Health and Wellness : EBOLA OUT BREAK SPREADS!

Discussion in 'Black Health and Wellness' started by Kemetstry, Mar 29, 2014.

  1. Kemetstry

    Kemetstry going above and beyond PREMIUM MEMBER

    Country:
    United States
    Joined:
    Feb 19, 2001
    Messages:
    22,425
    Likes Received:
    5,277
    Gender:
    Male
    Occupation:
    Chemist
    Location:
    Detroit
    Ratings:
    +6,288
    Ebola’s reign of terror: since outbreak a year ago virus has killed over 7,500

    Lucy Lamble
    It is now a year since the outbreak of Ebola in Guinea, after a toddler in the rural south-east came into contact with a fruit bat. By March, the virus had spread across the border to Liberia and it reached Sierra Leone in May.
    More people have died in this outbreak – 7,588 as of 24 December, according to the World Health Organisation – than in all known occurrences combined.
    Medical professionals were particularly affected due to the nature of their work, further weakening already fragile healthcare in these countries. The social and economic impact of the outbreak is hard to overestimate. In September Unicef assessed that at least 3,700 children in Guinea, Liberia and Sierra Leone had lost one or both parents to Ebola.
    The outbreak was reported in March when hospital staff alerted Guinea’s Ministry of Health to a mysterious disease with a high death rate and symptoms including fever, diarrhoea and vomiting. By June, Médecins sans Frontières (MSF), who were at the forefront of efforts to tackle Ebola, described the outbreak as “out of control”.
    A civil servant Patrick Sawyer, travelled by air from Monrovia to Lagos on 20 July, triggering a series of cases in southern Nigeria. He died in hospital five days later. Nineteen people were infected: seven died. At one point about 200 were under surveillance. Senegal successfully contained its sole case, reported in August.
    As frustration grew over the slow response, calls for funding and especially medical staff increased. In September, Barack Obama called the epidemic “a potential threat to global security” and WHO’s emergency chief, Bruce Aylward, said the outbreak was “unparalleled in modern times”.
    In Europe, France, Italy, Germany, Spain, Norway and Switzerland have treated patients who contracted the virus in west Africa. In August a nurse, Will Pooley, the first Briton confirmed to have Ebola, recovered after treatment in London. He returned to work in Sierra Leone in October.
    Two priests with Ebola were repatriated to Spain and treated in Madrid. Both died. On 6 October, Spanish authorities said that a nurse, Teresa Romero Ramos, part of the team treating the Spanish missionaries, had tested positive for the disease. Ramos, the first known person to become infected outside west Africa, was confirmed free of Ebola on 21 October.
    In Dallas, Texas, on 30 September the first case diagnosed in the US was Thomas Duncan, who had travelled from Monrovia. A Liberian national, he was treated at the Texas Presbyterian hospital after initially being sent home, but died on 8 October.
    Nurses Nina Pham and Amber Joy Vinson, who had cared for Duncan, tested positive. Both recovered and were discharged from centres in Maryland and Georgia in late October. That same month, a Nebraska hospital treated the US national Ashoka Mukpo, a cameraman who had been working for NBC in Liberia when he contracted the disease.
    In New York a doctor, Craig Spencer, who had returned from Guinea, where he had been working for MSF, was revealed to have contracted Ebola. He, too, recovered and was discharged on 11 November.
    The “inappropriate” quarantine imposed on Kaci Hickox, an American nurse, despite her testing negative for Ebola on returning to the US after working in Sierra Leone, was eventually lifted as the governors of New York and New Jersey scaled back plans to forcibly isolate medics who had come into contact with the virus.
    A two-year-old girl died from Ebola on 24 October in Kayes, in the west of Mali, after travelling from Guinea. This case was contained but in November, in an unrelated case cluster in Mali’s capital, Bamako, a nurse and a doctor died. Both had treated an Islamic preacher from Guinea who was initially diagnosed with a kidney problem and later died. According to the US Centers for Disease Control and Prevention, six Malians have now died from Ebola.
    The WHO set a 60-day goal for tackling Ebola – to isolate and treat 70% of those infected, and bury safely 70% of those who died, by 1 December. This target was met in Liberia and Guinea, but Sierra Leone did not reach the treatment figure, as cases are still rising in the west of the country.
    At the start of this month, a Cuban doctor, Felix Baez, who contracted Ebola in Sierra Leone, returned home after successful treatment in Switzerland, telling reporters in Havana: “I will return there to finish what I started.”





    .
     
  2. Kemetstry

    Kemetstry going above and beyond PREMIUM MEMBER

    Country:
    United States
    Joined:
    Feb 19, 2001
    Messages:
    22,425
    Likes Received:
    5,277
    Gender:
    Male
    Occupation:
    Chemist
    Location:
    Detroit
    Ratings:
    +6,288
    Ebola’s lessons, painfully learned at great cost in dollars and human lives

    Lena H. Sun, Brady Dennis and Joel Achenbach
    [​IMG] © Provided by Washington Post
    A year after it began, the Ebola epidemic in West Africa continues to be unpredictable, forcing governments and aid groups to improvise strategies as they chase a virus that is unencumbered by borders or bureaucracy.
    The people fighting Ebola are coming up with lists of lessons learned — not only for the current battle, which has killed more than 7,500 people and is far from over, but also for future outbreaks of deadly contagions.
    Many of the lessons are surprising and specific — the color of body bags turns out to be important, as does the design of Ebola clinics. The most common-sense lesson is that all Ebola is local; solutions can’t be dictated from Geneva or New York.
    The broader and more ominous lesson is that global health organizations aren’t ready for a pandemic. There are countless conferences, reports and carefully wrought strategies for stopping epidemics, but this terrible year has demonstrated how hard it is to get resources — even something as simple as bars of soap and buckets of bleach — to vulnerable people on the front line of an explosive disease outbreak.
    Man vs. microbe is certain to be a recurring narrative in the 21st century. It’s a natural consequence of a burgeoning human population. Our vulnerability to new pathogens will not be easily fixed.
    LESSON: Rely on the local leadership
    When Peggy Chilcott looks back on the great Ebola outbreak of 2014, she will picture herself in a remote village in West Africa where the inhabitants feared that outsiders had come to poison them.
    Chilcott, 34, a doctor with the charity group Samaritan’s Purse, traveled from Spokane, Wash., to Liberia in November. One day she and two colleagues made a journey by helicopter to a remote village in Gbarpolu County, north of Monrovia. Two people there had tested positive for Ebola.
    The villagers were skeptical of the outsiders and their medicines, which included malaria pills. Go away, one man said, “and take your poison with you.” Chilcott tried to reassure them by swallowing pills as they watched.
    But the mood became increasingly hostile. Alarmed, Chilcott sent an emergency satellite signal for the helicopter to return. It arrived in 21 minutes and swooped everyone away before they had even buckled their seat belts.
    That wasn’t the end of the story, however. A regional chief intervened. He vouched for the integrity of the foreign health workers and pleaded for them to return to help people survive the deadly contagion. The village also exiled a local troublemaker.
    With the level of trust higher, Chilcott, her colleagues and other aid workers trekked back through the rain forest to the village and this time were greeted with smiles and clapping.
    Countless variations of this story have played out across West Africa.
    “You can’t just blast into a place and expect people to drop everything and do what you tell them to do,” says David Nabarro, the U.N. special envoy on Ebola. “They have to be utterly convinced your motives are good. They have to be able to share their view with you.”
    Archie C. Gbessay, a Liberian who is coordinator of the Active Case Finders and Awareness Team in Monrovia, said recently that if foreign intervention and billions of dollars in contributions were all it took to stop the disease, “we should already be celebrating the eradication of Ebola from my country.”
    This same lesson was hammered home by Monique Nagelkerke, who recently wrapped up two months as the head of mission in Sierra Leone for Doctors Without Borders.
    “It’s the experts that get interviewed, but it’s people from the region themselves that come to work day after day,” Nagelkerke said. “They are the real heroes.”
    LESSON: Be sensitive to peoples’ cultures
    Julienne Anoko, an anthropologist working on the Ebola response in Guinea, faced a situation involving a pregnant woman who had died of Ebola with her dead baby inside her. Tribal custom required that the baby be removed from the womb and buried separately. The doctors forbade the baby’s removal, saying such surgery could spread the disease.
    Anoko had to find a way to satisfy the family and the medical establishment. She tracked down an 80-year-old ritualist. He put together a culturally acceptable set of rituals that included the sacrifice of a goat and prayers to appease the ancestors.
    The people suffering through this epidemic, Anoko said, “have something to say, and it’s important to listen to them first, instead of building solutions elsewhere and saying to the community, ‘We know your problem; this is the solution.’ ”
    LESSON: Simple changes can yield significant results
    Many lessons were learned on the fly, in crisis mode, and they amounted to slight adjustments in tactics based on feedback from locals. For example, Western aid workers initially used black body bags for burials in Liberia. But white is a traditional color of mourning, especially for Muslims, and Liberians balked. Simple fix: Officials ordered white body bags.
    Another simple innovation involved the design of Ebola treatment units.
    “By the end of July, no one had ever heard of an Ebola treatment unit, and at the same time there was a requirement to move fast, at scale, and mount a response that could intercept this crazy, increasing infection rate,” said Nancy Lindborg, a top official at the U.S. Agency for International Development.
    Family members didn’t want to send loved ones to the centers, afraid they might never see them again. They had seen too many people simply vanish. Officials came up with an innovation: transparency. They replaced walls with fences and added windows, which improved air circulation and offered a glimpse inside.
    “Make it look less like Guantanamo Bay and make it more of a patient-friendly kind of environment,” Nagelkerke said.
    LESSON: Speed and agility matter more than size
    Ebola has repeatedly outfoxed and outraced global responders.
    The United States developed a plan in late summer for a massive intervention in Liberia, centered on the construction of up to 17 large Ebola treatment units — but then the infection rate began dropping rapidly.
    The result is that Americans are, at great cost, finishing ETUs that have many beds but few patients. These are temporary structures that can’t be used for other purposes and, when the epidemic is over, will probably be burned to the ground.
    Meanwhile, Sierra Leone has surpassed Liberia as the country with the highest infection rate. The global response has been divided up along colonial-era lines: Britain is focused on Sierra Leone and France on Guinea.
    The United States is starting to shift some resources to Sierra Leone, deploying additional personnel under the auspices of USAID, sending two Defense Department laboratories and talking to nongovernmental organizations and other global partners about dispatching more of their health-care workers, according to a senior administration official.
    “You can get a strategy and it becomes an immovable constraint,” Lindborg said. As the epidemic has evolved, she said, the United States has decided to shift to “a rapid-response strategy” aimed at smothering Ebola wherever it pops up. “You have to be adaptable to the course of the disease.”
    LESSON: We’re all connected — and unprepared for the consequences
    In an increasingly interconnected world, affluent countries have to be aware of — and care about — what’s happening in the poorest.
    “This is the poster child for why we should pay attention to fragile states,” Lindborg said. “This is a wake-up call. Thank God it was Ebola and not something airborne.”
    Ken Isaacs, head of Samaritan’s Purse, the North Carolina-based Christian missionary organization that has been working in West Africa, argues that the global community cannot merely rely on the World Health Organization, which has a decentralized management structure and got caught flat-footed by Ebola. He would like to see a new structure formed, one with political leverage, laboratory research capabilities and a global reach.
    Experts have warned for years that all countries need to do more to improve their ability to detect and curb outbreaks. Multiple initiatives on that front have had mixed results.
    In February, in the middle of a Washington snowstorm, the White House launched the Global Health Security Agenda. The United States has pledged to help 30 countries bolster their capacity to deal with biological threats of any kind, from natural epidemics to bioterrorism. Vulnerable countries should also take several steps to protect themselves, such as identifying and tracking the most prevalent deadly pathogens and being able to activate an emergency operations center within hours of an outbreak.
    In the current epidemic, countries in West Africa were slow to create a functional “incident command” structure, one in which officials were empowered to make decisions quickly.
    Money for the Global Health Security Agenda is materializing: Congress just approved over $5 billion in emergency Ebola funding, more than $800 million of which will go to efforts to stop future epidemics.
    LESSON: An ounce of prevention
    The year of Ebola showed that it is a lot cheaper and easier to stop a viral outbreak early, before it metastasizes into a full-blown epidemic. But that common-sense notion collides with another one: Watching out for emerging diseases and other proactive efforts aren’t terribly glamorous.
    The epidemic that didn’t happen is like the nuclear power plant that didn’t have a meltdown — desirable, but not headline-grabbing. That can make such efforts a tough sell, politically.
    Ebola surveillance and research is now getting abundant funding, but Ebola isn’t necessarily the most dangerous pathogen that humanity could face in the near future.
    “We’re always chasing what just happened,” said Jonna Mazet, a professor of epidemiology and disease ecology at the University of California at Davis and the director of the Predict project, a disease-surveillance program funded largely by USAID and operating in 20 countries.
    The project Mazet oversees has set up dozens of labs in the developing world. It has tested thousands of animals — bats, rats and monkeys among them — and identified about 800 previously unknown viruses.
    “If we don’t start getting ahead of the curve on pandemics, we’re sitting here like victims waiting for the next one,” said Peter Daszak, a well-known disease ecologist who works on the same project.
    In an office 17 floors above West 34th Street in Manhattan, analysts working for Daszak pour data into complex mathematical models, trying to decipher the most likely places an epidemic might surface next. The data behind those “heat maps” come from intense detective work around the globe, from Thailand and Tanzania to Bolivia and Bangladesh.
    In Vietnam, for example, researchers affiliated with Oxford University head out almost daily to slaughterhouses and animal farms. They visit open-air markets teeming with ducks, porcupines, bamboo rats and other animals to understand what viruses and bacteria the animals harbor and to watch closely for the moment any of them might infect humans.
    This kind of work is more crucial than ever, said Mark Woolhouse, a professor of infectious disease epidemiology at the University of Edinburgh in Scotland.
    “The early 21st century is about as good as it gets for emerging viruses and pathogens,” he said. “Changes in trade, travel and population — it’s a perfect storm for viral emergence.”
    LESSON: Keep fear in check
    When Tom Frieden, director of the Centers for Disease Control and Prevention, visited Liberia in August, he went to a crematorium that operated day and night as the bodies of Ebola victims were immolated.
    Soon afterward, he developed a nosebleed. “To have blood spurting out of your nose in the middle of an Ebola outbreak is a little bit anxiety producing,” he recalled.
    Rationally, he knew he didn’t have Ebola. He figured the nosebleed was caused by the dryness from his recent flight. His main concern was that people would think he had Ebola. But even the CDC director wrestled with nagging doubts about his health.
    “You worry about every symptom, like a sore throat,” he said, “even if you had no chance of being infected.”
    One of his deputies, Jordan Tappero, spent five weeks in Liberia in late summer and had a bout of travelers’ diarrhea. “Stuff goes through your head when you’re getting up in the middle of the night,” Tappero said. “I was always able to talk myself off the ledge.”
    These anxieties were minor compared with the national hysteria that accompanied the Ebola epidemic when it crossed the Atlantic. More than one school system shut down over a worry that the parent of a student possibly had contact with an Ebola victim. A controversy broke out over whether returning humanitarian volunteers should be quarantined for weeks. Scientists who had been to West Africa were disinvited to a medical conference.
    In mid-October, a U.S. Coast Guard helicopter and plane were dispatched to a cruise ship off the coast of Mexico to obtain blood samples from a passenger on vacation. She had, 19 days earlier, been working in a lab at a Dallas hospital and possibly had come in contact with a sealed vial of blood belonging to Thomas Eric Duncan, a Liberian who became the first person to die of the disease in the United States. She had no symptoms.
    The plane flew her sample to Austin, where lab technicians confirmed what doctors already knew: She did not have Ebola. The Coast Guard spent $86,256 to retrieve and deliver the blood, an agency spokesman said.
    This eruption of alarmism came despite repeated assurances from experts that Ebola is not very contagious, as viral diseases go. The only two people who caught Ebola in the United States were nurses caring for Duncan.
    But Frieden acknowledges a basic mistake in his communication efforts. In a Sept. 30 news conference after it was confirmed that Duncan had Ebola, Frieden assured the public that the virus wouldn’t spread here. “I have no doubt that we will stop it in its tracks in the U.S.,” he said.
    Then the two nurses got sick.
    Frieden’s words, on their face, were correct: Ebola did not “go viral” in the United States. But his confident language implied an element of certainty that is hard to back up during an evolving public-health emergency.
    “Clearly I did not convey adequately the degree it was going to be hard” to stop the virus, Frieden recently told The Washington Post, “and that we would be adjusting and learning.”



    .
     
  3. Kemetstry

    Kemetstry going above and beyond PREMIUM MEMBER

    Country:
    United States
    Joined:
    Feb 19, 2001
    Messages:
    22,425
    Likes Received:
    5,277
    Gender:
    Male
    Occupation:
    Chemist
    Location:
    Detroit
    Ratings:
    +6,288
    CDC now puts death toll at 20k.

    Disease may now pass to unborn






    .
     
  4. Kemetstry

    Kemetstry going above and beyond PREMIUM MEMBER

    Country:
    United States
    Joined:
    Feb 19, 2001
    Messages:
    22,425
    Likes Received:
    5,277
    Gender:
    Male
    Occupation:
    Chemist
    Location:
    Detroit
    Ratings:
    +6,288
    Mali says it is free from Ebola

    [​IMG] © AP Health workers in Mali
    Mali's health minister says the country is now free of the Ebola virus, after 42 days without a new case of the disease.
    "I declare this day... the end of the epidemic of the Ebola virus in Mali," said Ousmane Kone.
    The last Ebola-infected patient in Mali recovered and left hospital in early December.
    Latest figures show the three West African countries worst affected have all seen a decline in new Ebola cases.
    Sierra Leone and Guinea both recorded the lowest weekly total of confirmed Ebola cases since August, according to UN figures on Thursday.
    Liberia, which reported no new cases on two days last week, had its lowest weekly total since June.
    The overall death toll has reached 8,429 with 21,296 cases so far.
    Mali recorded its first case of Ebola in October, when a two-year-old from Guinea fell ill and died.
    At its worst, there were 300 contact cases under investigation in the country.
    But the country has now "come out" of the epidemic, said Ibrahima Soce Fall, the head of the Malian office of the United Nations Mission for Ebola Emergency Response (UMEER).
    Ebola virus disease (EVD)
    Symptoms include high fever, bleeding and central nervous system damage
    Spread by body fluids, such as blood and saliva
    Fatality rate can reach 90% - but current outbreak has mortality rate of about 70%
    Incubation period is two to 21 days
    There is no proven vaccine or cure
    Supportive care such as rehydrating patients who have diarrhoea and vomiting can help recovery
    Fruit bats, a delicacy for some West Africans, are considered to be virus's natural host
    Ebola basics: What you need to know




    .
     
  5. Kemetstry

    Kemetstry going above and beyond PREMIUM MEMBER

    Country:
    United States
    Joined:
    Feb 19, 2001
    Messages:
    22,425
    Likes Received:
    5,277
    Gender:
    Male
    Occupation:
    Chemist
    Location:
    Detroit
    Ratings:
    +6,288
    U.S.-built Ebola centers in Liberia sit largely empty as epidemic subsides

    [​IMG] © The Washington Post
    TUBMANBURG, Liberia — Near the hillside shelter where dozens of men and women died of Ebola, a row of green U.S. military tents sit atop a vast expanse of imported gravel. The generators hum; chlorinated water churns in brand-new containers; surveillance cameras send a live feed to a large-screen television.
    There’s only one thing missing from this state-of-the-art Ebola treatment center: Ebola patients.
    The U.S. military sent about 3,000 troops to West Africa to build centers like this one in recent months. They were intended as a crucial safeguard against an epidemic that flared in unpredictable, deadly waves. But as the outbreak fades in Liberia, it has become clear that the disease had already drastically subsided before the first American centers were completed. Several of the U.S.-built units haven’t seen a single patient infected with Ebola.
    It now appears that the alarming epidemiological predictions that in large part prompted the U.S. aid effort here were far too bleak. Although future flare-ups of the disease are possible, the near-empty Ebola centers tell the story of an aggressive American military and civilian response that occurred too late to help the bulk of the more than 8,300 Liberians who became infected. Last week, even as international aid organizations built yet more Ebola centers, there was an average of less than one new case reported in Liberia per day.
    “If they had been built when we needed them, it wouldn’t have been too much,” said Moses Massaquoi, the Liberian government’s chairman for Ebola case management. “But they were too late.”
    It was impossible to predict the decline in the Ebola caseload last September, when the U.S. Centers for Disease Control and Prevention suggested a worst-case scenario of 1.4 million victims in West Africa. At that point, the American military’s logistical and engineering prowess appeared to be urgently needed — even if critics said the assistance was slow to arrive.
    “With that kind of dire prediction from the CDC, and not having seen anything like this before, we had to try everything at our disposal,” said Douglas Mercado, the top USAID official in Liberia.
    [​IMG] © John Moore/Getty Images Workers unload medical supplies to fight the Ebola epidemic from a USAID cargo flight on August 24, 2014 in Harbel, Liberia.
    U.S. officials reject the suggestion that resources were misallocated.
    “A lot of people are evaluating the strategy based on what we know today, not what we knew at the time,” said Maj. Gen. Gary Volesky, the top U.S. military officer in Liberia.
    Before the center opened in Tubmanburg on Nov. 18, there were about 200 suspected or confirmed Ebola victims in the town, many of whom died while awaiting treatment. Since the U.S. facility opened, 46 suspected or confirmed cases have been admitted.
    In Monrovia, 45 miles away and the heart of the outbreak, the scenes of suffering Ebola patients shocked the world. At the height of the epidemic, the afflicted writhed in the streets. There was a shortage of bed space at treatment centers for months. The international community, led by the United States, responded with a massive construction and assistance campaign — including American engineers, Cuban doctors, African Union health workers and many others — that turned out to be far in excess of what was necessary.
    There are now seven Ebola treatment centers in greater Monrovia. Most of them were completed after the epidemic began to abate. Surplus tents now store excess supplies: mattresses, food and medicine for patients who never arrived. There are so few patients and so many available beds that a USAID-funded Ebola center, opened in October, will soon close its doors. Three other centers will be shuttered at least temporarily.
    Paradoxically, isolation centers are still being built, mostly by UNICEF.
    “It just makes no sense,” said Laurence Sailly, the head of mission for the Doctors Without Borders aid group in Liberia.
    Help arrives, belatedly
    Amelia Garbla remembers when she saw the first American aircraft land in Tubmanburg. It was late September, and she was a nurse at the local holding center — little more than plastic sheeting and dirty mattresses — where Ebola patients were dying constantly.
    “I was jumping up and down and waving. I was so happy,” she said.
    About two weeks earlier, on Sept. 16, President Obama announced that 3,000 U.S. troops would be dispatched to West Africa as part of a $750 million plan to fight Ebola.
    “We know that if we take the proper steps, we can save lives,” Obama said. “But we have to act fast.”
    The news of Obama’s plan had made it to Garbla’s makeshift treatment center, with its tiny shed for nurses to don their protective gear. The situation was desperate.
    “There was nothing we could do. The things we should have had, we didn’t have,” she said.
    Through September and October, Garbla was surrounded by the dead and the dying, including 14 of her colleagues — health-care workers from this small city who fought the disease with almost no outside help. She saw the American helicopters and the white men in uniform surveying the land. She watched as they unloaded equipment and construction materials.
    “We were praying for something to be built,” she said.
    But while the Americans were finishing the Tubmanburg Ebola center, their first in Liberia, the national caseload suddenly began to decline. By the time the treatment unit opened in November, the country was down to fewer than 100 cases per week, from a peak of more than 300. By December, the number had dropped to fewer than 30 cases per week.
    The reasons for the sudden plunge are still being debated. Was it that Liberians had changed their behavior to avoid contracting the disease? Had early increases in bed space at Ebola centers been enough to isolate those with the virus? Was there more effective use of contact tracers, who tracked down and isolated people exposed to the virus? Experts say it was probably all of those changes, though the inflection point of the epidemic will be studied for years by epidemiologists.
    “I don’t think you can point to one silver bullet that solved Ebola,” Volesky said. “My argument is it’s the whole strategy that’s showing us a positive trend.”
    On a scorching day in late October, the U.S. ambassador came to tour the nearly completed Tubmanburg center. Members of the Liberian army, who helped with construction, chanted as the dignitaries walked through the new tents.
    When the center began accepting patients on Nov. 20, Garbla and her colleagues were glad to have a modern, functional Ebola treatment unit, even if it appeared that the epidemic was fading. Now, if the cases spiked again, she and her colleagues would be ready.
    The U.S. plans for the Ebola centers have changed in some ways to reflect the new reality. In a number of cases, aid groups contracted to operate the centers have diverted their staff members to work in general hospitals that were ravaged by Ebola. Some training sessions intended for nurses and hygienists at the Ebola centers have been altered to cover a broader range of infection-control measures.
    As the disease continued to fade, U.S. officials had to decide whether to scrap their plans to build a total of 17 Ebola centers. In the end, they cut only two of the units. Their judgment appeared to be validated in December, when an isolated outbreak emerged in the county of Grand Cape Mount — where, luckily, a U.S.-built Ebola center had just been completed.
    “Even when it started going down, no one was declaring victory and saying we beat this thing,” Volesky said. “Because it only takes one person walking from Guinea into Lofa,” a county in Liberia.
    ‘We have to build it’
    Still, there’s no question that the need is less than anticipated. For its part, UNICEF has continued building Ebola isolation centers, even though many here argue that they serve no purpose anymore.
    “Halting construction now would cause much bigger problems for the community. They’ve agreed to them, they’ve supported them, and they’re employed there,” said Sheldon Yett, UNICEF’s country director.
    Another U.N.-led effort, to distribute thousands of home health-care kits, has ground to a halt, with most of the supplies sitting in unopened boxes across the country.
    To some of the Liberian doctors who have been fighting the disease almost since the beginning of the outbreak last spring, the continued push to construct Ebola centers makes little sense.
    Jerry Brown, a doctor who directs an Ebola center just outside Monrovia, used to attend the daily meetings where international aid groups, governments and U.N. agencies would discuss the collective response to the outbreak. He watched as the epidemic faded but the construction effort continued.
    “They said: ‘We have to build it. That’s what is written, and that is what we’ll do,’ ” he said.
    Out of frustration, Brown stopped attending the meetings in November.
    Another Liberian doctor, J. Soka Moses, worked at one of Monrovia’s most chaotic Ebola centers, JFK Hospital, during the worst days of the crisis. It was closed in October after some health-care workers contracted the disease. Moses was eventually reassigned to a large new Ebola center built by the World Food Program and USAID.
    “We are more prepared now that the outbreak is over,” he sighed. His new Ebola center, with a capacity of more than 200 beds, is now due to close.





    .
     
  6. Kemetstry

    Kemetstry going above and beyond PREMIUM MEMBER

    Country:
    United States
    Joined:
    Feb 19, 2001
    Messages:
    22,425
    Likes Received:
    5,277
    Gender:
    Male
    Occupation:
    Chemist
    Location:
    Detroit
    Ratings:
    +6,288
    Fast Track on Drug for Ebola Has Faltered

    ANDREW POLLACK
    [​IMG] © Gerry Broome/Associated Press Medicago, in North Carolina, is gearing up for possible production of the Ebola drug ZMapp using its plant-based technology.
    As Ebola raged through West Africa last summer, an experimental drug was tried for the first time on two American aid workers in Liberia who were gravely ill with the virus. Both recovered, one of them rapidly.
    Though it could not be said for sure that the drug, ZMapp, was responsible, patients and doctors began clamoring for it. But there was enough to treat only a handful of patients. Federal officials vowed to produce more.
    Six months later, very little has been produced, diminishing the chances that the drug can be used to treat large numbers of patients in the current outbreak, which appears to be ebbing.
    The delays show some gaps in preparedness and have frustrated biodefense and infectious disease experts.
    “I think it’s inexcusable that they haven’t moved on it,” said Dr. Philip K. Russell, a retired major general who once ran the United States Army Medical Research and Development Command. “They’ve had months.”
    Government officials announced on Thursday that a clinical trial to test whether ZMapp is effective would begin in Liberia, probably within three weeks. But that trial will involve at most 150 patients, the officials said.
    Efforts to procure more of the drug have run into snags, according to federal officials, researchers and biotechnology executives. The Department of Health and Human Services asked for proposals to produce more of it to be submitted by November, but so far, no contracts have been awarded.
    Facilities that Health and Human Services created, at a cost of hundreds of millions of dollars, expressly for rapidly manufacturing drugs or vaccines in a public health emergency are not being used to produce ZMapp yet. The same is true, with one exception, of facilities the Department of Defense invested in to build the capacity for rapid response.
    Thomas W. Geisbert, an Ebola expert at the University of Texas Medical Branch in Galveston, said ZMapp and another drug also in short supply, called TKM-Ebola, were the most promising potential treatments for Ebola based on their effectiveness in treating monkeys.
    “Make more of them. We know they work,” he said. “If I were exposed to the virus, those are the two things I would want.”
    The government is now working with two leading biotechnology companies, Genentech and Regeneron Pharmaceuticals, and reports rapid progress. Regeneron executives say that not only can they produce ZMapp, but they have also come up with drug candidates that might be even better.
    Federal officials defend their performance. “We feel with our partners that we’ve made significant progress in the Ebola crisis,” Robin Robinson, who is in charge of biodefense procurement for Health and Human Services, said in a news conference on Thursday.
    By government contracting standards, the effort might be moving at a lightning pace, just not fast enough for the epidemic. And problems unique to ZMapp have made it difficult to expect mass production. The drug is owned by a tiny company, Mapp Biopharmaceutical of San Diego, which has few resources of its own. ZMapp was in a very early stage of development when the outbreak began, and Mapp was not producing more because it had all it needed for early studies.
    ZMapp is a combination of three antibodies, which are immune system proteins that can home in on a virus and neutralize it. Partly because it had little money, Mapp chose to manufacture the antibodies in genetically modified tobacco plants. That seemed to be a less expensive way to get small quantities of the drug than the usual biotechnology industry method of producing antibodies in genetically engineered animal cells grown in stainless steel vats.
    But there are not many factories that can produce proteins in tobacco, limiting how much can be made now.
    A research arm of the Defense Department gave money several years ago to help set up facilities to produce vaccines rapidly in tobacco in the event of a pandemic. At least one of the centers passed a “live fire” test in 2012, producing 10 million doses of a flu vaccine in a month.
    But vaccines require a lot less material than antibodies. And after being formed, the tobacco production centers have had to drum up business to remain staffed and ready and have not always been able to do so.
    Production of ZMapp began in August at one of these facilities, Kentucky BioProcessing, which is now owned by Reynolds American, the cigarette company. That output is slated for the clinical trials beginning next month.
    The Biomedical Advanced Research and Development Authority, or Barda, which is the biodefense procurement agency in Health and Human Services run by Dr. Robinson, decided to seek additional production. It turned to three centers it had set up on its own to provide rapid production of drugs and vaccines in an emergency.
    Two of the centers, one run by Texas A&M University and the other by the biotech company Emergent Biosolutions, submitted proposals by the Nov. 10 deadline. The third, run by Novartis, which is getting out of the vaccine business, did not.
    But those centers had no experience manufacturing using tobacco. So they had to work with the tobacco facilities that the Defense Department had financed.
    Dr. Russell, the retired Army biodefense official, said Barda might have saved time by dealing directly with the tobacco companies but probably felt a need to justify its investment in its own centers. Others say dealing with centers it was already familiar with allowed Barda to move faster.
    Still, no contracts have been awarded. Some industry executives say Barda found the bids too high. While Emergent, Texas A&M and Barda say the proposals are still under evaluation, Barda is exploring alternatives.
    The initial plan was to have the other centers produce ZMapp using the same technology employed by Kentucky BioProcessing. But another tobacco facility, Caliber Biotherapeutics, could not reach an agreement with Kentucky BioProcessing on licensing the technology, said a federal official who spoke on the condition of anonymity because contract discussions are continuing. Moreover, this official said, Kentucky felt it could not devote manpower to helping Caliber when it was scrambling to produce ZMapp on its own.
    So Barda is now letting tobacco production companies use their own technology. Dr. Robinson said in the news conference that the agency might go through the Defense Department, which has standing contracts with these facilities, to procure the drug. One company gearing up for possible production is Medicago, which declined to comment.
    Barda is also working with Genentech and Regeneron to see if the antibodies can be manufactured in Chinese hamster ovary cells, or CHO cells, the biotechnology industry’s usual method. There is a lot of capacity available for such production.
    Regeneron executives said they had developed CHO cells that can produce the ZMapp antibodies. But they have also developed their own antibodies that the company says bind to the virus more tightly and have better pharmaceutical properties.
    Since both sets of antibodies are probably at least somewhat different from ZMapp, they will have to be first tested in monkeys. That will happen soon, but it will delay their possible use in people.
    Dr. Robinson of Barda said hundreds or thousands of treatment courses made in tobacco could be available by the end of the year. And thousands of doses made in CHO cells could be available by then. Barda’s rapid response centers could be enlisted to help manufacture using CHO cells, he said.
    But it is possible the outbreak will be over by then. In West Africa, trials have begun of other drugs that do not yet have the same results in monkeys as ZMapp but that would be available in large quantities should they prove effective.
    Dr. George D. Yancopoulos, chief scientific officer of Regeneron, said the crisis had pointed up shortcomings in biodefense. “Nobody is really prepared,” he said. “Nobody in the world has rapid response capabilities.”




    .
     
  7. Kemetstry

    Kemetstry going above and beyond PREMIUM MEMBER

    Country:
    United States
    Joined:
    Feb 19, 2001
    Messages:
    22,425
    Likes Received:
    5,277
    Gender:
    Male
    Occupation:
    Chemist
    Location:
    Detroit
    Ratings:
    +6,288
    Suspected Ebola patient admitted to California hospital

    By Sharon Bernstein
    [​IMG] © UC Davis Medical Center via Facebook UC Davis Medical Center in Sacramento, Calif.
    SACRAMENTO, Calif. (Reuters) - A patient suspected of being infected with Ebola was admitted on Thursday to a special isolation unit of a University of California hospital in Sacramento and was being tested for infection, hospital and public health officials said.
    The patient was transferred on Thursday morning to UC Davis Medical Center from Mercy General Hospital in Sacramento, the state capital, with "symptoms consistent with Ebola infection," the medical center said in a statement.
    The statement gave no further information about the case.
    Sacramento County Public Health Department spokeswoman Laura McCasland was quoted as telling the Sacramento Bee newspaper: "The patient is considered low-risk and more information is being gathered."
    Hospital spokeswoman Dorsey Griffith said the patient was being tested but she did not know whether the individual had traveled recently in West Africa, the epicenter of the worst Ebola epidemic on record.
    Griffith declined to specify the symptoms exhibited by the person but said they were serious enough "that the patient was admitted as a suspected Ebola patient." The individual was being treated in a special Ebola isolation unit set up at the hospital, she said.
    Dr. Gil Chavez, state epidemiologist for the California Department of Public Health, suggested the patient in question may have been in West Africa's Ebola zone.
    "Whenever there is a person displaying symptoms that may be Ebola, who has recently traveled to Sierra Leone, Liberia or Guinea, certain precautions are taken, including isolating the patient, ruling out other infectious diseases and testing for Ebola if warranted," he said.
    UC Davis Medical Center has been designated by state health officials as a priority hospital equipped to handle confirmed Ebola patients. The medical center remained open and was operating as normal, the hospital said.
    At least 10 people are known to have been treated for Ebola in the United States, four of whom were diagnosed with the deadly disease on U.S. soil, during an epidemic that has taken at least 8,800 lives, mostly in the West African countries of Liberia, Sierra Leone and Guinea.
    Only two people are known to have contracted the virus in the United States - two nurses who treated an Ebola patient from Liberia who became sick while visiting in Dallas. That man, Thomas Duncan, later died.
    Dozens of others tested for Ebola in the United States after showing possible signs of the disease or thought to have been exposed to the virus have turned out not to have been infected.
    (Reporting by Sharon Bernstein; Writing and additional reporting by Steve Gorman in Los Angeles; Editing by Sandra Maler, Peter Cooney and Bill Trott)
    (Reporting by Sharon Bernstein; Writing and Additional Reporting by Steve Gorman in Los Angeles; Editing by Sandra Maler)




    .
     
  8. Fine1952

    Fine1952 Happy Winter Solstice MEMBER

    Country:
    United States
    Joined:
    Sep 27, 2005
    Messages:
    7,576
    Likes Received:
    2,300
    Gender:
    Female
    Ratings:
    +2,989
    humph! so ebola is back after an extended holiday :lol:
     
    • Like Like x 1
    • Love It Love It x 1
    • List
  9. Kemetstry

    Kemetstry going above and beyond PREMIUM MEMBER

    Country:
    United States
    Joined:
    Feb 19, 2001
    Messages:
    22,425
    Likes Received:
    5,277
    Gender:
    Male
    Occupation:
    Chemist
    Location:
    Detroit
    Ratings:
    +6,288


    xmas break. :lol:





    .
     
  10. chuck

    chuck Well-Known Member MEMBER

    Country:
    United States
    Joined:
    Aug 9, 2003
    Messages:
    13,533
    Likes Received:
    2,132
    Gender:
    Male
    Ratings:
    +2,591
    Yes, I applaud you for the updates, but why have so many others gone awol, and now it's nearly February, too?!?

    SMH
     
Loading...