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Fighting Ebola, and the Mud

NEW YORK TIMES                         Oct. 21, 2014

Op-ed in Today's New York Times by Karen Huster, a nurse working in Liberia for Last Mile Health says that Liberia’s dysfunctional transportation system is standing in the way of fighting the Ebola epidemic and suggests some solutions
 

"Patients have died on grueling journeys to treatment units. Blood samples have sat waiting for days, eventually becoming invalid....

 "The best solution is removing the need to travel altogether by building more easily accessible treatment centers all over the country, where patients with confirmed or suspected cases of Ebola can be housed and treated. The United States military is building these structures, but it is taking time. Nimbler nongovernmental organizations must also step in. Save the Children has already done so and is also building smaller community care centers — sort of homes away from home, where families can continue to care for their sick loved ones safely removed from the community. A makeshift center with tents instead of permanent structures could be set up within a week.

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Ebola crisis: Worst-hit African nations get key supplies

BBC                                                                                   Oct. 20, 2014

Vital supplies and resources to tackle Ebola are beginning to arrive in the three worst-hit West African countries, Ghana's President John Mahama has said.

Mr Mahama, who heads the regional bloc Ecowas, also told the BBC that treatment centres were being set up in Guinea, Liberia and Sierra Leone. But he called for proper co-ordination between agencies to avoid duplication.


Red Cross workers are among those fighting the outbreak in Sierra Leone

Mr Mahama told the BBC that the World Food Programme was airlifting humanitarian aid to Liberia, Sierra Leone and Guinea.

"Vehicles, motorcycles and other means of transport are going in there. There's more protective clothing being provided," he said.

"But there's no need for us to duplicate each other and have more treatment centres when we do not have volunteers and health workers to treat the people in the treatment centres.

Read full story

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DHS requires West Africa travelers to arrive at five airports

USA TODAY                                                                                     Oct. 21, 2914By Bart Jansen

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

                                                                       (Photo: Melissa Maraj, AP)

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

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

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

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EU seeks $1.27 billion in Ebola aid for W. Africa

ASSOCIATED PRESS                               Oct. 20, 2014

By Raf Casert
LUXEMBOURG (AP) — The European Union committed itself Monday to step up efforts toward getting 1 billion euros ($1.27 billion) in aid to fight Ebola in West Africa and rejected the idea of halting direct flights coming from the region.

The EU foreign ministers set off a week of continentwide action with a pledge "to play an active role in enhancing the international response" to Ebola, which so far has been late and insufficient to contain the deadly virus that has claimed at least 4,500 lives.

British Prime Minister David Cameron wants a two-day summit of the 28 EU leaders ending Friday to reach the $1.27 billion aid threshold, agreeing on a variety of topics from more financial aid to common repatriation procedures, more Ebola treatment facilities and better training for health care workers.

...So far, the overall anti-Ebola total for the EU, including EU national contributions, stands at 500 million euros ($640 million), with Britain contributing 160 million euros ($204 million). The Netherlands also promised to send a frigate to West Africa to help, matching a similar contribution from Britain.

EU ministers rejected the idea of scrapping flights from West Africa to keep the virus out of Europe.

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Special Report - A Primer on Ebola for Clinicians

journals.cambridge.org -  Eric Toner, Amesh Adalja and Thomas Inglesby. A Primer on Ebola for Clinicians.
Disaster Medicine and Public Health Preparedness, available on CJO2014. doi:10.1017/dmp.2014.115.

Abstract

The size of the world’s largest Ebola outbreak now ongoing in West Africa makes clear that further exportation of Ebola virus disease to other parts of the world will remain a real possibility for the indefinite future. Clinicians outside of West Africa, particularly those who work in emergency medicine, critical care, infectious diseases, and infection control, should be familiar with the fundamentals of Ebola virus disease, including its diagnosis, treatment, and control. In this article we provide basic information on the Ebola virus and its epidemiology and microbiology. We also describe previous outbreaks and draw comparisons to the current outbreak with a focus on the public health measures that have controlled past outbreaks. We review the pathophysiology and clinical features of the disease, highlighting diagnosis, treatment, and hospital infection control issues that are relevant to practicing clinicians. We reference official guidance and point out where important uncertainty or controversy exists. (Disaster Med Public Health Preparedness. 2014;0:1-5)

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Ebola Doctors at Breaking Point: 'This Constant Feeling That the Boat's Sinking'

      

A doctor outside the JFK Ebola treatment center speaks to journalists on Oct. 13, 2014 in Monrovia, Liberia.  Photographer: John Moore/Getty Images
 
bloomberg.com - by Makiko Kitamura and Naomi Kresge - October 20, 2014

At 3:30 a.m. in the world’s biggest Ebola treatment center, Daniel Lucey found the outbreak reduced to its essentials: patients lying on mattresses on the floor and vomiting in the dark, visible only by the wavering flashlight beam of a single volunteer doctor.

“I don’t see a light at the end of the tunnel,” said Lucey, a physician and professor from Georgetown University who is halfway through a five-week tour in Liberia with Medecins Sans Frontieres, the medical charity known in English as Doctors Without Borders. “The epidemic is still getting worse,” he said by phone between shifts.

(READ COMPLETE ARTICLE)

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Review of Human-to-Human Transmission of Ebola Virus

CDC                                                              Posted Oct. 20, 2014 from  CDC  Oct. 17 document

This document is a concise summary of published information on the current science about human-to-human transmission of Ebola virus. It is developed for use by healthcare personnel and public health professionals to use. It is a complement to the many guidance documents that CDC has issued already online at

www.cdc.gov/ebola.

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Liberia president describes heavy cost of Ebola

Liberia's president calls for more investment in health systems, news article, op-ed

ASSOCIATED PRESS                               Oct. 20, 2014

by Jonathan Paye-Layleh

Monrovia, Liberia — Liberian President Ellen Johnson Sirleaf said Ebola has killed more than 2,000 people in her country and has brought it to “a standstill,” noting that Liberia and two other badly hit countries were already weakened by years of war.

Appealing for more international help, Sirleaf described the devastating effects of Ebola in a “Letter to the World” that was broadcast Sunday by the BBC.   https://soundcloud.com/bbc-world-service/a-letter-to-the-world-on-ebola-from-liberian-president-ellen-johnson-sirleaf?ocid=socialflow_twitter

“Across West Africa, a generation of young people risk being lost to an economic catastrophe as harvests are missed, markets are shut and borders are closed,” the Nobel Peace Prize laureate said. “The virus has been able to spread so rapidly because of the insufficient strength of the emergency, medical and military services that remain under-resourced....”

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Nigeria Is Ebola-Free: Here’s What They Did Right

It's been 42 days since the last new case

TIME MAGAZINE                                                      OCT. 20, 2014

Alexandra Sifferlin

 The World Health Organization declared Nigeria free of Ebola on Monday, a containment victory in an outbreak that has stymied other countries’ response efforts....

 

A school official takes a pupil's temperature using an infrared digital laser thermometer in front of the school premises, at the resumption of private schools, in Lagos, Sept. 22, 2014. Akintunde Akinleye—Reuters

“It’s possible to control Ebola. It’s possible to defeat Ebola. We’ve seen it here in Nigeria,” Nigerian Minister of Health Onyebuchi Chukwu told TIME. “If any cases emerge in the future, it will be considered—by international standards—a separate outbreak. If that happens, Nigeria will be ready and able to confront it exactly as we have done with this outbreak.”

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U.S. to issue new Ebola care guidelines, watch lists to shrink

ROUNDUP OF DEVELOPMENTS SUNDAY

REUTERS                                     Oct 19, 2014

GALVESTON Texas --(Reuters) - The United States will issue strict new guidelines telling American health workers to cover their skin and hair when dealing with Ebola patients, a top health official said on Sunday, while some of the dozens of people being watched for possible exposure to the virus are expected to be cleared.

 

 A health care worker receives protocol on the proper removal of personal protection equipment from Centers for Disease Control and Prevention (CDC) instructors in preparation for the response to the current Ebola outbreak, during a CDC safety training course in Anniston, Alabama, October 6, 2014. Credit: Reuters/Tami Chappell

In Texas, a lab worker who spent much of a Caribbean holiday cruise in isolation tested negative for the deadly virus and left the Carnival Magic liner with other passengers after it docked at Galveston early on Sunday morning....

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