Scott Sigler — Infected — Videos

Posted on February 4, 2017. Filed under: American History, Art, Art, Articles, Biology, Blogroll, Books, Chemistry, Communications, Congress, Culture, Entertainment, history, Law, liberty, Life, Links, Literacy, Medical, Non-Fiction, People, Philosophy, Photos, Radio, Raves, Science, Video, War, Wealth, Weapons, Wisdom, Work, Writing | Tags: , , , , , , , , , |

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INFECTED Trailer from the novel by Scott Sigler (Book I of the INFECTED Trilogy)

Scott Sigler: “Rewriting Publishing with Podcasts” | Talks At Google

Scott Sigler Interview

PANDEMIC Trailer (Book III in the INFECTED Trilogy)

NOCTURNAL book trailer, novel by Scott Sigler

Scott Sigler Extended Bonus Interview from Sword & Laser Ep 1

Interview with Scott Sigler at San Diego Comic Con 2012

“The Writing Process” with Scott Sigler (from Joe Rogan Experience #437)

How To Write Your First Novel (So You Wanna Be A Writer #1)

The Big-Ass Binder (So You Wanna Be A Writer #2)

Should You Outline? (So You Wanna Be A Writer #3)

Should You Outline? (So You Wanna Be A Writer #4)

Should You Outline? (So You Wanna Be A Writer #5)

Should You Outline? (So You Wanna Be A Writer #6)

So You Want to Write a Novel

Scott Sigler

From Wikipedia, the free encyclopedia
Scott Sigler
Scott Sigler (4772655043).jpg
Born Scott Carl Sigler
Cheboygan, Michigan, USA
Occupation Author
Nationality American
Genre Science fiction/Horror
Literary movement The Podiobook (Podcast Novel)
Website
scottsigler.com

Scott Carl Sigler is a contemporary American author of science fiction and horror as well as an avid podcaster. Scott is the New York Times #1 bestselling author of sixteen novels, six novellas, and dozens of short stories. He is the co-founder of Empty Set Entertainment, which publishes his young adult Galactic Football League series. He lives in San Diego.

Life and work

Raised in Cheboygan, Michigan Sigler’s father passed his love of classic monster films along to his son. His mother, a school teacher, encouraged his reading offering him any book he wanted.[1] Sigler wrote his first monster story, “Tentacles”, at the age of eight.[2] Sigler didn’t travel far for college having attended Olivet College (Olivet, MI) and Cleary College (Ann Arbor, MI) where he earned a BA in Journalism and a BS in Marketing. Scott has had a varied career path having worked fast food, picking fruit, shoveling horse manure, a sports reporter, director of marketing for a software company, software startup founder, marketing consultant, guitar salesman, bum in a rock band,[3] and currently as a social media strategist. He now resides in San Diego, California with his dog, Reesie.

EarthCore was originally published in 2001 by iPublish, an AOL/Time Warner imprint.[4] With the novel doing well as a promotional ebook, Time Warner was planning on publishing the novel. With the economic slump following September 11, 2001 terrorist attacks, Time Warner did away with the imprint in 2004. Scott then decided to start podcasting his novel in March, 2005 as the world’s first podcast-only novel[5] to build hype and garner an audience for his work. Sigler considered it a “no brainer” to offer the book as a free audio download. Having searched for podcast novels and finding none, Sigler decided to be the first.[6][7] Sigler was able to get EarthCore offered as a paid download on iTunes in 2006.[8] After EarthCore’s success (EarthCore had over 10,000 subscribers[9]), Sigler released Ancestor, Infected, The Rookie, Nocturnal, and Contagious via podcast.[10]

Sigler released an Adobe PDF version of Ancestor in March 2007 through Sigler’s own podcast as well as others. Ancestor was released on April 1, 2007 to much internet hype and, despite having been released two weeks earlier as a free ebook, reached #7 on Amazon.com‘s best-seller list and #1 on Sci-Fi, Horror and Genre-Fiction on the day of release.[11] Sigler is leveraging new media to keep in-touch with his fans, regularly talking with them using social networking sites, via email, and IM. Scott Sigler was featured in a New York Times article on March 1, 2007 by Andrew Adam Newman, which was covering authors using podcasting innovations to garner a broader audience.[12]

In March 2014, Executive Editor Mark Tavani at Ballantine Bantam Dell bought World Rights to a science fiction trilogy by Sigler. In the first book, Alive, a young woman awakes trapped in a confined space with no idea who she is or how she got there. She soon frees other young adults in the room and together they find that they are surrounded by the horrifying remains of a war long past … and matched against an enemy too horrible to imagine. Further adventures will follow in two more books, Alight and Alone. The books will be published under the Del Rey imprint.[13] On Wednesday, July 15, 2016, it was announced that Alive made #1 on the New York Times Bestseller list in the Young Adult E-Book category.[14]

Sigler calls Stephen King a “‘master craftsman’, who writes from the ‘regular guy’ strata from which he hails. His older stuff had no pretense, no ‘higher message,’ no ‘I’m extremely important’ attitude, just rock-solid storytelling and character development. He also would whack any character at any time, and that’s what hooked you in – when characters got into trouble, you didn’t know if they’d live, unlike 99% of the books out there that are trying to develop franchise characters.” According to Sigler, Jack London‘s “The Sea Wolf totally changed my views on life”. Sigler saw King Kong (1976 version) when he was a little kid. He said it, “Scared the crap out of me. I hid behind my dad’s shoulder and begged to leave the theatre. As soon as we were out, I asked when we could see it again – that was the moment I knew I wanted to tell monster stories. I wanted to have that same impact on other people.”

Awards

Sigler has been a runner up in both the 2006 and 2007 Parsec Awards. In 2006 Sigler was a runner up for his short story Hero in the Best Fiction (Short) category and for Infected in the Best Fiction (Long) category. In 2007 Sigler was a runner up for The Rookie in the Best Speculative Fiction Story (Novel Form) category. In 2008 Sigler’s Contagious, the sequel to Infected was listed at 33 on the New York Times best sellers list.

In 2008 Sigler broke through and won the Parsec Award for Red Man in the Best Speculative Fiction Story (Short Form) category. He followed up with another win in 2009 for Eusocial Networking in the Best Speculative Fiction Story (Novella Form) category. 2010 saw him continue to win in the Best Speculative Fiction Story (Short Form) category with his podcast, The Tank, and in 2011 he again took out the Best Speculative Fiction Story (Novella Form) category with Kissyman & the Gentleman.

On July 31, 2015, Scott was inducted into the inaugural class of the Academy of Podcasters Hall of Fame at a ceremony in Fort Worth, Texas.[15]

Bibliography

Stand-alone novels

Infected Trilogy

Galactic Football League Series

Generations Trilogy

Other works

  • See the Scott Sigler bibliography page for more detailed information about the above novels and his many other works, including novellas related to the Galactic Football League series, short story collections, other short stories, upcoming projects, etc.

Adaptations

Film

In May, 2007 the novel Infected was optioned by Rogue Pictures and Random House Films;[17] however, the option lapsed in April 2010.[citation needed] The short story Sacred Cow was made into an online only mini-film by StrangerThings.tv and was Stranger Things debut episode.[18] “Cheating Bastard”, a short film about a couple in love with football and their obsession with it, was created by Brent Weichsel and released via Sigler’s RSS feed.

Graphic novel

In 2010 work began on a graphic novel adaptation of Sigler’s Infected.[19] The first issue was released August 1, 2012,[20]but the series was put on hold indefinitely due to delays with subsequent issues.[21]

Recordings

Albums

  • The Crucible (2016) by Separation Of Sanity. Scott’s original spoken word appears on four tracks: The Pact, Pandemic (inspired by his novel of the same name), Bag Of Blood (his major appearance on the album), and End Of Days.

Readings

  • Scott reads Union Dues – Off White Lies by Jeffrey R. DeRego on Escape Pod, Episode 49, on April 13, 2006.
  • Scott reads Reggie vs. Kaiju Storm Chimera Wolf by Matthew Wayne Selznick on Escape Pod, Episode 117, on August 2, 2007.

References

  1. Jump up^ Detrich, Allan (2007-04-01). “Podcasts are a novel idea for Scott Sigler”. Toledo Blade. Archived from the original on April 7, 2008. Retrieved 2007-09-18.
  2. Jump up^ Newman, Heather (2001-12-04). “Detroit Free Press Home Computing Column”. Detroit Free Press Knight Ridder/Tribune Business News. Retrieved 2007-09-17.
  3. Jump up^ “iPublish.com at Time Warner Books unveils third round of authors discovered through online writer community.”. Ingram Investment Ltd. 2001-11-07. Retrieved 2007-09-17.
  4. Jump up^ Weinberg, Anna (2005-08-26). “A Novel Approach to Podcasting”. The Book Standard. Retrieved 2007-09-17.
  5. Jump up^ Angell, LC (2005-03-24). “Fiction author releases ‘Podcast-only’ novel”. iLounge.com. Retrieved 2007-09-17.
  6. Jump up^ Kerley, Christina (2006-08-26). “Access to Supply Powers Demand–and First Sci-Fi Podcast Novel. (Q&A with Scott Sigler)”. CK’s Blog. Retrieved 2007-09-18.
  7. Jump up^ “From Podcast to Paidcast”. PRNewswire. 2006-03-09. Retrieved 2007-09-18.
  8. Jump up^ “Earthcore Podcast Now Pay to Play”. Podcasting News. 2006-02-21. Retrieved 2007-09-18.
  9. Jump up^ Mehta, Devanshu (2006-02-23). “From Podcast to Paidcast”. Apple Matters. Retrieved 2007-09-18.
  10. Jump up^ Newman, Andrew Adam (2007-03-01). “Authors Find Their Voice, and Audience, in Podcasts”. The New York Times. Retrieved 2007-09-16.
  11. Jump up^ “Scott Sigler’s Ancestor Skyrockets to Top 10 of Amazon Best-Seller List on First Day of Release”. PodShow.com. 2007-04-02. Retrieved 2007-09-18.
  12. Jump up^ Ploutz, Morgan (2010-10-22). “Scott Sigler Talks Ancestor and Hard Science Horror Writing”. Dread Central. Retrieved 2010-10-22.
  13. Jump up^ Sigler, Scott (March 19, 2014). “New print deal: Three books with Del Rey”. scottsigler.com. Retrieved 2016-05-30.
  14. Jump up^ “Scott Sigler’s novel Alive (Del Rey) is #1 on the New York Times Bestseller list in the Young Adult E-Book category.”. The New York Times. 2016-07-24.
  15. Jump up^ Academy of Podcasters Awards and Hall of Fame Ceremony.
  16. Jump up^ “Pandemic (review)”. PW. Retrieved 30 November 2013.
  17. Jump up^ Borys, Kit (2007-05-31). “Rogue, Random book ‘Infested'”. The Hollywood Reporter. Archived from the original on 2007-09-30. Retrieved 2007-09-18.
  18. Jump up^ Newton, Earl (2007-03-02). “Episode 01: Sacred Cow”. StrangerThings.tv. Retrieved 2007-09-18.
  19. Jump up^ “IDW Get Infected With Scott Sigler”. Bleeding Cool. Retrieved 13 September 2013.
  20. Jump up^ “PREVIEW: INFECTED #1”. CBR. Retrieved 13 September 2013.
  21. Jump up^ Sigler, Scott. “INFECTED Graphic Novel”. Scott Sigler. Retrieved 13 September 2013.

External links

https://en.wikipedia.org/wiki/Scott_Sigler

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Obama Recklessly Endangers The Health of The American People By Allowing West Africans From Ebola Infected Countries To Fly Into United States — Open Borders To Illegal Aliens Fleeing Ebola Pandemic — Obama Panics And Appoints New Ebola Czar — Another Political Elitist Establishment (PEE) Washington Insider With No Executive Leadership or Medical Experience — Videos

Posted on October 18, 2014. Filed under: American History, Babies, Blogroll, Books, Business, Chemistry, Communications, Computers, Constitution, Crisis, Diasters, Documentary, Economics, Education, Federal Government, Food, government, government spending, history, Illegal, Immigration, Links, Literacy, media, Medical, Medicine, Non-Fiction, People, Photos, Radio, Radio, Video, War | Tags: , , , , , , , , , , , , , , , , , , , , , , , , |

Project_1

The Pronk Pops Show Podcasts

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: Obama Recklessly Endangers The Health of The American People By Allowing West Africans From Ebola Infected Countries To Fly Into United States — Open Borders To Illegal Aliens Fleeing Ebola Pandemic — Obama Panics And Appoints New Ebola Czar —  Another Political Elitist Establishment (PEE) Washington Insider With No Executive Leadership or Medical Experience —  Videos

BSL-4 US

stop_the_flights

Team of Fort Detrick Scientists Labored for Years to Develop Vaccine

Biosafety Level 4 Laboratory Spacesuits

Ebola_enemies

level_3_4_lab

Biosafety Level 4 Hospital Spacesuits

Ebola Americans Nebraskabiocontainment spacesuitEbola Americans Nebraska

CDC warns against travel ban on Ebola-affected countries

Bill Johnson Discusses the Congressional Ebola Hearing with Fox News’ Gretchen Carlson

Ebola outbreak: Nebraska Medical Center ready at moment’s notice

Activation- A Nebraska Medical Center Biocontainment Unit Story

NEIDL: Biosafety Level 4

A Mission of Safety

NEIDL

In the Hot Zone with Virus X – Richard Preston

Elbows-Deep in Ebola Virus – Richard Preston

CNN Reporter To WH: What Does Obama’s Ebola Czar Know About Ebola?

Dr Nicole Lurie on National Health Security and Resiliency

Nicole Lurie, HHS: Flu Pandemic Lessons for Future Biothreats

How to Prioritize Flu Vaccine in Future (Panel discussion)

How Influenza Pandemics Occur

Hospitals “Full-Up”: The 1918 Influenza Pandemic

Dr. Nicole Lurie – HHS Assistant Secretary for Preparedness & Response

Ebola Czar hides away in bunker — Dr. Nicole Lurie

Weekly Examiner: Obama appoints Ebola czar

Obama Appoints Ebola ‘czar’ As Anxiety Mounts

Source: Obama to name Ron Klain as Ebola czar

President Obama appoints Ron Klain as Ebola “czar”

Remarks of Ron Klain

Actor Kevin Spacey, Georgetown’s Ron Klain Discuss Politics and Ethics

Obama’s New Ebola ‘Czar’ Has NO Health or Medical Background!

Biosafety level

Krauthammer: Obama Is a Narcissist ‘Surrounded by Sycophants’

President Obama Speaks on Ebola

Fast Facts on US Hospitals

The American Hospital Association conducts an annual survey of hospitals in the United States. The data below, from the 2012 AHA Annual Survey, are a sample of what you will find in AHA Hospital Statistics, 2014 edition. The definitive source for aggregate hospital data and trend analysis, AHA Hospital Statistics includes current and historical data on utilization, personnel, revenue, expenses, managed care contracts, community health indicators, physician models, and much more.

AHA Hospital Statistics is published annually by Health Forum, an affiliate of the American Hospital Association. Additional details on AHA Hospital Statistics and other Health Forum data products are available at www.ahadataviewer.com. To order AHA Hospital Statistics, call (800) AHA-2626 or click on www.ahaonlinestore.com.

For further information or customized data and research, contact the AHA Resource Center at (312) 422-2050 or rc@aha.org.

  Total Number of All U.S. Registered * Hospitals

5,723

         Number of U.S. Community ** Hospitals

4,999

               Number of Nongovernment Not-for-Profit Community Hospitals

2,894

               Number of Investor-Owned (For-Profit) Community Hospitals

1,068

               Number of State and Local Government Community Hospitals

1,037

        Number of Federal Government Hospitals

211

        Number of Nonfederal Psychiatric Hospitals

413

        Number of Nonfederal Long Term Care Hospitals

89

        Number of Hospital Units of Institutions
(Prison Hospitals, College Infirmaries, Etc.)

11

  Total Staffed Beds in All U.S. Registered * Hospitals

920,829

        Staffed Beds in Community** Hospitals

800,566

  Total Admissions in All U.S. Registered * Hospitals

36,156,245

        Admissions in Community** Hospitals

34,422,071

  Total Expenses for All U.S. Registered * Hospitals

$829,665,386,000

        Expenses for Community** Hospitals

$756,916,757,000

  Number of Rural Community** Hospitals

1,980

  Number of Urban Community** Hospitals

3,019

  Number of Community Hospitals in a System ***

3,100

  Number of Community Hospitals in a Network ****

1,508

 *Registered hospitals are those hospitals that meet AHA’s criteria for registration as a hospital facility. Registered hospitals include AHA member hospitals as well as nonmember hospitals. For a complete listing of the criteria used for registration, please see Registration Requirements for Hospitals.

**Community hospitals are defined as all nonfederal, short-term general, and other special hospitals. Other special hospitals include obstetrics and gynecology; eye, ear, nose, and throat; rehabilitation; orthopedic; and other individually described specialty services. Community hospitals include academic medical centers or other teaching hospitals if they are nonfederal short-term hospitals. Excluded are hospitals not accessible by the general public, such as prison hospitals or college infirmaries.

***System is defined by AHA as either a multihospital or a diversified single hospital system. A multihospital system is two or more hospitals owned, leased, sponsored, or contract managed by a central organization. Single, freestanding hospitals may be categorized as a system by bringing into membership three or more, and at least 25 percent, of their owned or leased non-hospital preacute or postacute health care organizations. System affiliation does not preclude network participation.

**** Network is a group of hospitals, physicians, other providers, insurers and/or community agencies that work together to coordinate and deliver a broad spectrum of services to their community. Network participation does not preclude system affiliation.

http://www.aha.org/research/rc/stat-studies/fast-facts.shtml

Inside The Isolation Wards That Keep Americans Safe From Ebola

Inside the Isolation Wards That Keep Us Safe From Ebola

Ebola has officially made it to the US, but there is absolutely no reason to freak out. That’s in large part thanks to Emory University Hospital’s state-of-the-art isolation ward, which is better-equipped to field Ebola cases than any ordinary hospital in the country. Here’s a look at the tech that keeps doctors and nurses safe.

Emory is one of four high-level biocontainment patient care units in the US; the others are located at the National Institutes of Health in Maryland, Rocky Mountain Laboratories in Montana, and the University of Nebraska Medical Center. We spoke with Dr. Angela Hewlett, associate medical director at the Nebraska Biocontainment Patient Care Unit — the largest of the four facilities — about biocontainment suits, wearing three pairs of gloves, and custom air pressure systems.

Perhaps the most comfort Hewlett was able to provide is that none of the super-fancy tech that these four high-level isolation wards have at their disposal is even necessary for Ebola. “There’s a big fear factor with this illness but really, these types of patients can taken care of at any good healthcare facility,” says Dr. Hewlett.

That’s because the Ebola virus easily dies outside of the human body, so unless you’ve been handling a sick person’s blood or feces, you are almost certainly A-OK. Ebola is pretty darn hard to get compared to an airborne disease like SARS or even the regular old flu. But with a mortality rate of up to 90 per cent — and over 50 per cent with the strain in the current outbreak — we still need to keep doctors and nurses as safe as we can. Here’s how Nebraska Biocontainment Unit keeps diseases like Ebola — and much, much worse — from spreading in the hospital.

Inside the Isolation Wards That Keep Us Safe From Ebola

Negative air pressure. As with Emory in Atlanta, the isolation unit in Nebraska is isolated from the rest of the general hospital. It runs on its own air circulation system, and the air is passed through a high-efficiency particulate air (HEPA) filter before it is vented outside of the building. That’s the same kind of precautions that you would see in a biosafety level 4 lab (the highest) that works with deadly or highly contagious diseases.

In addition, the biocontainment unit has negative air pressure, which means that air pressure inside the isolation rooms is slightly lower than that outside. Essentially, air is gently sucked into the room, so particles from inside the room can’t float out when you open a door. As another line of protection, ultraviolet lights zap any viruses or bacteria in the air or on surfaces.

Inside the Isolation Wards That Keep Us Safe From Ebola

Full-body suits and THREE pairs of gloves. The Biocontainment Unit is equipped with gear that covers you head to toe, in some places three times over. That includes personal respirators, headgear, full-body suits and gloves. Healthcare workers wear three pairs, including one thick pair that protects against needle accidents, and then two pairs of ordinary gloves so they have an extra pair to work with patients.

Entering and exiting the room becomes an elaborate production because putting on and taking off all the gear can take more than 10 minutes each way. A second person assists to make sure every piece of equipment is put on right and there are no rips or tears in any of the protective gear. Afterwards, every piece of equipment is wiped down to kill the pathogen; in the case of Ebola, simple bleach is enough to do the trick. The full-body suit is discarded after each use.

Inside the Isolation Wards That Keep Us Safe From Ebola

Training and training and training. Having fancy technology is great but not if you don’t know how to use it properly. “They have to go through really extensive training,” says Hewlett of the the 30-person team that works in the unit. They get 80 hours of training before they can begin, followed by monthly meetings and quarterly drills, where the photos in this post were taken.

It’s worth reiterating that most of this equipment and these procedures go above and beyond protecting for Ebola. The air systems and full-body suits are really there to guard against possible airborne diseases, like smallpox or SARS or some highly contagious avian flu viruses that may emerge in the future.

In fact, the CDC’s current guidelines for treating Ebola in U.S. hospitals require only gloves, goggles, a facemask, and a gown in most situations. Even if someone inadvertently brings Ebola to other hospitals, it’s highly unlikely to spread in the U.S. The situation is different in Africa, where inadequate equipment and fear of healthcare workers has contributed to the worsening situation.

A State Department official did visit Nebraska to see whether the unit would be ready to accept any Ebola patients in the future, though the facility hasn’t yet been used despite being open for nine years. There hasn’t been a disease serious enough to merit it. “This is good thing,” says Dr. Hewlett, “However with world travel the way it is, it is inevitable these things are going to come eventually.” If and when Ebola does come to the U.S. again, we are definitely prepared, which is not something we can say about what else may be coming down the line.

Pictures: University of Nebraska Medical Center

Obama names Ron Klain as Ebola ‘czar’

David Jackson

President Obama tapped veteran government insider Ron Klain to coordinate his administration’s efforts to contain the Ebola virus Friday.

Klain, a former chief of staff to Vice Presidents Joe Biden and Al Gore, is well-known by Obama and White House aides. He was selected for his management experience and contacts throughout the government, White House spokesman Josh Earnest said.

“He is the right person for the job,” Earnest said, particularly the challenge of “integrating the interagency response.”

Klain’s appointment marks a swift turnabout for Obama, who until Thursday had resisted calls to appoint a single official to run the government’s response to Ebola.

Asked Thursday about the prospect of an “Ebola czar,” Obama said, “It may make sense for us to have one person, in part just so that after this initial surge of activity, we can have a more regular process just to make sure that we’re crossing all the t’s and dotting all the i’s going forward.”

Obama did not mention Klain’s appointment during a speech Friday to the Consumer Financial Protection Bureau, but he said his administration is taking an “all-hands-on-deck” approach to fighting Ebola.

The administration has come under increased pressure to name an anti-Ebola coordinator in the wake of news that two nurses in Dallas contracted the deadly virus. Both had treated a man who died of Ebola.

Klain played a high-profile file in Gore’s 2000 presidential campaign. Oscar-winning actor Kevin Spacey portrayed him in an HBO movie on that year’s Florida recount.

The Ebola response includes efforts to screen travelers from West African nations where Ebola has reached epidemic proportions and killed more than 4,500 people. Klain will help coordinate the assistance the U.S. military provides in West Africa.

Some Republican lawmakers criticized Obama for entrusting the job to a former government manager rather than a professional.

Rep. Andy Harris, R-Md., tweeted, “Worst ebola epidemic in world history and Pres. Obama puts a government bureaucrat with no healthcare experience in charge. Is he serious?”

Members of the public health community expressed surprise.

“When are they going to stop making mistakes?” said Robert Murphy, the director of the Center for Global Health at Northwestern University’s Feinberg School of Medicine. “We need a czar, but optimally a strong public health expert. I am so disappointed. This is not what we need.”

Physician Amesh Adalja, a spokesman for the Infectious Diseases Society of America, said, “It’s clear that there’s a desperate desire for an organized approach to dealing with this outbreak. I don’t necessarily think we need a disease-specific czar — we have one for HIV — but more of an emerging infectious diseases/biosecurity coordinator who reports to the president.”

The Ebola position is designed to be more managerial in nature, involving an array of government agencies ranging from the Pentagon to Health and Human Services.

“This is much broader than a medical response,” Earnest said.

As for Republican criticism, Earnest joked, “That’s a shocking development.” He noted that national elections are less than three weeks away.

Klain may weigh in on another question facing the administration: the prospect of a U.S. travel ban from West African nations where there have been Ebola outbreaks.

Obama and aides have disputed the need for a travel ban, questioning whether it would work and arguing that it might create unintended problems.

Thursday, Obama said experts in infectious diseases have told him “a travel ban is less effective than the measures that we are currently instituting that involve screening passengers who are coming from West Africa.”

Klain is likely to take a low key role publicly.

Earnest said Obama wasn’t looking for an Ebola expert but “an implementation expert.”

He confirmed Klain’s title: “Ebola response coordinator.”

Klain will report to two officials involved in the anti-Ebola effort: homeland security adviser Lisa Monaco and national security adviser Susan Rice.

Obama is pleased with the work of Monaco and Rice, but “given their management of other national and homeland security priorities, additional bandwidth will further enhance the government’s Ebola response,” a White House official said, speaking on condition of anonymity.

The president has long known Klain, who helped prepare him for debates with Mitt Romney during the 2012 presidential campaign.

Klain has been out of government since leaving Biden’s staff during Obama’s first term.

http://www.usatoday.com/story/news/politics/2014/10/17/obama-ebola-czar-ron-klain/17429121/

Who Do They Think We Are?

By PEGGY NOONAN

The administration’s Ebola evasions reveal its disdain for the American people.

The administration’s handling of the Ebola crisis continues to be marked by double talk, runaround and gobbledygook. And its logic is worse than its language. In many of its actions, especially its public pronouncements, the government is functioning not as a soother of public anxiety but the cause of it.

An example this week came in the dialogue between Megyn Kelly of Fox News andThomas Frieden, director of the Centers for Disease Control.

Their conversation focused largely on the government’s refusal to stop travel into the United States by citizens of plague nations. “Why not put a travel ban in place,” Ms. Kelly asked, while we shore up the U.S. public-health system?

Dr. Frieden replied that we now have screening at airports, and “we’ve already recommended that all nonessential travel to these countries be stopped for Americans.” He added: “We’re always looking at ways that we can better protect Americans.”

“But this is one,” Ms. Kelly responded.

Dr. Frieden implied a travel ban would be harmful: “If we do things that are going to make it harder to stop the epidemic there, it’s going to spread to other parts of—”

Ms. Kelly interjected, asking how keeping citizens from the affected regions out of America would make it harder to stop Ebola in Africa.

“Because you can’t get people in and out.”

“Why can’t we have charter flights?”

“You know, charter flights don’t do the same thing commercial airliners do.”

“What do you mean? They fly in and fly out.”

Dr. Frieden replied that limiting travel between African nations would slow relief efforts. “If we isolate these countries, what’s not going to happen is disease staying there. It’s going to spread more all over Africa and we’ll be at higher risk.”

Later in the interview, Ms. Kelly noted that we still have airplanes coming into the U.S. from Liberia, with passengers expected to self-report Ebola exposure.

Dr. Frieden responded: “Ultimately the only way—and you may not like this—but the only way we will get our risk to zero here is to stop the outbreak in Africa.”

Ms. Kelly said yes, that’s why we’re sending troops. But why can’t we do that and have a travel ban?

“If it spreads more in Africa, it’s going to be more of a risk to us here. Our only goal is protecting Americans—that’s our mission. We do that by protecting people here and by stopping threats abroad. That protects Americans.”

Dr. Frieden’s logic was a bit of a heart-stopper. In fact his responses were more non sequiturs than answers. We cannot ban people at high risk of Ebola from entering the U.S. because people in West Africa have Ebola, and we don’t want it to spread. Huh?

In testimony before Congress Thursday, Dr. Frieden was not much more straightforward. His answers often sound like filibusters: long, rolling paragraphs of benign assertion, advertising slogans—“We know how to stop Ebola,” “Our focus is protecting people”—occasionally extraneous data, and testimony to the excellence of our health-care professionals.

It is my impression that everyone who speaks for the government on this issue has been instructed to imagine his audience as anxious children. It feels like how the pediatrician talks to the child, not the parents. It’s as if they’ve been told: “Talk, talk, talk, but don’t say anything. Clarity is the enemy.”

The language of government now is word-spew.

Dr. Frieden did not explain his or the government’s thinking on the reasons for opposition to a travel ban. On the other hand, he noted that the government will consider all options in stopping the virus from spreading here, so perhaps that marks the beginning of a possible concession.

It is one thing that Dr. Frieden, and those who are presumably making the big decisions, have been so far incapable of making a believable and compelling case for not instituting a ban. A separate issue is how poor a decision it is. To call it childish would be unfair to children. In fact, if you had a group of 11-year-olds, they would surely have a superior answer to the question: “Sick people are coming through the door of the house, and we are not sure how to make them well. Meanwhile they are starting to make us sick, too. What is the first thing to do?”

The children would reply: “Close the door.” One would add: “Just for a while, while you figure out how to treat everyone getting sick.” Another might say: “And keep going outside the door in protective clothing with medical help.” Eleven-year-olds would get this one right without a lot of struggle.

If we don’t momentarily close the door to citizens of the affected nations, it is certain that more cases will come into the U.S. It is hard to see how that helps anyone. Closing the door would be no guarantee of safety—nothing is guaranteed, and the world is porous. But it would reduce risk and likelihood, which itself is worthwhile.

Africa, by the way, seems to understand this. The Associated Press on Thursday reported the continent’s health-care officials had limited the threat to only five countries with the help of border controls, travel restrictions, and aggressive and sophisticated tracking.

All of which returns me to my thoughts the past few weeks. Back then I’d hear the official wordage that doesn’t amount to a logical thought, and the unspoken air of “We don’t want to panic you savages,” and I’d look at various public officials and muse: “Who do you think you are?”

Now I think, “Who do they think we are?”

Does the government think if America is made to feel safer, she will forget the needs of the Ebola nations? But Americans, more than anyone else, are the volunteers, altruists and in a few cases saints who go to the Ebola nations to help. And they were doing it long before the Western media was talking about the disease, and long before America was experiencing it.

At the Ebola hearings Thursday, Rep. Henry Waxman (D., Calif.) said, I guess to the American people: “Don’t panic.” No one’s panicking—except perhaps the administration, which might explain its decisions.

Is it always the most frightened people who run around telling others to calm down?

This week the president canceled a fundraiser and returned to the White House to deal with the crisis. He made a statement and came across as about three days behind the story—“rapid response teams” and so forth. It reminded some people of the statement in July, during another crisis, of the president’s communications director, who said that when a president rushes back to Washington, it “can have the unintended consequence of unduly alarming the American people.” Yes, we’re such sissies. Actually, when Mr. Obama eschews a fundraiser to go to his office to deal with a public problem we are not scared, only surprised.

But again, who do they think we are? You gather they see us as poor, panic-stricken people who want a travel ban because we’re beside ourselves with fear and loathing. Instead of practical, realistic people who are way ahead of our government.

http://online.wsj.com/articles/who-do-they-think-we-are-1413502475

Ron Klain

From Wikipedia, the free encyclopedia
Not to be confused with Ron Klein.
Ron Klain
Chief of Staff to the Vice President of the United States
In office
January 20, 2009 – January 14, 2011
Vice President Joe Biden
Preceded by David Addington
Succeeded by Bruce Reed
In office
1995–1999
Vice President Al Gore
Preceded by Jack Quinn
Succeeded by Charles Burson
Personal details
Born August 8, 1961 (age 53)
Indianapolis, Indiana, U.S.
Political party Democratic
Alma mater Georgetown University
Harvard University

Ronald A. “Ron” Klain is an American lawyer and political operative best known for serving as Chief of Staff to two Vice PresidentsAl Gore (1995–1999) and Joseph Biden (2009–2011).[1][2] He is an influential Democratic Party insider. Earlier in his career, he was a law clerk for Supreme Court Justice Byron “Whizzer” White during the Court’s 1987 and 1988 Terms and worked on Capitol Hill, where he was Chief Counsel to the Senate Judiciary Committee during theClarence Thomas Supreme Court nomination. He was portrayed by Kevin Spacey in the HBO film Recount depicting the tumult of the 2000 presidential election. On October 17, 2014, President Obama named Klain the newly created “Ebola response coordinator” (or, less officially, Ebola “czar”).[3][4][5]

Early life

Klain was born on August 8, 1961 in Indianapolis, He is a member of the DayBreak Boys Band and grew up in a Jewish home.[6] He graduated from North Central High School[7] in 1979 and was on the school’s Brain Game team, which finished as season runner-up.[citation needed] He graduated summa cum laude from Georgetown University in 1983. In 1987, he graduated magna cum laude from Harvard Law School,[7] where he was one of several to win the Sears Prize for the highest grade point average in 1984–85. While at Harvard Law School, Klain was also an editor of the Harvard Law Review.

Career

Capitol Hill career

Klain’s early experience on Capitol Hill included serving as Legislative Director for U.S. Representative Ed Markey. From 1989 to 1992, he served as Chief Counsel to the U.S. Senate Committee on the Judiciary, overseeing the legal staff’s work on matters of constitutional law, criminal law, antitrust law, and Supreme Court nominations. In 1995, Senator Tom Daschle appointed him the Staff Director of the Senate Democratic Leadership Committee.

Clinton administration

Klain joined the Clinton-Gore campaign in 1992. He ultimately was involved in both of Bill Clinton‘s campaigns, oversaw Clinton’s judicial nominations, and was General Counsel to Al Gore’s recount committee in the 2000 election aftermath. Some published reports have given him credit for Clinton’s “100,000 cops” proposal during the 1992 campaign; at a minimum, he worked closely with Clinton aide Bruce Reed in formulating it. In the White House, he was Associate Counsel to the President, directing judicial selection efforts, and led the team that won confirmation of Supreme Court Associate Justice Ruth Bader Ginsburg. Klain left the judicial selection role in 1994 to become Chief of Staff and Counselor to Attorney General Janet Reno. In 1995, he became Assistant to the President, and Chief of Staff and Counselor to Al Gore.

Gore campaign

During Klain’s tenure as Gore’s Chief of Staff, Gore consolidated his position as the likely Democratic nominee in 2000. Still, Klain was seen as too loyal to Clinton by some longtime Gore advisors. Feuding broke out between Clinton and Gore loyalists in the White House in 1999, and Klain was ousted by Gore campaign chairmanTony Coelho in August of that year. In October 1999, he joined the Washington, D.C. office of the law firm of O’Melveny & Myers. A year later, Klain returned to the Gore campaign, once Coelho was replaced by William M. Daley. Daley hired Klain for a senior position in the Gore campaign and then named him General Counsel of Gore’s Recount Committee.

Legal career

In 1994, Time named Klain one of the “50 most promising leaders in America” under the age of 40. In 1999, Washingtonian magazine named him the top lawyer in Washington under the age of 40, and the American Bar Association’s Barrister magazine named him one of the top 20 young lawyers nationwide. The National Law Journal named him one of its Lawyers of the Year for 2000.

Lobbying

Klain helped Fannie Mae overcome “regulatory issues”.[8]Lobbying on “regulatory issues concerning Fannie Mae” in 2004, as disclosure forms indicate Klain did, involved convincing Congress and Fannie Mae’s regulators that Fannie Mae wasn’t doing anything dangerous, and wasn’t exposing taxpayers to risk. In other words, Ron Klain got paid to help fuel the housing bubble up until a couple of years before it popped.

2004-2008

During the 2004 Presidential campaign, Klain worked as an adviser to Wesley Clark in the early primaries. Later, during the General Election, Klain was heavily involved behind the scenes in John Kerry‘s campaign and is widely credited for his role in preparing Senator Kerry for a strong performance in the debates against President George W. Bush, which gave Kerry a significant boost in the polls.[9] He then acted as an informal adviser to Evan Bayh, who is from Klain’s home state of Indiana. Klain has also commented on matters of law and policy on televised programs such as the Today Show, Good Morning America, Nightline, Capital Report,NewsHour with Jim Lehrer, and Crossfire.

In 2005, Klain left his partnership at O’Melveny & Myers to serve as Executive Vice President and General Counsel of a new investment firm, Revolution LLC, launched by AOL co-founder Steve Case.[citation needed]

Obama administration

On November 12, 2008, Roll Call announced that Klain had been chosen to serve as Chief of Staff to Vice President Joe Biden, the same role he served for Gore.[10]Klain had worked with Biden previously, having served as counsel to the United States Senate Committee on the Judiciary while Biden chaired that committee and assisted Biden’s speechwriting team during the 1988 presidential campaign.[11]

Klain was mentioned as a possible replacement for White House Chief of Staff Rahm Emanuel,[12] but opted to leave the White House for a position in the private sector in January 2011.[2]

Klain apparently signed off on President Obama’s support of a $535 million loan guarantee for now-defunct solar-panel company Solyndra. Despite concerns about whether the company was viable, Klain approved an Obama visit, stating, “The reality is that if POTUS visited 10 such places over the next 10 months, probably a few will be belly-up by election day 2012.”[13]

On October 17, 2014, Klain was appointed the “Ebola response coordinator” (or, less officially, Ebola “czar”)[3] by President Obama, to help coordinate the nation’s response to the Ebola virus.[4][5][14]

Dr. Lurie is the Assistant Secretary for Preparedness and Response (ASPR) at the US Department of Health and Human Services (HHS).

The mission of her office is to lead the nation in preventing, responding to and recovering from the adverse health effects of public health emergencies and disasters, ranging from hurricanes to bioterrorism.
Dr. Lurie was previously Senior Natural Scientist and the Paul O’ Neill Alcoa Professor of Health Policy at the RAND Corporation. There she directed RAND’s public health and preparedness work as well as RAND’s Center for Population Health and Health Disparities. She also served as Principal Deputy Assistant Secretary of Health in the US Department of Health and Human Services; in state government, as Medical Advisor to the Commissioner at the Minnesota Department of Health; and in academia, as Professor in the University of Minnesota Schools of Medicine and Public Health. Dr. Lurie has a long history in the health services research field, primarily in the areas of access to and quality of care, mental health, prevention, public health infrastructure and preparedness and health disparities.

Dr. Lurie attended college and medical school at the University of Pennsylvania, and completed her residency and MSPH at UCLA, where she was also a Robert Wood Johnson Foundation Clinical Scholar. She is the recipient of numerous awards, and is a member of the Institute of Medicine.

Finally, Dr. Lurie continues to practice clinical medicine in the health care safety net in Washington, DC. She has three sons.

Nicole Lurie

From Wikipedia, the free encyclopedia
Nicole Lurie, M.D., M.S.P.H.
Nicole-lurie.jpg
Assistant Secretary for Preparedness and Response
Incumbent
Assumed office
July 10,2009
President Barack Obama
Personal details
Alma mater University of Pennsylvania: M.D.
University of California, Los Angeles (UCLA): Residency and M.S.P.H.

Nicole Lurie, M.D., M.S.P.H., is the Assistant Secretary for Preparedness and Response (ASPR) at the U.S. Department of Health and Human Services (HHS).[1] Lurie is a Rear Admiral in the U.S. Public Health Service.

The Assistant Secretary for Preparedness and Response serves as the Secretary’s principal advisor on matters related to bioterrorism and other public health emergencies. The ASPR also coordinates interagency activities between HHS, other Federal departments, agencies, and offices, and State and local officials responsible for emergency preparedness and the protection of the civilian population from acts of bioterrorism and other public health emergencies.[2] The mission of her office is to lead the nation in preventing, responding to and recovering from the adverse health effects of public health emergencies and disasters. Dr. Lurie was nominated to the position by President Obama on May 12, 2009[3] and her confirmation by the U.S. Senate[4] was announced by HHS Secretary Kathleen Sebelius on July 10, 2009.[5]

Led by The Federalist website her absence from the media has been noted with regards to the events of the Ebola virus disease affair.[6]

Early career

Dr. Lurie has served as the Senior Natural Scientist and the Paul O’ Neill Alcoa Professor of Health Policy at the RAND Corporation.[7] There she directed RAND’s public health and preparedness work as well as RAND’s Center for Population Health and Health Disparities. She has previously served in federal government, as Principal Deputy Assistant Secretary of Health in the US Department of Health and Human Services; in state government, as Medical Advisor to the Commissioner at the Minnesota Department of Health; and in academia, as Professor in the University of Minnesota School of Medicine and the University of Minnesota School of Public Health. Dr. Lurie has a long history in the health services research field, primarily in the areas of access to and quality of care, managed care, mental health, prevention, public health infrastructure and preparedness and health disparities.

Lurie has served as the Senior Editor for Health Services Research and has served on editorial boards and as a reviewer for numerous journals. She has served on the council and was President of the Society of General Internal Medicine,[8] and on the board of directors for Academy Health, and has served on multiple other national committees.

Education

Lurie attended college and medical school at the University of Pennsylvania, and completed her residency and Master of Science of Public Health (MSPH) at UCLA, where she was also a Robert Wood Johnson Foundation Clinical Scholar.

Professional awards

Lurie is the recipient of numerous awards, including the AHSR Young Investigator Award, the Nellie Westerman Prize for Research in Ethics, the Heroine in Health Care Award, the University of Pennsylvania Perelman School of Medicine’s Distinguished Alumni Award, and is a member of the Institute of Medicine.

References

  1. Jump up^ Biography of Dr. Lurie
  2. Jump up^ Emergency Support Function #8. Public Health and Medical Services Annex. Federal Emergency Management Agency
  3. Jump up^ President Obama Announces More Key Administration Posts
  4. Jump up^ Nominations Confirmed (Civilian) – United States Senate
  5. Jump up^ HHS Secretary Sebelius Announces Senate Confirmation of Assistant Secretary for Preparedness and Response Dr. Nicole Lurie
  6. Jump up^ http://philadelphia.cbslocal.com/2014/10/15/editor-from-the-federalist-as-ebola-outbreak-surges-on-where-is-the-secretary-for-preparedness-and-response/
  7. Jump up^ RAND Awards Paul O’ Neill Alcoa Chair to Dr. Nicole Lurie. RAND Corporation. January 3, 2002
  8. Jump up^ Past Presidents. Society of General Internal Medicine.

External links[edit]

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

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

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

Project_1

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Pronk Pops Show 348: October 14, 2014

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

USA Invaded by Central America….

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

Why Do Viruses Kill

MicroKillers: Super Flu

The Influenza Pandemic of 1918

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

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

After Armageddon  (when deadly virus strikes)

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

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

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

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

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

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

\

immigrants bring in serious, contagious diseases

PJTV – Illegal Immigrants Being Illegally Dumped in Arizona…Illegally

Gen. Kelly at University of South Florida

 

 

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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.

Games – Click Here for More!
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.

Games – Click Here for More!
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

Posted on October 8, 2014. Filed under: Uncategorized | Tags: , , , , , , , , , , , , , , , , , , , , , , |

Project_1

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

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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.

l

“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

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  132. Jump up^ “Three leading Ebola experts call for release of experimental drug”. Los Angeles Times. 2014-08-06.
  133. Jump up^ “In Ebola Outbreak, Who Should Get Experimental Drug?”. The New York Times. 2014-08-08.
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  136. Jump up^ “Forbes – BioCryst to Launch NHP Ebola Drug Safety, Efficacy Studies ‘Within Weeks'”. Forbes. 29 August 2014. Retrieved 7 October 2014.
  137. Jump up^ “French nurse cured of Ebola contracted in Liberia”. MSN. Retrieved 7 October 2014.
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  139. Jump up^ Nathan Seppa (29 August 2014). “ZMapp drug fully protects monkeys against Ebola virus”. Science News (Society for Science & the Public). Retrieved 1 October 2014.
  140. Jump up^ Oestereich L, Lüdtke A, Wurr S, Rieger T, Muñoz-Fontela C, Günther S (2014). “Successful treatment of advanced Ebola virus infection with T-705 (favipiravir) in a small animal model”. Antiviral Res. 105: 17–21. doi:10.1016/j.antiviral.2014.02.014.PMID 24583123.
  141. Jump up^ “French nurse cured of Ebola contracted in Liberia”. MSN. Retrieved 7 October 2014.
  142. Jump up^ “BioCryst to Launch NHP Ebola Drug Safety, Efficacy Studies ‘Within Weeks’. David Kroll, Forbes Magazine. 29 August 2014”. Forbes. 29 August 2014. Retrieved 5 October 2014.
  143. Jump up^ “DURHAM: BioCryst receives additional funding for Ebola drug – WNCN: News, Weather”. WNCN. 18 September 2014. Retrieved 5 October 2014.
  144. Jump up^ WNCN Staff (3 September 2014). “Chimerix experimental drug shows promise in fighting Ebola virus. WNCN News, 4 September 2014”. Retrieved 7 October 2014.
  145. Jump up^ “Chimerix Announces Emergency Investigational New Drug Applications for Brincidofovir Authorized by FDA for Patients With Ebola Virus Disease”. Retrieved 7 October 2014.
  146. Jump up^ “Doctor treats Ebola with HIV drug in Liberia — seemingly successfully. Elizabeth Cohen, CNN news. 29 September 2014”. CNN. 27 September 2014. Retrieved 7 October 2014.
  147. Jump up^ “A Liberian doctor is using HIV drugs to treat Ebola victims. The NIH is intrigued. Elahe Izadi, Washington Post. 2 October 2014”. Washington Post. Retrieved 7 October 2014.
  148. Jump up^ Geisbert TW, Lee AC, Robbins M, Geisbert JB, Honko AN, Sood V, Johnson JC, de Jong S, Tavakoli I, Judge A, Hensley LE, Maclachlan I (29 May 2010). “Postexposure protection of non-human primates against a lethal Ebola virus challenge with RNA interference: A proof-of-concept study”. The Lancet 375 (9729): 1896–1905. doi:10.1016/S0140-6736(10)60357-1.PMID 20511019.
  149. Jump up^ Warren TK, Warfield KL, Wells J, Swenson DL, Donner KS, Van Tongeren SA, Garza NL, Dong L, Mourich DV, Crumley S, Nichols DK, Iversen PL, Bavari S (September 2010). “Advanced antisense therapies for postexposure protection against lethal filovirus infections”. Nature Medicine 16 (9): 991–994.doi:10.1038/nm.2202. PMID 20729866.
  150. Jump up^ Helen Branswell (3 August 2014). “Nancy Writebol, U.S. missionary, didn’t get TKM-Ebola drug, Tekmira says”. CBC News. Canadian Press.
  151. Jump up^ Heald AE, Iversen PL, Saoud JB, Sazani P, Charleston JS, Axtelle T, Wong M, Smith WB, Vutikullird A, Kaye E (25 August 2014). “Safety and pharmacokinetic profiles of phosphorodiamidate morpholino oligomers with activity against Ebola virus and Marburg virus: results of two single ascending dose studies”. Antimicrobial Agents and Chemotherapy.doi:10.1128/AAC.03442-14. PMID 25155593.
  152. Jump up^ Johansen LM, Brannan JM, Delos SE, Shoemaker CJ, Stossel A, Lear C, Hoffstrom BG, Dewald LE, Schornberg KL, Scully C, Lehár J, Hensley LE, White JM, Olinger GG (2013). “FDA-approved selective estrogen receptor modulators inhibit Ebola virus infection”. Sci Transl Med 5 (190): 190ra79.doi:10.1126/scitranslmed.3005471. PMC 3955358.PMID 23785035. Lay summaryHealthline Networks, Inc.
  153. Jump up^ Gehring G, Rohrmann K, Atenchong N, Mittler E, Becker S, Dahlmann F, Pöhlmann S, Vondran FW, David S, Manns MP, Ciesek S, von Hahn T (2014). “The clinically approved drugs amiodarone, dronedarone and verapamil inhibit filovirus cell entry”. J. Antimicrob. Chemother. 69 (8): 2123–31.doi:10.1093/jac/dku091. PMID 24710028.
  154. Jump up^ Tan, DX; Reiter, RJ; Manchester, LC (2014 Sep 27). “Ebola virus disease: Potential use of melatonin as a treatment.”. Journal of pineal research. PMID 25262626.
  155. Jump up^ “Blood transfusion named as priority treatment for Ebola”. Nature. Retrieved 11 September 2014.
  156. Jump up^ “Use of convalescent whole blood or plasma collected from patients recovered from Ebola virus disease Empirical treatment during outbreaks”. WHO. Retrieved 4 October 2014.
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  159. Jump up^ Saphire EO (2013). “An update on the use of antibodies against the filoviruses”. Immunotherapy 5 (11): 1221–33.doi:10.2217/imt.13.124. PMID 24188676.
  160. Jump up^ Gulland, A. (8 September 2014). “First Ebola treatment is approved by WHO”. BMJ 349 (sep08 7): g5539–g5539.doi:10.1136/bmj.g5539. PMID 25200068.
  161. Jump up^ Xu L, Sanchez A, Yang Z, Zaki SR, Nabel EG, Nichol ST, Nabel GJ (January 1998). “Immunization for Ebola virus infection”.Nature Medicine 4 (1): 37–42. doi:10.1038/nm0198-037.PMID 9427604.
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  163. Jump up^ Geisbert TW, Daddario-Dicaprio KM, Geisbert JB, Reed DS, Feldmann F, Grolla A, Ströher U, Fritz EA, Hensley LE, Jones SM, Feldmann H (9 December 2008). “Vesicular stomatitis virus-based vaccines protect nonhuman primates against aerosol challenge with Ebola and Marburg viruses”. Vaccine 26 (52): 6894–6900. doi:10.1016/j.vaccine.2008.09.082.PMC 3398796. PMID 18930776.
  164. Jump up^ Geisbert TW, Daddario-Dicaprio KM, Lewis MG, Geisbert JB, Grolla A, Leung A, Paragas J, Matthias L, Smith MA, Jones SM, Hensley LE, Feldmann H, Jahrling PB (November 2008).“Vesicular stomatitis virus-based Ebola vaccine is well-tolerated and protects immunocompromised nonhuman primates”. In Kawaoka, Yoshihiro. PLoS Pathogens 4 (11): e1000225.doi:10.1371/journal.ppat.1000225. PMC 2582959.PMID 19043556.
  165. Jump up^ Geisbert TW, Geisbert JB, Leung A, Daddario-DiCaprio KM, Hensley LE, Grolla A, Feldmann H (2009). “Single-injection vaccine protects nonhuman primates against infection with Marburg virus and three species of Ebola virus”. Journal of Virology 83 (14): 7296–7304. doi:10.1128/JVI.00561-09.PMC 2704787. PMID 19386702.
  166. Jump up^ Warfield KL, Swenson DL, Olinger GG, Kalina WV, Aman MJ, Bavari S (2007). “Ebola virus‐like particle–based vaccine protects nonhuman primates against lethal ebola virus challenge”. The Journal of Infectious Diseases 196: S430–S437.doi:10.1086/520583. PMID 17940980.
  167. ^ Jump up to:a b Oplinger, Anne A. (2003-11-18). NIAID Ebola vaccine enters human trial. Bio-Medicine.
  168. ^ Jump up to:a b “Ebola/Marburg vaccine development” (Press release). National Institute of Allergy and Infectious Diseases. 15 September 2008.
  169. Jump up^ Martin JE, Sullivan NJ, Enama ME, Gordon IJ, Roederer M, Koup RA, Bailer RT, Chakrabarti BK, Bailey MA, Gomez PL, Andrews CA, Moodie Z, Gu L, Stein JA, Nabel GJ, Graham BS (November 2006). “A DNA vaccine for Ebola virus is safe and immunogenic in a phase I clinical trial”. Clinical and Vaccine Immunology 13 (11): 1267–1277. doi:10.1128/CVI.00162-06.PMC 1656552. PMID 16988008.
  170. Jump up^ Bush, L (21 April 2005). “Crucell and NIH sign Ebola vaccine manufacturing contract”. Pharmaceutical Technology 29. p. 28.
  171. Jump up^ Jones SM, Feldmann H, Ströher U, Geisbert JB, Fernando L, Grolla A, Klenk HD, Sullivan NJ, Volchkov VE, Fritz EA, Daddario KM, Hensley LE, Jahrling PB, Geisbert TW (July 2005). “Live attenuated recombinant vaccine protects nonhuman primates against Ebola and Marburg viruses”. Nature Medicine 11 (7): 786–790. doi:10.1038/nm1258. PMID 15937495.
  172. Jump up^ “Viral Hemorrhagic Fever”. Infectious Disease Emergencies. San Francisco Department of Public Health. Ribavirin Therapy. Retrieved 24 October 2014.
  173. Jump up^ Phoolcharoen W, Dye JM, Kilbourne J, Piensook K, Pratt WD, Arntzen CJ, Chen Q, Mason HS, Herbst-Kralovetz MM (2011). “A nonreplicating subunit vaccine protects mice against lethal Ebola virus challenge”. Proc. Natl. Acad. Sci. U.S.A. 108 (51): 20695–700. Bibcode:2011PNAS..10820695P.doi:10.1073/pnas.1117715108. PMC 3251076.PMID 22143779. Lay summaryBBC News.
  174. Jump up^ “Canadian-made Ebola vaccine used after German lab accident”. CBCNews (Canadian Broadcasting Corporation). Canadian Press. 20 March 2009. Retrieved 2 August 2014.
  175. Jump up^ Tuffs A (March 2009). “Experimental vaccine may have saved Hamburg scientist from Ebola fever”. BMJ 338: b1223.doi:10.1136/bmj.b1223. PMID 19307268.
  176. Jump up^ Feldmann H, Jones SM, Daddario-DiCaprio KM, Geisbert JB, Ströher U, Grolla A, Bray M, Fritz EA, Fernando L, Feldmann F, Hensley LE, Geisbert TW (January 2007). “Effective post-exposure treatment of Ebola infection”. PLoS Pathogens 3 (1): e2. doi:10.1371/journal.ppat.0030002. PMC 1779298.PMID 17238284.
  177. Jump up^ Geisbert TW, Daddario-DiCaprio KM, Williams KJ, Geisbert JB, Leung A, Feldmann F, Hensley LE, Feldmann H, Jones SM (June 2008). “Recombinant vesicular stomatitis virus vector mediates postexposure protection against Sudan Ebola hemorrhagic fever in nonhuman primates”. Journal of Virology 82 (11): 5664–5668. doi:10.1128/JVI.00456-08. PMC 2395203.PMID 18385248.
  178. ^ Jump up to:a b c “Experimental Ebola Vaccine Processed in Maryland”.Drug Discov. Dev. Associated Press. 2 October 2014.
  179. Jump up^ “First British volunteer injected with trial Ebola vaccine in Oxford”. Guardian. 17 September 2014. Retrieved 17 September 2014.
  180. Jump up^ “An Ebola vaccine was given to 10 volunteers, and there are ‘no red flags’ yet”. Washington Post. 16 September 2014. Retrieved 17 September 2014.

Bibliography

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

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