Much ground to cover in the increasingly dramatic unfolding of the Ebola crisis, but we begin with that other hemorrhagic fever outbreak that is causing great concern,. From the Daily Monitor in Kampala, Uganda:
Number of Marburg suspects raise to eight
The Ministry with the support of MSF and the US Center for Disease Control and Prevention, on Monday trained a total of 103 health workers from Mengo Hospital in Marburg prevention, treatment and control
Eight people who earlier got into contact with the Marburg confirmed case have developed signs of the disease, according to the Ministry of Health.
Samples have also been taken from the eight suspects and are being investigated at the Uganda Virus Research Institute.
The Director General of Health Services Dr. Alex Opio said four of them are from Mpigi, two from Kasese and two from Kampala district.
“Preparations are underway to quarantine the suspects as a preventive measure for the spread of the disease. To date there is only one laboratory confirmed case that has been reported in the country. This is the first case that was reported at Mengo Hospital and has since died,” Dr Opio said in a statement issued on Monday evening by the Ministry of Health.
And on to Ebola, first with a brief video report from the Associated Press:
CDC Notes Some Progress in Ebola Fight
The CDC says there is some progress in the fight against Ebola. Dr. Thomas Frieden says so far no one who had contact with the Dallas patient is sick, and cases recently have ‘plummeted’ in a key region of Liberia
The Japan Times gives an update on America’s patient:
Dallas Ebola patient on ventilator and receiving kidney dialysis
The Ebola patient fighting for his life in a Dallas hospital is on a ventilator and a kidney dialysis machine to help stabilize his health, the hospital said on Tuesday.
Liberian national Thomas Eric Duncan, the first person diagnosed with the deadly virus on U.S. soil, has also been given the experimental medication brincidofovir. A hospital in Nebraska said it is using the same drug to treat an American journalist who was airlifted from Liberia and arrived Monday.
Texas Health Presbyterian Hospital said in a statement that Duncan’s liver function declined over the weekend. It said although it has since improved, “doctors caution that this could vary in coming days.”
A question from the Christian Science Monitor:
Why didn’t Texas Ebola patient receive experimental drug sooner?
Doctors were concerned about the risks the experimental drug posed to the Ebola patient, Thomas Eric Duncan. But a worsening condition appears to have changed the equation.
News that Thomas Eric Duncan, the Ebola patient in Dallas, is receiving an experimental antiviral drug is another chapter in a fast-moving geopolitical drama exploring, patient by patient, the frontiers of medicine and ethics.
As the global community scrambles to contain the virus, and as the cases outside Africa grow, questions have been raised about why Mr. Duncan, a Liberian war survivor who came to the United States to marry his son’s mother, hasn’t received the same experimental drug that doctors say may have played a role in the recovery of two American medical workers, Dr. Kent Brantly and aid worker Nancy Writebol.
The medical community, led by the Centers for Disease Control and Prevention (CDC), is scrambling to find a medicine to stave off the disease. Two potential Ebola vaccines are now being tested on humans, but even if they’re deemed successful, it will be months before they’re available.
And from the London Daily Mail, the inevitable hyperbole:
EXCLUSIVE: First picture of Ebola victim’s quarantined ‘wife’ – as DA threatens charge of aggravated assault with a DEADLY WEAPON after he lied to get into America
- Thomas Eric Duncan could face the charge – which carries a sentence of up to 20 years – if he survives and is charged
- Dallas DA said it is something they are ‘taking seriously’ after Duncan lied on forms about his exposure to Ebola to get on a plane to America
- Meanwhile, a gofundme set up for him has only raised $50 in six days
- Commentors on the page expressed anger that he had been deceitful
- Jesse Jackson flew into to Dallas on Tuesday to support the family
- Duncan remains in a critical but stable condition with a slight improvement after being given an experimental drug
While the Los Angeles Times focuses on a more troubling concern:
Some Ebola experts worry virus may spread more easily than assumed
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.
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.
More from The Hill:
CDC: Airborne Ebola possible but unlikely
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.
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.”
From the New York Times, screening:
U.S. to Require Tougher Ebola Screening at Airports: Senator
U.S. health officials are preparing to require tougher Ebola screening at American airports this week to keep the deadly virus from spreading to this country, Senator Chuck Schumer said on Tuesday.
The new measures may include screening air travelers for fever when they arrive in the United States from the worst-stricken countries in West Africa, on direct or indirect flights, Schumer said in a statement.
He said U.S. Centers for Disease Control and Prevention (CDC) Director Dr. Thomas Frieden told him the agency might adopt some of the recommendations Schumer had made on Ebola screening over the weekend.
And the Associated Press covers one measure already implemented:
Coast Guard sector issues new steps on Ebola
One U.S. Coast Guard sector says it will contact ships that have recently been to Ebola-affected countries to ask whether passengers have symptoms of the virus before they are allowed into port.
The sector, which includes parts of New York and Connecticut, issued a bulletin to the maritime community in Long Island Sound on Monday that describes protocols being put into place due to Ebola.
“We wanted to have those specific steps identified in advance so we’ve prepared the captains of these vessels doing business in our ports for the questions we’re going to ask,” said Capt. Edward J. Cubanski III, the sector commander.
Here is the full CDC briefing, via the Washington Post:
CDC holds news briefing on Ebola patient in Texas
The CDC gives members of the media an update on the condition a man in Dallas who was diagnosed with Ebola.
The Associated Press covers belated safeguards:
US health providers expand their Ebola precautions
Public hospitals in New York City are so concerned about Ebola, they’ve secretly been sending actors with mock symptoms into emergency rooms to test how well the triage staffs identify and isolate possible cases.
A small Ohio hospital has hung up signs imploring patients to let nurses know immediately if they have traveled recently to West Africa.
And across the U.S., one of the nation’s largest ambulance companies has put together step-by-step instructions for wrapping the interior of a rig with plastic sheeting.
There hasn’t been a single confirmed case of an Ebola infection happening on U.S. soil; the case confirmed in Dallas involves a man who, like several health care workers treated in the U.S., contracted the virus in Liberia. But health care providers are worried enough to take a wide variety of precautions.
And then there’s this from Reuters:
Male Ebola survivors told: Use a condom
Sex could keep the Ebola epidemic alive even after the World Health Organization (WHO) declares an area free of the disease, one of the discoverers of the deadly virus said on Tuesday.
The WHO is hoping to announce later this week that Nigeria and Senegal are free of Ebola after 42 days with no infections — the standard period for declaring an outbreak over, twice the maximum 21-day incubation period of the virus.
However, it appears the disease can last much longer in semen. “In a convalescent male, the virus can persist in semen for at least 70 days; one study suggests persistence for more than 90 days,” the WHO said in an information note on Monday.
“Certainly, the advice has to be for survivors to use a condom, to not have unprotected sex, for 90 days,” said Peter Piot, a professor at the London School of Hygiene and Tropical Medicine and a discoverer of Ebola in 1976.
On to Spain, and Europe’s first home grown patient, via Reuters:
Four hospitalized in Spain after first Ebola transmission outside Africa
Four people have been hospitalized in Spain to try to stem the spread of Ebola after a Spanish nurse became the first person in the world known to have contracted the virus outside of Africa, health authorities said on Tuesday.
The nurse, who tested positive for the virus on Monday, her husband, who is showing no symptoms of the disease, and two other people are being closely monitored in hospital, health officials told a news conference in Madrid.
One of those hospitalized is a health worker who has diarrhea but no fever. The other is a Spaniard who traveled from Nigeria, said Rafael Perez-Santamaria, head of the Carlos III Hospital where the infected nurse treated two Spanish missionaries who contracted the disease in Africa.
More from El País:
Nurse’s assistant came into contact with 21 people at Alcorcón Hospital
- Staff including doctors, nurses and ambulance crew will be monitored for symptoms
A day after news broke that a Spanish nursing assistant had become the first person in Europe to contract the ebola virus, health authorities were working to close the net around people with whom the 40-year-old woman could have come into contact.
The nurse’s assistant, who was part of the health team who looked after two Spanish missionaries with ebola who had been brought back from Africa for treatment in Madrid, was initially treated in Alcorcón Hospital in the southwestern suburb of the same name. The hospital has so far identified 21 members of staff with whom the patient came into contact, including an ambulance crew and doctors and nurses, according to health sources contacted by EL PAÍS.
All of them have been contacted by the health center and told they will have to be monitored for symptoms of the disease. They will have their temperature checked twice a day, but can continue with their normal day-to-day lives, given that the virus is not contagious until symptoms, which include fever, appear.
And a video report from Deutsche Welle:
Madrid hospital staff want answers
Medical staff at the Madrid hospital where a nurse contracted ebola, are angry. They want to know how the woman could have become infected, despite safety measures. The nurse had treated two priests who caught the virus in West Africa.
Questions from the Los Angeles Times:
Questions raised about safety measures used for Ebola cases in Spain
Questions were raised Tuesday about the quality of the protective equipment and training received by Spanish medical personnel caring for Ebola patients as three more people were placed in quarantine for possible exposure to the virus.
Spain’s Health Ministry announced Monday that a nursing assistant at the Carlos III Hospital in Madrid had tested positive for the virus, the first person known to have contracted Ebola outside Africa in the current epidemic.
Healthcare workers have been among those hardest hit in the outbreak, which has killed more than 3,400 of the nearly 7,500 suspected and confirmed Ebola patients in West Africa. As of Oct. 1, 382 healthcare workers were reported to have developed Ebola, including 216 people who died of the disease.
The case in Spain was a reminder that medical personnel can be at risk in Western hospitals, as well as at under-resourced and overwhelmed African facilities. The Ebola virus is spread through contact with the bodily fluids of symptomatic patients.
The patient had helped care for Manuel Garcia Viejo, a 69-year-old missionary in Sierra Leone who died of Ebola on Sept. 25 after being evacuated to Spain for treatment. She entered the priest’s room twice, once to help care for him and once to collect his belongings after he died, hospital officials said.
And the Guardian covers the seemingly inevitable:
Ebola in Europe is unavoidable, says WHO as Spain rushes to contain case
- WHO’s European director says continent remains at low risk and one of the best prepared places to respond to the infection
The World Health Organisation has said it is ready to provide support for Spain as authorities in the country scrambled to contain the first case of Ebola infection within Europe.
The WHO’s European director, Zsuzsanna Jakab, said it was “quite unavoidable … that such incidents will happen in the future because of the extensive travel from Europe to the affected countries and the other way around”.
She added: “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 haemorrhagic fevers including Ebola.”
But the New York Times covers another angle:
Spain Is Pressed for Answers After a Nurse Is Infected With Ebola
Spain’s government came under heavy criticism Tuesday as it dealt with the repercussions of Western Europe’s first Ebola case, quarantining three more people and monitoring dozens who had come into contact with an infected nurse.
Health care workers, who have been sparring with the government over cutbacks, said they had not received proper training or equipment to handle an Ebola case. The European Commission, the executive arm of the European Union, asked for an explanation, according to news reports. And some opposition politicians called for the health minister, Ana Mato, to resign.
At a news conference in Madrid, officials insisted that they had taken all appropriate measures to prevent the spread of the virus. But in a sign of the government’s unease with the possible political consequences, a lower-ranking official, María Mercedes Vinuesa, director of public health, went before Parliament on Tuesday to answer questions, not Ms. Mato.
While the Guardian suggests a partial explanation:
Spanish nurse Ebola infection blamed on substandard gear and protocol lapse
- Staff at Madrid’s Carlos III hospital say protective suits do not meet WHO standards as second nurse undergoes tests for virus
Staff at the hospital where she worked told El País that the protective suits they were given did not meet World Health Organisation (WHO) standards, which specify that suits must be impermeable and include breathing apparatus. Staff also pointed to latex gloves secured with adhesive tape as an example of how the suits were not impermeable and noted that they did not have their own breathing equipment.
The nurse was part of a team attending to missionary Manuel García Viejo, 69, who died four days after being brought to Carlos III hospital on 20 September. The same team, including the nurse, also treated missionary Miguel Pajares, 75, who was repatriated from Liberia in August and died five days later.
Staff at the hospital said waste from the rooms of both patients was carried out in the same elevator used by all personnel and, in the case of the second patient, the hospital was not evacuated.
And the Associated Press covers collateral canine damage:
Ebola escapes Europe’s defenses; pet dog must die
Health officials scrambled Tuesday to figure out how West Africa’s Ebola outbreak got past Europe’s defenses, quarantining four people at a Madrid hospital where a Spanish nursing assistant became infected. Determined to contain the spread of the deadly virus, they even announced plans to euthanize the woman’s pet dog.
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 hospitalized as a precaution.
Madrid’s regional government even got a court order to euthanize and incinerate their pet, “Excalibur,” against the couple’s objections. The government said available scientific knowledge suggests a risk that the mixed-breed dog could transmit the virus to humans, and promised to use “biosecurity” measures to prevent any such transmission.
On to an anxious Old Blighty, first with BBC News:
No Ebola screening for arrivals to UK – Public Health England
There are no plans to introduce Ebola screening for those arriving in the UK, Public Health England (PHE) has said.
President Barack Obama said on Monday that the US planned to screen incoming air passengers for the virus.
But PHE said this was not recommended by the World Health Organization and would mean screening “huge numbers of low-risk people”.
A contrarian view from the Independent:
Ebola outbreak: Britain needs to start screening for the virus, says Home Office minister
A Home Office minister has said Britain should consider introducing screening for Ebola carriers arriving at airports, after a Spanish nurse became the first person to have caught the virus in Europe.
Public Health England said it had no plans to bring in screening for the disease, which has already claimed 3,400 lives in West Africa. Rates of infection are set to increase dramatically.
The Home Office also insisted there would be no change of policy. But Norman Baker, a Liberal Democrat minister in the department, described Ebola’s arrival in Europe as a “very concerning development” and said the case for increasing screening in airports had to be examined. He told The Independent: “We need to consider whether existing controls are adequate.”
And the London Telegraph covers preparations:
Ebola: NHS hospitals put on standby
- Hospitals on standby as health officials admit ‘real risk’ Ebola could reach British shores and Prime Minister convenes emergency Cobra committee to discuss the threat
Major NHS hospitals across the country have been put on standby, as health officials warn of a “real risk” that the deadly Ebola virus could spread to Britain.
The Prime Minister will convene a meeting of the Government’s Cobra emergency committee on Wednesday morning to discuss the growing threat to the UK from the spread of Ebola.
Four major NHS hospitals in England have now been identified as units to take patients with Ebola if the need arises.
Next, on to Norway and other European evacuated via TheLocal.no:
Ebola virus victim arrives in Norway by special jet
The Norwegian woman, diagnosed with Ebola while working for a charity organization in Sierra Leone, will arrive in Oslo for treatment on Tuesday.
The woman, who was working for Médecins Sans Frontières, fell ill at the weekend and was placed in isolation on Sunday. On Monday she was confirmed as having contracted Ebola and is scheduled to be flown into the country on a specially constructed private jet plane. The craft, normally used for business flights, is equipped to provide medical care for the patient and ensure the airborne virus is not spread beyond the infected invidual.
Secretary general for Médecins Sans Frontières, Anne Cecilie Kaltenborn, said at a press conference in Sierra Leone on Monday: “We regrettably confirm that one of our Norwegian field workers tested positively for Ebola. The person was on a mission in Sierra Leone, where Médecins Sans Frontières has 1,200 employees. 86 of those are international aid workers.”
TheLocal.no, with a choice certain to star ethical debate:
Norway to get world’s last dose of Ebola cure
The Norwegian woman, infected by the Ebola in Sierra Leone and currently receiving treatment in Oslo, will get the last dose of the virus treatment medicine ZMapp available in the world.
The news was released by the Norwegian Medicines Agency on Tuesday, according to NTB. Steinar Madsen, medical director of the Norwegian Medicines Agency, said to Dagens Medisin: “It looks like we could get the last available dose of ZMapp to Norway. The medicine is now in Canada.”
According to the professional medic’s magazine, the agency has given Oslo University hospital the authorisation to import Ebola medicines not approved of in Norway.
On to Japan and confidence from the Japan Times:
Japan could handle Ebola outbreak, health official says
The news that a nurse in Spain has become the first person to contract Ebola outside the outbreak zone in West Africa has raised concerns that it might happen in Japan.
However, the nation has a system in place that could handle potential patients safely, a senior official at the National Institute of Infectious Diseases said Tuesday.
Although Japan has not yet had to deal with an actual case of infection and therefore lacks Ebola-specific procedures to diagnose and treat it, Masayuki Saijo, head of one of the institute’s virology departments, said his team has handled suspected cases that turned out to be negative.
While the Wall Street Journal covers the Japanese corporate upside:
Fujifilm Drug Gets More Notice as Possible Ebola Treatment
An anti-influenza drug from Japan’s Fujifilm Holdings Corp. has gathered international attention as a potential treatment for Ebola virus, helping send the company’s shares to a six-year high on Tuesday.
The Japanese camera and imaging company said Monday the governments of France and the West African nation of Guinea were considering trials of the drug, called favipiravir, beginning in November.
The company said it has also been contacted by several other nations and international organizations about providing the drug and will respond to the requests in coordination with the Japanese government.
After the jump, the latest from Africa, including a shortage of sanitation and engineering help in the Ebola fight, a plea for help, the Pentagon sets a price on its African Ebola effort and announces that U.S. soldiers will — contrary to earlier denials — be in immediate contact with Ebola patients [plus a video of the full Pentagon briefing], fears that Ebola angst will trump even deadlier healthcare woes, British Airways blasted for hampering aid flights, on to Sierra Leone and aid shipment Bureaucratic gridlock, a presidential plea for help from Ebola survivors, and epidemic-devastated villages, then on to Liberia and arriving Cuban medical teams, a strike threatened, and a press crackdown underway, and lastly, on to Nigeria and Ebola-spawned school closures ended. . . Continue reading