Wednesday 8 October 2014

Ebola update - 10/07/2014

Without a doubt the best coverage is coming from the Extinction Protocol

Ebola escapes Europe's defenses; pet dog must die


An ambulance carrying a Spanish nurse infected with Ebola arrives at the Carlos III Hospital in Madrid early October 7, 2014 in this still image from video. (Reuters / Reuters TV)

AP,
7 October, 2014

MADRID (AP) — Health officials in Spain rushed to contain the Ebola virus Tuesday after it escaped Europe's defenses, quarantining four people at a Madrid hospital where a nursing assistant got infected and even getting a court order to kill the woman's dog.

The first case of Ebola transmitted outside Africa, where a months-long outbreak has killed more than 3,400 people, is raising questions about how prepared wealthier countries really are. Health workers complained Tuesday that they lack the training and equipment to handle the virus, and the all-important tourism industry was showing its anxiety.

Medical officials in the United States, meanwhile, are retraining hospital staff and fine-tuning infection control procedures after the mishandling of a critically ill Liberian man in Texas, who might have exposed many others to the virus after being sent away by a hospital.

In Africa, the U.S. military was preparing to open a 25-bed mobile hospital catering to health care workers with Ebola, before building a total of 17 promised 100-bed Ebola Treatment Units in Liberia. The virus has taken an especially devastating toll on health care workers, sickening or killing more than 370 in the hardest-hit countries of Liberia, Guinea and Sierra Leone, where doctors and nurses were already in short supply.

And as the disease moved from a seemingly distant continent to the doorsteps of the world's largest economies, government leaders faced growing pressure to ramp up responses. Spanish opposition parties called for the resignation of Health Minister Ana Mato, and the European Union demanded answers to what went wrong.

Obama administration spokesman Josh Earnest said Tuesday that more passenger screening measures would be announced "in the next couple of days," even though the White House remains "confident in the screening measures that are currently in place."

The nursing assistant in Madrid was part of a special team caring for a Spanish priest who died of Ebola last month after being evacuated from Sierra Leone. The nursing assistant wore a hazmat suit both times she entered his room, officials said, and no records point to any accidental exposure to the virus, which spreads through direct contact with the bodily fluids of a sickened person.

The woman, who had been on vacation in the Madrid area after treating the priest, was diagnosed with Ebola on Monday after coming down with a fever, and was said to be stable Tuesday. Her husband also was isolated as a precaution. Another quarantined nurse tested negative, but a man who traveled in Nigeria remained in isolation.

Madrid's regional government even got a court order to euthanize and incinerate their pet, Excalibur, against the couple's objections, without even testing the animal. A government statement said "available scientific information" provides no guarantee that infected dogs can't transmit the virus to humans.

Some reports in medical journals suggest that dogs can be infected with Ebola without showing symptoms, but whether they can spread the disease to people is unclear.

Ebola's source in nature hasn't been pinpointed. The leading suspect is a certain type of fruit bat, but the World Health Organization lists chimpanzees, gorillas, monkeys, forest antelope and porcupines as possibly playing a role in spread of the disease. Even pigs may amplify infection because of bats on farms in Africa.

Spanish authorities also were tracking down all the woman's contacts, and put more than 50 other people under observation, including her relatives and fellow health care workers. "The priority now is to establish that there is no risk to anybody else," emergency coordinator Fernando Simon said.

Even so, the potential repercussions of Ebola's presence in Europe became clear, as shares of Spanish airline and hotel chain companies slumped in Tuesday's trading. Spain is Europe's biggest vacation destination after France, and investors were apparently spooked that the deadly virus could scare away travelers.

The afflicted woman, reportedly in her 40s and childless, was not identified to protect her privacy, but nursing union officials she had 14 years' experience. Spanish officials said she had changed a diaper for the priest and collected material from his room after he died. Dead Ebola victims are highly infectious, and in West Africa their bodies are collected by workers in hazmat outfits.

An official investigation has begun and aims to "identify ... what is vulnerable: the procedures, or their implementation," he said.

The Madrid infection shows that even in countries with sophisticated medical procedures, frontline health care workers are at risk while caring for Ebola patients. Some two dozen health workers protested outside a Madrid hospital Tuesday, where union representative Esther Quinones complained that they lack resources and training.

In the United States, health care providers are implementing many precautions — reviewing triage procedures, creating isolation units, and even sending actors with mock symptoms into New York City's public hospital emergency rooms to test reactions.

"You never know when (an Ebola) patient's going to walk in," said Dr. Debra Spicehandler, an infectious disease expert at Northern Westchester Hospital in Mount Kisco, New York. "Education is key to controlling this — education of the public and of health care workers."



Vaccine may be only way to bring Ebola under control in West Africa – may have to vaccinate an entire country to save it



http://theextinctionprotocol.wordpress.com/2014/10/08/vaccine-may-be-only-way-to-bring-ebola-under-control-in-west-africa-may-have-to-vaccinate-an-entire-country-to-save-it/

October 2014 – HEALTH - A dire warning from one of the aid groups on the ground in western Africa: UNICEF has now declared the Ebola epidemic an extreme crisis. And one of the outcomes of this crisis is the thousands of children who are now Ebola orphans. Jackson Proskow reports. As West Africa’s Ebola outbreak continues to rage, some experts are coming to the conclusion that it may take large amounts of vaccines and maybe even drugs – all still experimental and in short supply – to bring the outbreak under control. Embedded in that notion is the reality that the catastrophic epidemic may remain unchecked for months, given that these products haven’t yet been proven to be safe or effective in people, and won’t be available in significant amounts any time soon. Experimental Ebola drugs in particular will remain in scarce supply for a considerable time.“It is conceivable that this epidemic will not turn around even if we pour resources into it. It may just keep going and going and it might require a vaccine,” Dr. Anthony Fauci, director of the U.S. National Institute for Allergy and Infectious Diseases, told The Canadian Press in an interview.
As the epidemic gets more and more formidable and in some cases out of control it is quite conceivable, if not likely, that we may need to deploy the vaccine to the entire country to be able to shut the epidemic down. That is clearly a possibility.” Earlier in the outbreak many experts insisted experimental vaccines could not be tested and produced in large enough amounts in time to have an impact on the outcome. They stressed – publicly, some still do – that the “tried and true” measures used to contain Ebola outbreaks in the past would eventually control this one. Those measures are aimed at breaking the chains of transmission. The sick are housed in isolation units, where the only people they have contact with are garbed head-to-toe in protective apparel. Those who don’t survive are buried in thick body bags, without the cultural rituals that often spread the disease. Contacts of the sick are monitored for 21 days and are whisked into isolation if they start to get ill. People with Ebola are believed to be contagious only when they have symptoms, which is when you need to ensure they don’t come into contact with others.
But this epidemic is so large it has long since outstripped the capacity of responders to care for all the sick, let alone trace their contacts. People are dying at home, infecting their families in the process. Some are dying abandoned on streets, or outside the gates of over-full treatment centers. On Sunday, Sierra Leone reported 121 deaths. That is more deaths in a single day than recorded in most Ebola outbreaks from start to finish. The World Health Organization says to date about 7,500 people are known to have been infected with the virus, and more than 3,400 have died. The head of the Wellcome Trust says it’s time to stop telling the public the traditional way of containing Ebola can quell this epidemic. Dr. Jeremy Farrar, who runs the global charitable foundation, says that message is now counterproductive, getting in the way of spurring the pharmaceutical industry to put on the type of full-court press that the situation demands.


Liberia burns its bodies as Ebola fears run rampant – burial crews in Sierra Leone go on strike

http://theextinctionprotocol.wordpress.com/2014/10/08/liberia-burns-its-bodies-as-ebola-fears-run-rampant-burial-crews-in-sierra-leone-go-on-strike/
October 2014 – LIBERIA – In an effort to stem Ebola’s spread, Liberia’s government has all but banned burials in favor of cremation. In the dusty shop-front of one of downtown Monrovia’s more desolate side streets, Sam Agyra flips through a fly-specked photo album showing off his custom caskets. Cake-like confections of pale satin, gold detailing and elaborate wooden scrollwork, his coffins have earned him a well-deserved reputation for beautiful work at a cheap price. In good times he was turning out five handcrafted pine coffins a week. Now? He doesn’t even want to talk about it. Instead he just laughs, the hysterical cackle of a man watching his business of 25 years grind to a halt. He hasn’t sold a coffin in two months, ever since the Liberian government declared, in an effort to tackle the Ebola crisis, that all of the country’s dead should be burned and not buried. An Ebola victim is most contagious in the moments and days after death, when unprotected contact with infected bodily fluids carries an extremely high risk of transmission. Liberia’s traditional burial practices, in which mourners bathe, dress and even kiss the corpse, are widely credited with the early explosion of Ebola in the country, where over 2,000 have so far died of the disease.

Overwhelmed by the increasing number of dead, and faced with community fears that the buried bodies may also transmit the disease—which, if interred properly, they won’t—Liberia’s government declared in August that all those who died of Ebola should be cremated. With international help and advice, the government established a Dead Body Management program to pick up Ebola’s victims and dispose of them safely. But testing for Ebola is difficult and time consuming. What little testing resources do exist are reserved for the living, says assistant health minister, Tolbert Nyenswah. With hospitals closed and doctors overwhelmed, it is almost impossible to prove that the cause of death is anything but the deadly virus. “These days, if someone dies, it’s Ebola,” says Agyra. “There is no testing, no questions. Just Ebola, and they take the body away. No one has time for coffins.” The government directive, while logical from an epidemiological aspect, has taken a toll on a society already traumatized by Ebola’s sweep. It denies communities a final farewell, and has led to standoffs with the Dead Body Management teams who must pick up the dead even as the living insist that the cause of death was measles, or stroke, or malaria — anything but Ebola. “We take every body, and burn it,” says Nelson Sayon, who works on one of the teams. Dealing with the living is one of the most difficult aspects of his job, he says, because he knows how important grieving can be.
 “No one gets their body back, not even the ashes, so there is nothing physical left to mourn.” Monrovia’s mass cremations, which take place in a rural area far on the outskirts of town, happen at night, to minimize the impact on neighboring communities. For a while the bodies were simply burned in a pile; now they are placed in incinerators donated by an international NGO. There are so many that it can sometimes take all night, says Sayon. In a country where distrust between the people and the government runs deep, the mass cremations have caused a deeper rift, says Kenneth Martu, a community organizer from the Westpoint area of Monrovia. “In west Africa we don’t cremate bodies at all. So when the government takes away our bodies, and can’t even tell us if they died of Ebola or not, it breeds resentment.” Liberians, he points out, are no strangers to mass casualties: two civil wars, from 1989 to 1996 and 1999 to 2003, saw nearly half a million die. “Even with mass.  “Even with mass graves, people can bring flowers. They know where to find the dead. But here we don’t even know where the ashes are.” There are exceptions to the cremation directive. If a family can get a signed death certificate from the Ministry of Health stating that the cause of death was not Ebola, they can take the body to a funeral parlor for embalming and eventual burial. There are even dispensations for those who do die of Ebola; under certain circumstances the dead can be buried in a cemetery, if the Dead Body Management team conducts the preliminary steps of laying the body six feet deep and soaking the next four feet of earth with chlorine solution.
 –Time 
Burial crews in Sierra Leone go on strike: Workers charged with burying the bodies of Ebola victims in and around Sierra Leone’s capital Freetown have gone on strike. The action has been called over the alleged non-payment of a weekly risk allowance. One of the workers, Tamba Nyandemoh, told Reuters: “We have decided to stop working until they pay us our weekly risk allowance.” The specialized teams who are striking say they bury between 17 and 35 bodies a week and wear protective clothing to remove and dispose of the corpses. “We have been stigmatized in our communities, so let the government try to pay us our money.” One of the burial team workers who asked to remain anonymous. Sierra Leone’s deputy health minister Madina Rahman said the burial teams have been paid through the end of September and were only awaiting payment for this week. 


WHO says Ebola spread ‘unavoidable’ in Europe due to extensive travel

http://theextinctionprotocol.wordpress.com/2014/10/08/who-says-ebola-spread-unavoidable-in-europe-due-to-extensive-travel/
October 2014 – GENEVA - The spread of Ebola in Europe is “unavoidable,” the World Health Organization said shortly after the contraction of four new cases was announced in Spain. “Such imported cases and similar events as have happened in Spain will happen also in the future, most likely,” the WHO European director Zsuzsanna Jakab told Reuters. On Monday scientists predicted that there was a 75 percent chance that Ebola would reach France by the end October and a 50 percent chance for the UK. A new study warns there’s now more than a 75% chance Ebola will reach France by end October,  and a 50% chance it will reach the UK before the end of October.  The most dangerous contributor to the spread is the behavior of the virus. Its symptoms catch people unawares and normally follow a 21-day incubation period, during which there’s literally no visible sign the person has contracted Ebola.  This is further complicated by the EU’s free movement system – one can literally infect anyone they come into contact with in the space of a few days if they were to drive or fly from one country to another.


It is quite unavoidable … that such incidents will happen in the future because of the extensive travel both from Europe to the affected countries and the other way around,” Jakab said. WHO has so far placed no restrictions on flights to the worst-affected countries. While British Airways and Emirates are no longer flying there, Air France has only suspended flights to Sierra Leone – not Liberia, Guinea or Nigeria (though air crews were recently offered the option to refuse flying to those destinations). Additionally, patients who have contacted the disease in West Africa have been repatriated for treatment – such as the two missionaries who died in September in Spain – one of whom infected a 44-year-old Spanish nurse who was diagnosed on Monday. 
Health officials in Madrid said on Tuesday that three more people are in hospital on suspicion of contracting Ebola after the diagnosis of the nurse. The nurse is now being treated with a drip using antibodies from those previously infected with the virus. Approximately 22 people who have been in contact with the woman, dubbed by media the “Spanish Ebola nurse,” have been identified and are being monitored, Madrid health officials told reporters Tuesday. However, WHO has stated that the continent is well prepared to control the disease. “It will happen,” she said. “But the most important thing in our view is that Europe is still at low risk and that the western part of the European region particularly is the best prepared in the world to respond to viral hemorrhagic fevers including Ebola,” Jakab said.
 -RT


Who’s going to pay? The average cost to treat an Ebola patient could run as high as half a million dollars

Ebola Hospital Bills TEP
http://theextinctionprotocol.wordpress.com/2014/10/08/whos-going-to-pay-the-average-cost-to-treat-an-ebola-patient-could-run-as-high-as-half-a-million-dollars/
October 2014 – HEALTH - Caring for Thomas Eric Duncan, the Dallas Ebola patient, may cost as much as $500,000, a bill that his hospital is unlikely to ever collect. Duncan is in critical condition at Texas Health Presbyterian Hospital Dallas, where he has been isolated since Sept. 28. He’s on a ventilator, has been given an experimental medicine and is receiving kidney dialysis, a hospital spokeswoman said Tuesday. His treatment probably includes fluids replacement, blood transfusions and drugs to maintain blood pressure. There’s also the cost of security, disposing of Ebola-contaminated trash and equipment to protect caregivers. The bill may eventually total $500,000 including indirect costs such as the disruption to other areas of hospital care, said Dan Mendelson, chief executive officer of Avalere Health, a Washington consulting firm. Duncan’s care probably costs $18,000 to $24,000 a day, said Gerard Anderson, a health policy professor at Johns Hopkins University’s Bloomberg School of Public Health.

Duncan has been in isolation in the hospital for nine days so far. “If they recognize that he has no money they will clearly just write it off as charity care,” Anderson said in a telephone interview. Duncan came to the United States from Liberia on Sept. 20 on a tourist visa. He has no health insurance to pay for his care, said civil rights activist Jesse Jackson, who traveled to Dallas at the request of Duncan’s mother. Spokesmen for Texas Health Presbyterian and for the Liberian embassy in Washington declined to discuss who will pay for Duncan’s care. “It’s too early to make a decision about payment of bills; he is in critical condition,” Gabriel Williams, a Liberian Embassy spokesman, said in a phone interview. “The focus is on his health.” Duncan is the first case of Ebola diagnosed in the United States. Emory University Hospital in Atlanta and Nebraska Medical Center in Omaha have also treated Ebola patients, three of whom have been released after recovering. A fourth patient is under care in Omaha and a fifth in Atlanta. Neither of the hospitals would comment on the cost of treating those patients. Kent Brantly, the first person to be transported from Liberia to the United States for care, was covered under health insurance provided by his charity, Samaritan’s Purse, said Todd Shearer, a spokesman for the group. Two other aid workers, Nancy Writebol and Rick Sacra, went to Liberia with the Charlotte, N.C.-based missionary group SIM. They are covered by the group’s health and workers’ compensation insurance plans, and SIM plans to pay their $25,000 deductibles, said George Salloum, the group’s vice president for finance and operations.
Writebol’s evacuation from Liberia was covered in full by one of SIM’s insurance carriers, Aetna Inc., he said. He’s still waiting for bills from other carriers, whom he declined to name, and said he didn’t know what the hospital care cost. “The hospitals have not disclosed that information to us,” Salloum said in a phone interview. “I’m very anxious to find out, personally, just wondering what they’re charging for that kind of care.” Emory and Nebraska are known for their expertise in exotic diseases and careful isolation of infectious patients. Texas Health Presbyterian doesn’t not have that reputation, but is ranked the fifth-best hospital in the Dallas-Fort Worth region by U.S. News and World Report. Duncan arrived there in an ambulance on Sept. 28, after being initially sent home two days earlier from the emergency room with antibiotics. Anderson, a former federal health official, said that as a foreign citizen Duncan wouldn’t be eligible for any U.S. health programs such as Medicaid, for low income people. Texas hospitals charge $8,176 per day on average for treatment of viral illnesses, including exotic diseases such as West Nile virus and Dengue fever, said Andrew Fitch, a health-care pricing expert at NerdWallet, a San Francisco-based company that provides consumer finance and health data. That figure “is actually probably on the low end” for Ebola, Fitch said in a phone interview. “The isolation ward would bump up the charge a lot.” –

Spanish officials mystified how nurse contracted Ebola – ‘we followed protocols, she was in a full body suit’

http://theextinctionprotocol.wordpress.com/2014/10/08/spanish-officials-mystified-how-nurse-contracted-ebola-we-followed-protocols-she-was-in-a-full-body-suit/
October 2014 – SPAIN – The director of the Centers for Disease Control and Prevention says details on the measures to screen air passengers for Ebola, mentioned Monday by President Obama, will be announced this week. Thomas Frieden, in an interview with All Things Considered, says he’s “confident that you’ll hear about it this week. When we tell you about it this week, we’ll tell you when we’ll start,” Frieden says. Obama said Monday that the U.S. would step up screening for travelers with the disease at airports in the United States and West Africa. The CDC director’s remarks come as doctors say a man being treated in Dallas for Ebola remains in critical condition but has stabilized somewhat, and that he is receiving an experimental drug. And, in Spain, a nurse who cared for an Ebola patient there has tested positive for the disease — the first known instance of a transmission of the virus outside West Africa. Texas Health Presbyterian Hospital announced Monday that Thomas Eric Duncan, who apparently contracted Ebola in Liberia before coming to the U.S., is being treated with brincidofovir, an oral medicine developed by Chimerix Inc. North Carolina-based Chimerix announced Monday that “brincidofovir” has been provided for potential use in patients with Ebola Virus Disease. These requests were made by treating physicians. “Chimerix is working closely with the FDA to finalize a clinical trial protocol early this week to assess the safety, tolerability, and efficacy of brincidofovir in patients who are confirmed to have an infection with the Ebola virus,” the company said.


Duncan began receiving the drug Saturday, according to a spokeswoman for Texas Health Resources, which operates the hospital where Duncan is receiving care. Another patient, Ashoka Mukpo, a freelance cameraman who contracted the disease in West Africa and is being treated in Nebraska, is also receiving the experimental drug. In Madrid, the health of the 40-year-old nurse with Ebola is said to have stabilized. Health officials said the woman, who has not been identified, had no symptoms besides a fever, according to The Associated Press. The infected nurse had assisted in the treatment of a 75-year-old Spanish priest who had been flown from Liberia. The priest died after being treated with the experimental Ebola medicine ZMapp, the AP says. NPR’s Lauren Frayer reports that a few months ago, Spanish officials were touting the country’s ability to handle Ebola patients. “But last night, the tone abruptly changed,” Lauren reports on Morning Edition. Spanish Health Minister Ana Mato urged the country to remain calm. “We followed the protocol and we don’t know how she got infected,” Mato told a news conference. We know she entered the infected priest’s room twice — once to treat him and once after he died to collect some of his things,” said Dr. Antonio Alemany, a health official from the regional government of Madrid. “As far as we know, she was wearing a protective suit the whole time and didn’t have any accidental contact with him.”
Alemany said the nurse went on vacation for a week after treating the priest, but he didn’t say where. He said that all of the woman’s co-workers were being monitored twice a day for fever. The World Health Organization issued a statement saying: “Spanish authorities are conducting an intensive investigation of this case, in order to determine the mode of transmission and to trace those who have been in contact with the health care worker. WHO is ready to provide support to Spain, as and if required.” The Guardian reports that health officials in Madrid have blamed substandard equipment and “a failure to follow protocol” for the nurse’s infection. –NPR

See also: Ebola:Evolution of an epidemic (INTERACTIVE MAP)


The gap between medical knowledge and the political response. Definitely worth watching despite the fact this comes from the Alex Jones show – without Alex Jones

Governments Continue To Censor Information About Ebola


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