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Ebola Study Projects Spread of Virus on Overseas Flights

A study projects up to three Ebola-infected people could be on overseas flights each month from the three most-affected African countries. WSJ's Gautam Naik reports. Photo: Getty

CLICK HERE - The Lancet - Assessment of the potential for international dissemination of Ebola virus via commercial air travel during the 2014 west African outbreak

wsj.com - by Gautam Naik - Oct. 20, 2014

Up to three Ebola-infected people could embark on overseas flights every month from the three most-affected African countries, according to a new study that projected travel patterns based on infection rates and recent flight schedules.

The findings, published Monday in the journal Lancet, suggest that Ebola cases could be spread overseas by unwitting travelers from the worst-hit countries—Guinea, Liberia and Sierra Leone.

The World Health Organization has estimated that, by early December, there could be as many as 10,000 new cases a week in west Africa.

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Neighboring countries shore up anti-Ebola defenses

DEUTSCHE  WELLE                                                                             Oct. 21, 1914

 By Philipp Sandner and Ibrahima Bah

West African countries that have escaped the Ebola outbreak intend to stay free of it by preparing for the worst. It is a strategy that can work as events in Senegal and Nigeria have shown. 

Mali, Senegal, Ivory Coast and Guinea-Bissau are countries that border on the epicenter of the Ebola epidemic that encompasses Guinea, Liberia and Sierra Leone. All these nations wish to protect themselves.

A health worker takes the temperature of man entering Mali from Guinea

One of the more obvious measures is to screen people entering the country. "We are using thermal imaging cameras to detect people at airports and borders who are running a temperature," said Malian physician Adamas Daou. He works at Mali's National Action Center for the fight against Ebola. Medical personnel are also on duty urging Malians to practice good personal hygiene. "This includes washing their hands in chlorinated water" Daou said.

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As Ebola patients vanish in Liberia’s health system, survivors go on a desperate search

WASHINGTON POST                           OCT. 21, 2014
BY  Kevin Sieff

MONROVIA ...many people who have simply vanished as Ebola tears through the city.

Ebola ravaged this capital so quickly that some patients passed through an already broken medical system with hardly any paper trail. Others were admitted to one clinic and transferred to another without notice. Hundreds were cremated long before their families were notified that they had died.

The world has heard about the deaths. Ebola has claimed 2,500 lives in this country, most of them in Monrovia. But the epidemic has also left in its trail another form of grief and anguish for those whose friends and relatives are missing. About 30 percent of Ebola victims survive. That’s the number many here obsess over — it is just high enough to offer hope and to fuel uncertainty.

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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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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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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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