Good News and Bad News Concerning Ebola — 2 Nurses Ebola Free and 1 Doctor Has Confirmed Case of Ebola in New York City — Ebola Infected Dr. Craig Spencer Took A-Train, L-Train and High-Line – Went Bowling — Contact Tracing Begins — Airborne Ebola Theme Song — If I can make it there, I can make it anywhere, New York, New York — Videos

Posted on October 26, 2014. Filed under: American History, Biology, Blogroll, Chemistry, Communications, Demographics, Diasters, Disease, Documentary, Ebola, Education, Employment, Foreign Policy, Genocide, government, government spending, Health Care, history, Illegal, Immigration, Law, liberty, Life, Links, Literacy, media, Medical, People, Philosophy, Photos, Politics, Press, Programming, Psychology, Radio, Radio, Rants, Raves, Resources, Science, Strategy, Terrorism, Unemployment, Video, War, Wealth, Weapons of Mass Destruction, Weather, Welfare, Wisdom, Writing | Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |

Project_1

The Pronk Pops Show Podcasts

Pronk Pops Show 356: October 24, 2014

Pronk Pops Show 355: October 23, 2014

Pronk Pops Show 354: October 22, 2014

Pronk Pops Show 353: October 21, 2014

Pronk Pops Show 352: October 20, 2014

Pronk Pops Show 351: October 17, 2014

Pronk Pops Show 350: October 16, 2014

Pronk Pops Show 349: October 15, 2014

Pronk Pops Show 348: October 14, 2014

Pronk Pops Show 347: October 13, 2014

Pronk Pops Show 346: October 9, 2014

Pronk Pops Show 345: October 8, 2014

Pronk Pops Show 344: October 6, 2014

Pronk Pops Show 343: October 3, 2014

Pronk Pops Show 342: October 2, 2014

Pronk Pops Show 341: October 1, 2014

Pronk Pops Show 340: September 30, 2014

Pronk Pops Show 339: September 29, 2014

Pronk Pops Show 338: September 26, 2014

Pronk Pops Show 337: September 25, 2014

Pronk Pops Show 336: September 24, 2014

Pronk Pops Show 335: September 23 2014

Pronk Pops Show 334: September 22 2014

Pronk Pops Show 333: September 19 2014

Pronk Pops Show 332: September 18 2014

Pronk Pops Show 331: September 17, 2014

Pronk Pops Show 330: September 16, 2014

Pronk Pops Show 329: September 15, 2014

Pronk Pops Show 328: September 12, 2014

Pronk Pops Show 327: September 11, 2014

Pronk Pops Show 326: September 10, 2014

Pronk Pops Show 325: September 9, 2014

Pronk Pops Show 324: September 8, 2014

Pronk Pops Show 323: September 5, 2014

Pronk Pops Show 322: September 4, 2014

Pronk Pops Show 321: September 3, 2014

Pronk Pops Show 320: August 29, 2014

Pronk Pops Show 319: August 28, 2014

Pronk Pops Show 318: August 27, 2014 

Pronk Pops Show 317: August 22, 2014

Pronk Pops Show 316: August 20, 2014

Pronk Pops Show 315: August 18, 2014

Pronk Pops Show 314: August 15, 2014

Pronk Pops Show 313: August 14, 2014

Pronk Pops Show 312: August 13, 2014

Pronk Pops Show 311: August 11, 2014

Pronk Pops Show 310: August 8, 2014

Pronk Pops Show 309: August 6, 2014

Pronk Pops Show 308: August 4, 2014

Pronk Pops Show 307: August 1, 2014 

Pronk Pops Show 306: July 31, 2014

Pronk Pops Show 305: July 30, 2014

Pronk Pops Show 304: July 29, 2014

Pronk Pops Show 303: July 28, 2014

Pronk Pops Show 302: July 24, 2014

Pronk Pops Show 301: July 23, 2014

Pronk Pops Show 300: July 22, 2014

Pronk Pops Show 299: July 21, 2014

Pronk Pops Show 298: July 18, 2014

Pronk Pops Show 297: July 17, 2014

Pronk Pops Show 296: July 16, 2014

Pronk Pops Show 295: July 15, 2014

Pronk Pops Show 294: July 14, 2014

Pronk Pops Show 293: July 11, 2014

Pronk Pops Show 292: July 9, 2014

Pronk Pops Show 291: July 7, 2014

Pronk Pops Show 290: July 3, 2014

Pronk Pops Show 289: July 2, 2014

Story 1: Good News and Bad News Concerning Ebola — 2 Nurses Ebola Free and 1 Doctor Has Confirmed Case of Ebola in New York City — Ebola Infected Dr. Craig Spencer Took A-Train, L-Train and High-Line – Went Bowling — Contact Tracing Begins — Airborne Ebola Theme Song — If I can make it there, I can make it anywhere, New York, New York — Videos

Good News

Nurse-Nina-Pham-declared-free-of-Ebola-meets-President-Obama

Bad News

Ebola Czar Ron Klain 

SNL Cold Open Ridicules Obama on Ebola – ” Probably One of My Greatest Accomplishments “

Trey Gowdy vs Dr Lurie On Ron Klain Being Qualified For Ebola Czar. Ebola Hearing

CDC Director Grilled at House Hearing: Is Ebola Airborne at Airports?

Doctor Explains Why Ebola Could Spread Through the Air

Purdue virologist warns Ebola could become airborne

Could Ebola go airborne?

Max Alert! EBOLA Bodily Fluids Readily Airborne Weaponizable

White House Seeking To Reverse New York, New Jersey’s Ebola Quarantine Orders: NYT

US Health Official Criticizes Ebola Quarantine Protocols in NY, NJ

What We Now Know About New York’s First Ebola Case

dr spence

First Confirmed Ebola Case in New York

Doctor_in_New_York_being_treated_for_Ebola

biosafety level 4 spacesuit
Positive Pressure Personnel Suits
ebola-in-us

Biosafety Level 4 Positive Pressure Spacesuit!

BioContainment Unit at The Nebraska Medical Center

How Infectious Is Ebola? – Nebraska Medicine

Ebola_enemies

EbolaBellevue

New York City, Bellevue Hospital nurse Belkys Fortune, left, and Teressa Celia, Associate Director of Infection Prevention and Control, pose in protective suits in an isolation room, in the Emergency Room of Bellevue Hospital.

Note: They are not wearing a

Biosafety Level 4 Positive Pressure Spacesuit!

(See above photos)

MANDATORY EBOLA QUARANTINE Established in NEW YORK and NEW JERSEY – Mandatory Vaccine Next?

Calls To Quarantine Travelers And Ban Travel Follow NY Ebola Case

Ebola hysteria takes over New York City

Elbows-Deep in Ebola Virus – Richard Preston

USAMRIID The US Army Medical Research Institute of Infectious Disease

USAMRIID Overview

Ebola in NYC: Doctor’s Neighbors Speak Out | Mashable

CNN’s Dr. Sanjay Gupta suits up in Ebola protective …

BREAKING: Ebola is Airborne

NEW.Ebola : Inside the Deadly Outbreak (Documentary 2014)

Dr. Michael Osterholm Discusses Ebola Outbreak

Ebola Crisis Dean’s Symposium, Part 6: Challenges for Unprepared Health Systems

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

Ebola – What You’re Not Being Told

CDC Warns On AIRBORNE EBOLA

Airborne Ebola Fear Sparks Emergency VA Hospital HVAC Contract

Ebola discoverer: ‘This is unprecedented’

NIH Places Emergency Order To Stockpile 1 Year’s PPE Supply

Aerosolizing ONE DROP of EBOLA = 1/2 MILLION DEAD

Ebola hits New York, Craig Spencer Tests Positive May Infected Entire Bowling Alleyn Ebola in NYC

Dr. Craig Spencer Took A-Train, L-Train and High-Line – Went Bowling

Megyn Kelly on New Ebola Case: Dr. Craig Spencer Was ‘Irresponsible’

23 October 2014 Breaking news Ebola Crisis New York Dr Craig Spencer tests positive for Ebola virus

Ebola – The Truth About the Outbreak (Documentary)

EBOLA NYC: Biological Warfare in States

Ebola Theme Song — New York, New York

You Decide

Frank Sinatra-New York,New York

Frank Sinatra-New York,New York-Lyrics

Start spreadin’ the news, I’m leavin’ today
I want to be a part of it
New York, New York
These vagabond shoes, are longing to stray
Right through the very heart of it
New York, New YorkI want to wake up, in a city that never sleeps
And find I’m king of the hill
Top of the heapThese little town blues, are melting away
I’ll make a brand new start of it
In old New York
If I can make it there, I’ll make it anywhere
It’s up to you, New York..New YorkNew York…New York
I want to wake up, in a city that never sleeps
And find I’m A number one, top of the list
King of the hill, A number one….These little town blues, are melting away
I’ll make a brand new start of it
In old New York
If I can make it there, I’ll make it anywhere
It’s up to you, New York..New York New York!!!

Frank Sinatra – New York New York Song **Lyrics** [HD]

My Kind of Town (Chicago) – Frank Sinatra

“My Kind Of Town”

Now this could only happen to a guy like me
And only happen in a town like this
So may I say to each of you most gratef’lly
As I throw each one of you a kissThis is my kind of town, Chicago is
My kind of town, Chicago is
My kind of people, too
People who smile at youAnd each time I roam, Chicago is
Calling me home, Chicago is
Why I just grin like a clown
It’s my kind of town[brief instrumental]My kind of town, Chicago is
My kind of town, Chicago is
My kind of razzmatazz
And it has all that jazzAnd each time I leave, Chicago is
Tuggin’ my sleeve, Chicago is
The Wrigley Building, Chicago is
The Union Stockyard, Chicago is
One town that won’t let you down
It’s my kind of town

New York, New Jersey Set Up Mandatory Quarantine Requirement Amid Ebola Threat Christie: New Policy Has Already Been Used At Newark Liberty International Airport

In the wake of the first confirmed Ebola virus case in New York City, the states of New York and New Jersey have set up a new screening system that goes above and beyond the guidelines already set up by federal officials.

As CBS 2’s Alice Gainer reported, no other states have yet set up increased screening procedures for Ebola.

“We believe it’s appropriate to increase the current screening procedures from people coming from affected countries from the current (Centers for Disease Control and Prevention screening procedures),” Gov. Andrew Cuomo said Friday afternoon. “We believe it within the State of New York and the State of New Jersey’s legal rights.”

Under the new rules, state officials will establish a risk level by considering the countries that people have visited and their level of possible exposure to Ebola.

EXTRA: More On Ebola From The CDC

The patients with the highest level of possible exposure will be automatically quarantined for 21 days at a government-regulated facility. Those with a lower risk will be monitored for temperature and symptoms, Cuomo explained.

The New York and New Jersey health departments will determine their own specific procedures for hospitalization and quarantine, and will provide a daily recap to state officials on the status of screening, New York State Health Commissioner Dr. Howard Zucker said at the news conference.

The new procedures already have been put into use at Newark Liberty International Airport.

On Friday, a health care worker landed at Newark after treating Ebola patients in West Africa, New Jersey Gov. Chris Christie said at the news conference. A legal quarantine was issued for the woman, who was not a New Jersey resident and was set to go on to New York afterward.

“This woman, while her home residence is outside the area, said her next stop was going to be here in New York,” Christie said. “Governor Cuomo and I discussed it before we came out here, and a quarantine order will be issued.”

The woman will be quarantined in either New York or New Jersey, Christie said.

In discussing the new plan, Cuomo and Christie said a policy of voluntary quarantine simply does not go far enough.

“Voluntary quarantine – you know it’s almost an oxymoron. This is a very serious situation.” Cuomo said. “Voluntary quarantine – raise your right hand and promise you’re going to stay home for 21 days. We’ve seen what happens.”

The new rules were announced a day after Dr. Craig Spencer, a member of Doctors Without Borders, became New York City’s first Ebola patient.

He reported Thursday morning coming down with a fever and diarrhea and is being treated in an isolation ward at Bellevue Hospital, a designated Ebola center.

Spencer returned from West Africa last Friday after treating Ebola patients in Guinea with Doctors Without Borders. He arrived at John F. Kennedy International Airport, passing the extensive CDC screening process.

“When he arrived in the United States, he was also well with no symptoms,” said New York City Health Commissioner Mary Travis Bassett.

Doctors Without Borders said per the guidelines it provides its staff members on their return from Ebola assignments, “the individual engaged in regular health monitoring and reported this development immediately.” But Spencer also took the subway, walked the High Line, and went bowling in Williamsburg, Brooklyn the day before he became sick.

“He was a doctor, and even he didn’t follow the guidelines,” Cuomo said.

With that in mind, the states have to lay down the law, the governors said.

“It’s too serious a situation to leave it to the honor system,” Cuomo said.

The CDC is reviewing its policy for health care workers returning from West Africa, but anyone flying into a Port Authority of New York and New Jersey airport will need to abide by the new procedures.

http://newyork.cbslocal.com/2014/10/24/new-york-new-jersey-set-up-mandatory-quarantine-requirement-amid-ebola-threat/

Ebola Arrives in New York. How Prepared Is the City to Handle It?

Dr. Craig Spencer, the health care worker who recently returned from Guinea and tested positive for the Ebola virus, is now the first patient to be treated at New York’s Bellevue Hospital.

But the hospital, as well as city, state and federal officials, have been working for weeks or more to ensure the city is ready to identify and treat Ebola cases.

This preparation reflects the now-proven fact that the longer the outbreak rages on in West Africa, the more likely it was that a patient would wind up in Western cities, including New York.

On Oct. 15, the state designated Bellevue Hospital Center as the facility to receive Ebola patients from among the city’s 11 public hospitals, and to receive transferred patients from other hospitals as well, in the event that any Ebola cases occur in the city.

According to a statement from the New York City Health and Hospitals Corporation, the hospital has four single-bed rooms in its infectious disease ward to treat “high probability or confirmed Ebola cases.” This part of the hospital also has a new laboratory that can test for Ebola, separate from the rest of the hospital’s labs, to handle Ebola blood samples.

Because the virus can be spread through contact with an infected person’s bodily fluids, careful handling of blood and other samples is necessary.

According to the statement:

The hospital is particularly well suited due to its long history of being on the front lines of epidemics and emerging public health threats, and managing an isolation unit for diseases, such as TB, for many years with support from and collaboration with the City Health Department.

Three other hospitals in New York City have also been designated by the state to treat suspected and confirmed Ebola cases, including Mt. Sinai and New York Presbyterian in Manhattan and Montefiore in the Bronx, according to Governor Cuomo’s Ebola preparedness plan.

None of these hospitals, including Bellevue, has an isolated biocontainment unit like those that have treated patients at Emory University Hospital in Atlanta, Georgia, and Nebraska Medical Center in Omaha, Nebraska.

Those specially-designed units can only hold nine patients at the same time.

The American public may not have much faith in ordinary hospitals to treat Ebola, considering that the only non-specialized hospital to treat Ebola patients, Texas Health Presbyterian Hospital Dallas, allowed the virus to spread to two nurses who worked on the original patient, Thomas Eric Duncan, who died of Ebola on Oct. 8. Both of the nurses are now being treated in a biocontainment unit.

The probability of an Ebola case in New York was always considerably higher than it was for many other cities in the U.S., given that two of the city’s international airports — JFK and Newark — are key gateways for travelers to and from West Africa, via stops in Europe or elsewhere in Africa.

“New York City is a frequent port of entry for travelers from West Africa, a home to communities of West African immigrants who travel back to their home countries, and a home to health care workers who travel to West Africa to treat Ebola patients,” The Centers for Disease Control and Prevention (CDC) said in a report on Oct. 17.

“Ongoing transmission of Ebola virus in West Africa could result in an infected person arriving in NYC,” the report said. However, the chance that a New Yorker who has not traveled to an Ebola hotspot would come down with the virus is “extremely slim,” since the disease is only spread through direct contact with an infectious person’s bodily fluids.

Ultimately, it was a doctor who lived in the city who would bring the virus home.

In recent weeks, the New York Health Commissioner issued a “Commissioner’s Order” to all hospitals and ambulance services in the state, “requiring that they follow protocols for identification, isolation and medical evaluation of patients requiring care.”

The state has been conducting “unannounced drills” at hospitals and health care facilities to test preparedness for handling possible Ebola cases. The state has also involved the Metropalitan Transit Authority, which operates the city’s subways and buses, in training for encountering possible Ebola patients.

And a mass Ebola training for health care workers, which included demonstrations for putting on and taking off protective equipment, took place in the city on Oct. 21.

According to new guidelines the CDC issued on Monday, there are now 30 steps health care workers have to take every time they treat a patient with Ebola or Ebola-like symptoms.

At hospitals like Bellevue, actors have played the role of patients with Ebola symptoms have been part of the drills, and the city’s 911 operators have been told to ask people who call in with Ebola-like symptoms if they have recently traveled to West Africa, according to the Guardian.

As of Thursday, there have been nearly 10,000 cases of Ebola in West Africa, along with about 4,900 deaths. However, these figures are likely to be underestimates, since the lack of treatment facilities and other circumstances are causing many patients to go uncounted.

http://mashable.com/2014/10/23/new-york-city-ebola-preparations/

Doctor in New York City Is Sick With Ebola

The Pronk Pops Show Podcasts Portfolio

Listen To Pronk Pops Podcast or Download Show 354-356

Listen To Pronk Pops Podcast or Download Show 346-353

Listen To Pronk Pops Podcast or Download Show 338-345

Listen To Pronk Pops Podcast or Download Show 328-337

Listen To Pronk Pops Podcast or Download Show 319-327

Listen To Pronk Pops Podcast or Download Show 307-318

Listen To Pronk Pops Podcast or Download Show 296-306

Listen To Pronk Pops Podcast or Download Show 287-295

Listen To Pronk Pops Podcast or Download Show 277-286

Listen To Pronk Pops Podcast or Download Show 264-276

Listen To Pronk Pops Podcast or Download Show 250-263

Listen To Pronk Pops Podcast or Download Show 236-249

Listen To Pronk Pops Podcast or Download Show 222-235

Listen To Pronk Pops Podcast or Download Show 211-221

Listen To Pronk Pops Podcast or DownloadShow 202-210

Listen To Pronk Pops Podcast or Download Show 194-201

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Listen To Pronk Pops Podcast or Download Show 174-183

Listen To Pronk Pops Podcast or Download Show 165-173

Listen To Pronk Pops Podcast or Download Show 158-164

Listen To Pronk Pops Podcast or Download Show 151-157

Listen To Pronk Pops Podcast or Download Show 143-150

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Listen To Pronk Pops Podcast or Download Show 124-130

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

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

Project_1

The Pronk Pops Show Podcasts

Pronk Pops Show 354: October 22, 2014

Pronk Pops Show 353: October 21, 2014

Pronk Pops Show 352: October 20, 2014

Pronk Pops Show 351: October 17, 2014

Pronk Pops Show 350: October 16, 2014

Pronk Pops Show 349: October 15, 2014

Pronk Pops Show 348: October 14, 2014

Pronk Pops Show 347: October 13, 2014

Pronk Pops Show 346: October 9, 2014

Pronk Pops Show 345: October 8, 2014

Pronk Pops Show 344: October 6, 2014

Pronk Pops Show 343: October 3, 2014

Pronk Pops Show 342: October 2, 2014

Pronk Pops Show 341: October 1, 2014

Pronk Pops Show 340: September 30, 2014

Pronk Pops Show 339: September 29, 2014

Pronk Pops Show 338: September 26, 2014

Pronk Pops Show 337: September 25, 2014

Pronk Pops Show 336: September 24, 2014

Pronk Pops Show 335: September 23 2014

Pronk Pops Show 334: September 22 2014

Pronk Pops Show 333: September 19 2014

Pronk Pops Show 332: September 18 2014

Pronk Pops Show 331: September 17, 2014

Pronk Pops Show 330: September 16, 2014

Pronk Pops Show 329: September 15, 2014

Pronk Pops Show 328: September 12, 2014

Pronk Pops Show 327: September 11, 2014

Pronk Pops Show 326: September 10, 2014

Pronk Pops Show 325: September 9, 2014

Pronk Pops Show 324: September 8, 2014

Pronk Pops Show 323: September 5, 2014

Pronk Pops Show 322: September 4, 2014

Pronk Pops Show 321: September 3, 2014

Pronk Pops Show 320: August 29, 2014

Pronk Pops Show 319: August 28, 2014

Pronk Pops Show 318: August 27, 2014 

Pronk Pops Show 317: August 22, 2014

Pronk Pops Show 316: August 20, 2014

Pronk Pops Show 315: August 18, 2014

Pronk Pops Show 314: August 15, 2014

Pronk Pops Show 313: August 14, 2014

Pronk Pops Show 312: August 13, 2014

Pronk Pops Show 311: August 11, 2014

Pronk Pops Show 310: August 8, 2014

Pronk Pops Show 309: August 6, 2014

Pronk Pops Show 308: August 4, 2014

Pronk Pops Show 307: August 1, 2014 

Pronk Pops Show 306: July 31, 2014

Pronk Pops Show 305: July 30, 2014

Pronk Pops Show 304: July 29, 2014

Pronk Pops Show 303: July 28, 2014

Pronk Pops Show 302: July 24, 2014

Pronk Pops Show 301: July 23, 2014

Pronk Pops Show 300: July 22, 2014

Pronk Pops Show 299: July 21, 2014

Pronk Pops Show 298: July 18, 2014

Pronk Pops Show 297: July 17, 2014

Pronk Pops Show 296: July 16, 2014

Pronk Pops Show 295: July 15, 2014

Pronk Pops Show 294: July 14, 2014

Pronk Pops Show 293: July 11, 2014

Pronk Pops Show 292: July 9, 2014

Pronk Pops Show 291: July 7, 2014

Pronk Pops Show 290: July 3, 2014

Pronk Pops Show 289: July 2, 2014

Story 1: American People Will Push-back on Election Day November 4 — Democrat Party Candidates  Will Lose Due To Job Insecurity, The Economy, Obama-care, Amnesty for Illegal Aliens, Tax Hikes, Failed Economic and Foreign Policies in Libya, Syria, Iraq and Iran, and Scandals Including Benghazi, Fast and Furious, NSA, IRS, Veterans Administration and Now Ebola  —  Democrats On Verge of Losing Massively Including Control of The Senate — Obama is An Epic Failure and Loser That Buried The Democratic Party — Rest In Peace — Videos 

the failure

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

 

Mid-term elections forecast

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

Midterm Elections 2014: Here are the Key Senate Races

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

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

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

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

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

Which Party Should Control Congress? AP/Gallup POLL Results

 

 

Latest AP National Poll Is a Nightmare for Democrats

By Jim Geraghty

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

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

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

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

Now brace yourself:

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

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

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

The polls are grim, Mr. President.

America’s Anxious Mood and What it Means for Republicans

Obama’s Gift to Republicans

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

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

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Story 1: Tyrant Obama’s October Surprise Shafts American People: Permanent Resident Cards (PRC) and Employment Authorization Document (EAD) cards (green cards and work permit cards) — The requirement is for an estimated minimum of 4 million cards annually with the potential to buy as many as 34 million cards total! — Illegal, Unconstitutional and Impeachable — Throw The Tyrant Out — Deport 30-50 Million Illegal Aleins — VideosPRCpermanent resident cardEmployment Authorization card

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

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

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

Stop President Obama’s Amnesty!

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

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

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Mark Levin Obama Will Use Executive Fiat to Grant Amnesty

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

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

Obama Eases Deportation Rules – Obama halts deportations – immigration

Permanent residence (United States)

5 Harmful Mistakes to Avoid in Your Immigration Case

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

9 Misconceptions about the Green Card

The Citizenship Interview and Test

H-1B Work Visas: Basic Requirements

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Card Consumables

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

Note:

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

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

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

The solicitation will be posted at this FedBidOpps webpage.

Contracting Office Address:
70 Kimball Avenue
Burlington, Vermont 05403

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

United States Citizenship and Immigration Services

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

Functions

Atlanta, Georgia

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

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

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

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

Forms

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

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

Immigrations courts and judges

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

Operations]

Internet presence]

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

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

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

Funding

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

Staffing

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

History

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

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

See also

References

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

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

External links

Employment authorization document

From Wikipedia, the free encyclopedia

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

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

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

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

Restriction

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

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

USCIS issues EADs in the following categories:

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

Obtaining an EAD

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

Interim EAD

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

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

See also

References

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

External links

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

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

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

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The Pronk Pops Show Podcasts

Pronk Pops Show 349: October 15, 2014

Pronk Pops Show 348: October 14, 2014

Pronk Pops Show 347: October 13, 2014

Pronk Pops Show 346: October 9, 2014

Pronk Pops Show 345: October 8, 2014

Pronk Pops Show 344: October 6, 2014

Pronk Pops Show 343: October 3, 2014

Pronk Pops Show 342: October 2, 2014

Pronk Pops Show 341: October 1, 2014

Pronk Pops Show 340: September 30, 2014

Pronk Pops Show 339: September 29, 2014

Pronk Pops Show 338: September 26, 2014

Pronk Pops Show 337: September 25, 2014

Pronk Pops Show 336: September 24, 2014

Pronk Pops Show 335: September 23 2014

Pronk Pops Show 334: September 22 2014

Pronk Pops Show 333: September 19 2014

Pronk Pops Show 332: September 18 2014

Pronk Pops Show 331: September 17, 2014

Pronk Pops Show 330: September 16, 2014

Pronk Pops Show 329: September 15, 2014

Pronk Pops Show 328: September 12, 2014

Pronk Pops Show 327: September 11, 2014

Pronk Pops Show 326: September 10, 2014

Pronk Pops Show 325: September 9, 2014

Pronk Pops Show 324: September 8, 2014

Pronk Pops Show 323: September 5, 2014

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Pronk Pops Show 320: August 29, 2014

Pronk Pops Show 319: August 28, 2014

Pronk Pops Show 318: August 27, 2014 

Pronk Pops Show 317: August 22, 2014

Pronk Pops Show 316: August 20, 2014

Pronk Pops Show 315: August 18, 2014

Pronk Pops Show 314: August 15, 2014

Pronk Pops Show 313: August 14, 2014

Pronk Pops Show 312: August 13, 2014

Pronk Pops Show 311: August 11, 2014

Pronk Pops Show 310: August 8, 2014

Pronk Pops Show 309: August 6, 2014

Pronk Pops Show 308: August 4, 2014

Pronk Pops Show 307: August 1, 2014 

Pronk Pops Show 306: July 31, 2014

Pronk Pops Show 305: July 30, 2014

Pronk Pops Show 304: July 29, 2014

Pronk Pops Show 303: July 28, 2014

Pronk Pops Show 302: July 24, 2014

Pronk Pops Show 301: July 23, 2014

Pronk Pops Show 300: July 22, 2014

Pronk Pops Show 299: July 21, 2014

Pronk Pops Show 298: July 18, 2014

Pronk Pops Show 297: July 17, 2014

Pronk Pops Show 296: July 16, 2014

Pronk Pops Show 295: July 15, 2014

Pronk Pops Show 294: July 14, 2014

Pronk Pops Show 293: July 11, 2014

Pronk Pops Show 292: July 9, 2014

Pronk Pops Show 291: July 7, 2014

Pronk Pops Show 290: July 3, 2014

Pronk Pops Show 289: July 2, 2014

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

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

Friedrich August von Hayek

Obama Calls for CDC ‘SWAT’ Team for Ebola Virus

Response Team to Be Sent for Any Ebola Case: Obama

Experts: Ebola Could Go Airborne, Kill Millions

Expert Doctor says CDC is lying about Ebola virus

Ebola strain appears to be different

Second Health Care Worker Tests Positive For Ebola In Texas

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

Texas officials confirm second healthcare worker has Ebola

CDC: Ebola patient flew on plane before diagnosis

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

BioContainment Unit at The Nebraska Medical Center

USAMRIID The US Army Medical Research Institute of Infectious Disease

USAMRIID Overview

Activation- A Nebraska Medical Center Biocontainment Unit Story

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

Max Alert! EBOLA Bodily Fluids Readily Airborne Weaponizable

Aerosolizing ONE DROP of EBOLA = 1/2 MILLION DEAD

Ebola – The Truth About the Outbreak (Documentary)

Why Do Viruses Kill

MicroKillers: Super Flu

The Influenza Pandemic of 1918

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

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

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

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

“There are two things that I harken back to this. The only way that we are going to beat this is person by person, moment by moment, detail by detail. We have those protocols in place, the city and county, working closely with the CDC and the hospital. The second is we want to minimize rumors and maximize facts. We want to deal with facts, not fear. And I continue to believe that while Dallas is anxious about this and with this news this morning, the anxiety level goes up a level, we are not fearful and I’m pleased and proud of the citizens that I talk to day in and day out knowing that there is hope if we take care and do what is right in these details. It may get worse before it gets better. But it will get better.”

The comments were given at a news conference in Dallas this morning announcing that another hospital worker in Dallas has been diagnosed with Ebola.

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

Nurses’ Union: Ebola Patient Left In Open Area Of ER For Hours

A Liberian Ebola patient was left in an open area of a Dallas emergency room for hours, and nurses treating him worked without proper protective gear and faced constantly changing protocols, according to a statement released by the nation’s largest nurses’ union.

Among those nurses was Nina Pham, 26, who has been hospitalized since Friday after catching Ebola while caring for Thomas Eric Duncan, the first person diagnosed with the virus in the U.S. He died last week.

Public-health authorities announced Wednesday that a second Texas Health Presbyterian Hospital health care worker had tested positive for Ebola, raising more questions about whether American hospitals and their staffs are adequately prepared to contain the virus.

The CDC has said some breach of protocol probably sickened Pham, but National Nurses United contends the protocols were either non-existent or changed constantly after Duncan arrived in the emergency room by ambulance on Sept. 28.

Medical records provided to The Associated Press by Duncan’s family show that Pham helped care for him throughout his hospital stay, including the day he arrived in intensive care with diarrhea, abdominal pain, nausea and vomiting, and the day before he died.

When Pham’s mother learned she was caring for Duncan, she tried to reassure her that she would be safe.

Pham told her: “Mom, no. Don’t worry about me,” family friend Christina Tran told The Associated Press.

Duncan’s medical records make numerous mentions of protective gear worn by hospital staff, and Pham herself notes wearing the gear in visits to Duncan’s room. But there is no indication in the records of her first encounter with Duncan, on Sept. 29, that Pham donned any protective gear.

Deborah Burger of National Nurses United, who convened a conference call with reporters to relay what she said were concerns of nurses at the hospital, said they were forced to use medical tape to secure openings in their flimsy garments and worried that their necks and heads were exposed as they cared for Duncan.

RoseAnn DeMoro, executive director of Nurses United, said the statement came from “several” and “a few” nurses, but she refused repeated inquiries to state how many. She said the organization had vetted the claims, and that the nurses cited were in a position to know what had occurred at the hospital. She did not specify whether they were among the nurses caring for Duncan.

The nurses allege that his lab samples were allowed to travel through the hospital’s pneumatic tubes, possibly risking contaminating of the specimen-delivery system. They also said that hazardous waste was allowed to pile up to the ceiling.

Wendell Watson, a Presbyterian spokesman, did not respond to specific claims by the nurses but said the hospital has not received similar complaints.

“Patient and employee safety is our greatest priority, and we take compliance very seriously,” he said in a statement. He said the hospital would “review and respond to any concerns raised by our nurses and all employees.”

The nurses’ statement said they had to “interact with Mr. Duncan with whatever protective equipment was available,” even as he produced “a lot of contagious fluids.” Duncan’s medical records underscore that concern. They also say nurses treating Duncan were also caring for other patients in the hospital and that, in the face of constantly shifting guidelines, they were allowed to follow whichever ones they chose.

When Ebola was suspected but unconfirmed, a doctor wrote that use of disposable shoe covers should also be considered. At that point, by all protocols, shoe covers should have been mandatory to prevent anyone from tracking contagious body fluids around the hospital.

A few days later, however, entries in the hospital charts suggest that protection was improving.

“RN entered room in Tyvek suits, triple gloves, triple boots, and respirator cap in place,” a nurse wrote.

The Presbyterian nurses are not represented by Nurses United or any other union. DeMoro and Burger said the nurses claimed they had been warned by the hospital not to speak to reporters or they would be fired.

The AP has attempted since last week to contact dozens of individuals involved in Duncan’s care. Those who responded to reporters’ inquiries have so far been unwilling to speak.

David R. Wright, deputy regional administrator for the U.S. Centers for Medicare & Medicaid Services, which monitors patient safety and has the authority to withhold federal funding, said his agency is going to want to get all of the information the nurses provided.

“We can’t talk about whether we’re going to investigate or not, but we’d be interested in hearing that information,” he said.

CDC officials did not immediately respond to requests for comment.

Duncan first sought care at the hospital’s ER late on Sept. 25 and was sent home the next morning. He was rushed by ambulance back to the hospital on Sept. 28. Unlike his first visit, mention of his recent arrival from Liberia immediately roused suspicion of an Ebola risk, records show.

The CDC said 76 staff members at the hospital could have been exposed to Duncan after his second ER visit. Another 48 people who may have had contact with him before he was isolated are being monitored. Pham remained hospitalized Tuesday in good condition and said in a statement that she was doing well.

The Rev. Jim Khoi, pastor at Our Lady of Fatima Church in Fort Worth, which Pham’s family attends, said the 2010 Texas Christian University nursing school graduate appeared to be in good spirits when she spoke to her mother via video chat.

Pham’s mother, Ngoc Pham, is “calm,” Khoi said. “She trusts in God. And she asks for prayers.”

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

CDC: Ebola Patient Traveled By Air With “Low-Grade” Fever

The CDC has announced that the second healthcare worker diagnosed with Ebola — now identified as Amber Joy Vinson of Dallas — traveled by air Oct. 13, with a low-grade fever, a day before she showed up at the hospital reporting symptoms.

The CDC is now reaching out to all passengers who flew on Frontier Airlines flight 1143 Cleveland to Dallas/Fort Worth. The flight landed at 8:16 p.m. CT.

All 132 passengers on the flight are being asked to call 1 800-CDC INFO (1 800 232-4636). Public health professionals will begin interviewing passengers about the flight Wednesday afternoon.

“Although she (Vinson) did not report any symptoms and she did not meet the fever threshold of 100.4, she did report at that time she took her temperature and found it to be 99.5,” said CDC Director Tom Frieden.  Her temperature coupled with the fact that she had been exposed to the virus should have prevented her from getting on the plane, he said.  “I don’t think that changes the level of risk of people around her.  She did not vomit, she was not bleeding, so the level of risk of people around her would be extremely low.”

Vinson first reported a fever to the hospital on Tuesday (Oct. 14) and was isolated within 90 minutes, according to officials. She did not exhibit symptoms while on the Monday flight, according to crew members. However, the CDC says passenger notification is needed as an “extra level of safety” due to the proximity in time between the flight and the first reported symptoms.

“Those who have exposures to Ebola, she should not have traveled on a commercial airline,” said Dr. Frieden. “The CDC guidance in this setting outlines the need for controlled movement. That can include a charter plane; that can include a car; but it does not include public transport. We will from this moment forward ensure that no other individual who is being monitored for exposure undergoes travel in any way other than controlled movement.”

Frieden specifically noted that the remaining 75 healthcare workers who treated Thomas Duncan at Texas Health Presbyterian Hospital will not be allowed to fly. The CDC will work with local and state officials to accomplish this.

Frontier Airlines is working closely with the CDC to identify and notify all passengers on the flight. The airline also says the plane has been thoroughly cleaned and was removed from service following CDC notification early Wednesday morning.

However, according to Flighttracker, the plane was used for five additional flights on Tuesday before it was removed from service. Those flights include a return flight to Cleveland, Cleveland to Fort Lauderdale–Hollywood International Airport (FLL), FLL to Cleveland, Cleveland to Hartsfield–Jackson Atlanta International Airport (ATL), and ATL to Cleveland.

While in Ohio, Vinson visited relatives, who are employees at Kent State University.  The university is now asking Vinson’s three relatives stay off campus and self-monitor per CDC protocol for the next 21 days out of an “abundance of caution.”

“It’s important to note that the patient was not on the Kent State campus,” said Kent State President Beverly Warren. “She stayed with her family at their home in Summit County and did not step foot on our campus. We want to assure our university community that we are taking this information seriously, taking steps to communicate what we know,” said Dr. Angela DeJulius, director of University Health Services at Kent State.

Vinson is a Kent State graduate.  She received degrees from there in 2006 and 2008.

Cleveland’s Public Health Director, Toinette Parrilla, said Vinson was visiting in preparation for her wedding.  While there, she visited her mother and her fiance.

Complete Coverage Of Ebola In North Texas

The latest Ebola diagnosis was announced by the Texas Department of State Health Services early Wednesday morning.

Vinson is the second worker at Presbyterian Hospital to be diagnosed after providing health care to Duncan, the first person to be diagnosed with Ebola in the United States. He died last week.

Medical records provided to The Associated Press by Thomas Eric Duncan’s family show Amber Joy Vinson was actively engaged in caring for Duncan in the days before his death. The records show she inserted catheters, drew blood, and dealt with Duncan’s body fluids.

Dallas Mayor Mike Rawlings addressed the media on Wednesday, saying the patient lives alone and has no pets.

“It may get worse before it gets better,” Rawlings said, “but it will get better.”

Crews worked to decontaminate the common areas of Vinson’s Dallas apartment building Tuesday morning. The apartment unit will be decontaminated by contractors starting early Wednesday afternoon.

The CDC announced that Vinson will be transported to Emory Hospital in Atlanta for further treatment. Two previous American Ebola patients, Dr. Kent Brantly and Nancy Writebol, were treated at Emory and were the first Ebola patients to be treated in the United States. They were released in August.

Nina Pham was diagnosed with the virus over the weekend and remains isolated in good condition. Pham’s dog — a Cavalier King Charles Spaniel named Bentley — has been taken into custody and is being cared for at an undisclosed location.

Frontier Airlines released the following statement:

“At approximately 1:00 a.m. MT on October 15, Frontier was notified by the CDC that a customer traveling on Frontier Airlines flight 1143 Cleveland to Dallas/Fort Worth on Oct. 13 has since tested positive for the Ebola virus. The flight landed in Dallas/Fort Worth at 8:16 p.m. local and remained overnight at the airport having completed its flying for the day at which point the aircraft received a thorough cleaning per our normal procedures which is consistent with CDC guidelines prior to returning to service the next day. It was also cleaned again in Cleveland last night. Previously the customer had traveled from Dallas Fort Worth to Cleveland on Frontier flight 1142 on October 10.

Customer exhibited no symptoms or sign of illness while on flight 1143, according to the crew. Frontier responded immediately upon notification from the CDC by removing the aircraft from service and is working closely with CDC to identify and contact customers who may traveled on flight 1143.

Customers who may have traveled on either flight should contact CDC at 1 800 CDC-INFO.

The safety and security of our customers and employees is our primary concern. Frontier will continue to work closely with CDC and other governmental agencies to ensure proper protocols and procedures are being followed.”

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

Frontier jet made 5 flights before taken out of service in Ebola scare

The Frontier Airlines jet that carried a Dallas healthcare worker diagnosed with Ebola made five additional flights after her trip before it was taken out of service, according to a flight-monitoring website.

Denver-based Frontier said in a statement that it grounded the plane immediately after the carrier was notified late Tuesday night by the Centers for Disease Control and Prevention about the Ebola patient.

Ebola patient flew day before symptoms surfaced
Amber Joy Vinson of Dallas, traveled by air on Oct. 13, the day before she first reported symptoms.
Flight 1143, on which the woman flew from Cleveland to Dallas/Fort Worth, was the last trip of the day Monday for the Airbus A320. But Tuesday morning the plane was flown back to Cleveland and then to Fort Lauderdale, Fla., back to Cleveland and then to Atlanta and finally back to Cleveland again, according to Daniel Baker, chief executive of the flight-monitoring site Flightaware.com.

He said his data did not include any passenger manifests, so he could not tell how many total passengers flew on the plane Tuesday.

The airline said it is working with the CDC to contact all 132 passengers on the Monday flight that carried the Ebola patient.

Frontier could not be reached to confirm the FlightAware data, and it was unclear if passengers on the additional flights were being contacted.

The passenger “exhibited no symptoms or sign of illness while on Flight 1143, according to the crew,” Frontier said.
The plane went through a routine but “thorough” cleaning Monday night, Frontier said. Airline industry experts said routine overnight cleaning includes wiping down tray tables, vacuuming carpet and disinfecting restrooms.

The healthcare worker also had flown to Cleveland from Dallas three days earlier on Frontier Flight 1142, the airline reported.

In response to the news that another Ebola patient flew on a commercial flight, the union that represents 60,000 flight attendants on 19 airlines is asking the CDC to monitor and care for the four flight attendants who were on flight from Cleveland to Dallas/Fort Worth.

cComments
whats it going to take to close the border to people from africa? 10 dead? 100 dead? 1000 dead? we know obumma doesnt give a flying fluke about the american citizens, but isn’t there someone in the government with an ounce of brains? or is this part of obumma’s scheme to declare martial law?…

The Assn. of Flight Attendants “will continue to press that crew members are regularly monitored and provided with any additional resources that may be required,” the group said.

The Ebola scare prompted the union last week to call for better measures to protect flight attendants from exposure to the deadly virus.

The group’s international president, Sara Nelson, suggested that flight attendants are being asked to do too much in the fight against Ebola.
“We are not, however, professional healthcare providers and our members have neither the extensive training nor the specialized personal protective equipment required for handling an Ebola patient,” she said in a statement.

Earlier this month, United Airlines was rushing to contact passengers who flew on two flights that carried a Liberian man infected with Ebola from Brussels to Washington, D.C., and then to Dallas.

The Ebola-stricken healthcare worker who flew on Frontier had been treating the Liberian man, Thomas Eric Duncan, who has since died.

Airline-industry stock prices have taken a beating in recent weeks, with some analysts blaming the Ebola scare.
On Wednesday, stocks of Delta Air Lines and American Airlines fell more than 6% in early trading before partially recovering. With less than 90 minutes remaining in the regular trading session, the two stocks were each down about 2% from Tuesday’s closes. Frontier is privately held.

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

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

Story

The UK is well set for an Ebola outbreak (sarcasm alert) We have TWO isolation units, but one is getting ‘redeveloped’ so it’s not available right now. Called High Security Infectious Diseases Units there are two in the country, each capable of taking two patients. One is at The Royal Free Hospital in Hampstead North London, the other, the one getting a bit of a make-over, is at The Royal Victoria Infirmary in Newcastle, up in the north-east of England.

Four level 4 bio-containment beds between 69,000,000 people

In the US there are 4 units geared up to handle Ebola. The National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, has 3 beds. Nebraska Medical Center, Omaha, has 10 beds. Emory Hospital, Atlanta has 3 beds and St Patricks Hospital, Missoula  has 3 beds (source)

19 level four biocontainment beds for 317,000,000 people

I think we just found out why the government(s) are under-playing the situation. They simply do not have the facilities to cope with even a small outbreak. They are, in fact in exactly the same position as the dirt-poor hospitals in West Africa…there are not enough facilities to stop the spread of the disease if it gets out. The quality of care is better, but the availability of containment most likely isn’t.

I am sure ‘regular’  isolation units will be pressed into use but they are not designed to handle level 4 biohazards, they are nowhere near as secure medically speaking, as biocontainment units.

A couple of days ago I explained how exponential spread works. You can read that article here if you like. As a quick recap.  Once a disease is at the point where every carrier infects 2 more people,(exponential spread) it will continue until it:

A) runs out of hosts

B) is stopped by medical science or

C) mutates into something less harmful.

What follows will show you how woefully inadequately our governments have prepared for something as lethal as Ebola.

In the flu pandemic of 1918-1920 28% of Americans were infected with the disease…try to remember I am talking numbers here not HOW  disease spreads or any medical similarities between diseases, 625,000 Americans lost their lives out of some 29,400,000 infections. The population of the United States at that time was 105,000,000 people. (source)

Fast forward to today. If that flu pandemic had hit the United States in 2014, when the population stands at 317,000,000 people 88,760,000 people would have been infected and 2,130,240 of them would have died.

Now, let’s try this with Ebola. I have picked Liberia just because it is in the news due to the Thomas Duncan case.

Liberia has a population of 4,290,000 people, as of the latest figures there have been 3692 cases of Ebola, this represents 0.0086% of the population.Of those infections, 1998 people have died that’s a fatality rate of 54%. (source)

If that same infection and death rate were applied to the United States Ebola would infect 269,000 people and of those 156,281 would die.

Now, if as doctors and scientists fear the basic reproduction rate rises to 2 in Liberia the numbers change very quickly. Using the mean average incubation time of 9 days it would take around 13 weeks for the entire population of Liberia to become infected. (10 doublings starting with 3692 = just under the population of Liberia. This multiplied by 9 days gives us 90 days which divided by 7 gives 12.85 weeks.) Of the 4,290,000 people infected 2,316,000 would lose their lives.

This is just Liberia, not the other affected countries in West Africa. 

Translated to an equivalent outbreak in the United States, where the basic reproduction rate is also 2, the numbers are horrifying. Starting with patient zero it would take around 245 days, 35 weeks for every person in the United States to become infected. Of those 17,118,000 people would die. (27.17 doublings x 9 days = 245 days =35 weeks)

Please remember the figures for Liberia are pulled from the CDC website, the percentages are correct.

United States was based on exactly the same parameters as for Liberia…a like for like comparison.

The CDC could be spending their time educating people, advising people to stock up,  get ready for  the possibility of staying in their homes. Self imposed isolation, or if need be state imposed isolation, that may last for an extended time period may become a reality. They’re not doing it though are they? They are sprouting figures and applying them to West Africa, and they can’t even get that right. They are saying that there could be 1.4 deaths in West Africa in a worst case scenario. When actually applying the figures they supplied with some simple mathematics we can see that 1.4 million deaths is a gross understatement.

Even a basic reproduction rate of 1.7, the latest figure for Liberia it will only take around  30 weeks to get to the same point as the above scenario, over 2,000,000 dead.

Don’t get me wrong, I am not saying that the UK government is any better, if anything they are worse, they don’t even try to do the maths. Most of them went to Eton (a very expensive school that churns out politicians) so it’s unlikely they would be capable of it even if they wanted to. You only have to look at our national finances to see they are no good at sums. They send out press briefings  that there will be an emergency COBRA meeting, do you have any clue what that stands for? Let me enlighten you, Cabinet Office Briefing Room A.  COBRA is not an emergency planning group, it’s an effing office.

Although I am loathed to say it, it’s time that our governments started worrying about the facilities at home rather than worrying about the facilities abroad. Stopping the disease in Africa does not mean we are out of the woods. There are so many unreported cases, people turned away from medica facilities in West Africa that nobody has the slightest idea how many cases of Ebola are actually out there. The porous borders of the region mean that people move around without the controls that are usually exercised in the west. There has to be a travel ban on non-US citizens entering the United States from these areas, the same applies from the UK.

Border control has to be improved in both countries if we have any hope of halting the spread of this terrible disease. The west is going to be the destination for anyone from Ebola hit areas that can afford to make their way from Africa. Many West Africans have contacts in the west who will help them get out, and shelter them when they arrive. As harsh as it seems this has to be stopped, it’s time for governments to put their own citizens first. Repatriation of your own is one thing, risking millions of lives at home because you won’t man up and prevent foreigners entering is quite another.

Take Care

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

The Ebola Outbreak in West Africa

Samuel Aranda for The New York Times

Guinea, Liberia and Sierra Leone have been struggling since March to stop what has become the largest Ebola outbreak ever recorded. The disease is causing widespread fear and disruption in West Africa, and shows no signs of being brought under control.

CHRONOLOGY OF COVERAGE

  1. OCT. 15, 2014

    Spain’s ad hoc, improvisational response to citizens infected by Ebola virus and brought back to the country underscores holes in West’s readiness to confront wider outbreak; cases of Ebola in Spain have raised urgent questions about risks of disease spreading even in developed countries, particularly among health care workers. MORE

  2. OCT. 15, 2014

    Doctors Without Borders criticizes lack of reliable evacuation systems from West Africa, saying that more would volunteer to fight Ebola in region if it were not so difficult to leave in case of emergency; cites fact that it took 50 hours to evacuate French nurse to Paris after she tested positive for virus. MORE

  3. OCT. 15, 2014

    Bellevue Hospital is designated as center for treatment of the Ebola virus should it emerge in New York City; announcement comes amid widespread concerns that disease may not be so easily contained by every hospital that has an isolation unit. MORE

  4. OCT. 15, 2014

    World Health Organization warns new cases of Ebola virus could reach 10,000 a week in West Africa by December, nearly 10 times the current rate; reports none of the three most heavily affected countries, Liberia, Sierra Leone and Guinea, are adequately prepared for epidemic; comments come in report before the United Nations Security Council, which voices fear that epidemic could renew the risk of political instability in a region barely recovering from civil war.MORE

  5. OCT. 15, 2014

    Dr Thomas R Frieden, Centers for Disease Control and Prevention director, acknowledges for first time that quicker and more concerted action on agency’s part might have kept Dallas nurse from contracting Ebola virus; says agency plans a more robust response to any future Ebola cases in American hospitals. MORE

  6. OCT. 15, 2014

    Frank Bruni Op-Ed column contends other, more common ailments deserve more concern and attention in United States than Ebola; points out influenza kills between 3,000 and 50,000 Americans per year, and skin cancer kills 10,000 per year; lists other common, and much-researched, illnesses that Americans should vaccinate and protect themselves against. MORE

  7. OCT. 15, 2014

    Jere Longman On Soccer column examines plight of SIerra Leone’s national soccer team, caught amid self-destructive feud between nation’s soccer federation and sports ministry; observes that team was already exhausted from playing road-only games due to Ebola outbreak. MORE

  8. OCT. 14, 2014

    Transmission of Ebola virus to Dallas nurse Nina Pham forces Centers for Disease Control and Prevention to reconsider its approach to containing the disease; state and federal officials are re-examining whether equipment and procedures are adequate or too loosely followed, and whether more decontamination steps are necessary when health workers leave isolation units. MORE

  9. OCT. 14, 2014

    Experience of Emory University Hospital in Atlanta in caring for three Ebola patients calls into question oft repeated assurances from federal health officials that most American hospitals can safely treat disease; transmission of virus to Dallas nurse Nina Pham has also raised questions about general level of preparedness in hospitals around the country; medical experts have begun to suggest it may be better to transfer patients to designated centers with expertise in treating Ebola. MORE

  10. OCT. 14, 2014

    Public health concerns about Ebola virus have spread to both political parties, which are engaged in finger-pointing debate that could jar midterm elections; Republicans blame the Obama administration for failing to protect the United States, and Democrats are saying it is GOP budget cutting that has put Americans at risk. MORE

  11. OCT. 14, 2014

    Experts rule out notion that Ebola virus has become a super-pathogen and raise doubts that it will evolve into one; say virus is not fundamentally different from those in previous outbreaks dating back to 1976, and it is highly unlikely that natural selection will give it ability to spread more easily, particularly by becoming airborne. MORE

  12. OCT. 14, 2014

    Friends of Dallas nurse Nina Pham describe the 26-year-old, part of the team that treated Thomas Eric Duncan, as conscientious and caring, and from a very private family. MORE

  13. OCT. 14, 2014

    Editorial warns effort to combat the Ebola virus in Western Africa is lagging dangerously behind; contends the international community must dramatically step up aid if epidemic is to be controlled; holds obligation is particularly strong for the United Sates as it faces first case of patient who contracted the virus domestically. MORE

  14. OCT. 14, 2014

    Sierra Leone’s national soccer team is enduring a series of demeaning and discouraging indignities since outbreak of Ebola in West Africa; team is barred from playing in its own stricken country and it must play every match on the road as it struggles to qualify for the 2015 Africa Cup of Nations, continent’s biennial championship. MORE

  15. OCT. 14, 2014

    World Bank president Dr Jim Yong Kim, frustrated with slow global response to Ebola outbreak, has made fighting epidemic his mission, driving bank to act on Ebola with uncharacteristic speed; bank has committed $400 million to fighting disease. MORE

  16. OCT. 13, 2014

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

  17. OCT. 13, 2014

    News that a nurse at Texas Health Presbyterian Hospital has contracted Ebola virus transforms part of Dallas into scene of concern and contamination; residents in victim’s neighborhood are filled with anxiety, while hazardous-materials crews scramble to clean her apartment building. MORE

  18. OCT. 13, 2014

    Nurse at Texas Presbyterian Hospital in Dallas becomes first person to contract Ebola within United States; development prompts local, state and federal officials to scramble to determine how she became infected, despite wearing protective gear, and to monitor others potentially at risk; news further stokes fears among health care workers across country. MORE

  19. OCT. 13, 2014

    Centers for Disease Control and Prevention say agency will take new steps to help hospital workers protect themselves, providing more training and urging hospitals to practice dealing with potential Ebola patients. MORE

  20. OCT. 13, 2014

    Op-Ed article by Prof Siddhartha Mukherjee contends Ebola case of Thomas Eric Duncan in Dallas shows that medical community must rethink concept of quarantine, in light of the absence of any established anti-viral treatment; calls for development of pilot program for rapid-testing quarantine. MORE

  21. OCT. 12, 2014

    Liberian Army has suddenly become linchpin in fight against Ebola virus rampaging the country; for decades, Liberians viewed the armed forces with fear due to atrocities committed during civil war. MORE

  22. OCT. 11, 2014

    Doctors Without Borders, first to respond to Ebola crisis in West Africa, remains primary international medical aid group battling disease there; strained and overworked charity has erected six treatment centers in West Africa, with plans for more, and has treated the majority of patients, just as they have in previous Ebola outbreaks and some other epidemics in the developing world. MORE

  23. OCT. 10, 2014

    Health workers at International Medical Corps treatment center in Liberia face dilemma of how to care for newborn whose mother may have died of Ebola; many health workers have contracted Ebola while attending to births and being exposed to blood and other body fluids, provoking fears of providing maternity care; doctors speculate that Ebola can be transmitted from mother to baby (Series: The Ebola Ward). MORE

  24. OCT. 10, 2014

    Britain says it will introduce measures at airports and rail terminals to screen passengers from affected countries as concerns over Ebola grow in Europe. MORE

  25. OCT. 10, 2014

    Presidents of Guinea, Liberia and Sierra Leone, nations most affected by the Ebola outbreak, implore world leaders to increase their support to fight the disease; speak at meeting of the World Bank and the International Monetary Fund in Washington. MORE

  26. OCT. 10, 2014

    Nebraska Biocontainment Patient Care Unit in Omaha, with arrival of two Ebola patients in last six weeks, is at forefront of the nation’s response to the disease; unit’s 10 beds sat empty for years. MORE

  27. OCT. 10, 2014

    Dallas officials say Sgt Michael Monnig, local shefiff’s deputy examined for possible infection with Ebola virus, has tested negative and is sent home from hospital; many in city remain uneasy. MORE

  28. OCT. 9, 2014

    Thomas Eric Duncan dies of Ebola in Dallas, renewing questions about whether delay in receiving treatment could have played a role in his death and what role it played in the possibility of his spreading the disease to others; it remains unclear why, and how, Texas Health Presbyterian Hospital did not initially view the Liberian man as a potential Ebola case; nearly 50 people who came into contact with Duncan when he was experiencing active symptoms are being monitored. MORE

  29. OCT. 9, 2014

    Federal health officials will require temperature checks for the first time at five major American airports for people arriving from three West African countries hardest hit by Ebola epidemic; however, health experts say measures are more likely to calm worried public than to prevent people with Ebola from entering country; move comes after death of Thomas Eric Duncan, Liberian man who was the first person diagnosed with Ebola in the United States. MORE

  30. OCT. 9, 2014

    Bellevue Hospital Center in Manhattan shows off its isolation rooms and its leave-no-skin-cell-uncovered precautions in an attempt to reassure New Yorkers that should the Ebola virus arrive in the city, its premier public hospital could handle it. MORE

  31. OCT. 9, 2014

    European leaders are scrambling to upgrade their response to Ebola crisis after Pres Obama’s announcement that he will send 3,000 troops to West Africa to build hospitals and otherwise help in fight against the disease. MORE

  32. OCT. 9, 2014

    Spanish health officials explain how auxiliary nurse Maria Teresa Romero Ramos became the first Ebola case in Western Europe, saying that it was likely she became infected when she touched her face with the gloves she had worn while tending to a Spanish missionary with Ebola at a Madrid hospital. MORE

  33. OCT. 9, 2014

    Dog named Excalibur who belonged to Ebola-infected nurse Maria Teresa Romero Ramos is destroyed by Spanish health officials, even as protesters and animal rights activists surround Madrid home of the nurse and her husband; online petition calling for dog’s life to be spared drew hundreds of thousands of signatures. MORE

  34. OCT. 9, 2014

    Editorial notes new screening procedures directed at travelers entering United States from Guinea, Liberia or Sierra Leone, center of the Ebola epidemic in West Africa; holds screenings, while burdensome and possibly of little practical value, may ease public anxieties about keeping virus out of country and assure people that risks are being minimized. MORE

  35. OCT. 8, 2014

    Schedule for a single day at newly opened Ebola treatment center in Suakoko, Liberia, run by International Medical Corps charity, offers portrait of efforts to halt spread of virus; center is both ordinary and otherwordly, where health workers tend to those infected and those quarantined while awaiting test results (Series: The Ebola Ward).MORE

  36. OCT. 8, 2014

    Spain’s government comes under heavy criticism for its handling of Western Europe’s first Ebola case, as health care workers argue that they have not been given proper training or equipment to handle the disease; government quarantines three more people and monitors dozens who had come into contact with infected nurse. MORE

  37. OCT. 8, 2014

    Centers for Disease Control and Prevention scrambles to address concerns from health workers nationwide as anxiety mounts over Ebola virus; agency has scheduled two nationwide conference calls, but has so far not changed its recommendations on protective gear.MORE

  38. OCT. 8, 2014

    Doctors report first positive signs in recovery of Thomas Eric Duncan, Liberian man battling Ebola virus in Dallas hospital; Duncan’s temperature and blood pressure have normalized, though he remains on a ventilator and is still receiving kidney dialysis. MORE

  39. OCT. 8, 2014

    Centers for Disease Control and Prevention officials promise additional measures to screen airline passengers arriving in United States for Ebola virus; remain opposed to draconian travel restrictions such as outright bans, saying that they would cause more problems than they would solve. MORE

  40. OCT. 7, 2014

    Nurse in Spain becomes first health worker to be infected with Ebola virus outside West Africa, raising serious concerns about how prepared Western nations are to safely treat people with the deadly illness; nurse contracted the illness while treating a Spanish missionary who was infected in Sierra Leone and flown to Madrid, where he died; infection exposes weak spots in Spain’s highly praised health care defense systems. MORE

  41. OCT. 7, 2014

    Adel Faqih, Saudi Arabia’s acting health minister, says this year’s hajj has been free of Ebola and other contagious diseases like Middle East Respiratory Syndrome because of measures taken to protect more than two million Muslim pilgrims. MORE

  42. OCT. 7, 2014

    Pres Obama says screening for Ebola virus at airports both in the United States and West Africa will increase, but does not offer specifics; Dallas residents remain on edge as they await to learn if those who came into contact with Ebola patient Thomas Eric Duncan became infected. MORE

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

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

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

Texas-Hospital-Patient-Confirmed

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

Oliver Cromwell

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CDC investigating Ebola protocol, as second U.S. patient confirmed

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

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

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

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

CDC Warns On AIRBORNE EBOLA

Max Alert! EBOLA Bodily Fluids Readily Airborne Weaponizable

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

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

Ebola Health care worker tests positive at Texas hospital

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

Ebola – The Truth About the Outbreak (Documentary)

What Pisses Me Off About Ebola

Science Today: Virus Mutation | California Academy of Sciences

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Flu Shift and Drift

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The majority of African Americans and Hispanics have O positive.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

CDC chief backtracks after blaming nurse who got Ebola

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

WHEN IS EBOLA CONTAGIOUS?

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

HOW DOES EBOLA SPREAD?

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

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

WHAT ABOUT MORE CASUAL CONTACT?

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

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

WHO GETS TESTED WHEN EBOLA IS SUSPECTED?

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

HOW IS IT CLEANED UP?

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

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

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

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

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

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

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

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

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

Key Question: How Did Dallas Worker Contract Ebola?

How did it happen?

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

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

Ebola-Nurse

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

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

 

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

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

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

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

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

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

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

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

 

Some questions and answers about the new case.

Q: What protection do health workers have?

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

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

Q: How might infection have occurred?

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

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

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

Q: How else could infection have happened?

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

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

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

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

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

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

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

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

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

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

Q. What is CDC recommending that a hospital do?

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

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

 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

=====

Update at 2:59 p.m.

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

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

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

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

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

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

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

Update at 12:21 p.m.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Update at 12:21 p.m.

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

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

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

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

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

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

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

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

TEXAS EBOLA HOSPITAL CAFETERIA BECOMES GHOST TOWN

 By Bob Price

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

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

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

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

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

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

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

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

WHO: EBOLA IS MODERN ERA’S WORST HEALTH EMERGENCY

BY JIM GOMEZ

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

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

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

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

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

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

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

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

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

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

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

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

U.S. lacks a single standard for Ebola response

Larry Copeland

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Contributing: Rick Jervis in Dallas, Gregory Korte

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

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

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

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

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

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

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

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

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

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

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

Not “airborne” but can spread through the air

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

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

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

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

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

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

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

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

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

 

USAMRIID The US Army Medical Research Institute of Infectious Disease

USAMRIID Overview

BioContainment Unit at The Nebraska Medical Center

Activation- A Nebraska Medical Center Biocontainment Unit Story

Max Alert! EBOLA Bodily Fluids Readily Airborne Weaponizable

Aerosolizing ONE DROP of EBOLA = 1/2 MILLION DEAD

 

The Secret Ebola Open Border Connection Revealed: Special Report

Ebola – The Truth About the Outbreak (Documentary)

What Pisses Me Off About Ebola

 

germs gerns_2

 

The ominous math of the Ebola epidemic

By Joel Achenbach, Lena H. Sun and Brady Dennis

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

Right now, the math still favors the virus.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

http://www.washingtonpost.com/national/health-science/the-ominous-math-of-the-ebola-epidemic/2014/10/09/3cad9e76-4fb2-11e4-8c24-487e92bc997b_story.html

 

 

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

Story

 

The UK is well set for an Ebola outbreak (sarcasm alert) We have TWO isolation units, but one is getting ‘redeveloped’ so it’s not available right now. Called High Security Infectious Diseases Units there are two in the country, each capable of taking two patients. One is at The Royal Free Hospital in Hampstead North London, the other, the one getting a bit of a make-over, is at The Royal Victoria Infirmary in Newcastle, up in the north-east of England.

Four level 4 bio-containment beds between 69,000,000 people

In the US there are 4 units geared up to handle Ebola. The National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, has 3 beds. Nebraska Medical Center, Omaha, has 10 beds. Emory Hospital, Atlanta has 3 beds and St Patricks Hospital, Missoula  has 3 beds (source)

19 level four biocontainment beds for 317,000,000 people

I think we just found out why the government(s) are under-playing the situation. They simply do not have the facilities to cope with even a small outbreak. They are, in fact in exactly the same position as the dirt-poor hospitals in West Africa…there are not enough facilities to stop the spread of the disease if it gets out. The quality of care is better, but the availability of containment most likely isn’t.

I am sure ‘regular’  isolation units will be pressed into use but they are not designed to handle level 4 biohazards, they are nowhere near as secure medically speaking, as biocontainment units.

A couple of days ago I explained how exponential spread works. You can read that article here if you like. As a quick recap.  Once a disease is at the point where every carrier infects 2 more people,(exponential spread) it will continue until it:

A) runs out of hosts

B) is stopped by medical science or

C) mutates into something less harmful.

What follows will show you how woefully inadequately our governments have prepared for something as lethal as Ebola.

In the flu pandemic of 1918-1920 28% of Americans were infected with the disease…try to remember I am talking numbers here not HOW  disease spreads or any medical similarities between diseases, 625,000 Americans lost their lives out of some 29,400,000 infections. The population of the United States at that time was 105,000,000 people. (source)

Fast forward to today. If that flu pandemic had hit the United States in 2014, when the population stands at 317,000,000 people 88,760,000 people would have been infected and 2,130,240 of them would have died.

Now, let’s try this with Ebola. I have picked Liberia just because it is in the news due to the Thomas Duncan case.

Liberia has a population of 4,290,000 people, as of the latest figures there have been 3692 cases of Ebola, this represents 0.0086% of the population.Of those infections, 1998 people have died that’s a fatality rate of 54%. (source)

If that same infection and death rate were applied to the United States Ebola would infect 269,000 people and of those 156,281 would die.

Now, if as doctors and scientists fear the basic reproduction rate rises to 2 in Liberia the numbers change very quickly. Using the mean average incubation time of 9 days it would take around 13 weeks for the entire population of Liberia to become infected. (10 doublings starting with 3692 = just under the population of Liberia. This multiplied by 9 days gives us 90 days which divided by 7 gives 12.85 weeks.) Of the 4,290,000 people infected 2,316,000 would lose their lives.

This is just Liberia, not the other affected countries in West Africa. 

Translated to an equivalent outbreak in the United States, where the basic reproduction rate is also 2, the numbers are horrifying. Starting with patient zero it would take around 245 days, 35 weeks for every person in the United States to become infected. Of those 17,118,000 people would die. (27.17 doublings x 9 days = 245 days =35 weeks)

Please remember the figures for Liberia are pulled from the CDC website, the percentages are correct. The scenario for the United States was based on exactly the same parameters as for Liberia…a like for like comparison.

The CDC could be spending their time educating people, advising people to stock up,  get ready for  the possibility of staying in their homes. Self imposed isolation, or if need be state imposed isolation, that may last for an extended time period may become a reality. They’re not doing it though are they? They are sprouting figures and applying them to West Africa, and they can’t even get that right. They are saying that there could be 1.4 deaths in West Africa in a worst case scenario. When actually applying the figures they supplied with some simple mathematics we can see that 1.4 million deaths is a gross understatement.

Even a basic reproduction rate of 1.7, the latest figure for Liberia it will only take around  30 weeks to get to the same point as the above scenario, over 2,000,000 dead.

Don’t get me wrong, I am not saying that the UK government is any better, if anything they are worse, they don’t even try to do the maths. Most of them went to Eton (a very expensive school that churns out politicians) so it’s unlikely they would be capable of it even if they wanted to. You only have to look at our national finances to see they are no good at sums. They send out press briefings  that there will be an emergency COBRA meeting, do you have any clue what that stands for? Let me enlighten you, Cabinet Office Briefing Room A.  COBRA is not an emergency planning group, it’s an effing office.

Although I am loathed to say it, it’s time that our governments started worrying about the facilities at home rather than worrying about the facilities abroad. Stopping the disease in Africa does not mean we are out of the woods. There are so many unreported cases, people turned away from medica facilities in West Africa that nobody has the slightest idea how many cases of Ebola are actually out there. The porous borders of the region mean that people move around without the controls that are usually exercised in the west. There has to be a travel ban on non-US citizens entering the United States from these areas, the same applies from the UK.

Border control has to be improved in both countries if we have any hope of halting the spread of this terrible disease. The west is going to be the destination for anyone from Ebola hit areas that can afford to make their way from Africa. Many West Africans have contacts in the west who will help them get out, and shelter them when they arrive. As harsh as it seems this has to be stopped, it’s time for governments to put their own citizens first. Repatriation of your own is one thing, risking millions of lives at home because you won’t man up and prevent foreigners entering is quite another.

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

 

BSL-4 Laboratories in the United States

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

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

National & Regional Biocontainment Laboratories

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

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

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

Regional Centers of Excellence

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

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

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

 

 

Biosafety Level 4 Labs and BSL Information

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

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

Biosafety Level Information

BSL-4, Biosafety Level 4

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

BSL-3, Biosafety Level 3

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

 

BSL-2, Biosafety Level 2

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

 

BSL-1, Biosafety Level 1

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

 

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

 

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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

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The Pronk Pops Show Podcasts

Pronk Pops Show 345: October 8, 2014

Pronk Pops Show 344: October 6, 2014

Pronk Pops Show 343: October 3, 2014

Pronk Pops Show 342: October 2, 2014

Pronk Pops Show 341: October 1, 2014

Pronk Pops Show 340: September 30, 2014

Pronk Pops Show 339: September 29, 2014

Pronk Pops Show 338: September 26, 2014

Pronk Pops Show 337: September 25, 2014

Pronk Pops Show 336: September 24, 2014

Pronk Pops Show 335: September 23 2014

Pronk Pops Show 334: September 22 2014

Pronk Pops Show 333: September 19 2014

Pronk Pops Show 332: September 18 2014

Pronk Pops Show 331: September 17, 2014

Pronk Pops Show 330: September 16, 2014

Pronk Pops Show 329: September 15, 2014

Pronk Pops Show 328: September 12, 2014

Pronk Pops Show 327: September 11, 2014

Pronk Pops Show 326: September 10, 2014

Pronk Pops Show 325: September 9, 2014

Pronk Pops Show 324: September 8, 2014

Pronk Pops Show 323: September 5, 2014

Pronk Pops Show 322: September 4, 2014

Pronk Pops Show 321: September 3, 2014

Pronk Pops Show 320: August 29, 2014

Pronk Pops Show 319: August 28, 2014

Pronk Pops Show 318: August 27, 2014 

Pronk Pops Show 317: August 22, 2014

Pronk Pops Show 316: August 20, 2014

Pronk Pops Show 315: August 18, 2014

Pronk Pops Show 314: August 15, 2014

Pronk Pops Show 313: August 14, 2014

Pronk Pops Show 312: August 13, 2014

Pronk Pops Show 311: August 11, 2014

Pronk Pops Show 310: August 8, 2014

Pronk Pops Show 309: August 6, 2014

Pronk Pops Show 308: August 4, 2014

Pronk Pops Show 307: August 1, 2014 

Pronk Pops Show 306: July 31, 2014

Pronk Pops Show 305: July 30, 2014

Pronk Pops Show 304: July 29, 2014

Pronk Pops Show 303: July 28, 2014

Pronk Pops Show 302: July 24, 2014

Pronk Pops Show 301: July 23, 2014

Pronk Pops Show 300: July 22, 2014

Pronk Pops Show 299: July 21, 2014

Pronk Pops Show 298: July 18, 2014

Pronk Pops Show 297: July 17, 2014

Pronk Pops Show 296: July 16, 2014

Pronk Pops Show 295: July 15, 2014

Pronk Pops Show 294: July 14, 2014

Pronk Pops Show 293: July 11, 2014

Pronk Pops Show 292: July 9, 2014

Pronk Pops Show 291: July 7, 2014

Pronk Pops Show 290: July 3, 2014

Pronk Pops Show 289: July 2, 2014

Story 1: Breaking News: 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

ebola

hot_zone

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

SOUTHCOM Commander: Ebola Outbreak in Central America Could Cause Mass Migration to U.S.

By:
Published:
Updated: October 7, 2014 10:26 PM

Marine Corps Gen. John F. Kelly, center, commander of U.S. Southern Command, speaks with Adm. Sigifrido Pared Perez, Dominican Republic minister of defense, in Barahona, Dominican Republic on June 9, 2014. SOUTHCOM Photo

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.”

http://news.usni.org/2014/10/07/southcom-commander-ebola-outbreak-central-america-haiti-nightmare-scenario

 

Ebola Patient Has Died During a Crucial Week for Dallas

If Thomas Eric Duncan passed the virus onto anyone else, that would likely become evident this week.

(Mike Stone/Getty Images)

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.

http://www.nationaljournal.com/health-care/dallas-ebola-patient-has-died-20141008

Triage and Management of Accidental Laboratory Exposures to Biosafety Level-3 and -4 Agents

Abstract

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.

 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2749272/

 

Biosafety level

From Wikipedia, the free encyclopedia

A biosafety level is a level of the biocontainment precautions required to isolate dangerous biological agents in an enclosed facility. The levels of containment range from the lowest biosafety level 1 (BSL-1) to the highest at level 4 (BSL-4). In the United States, the Centers for Disease Control and Prevention (CDC) have specified these levels.[1] In the European Union, the same biosafety levels are defined in a directive.[2]

History

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.[3]

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.[4][5]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.[6]

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.[6] 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.[6]

Rationale

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.

Levels

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).[7]

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.

Biosafety level 2

This level is similar to Biosafety Level 1 and is suitable for work involving agents of moderate potential hazard to personnel and the environment.[7] It includes various bacteria and viruses that cause only mild disease to humans, or are difficult to contract via aerosol in a lab setting, such as C. difficile, most Chlamydiae, hepatitis A, B, and C, orthopoxviruses (other than smallpox), influenza A, Lyme disease, Salmonella, mumps, measles,[8] scrapie, MRSA, and VRSA. BSL-2 differs from BSL-1 in that:

  1. laboratory personnel have specific training in handling pathogenic agents and are directed by scientists with advanced training;
  2. access to the laboratory is limited when work is being conducted;
  3. extreme precautions are taken with contaminated sharp items; and
  4. certain procedures in which infectious aerosols or splashes may be created are conducted in biological safety cabinets or other physical containment equipment.

Biosafety level 3

Researcher at US Centers for Disease Control, Atlanta, Georgia, working with influenza virus under biosafety level 3 conditions, with respirator inside a biosafety cabinet (BSC).

This level is applicable to clinical, diagnostic, teaching, research, or production facilities in which work is done with indigenous or exotic agents which may cause serious or potentially lethal disease after inhalation.[7] It includes various bacteria, parasites and viruses that can cause severe to fatal disease in humans but for which treatments exist, such as Yersinia pestis (causative agent of plague), Francisella tularensis, Leishmania donovani, Mycobacterium tuberculosis, Chlamydia psittaci, Venezuelan equine encephalitis virus, Eastern equine encephalitis virus, SARS coronavirus, Coxiella burnetii, Rift Valley fever virus,Rickettsia rickettsii, several species of Brucella, rabies virus, chikungunya, yellow fever virus, and West Nile virus.

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

  1. the filtered exhaust air from the laboratory room is discharged to the outdoors,
  2. the ventilation to the laboratory is balanced to provide directional airflow into the room,
  3. access to the laboratory is restricted when work is in progress, and
  4. 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.

Biosafety level 4

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.

List of BSL-4 facilities

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 [9]). 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.[9]

The following is a list of existing BSL-4 facilities worldwide.

Name Location Date
established
Description
Virology Laboratory of the Queensland Department of Health Australia, Queensland,Coopers Plains
Korea Centers for Disease Control and Prevention (KCDC) Osong, Cheongwoncounty, North Chungcheong province, South Korea 2013
University of Queensland – Sir Albert Sakzewski Virus Research Centre (SASVRC) Royal Women’s Hospital Brisbane P3 (BL3) Australia, Queensland,Herston
Australian Animal Health Laboratory Australia, Victoria,Geelong
National High Security Laboratory Australia, Victoria, North Melbourne National High Security Laboratory Operates under the auspice of the Victoria Infectious Diseases Reference Laboratory.
Republican Research and Practical Center for Epidemiology and Microbiology Belarus, Minsk Department of Molecular Epidemiology & Innovational Biotechnologies
National Microbiology Laboratory Canada, Manitoba,Winnipeg Located at the Canadian Science Centre for Human and Animal Health, it is jointly operated by the Public Health Agency of Canada and the Canadian Food Inspection Agency.
Wuhan Institute of Virology of the Chinese Academy of Sciences China, Hubei, Wuhan 2003 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.[10][11] It will be the first at level 4 in China, under the direction of Shi Zhengli.[12]
Biological Defense Center Czech Republic,Pardubice, Těchonín 1971, rebuilt 2003-2007 Located at the Centrum biologické ochrany (Biological Defense Center)[13]
Laboratoire P4 Jean Mérieux France, Rhône-Alpes,Lyon 1999-03-05 Jean Mérieux laboratory is a co-operation between the Pasteur Institute and INSERM. Note that in France, it is P4 for Pathogen or Protection level 4.[14]
Laboratoire de la DGA France, Vert-le-Petit,Essonne 2013-10-24 The Laboratoire de la DGA [1] is part of the Ministry of Defence.
Centre International de Recherches Médicales de Franceville Gabon This facility is operated by a research organization supported by both Gabonese (mainly) and French governments, and is West Africa’s only P4 lab (BSL-4).[15]
Robert Koch Institute Germany, Berlin The facility was licenced for construction by City of Berlin on November 30, 2008.
Bernhard Nocht Institute for Tropical Medicine Germany, Hamburg
Friedrich Loeffler Institute on the Isle of Riems Germany, Isle of Riems (Greifswald) 2010 Deals especially with virology
Philipps University of Marburg Germany, Marburg 2008 The facility is licenced to work with genetically modified organisms
High Security Animal Disease Laboratory (HSADL) India, Bhopal 1998 This facility deals especially to zoonotic organisms and emerging infectious disease threats.
Centre for Cellular and Molecular Biology India, Hyderabad 2009 National Bio-Safety Level-4 Containment Facility for Human Infectious Diseases & Clinical Research Facility in Regenerative Medicine [16][17]
All India Institute of Medical Sciences India, New Delhi 1993 Conducts studies on major pathogenic organisms. Has contributed in discovering new strains & vaccines.
Microbial Containment Complex India, Pune 2012 Bio-Safety Level-IV Laboratory established by ICMR with support from Department of Science & Technology
Azienda Ospedaliera Ospedale Luigi Sacco Italy, Lombardy, Milan A university hospital located in the city’s Polo Universitario; it contains two special vehicles for the safe transportation of infectious patients.
Istituto Nazionale per le Malattie Infettive Italy, Lazio, Rome 1936 (1997) 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. [18]
National Institute for Infectious Diseases Japan, Tokyo,Musashimurayama 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.
Institute of Physical and Chemical Research Japan, Ibaraki, Tsukuba This is a non-operating BSL-4 facility.
Netherlands National Institute for Public Health and the Environment (RIVM) Netherlands, Bilthoven 2009
Cantacuzino Microbiological Research Institute (INCDMI) Romania, Bucharest [19]
“Dr. Carol Davila” Central Military Hospital Romania, Bucharest [20]
State Research Center of Virology and Biotechnology VECTOR Russia, Novosibirsk Oblast, Koltsovo It is one of two facilities in the world that officially hold smallpox. The other Russian BSL-4 facilities have been dismantled.
National Institute for Communicable Diseases South Africa,Johannesburg National Institute for Communicable Diseases of Special Pathogens Unit is one of only two BSL-4 facilities in Africa but the only suit laboratory on the continent.
The Swedish BSL-4 Laboratory[21] Sweden, Solna 2001 Located at the Public Health Agency of Sweden premises, this is the only BSL-4 facility in the Nordic region. The facility also houses a BSL-3 laboratory.[22][23][24]
University Hospital of Geneva Switzerland
Spiez Laboratory Switzerland, Spiez
Kwen-yang Laboratory (昆陽實驗室) Center of Disease Control Taiwan Part of the Department of Health, Taiwan.
Preventive Medical Institute of ROC Ministry of National Defense Taiwan
Health Protection Agency‘s Centre for Infections United Kingdom,Colindale Located in the Viral Zoonosis unit.
National Institute for Medical Research United Kingdom,London [25]
Institute for Animal Health United Kingdom,Pirbright
Institute for Animal Health Compton Laboratory United Kingdom,Compton [26]
Defence Science and Technology Laboratory United Kingdom, Porton Down
Health Protection Agency United Kingdom, Porton Down Special Pathogens Reference Unit.
Health Protection Agency United Kingdom, Porton Down Botulism.
Francis Crick Institute[27] United Kingdom,London Under construction. The UKCMRI will not work on Human Hazard Group 4 agents.
Centers for Disease Control and Prevention United States, Georgia,Atlanta Currently operates in two buildings. One of two facilities in the world that officially holdsmallpox.
Georgia State University United States, Georgia,Atlanta Is an older design “glovebox” facility.
National Bio and Agro-Defense Facility(NBAF), Kansas State University United States, Kansas,Manhattan Under construction. Facility to be operated by the Department of Homeland Security, and replace the Plum Island Animal Disease Center (which is not a BSL-4 facility). Planned to be operational by 2015, but likely delayed.
National Institutes of Health (NIH) United States,Maryland, Bethesda Located on the NIH Campus, it currently only operates with BSL-3 agents.
Integrated Research Facility United States,Maryland, Fort Detrick Under construction. This facility will be operated by National Institute of Allergy and Infectious Diseases (NIAID), it is planned to begin operating at 2009 at the earliest.[needs update]
National Biodefense Analysis and Countermeasures Center (NBACC) United States,Maryland, Fort Detrick Under construction, it will be operated for the Department of Homeland Security.
US Army Medical Research Institute of Infectious Diseases (USAMRIID) United States,Maryland, Fort Detrick 1969 Old building
US Army Medical Research Institute of Infectious Diseases (USAMRIID) United States,Maryland, Fort Detrick 2017? New building, currently under construction
National Emerging Infectious Diseases Laboratory (NEIDL), Boston University United States,Massachusetts, Boston Under construction by Boston University, building and staff training complete, waiting for regulatory approval.
NIAID Rocky Mountain Laboratories United States, Montana,Hamilton National Institute of Allergy and Infectious Diseases
Kent State University, Kent Campus United States, Ohio,Kent Operates as a clean lab at level 3 for training purposes. Scheduled for conversion to a hot level 4 lab in response to a bioterrorism event in the USA.
Galveston National Laboratory, National Biocontainment Facility United States, Texas,Galveston Opened in 2008, facility is operated by the University of Texas Medical Branch.[28]
Shope Laboratory United States, Texas,Galveston Operated by the University of Texas Medical Branch (UTMB).
Texas Biomedical Research Institute United States, Texas,San Antonio The only privately owned BSL-4 lab in the US.

See also[edit]

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

 

 

Texas Ebola patient’s remains will be cremated

By Ashley Fantz and Elizabeth Cohen, CNN
updated 3:28 PM EDT, Wed October 8, 2014

(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.

Read more: Who was Duncan?

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.

Airport screenings

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.

Can you catch Ebola on a plane?

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.

U.S. personnel are also being deployed.

Read more: Pentagon says troops heading to West Africa

Cases in West Africa

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.

The CDC is tracking the latest cases in the region.

NBC News freelance cameraman Ashoka Mukpo was diagnosed with Ebola in Liberia on Thursday. He left Liberia on a specially equipped plane Sunday and was headed to Nebraska, the network reported.

Mukpo is in stable condition at The Nebraska Medical Center, hospital representative Taylor Wilson said Wednesday.

The CDC’s Frieden said Tuesday that battling the virus will be a “long, hard fight.”

“The virus is spreading so fast,” he said, “that it’s hard to keep up.”

http://www.cnn.com/2014/10/08/health/ebola-us/

Steven Hatfill

From Wikipedia, the free encyclopedia
Steven Jay Hatfill
Born October 24, 1953 (age 60)
Saint Louis, Missouri
Education Southwestern College (1975)University of Zimbabwe (1984)University of Stellenbosch (1993)

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.[1] 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.

Early life and education

Hatfill was born in Saint Louis, Missouri, and graduated from Mattoon Senior High School, Mattoon, Illinois (1971), and Southwestern College in Winfield, Kansas (1975), where he studied biology.

Hatfill was enlisted as a private in the U.S. Army from 1975 to 1977.[2] (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.[3]) Following his Army discharge, Hatfill qualified and worked as a medical laboratory technician, but soon resolved to become a doctor.

Hatfill then settled in Rhodesia (now Zimbabwe) entering the Godfrey Huggins Medical School[4] in Salisbury (now Harare) in 1978. (His claimed military associations during this period included assistance as a medic with the Selous Scouts and membership in theRhodesian SAS, but according to one journalist[5] the regimental association of the latter is “adamant Hatfill never belonged to the unit”.) He graduated (after failing in 1983) with a M ChB degree in 1984 and then completed a one year internship (1984–85) at a small rural hospital in South Africa’s North West Province. The South African government recruited him to be medical officer on a 14 month (1986–88) tour of duty in Antarctica with the South African National Antarctic Expedition (SANAE). He then completed (1988) a master’s degree in microbiology at the University of Cape Town. He worked toward a second master’s (1990; medical biochemistry and radiation biology) at the University of Stellenbosch, while working again as a paid med tech in the University’s clinical hematology lab. A 3-yearhematological pathology residency (1991–93) at Stellenbosch followed, during which time Hatfill conducted research on the treatment of leukemia with thalidomide.[5] This research, toward an anticipated PhD degree, was conducted (1992–95) under the supervision of Professor Ralph Kirby at Rhodes University.

Hatfill submitted his PhD thesis for examination to Rhodes in January 1995, but it was failed in November and no degree was ever granted.[5] Hatfill later claimed a Ph.D. degree in “molecular cell biology” from Rhodes, as well as completion of a post-doctoral fellowship (1994–95) at the University of Oxford in England and three master’s degrees (in microbial genetics, medical biochemistry, and experimental pathology). Some of these credentials have been questioned. During a later investigation, officials at Rhodes insisted that he had never been awarded a Ph.D. from their institution.[6] (In 2007, Hatfill’s lawyer Tom Connolly[7] — in his lawsuit against former U.S. Attorney General John Ashcroft and the FBI — admitted that his client had “Puffed on his resume. Absolutely. Forged a diploma. Yes, that’s true.”[8])

Back in the U.S., another of Hatfill’s post-doctoral appointments commenced at the National Institute of Child Health and Human Development (NICHD), one of the National Institutes of Health (NIH) in Bethesda, Maryland, in 1995. He subsequently worked (1997–99) as a civilian researcher at the United States Army Medical Research Institute of Infectious Diseases (USAMRIID), the U.S. Department of Defense‘s medical research institute for biological warfare (BW) defense at Fort Detrick, Frederick, MD. There he studied, under aNational Research Council fellowship, new drug treatments for the Ebola virus and became a specialist in virology and BW defense.

Anthrax attacks

In January 1999 Hatfill transferred to a “consulting job” at Science Applications International Corporation (SAIC), which has a “sprawling campus” in nearby McLean, Virginia. The corporation did work for a multitude of federal agencies. Many projects were classified.

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.[9] After the attacks, the report drew the attention of the media and others, and led to their investigation of Patrick and Hatfill.[10]

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.[11] 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”.[12]

Rosenberg discussed the case with reporters from the New York Times.[13] On January 4, 2002, Nicholas Kristof of the New York Times published a column titled “Profile of a Killer”[14] 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?”[15] 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.”[16] The Washington Post reported that “FBI officials over the last week have flatly discounted Dr. Rosenberg’s claims.”[17]

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.[18] 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.”[19] Both The American Prospect and Salon.com reported that “Hatfill is not a suspect in the anthrax case, the FBI says.”[20] 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.”[21]

Person of interest

In August 2002, Attorney General John 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.[22]

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.[23]

His lawyer, Victor M. Glasberg,[24] 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.”[25]

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”.[26] He and his attorneys fought the ticket, but a hearing officer upheld the ticket and ordered Hatfill to pay the requisite $5 fine.[27]

FBI Director Robert S. Mueller III changed leadership of the investigation in late 2006, and at that time another suspect, USAMRIID bacteriologist Bruce Ivins, became the main focus of the investigation.[28] Considerable questions have been raised, however, about the credibility of the case against Ivins as well.[29]

60 Minutes interview

Hatfill’s lawyer, Tom Connolly, was featured in a CBS News 60 Minutes interview about the anthrax incidents on March 11, 2007.[8] 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.[30] 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.[31]

Lawsuits

Hatfill v. John Ashcroft, et al.

On the 26th of August 2003, Hatfill filed a lawsuit[32] against the Attorney General of the United States John Ashcroft, the United States Department of Justice, DOJ employees Timothy Beres and Daryl Darnell, the Federal Bureau of Investigation, FBI Supervisory Special Agent Van Harp and an unknown number of FBI agents.[33]

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.[34]

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.”[35]

During the first round of depositions, Hatfill subpoenaed six reporters: Michael Isikoff and Daniel Klaidman of Newsweek, Brian Ross of ABC, Allan Lengel of The Washington Post, Jim Stewart of CBS, and Toni Locy of USA Today.

Hatfill now has subpoenaed eight news organizations, including three that he didn’t name before: The New York Times (Nicolas Kristof, David Johnson, William Broad, Kate Zernike, Judith Miller, Scott Shane, and Frank D. Roylance), The Baltimore Sun (Gretchen Parker and Curt Anderson), and the Associated Press. Subpoenas for Washington Post writers Marilyn W. Thompson, David Snyder, Guy Gugliotta, Tom Jackman, Dan Eggen and Carol D. Loenning, and for Mark Miller of Newsweek, are now included.

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.[36] 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.”[37]

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.[38]

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)[39] to settle the lawsuit in which Hatfill claimed the Justice Department violated his privacy rights by speaking with reporters about the case.[40][41]

Hatfill v. The New York Times

In July 2004, Hatfill filed a lawsuit against The New York Times Company and Nicholas D. Kristof.

In a sealed motion[42] 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.”[citation needed]

A redacted copy[42] 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.[43]

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[44] of their opposition has been made available by Secrecy News.[45]

On January 12, 2007, a judge dismissed a lawsuit filed by Hatfill against The New York Times.[46]

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.[31]

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.[47] 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”.[48]

Hatfill subsequently sued Donald Foster, Condé Nast Publications, Vassar College, and The Reader’s Digest Association. The suit sought $10 million in damages, claiming defamation.[49] The Reader’s Digest published a condensed version of the article in December 2003.

The lawyers delayed bringing the Hatfill v. Foster lawsuit to court because “the parties are close to finalizing the settlement”.

On February 27, 2007, The New York Sun reported that he settled without a trial.[50]

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

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

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Pronk Pops Show 307: August 1, 2014 

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

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CDC: Airborne Ebola possible but unlikely

By Elise Viebeck

The Ebola virus becoming airborne is a possible but unlikely outcome in the current epidemic, Centers for Disease Control and Prevention (CDC) Director Tom Frieden said Tuesday.

The outbreak involves Ebola Zaire, a strain that is passed through bodily fluids, not the air. But some experts have expressed fear about viral mutations due to the unprecedented — and rising — number of Ebola cases.

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Frieden sought to allay those fears during a call with reporters.

“The rate of change [with Ebola] is slower than most viruses, and most viruses don’t change how they spread,” he said. Frieden is unofficially spearheading the U.S. response to Ebola.

“That is not to say it’s impossible that it could change [to become airborne],” he continued. “That would be the worst-case scenario. We would know that by looking at … what is happening in Africa. That is why we have scientists from the CDC on the ground tracking that.”

A change in the way Ebola spreads would make the virus significantly more dangerous. The disease kills roughly half the people it infects, and lacking a vaccine or cure, its traceable chain of transmission through bodily fluids is one reason officials believe they can contain it.

Still, there is almost no precedent for a human virus mutating to become transmissible in a different way, a key piece of evidence in weighing whether that kind of shift is likely for Ebola.

“We have so many problems with Ebola, let’s not make another one that, of course, is theoretically possible but is pretty way down on the list of likely issues,” infectious diseases expert William Schaffner of Vanderbilt University told Scientific American.

Frieden touted new progress against Ebola in West Africa and Dallas, where a Liberian man remains in critical condition, but warned that “globally, this is going to be a long, hard fight.”

The Dallas patient interacted with 10 definite and 38 possible interlocturos who are now being monitored, he said. None have shown symptoms.

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

 

Some Ebola experts worry virus may spread more easily than assumed

Ebola could be spread through air in tight quarters, some scientists fear
Some Ebola experts worry that the virus may spread more easily than thought — through the air in small spaces, for example.
By DAVID WILLMAN contact the reporter NationMedical ResearchAfricaScientific ResearchDiseases and IllnessesEbolaU.S. Centers for Disease Control and Prevention

Ebola researcher says he would not rule out possibility that the virus spreads through air in tight quarters
‘There are too many unknowns here,’ a virologist says of how Ebola may spread
Ebola researcher says he thinks there is a chance asymptomatic people could spread the virus
U.S. officials leading the fight against history’s worst outbreak of Ebola have said they know the ways the virus is spread and how to stop it. They say that unless an air traveler from disease-ravaged West Africa has a fever of at least 101.5 degrees or other symptoms, co-passengers are not at risk.

“At this point there is zero risk of transmission on the flight,” Dr. Thomas Frieden, director of the federal Centers for Disease Control and Prevention, said after a Liberian man who flew through airports in Brussels and Washington was diagnosed with the disease last week in Dallas.

First Ebola infection outside West Africa
Three more people have been hospitalized in Madrid for possible exposure to the Ebola virus after a Spanish nurse tested positive for the virus.
Other public health officials have voiced similar assurances, saying Ebola is spread only through physical contact with a symptomatic individual or their bodily fluids. “Ebola is not transmitted by the air. It is not an airborne infection,” said Dr. Edward Goodman of Texas Health Presbyterian Hospital in Dallas, where the Liberian patient remains in critical condition.

Yet some scientists who have long studied Ebola say such assurances are premature — and they are concerned about what is not known about the strain now on the loose. It is an Ebola outbreak like none seen before, jumping from the bush to urban areas, giving the virus more opportunities to evolve as it passes through multiple human hosts.

Dr. C.J. Peters, who battled a 1989 outbreak of the virus among research monkeys housed in Virginia and who later led the CDC’s most far-reaching study of Ebola’s transmissibility in humans, said he would not rule out the possibility that it spreads through the air in tight quarters.

“We just don’t have the data to exclude it,” said Peters, who continues to research viral diseases at the University of Texas in Galveston.

 

Dr. Philip K. Russell, a virologist who oversaw Ebola research while heading the U.S. Army’s Medical Research and Development Command, and who later led the government’s massive stockpiling of smallpox vaccine after the Sept. 11 terrorist attacks, also said much was still to be learned. “Being dogmatic is, I think, ill-advised, because there are too many unknowns here.”

If Ebola were to mutate on its path from human to human, said Russell and other scientists, its virulence might wane — or it might spread in ways not observed during past outbreaks, which were stopped after transmission among just two to three people, before the virus had a greater chance to evolve. The present outbreak in West Africa has killed approximately 3,400 people, and there is no medical cure for Ebola.

“I see the reasons to dampen down public fears,” Russell said. “But scientifically, we’re in the middle of the first experiment of multiple, serial passages of Ebola virus in man…. God knows what this virus is going to look like. I don’t.”
A resident looks from behind a gate during the Liberian government’s 11-day Ebola quarantine in the West Point district of Monrovia.
Tom Skinner, a spokesman for the CDC in Atlanta, said health officials were basing their response to Ebola on what has been learned from battling the virus since its discovery in central Africa in 1976. The CDC remains confident, he said, that Ebola is transmitted principally by direct physical contact with an ill person or their bodily fluids.

Skinner also said the CDC is conducting ongoing lab analyses to assess whether the present strain of Ebola is mutating in ways that would require the government to change its policies on responding to it. The results so far have not provided cause for concern, he said.

The researchers reached in recent days for this article cited grounds to question U.S. officials’ assumptions in three categories.

 

One issue is whether airport screenings of prospective travelers to the U.S. from West Africa can reliably detect those who might have Ebola. Frieden has said the CDC protocols used at West African airports can be relied on to prevent more infected passengers from coming to the U.S.

“One hundred percent of the individuals getting on planes are screened for fever before they get on the plane,” Frieden said Sept. 30. “And if they have a fever, they are pulled out of the line, assessed for Ebola, and don’t fly unless Ebola is ruled out.”

Individuals who have flown recently from one or more of the affected countries suggested that travelers could easily subvert the screening procedures — and might have incentive to do so: Compared with the depleted medical resources in the West African countries of Liberia, Sierra Leone and Guinea, the prospect of hospital care in the U.S. may offer an Ebola-exposed person the only chance to survive.

U.S. To Increase Airport Screening For Ebola
The deteriorating conditions in Africa make it more likely additional cases of Ebola will appear in the United States and officials are pushing for increased screenings at airports.
A person could pass body temperature checks performed at the airports by taking ibuprofen or any common analgesic. And prospective passengers have much to fear from identifying themselves as sick, said Kim Beer, a resident of Freetown, the capital of Sierra Leone, who is working to get medical supplies into the country to cope with Ebola.

“It is highly unlikely that someone would acknowledge having a fever, or simply feeling unwell,” Beer said via email. “Not only will they probably not get on the flight — they may even be taken to/required to go to a ‘holding facility’ where they would have to stay for days until it is confirmed that it is not caused by Ebola. That is just about the last place one would want to go.”

Liberian officials said last week that the patient hospitalized in Dallas, Thomas Eric Duncan, did not report to airport screeners that he had had previous contact with an Ebola-stricken woman. It is not known whether Duncan knew she suffered from Ebola; her family told neighbors it was malaria.
The potential disincentive for passengers to reveal their own symptoms was echoed by Sheka Forna, a dual citizen of Sierra Leone and Britain who manages a communications firm in Freetown. Forna said he considered it “very possible” that people with fever would medicate themselves to appear asymptomatic.

It would be perilous to admit even nonspecific symptoms at the airport, Forna said in a telephone interview. “You’d be confined to wards with people with full-blown disease.”

On Monday, the White House announced that a review was underway of existing airport procedures. Frieden and President Obama’s assistant for homeland security and counter-terrorism, Lisa Monaco, said Friday that closing the U.S. to passengers from the Ebola-affected countries would risk obstructing relief efforts.

CDC officials also say that asymptomatic patients cannot spread Ebola. This assumption is crucial for assessing how many people are at risk of getting the disease. Yet diagnosing a symptom can depend on subjective understandings of what constitutes a symptom, and some may not be easily recognizable. Is a person mildly fatigued because of short sleep the night before a flight — or because of the early onset of disease?
Moreover, said some public health specialists, there is no proof that a person infected — but who lacks symptoms — could not spread the virus to others.

“It’s really unclear,” said Michael Osterholm, a public health scientist at the University of Minnesota who recently served on the U.S. government’s National Science Advisory Board for Biosecurity. “None of us know.”

Russell, who oversaw the Army’s research on Ebola, said he found the epidemiological data unconvincing.
“The definition of ‘symptomatic’ is a little difficult to deal with,” he said. “It may be generally true that patients aren’t excreting very much virus until they become ill, but to say that we know the course of [the virus’ entry into the bloodstream] and the course of when a virus appears in the various secretions, I think, is premature.”

The CDC’s Skinner said that while officials remained confident that Ebola can be spread only by the overtly sick, the ongoing studies would assess whether mutations that might occur could increase the potential for asymptomatic patients to spread it.

Finally, some also question the official assertion that Ebola cannot be transmitted through the air. In late 1989, virus researcher Charles L. Bailey supervised the government’s response to an outbreak of Ebola among several dozen rhesus monkeys housed for research in Reston, Va., a suburb of Washington.

What Bailey learned from the episode informs his suspicion that the current strain of Ebola afflicting humans might be spread through tiny liquid droplets propelled into the air by coughing or sneezing.

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“We know for a fact that the virus occurs in sputum and no one has ever done a study [disproving that] coughing or sneezing is a viable means of transmitting,” he said. Unqualified assurances that Ebola is not spread through the air, Bailey said, are “misleading.”

Peters, whose CDC team studied cases from 27 households that emerged during a 1995 Ebola outbreak in Democratic Republic of Congo, said that while most could be attributed to contact with infected late-stage patients or their bodily fluids, “some” infections may have occurred via “aerosol transmission.”

Ailing in Monrovia, Liberia
Relatives pray over a weak Siata Johnson, 23, outside the Ebola treatment center at a hospital on the outskirts of Monrovia, Liberia. (John Moore / Getty Images)
Skinner of the CDC, who cited the Peters-led study as the most extensive of Ebola’s transmissibility, said that while the evidence “is really overwhelming” that people are most at risk when they touch either those who are sick or such a person’s vomit, blood or diarrhea, “we can never say never” about spread through close-range coughing or sneezing.

“I’m not going to sit here and say that if a person who is highly viremic … were to sneeze or cough right in the face of somebody who wasn’t protected, that we wouldn’t have a transmission,” Skinner said.

Peters, Russell and Bailey, who in 1989 was deputy commander for research of the Army’s Medical Research Institute of Infectious Diseases, in Frederick, Md., said the primates in Reston had appeared to spread Ebola to other monkeys through their breath.

 

The Ebola strain found in the monkeys did not infect their human handlers. Bailey, who now directs a biocontainment lab at George Mason University in Virginia, said he was seeking to research the genetic differences between the Ebola found in the Reston monkeys and the strain currently circulating in West Africa.

Though he acknowledged that the means of disease transmission among the animals would not guarantee the same result among humans, Bailey said the outcome may hold lessons for the present Ebola epidemic.

“Those monkeys were dying in a pattern that was certainly suggestive of coughing and sneezing — some sort of aerosol movement,” Bailey said. “They were dying and spreading it so quickly from cage to cage. We finally came to the conclusion that the best action was to euthanize them all.”

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

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

By Abby Phillip

Dallas County Judge Clay Jenkins pulled into the Ivy Apartments community late in the evening Friday wearing suit pants and a lavender dress shirt.

There were hazardous materials trucks all around, as cleaning crews had arrived to remove materials that might have been touched by Thomas Duncan, a Liberian man who is hospitalized in Texas with Ebola. The hazmat workers were covered from head to toe in bright yellow body suits, green gloves and breathing masks.

Jenkins walked into the apartment in building No. 6 to greet Louise Troh, her family and others who live with her and had been court-ordered to stay in their home because they were considered high risk after coming into contact with Duncan.

It was time to move, and Troh, her 13-year old son, a relative of Duncan’s and another man — all of whom lived in the apartment — got into the judge’s car for the 45-minute drive to their new, temporary home, in an undisclosed part of Dallas.

Jenkins, the judge, never covered up.

“I’m a married man with a little girl,” Jenkins told reporters later that night. “I’m wearing the same shirt I was when I was in the car with that family.

“I was in their house next to those materials, meeting with them, listening to them, and assuring them last night and again of course today. If there were any risk, I would not expose myself or my family to that risk.”

He added: “There is zero risk.”

In the face of widespread fear — and in some cases misinformation — about Ebola following the first diagnosis of the virus in the United States, Dallas officials have taken a notable visual approach to make the point that, at least right now, the city is safe.
The Ebola outbreak in West Africa has reached the United States, as officials confirm one case in Dallas. Here’s how U.S. health officials plan to stop the virus. (Gillian Brockell and Jorge Ribas/The Washington Post)
On a daily basis, workers monitoring the temperatures and health of as many as nine individuals who they believe might have had direct contact with Duncan have entered those people’s homes with no gloves, no masks and no personal protective equipment whatsoever.

And city officials including Jenkins, Dallas Mayor Mike Rawlings and Dallas County Health and Human Services Director Zachary Thompson have interacted with the family no differently that they might have if the four people who are in a state of semi-isolation had been suspected of having come into contact with somebody sick with the flu.
“Based on our assessment, they were asymptomatic; therefore, I didn’t feel they posed any threat to me,” Thompson said in an interview with The Washington Post on Monday. “There is a standard procedure for when they should be using the PPE’s (personal protective equipment). In this case we knew our nurses, our staff, had assessed that they were asymptomatic.”

So far, none of the people who have potentially had contact with Duncan are showing any symptoms, Thompson said.

Yet concern and stigma are widespread in Dallas.

Photographs from Liberia, Sierra Leone and Guinea — where the epidemic is spiraling out of control — frequently show fully masked health workers carrying infected people to hospitals or burial sites. Those images have become closely associated with the virus and the outbreak in the public’s mind.

And for one day, similar images briefly appeared in Dallas as cleaning crews removed materials from Troh’s apartment that might have come into contact with the virus.
A hazmat team arrives on Oct. 3 to clean a unit at the Dallas apartment complex where the confirmed Ebola patient was staying. (Joe Raedle/Getty Images)
The decision for the crew to wear personal protective equipment was made by the company, the “Cleaning Guys,” according to Dallas officials.

“We train for this type of thing,” company executive Brad Smith told ABC News. “Obviously, we haven’t trained for Ebola because there hasn’t been a situation in Texas until now.”

The Ebola virus is not very hearty outside of the human body.

Still, touching and destroying potentially infected materials is far different from speaking to or being in the same room with people who might have been exposed to the virus.

And public health expert Gavin Macgregor-Skinner, who worked in Nigeria to end that country’s outbreak, said that treating people with a sense of humanity and not feeding hysteria is critical to managing the Dallas Ebola case and others that might occur around the world.

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“Even in West Africa when we do contact tracing, we don’t put on personal protective equipment,” said Macgregor-Skinner, an assistant professor in the Department of Public Health Sciences at the Penn State Milton S. Hershey Medical Center. “We have the six-feet rule: We stay about six feet away from people and I can interview them and I can make them feel like people.

“If they have no symptoms, we need to make them feel normal, like they’re part of the community, like they are still loved.”

Dallas officials have also urged residents to go about their normal activities and attend community gatherings and fairs without fear.

“The broader perspective is that we had done immediate disease tracking and contact tracing and the family had been identified who had had close contact and they had not shown any symptoms,” said Thompson. “Other than that one case, basically, his virus has been contained.”

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

 

‘In 1976 I discovered Ebola – now I fear an unimaginable tragedy’

Peter Piot was a researcher at a lab in Antwerp when a pilot brought him a blood sample from a Belgian nun who had fallen mysteriously ill in Zaire
Peter Piot
Professor Peter Piot, the Director of the London School of Hygiene and Tropical Medicine: ‘Around June it became clear to me there was something different about this outbreak. I began to get really worried’ Photograph: Leon Neal/AFP

Professor Piot, as a young scientist in Antwerp, you were part of the team that discovered the Ebola virus in 1976. How did it happen?

I still remember exactly. One day in September, a pilot from Sabena Airlines brought us a shiny blue Thermos and a letter from a doctor in Kinshasa in what was then Zaire. In the Thermos, he wrote, there was a blood sample from a Belgian nun who had recently fallen ill from a mysterious sickness in Yambuku, a remote village in the northern part of the country. He asked us to test the sample for yellow fever.

These days, Ebola may only be researched in high-security laboratories. How did you protect yourself back then?

We had no idea how dangerous the virus was. And there were no high-security labs in Belgium. We just wore our white lab coats and protective gloves. When we opened the Thermos, the ice inside had largely melted and one of the vials had broken. Blood and glass shards were floating in the ice water. We fished the other, intact, test tube out of the slop and began examining the blood for pathogens, using the methods that were standard at the time.

But the yellow fever virus apparently had nothing to do with the nun’s illness.

No. And the tests for Lassa fever and typhoid were also negative. What, then, could it be? Our hopes were dependent on being able to isolate the virus from the sample. To do so, we injected it into mice and other lab animals. At first nothing happened for several days. We thought that perhaps the pathogen had been damaged from insufficient refrigeration in the Thermos. But then one animal after the next began to die. We began to realise that the sample contained something quite deadly.

But you continued?

Other samples from the nun, who had since died, arrived from Kinshasa. When we were just about able to begin examining the virus under an electron microscope, the World Health Organisation instructed us to send all of our samples to a high-security lab in England. But my boss at the time wanted to bring our work to conclusion no matter what. He grabbed a vial containing virus material to examine it, but his hand was shaking and he dropped it on a colleague’s foot. The vial shattered. My only thought was: “Oh, shit!” We immediately disinfected everything, and luckily our colleague was wearing thick leather shoes. Nothing happened to any of us.

In the end, you were finally able to create an image of the virus using the electron microscope.

Yes, and our first thought was: “What the hell is that?” The virus that we had spent so much time searching for was very big, very long and worm-like. It had no similarities with yellow fever. Rather, it looked like the extremely dangerous Marburg virus which, like ebola, causes a haemorrhagic fever. In the 1960s the virus killed several laboratory workers in Marburg, Germany.

Were you afraid at that point?

I knew almost nothing about the Marburg virus at the time. When I tell my students about it today, they think I must come from the stone age. But I actually had to go the library and look it up in an atlas of virology. It was the American Centres for Disease Control which determined a short time later that it wasn’t the Marburg virus, but a related, unknown virus. We had also learned in the meantime that hundreds of people had already succumbed to the virus in Yambuku and the area around it.

A few days later, you became one of the first scientists to fly to Zaire.

Yes. The nun who had died and her fellow sisters were all from Belgium. In Yambuku, which had been part of the Belgian Congo, they operated a small mission hospital. When the Belgian government decided to send someone, I volunteered immediately. I was 27 and felt a bit like my childhood hero, Tintin. And, I have to admit, I was intoxicated by the chance to track down something totally new.

Suspected Ebola patient in MonroviaA girl is led to an ambulance after showing signs of Ebola infection in the village of Freeman Reserve, 30 miles north of the Liberian capital, Monrovia. Photograph: Jerome Delay/APWas there any room for fear, or at least worry?

Of course it was clear to us that we were dealing with one of the deadliest infectious diseases the world had ever seen – and we had no idea that it was transmitted via bodily fluids! It could also have been mosquitoes. We wore protective suits and latex gloves and I even borrowed a pair of motorcycle goggles to cover my eyes. But in the jungle heat it was impossible to use the gas masks that we bought in Kinshasa. Even so, the Ebola patients I treated were probably just as shocked by my appearance as they were about their intense suffering. I took blood from around 10 of these patients. I was most worried about accidentally poking myself with the needle and infecting myself that way.

But you apparently managed to avoid becoming infected.

Well, at some point I did actually develop a high fever, a headache and diarrhoea …

… similar to Ebola symptoms?

Exactly. I immediately thought: “Damn, this is it!” But then I tried to keep my cool. I knew the symptoms I had could be from something completely different and harmless. And it really would have been stupid to spend two weeks in the horrible isolation tent that had been set up for us scientists for the worst case. So I just stayed alone in my room and waited. Of course, I didn’t get a wink of sleep, but luckily I began feeling better by the next day. It was just a gastrointestinal infection. Actually, that is the best thing that can happen in your life: you look death in the eye but survive. It changed my whole approach, my whole outlook on life at the time.

You were also the one who gave the virus its name. Why Ebola?

On that day our team sat together late into the night – we had also had a couple of drinks – discussing the question. We definitely didn’t want to name the new pathogen “Yambuku virus”, because that would have stigmatised the place forever. There was a map hanging on the wall and our American team leader suggested looking for the nearest river and giving the virus its name. It was the Ebola river. So by around three or four in the morning we had found a name. But the map was small and inexact. We only learned later that the nearest river was actually a different one. But Ebola is a nice name, isn’t it?

In the end, you discovered that the Belgian nuns had unwittingly spread the virus. How did that happen?

In their hospital they regularly gave pregnant women vitamin injections using unsterilised needles. By doing so, they infected many young women in Yambuku with the virus. We told the nuns about the terrible mistake they had made, but looking back I would say that we were much too careful in our choice of words. Clinics that failed to observe this and other rules of hygiene functioned as catalysts in all additional Ebola outbreaks. They drastically sped up the spread of the virus or made the spread possible in the first place. Even in the current Ebola outbreak in westAfrica, hospitals unfortunately played this ignominious role in the beginning.

After Yambuku, you spent the next 30 years of your professional life devoted to combating Aids. But now Ebola has caught up to you again. American scientists fear that hundreds of thousands of people could ultimately become infected. Was such an epidemic to be expected?

No, not at all. On the contrary, I always thought that Ebola, in comparison to Aids or malaria, didn’t present much of a problem because the outbreaks were always brief and local. Around June it became clear to me that there was something fundamentally different about this outbreak. At about the same time, the aid organisation Médecins Sans Frontières sounded the alarm. We Flemish tend to be rather unemotional, but it was at that point that I began to get really worried.

Why did WHO react so late?

On the one hand, it was because their African regional office isn’t staffed with the most capable people but with political appointees. And the headquarters in Geneva suffered large budget cuts that had been agreed to by member states. The department for haemorrhagic fever and the one responsible for the management of epidemic emergencies were hit hard. But since August WHO has regained a leadership role.

There is actually a well-established procedure for curtailing Ebola outbreaks: isolating those infected and closely monitoring those who had contact with them. How could a catastrophe such as the one we are now seeing even happen?

I think it is what people call a perfect storm: when every individual circumstance is a bit worse than normal and they then combine to create a disaster. And with this epidemic there were many factors that were disadvantageous from the very beginning. Some of the countries involved were just emerging from terrible civil wars, many of their doctors had fled and their healthcare systems had collapsed. In all of Liberia, for example, there were only 51 doctors in 2010, and many of them have since died of Ebola.

The fact that the outbreak began in the densely populated border region between Guinea, Sierra Leone and Liberia …

… also contributed to the catastrophe. Because the people there are extremely mobile, it was much more difficult than usual to track down those who had had contact with the infected people. Because the dead in this region are traditionally buried in the towns and villages they were born in, there were highly contagious Ebola corpses travelling back and forth across the borders in pickups and taxis. The result was that the epidemic kept flaring up in different places.

For the first time in its history, the virus also reached metropolises such as Monrovia and Freetown. Is that the worst thing that can happen?

In large cities – particularly in chaotic slums – it is virtually impossible to find those who had contact with patients, no matter how great the effort. That is why I am so worried about Nigeria as well. The country is home to mega-cities like Lagos and Port Harcourt, and if the Ebola virus lodges there and begins to spread, it would be an unimaginable catastrophe.

Have we completely lost control of the epidemic?

I have always been an optimist and I think that we now have no other choice than to try everything, really everything. It’s good that the United States and some other countries are finally beginning to help. But Germany or even Belgium, for example, must do a lot more. And it should be clear to all of us: This isn’t just an epidemic any more. This is a humanitarian catastrophe. We don’t just need care personnel, but also logistics experts, trucks, jeeps and foodstuffs. Such an epidemic can destabilise entire regions. I can only hope that we will be able to get it under control. I really never thought that it could get this bad.

What can really be done in a situation when anyone can become infected on the streets and, like in Monrovia, even the taxis are contaminated?

We urgently need to come up with new strategies. Currently, helpers are no longer able to care for all the patients in treatment centres. So caregivers need to teach family members who are providing care to patients how to protect themselves from infection to the extent possible. This on-site educational work is currently the greatest challenge. Sierra Leone experimented with a three-day curfew in an attempt to at least flatten out the infection curve a bit. At first I thought: “That is totally crazy.” But now I wonder, “why not?” At least, as long as these measures aren’t imposed with military power.

A three-day curfew sounds a bit desperate.

Yes, it is rather medieval. But what can you do? Even in 2014, we hardly have any way to combat this virus.

Do you think we might be facing the beginnings of a pandemic?

There will certainly be Ebola patients from Africa who come to us in the hopes of receiving treatment. And they might even infect a few people here who may then die. But an outbreak in Europe or North America would quickly be brought under control. I am more worried about the many people from India who work in trade or industry in west Africa. It would only take one of them to become infected, travel to India to visit relatives during the virus’s incubation period, and then, once he becomes sick, go to a public hospital there. Doctors and nurses in India, too, often don’t wear protective gloves. They would immediately become infected and spread the virus.

The virus is continually changing its genetic makeup. The more people who become infected, the greater the chance becomes that it will mutate …

… which might speed its spread. Yes, that really is the apocalyptic scenario. Humans are actually just an accidental host for the virus, and not a good one. From the perspective of a virus, it isn’t desirable for its host, within which the pathogen hopes to multiply, to die so quickly. It would be much better for the virus to allow us to stay alive longer.

Could the virus suddenly change itself such that it could be spread through the air?

Like measles, you mean? Luckily that is extremely unlikely. But a mutation that would allow Ebola patients to live a couple of weeks longer is certainly possible and would be advantageous for the virus. But that would allow Ebola patients to infect many, many more people than is currently the case.

But that is just speculation, isn’t it?

Certainly. But it is just one of many possible ways the virus could change to spread itself more easily. And it is clear that the virus is mutating.

You and two colleagues wrote a piece for the Wall Street Journalsupporting the testing of experimental drugs. Do you think that could be the solution?

Patients could probably be treated most quickly with blood serum from Ebola survivors, even if that would likely be extremely difficult given the chaotic local conditions. We need to find out now if these methods, or if experimental drugs like ZMapp, really help. But we should definitely not rely entirely on new treatments. For most people, they will come too late in this epidemic. But if they help, they should be made available for the next outbreak.

Testing of two vaccines is also beginning. It will take a while, of course, but could it be that only a vaccine can stop the epidemic?

I hope that’s not the case. But who knows? Maybe.

In Zaire during that first outbreak, a hospital with poor hygiene was responsible for spreading the illness. Today almost the same thing is happening. Was Louis Pasteur right when he said: “It is the microbes who will have the last word”?

Of course, we are a long way away from declaring victory over bacteria and viruses. HIV is still here; in London alone, five gay men become infected daily. An increasing number of bacteria are becoming resistant to antibiotics. And I can still see the Ebola patients in Yambuku, how they died in their shacks and we couldn’t do anything except let them die. In principle, it’s still the same today. That is very depressing. But it also provides me with a strong motivation to do something. I love life. That is why I am doing everything I can to convince the powerful in this world to finally send sufficient help to west Africa. Now!

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

Ebola virus disease

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

A 1976 photograph of two nurses standing in front of Mayinga N., a person with Ebola virus disease; she died only a few days later due to severe internal hemorrhaging.
ICD10 A98.4
ICD9 065.8
DiseasesDB 18043
MedlinePlus 001339
eMedicine med/626
MeSH D019142

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

The virus may be acquired upon contact with blood or bodily fluids of an infected human or other animal.[1] Spreading through the air has not been documented in the natural environment.[2] Fruit bats are believed to be a carrier and may spread the virus without being affected. Once human infection occurs, the disease may spread between people, as well. Male survivors may be able to transmit the disease via semen for nearly two months. To make the diagnosis, typically other diseases with similar symptoms such as malaria, cholera and other viral hemorrhagic fevers are first excluded. To confirm the diagnosis, blood samples are tested for viral antibodies, viralRNA, or the virus itself.[1]

Outbreak control require community engagement, case management, surveillance and contact tracing, a good laboratory service, and safe burials.[1] Prevention includes decreasing the spread of disease from infected animals to humans. This may be done by checking such animals for infection and killing and properly disposing of the bodies if the disease is discovered. Properly cooking meat and wearing protective clothing when handling meat may also be helpful, as are wearing protective clothing and washing hands when around a person with the disease. Samples of bodily fluids and tissues from people with the disease should be handled with special caution.[1]

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

Signs and symptoms

Signs and symptoms of Ebola.[8]

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

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

Heavy bleeding is rare and is usually confined to the gastrointestinal tract.[12][15] In general, the development of bleeding symptoms often indicates a worse prognosis and this blood loss can result in death.[9] All people infected show some signs of circulatory system involvement, including impaired blood clotting.[12] If the infected person does not recover, death due to multiple organ dysfunction syndrome occurs within 7 to 16 days (usually between days 8 and 9) after first symptoms.[14]

Causes

Life cycles of the Ebolavirus

EVD is caused by four of five viruses classified in the genus Ebolavirus, family Filoviridae, order Mononegavirales. The four disease-causing viruses are Bundibugyo virus (BDBV), Sudan virus (SUDV), Taï Forest virus (TAFV), and one called, simply, Ebola virus (EBOV, formerly Zaire Ebola virus)). Ebola virus is the sole member of the Zaire ebolavirus species and the most dangerous of the known Ebola disease-causing viruses, as well as being responsible for the largest number of outbreaks.[16] The fifth virus, Reston virus (RESTV), is not thought to be disease-causing in humans. These five viruses are closely related to the Marburg viruses.

Transmission

Human-to-human transmission can occur via direct contact with blood or bodily fluids from an infected person (including embalming of an infected dead person) or by contact with objects contaminated by the virus, particularly needles and syringes.[17] Other body fluids with ebola virus include saliva, mucus, vomit, feces, sweat, tears, breast milk, urine, and semen. Entry points include the nose, mouth, eyes, or open wounds, cuts and abrasions.[18] The potential for widespread EVD infections is considered low as the disease is only spread by direct contact with the secretions from someone who is showing signs of infection.[17] The symptoms limit a person’s ability to spread the disease as they are often too sick to travel.[19] Because dead bodies are still infectious, traditional burial rituals may spread the disease. Nearly two thirds of the cases of Ebola in Guinea during the 2014 outbreak are believed to be due to burial practices.[20][21] Semen may be infectious in survivors for up to 7 weeks.[1] It is not entirely clear how an outbreak is initially started.[22] The initial infection is believed to occur after ebola virus is transmitted to a human by contact with an infected animal’s body fluids.

One of the primary reasons for spread is that the health systems in the part of Africa where the disease occurs function poorly.[23] Medical workers who do not wear appropriate protective clothing may contract the disease.[24] Hospital-acquired transmission has occurred in African countries due to the reuse of needles and lack of universal precautions.[25][26] Some healthcare centers caring for people with the disease do not have running water.[27]

Airborne transmission has not been documented during EVD outbreaks.[2] They are, however, infectious as breathable 0.8– to 1.2-μm laboratory-generated droplets.[28] The virus has been shown to travel, without contact, from pigs to primates, although the same study failed to demonstrate similar transmission between non-human primates.[29]

Bats drop partially eaten fruits and pulp, then land mammals such as gorillas and duikers feed on these fallen fruits. This chain of events forms a possible indirect means of transmission from the natural host to animal populations, which has led to research towards viral shedding in the saliva of bats. Fruit production, animal behavior, and other factors vary at different times and places that may trigger outbreaks among animal populations.[30]

Reservoir

Bushmeat being prepared for cooking in Ghana, 2013. Human consumption of equatorial animals in Africa in the form of bushmeat has been linked to the transmission of diseases to people, including Ebola.[31]

Bats are considered the most likely natural reservoir of the EBOV. Plants, arthropods, and birds were also considered.[1][32] Bats were known to reside in the cotton factory in which the first cases for the 1976 and 1979 outbreaks were observed, and they have also been implicated in Marburg virus infections in 1975 and 1980.[33] Of 24 plant species and 19 vertebrate species experimentally inoculated with EBOV, only bats became infected.[34] The absence of clinical signs in these bats is characteristic of a reservoir species. In a 2002–2003 survey of 1,030 animals including 679 bats from Gabon and the Republic of the Congo, 13 fruit bats were found to contain EBOV RNA fragments.[35] As of 2005, three types of fruit bats (Hypsignathus monstrosus, Epomops franqueti, and Myonycteris torquata) have been identified as being in contact with EBOV. They are now suspected to represent the EBOV reservoir hosts.[36][37] Antibodies against Zaire and Reston viruses have been found in fruit bats in Bangladesh, thus identifying potential virus hosts and signs of the filoviruses in Asia.[38]

Between 1976 and 1998, in 30,000 mammals, birds, reptiles, amphibians and arthropods sampled from outbreak regions, no ebolavirus was detected apart from some genetic traces found in six rodents (Mus setulosus andPraomys) and one shrew (Sylvisorex ollula) collected from the Central African Republic.[33][39] Traces of EBOV were detected in the carcasses of gorillas and chimpanzees during outbreaks in 2001 and 2003, which later became the source of human infections. However, the high lethality from infection in these species makes them unlikely as a natural reservoir.[33]

Transmission between natural reservoir and humans is rare, and outbreaks are usually traceable to a single case where an individual has handled the carcass of gorilla, chimpanzee or duiker.[40] Fruit bats are also eaten by people in parts of West Africa where they are smoked, grilled or made into a spicy soup.[37][41]

Virology

Genome

Electron micrograph of an Ebola virus virion

Like all mononegaviruses, ebolavirions contain linear nonsegmented, single-strand, non-infectious RNA genomes of negative polarity that possesses inverse-complementary 3′ and 5′ termini, do not possess a 5′ cap, are notpolyadenylated, and are not covalently linked to a protein.[42] Ebolavirus genomes are approximately 19 kilobase pairs long and contain seven genes in the order 3′-UTRNPVP35VP40GPVP30VP24L5′-UTR.[43] The genomes of the five different ebolaviruses (BDBV, EBOV, RESTV, SUDV, and TAFV) differ in sequence and the number and location of gene overlaps.

Structure

Like all filoviruses, ebolavirions are filamentous particles that may appear in the shape of a shepherd’s crook or in the shape of a “U” or a “6”, and they may be coiled, toroid, or branched.[43] In general, ebolavirions are 80 nm in width, but vary somewhat in length. In general, the median particle length of ebolaviruses ranges from 974 to 1,086 nm (in contrast to marburgvirions, whose median particle length was measured at 795–828 nm), but particles as long as 14,000 nm have been detected in tissue culture.[44]

Replication

The ebolavirus life cycle begins with virion attachment to specific cell-surface receptors, followed by fusion of the virion envelope with cellular membranes and the concomitant release of the virus nucleocapsid into the cytosol. The viral RNA polymerase, encoded by the L gene, partially uncoats the nucleocapsid and transcribes the genes into positive-strand mRNAs, which are then translated into structural and nonstructural proteins. Ebolavirus RNA polymerase (L) binds to a single promoter located at the 3′ end of the genome. Transcription either terminates after a gene or continues to the next gene downstream. This means that genes close to the 3′ end of the genome are transcribed in the greatest abundance, whereas those toward the 5′ end are least likely to be transcribed. The gene order is, therefore, a simple but effective form of transcriptional regulation. The most abundant protein produced is the nucleoprotein, whose concentration in the cell determines when L switches from gene transcription to genome replication. Replication results in full-length, positive-strand antigenomes that are, in turn, transcribed into negative-strand virus progeny genome copy. Newly synthesized structural proteins and genomes self-assemble and accumulate near the inside of the cell membrane. Virions bud off from the cell, gaining their envelopes from the cellular membrane they bud from. The mature progeny particles then infect other cells to repeat the cycle. The Ebola virus genetics are difficult to study due to its virulent nature.[45]

Pathophysiology

Pathogenesis schematic

Endothelial cells, macrophages, monocytes, and liver cells are the main targets of infection. After infection, a secreted glycoprotein (sGP) known as the Ebola virus glycoprotein (GP) is synthesized. Ebola replication overwhelms protein synthesis of infected cells and host immune defenses. The GP forms a trimeric complex, which binds the virus to the endothelial cells lining the interior surface of blood vessels. The sGP forms a dimeric protein that interferes with the signaling of neutrophils, a type of white blood cell, which allows the virus to evade the immune system by inhibiting early steps of neutrophil activation. These white blood cells also serve as carriers to transport the virus throughout the entire body to places such as the lymph nodes, liver, lungs, and spleen.[46]

The presence of viral particles and cell damage resulting from budding causes the release of chemical signals (to be specific, TNF-α, IL-6, IL-8, etc.), which are the signaling molecules for fever and inflammation. The cytopathic effect, from infection in the endothelial cells, results in a loss of vascular integrity. This loss in vascular integrity is furthered with synthesis of GP, which reduces specific integrins responsible for cell adhesion to the inter-cellular structure, and damage to the liver, which leads to improper clotting.[47]

Diagnosis

The travel and work history along with exposure to wildlife are important to consider when the diagnosis of EVD is suspected. The diagnosis is confirmed by isolating the virus, detecting its RNA or proteins, or detecting antibodiesagainst the virus in a person’s blood. Isolating the virus by cell culture, detecting the viral RNA by polymerase chain reaction (PCR) and detecting proteins by enzyme-linked immunosorbent assay (ELISA) works best early and in those who have died from the disease. Detecting antibodies against the virus works best late in the disease and in those who recover.[48]

During an outbreak, virus isolation is often not feasible. The most common diagnostic methods are therefore real-time PCR and ELISA detection of proteins, which can be performed in field or mobile hospitals.[49] Filovirions can be seen and identified in cell culture by electron microscopy due to their unique filamentous shapes, but electron microscopy cannot tell the difference between the various filoviruses despite there being some length differences.[44]

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

Classification

The genera Ebolavirus and Marburgvirus were originally classified as the species of the now-obsolete Filovirus genus. In March 1998, the Vertebrate Virus Subcommittee proposed in the International Committee on Taxonomy of Viruses (ICTV) to change the Filovirus genus to the Filoviridae family with two specific genera: Ebola-like viruses andMarburg-like viruses. This proposal was implemented in Washington, DC, on April 2001 and in Paris on July 2002. In 2000, another proposal was made in Washington, D.C., to change the “-like viruses” to “-virus” resulting in today’s Ebolavirus and Marburgvirus.[50]

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

Differential diagnosis

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

Prevention

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

Infection control and containment

The risk of transmission is increased among those caring for people infected. Recommended measures when caring for those who are infected include isolating them, sterilizing equipment and surfaces, and wearing protective clothing including masks, gloves, gowns, and goggles.[22] If a person with Ebola dies, direct contact with the body of the deceased patient should be avoided.[22]

In order to reduce the spread, the World Health Organization recommends raising community awareness of the risk factors for Ebola infection and the protective measures individuals can take.[60] These include avoiding contact with infected people and regular hand washing using soap and water.[61] Traditional burial rituals, especially those requiring washing or embalming of bodies, should be discouraged or modified.[62][63] Social anthropologists may help find alternatives to traditional rules for burials.[64] Airline crews are instructed to isolate anyone who has symptoms resembling Ebola virus.[65]

The Ebola virus can be eliminated with heat (heating for 30 to 60 minutes at 60 °C or boiling for 5 minutes). On surfaces, some lipid solvents such as some alcohol-based products, detergents, sodium hypochlorite (bleach) or calcium hypochlorite (bleaching powder), and other suitable disinfectants at appropriate concentrations can be used as disinfectants.[66][67]

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

Quarantine

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

Contact tracing

Contact tracing is regarded as important to contain an outbreak. It involves finding everyone who had close contact with infected individuals and watching for signs of illness for 21 days. If any of these contacts comes down with the disease, they should be isolated, tested, and treated. Then repeat the process by tracing the contacts’ contacts.[73][74]

Treatment

Standard support

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

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

Intensive care

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

Prognosis

The disease has a high mortality rate: often between 25 percent and 90 percent.[1][3] As of September 2014, information from WHO across all occurrences to date puts the overall fatality rate at 50%.[1] There are indications based on variations in death rate between countries that early and effective treatment of symptoms (e.g., supportive care to prevent dehydration) may reduce the fatality rate significantly.[78] If an infected person survives, recovery may be quick and complete. Prolonged cases are often complicated by the occurrence of long-term problems, such as inflammation of the testicles, joint pains, muscle pains, skin peeling, or hair loss. Eye symptoms, such as light sensitivity, excess tearing, iritis, iridocyclitis, choroiditis, and blindness have also been described. EBOV and SUDV may be able to persist in the semen of some survivors for up to seven weeks, which could give rise to infections and disease via sexual intercourse.[1]

Epidemiology

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

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

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

1976

The first identified case of Ebola was on 26 August 1976, in Yambuku, a small rural village in Mongala District in northern Democratic Republic of the Congo (then known as Zaire).[79] The first victim, and the index case for the disease, was village school headmaster Mabalo Lokela, who had toured an area near the Central African Republic border along the Ebola river between 12–22 August. On 8 September he died of what would become known as the Ebola virus species of the ebolavirus.[80] Subsequently a number of other cases were reported, almost all centered on the Yambuku mission hospital or having close contact with another case.[80] 318 cases and 280 deaths (a 88% fatality rate) occurred in the DRC.[81] The Ebola outbreak was contained with the help of the World Health Organization and transport from the Congolese air force, by quarantining villagers, sterilizing medical equipment, and providing protective clothing. The virus responsible for the initial outbreak, first thought to be Marburg virus, was later identified as a new type of virus related to Marburg, and named after the nearby Ebola river. Another ebolavirus, the Sudan virus species, was also identified that same year when an outbreak occurred in Sudan, affecting 284 people and killing 151.[82]

1995 to 2013

The second major outbreak occurred in 1995 in the Democratic Republic of Congo, affecting 315 and killing 254. The next major outbreak occurred in Uganda in 2000, affecting 425 and killing 224; in this case the Sudan virus was found to be the ebolavirus species responsible for the outbreak.[83] In 2003 there was an outbreak in the Republic of Congo that affected 143 and killed 128, a death rate of 90%, the highest to date.[84]

In August 2007, 103 people were infected by a suspected hemorrhagic fever outbreak in the village of Kampungu, Democratic Republic of the Congo. The outbreak started after the funerals of two village chiefs, and 217 people in four villages fell ill.[83][85][86] The 2007 outbreak eventually affected 264 individuals and resulted in the deaths of 187.[1]

On 30 November 2007, the Uganda Ministry of Health confirmed an outbreak of Ebola in the Bundibugyo District in Western Uganda. After confirmation of samples tested by the United States National Reference Laboratories and the Centers for Disease Control, the World Health Organization confirmed the presence of a new species of Ebolavirus, which was tentatively named Bundibugyo.[87] The WHO reported 149 cases of this new strain and 37 of those led to deaths.[1]

The WHO confirmed two small outbreaks in Uganda in 2012. The first outbreak affected 7 people and resulted in the death of 4 and the second affected 24, resulting in the death of 17. The Sudan variant was responsible for both outbreaks.[1]

On 17 August 2012, the Ministry of Health of the Democratic Republic of the Congo reported an outbreak of the Ebola-Bundibugyo variant[88] in the eastern region.[89][90] Other than its discovery in 2007, this was the only time that this variant has been identified as the ebolavirus responsible for an outbreak. The WHO revealed that the virus had sickened 57 people and claimed 29 lives. The probable cause of the outbreak was tainted bush meat hunted by local villagers around the towns of Isiro and Viadana.[1][91]

2014 outbreak

Increase over time in the cases and deaths during the 2014 outbreak

In March 2014, the World Health Organization (WHO) reported a major Ebola outbreak in Guinea, a western African nation.[92] Researchers traced the outbreak to a two-year old child who died on 28 December 2013.[93][94] The disease then rapidly spread to the neighboring countries of Liberia and Sierra Leone. It is the largest Ebola outbreak ever documented, and the first recorded in the region.[92]

On 8 August 2014, the WHO declared the epidemic to be an international public health emergency. Urging the world to offer aid to the affected regions, the Director-General said, “Countries affected to date simply do not have the capacity to manage an outbreak of this size and complexity on their own. I urge the international community to provide this support on the most urgent basis possible.”[95] By mid-August 2014, Doctors Without Borders reported the situation in Liberia’s capital Monrovia as “catastrophic” and “deteriorating daily”. They reported that fears of Ebola among staff members and patients had shut down much of the city’s health system, leaving many people without treatment for other conditions.[96] By late August 2014, the disease had spread to Nigeria, and one case was reported in Senegal.[97][98] [99][100] On 30 September 2014, the first confirmed case of Ebola was diagnosed in the United States at Texas Health Presbyterian Hospital in Dallas, Texas.[101]

Aside from the human cost, the outbreak has severely eroded the economies of the affected countries. A Financial Times report suggested the economic impact of the outbreak could kill more people than the virus itself. As of 23 September, in the three hardest hit countries, Liberia, Sierra Leone, and Guinea, there were only 893 treatment beds available while the current need was 2122. In a 26 September statement, the WHO said, “The Ebola epidemic ravaging parts of West Africa is the most severe acute public health emergency seen in modern times. Never before in recorded history has a biosafety level four pathogen infected so many people so quickly, over such a broad geographical area, for so long.”[102]

By 29 September 2014, 7,192 suspected cases and 3,286 deaths had been reported, however the World Health Organization has said that these numbers may be vastly underestimated.[103] The WHO reports that more than 216 healthcare workers are among the dead, partly due to the lack of equipment and long hours.[104][105]

History

For more about the outbreak in Virginia, US, see Reston virus.

Cases of ebola fever in Africa from 1979 to 2008.

The first recorded outbreak of EBD occurred in Southern Sudan in June 1976. A second outbreak soon followed in the Democratic Republic of the Congo (then Zaire).[106] Virus isolated from both outbreaks was named “Ebola virus” by Belgian researchers[107] after the Ebola River, located near the Zaire outbreak.[108] Although it was assumed that the two outbreaks were connected, scientists later realized that they were caused by distinct species of filoviruses, Sudan virus and Ebola virus.[106]

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

Shortly afterward, a US Army team headquartered at USAMRIID went into action to euthanize the monkeys which had not yet died, bringing those monkeys and those which had already died of the disease toFt. Detrick for study by the Army’s veterinary pathologists and virologists, and eventual disposal under safe conditions.[109]

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

The Philippines and the United States had no previous cases of Ebola infection, and upon further isolation, researchers concluded it was another strain of Ebola, or a new filovirus of Asian origin, which they named Reston ebolavirus (REBOV) after the location of the incident.[109]

Society and culture

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

Literature

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

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

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

Other animals

Wild animals

It is widely believed that outbreaks of EVD among human populations result from handling infected wild animal carcasses. Some research suggests that an outbreak in the wild animals used for consumption, bushmeat, may result in a corresponding human outbreak. Since 2003, such outbreaks have been monitored through surveillance of animal populations with the aim of predicting and preventing Ebola outbreaks in humans.[119]

Recovered carcasses from gorillas contain multiple Ebola virus strains, which suggest multiple introductions of the virus. Bodies decompose quickly and carcasses are not infectious after three to four days. Contact between gorilla groups is rare, suggesting transmission among gorilla groups is unlikely, and that outbreaks result from transmission between viral reservoir and animal populations.[120]

Ebola has a high mortality among primates.[121] Frequent outbreaks of Ebola may have resulted in the deaths of 5,000 gorillas.[122] Outbreaks of Ebola may have been responsible for an 88% decline in tracking indices of observed chimpanzee populations in 420 square kilometer Lossi Sanctuary between 2002 and 2003.[120] Transmission among chimpanzees through meat consumption constitutes a significant risk factor, while contact between individuals, such as touching dead bodies and grooming, is not.[123]

Domesticated animals

Reston ebolavirus (REBOV) can be transmitted to pigs.[124] This virus was discovered during an outbreak of what at the time was thought to be simian hemorrhagic fever virus (SHFV) in crab-eating macaques in Reston, Virginia (hence the name Reston elabavirus) in 1989. Since the initial outbreak it has since been found in nonhuman primates in Pennsylvania, Texas, and Italy. In each case, the affected animals had been imported from a facility in the Philippines,[70] where the virus had infected pigs.[125] Despite its status as a Level‑4organism and its apparent pathogenicity in monkeys, REBOV has not caused disease in exposed human laboratory workers.[126] In 2012 it was demonstrated that the virus can travel without contact from pigs to nonhuman primates, although the same study failed to achieve transmission in that manner between primates.[124] According to the WHO, routine cleaning and disinfection of pig (or monkey) farms with sodium hypochlorite or other detergents should be effective in inactivating the Reston ebolavirus. If an outbreak is suspected, the area must be immediately quarantined.[82]

While pigs that have been infected with REBOV tend to show symptoms of the disease, it has been shown that dogs may become infected with EBOV and remain asymptomatic. Dogs in some parts of Africa scavenge for their food and it is known that they sometimes eat infected animals and the corpses of humans. Although they remain asymptomatic, a 2005 survey of dogs during an EBOV outbreak found that over 31.8% showed a seroprevalence for EBOV closest to an outbreak versus 9% a farther distance away.[127]

Research

A number of experimental treatments are being studied.[128] In the United States, the Food and Drug Administration (FDA)’s animal efficacy rule is being used to demonstrate reasonable safety to obtain permission to treat people who are infected with Ebola. It is being used as the normal path for testing drugs is not possible for diseases caused by dangerous pathogens or toxins. Experimental drugs are made available for use with the approval of regulatory agencies under named patient programs, known in the US as “expanded access”.[129] On 12 August 2014 the WHO released a statement that the use of not yet proven treatments is ethical in certain situations in an effort to treat or prevent the disease.[130]

Medications

Researchers looking at slides of cultures of cells that make monoclonal antibodies. These are grown in a lab and the researchers are analyzing the products to select the most promising of them.

As of August 14, 2014, the United States Food and Drug Administration (FDA) has not approved any drugs to treat or prevent Ebola and advises people to watch out for fraudulent products.[131] The unavailability of experimental treatments in the most affected regions during the 2014 outbreak spurred controversy, with some calling for experimental drugs to be made more widely available in Africa on a humanitarian basis, and others warning that making unproven experimental drugs widely available would be unethical, especially in light of past experimentation conducted in developing countries by Western drug companies.[132][133]

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

ZMapp is a monoclonal antibody vaccine. The limited supply of the drug has been used to treat a small number of individuals infected with the Ebola virus. Although some of these have recovered the outcome is not consideredstatistically significant.[138] ZMapp has proved effective in a trial involving Rhesus macaque monkeys.[139]

Antivirals

A number of antiviral medications are being studied. Favipiravir, an anti-viral drug approved in Japan for stockpiling against influenza pandemics, appears to be useful in a mouse model of Ebola.[9][140] On 4 October 2014, it was reported that a French nun who contracted Ebola while volunteering in Liberia was cured with Favipiravir treatment.[141] BCX4430 is a broad-spectrum antiviral drug developed by BioCryst Pharmaceuticals and currently being researched as a potential treatment for Ebola by USAMRIID.[142] The drug has been approved to progress to Phase 1 trials, expected late in 2014.[143] Brincidofovir, another broad-spectrum antiviral drug, has been granted an emergency FDA approval as an investigational new drug for the treatment of Ebola, after it was found to be effective against Ebolavirus in in vitro tests.[144] It has subsequently been used to treat the first patient diagnosed with Ebola in the USA, after he had recently returned from Liberia.[145] The antiviral drug lamivudine, which is usually used to treat HIV / AIDS, was reported in September 2014 to have been used successfully to treat 13 out of 15 Ebola-infected patients by a doctor in Liberia, as part of a combination therapy also involving intravenous fluids and antibiotics to combat opportunistic bacterial infection of Ebola-compromised internal organs.[146] Western virologists have however expressed caution about the results, due to the small number of patients treated and confounding factors present. Researchers at the NIH stated that lamivudine had so far failed to demonstrate anti-Ebola activity in preliminary in vitro tests, but that they would continue to test it under different conditions and would progress it to trials if even slight evidence for efficacy is found.[147]

Antisense technology

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

Other

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

A 2014 study found that three ion channel blockers used in the treatment of heart arrhythmias, amiodarone, dronedarone and verapamil, block the entry of Ebolavirus into cells in vitro.[153] Given their oral availability and history of human use, these drugs would be candidates for treating Ebola virus infection in remote geographical locations, either on their own or together with other antiviral drugs.

Melatonin has also been suggested as a potential treatment for Ebola based on promising in vitro results.[154]

Blood products

The WHO has stated that transfusion of whole blood or purified serum from Ebola survivors is the therapy with the greatest potential to be implemented immediately, although there is little information as to its efficacy.[155] At the end of September, WHO issued an interim guideline for this therapy.[156] The blood serum from those who have survived an infection is currently being studied to see if it is an effective treatment.[157] During a meeting arranged by WHO this research was deemed to be a top priority.[157] Seven of eight people with Ebola survived after receiving a transfusion of blood donated by individuals who had previously survived the infection in an 1999 outbreak in the Democratic Republic of the Congo.[76][158] This treatment, however, was started late in the disease meaning they may have already been recovering on their own and the rest of their care was better than usual.[76] Thus this potential treatment remains controversial.[77] Intravenous antibodies appear to be protective in non-human primates who have been exposed to large doses of Ebola.[159]The World Health Organisation has approved the use of convalescent serum and whole blood products to treat people with Ebola.[160]

Vaccine

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

Vaccines have protected nonhuman primates. Immunization takes six months, which impedes the counter-epidemic use of the vaccines. Searching for a quicker onset of effectiveness, in 2003, a vaccine using an adenoviral (ADV) vector carrying the Ebola spike protein was tested on crab-eating macaques. Twenty-eight days later, they were challenged with the virus and remained resistant.[162] A vaccine based on attenuated recombinant vesicular stomatitis virus (VSV) vector carrying either the Ebola glycoprotein or the Marburg glycoprotein in 2005 protected nonhuman primates,[171] opening clinical trials in humans.[167] The study by October completed the first human trial, over three months giving three vaccinations safely inducing an immune response. Individuals for a year were followed, and, in 2006, a study testing a faster-acting, single-shot vaccine began; this new study was completed in 2008.[168] Trying the vaccine on a strain of Ebola that more resembles one that infects humans is the next step.[172] On 6 December 2011, the development of a successfulvaccine against Ebola for mice was reported. Unlike the predecessors, it can be freeze-dried and thus stored for long periods in wait for an outbreak.[173] An experimental vaccine made by researchers at Canada’s national laboratory in Winnipeg was used, in 2009, to pre-emptively treat a German scientist who might have been infected during a lab accident.[174] However, actual EBOV infection was never demonstrated beyond doubt.[175] Experimentally, recombinant vesicular stomatitis Indiana virus (VSIV) expressing the glycoprotein of EBOV or SUDV has been used successfully in nonhuman primate models as post-exposure prophylaxis.[176][177] The CDC’s recommendations are currently under review.[citation needed]

Simultaneous phase 1 trials of an experimental vaccine known as the NIAID/GSK vaccine commenced in September 2014.[178] GlaxoSmithKline and the NIH jointly developed the vaccine,[178] based on a modified chimpanzee adenovirus, and contains parts of the Zaireand Sudan ebola strains.[178] If this phase is completed successfully, the vaccine will be fast tracked for use in West Africa. In preparation for this, GSK is preparing a stockpile of 10,000 doses.[179][180]

See also

References

Notes

  1. ^ Jump up to:a b c d e f g h i j k l m n o p q r s t u v w x “Ebola virus disease Fact sheet N°103”. World Health Organization. 2014-03-01. Retrieved 2014-04-12.
  2. ^ Jump up to:a b “2014 Ebola Virus Disease (EVD) outbreak in West Africa”. WHO. 2014-04-21. Retrieved 2014-08-03.
  3. ^ Jump up to:a b C.M. Fauquet (2005). Virus taxonomy classification and nomenclature of viruses; 8th report of the International Committee on Taxonomy of Viruses. Oxford: Elsevier/Academic Press. p. 648. ISBN 9780080575483.
  4. ^ Jump up to:a b “Ebola Viral Disease Outbreak — West Africa, 2014”.CDC. 2014-06-27. Retrieved 2014-06-26.
  5. ^ Jump up to:a b c “CDC urges all US residents to avoid nonessential travel to Liberia, Guinea and Sierra Leone because of an unprecedented outbreak of Ebola.”. CDC. 2014-07-31. Retrieved 2014-08-02.
  6. ^ Jump up to:a b “Outbreak of Ebola in Guinea, Liberia and Sierra Leone”.CDC. 2014-08-04. Retrieved 2014-08-05.
  7. Jump up^ “2014 Ebola Outbreak in West Africa – Case Counts”. CDC (Centers for Disease Control and Prevention). 02.10.2014. Retrieved 03.10.2014.
  8. Jump up^ “Ebola Hemorrhagic Fever: Signs and Symptoms”. United States Centers for Disease Control and Prevention.
  9. ^ Jump up to:a b c d e Gatherer D (2014). “The 2014 Ebola virus disease outbreak in West Africa”. J. Gen. Virol. 95 (Pt 8): 1619–1624.doi:10.1099/vir.0.067199-0. PMID 24795448.
  10. ^ Jump up to:a b c d “Ebola Hemorrhagic Fever Signs and Symptoms”.CDC. 2014-01-28. Retrieved 2014-08-02.
  11. Jump up^ “Ebola virus disease”. Fact sheet N°103. World Health Organization. 2014-04-01.
  12. ^ Jump up to:a b c Hoenen T, Groseth A, Falzarano D, Feldmann H (