room with people who might have been exposed to the virus.
And public health expert Gavin Macgregor-Skinner, who worked in Nigeria to end that country’s outbreak, said that treating people with a sense of humanity and not feeding hysteria is critical to managing the Dallas Ebola case and others that might occur around the world.
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“Even in West Africa when we do contact tracing, we don’t put on personal protective equipment,” said Macgregor-Skinner, an assistant professor in the Department of Public Health Sciences at the Penn State Milton S. Hershey Medical Center. “We have the six-feet rule: We stay about six feet away from people and I can interview them and I can make them feel like people.
“If they have no symptoms, we need to make them feel normal, like they’re part of the community, like they are still loved.”
Dallas officials have also urged residents to go about their normal activities and attend community gatherings and fairs without fear.
“The broader perspective is that we had done immediate disease tracking and contact tracing and the family had been identified who had had close contact and they had not shown any symptoms,” said Thompson. “Other than that one case, basically, his virus has been contained.”
‘In 1976 I discovered Ebola – now I fear an unimaginable tragedy’
Peter Piot was a researcher at a lab in Antwerp when a pilot brought him a blood sample from a Belgian nun who had fallen mysteriously ill in Zaire
Professor Peter Piot, the Director of the London School of Hygiene and Tropical Medicine: ‘Around June it became clear to me there was something different about this outbreak. I began to get really worried’ Photograph: Leon Neal/AFP
Professor Piot, as a young scientist in Antwerp, you were part of the team that discovered the Ebola virus in 1976. How did it happen?
I still remember exactly. One day in September, a pilot from Sabena Airlines brought us a shiny blue Thermos and a letter from a doctor in Kinshasa in what was then Zaire. In the Thermos, he wrote, there was a blood sample from a Belgian nun who had recently fallen ill from a mysterious sickness in Yambuku, a remote village in the northern part of the country. He asked us to test the sample for yellow fever.
These days, Ebola may only be researched in high-security laboratories. How did you protect yourself back then?
We had no idea how dangerous the virus was. And there were no high-security labs in Belgium. We just wore our white lab coats and protective gloves. When we opened the Thermos, the ice inside had largely melted and one of the vials had broken. Blood and glass shards were floating in the ice water. We fished the other, intact, test tube out of the slop and began examining the blood for pathogens, using the methods that were standard at the time.
But the yellow fever virus apparently had nothing to do with the nun’s illness.
No. And the tests for Lassa fever and typhoid were also negative. What, then, could it be? Our hopes were dependent on being able to isolate the virus from the sample. To do so, we injected it into mice and other lab animals. At first nothing happened for several days. We thought that perhaps the pathogen had been damaged from insufficient refrigeration in the Thermos. But then one animal after the next began to die. We began to realise that the sample contained something quite deadly.
But you continued?
Other samples from the nun, who had since died, arrived from Kinshasa. When we were just about able to begin examining the virus under an electron microscope, the World Health Organisation instructed us to send all of our samples to a high-security lab in England. But my boss at the time wanted to bring our work to conclusion no matter what. He grabbed a vial containing virus material to examine it, but his hand was shaking and he dropped it on a colleague’s foot. The vial shattered. My only thought was: “Oh, shit!” We immediately disinfected everything, and luckily our colleague was wearing thick leather shoes. Nothing happened to any of us.
In the end, you were finally able to create an image of the virus using the electron microscope.
Yes, and our first thought was: “What the hell is that?” The virus that we had spent so much time searching for was very big, very long and worm-like. It had no similarities with yellow fever. Rather, it looked like the extremely dangerous Marburg virus which, like ebola, causes a haemorrhagic fever. In the 1960s the virus killed several laboratory workers in Marburg, Germany.
Were you afraid at that point?
I knew almost nothing about the Marburg virus at the time. When I tell my students about it today, they think I must come from the stone age. But I actually had to go the library and look it up in an atlas of virology. It was the American Centres for Disease Control which determined a short time later that it wasn’t the Marburg virus, but a related, unknown virus. We had also learned in the meantime that hundreds of people had already succumbed to the virus in Yambuku and the area around it.
A few days later, you became one of the first scientists to fly to Zaire.
Yes. The nun who had died and her fellow sisters were all from Belgium. In Yambuku, which had been part of the Belgian Congo, they operated a small mission hospital. When the Belgian government decided to send someone, I volunteered immediately. I was 27 and felt a bit like my childhood hero, Tintin. And, I have to admit, I was intoxicated by the chance to track down something totally new.
A girl is led to an ambulance after showing signs of Ebola infection in the village of Freeman Reserve, 30 miles north of the Liberian capital, Monrovia. Photograph: Jerome Delay/APWas there any room for fear, or at least worry?
Of course it was clear to us that we were dealing with one of the deadliest infectious diseases the world had ever seen – and we had no idea that it was transmitted via bodily fluids! It could also have been mosquitoes. We wore protective suits and latex gloves and I even borrowed a pair of motorcycle goggles to cover my eyes. But in the jungle heat it was impossible to use the gas masks that we bought in Kinshasa. Even so, the Ebola patients I treated were probably just as shocked by my appearance as they were about their intense suffering. I took blood from around 10 of these patients. I was most worried about accidentally poking myself with the needle and infecting myself that way.
But you apparently managed to avoid becoming infected.
Well, at some point I did actually develop a high fever, a headache and diarrhoea …
… similar to Ebola symptoms?
Exactly. I immediately thought: “Damn, this is it!” But then I tried to keep my cool. I knew the symptoms I had could be from something completely different and harmless. And it really would have been stupid to spend two weeks in the horrible isolation tent that had been set up for us scientists for the worst case. So I just stayed alone in my room and waited. Of course, I didn’t get a wink of sleep, but luckily I began feeling better by the next day. It was just a gastrointestinal infection. Actually, that is the best thing that can happen in your life: you look death in the eye but survive. It changed my whole approach, my whole outlook on life at the time.
You were also the one who gave the virus its name. Why Ebola?
On that day our team sat together late into the night – we had also had a couple of drinks – discussing the question. We definitely didn’t want to name the new pathogen “Yambuku virus”, because that would have stigmatised the place forever. There was a map hanging on the wall and our American team leader suggested looking for the nearest river and giving the virus its name. It was the Ebola river. So by around three or four in the morning we had found a name. But the map was small and inexact. We only learned later that the nearest river was actually a different one. But Ebola is a nice name, isn’t it?
In the end, you discovered that the Belgian nuns had unwittingly spread the virus. How did that happen?
In their hospital they regularly gave pregnant women vitamin injections using unsterilised needles. By doing so, they infected many young women in Yambuku with the virus. We told the nuns about the terrible mistake they had made, but looking back I would say that we were much too careful in our choice of words. Clinics that failed to observe this and other rules of hygiene functioned as catalysts in all additional Ebola outbreaks. They drastically sped up the spread of the virus or made the spread possible in the first place. Even in the current Ebola outbreak in westAfrica, hospitals unfortunately played this ignominious role in the beginning.
After Yambuku, you spent the next 30 years of your professional life devoted to combating Aids. But now Ebola has caught up to you again. American scientists fear that hundreds of thousands of people could ultimately become infected. Was such an epidemic to be expected?
No, not at all. On the contrary, I always thought that Ebola, in comparison to Aids or malaria, didn’t present much of a problem because the outbreaks were always brief and local. Around June it became clear to me that there was something fundamentally different about this outbreak. At about the same time, the aid organisation Médecins Sans Frontières sounded the alarm. We Flemish tend to be rather unemotional, but it was at that point that I began to get really worried.
Why did WHO react so late?
On the one hand, it was because their African regional office isn’t staffed with the most capable people but with political appointees. And the headquarters in Geneva suffered large budget cuts that had been agreed to by member states. The department for haemorrhagic fever and the one responsible for the management of epidemic emergencies were hit hard. But since August WHO has regained a leadership role.
There is actually a well-established procedure for curtailing Ebola outbreaks: isolating those infected and closely monitoring those who had contact with them. How could a catastrophe such as the one we are now seeing even happen?
I think it is what people call a perfect storm: when every individual circumstance is a bit worse than normal and they then combine to create a disaster. And with this epidemic there were many factors that were disadvantageous from the very beginning. Some of the countries involved were just emerging from terrible civil wars, many of their doctors had fled and their healthcare systems had collapsed. In all of Liberia, for example, there were only 51 doctors in 2010, and many of them have since died of Ebola.
The fact that the outbreak began in the densely populated border region between Guinea, Sierra Leone and Liberia …
… also contributed to the catastrophe. Because the people there are extremely mobile, it was much more difficult than usual to track down those who had had contact with the infected people. Because the dead in this region are traditionally buried in the towns and villages they were born in, there were highly contagious Ebola corpses travelling back and forth across the borders in pickups and taxis. The result was that the epidemic kept flaring up in different places.
For the first time in its history, the virus also reached metropolises such as Monrovia and Freetown. Is that the worst thing that can happen?
In large cities – particularly in chaotic slums – it is virtually impossible to find those who had contact with patients, no matter how great the effort. That is why I am so worried about Nigeria as well. The country is home to mega-cities like Lagos and Port Harcourt, and if the Ebola virus lodges there and begins to spread, it would be an unimaginable catastrophe.
Have we completely lost control of the epidemic?
I have always been an optimist and I think that we now have no other choice than to try everything, really everything. It’s good that the United States and some other countries are finally beginning to help. But Germany or even Belgium, for example, must do a lot more. And it should be clear to all of us: This isn’t just an epidemic any more. This is a humanitarian catastrophe. We don’t just need care personnel, but also logistics experts, trucks, jeeps and foodstuffs. Such an epidemic can destabilise entire regions. I can only hope that we will be able to get it under control. I really never thought that it could get this bad.
What can really be done in a situation when anyone can become infected on the streets and, like in Monrovia, even the taxis are contaminated?
We urgently need to come up with new strategies. Currently, helpers are no longer able to care for all the patients in treatment centres. So caregivers need to teach family members who are providing care to patients how to protect themselves from infection to the extent possible. This on-site educational work is currently the greatest challenge. Sierra Leone experimented with a three-day curfew in an attempt to at least flatten out the infection curve a bit. At first I thought: “That is totally crazy.” But now I wonder, “why not?” At least, as long as these measures aren’t imposed with military power.
A three-day curfew sounds a bit desperate.
Yes, it is rather medieval. But what can you do? Even in 2014, we hardly have any way to combat this virus.
Do you think we might be facing the beginnings of a pandemic?
There will certainly be Ebola patients from Africa who come to us in the hopes of receiving treatment. And they might even infect a few people here who may then die. But an outbreak in Europe or North America would quickly be brought under control. I am more worried about the many people from India who work in trade or industry in west Africa. It would only take one of them to become infected, travel to India to visit relatives during the virus’s incubation period, and then, once he becomes sick, go to a public hospital there. Doctors and nurses in India, too, often don’t wear protective gloves. They would immediately become infected and spread the virus.
The virus is continually changing its genetic makeup. The more people who become infected, the greater the chance becomes that it will mutate …
… which might speed its spread. Yes, that really is the apocalyptic scenario. Humans are actually just an accidental host for the virus, and not a good one. From the perspective of a virus, it isn’t desirable for its host, within which the pathogen hopes to multiply, to die so quickly. It would be much better for the virus to allow us to stay alive longer.
Could the virus suddenly change itself such that it could be spread through the air?
Like measles, you mean? Luckily that is extremely unlikely. But a mutation that would allow Ebola patients to live a couple of weeks longer is certainly possible and would be advantageous for the virus. But that would allow Ebola patients to infect many, many more people than is currently the case.
But that is just speculation, isn’t it?
Certainly. But it is just one of many possible ways the virus could change to spread itself more easily. And it is clear that the virus is mutating.
You and two colleagues wrote a piece for the Wall Street Journalsupporting the testing of experimental drugs. Do you think that could be the solution?
Patients could probably be treated most quickly with blood serum from Ebola survivors, even if that would likely be extremely difficult given the chaotic local conditions. We need to find out now if these methods, or if experimental drugs like ZMapp, really help. But we should definitely not rely entirely on new treatments. For most people, they will come too late in this epidemic. But if they help, they should be made available for the next outbreak.
Testing of two vaccines is also beginning. It will take a while, of course, but could it be that only a vaccine can stop the epidemic?
I hope that’s not the case. But who knows? Maybe.
In Zaire during that first outbreak, a hospital with poor hygiene was responsible for spreading the illness. Today almost the same thing is happening. Was Louis Pasteur right when he said: “It is the microbes who will have the last word”?
Of course, we are a long way away from declaring victory over bacteria and viruses. HIV is still here; in London alone, five gay men become infected daily. An increasing number of bacteria are becoming resistant to antibiotics. And I can still see the Ebola patients in Yambuku, how they died in their shacks and we couldn’t do anything except let them die. In principle, it’s still the same today. That is very depressing. But it also provides me with a strong motivation to do something. I love life. That is why I am doing everything I can to convince the powerful in this world to finally send sufficient help to west Africa. Now!
The virus may be acquired upon contact with blood or bodily fluids of an infected human or other animal. Spreading through the air has not been documented in the natural environment.Fruit bats are believed to be a carrier and may spread the virus without being affected. Once human infection occurs, the disease may spread between people, as well. Male survivors may be able to transmit the disease via semen for nearly two months. To make the diagnosis, typically other diseases with similar symptoms such as malaria, cholera and other viral hemorrhagic fevers are first excluded. To confirm the diagnosis, blood samples are tested for viral antibodies, viralRNA, or the virus itself.
Outbreak control require community engagement, case management, surveillance and contact tracing, a good laboratory service, and safe burials. Prevention includes decreasing the spread of disease from infected animals to humans. This may be done by checking such animals for infection and killing and properly disposing of the bodies if the disease is discovered. Properly cooking meat and wearing protective clothing when handling meat may also be helpful, as are wearing protective clothing and washing hands when around a person with the disease. Samples of bodily fluids and tissues from people with the disease should be handled with special caution.
Heavy bleeding is rare and is usually confined to the gastrointestinal tract. In general, the development of bleeding symptoms often indicates a worse prognosis and this blood loss can result in death. All people infected show some signs of circulatory system involvement, including impaired blood clotting. If the infected person does not recover, death due to multiple organ dysfunction syndrome occurs within 7 to 16 days (usually between days 8 and 9) after first symptoms.
EVD is caused by four of five viruses classified in the genus Ebolavirus, family Filoviridae, order Mononegavirales. The four disease-causing viruses are Bundibugyo virus (BDBV), Sudan virus (SUDV), Taï Forest virus (TAFV), and one called, simply, Ebola virus (EBOV, formerly Zaire Ebola virus)). Ebola virus is the sole member of the Zaire ebolavirus species and the most dangerous of the known Ebola disease-causing viruses, as well as being responsible for the largest number of outbreaks. The fifth virus, Reston virus (RESTV), is not thought to be disease-causing in humans. These five viruses are closely related to the Marburg viruses.
Human-to-human transmission can occur via direct contact with blood or bodily fluids from an infected person (including embalming of an infected dead person) or by contact with objects contaminated by the virus, particularly needles and syringes. Other body fluids with ebola virus include saliva, mucus, vomit, feces, sweat, tears, breast milk, urine, and semen. Entry points include the nose, mouth, eyes, or open wounds, cuts and abrasions. The potential for widespread EVD infections is considered low as the disease is only spread by direct contact with the secretions from someone who is showing signs of infection. The symptoms limit a person’s ability to spread the disease as they are often too sick to travel. Because dead bodies are still infectious, traditional burial rituals may spread the disease. Nearly two thirds of the cases of Ebola in Guinea during the 2014 outbreak are believed to be due to burial practices. Semen may be infectious in survivors for up to 7 weeks. It is not entirely clear how an outbreak is initially started. The initial infection is believed to occur after ebola virus is transmitted to a human by contact with an infected animal’s body fluids.
One of the primary reasons for spread is that the health systems in the part of Africa where the disease occurs function poorly. Medical workers who do not wear appropriate protective clothing may contract the disease.Hospital-acquired transmission has occurred in African countries due to the reuse of needles and lack of universal precautions. Some healthcare centers caring for people with the disease do not have running water.
Airborne transmission has not been documented during EVD outbreaks. They are, however, infectious as breathable 0.8– to 1.2-μm laboratory-generated droplets. The virus has been shown to travel, without contact, from pigs to primates, although the same study failed to demonstrate similar transmission between non-human primates.
Bats drop partially eaten fruits and pulp, then land mammals such as gorillas and duikers feed on these fallen fruits. This chain of events forms a possible indirect means of transmission from the natural host to animal populations, which has led to research towards viral shedding in the saliva of bats. Fruit production, animal behavior, and other factors vary at different times and places that may trigger outbreaks among animal populations.
Bushmeat being prepared for cooking in Ghana, 2013. Human consumption of equatorial animals in Africa in the form of bushmeat has been linked to the transmission of diseases to people, including Ebola.
Bats are considered the most likely natural reservoir of the EBOV. Plants, arthropods, and birds were also considered. Bats were known to reside in the cotton factory in which the first cases for the 1976 and 1979 outbreaks were observed, and they have also been implicated in Marburg virus infections in 1975 and 1980. Of 24 plant species and 19 vertebrate species experimentally inoculated with EBOV, only bats became infected. The absence of clinical signs in these bats is characteristic of a reservoir species. In a 2002–2003 survey of 1,030 animals including 679 bats from Gabon and the Republic of the Congo, 13 fruit bats were found to contain EBOV RNA fragments. As of 2005, three types of fruit bats (Hypsignathus monstrosus, Epomops franqueti, and Myonycteris torquata) have been identified as being in contact with EBOV. They are now suspected to represent the EBOV reservoir hosts. Antibodies against Zaire and Reston viruses have been found in fruit bats in Bangladesh, thus identifying potential virus hosts and signs of the filoviruses in Asia.
Between 1976 and 1998, in 30,000 mammals, birds, reptiles, amphibians and arthropods sampled from outbreak regions, no ebolavirus was detected apart from some genetic traces found in six rodents (Mus setulosus andPraomys) and one shrew (Sylvisorex ollula) collected from the Central African Republic. Traces of EBOV were detected in the carcasses of gorillas and chimpanzees during outbreaks in 2001 and 2003, which later became the source of human infections. However, the high lethality from infection in these species makes them unlikely as a natural reservoir.
Transmission between natural reservoir and humans is rare, and outbreaks are usually traceable to a single case where an individual has handled the carcass of gorilla, chimpanzee or duiker. Fruit bats are also eaten by people in parts of West Africa where they are smoked, grilled or made into a spicy soup.
Like all mononegaviruses, ebolavirions contain linear nonsegmented, single-strand, non-infectious RNAgenomes of negative polarity that possesses inverse-complementary 3′ and 5′ termini, do not possess a 5′ cap, are notpolyadenylated, and are not covalently linked to a protein. Ebolavirus genomes are approximately 19 kilobase pairs long and contain seven genes in the order 3′-UTR-NP-VP35-VP40-GP-VP30-VP24-L-5′-UTR. The genomes of the five different ebolaviruses (BDBV, EBOV, RESTV, SUDV, and TAFV) differ in sequence and the number and location of gene overlaps.
Like all filoviruses, ebolavirions are filamentous particles that may appear in the shape of a shepherd’s crook or in the shape of a “U” or a “6”, and they may be coiled, toroid, or branched. In general, ebolavirions are 80 nm in width, but vary somewhat in length. In general, the median particle length of ebolaviruses ranges from 974 to 1,086 nm (in contrast to marburgvirions, whose median particle length was measured at 795–828 nm), but particles as long as 14,000 nm have been detected in tissue culture.
The ebolavirus life cycle begins with virion attachment to specific cell-surface receptors, followed by fusion of the virion envelope with cellular membranes and the concomitant release of the virus nucleocapsid into the cytosol. The viral RNA polymerase, encoded by the L gene, partially uncoats the nucleocapsid and transcribes the genes into positive-strand mRNAs, which are then translated into structural and nonstructural proteins. Ebolavirus RNA polymerase (L) binds to a single promoter located at the 3′ end of the genome. Transcription either terminates after a gene or continues to the next gene downstream. This means that genes close to the 3′ end of the genome are transcribed in the greatest abundance, whereas those toward the 5′ end are least likely to be transcribed. The gene order is, therefore, a simple but effective form of transcriptional regulation. The most abundant protein produced is the nucleoprotein, whose concentration in the cell determines when L switches from gene transcription to genome replication. Replication results in full-length, positive-strand antigenomes that are, in turn, transcribed into negative-strand virus progeny genome copy. Newly synthesized structural proteins and genomes self-assemble and accumulate near the inside of the cell membrane. Virions bud off from the cell, gaining their envelopes from the cellular membrane they bud from. The mature progeny particles then infect other cells to repeat the cycle. The Ebola virus genetics are difficult to study due to its virulent nature.
Endothelial cells, macrophages, monocytes, and liver cells are the main targets of infection. After infection, a secreted glycoprotein (sGP) known as the Ebola virus glycoprotein (GP) is synthesized. Ebola replication overwhelms protein synthesis of infected cells and host immune defenses. The GP forms a trimeric complex, which binds the virus to the endothelial cells lining the interior surface of blood vessels. The sGP forms a dimeric protein that interferes with the signaling of neutrophils, a type of white blood cell, which allows the virus to evade the immune system by inhibiting early steps of neutrophil activation. These white blood cells also serve as carriers to transport the virus throughout the entire body to places such as the lymph nodes, liver, lungs, and spleen.
The presence of viral particles and cell damage resulting from budding causes the release of chemical signals (to be specific, TNF-α, IL-6, IL-8, etc.), which are the signaling molecules for fever and inflammation. The cytopathic effect, from infection in the endothelial cells, results in a loss of vascular integrity. This loss in vascular integrity is furthered with synthesis of GP, which reduces specific integrins responsible for cell adhesion to the inter-cellular structure, and damage to the liver, which leads to improper clotting.
The travel and work history along with exposure to wildlife are important to consider when the diagnosis of EVD is suspected. The diagnosis is confirmed by isolating the virus, detecting its RNA or proteins, or detecting antibodiesagainst the virus in a person’s blood. Isolating the virus by cell culture, detecting the viral RNA by polymerase chain reaction (PCR) and detecting proteins by enzyme-linked immunosorbent assay (ELISA) works best early and in those who have died from the disease. Detecting antibodies against the virus works best late in the disease and in those who recover.
During an outbreak, virus isolation is often not feasible. The most common diagnostic methods are therefore real-time PCR and ELISA detection of proteins, which can be performed in field or mobile hospitals. Filovirions can be seen and identified in cell culture by electron microscopy due to their unique filamentous shapes, but electron microscopy cannot tell the difference between the various filoviruses despite there being some length differences.
Phylogenetic tree comparing the Ebolavirus and Marburgvirus. Numbers indicate percent confidence of branches.
The genera Ebolavirus and Marburgvirus were originally classified as the species of the now-obsolete Filovirus genus. In March 1998, the Vertebrate Virus Subcommittee proposed in the International Committee on Taxonomy of Viruses (ICTV) to change the Filovirus genus to the Filoviridae family with two specific genera: Ebola-like viruses andMarburg-like viruses. This proposal was implemented in Washington, DC, on April 2001 and in Paris on July 2002. In 2000, another proposal was made in Washington, D.C., to change the “-like viruses” to “-virus” resulting in today’s Ebolavirus and Marburgvirus.
The risk of transmission is increased among those caring for people infected. Recommended measures when caring for those who are infected include isolating them, sterilizing equipment and surfaces, and wearing protective clothing including masks, gloves, gowns, and goggles. If a person with Ebola dies, direct contact with the body of the deceased patient should be avoided.
In order to reduce the spread, the World Health Organization recommends raising community awareness of the risk factors for Ebola infection and the protective measures individuals can take. These include avoiding contact with infected people and regular hand washing using soap and water. Traditional burial rituals, especially those requiring washing or embalming of bodies, should be discouraged or modified. Social anthropologists may help find alternatives to traditional rules for burials. Airline crews are instructed to isolate anyone who has symptoms resembling Ebola virus.
The Ebola virus can be eliminated with heat (heating for 30 to 60 minutes at 60 °C or boiling for 5 minutes). On surfaces, some lipid solvents such as some alcohol-based products, detergents, sodium hypochlorite (bleach) or calcium hypochlorite (bleaching powder), and other suitable disinfectants at appropriate concentrations can be used as disinfectants.
Quarantine, also known as enforced isolation, is usually effective in decreasing spread. Governments often quarantine areas where the disease is occurring or individuals who may be infected. In the United States, the law allows quarantine of those infected with Ebola. During the 2014 outbreak, Liberia closed schools.
Contact tracing is regarded as important to contain an outbreak. It involves finding everyone who had close contact with infected individuals and watching for signs of illness for 21 days. If any of these contacts comes down with the disease, they should be isolated, tested, and treated. Then repeat the process by tracing the contacts’ contacts.
A hospital isolation ward in Gulu, Uganda, during the October 2000 outbreak
The disease has a high mortality rate: often between 25 percent and 90 percent. As of September 2014, information from WHO across all occurrences to date puts the overall fatality rate at 50%. There are indications based on variations in death rate between countries that early and effective treatment of symptoms (e.g., supportive care to prevent dehydration) may reduce the fatality rate significantly. If an infected person survives, recovery may be quick and complete. Prolonged cases are often complicated by the occurrence of long-term problems, such as inflammation of the testicles, joint pains, muscle pains, skin peeling, or hair loss. Eye symptoms, such as light sensitivity, excess tearing, iritis, iridocyclitis, choroiditis, and blindness have also been described. EBOV and SUDV may be able to persist in the semen of some survivors for up to seven weeks, which could give rise to infections and disease via sexual intercourse.
The first identified case of Ebola was on 26 August 1976, in Yambuku, a small rural village in Mongala District in northern Democratic Republic of the Congo (then known as Zaire). The first victim, and the index case for the disease, was village school headmaster Mabalo Lokela, who had toured an area near the Central African Republic border along the Ebola river between 12–22 August. On 8 September he died of what would become known as the Ebola virus species of the ebolavirus. Subsequently a number of other cases were reported, almost all centered on the Yambuku mission hospital or having close contact with another case. 318 cases and 280 deaths (a 88% fatality rate) occurred in the DRC. The Ebola outbreak was contained with the help of the World Health Organization and transport from the Congolese air force, by quarantining villagers, sterilizing medical equipment, and providing protective clothing. The virus responsible for the initial outbreak, first thought to be Marburg virus, was later identified as a new type of virus related to Marburg, and named after the nearby Ebola river. Another ebolavirus, the Sudan virus species, was also identified that same year when an outbreak occurred in Sudan, affecting 284 people and killing 151.
1995 to 2013
The second major outbreak occurred in 1995 in the Democratic Republic of Congo, affecting 315 and killing 254. The next major outbreak occurred in Uganda in 2000, affecting 425 and killing 224; in this case the Sudan virus was found to be the ebolavirus species responsible for the outbreak. In 2003 there was an outbreak in the Republic of Congo that affected 143 and killed 128, a death rate of 90%, the highest to date.
In August 2007, 103 people were infected by a suspected hemorrhagic fever outbreak in the village of Kampungu, Democratic Republic of the Congo. The outbreak started after the funerals of two village chiefs, and 217 people in four villages fell ill. The 2007 outbreak eventually affected 264 individuals and resulted in the deaths of 187.
On 30 November 2007, the Uganda Ministry of Health confirmed an outbreak of Ebola in the Bundibugyo District in Western Uganda. After confirmation of samples tested by the United States National Reference Laboratories and the Centers for Disease Control, the World Health Organization confirmed the presence of a new species of Ebolavirus, which was tentatively named Bundibugyo. The WHO reported 149 cases of this new strain and 37 of those led to deaths.
The WHO confirmed two small outbreaks in Uganda in 2012. The first outbreak affected 7 people and resulted in the death of 4 and the second affected 24, resulting in the death of 17. The Sudan variant was responsible for both outbreaks.
On 17 August 2012, the Ministry of Health of the Democratic Republic of the Congo reported an outbreak of the Ebola-Bundibugyo variant in the eastern region. Other than its discovery in 2007, this was the only time that this variant has been identified as the ebolavirus responsible for an outbreak. The WHO revealed that the virus had sickened 57 people and claimed 29 lives. The probable cause of the outbreak was tainted bush meat hunted by local villagers around the towns of Isiro and Viadana.
Increase over time in the cases and deaths during the 2014 outbreak
In March 2014, the World Health Organization (WHO) reported a major Ebola outbreak in Guinea, a western African nation. Researchers traced the outbreak to a two-year old child who died on 28 December 2013. The disease then rapidly spread to the neighboring countries of Liberia and Sierra Leone. It is the largest Ebola outbreak ever documented, and the first recorded in the region.
On 8 August 2014, the WHO declared the epidemic to be an international public health emergency. Urging the world to offer aid to the affected regions, the Director-General said, “Countries affected to date simply do not have the capacity to manage an outbreak of this size and complexity on their own. I urge the international community to provide this support on the most urgent basis possible.” By mid-August 2014, Doctors Without Borders reported the situation in Liberia’s capital Monrovia as “catastrophic” and “deteriorating daily”. They reported that fears of Ebola among staff members and patients had shut down much of the city’s health system, leaving many people without treatment for other conditions. By late August 2014, the disease had spread to Nigeria, and one case was reported in Senegal. On 30 September 2014, the first confirmed case of Ebola was diagnosed in the United States at Texas Health Presbyterian Hospital in Dallas, Texas.
Aside from the human cost, the outbreak has severely eroded the economies of the affected countries. A Financial Times report suggested the economic impact of the outbreak could kill more people than the virus itself. As of 23 September, in the three hardest hit countries, Liberia, Sierra Leone, and Guinea, there were only 893 treatment beds available while the current need was 2122. In a 26 September statement, the WHO said, “The Ebola epidemic ravaging parts of West Africa is the most severe acute public health emergency seen in modern times. Never before in recorded history has a biosafety level four pathogen infected so many people so quickly, over such a broad geographical area, for so long.”
By 29 September 2014, 7,192 suspected cases and 3,286 deaths had been reported, however the World Health Organization has said that these numbers may be vastly underestimated. The WHO reports that more than 216 healthcare workers are among the dead, partly due to the lack of equipment and long hours.
For more about the outbreak in Virginia, US, see Reston virus.
Cases of ebola fever in Africa from 1979 to 2008.
The first recorded outbreak of EBD occurred in Southern Sudan in June 1976. A second outbreak soon followed in the Democratic Republic of the Congo (then Zaire). Virus isolated from both outbreaks was named “Ebola virus” by Belgian researchers after the Ebola River, located near the Zaire outbreak. Although it was assumed that the two outbreaks were connected, scientists later realized that they were caused by distinct species of filoviruses, Sudan virus and Ebola virus.
Shortly afterward, a US Army team headquartered at USAMRIID went into action to euthanize the monkeys which had not yet died, bringing those monkeys and those which had already died of the disease toFt. Detrick for study by the Army’s veterinary pathologists and virologists, and eventual disposal under safe conditions.
Blood samples were taken from 178 animal handlers during the incident. Of those, six animal handlers eventually seroconverted, including one who had cut himself with a bloody scalpel. When the handlers did not become ill, the CDC concluded that the virus had a very low pathogenicity to humans.
The Philippines and the United States had no previous cases of Ebola infection, and upon further isolation, researchers concluded it was another strain of Ebola, or a new filovirus of Asian origin, which they named Reston ebolavirus (REBOV) after the location of the incident.
It is widely believed that outbreaks of EVD among human populations result from handling infected wild animal carcasses. Some research suggests that an outbreak in the wild animals used for consumption, bushmeat, may result in a corresponding human outbreak. Since 2003, such outbreaks have been monitored through surveillance of animal populations with the aim of predicting and preventing Ebola outbreaks in humans.
Recovered carcasses from gorillas contain multiple Ebola virus strains, which suggest multiple introductions of the virus. Bodies decompose quickly and carcasses are not infectious after three to four days. Contact between gorilla groups is rare, suggesting transmission among gorilla groups is unlikely, and that outbreaks result from transmission between viral reservoir and animal populations.
Ebola has a high mortality among primates. Frequent outbreaks of Ebola may have resulted in the deaths of 5,000 gorillas. Outbreaks of Ebola may have been responsible for an 88% decline in tracking indices of observed chimpanzee populations in 420 square kilometer Lossi Sanctuary between 2002 and 2003. Transmission among chimpanzees through meat consumption constitutes a significant risk factor, while contact between individuals, such as touching dead bodies and grooming, is not.
Reston ebolavirus (REBOV) can be transmitted to pigs. This virus was discovered during an outbreak of what at the time was thought to be simian hemorrhagic fever virus (SHFV) in crab-eating macaques in Reston, Virginia (hence the name Reston elabavirus) in 1989. Since the initial outbreak it has since been found in nonhuman primates in Pennsylvania, Texas, and Italy. In each case, the affected animals had been imported from a facility in the Philippines, where the virus had infected pigs. Despite its status as a Level‑4organism and its apparent pathogenicity in monkeys, REBOV has not caused disease in exposed human laboratory workers. In 2012 it was demonstrated that the virus can travel without contact from pigs to nonhuman primates, although the same study failed to achieve transmission in that manner between primates. According to the WHO, routine cleaning and disinfection of pig (or monkey) farms with sodium hypochlorite or other detergents should be effective in inactivating the Reston ebolavirus. If an outbreak is suspected, the area must be immediately quarantined.
While pigs that have been infected with REBOV tend to show symptoms of the disease, it has been shown that dogs may become infected with EBOV and remain asymptomatic. Dogs in some parts of Africa scavenge for their food and it is known that they sometimes eat infected animals and the corpses of humans. Although they remain asymptomatic, a 2005 survey of dogs during an EBOV outbreak found that over 31.8% showed a seroprevalence for EBOV closest to an outbreak versus 9% a farther distance away.
A number of experimental treatments are being studied. In the United States, the Food and Drug Administration (FDA)’s animal efficacy rule is being used to demonstrate reasonable safety to obtain permission to treat people who are infected with Ebola. It is being used as the normal path for testing drugs is not possible for diseases caused by dangerous pathogens or toxins. Experimental drugs are made available for use with the approval of regulatory agencies under named patient programs, known in the US as “expanded access”. On 12 August 2014 the WHO released a statement that the use of not yet proven treatments is ethical in certain situations in an effort to treat or prevent the disease.
Researchers looking at slides of cultures of cells that make monoclonal antibodies. These are grown in a lab and the researchers are analyzing the products to select the most promising of them.
As of August 14, 2014, the United States Food and Drug Administration (FDA) has not approved any drugs to treat or prevent Ebola and advises people to watch out for fraudulent products. The unavailability of experimental treatments in the most affected regions during the 2014 outbreak spurred controversy, with some calling for experimental drugs to be made more widely available in Africa on a humanitarian basis, and others warning that making unproven experimental drugs widely available would be unethical, especially in light of past experimentation conducted in developing countries by Western drug companies.
ZMapp is a monoclonal antibody vaccine. The limited supply of the drug has been used to treat a small number of individuals infected with the Ebola virus. Although some of these have recovered the outcome is not consideredstatistically significant. ZMapp has proved effective in a trial involving Rhesus macaque monkeys.
A number of antiviral medications are being studied. Favipiravir, an anti-viral drug approved in Japan for stockpiling against influenza pandemics, appears to be useful in a mouse model of Ebola. On 4 October 2014, it was reported that a French nun who contracted Ebola while volunteering in Liberia was cured with Favipiravir treatment.BCX4430 is a broad-spectrum antiviral drug developed by BioCryst Pharmaceuticals and currently being researched as a potential treatment for Ebola by USAMRIID. The drug has been approved to progress to Phase 1 trials, expected late in 2014.Brincidofovir, another broad-spectrum antiviral drug, has been granted an emergency FDA approval as an investigational new drug for the treatment of Ebola, after it was found to be effective against Ebolavirus in in vitro tests. It has subsequently been used to treat the first patient diagnosed with Ebola in the USA, after he had recently returned from Liberia. The antiviral drug lamivudine, which is usually used to treat HIV / AIDS, was reported in September 2014 to have been used successfully to treat 13 out of 15 Ebola-infected patients by a doctor in Liberia, as part of a combination therapy also involving intravenous fluids and antibiotics to combat opportunistic bacterial infection of Ebola-compromised internal organs. Western virologists have however expressed caution about the results, due to the small number of patients treated and confounding factors present. Researchers at the NIH stated that lamivudine had so far failed to demonstrate anti-Ebola activity in preliminary in vitro tests, but that they would continue to test it under different conditions and would progress it to trials if even slight evidence for efficacy is found.
A 2014 study found that three ion channel blockers used in the treatment of heart arrhythmias, amiodarone, dronedarone and verapamil, block the entry of Ebolavirus into cells in vitro. Given their oral availability and history of human use, these drugs would be candidates for treating Ebola virus infection in remote geographical locations, either on their own or together with other antiviral drugs.
Melatonin has also been suggested as a potential treatment for Ebola based on promising in vitro results.
The WHO has stated that transfusion of whole blood or purified serum from Ebola survivors is the therapy with the greatest potential to be implemented immediately, although there is little information as to its efficacy. At the end of September, WHO issued an interim guideline for this therapy. The blood serum from those who have survived an infection is currently being studied to see if it is an effective treatment. During a meeting arranged by WHO this research was deemed to be a top priority. Seven of eight people with Ebola survived after receiving a transfusion of blood donated by individuals who had previously survived the infection in an 1999 outbreak in the Democratic Republic of the Congo. This treatment, however, was started late in the disease meaning they may have already been recovering on their own and the rest of their care was better than usual. Thus this potential treatment remains controversial.Intravenous antibodies appear to be protective in non-human primates who have been exposed to large doses of Ebola.The World Health Organisation has approved the use of convalescent serum and whole blood products to treat people with Ebola.
Vaccines have protected nonhuman primates. Immunization takes six months, which impedes the counter-epidemic use of the vaccines. Searching for a quicker onset of effectiveness, in 2003, a vaccine using an adenoviral (ADV) vector carrying the Ebola spike protein was tested on crab-eating macaques. Twenty-eight days later, they were challenged with the virus and remained resistant. A vaccine based on attenuated recombinant vesicular stomatitis virus (VSV) vector carrying either the Ebola glycoprotein or the Marburg glycoprotein in 2005 protected nonhuman primates, opening clinical trials in humans. The study by October completed the first human trial, over three months giving three vaccinations safely inducing an immune response. Individuals for a year were followed, and, in 2006, a study testing a faster-acting, single-shot vaccine began; this new study was completed in 2008. Trying the vaccine on a strain of Ebola that more resembles one that infects humans is the next step. On 6 December 2011, the development of a successfulvaccine against Ebola for mice was reported. Unlike the predecessors, it can be freeze-dried and thus stored for long periods in wait for an outbreak. An experimental vaccine made by researchers at Canada’s national laboratory in Winnipeg was used, in 2009, to pre-emptively treat a German scientist who might have been infected during a lab accident. However, actual EBOV infection was never demonstrated beyond doubt. Experimentally, recombinant vesicular stomatitis Indiana virus (VSIV) expressing the glycoprotein of EBOV or SUDV has been used successfully in nonhuman primate models as post-exposure prophylaxis. The CDC’s recommendations are currently under review.
Simultaneous phase 1 trials of an experimental vaccine known as the NIAID/GSK vaccine commenced in September 2014.GlaxoSmithKline and the NIH jointly developed the vaccine, based on a modified chimpanzee adenovirus, and contains parts of the Zaireand Sudan ebola strains. If this phase is completed successfully, the vaccine will be fast tracked for use in West Africa. In preparation for this, GSK is preparing a stockpile of 10,000 doses.
Jump up^Fisher-Hoch SP, Platt GS, Neild GH, Southee T, Baskerville A, Raymond RT, Lloyd G, Simpson DI (1985). “Pathophysiology of shock and hemorrhage in a fulminating viral infection (Ebola)”. J. Infect. Dis.152 (5): 887–894. doi:10.1093/infdis/152.5.887.PMID4045253.
Jump up^Pourrut X, Délicat A, Rollin PE, Ksiazek TG, Gonzalez JP, Leroy EM (2007). “Spatial and temporal patterns of Zaire ebolavirus antibody prevalence in the possible reservoir bat species”. The Journal of infectious diseases. Suppl 2 (s2): S176–S183.doi:10.1086/520541. PMID17940947.
Jump up^Morvan JM, Deubel V, Gounon P, Nakouné E, Barrière P, Murri S, Perpète O, Selekon B, Coudrier D, Gautier-Hion A, Colyn M, Volehkov V (1999). “Identification of Ebola virus sequences present as RNA or DNA in organs of terrestrial small mammals of the Central African Republic”. Microbes and Infection1 (14): 1193–1201. doi:10.1016/S1286-4579(99)00242-7.PMID10580275.
Jump up^Pringle, C. R. (2005). “Order Mononegavirales”. In Fauquet, C. M.; Mayo, M. A.; Maniloff, J.; Desselberger, U.; Ball, L. A. Virus Taxonomy – Eighth Report of the International Committee on Taxonomy of Viruses. San Diego, US: Elsevier/Academic Press. pp. 609–614. ISBN0-12-370200-3
^ Jump up to:abKiley MP, Bowen ET, Eddy GA, Isaäcson M, Johnson KM, McCormick JB, Murphy FA, Pattyn SR, Peters D, Prozesky OW, Regnery RL, Simpson DI, Slenczka W, Sureau P, van der Groen G, Webb PA, Wulff H (1982). “Filoviridae: A taxonomic home for Marburg and Ebola viruses?”. Intervirology18 (1–2): 24–32.doi:10.1159/000149300. PMID7118520.
Jump up^Feldmann, H.; Geisbert, T. W.; Jahrling, P. B.; Klenk, H.-D.; Netesov, S. V.; Peters, C. J.; Sanchez, A.; Swanepoel, R.; Volchkov, V. E. (2005). “Family Filoviridae”. In Fauquet, C. M.; Mayo, M. A.; Maniloff, J.; Desselberger, U.; Ball, L. A. Virus Taxonomy – Eighth Report of the International Committee on Taxonomy of Viruses. San Diego, US: Elsevier/Academic Press. pp. 645–653. ISBN0-12-370200-3
Jump up^Gear JH, Ryan J, Rossouw E (1978). “A consideration of the diagnosis of dangerous infectious fevers in South Africa”. South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde53 (7): 235–237. PMID565951.
Jump up^Grolla A, Lucht A, Dick D, Strong JE, Feldmann H (2005). “Laboratory diagnosis of Ebola and Marburg hemorrhagic fever”.Bulletin de la Societe de pathologie exotique (1990)98 (3): 205–209. PMID16267962.
Jump up^Bogomolov BP (1998). “Differential diagnosis of infectious diseases with hemorrhagic syndrome”. Terapevticheskii arkhiv70(4): 63–68. PMID9612907.
Jump up^Formenty P, Libama F, Epelboin A, Allarangar Y, Leroy E, Moudzeo H, Tarangonia P, Molamou A, Lenzi M, Ait-Ikhlef K, Hewlett B, Roth C, Grein T (2003). “[Outbreak of Ebola hemorrhagic fever in the Republic of the Congo, 2003: a new strategy?]“. Med Trop (Mars) (in French) 63 (3): 291–5.PMID14579469.
Jump up^Borio L, Inglesby T, Peters CJ, Schmaljohn AL, Hughes JM, Jahrling PB, Ksiazek T, Johnson KM, Meyerhoff A, O’Toole T, Ascher MS, Bartlett J, Breman JG, Eitzen EM, Hamburg M, Hauer J, Henderson DA, Johnson RT, Kwik G, Layton M, Lillibridge S, Nabel GJ, Osterholm MT, Perl TM, Russell P, Tonat K (2002). “Hemorrhagic fever viruses as biological weapons: medical and public health management”. Journal of the American Medical Association287 (18): 2391–405.doi:10.1001/jama.287.18.2391. PMID11988060.
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. PMID9988175.
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 Lancet375 (9729): 1896–1905. doi:10.1016/S0140-6736(10)60357-1.PMID20511019.
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 Medicine16 (9): 991–994.doi:10.1038/nm.2202. PMID20729866.
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. PMID24710028.
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. PMID25262626.