Ebola crisis: US says Cuban medical support 'welcome'

The disease has killed about 4,500 people so far, mostly in Liberia, Guinea and Sierra Leone

Cuba is a "welcome" addition to the fight against Ebola, a senior US official has said. 

A state department spokesman said the Cuban government was doing more than many others to contain the disease. "We welcome their support," she said.

The US has maintained an embargo on Cuba for more than five decades. Last month, Havana announced it would send about 450 medical and support staff to the region.

The BBC's Will Grant in Havana said that Cuba already had a tradition of sending its doctors and nurses to Africa before the recent Ebola outbreak.

Cuban officials are hosting a regional summit on the virus next week involving left-wing Latin American governments. Health ministers from Venezuela, Nicaragua, Bolivia and Ecuador are expected to attend to discuss how to bolster the region's response to the Ebola crisis.

So far the outbreak has killed about 4,500 people, mostly in Liberia, Guinea and Sierra Leone.

On Wednesday the head of a United Nations agency said a food crisis could soon hit the affected West African states.

Kanayo Nwanze, president of the UN's International Fund for Agriculture, said farmers in Sierra Leone, Guinea and Liberia had abandoned their crops because of fear of catching the disease.

The World Health Organization said on Thursday that a major Ebola outbreak in the West was unlikely.

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Ebola crisis: WHO says major outbreak in West 'unlikely'

A fast response team has now been set up to deal with Ebola cases in the US, as Alastair Leithead reports

A major outbreak of Ebola in the US and elsewhere in the West is unlikely given the strong health systems, the World Health Organization (WHO) says. 

US President Barack Obama also said the risk of Americans getting the virus was "extremely low", although he ordered a "much more aggressive response".

The US is investigating how a nurse infected when treating a victim in Texas was allowed to travel on a plane. Officials are trying to trace the 132 people who flew with Amber Vinson. The disease has killed about 4,500 people so far, mostly in Liberia, Guinea and Sierra Leone.

EU health ministers are meeting in Brussels to discuss the crisis, including increased screening of travellers and the possibility of sending more troops to West Africa to help contain the virus.

Meanwhile, US federal health officials will appear before a congressional committee on Thursday to answer questions about their handling of the crisis.

'Very low' 

Christopher Dye, WHO director of strategy, said the introduction of Ebola into the US or other countries in Western Europe was a matter "for very serious concern".

Amber Vinson was not supposed to travel on an aeroplane, health officials said

"The possibility that once an infection has been introduced that it spreads elsewhere, is something that everybody is going to be concerned about," he said.

 But he added: "We're confident that in North America and Western Europe where health systems are very strong, that we're unlikely to see a major outbreak in any of those places."

 Earlier, President Obama said the likelihood of a widespread Ebola outbreak was "very, very low".

New US Ebola control measures 

• A "site manager" will supervise how workers at the Texas Health Presbyterian Hospital put on and take off protective clothing 

•  Two nurses from Emory University Hospital in Atlanta will offer "enhanced training" in Dallas 

•  An immediate response team will travel to the site of any future Ebola diagnoses to hit the ground "within hours"

•  New guidelines for testing at hospitals throughout the US, with special emphasis on asking questions about travel history 

However, he promised a "much more aggressive" monitoring of Ebola cases in the US.

Britain, Canada and the US have introduced increased screening of travellers arriving at airports from West Africa.

France said on Wednesday that it would begin checks from Saturday on passengers arriving at Paris Charles de Gaulle airport from the Guinean capital, Conakry.

Nurse allowed to travel 

 US health officials are facing new questions about the response to Ebola infections in Texas.

Liberian Thomas Eric Duncan was treated at the Texas Health Presbyterian Hospital but died of the disease.

The disease has killed about 4,500 people so far, mostly in Liberia, Guinea and Sierra Leone

The UK's 22 Field Hospital prepares to fly out to Sierra Leone

Two nurses, Nina Pham and Amber Vinson, contracted Ebola after treating him.

Both wore face shields, hazardous materials suits and protective footwear as they drew blood and dealt with Mr Duncan's body fluids and it remains unclear how they were infected.

Ms Vinson later contacted the US Centers for Disease Control and Prevention (CDC) to inform it she was travelling on a plane on Monday - Frontier Airlines Flight 1143 from Cleveland to Dallas-Fort Worth.

She reported a temperature of 37.5C (99.5F).

CDC director Thomas Frieden said she should not have travelled on a commercial flight.

US media reaction 

• The New York Times says the appearance of the latest Ebola patient "provided more signs of concern about federal officials' ability to control the spread of the disease... and indications that the issue was becoming politicised" 

•  A report by USA Today says health officials now believe Ebola patients should be treated at four specially designed US clinics rather than at hospitals around the country 

•  Ebola is becoming "the next great American panic", writes Chico Harlan in the Washington Post 

•  The Christian Science Monitor looks at how much large donations, such as the $25m (£16m) given by Facebook chief executive Mark Zuckerberg and his wife, Priscilla Chan, can help fight the spread of the disease line 

However, another health official told the New York Times later that Ms Vinson was not prevented from flying because the temperature was mildly elevated and was in a category not covered by the CDC.

"I don't think we actually said she could fly, but they didn't tell her she couldn't fly," the official told the Times. "She called us... I really think this one is on us."

Officials are trying to trace all 132 passengers but insist that as Ms Vinson did not have a fever, the risk to "any around that individual on the plane would have been extremely low".

Farmers in Sierra Leone have deserted their land during the Ebola outbreak The BBC's Alastair Leithead on how to wear a bio-hazard suit Ms Vinson has now been transferred to Emory University hospital in Atlanta.

Mr Duncan, who was the first person to be diagnosed in the US with Ebola, started showing symptoms of the disease days after he arrived in Texas from Liberia.

Meanwhile, campaign group Avaaz said it had identified more than 2,000 international volunteers, including hundreds of doctors and nurses, who are willing to help fight the Ebola outbreak in West Africa.

The group said it would give the names to aid agencies working in the field but most are unlikely to arrive in the region in the near future because of the training needed before they can be deployed.

                        Ebola patients treated outside West Africa*

*In all but three cases the patient was infected with Ebola while in West Africa. Infection outside Africa has been restricted to health workers in Madrid and in Dallas. DR Congo has also reported a separate outbreak of an unrelated strain of Ebola.

How not to catch Ebola: 

• Avoid direct contact with sick patients as the virus is spread through contaminated body fluids 

•  Wear goggles to protect eyes

•  Clothing and clinical waste should be incinerated and any medical equipment that needs to be kept should be decontaminated 

People who recover from Ebola should abstain from sex or use condoms for three months

Protective Ebola suit

Surgical cap 

The cap forms part of a protective hood covering the head and neck. It offers medical workers an added layer of protection, ensuring that they cannot touch any part of their face whilst in the treatment centre.

Goggles 

Goggles, or eye visors, are used to provide cover to the eyes, protecting them from splashes. The goggles are sprayed with an anti-fogging solution before being worn.

Medical mask

Covers the mouth to protect from sprays of blood or body fluids from patients. When wearing a respirator, the medical worker must tear this outer mask to allow the respirator through.

Respirator 

A respirator is worn to protect the wearer from a patient's coughs. According to guidelines from the medical charity Medecins Sans Frontieres (MSF), the respirator should be put on second, right after donning the overalls.

Medical Scrubs

A surgical scrub suit, durable hospital clothing that absorbs liquid and is easily cleaned, is worn as a baselayer underneath the overalls. It is normally tucked into rubber boots to ensure no skin is exposed.

Overalls

The overalls are placed on top of the scrubs. These suits are similar to hazardous material (hazmat) suits worn in toxic environments. The team member supervising the process should check that the equipment is not damaged.

Double gloves

A minimum two sets of gloves are required, covering the suit cuff. When putting on the gloves, care must be taken to ensure that no skin is exposed and that they are worn in such a way that any fluid on the sleeve will run off the suit and glove. Medical workers must change gloves between patients, performing thorough hand hygiene before donning a new pair. Heavy duty gloves are used whenever workers need to handle infectious waste.

Apron 

A waterproof apron is placed on top of the overalls as a final layer of protective clothing.

Boots 

Ebola health workers typically wear rubber boots, with the scrubs tucked into the footwear. If boots are unavailable, workers must wear closed, puncture and fluid-resistant shoes.

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Ebola outbreak: How many people have died?

How many people have died from Ebola in West Africa? 

It sounds an easy question, but the answer is certainly not. The most recent official figure from the World Health Organization puts the number of deaths at 4,447.

But 12,000 could be a better estimate. Getting to this figure highlights a number of issues with the Ebola data.

How many cases? 

 First of all there is a fair bit of uncertainty about how many people have Ebola.

The ones we know about stand at 8,914 - this is made up of confirmed, suspected and probable cases.

A probable or suspected case is classified as confirmed when a sample from that person tests positive for Ebola virus in the laboratory.

Probable Any suspected case evaluated by a clinician OR any person who died from "suspected" Ebola and had an epidemiological link to a confirmed case but was not tested and did not have laboratory confirmation of the disease.

Suspected Any person, alive or dead, who has (or had) sudden onset of high fever and had contact with a suspected, probable or confirmed Ebola case, or a dead or sick animal. Or any person with sudden onset of high fever and at least three other Ebola symptoms.

However, Liberia, Sierra Leone and Guinea have some of the worst-funded healthcare systems in the world. We know people are contracting the disease, and dying from it, without being noticed.

Based on small trials, agencies including the WHO and the US Centers for Disease Control are taking an "educated guess" that the figure is around twice that. The widely reported estimate of 10,000 cases per week by December uses this doubling to account for under-reporting.

"We get that because 5,000 is the midpoint of our modelling scenarios and if we allow for under-reporting [by a factor of two] then that's 10,000," said Dr Christopher Dye, the director of strategy in the office of the director general at the WHO.

Use the same principle and the number of cases now could be around 18,000.

Ebola holding centre in Monrovia, Liberia

What is the death rate? 

Looking at the official figures again - 8,914 cases and 4,447 deaths - you might think that roughly half of patients die.

 "This is wrong," Dr Dye told me. The data is, quite frankly, a bit of a mess. Take the WHO Ebola response roadmap update on 10 October.

It has more confirmed deaths in Liberia from Ebola (1,072) than actual cases (943). This confusing set of figures comes about by collecting data on cases and deaths separately.

Also, comparing current cases and current deaths does not take account of people living with the disease for some time before either dying or recovering.

What you need is quality data and the best comes from a report in the New England Journal of Medicine. A team, including scientists at Imperial College London, looked at a sub-set of patients with full medical records from diagnosis through to either recovery or death.

Dr Dye told the BBC: "On the basis of this analysis, our best estimate is a 60-70% case fatality and it's sensible to use a range as there are variations from one place to another."

 Use the 70% figure on the 18,000 estimated cases and it seems around 12,000 are either dead or dying. Clearly that is not a definitive figure, but getting there shows how messy some of the data are.

And this is the same basic data being used to reach forecasts of 1.4 million cases by January or 10,000 new cases a week by December.

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Ebola treatments - how far off?

With the death toll rising and the disease still spreading, the race is on to find a treatment for Ebola. 

Experts already know lots about the virus and how it attacks, but fighting it with a drug is newer territory.

Since Ebola was first identified, in 1976, every outbreak has been contained with strict hygiene - isolation of patients and suspected patients, ensuring staff wore suitable protective clothing and carried out proper cleaning and disposal of clinical waste.

There have been no drugs to do the job because developing them is extremely expensive, and, until now, the major pharmaceutical companies have not seen enough of a market. That's changing.

Known target 

The virus can enter the body via infected droplets (blood, vomit, faeces) through broken skin or mucous membranes such as the eyes, the lining of the nose or the mouth.

Once inside, it rapidly multiplies in the blood, taking over and attacking cells.

The disease is not airborne like flu. Very close direct contact with an infected person is required for the virus to be passed to another person.

Infection may also occur through direct contact with contaminated bedding, clothing and surfaces.

All of this has been known for nearly 40 years, but only now is the world really gearing up to the threat.

Medical weapons

Scientists are focusing their efforts on two approaches:

• treatments to help people already infected with the virus vaccines to protect people from catching it in the first place There are lots of different experimental  

•  vaccines and drug treatments for Ebola under development, but they've not yet been fully tested for safety or effectiveness. 

Experimental drugs such as ZMapp have already been given to patients in the current outbreak, but they have not saved all patients.

Two US aid workers and a Briton recovered after taking it, but a Liberian doctor and a Spanish priest died.

The medicine has only previously been tested on animals, and experts say it is still unclear whether the drug boosts chances of recovery.

Stocks have been extremely limited, and the manufacturers of the drug say it will take months to increase production.

Blood transfusions from survivors are also being tried as a potential therapy. It's thought that this serum may contain particles that could neutralise the virus.

This buys the patient time - they would still need their own body to learn how to fight the virus for itself.

 Vaccines

The trial of the vaccine started in the US this month

The US, UK and Canada are testing different kinds of vaccine in controlled clinical trials. The aim is to have 20,000 doses that could be used in West Africa by early next year.

Normally it would take years of human trials before a completely new vaccine was approved for use. But such is the urgency of the Ebola outbreak that experimental vaccines are being fast-tracked at an astonishing rate.

Continue reading the main story “Start Quote Russia recently announced it is also developing three vaccines, with one being ready for clinical trials within three months.

David Heymann, professor of infectious disease epidemiology at the London School of Hygiene and Tropical Medicine, said: "There's been a lot of international attention to making sure that clinical trials of new vaccines and medicines are done.

"And my feeling is that if the resources continue those studies could possibly be begun and already provide some initial answers before Christmas." It's hoped these vaccines will offer protection by delivering a harmless agent that will teach the body how to mount an immune response against Ebola. If the person then came into contact with the real virus, their body should already know how to fight it.

Tests are ongoing, but there is no certainty how well they will work.

Dr Ben Neuman, an expert in virus and from the University of Reading, said: "Trials in monkeys have been promising. But they get a very different type of Ebola to humans. "In a person it's a different kind of disease and we don't know for sure if the same treatments will work.

"Plus we need to scale up the doses. People are a big, walking test tube essentially." Given the size of the outbreak, it's also unlikely that there will be enough vaccine or medicine to go round - at least initially.

Until these medicines to fight Ebola are ready, the focus has to be on disease control. It was basic techniques that beat previous outbreaks. The hope is they will do the same now.

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Ebola: Heathrow to start screening passengers

Heathrow airport

Heathrow airport is to start screening for Ebola among passengers flying into the UK from countries at risk.

The health secretary told MPs a "handful" of cases were expected to reach the UK before Christmas.

Screening will start at Terminal 1, before being extended to other terminals, Gatwick airport and Eurostar by the end of the week.

In September, about 1,000 people arrived in the UK from Ebola-affected countries in West Africa.

Meanwhile, reports say a UN worker infected with Ebola has died in a hospital in Germany.

Ebola is spreading across West Africa, but experts do not expect many cases in Europe

Symptoms of Ebola include fever, headache, vomiting, diarrhoea, bleeding - but these are similar to more common infections like flu and some stomach bugs.

If you have these symptoms and have had contact with an Ebola patient then ring 111 first, do not go directly to A&E or a GP.

If there has been no contact with Ebola then seek help from 111, your GP or A&E if necessary.

The chances of developing Ebola in the UK remain low.

Most passengers flying from Liberia, Sierra Leone and Guinea, where Ebola has killed more than 4,000 people, are screened before being allowed to board the plane.

Under the new UK screening measures, they will be identified by Border Force officers upon arrival. Nurses and consultants from Public Health England will then carry out the actual screening.

Passengers will have their temperatures taken, complete a risk questionnaire and have contact details recorded.

Anyone with suspected Ebola will be taken to hospital.

Passengers deemed to be at high risk due to contact with Ebola patients, but who are displaying no symptoms, will be contacted daily by Public Health England.

It is estimated that 85% of all arrivals to the UK from affected countries will come through Heathrow

There are no direct flights to the UK from Liberia, Sierra Leone or Guinea, which means people travelling from those countries would have to catch a connecting flight to the UK and could arrive at airports that are not screening passengers.

Instead "highly visible information" will be in place at all entry points to the UK. The Department of Health estimates that 85% of all arrivals to the UK from affected countries will come through Heathrow.

Simon Calder, the Independent's travel editor, has gone through the flight schedules between Africa and Europe and says a flight that left Liberia for Brussels on Monday night is the only one of interest.

"No-one knows what is happening behind the scenes," he said. "The most positive assumption is that the government has demanded details from the airlines of anyone transferring to the UK."

Three airlines are operating out of the three most-affected countries - Air France, Royal Air Maroc and Brussels Airlines - and there are only a handful of flights a week, he added.

'Low-risk people' 

Screening arrivals marks a rapid shift in policy from the UK government.

Last week, it said there were no plans for screening as people were tested before leaving affected countries.

Health Secretary Jeremy Hunt tells the Commons an Ebola case in the UK is "likely"

The WHO said it was unnecessary and that it would mean screening "huge numbers of low-risk people".

In the Commons on Monday, Health Secretary Jeremy Hunt said the UK needed to prepare for the situation deteriorating in West Africa.

He said: "[The chief medical officer] confirms that the public health risk in the UK remains low and measures currently in place, including exit screening in all three affected countries, offer the correct level of protection.

"However, whilst the response to global health emergencies should always be proportionate, she also advises the government to make preparations for a possible increase in the risk level."

 Mr Hunt added that tackling the outbreak in Africa was the "single most important way" of preventing Ebola arriving in the UK.

RFA Argus is moored in Falmouth, Cornwall, and is preparing to sail to Sierra Leone

The UK government has pledged £125m "to help contain, control, treat and defeat Ebola", hundreds of NHS staff have volunteered to travel to West Africa and 750 troops have been deployed to help build treatment centres and provide logistical support.

The UK's casualty vessel RFA Argus, which has a fully-equipped hospital, is expected to set sail for Sierra Leone later this week.

Isolation units 

There is no cure or vaccine for Ebola, which is transmitted through sweat, blood and saliva.

Anyone in the UK with suspected Ebola will be taken to hospital and blood samples will be taken to Public Health England's specialist laboratory for rapid testing.

If the test is positive, then the patient will be transferred to an isolation unit at the Royal Free Hospital in London. It is the centre that cared for the British nurse William Pooley, who contracted Ebola in West Africa.

The specialist isolation unit at London's Royal Free Hospital

Hospitals in Newcastle, Liverpool and Sheffield are on standby to offer similar facilities if there is a sudden surge in Ebola cases. A total of 26 isolation beds could be prepared at the four hospitals.

Shadow health secretary Andy Burnham told BBC Radio 5 live that introducing screening "was the right thing to do" based on advice from the chief medical officer.

He said there was a shortage of the experimental drug ZMapp, which has been used to treat Ebola patients, and more should be done to expand the manufacturing capacity.

Please what do you think we should do concerning this deadly virus called EBOLA? your comment is important to us please share your view and don't forget to like our facebook page we love you.

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Ebola outbreak: UN health worker dies in Germany hospital

The Ebola patient was being treated at St Georg hospital in Leipzig

A UN employee infected with Ebola has died at a hospital in Germany. 

 Doctors at the hospital in Leipzig said the man, 56, died despite receiving experimental drugs to treat the virus.

The outbreak has killed more than 4,000 people since March - mostly in Liberia, Sierra Leone, Guinea and Nigeria.

The World Health Organization described it as the "the most severe, acute health emergency seen in modern times". The US and UK are among countries to have introduced scanning at airports.

Elsewhere: 

• A unit of Sierra Leone's international peacekeeping force on standby for deployment in Somalia has been placed in quarantine after one member was confirmed with Ebola 

•  A Spanish nurse remains in critical condition after becoming the first person to contract the disease outside of Africa last week, although doctors say there are signs of improvemen.

  Ebola patients treated outside West Africa*

*In all cases but two, first in Madrid and later in Dallas, the patient was infected with Ebola while in West Africa.

How not to catch Ebola:

• Avoid direct contact with sick patients 

• Wear goggles to protect eyes 

• Clothing and clinical waste should be incinerated and any medical equipment that needs to be kept should be decontaminated 

• People who recover from Ebola should abstain from sex or use condoms for three months 

Temperature checks 

The man had been working as a UN medical official in Liberia - one of the worst affected countries - when he caught Ebola.

He arrived in Germany last Thursday for treatment and was put into a hermetically-sealed isolation ward which is accessed through airlock systems.

"Despite intensive medical measures and maximum efforts by the medical team, the 56-year-old UN employee succumbed to the serious infectious disease," a statement from St Georg hospital said.

He was the second member of the UN team in Liberia to die from the virus, the BBC's Jenny Hill in Berlin says.

The patient, who is yet to be identified, was reportedly Sudanese.

He was the third Ebola patient to be treated for the deadly virus in Germany after contracting the disease in the outbreak zone in West Africa.

One patient - a Ugandan doctor infected in Sierra Leone - is still receiving treatment in a hospital in Frankfurt, while a Senegalese aid worker was released from a hospital in Hamburg after five weeks of treatment.

Health workers are at high risk of contamination

Health workers are among those most at risk of catching the disease, with more than 90 killed by the virus in Liberia alone.

Many nurses and medical assistants there have ignored calls to strike over pay and working conditions.

The World Health Organisation (WHO) has warned the epidemic threatens the "very survival" of societies and could lead to failed states.

The UK has announced screening for passengers arriving at London's Heathrow airport from countries at risk.

People arriving from Liberia, Sierra Leone and Guinea will be questioned and may have their temperatures taken.

The US is already screening passengers at five of its major airports. Ebola deaths: Confirmed, probable and suspected

Ebola deaths: Confirmed, probable and suspected

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Ebola: Hospital mistakes blamed for US transmission

A US health chief has said a mistake was "clearly" made by hospital staff treating an Ebola victim in Texas, resulting in one member being infected. 

The US Centers for Disease Control and Prevention (CDC) has confirmed that a female health worker tested positive for the deadly virus in Dallas.

 CDC chief Dr Tom Frieden has promised a full inquiry into how the transmission could have occurred. He said 48 other people who may also have had contact were being observed.

The health worker at Texas Health Presbyterian Hospital is now on an isolation ward and is said to be in a stable condition.

She had been treating Ebola victim Thomas Eric Duncan, who caught the virus in his native Liberia and died on Wednesday.

The current Ebola outbreak, concentrated in Liberia, Guinea and Sierra Leone, has resulted in more than 8,300 confirmed and suspected cases, and at least 4,033 deaths.

In other developments

• The health authorities in Sierra Leone say they are now treating more Ebola patients in the capital Freetown than in the eastern districts of Kenema and Kailahun, where the first cases in the country were detected 

•  European health officials investigating how a nurse in Madrid caught Ebola told the BBC they believe it was simply the result of an accident and the risks to the wider population remain very low 

•  The UN special envoy on Ebola told the BBC the number of Ebola cases was currently increasing exponentially, but greater awareness would help contain the virus 

'Clearly a breach' 

Dr Frieden said a full investigation would be conducted into how the infection had occurred.

"Clearly there was a breach in protocol," he told US broadcaster CBS.

Rajini Vaidyanathan reports from Washington The CDC investigation, he told reporters, would focus on possible breaches made during two "high-risk procedures", dialysis and respiratory intubation.

The health worker who was infected has not been able to identify a specific breach of protocol that might have led to her being infected, he said.

Dr Daniel Varga, of the Texas Health Resource, said she had worn a gown, gloves, mask and shield when providing care to Duncan during his second and final hospital admission.

Dr Frieden said education and training of health workers would be stepped up and efforts would be made to reduce the number of staff treating Ebola cases.

Police are guarding the apartment complex where the woman lives in Dallas as decontamination work is carried out.

Officials have been knocking on doors, making automated phone calls and passing out fliers to notify people within a four-street radius about the situation, while seeking to reassure local people.

No details of her identity or position at the hospital have been given, in accordance with family wishes.

Duncan was admitted to Texas Health Presbyterian Hospital in Dallas

Police are guarding the home of the infected woman

A barrel labelled "biohazard" stands on a lawn outside the apartment complex of the infected health worker in Dallas

Staff at the Dallas hospital have been on alert for other cases after Thomas Duncan's death

US President Barack Obama discussed the Ebola response with Health and Human Services Secretary Sylvia Burwell by phone

Flight from Monrovia

Duncan tested positive in Dallas on 30 September, 10 days after arriving on a flight from Monrovia via Brussels.

He had become ill a few days after arriving in the US, and went to the hospital in Dallas with a high fever. But despite telling medical staff he had been in Liberia, he was sent home with painkillers and antibiotics.

Duncan was later put into an isolation unit at the hospital but died despite being given an experimental drug. Symptoms of Ebola include fever, headache, vomiting, diarrhoea and bleeding. The virus is spread through contact with bodily fluids.

Tulip Mazumdar describes the protective measures taken by journalists covering the Ebola crisis

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Ebola: Liberian health workers plan strike

Liberia has struggled to cope with Ebola cases in the country

Liberian health officials are appealing to nurses and medical assistants not to go ahead with a national strike, as the Ebola epidemic continues. 

The National Health Workers Association wants an increase in the monthly risk fee paid to those treating Ebola cases.

In the US, President Barack Obama has directed more steps to be taken to ensure high safety procedures when dealing with suspected Ebola patients.

A health worker treating an Ebola victim has herself caught the virus.

 Liberia's Assistant Health Minister Tolbert Nyenswah said a strike would have negative consequences on those suffering from Ebola and would adversely affect progress made so far in the fight against the disease.

The government says the scale of the epidemic means it now cannot afford the risk fee originally agreed. The risk fee is currently less than $500 a month, on top of basic salaries of between $200-$300.

Staff are now seeking a risk fee of $700 a month.

More than 4,000 people have died during the Ebola outbreak

The health workers also want personal protective equipment and insurance.

Ninety-five of their colleagues have so far died from Ebola. Liberia is one of the countries worst affected by the epidemic.

More than 4,000 people have so far died in the outbreak.

A new UN centre to co-ordinate the fight against the epidemic is being set up in Ghana. UN aid workers and logisticians are being flown in to Accra, the BBC's Mark Doyle reports.

Ghana itself has not so far seen any Ebola cases. Six months after the epidemic began in west Africa there are still only about a quarter of the treatment beds required to tackle it.

Food is now in short supply as markets are disrupted in some parts of the three countries worst affected: Liberia, Sierra Leone and Guinea.

In Liberia, elections have been postponed because the gathering of people at polling stations would endanger lives.

US inquiry 

Dr Tom Frieden, CDC: "At some point there was a breach in protocol" On Sunday evening, the US Centers for Disease Control and Prevention (CDC) confirmed that a female health worker had tested positive for Ebola in Dallas.

CDC chief Dr Tom Frieden has promised a full inquiry into how the transmission could have occurred.

The CDC investigation, he told reporters, would focus on possible breaches made during two "high-risk procedures", dialysis and respiratory intubation.

The health worker at Texas Health Presbyterian Hospital had been treating Ebola victim Thomas Eric Duncan, who caught the virus in his native Liberia and died on Wednesday.

She is now on an isolation ward and is said to be in a stable condition. Dr Frieden said 48 other people who may also have had contact with Duncan were being observed.

 Duncan tested positive in Dallas on 30 September, 10 days after arriving on a flight from Monrovia via Brussels.

He had become ill a few days after arriving in the US, and went to the hospital in Dallas with a high fever.

Symptoms of Ebola include fever, headache, vomiting, diarrhoea and bleeding. The virus is spread through contact with bodily fluids.

Duncan was admitted to Texas Health Presbyterian Hospital in Dallas

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17 Things You Didn’t Know About The Ebola Virus

It’s the worst Ebola virus outbreak in history. West Africa is in a state of panic and paranoia.

More than 2,473 people have been infected and 1,350 have died since the outbreak started more than four months ago. With up to a 90% fatality rate, the virus terrorizes residents of countries where breakouts occur, and terrifies the rest of us worried that it will spread. Preventing its spread is the primary goal of medical personnel.

Here are 17 things you didn’t know about the Ebola Virus, from its first cases in Central Africa, to the current red-alert situation, to treatment and containment methods, to hopeful signs for future prevention.

                                                                        Biology

Ebola is categorized as a member of the filoviridae family of viruses, one of three negative-stranded RNA viruses (Marburg, Ebola, and Reston) that often take on a “U” shape.

Although it’s not yet known how it enters the cell, once inside, the RNA of the ebola virus is transcribed and replicated inside the cytoplasm, thereby infecting the cell.

The Niemann-Pic C1 (NPC1) is a cholesterol transporter protein that is required for the ebola virus to permeate a cell, infect it, and replicate. The mutation of NPC1 is believed by many scientists to be key to finding a cure perhaps through its mutation.

As viruses are acellular, they do not replicate into other cells, but use the interior makeup of the host cell to multiply and assemble within the cell.

                                                      First cases and primary virus species

 Ebola takes its name from the DRC’s Ebola River, where the virus first broke out in what was then Zaire in 1976.

The original species was called Ebola-Zaire (considered the most lethal subtype), and the first outbreak occurred in the Yambuku region.

With 318 reported cases, it resulted in an 88% death rate (280 people).

The second Ebola subtype, Ebola-Sudan, was introduced to the world that same year, spreading quickly around the Nzara and Maridi areas of the Sudan. There, 53% of the 284 reported cases resulted in death (151 people).

                                            The Infamous Marburg Outbreak

In 1967, the Filoviridae virus Marburg made its first appearance during outbreaks in three European cities: Marburg and Frankurt, Germany, and Belgade, former Yugoslavia.

The source was said to be from labs where imported green monkeys from Uganda were being analyzed.

A total of 31 cases of infections were documented when lab workers starting showing similar violent symptoms, and seven of these workers died.

                                                  Other species of the virus

There are three other known types of the virus: ebola Côte d’Ivoire , ebola Bundibugyo (BDBV) and the Reston type.

The former virus is also known as the Tai’ Forest virus and first surfaced in 1995 after a Swiss ethologist was infected from doing a necropsy on a chimpanzee in the Côte d’Ivoire forest.

BDBV first surfaced in Uganda in 2007, and is as lethal as its cousin, the EBOV (classic ebola virus). The latter virus, Reston, is found in China and the Philippines, and while it can infect humans, has not killed one to date–instead causing the death of scores of monkeys and pigs.

                                             Continued outbreaks throughout history

The worst outbreak after the late ’70s surge of the virus was in 1995, in the Democratic Republic of Congo, where the ebola-Zaire strain ravaged the areas surrounding the town of Kikwit, infecting 317 patients and killing 245.

Lower-level outbreaks in the Gabon followed, but it was in Uganda in 2000 where the highest number of cases occurred; 415 people were infected with the Sudan subtype in the country’s Gulu district.

It spread to other areas of the country. Task forces and the World Health Organization helped contain and eventually eliminate the breakout, but only after 224 deaths occurred.

The last outbreak of high casualties was in 2007 in the D.R.C., where again ebola-Sudan’s hemorrhagic fever cut a swath through some very remote areas in the Kasai Occidental provinces. When the outbreak ended, 183 of the 247 infected had died.

                                                                 Transmission

Ebola can be transferred from animal to animal, from animal to human and from human to human.

The infection travels via fluid secretions (blood, urine, semen, mucus), usually orally or through broken skin.

In many cases, contaminated victims’ vomit has been a primary catalyst for the virus to travel, or burial ceremonies where improper handling methods infected community members.

In Africa, contact with animals infected with the virus such as pigs, monkeys, bats, and porcupines inflicted humans. Many healthcare and hospital workers have died from the disease through lack of knowledge or environmental exposure.

The source Studies throughout the decades have led researchers to believe that one of the greatest sources for ebola is the fruit-eating bat.

Three different bat species - hypsignathus monstrosus, epomops franqueti, and myonycteris torquata carry RNA sequences, proof that their bodies carry mutations from the ebola virus.

This suggests that these bats may have lived with the virus for a long time, and that they could be the source.

The often wide range of area a single outbreak can cover also implies that the source could be a mammal that can travel great distances very quickly.

A proposed chain of events by many scientists is: bat droppings are eaten by terrestrial animals; the animals die, and then their carcasses are handled by a human.

Keep in mind, not only the human race is at risk: approximately one third of gorillas in protected areas have perished from the virus in the last 15 years.

                                                                      Symptoms

Ebola and Marburg viruses start to show symptoms after approximately five days after infection.

Chills, sore throat, a typical-feeling fever, sore joints all common symptoms that would not necessarily send a victim to the doctor.

Days later, vomiting, bloody diarrhea, body rashes and red eyes begin, and increase in severity. Many cases result in internal hemorrhaging or external bleeding from the mouth, nose, ears, and rectum.

Containment Early symptoms of the virus do not look much different from the common flu, fever, or stomach viruses.

Therefore, the disease usually is unreadable until there are multiple cases, which is why containment is difficult.

In most outbreaks, isolation wards in hospitals or medical centers have been established. In many cases, isolating victims and tracking their contacts has helped prevent the disease from becoming more widespread.

The World Health Organization (WHO), Red Cross, Doctors Without Borders, and many disease control prevention workers descend on areas as soon as an breakout has been reported.

In light of the current West African outbreaks, Senegal has closed its borders with Guinea, and many airports are taking the temperatures of arriving travelers before allowing them to enter the country.

                                                                      Safety

“Barrier nursing techniques” are crucial for the safety of medical personnel during an Ebola outbreak.

Basically, they get suited up-goggles, gloves, face mask, gown, and protection for the shoes.

In the common event of an Ebola patient hemorrhaging or projectile vomiting, this helps to ensure that transmission does not occur.

Many cases of hospital workers becoming infected are from early incidents of an outbreak before the actual disease has been diagnosed.

Treatment While there is not a known cure, the ebola virus can be mollified and often eliminated if discovered in a timely fashion.

In 2012, groundbreaking scientific findings were published in Science Translational Magazine, claiming that two leukemia drugs showed signs of halting ebola virus replication.

Intensive care treatment is necessary, and many drug therapies are in the process of being validated.

Further work on finding a definitive vaccine continues; in many cases, electrolyte and nutritional management have aided in rehabilitating infected patients.

                                                               But why no cure?

There are many reasons why finding a cure for Ebola is quite an uphill battle.

For starters, antiviral treatments are much harder to establish than antibacterial.

The ebola virus develops rapidly and evolves at breakneck speed, which means that today’s vaccine could be obsolete tomorrow.

At a research safety level categorized as “biosafety level 4″, the total-lockdown laboratory situation means that there are limited facilities for studying the virus and extremely delicate, time-consuming procedures.

                                                               Early 2014 Outbreaks

As of late February, 2014, West Africa has seen an alarming outbreak of the Ebola virus.

In Guinea, the epidemic started with five confirmed cases in the capital of Conakry.

By March, cases were proliferating, with 60 deaths by hemorrhagic fever reported in three other districts. On May 15, the number of cases in Guinea totaled to 248, with 171 dead.

The borders between Guinea and Liberia were closed when Liberia reported 35 cases and 11 deaths. Sierra Leone reported its first-ever outbreak of the virus, with five deaths initially.

This has grown. The W.H.O. confirmed that the cases were along the country’s border with Guinea.

The New Outbreak: 1,000 and More Infected Sierra Leone is now being called the epicenter of this continued, intensified outbreak, which cut a swath across three countries in West Africa–Liberia, Guinea, Nigeria and Sierra Leone.

More than 2,473 cases have been reported by the World Health Organization, with 1,350 deaths documented. Hysteria is on the rise; many who feel symptoms of even a common cold will not admit to it, on account of becoming stigma.

There are two infected U.S. citizens being treated in intensive care in Liberia.

                                                   The Fight to Contain this Outbreak

The rush to quarantine all areas in West Africa where the virus may spread has been intense.

In Liberia, all public gatherings are banned and nearly every border has been shut down. Police forces as well as medical personnel are in a state of emergency, and work to enforce quarantines.

The hospital in Lagos–Africa’s most populated city– where the Liberian Patrick Sawyer died of ebola, has been entirely shut down.

Officials are tracing his contacts over the last few days, including fellow airline passengers and airport personnel. Airports in Liberia are screening all international passengers for symptoms.

                                                                         Bioterrorism 

In East Africa especially, where terrorist cells have been the culprits of serious acts of violence against the public, it may be a reasonable concern to fear a situation where the ebola virus surfaces as a deliberate outbreak.

While security in containment sites is always very high and areas always heavily monitored with surveillance, there is an increased need for policymakers to take measures against bioterrorism ever becoming a possibility.

Following the chain of transmission with every outbreak is a high priority, in order to root out the source.

                                                     The future “Stop eating bats!”

Guinea has already made this a legal order. Sanitary methods have been undertaken in West African countries, including the banning of ceremonially washing dead bodies by hand.

Scientists have been working on mutations of the virus to create a safe strain, with the hopes of finding a vaccination. Sporadic ebola flare-ups over the decades leave a big question mark over the continent of Africa.

Are better sanitation, better health care, and better education key to keeping this killer virus at bay?

What do you think that is needed to be done to eradicate this deadly VIRUS...Your comment is needed. 

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UN: Ebola outbreak could be controlled in three months

More than 4,000 people have died from the Ebola outbreak

The UN special envoy on Ebola says he hopes that the outbreak can be brought under control within three months.


David Nabarro told the BBC the number of Ebola cases was currently increasing exponentially, but greater community awareness would help contain the virus.

People were becoming aware that isolating those infected was the best way to prevent transmission, he added.

So far, there have been more than 8,300 confirmed and suspected cases of Ebola, and at least 4,033 deaths.

'Quite frightening'

Most fatalities - 4,024 - have occurred in the west African countries of Guinea, Liberia and Sierra Leone. Cases have also been reported in Nigeria, Senegal, Spain and the US.

Mr Nabarro said that the number of new cases was "quite frightening", as the spread of the disease was currently accelerating.

At the beginning, many west African communities did not understand that the outbreak was an infectious disease, he said.

"I think we've got much better community involvement [now] which leads me to believe that getting it under control within the next three months is a reasonable target," he said.

"By under control I mean... the numbers of new cases each week diminishes compared with the previous week to the point where there is no new transmission."

The Ebola virus is spread by direct contact with the bodily fluids of an infected person or animal.

Meanwhile, New York's JFK airport began screening passengers from Liberia, Sierra Leone and Guinea for the Ebola virus on Saturday, in an attempt to stem the outbreak.

Passengers from those countries will have their temperatures taken and have to answer a series of questions.

It comes after the first person died of Ebola in Texas on Wednesday.

Ebola deaths: Confirmed, probable and suspected

How not to catch Ebola:

• Avoid direct contact with sick patients
• Wear goggles to protect eyes
• Clothing and clinical waste should be incinerated and any medical equipment that needs to be kept should be decontaminated
• People who recover from Ebola should abstain from sex or use condoms for three months
 

Why Ebola is so dangerous

 



Healthcare workers are among those most at risk of catching Ebola

The Ebola outbreak in West Africa is the world's deadliest to date and the World Health Organization has declared an international health emergency as more than 3,850 people have died of the virus in Guinea, Liberia, Sierra Leone and Nigeria this year. 

What is Ebola? 

Ebola is a viral illness of which the initial symptoms can include a sudden fever, intense weakness, muscle pain and a sore throat, according to the World Health Organization (WHO). And that is just the beginning: subsequent stages are vomiting, diarrhoea and - in some cases - both internal and external bleeding. 

The disease infects humans through close contact with infected animals, including chimpanzees, fruit bats and forest antelope. 

It then spreads between humans by direct contact with infected blood, bodily fluids or organs, or indirectly through contact with contaminated environments. Even funerals of Ebola victims can be a risk, if mourners have direct contact with the body of the deceased. 

The incubation period can last from two days to three weeks, and diagnosis is difficult. The human disease has so far been mostly limited to Africa, although one strain has cropped up in the Philippines. 

Healthcare workers are at risk if they treat patients without taking the right precautions to avoid infection. People are infectious as long as their blood and secretions contain the virus - in some cases, up to seven weeks after they recover.  

Where does it strike? 

Ebola outbreaks occur primarily in remote villages in Central and West Africa, near tropical rainforests, says the WHO. 

Bushmeat - from animals such as bats, antelopes, porcupines and monkeys - is a prized delicacy in much of West Africa but can also be a source of Ebola

It was first discovered in the Democratic Republic of Congo in 1976 since when it has mostly affected countries further east, such as Uganda and Sudan.  

Ebola deaths since 1976

 

This year's outbreak is unusual because it started in Guinea, which has never before been affected, and it quickly spread to urban areas



Figures accurate from 4-6 October, depending on country. Death toll in Liberia includes probable, suspect and confirmed cases, while in Sierra Leone and Guinea only confirmed cases are shown

 

From Nzerekore, a remote area of south-eastern Guinea, the virus spread to the capital, Conakry, and neighbouring Liberia and Sierra Leone. 

 There have been 20 cases of Ebola being imported by someone travelling from a country of widespread transmission to Nigeria, with eight confirmed deaths. The US and Senegal have both confirmed one case each. The US Centers for Disease Control and Prevention (CDC) said in September that the virus might have been successfully contained in Nigeria and Senegal. 

In October, a nurse in Spain became the first person to contract the deadly virus outside of West Africa, after treating two Spanish missionaries who had eventually died of Ebola in Madrid.

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